Objective To discuss the relationship between traditional Chinese medicine (TCM ) syndromes and the laboratory in-dexes in chronic hepatitis B .Methods According to the TCM syndrome differentiation ,145 cases of chronic hepatitis B were divid-ed into the 5 syndromes :the stagnation of damp-heat in middle-jiao ,the stagnation of liver-QI and deficiency of the spleen ,the spleen-kidney Yang deficiency ,the collaterals obstruction by blood stasis and the liver-kidney Yin deficiency .The correlation be-tween the TCM syndromes and the laboratory indexes was observed .Results The research found that the stagnation of damp-heat in middle-jiao and the stagnation of liver-QI and deficiency of the spleen had the highest proportion in the five kinds of the CM syn-dromes ,which accounted for 53 .8% and 31 .7% ,respectively ;The positive rates of total bile(TBil) and indirect bile(IBil) in the stagnation of damp-heat in middle-jiao were 69 .4% and 68 .8% respectively ,which were significantly higher than those in other 3 groups (P<0 .05);However ,the positive rates of total bile acid (TBA) ,alanine aminotransferase(ALT ) and HBeAg in the liver-kidney Yin deficiency were higher than those in other 3 groups .The HBV-DNA viral load in the stagnation of damp-heat in middle-jiao was significantly higher than that in other 3 groups (HBV-DNA>105 copies/mL) ,and the HBV replication was most active . Conclusion There are some relationships between the TCM syndromes and the laboratory indexes in chronic hepatitis B ,therefore the laboratory indexes have more important clinical significance for the syndrome differentiation and treatment of chronic hepatitis B .

Objective To explore the effect of medlar polysaccharide(MP) on blood fat metabolism of rat with nonalcoholic fatty liver disease(NAFLD).Methods 40 SD rats were randomly divided into a blank control group(n=7), and a NAFLD model group (n=33). The control group was treated with normal forage, and the control group was treated with high-fat forage. After 8 weeks, 30 NAFLD models were successfully established and divided into three groups randomly: a LBP intervention group (treatment group, n=10) was perfused with 60 mg/(kg?d)MP, a simvastatin intervention group(control group, n=10) was perfused with 5mg/(kg?d) simvastatin, and a model group(model group,n=10) was perfused with the same volume of water along with high fat diet at the same time. After 8 weeks, triglycerides, total cholesterol, ALT, AST, leptin, and adiponectin in the plasma in rat were test. Malondialdehyde, Superoxide Dismutase and Gamma glutamyl cysteinyl glycine were also detected in the liver tissue. Results After 8 weeks, the contents of TG (0.94 ± 0.09 mmol/Lvs.1.19 ± 0.13 mmol/L), TC (2.15 ± 0.20 mmol/L vs. 3.52 ± 0.29 mmol/L), ALT (41.75 ± 4.14 U/L vs. 55.34 ± 5.38 U/L), AST (129.61 ± 12.07 U/L vs. 164.96 ± 15.49 U/L), LP (235.69 ± 23.52 pg/ml vs. 284.01 ±29.43 pg/ml) were decreased, the contents of ADP (35.47 ± 3.09 μg/L vs. 26.31 ± 2.58 μg/L) was increased in serum of the treatment group compared with the model group (P<0.05 orP<0.01);the contents of SOD (92.40 ± 8.89 U/mg vs. 61.60 ± 5.89 U/mg), GSH (22.25 ± 2.21 mg/g vs. 15.50 ± 1.36 mg/g)were increased, and the contents of MDA (0.84 ± 0.08 nmol/mg vs. 1.07 ± 0.09 nmol/mg) was decreased in liver tissue of the treatment group compared with the model group (P<0.05 orP<0.01). HE stain showed that the treatment group improved the injury.Conclusions Medlar polysaccharide(MP) can inhibit lipid peroxidation by adjusting lipid metabolism.

Objective To investigate the value of spiral CT for the diagnosis and treatment of congenital anorectal malformations (CARM). Methods Thirty children with CARM underwent lateral upside-down plain film in abdomen and spiral CT scanning in pelvic cavity before surgical operation. The distance between rectal blind end and anal fossa in two imaging modalities was measured. The correlation between the measurement results in two imaging modalities was compared with operational results. Sacral deformation was diagnosed according to 3D reconstruction of CT images. Results The measurement results obtained from CT were correlated positively with those of operation (r=0.99, P<0.01). CARM combined with curved sacrum was diagnosed in one child. No correlation was found between the measurement results of X-ray and operation (r=0.31, P>0.05). Conclusion Spiral CT scanning can accurately describe the atresic level of rectum and malformation of sacrum. It can provide reliable evidence for surgeon to choose the best surgical method and to judge prognosis.

Objective To investigate the structural response of diaphragm and soleus of the rat after mechanical ventilation (MV), and to explore the specific mechanism of the dysfunction of both muscles.Methods Sixteen male Sprague-Dawley (SD) rats were randomly divided into control group and MV group, with 8 rats in each group. Rats in MV group were treated with controlled ventilation and maintained anesthesia, and those in control group were only anesthetized without MV and maintained anesthesia. The diaphragm and soleus were harvested after MV for 18 hours, and the morphology changes were observed with light microscope. The cross section of muscle fiber was observed by immunofluorescence technique analysis, and the cross-sectional area of muscle fiber was calculated. The ultra structural changes in muscle fibers were observed under transmission electron microscope.Results ① Observed under light microscope, the cross section of the diaphragm and soleus muscle in the control group was regular, the nucleus was normal and the cytoplasm was homogeneous. The fibers in the diaphragm-biopsy specimens from MV subjects were smaller than those from control subjects, whereas these signs were not found in soleus. But fiber atrophy in MV specimens was not accompanied by an inflammatory-cell infiltrate. ② Under the fluorescence microscope, the control group had a smaller cross-section of the slow-twitch muscle in diaphragm, while the fast-twitch muscle fibers werelarger. As compared with diaphragm-biopsy specimens from control, specimens from MV subjects showed decreased cross-sectional areas of slow-twitch and fast-twitch fibers, respectively (μm2: 1069.00±155.24 vs. 1297.12±331.15, 2279.66±442.31 vs. 3031.80±596.11, bothP < 0.05). The disproportionate decrease in fast-twitch fibers cross-sectional areas [(70.42±3.61)% vs. (75.63±2.48)%] resulted inan increase in the percentage of total area occupied by the slow-twitch fibers [(29.58±3.61)% vs. (24.35±2.48)%, bothP < 0.01]. There were no significant differences in cross-sectional areas of slow-twitch and fast-twitch fibers in soleus between control group and MV group (μm2: 3193.80±559.36 vs. 3008.84±559.22, 3392.86±514.56 vs. 3594.35±651.67, bothP > 0.05). ③ In the control group, the muscle fibers of the diaphragm and soleus were arranged orderly, the boundary of the light and dark bands and the Z-line were clear, and there was no autophagy in the visual field. The outer membrane of the mitochondria was complete, and the cristae were in the shape of clapboard. The signs of misalignment of myofibrils, disruption of Z-line and vacuolar mitochondria were found in diaphragm from MV group, whereas these signs were not found in soleus. Diaphragm from MV group exhibited an increase in autophagic vesicles visualized by transmission electron microscopy as compared with control group.Conclusions Controlled MV for 18 hours resulted in diaphragmatic inactivity and promoted muscle injury and atrophy, while autophagy and mitochondrial dysfunction were enhanced. Soleus immobilization for 18 hours was not associated with muscle atrophy. These facts suggest that the signaling associated with diaphragm atrophy during MV may involve different mechanisms compared with other models of muscle atrophy. Diaphragm appeared to be more susceptible to MV.

OBJECTIVE:To improve the work quality in Pharmacy intravenous admixture service(PIVAS). METHODS:The major working links of PIVAS(labeling and drug admixture)were optimized,the work efficiency and error before and after optimi-zation were compared. RESULTS:The work efficiency was improved and error was decreased by adding logo and adjusting work range of personnel when labeling and improving distribution principles of drugs to be allocated in horizontal laminar flow table when drug admixture;compared with before,the labeling time for each bag decreased from(2.69±0.17)s to(2.19±0.08)s,to-tal time for admixture decreased from (104 ± 2) min to (83 ± 2) min,error rate of drug admixture decreased from 0.34% to 0.16%. CONCLUSIONS:The optimized work flow had improved the work quality of PIVAS.

Background and purpose: Ovarian lymphoma (OL) is usually misdiagnosed as ovarian cancer with bulk lymph node invasion (OC-BLN), and vice versa. Therefore, to distinguish these two types of disease, we compared their clinical characteristics in this study. Methods: This study retrospectively reviewed 14 OL and 14 OC-BLN patients from Fudan University Shanghai Cancer Center and Shanghai Eighth People's Hospital. The clinical char-acteristics, image and laboratory examination data were compared. Results: There was no significant difference in age, symptom, fever, weight loss and volume of ascitic fluid between the two groups. Comparing with OC-BLN, OL patients have larger tumor in ovaries [(13.04±5.94) cm vs (7.78±6.38) cm, P=0.033], and higher percentage of solid ovarian tumor (85.71% vs 28.5%, P=0.006). Lactate dehydrogenase(LDH)/CA125 was higher in OL (7.66±8.03) than OC-BLN (0.31±0.27, P=0.009). Using LDH/CA125 to diagnose OL, area under the curve (AUC) was 0.952. When the threshold value was set at 1, the sensitivity and specificity was 91.7% and 100%, respectively. Conclusion: OL and OC-BLN are easily to be misdiagnosed. OL has larger and more solid tumor than OC-BLN. LDH/CA125 can help to distinguish these two diseases and guide clinical decision making.

Objective To explore the association of galactose-deifcient IgA1 levels with clinical features, and further to provide guidance for individualized treatment of HSP. Methods According to the clinical symptoms and curative effect, 57 children with HSP were divided into four groups:non-HSPN group (n=26), HSPN group (n=7), refractory HSP group (n=7) and remission group (n=17). In non-HSPN group, 12 cases received glucorticoid therapy and 14 cases did not. Serum galactose-de-ifcient IgA1 (Gd-IgA1) concentrations were detected using a Helix aspersa-lectin-based enzyme-linked immunosorbent assay (ELISA), and the total IgA1 levels were measured by ELISA. Results The serum Gd-IgA1 level was signiifcantly higher in 40 HSP children who were not cured than that in remission group and control group (P<0.05). However, there was no difference in Gd-IgA1 level between remission group and control group (P>0.05). Compared with the control group, the serum Gd-IgA1 level was signiifcantly higher in HSPN group, non-HSPN group and refractory HSP, and children with refractory HSP had signiifcantly higher Gd-IgA1 level than children in non-HSPN group (P<0.05). No signiifcant difference in Gd-IgA1 level was found either between HSPN group and refractory HSP group or between HSPN group and non-HSPN group (P>0.05). Furthermore, in non-HSPN group, the serum Gd-IgA1 level in HSP children who were not treated with glucorticoid was signiifcantly higher than that in HSP children treated with glucorticoid (P<0.05). Conclusions The serum Gd-IgA1 level is associated with the disease activ-ity and curative effect of HSP, especially in children with refractory HSP, and it is thus likely to be a new non-invasive disease activity marker for guiding the proper usage of glucocorticoid and immunosuppressants in HSP children.

Background and purpose:Extranodal natural killer/T-cell lymphoma (ENKTL) is a form of non-Hodgkin’s lymphoma. The ENKTL incidence in China is much higher than that in the Western countries. The disease is highly malignant, not sensitive to chemotherapy, has short survival period and poor prognosis. Epstein-Barr virus (EBV) infection has close relationship with the development of the disease. However, there are still a few patients without EBV infection. This study aimed to discuss the clinical features and prognosis of EBV-encoded small RNA (EBER) in situ hybridization negative ENKTL.Methods:From Aug. 2011 to Oct. 2015, 326 cases were diagnosed with ENKTL from the First Affliated Hospital of Zhengzhou University. The expression of EBER was detected by in situ hy-bridization technique. The clinical pathological characteristics and prognosis of EBER-negative patients were analyzed. Results:In 326 patients with ENKTL, the negative rate of EBER was 2.45% (8/326). In 8 EBER-negative patients, the median survival time was 17 months. The log-rank test revealed that there was a signiifcant difference between EBER-negative and EBER-positive curves (χ2=6.407,P=0.011). Multivariate Cox proportional hazards regression analysis showed that in EBER-negative ENKTL, only lactate dehydrogenase (LDH) predicted survival time (P=0.008). EBV-DNA copy number in plasma was not signiifcantly correlated with survival time (P>0.05).Conclusion:The inci-dence of EBER-negative ENKTL is low. Patients with EBER-negative ENKTL have poorer prognosis than EBER-posi-tive patients. Elevated LDH may be a factor indicating poor prognosis.

Objective To detect the early diversification of the bone mineral density in skeletal fluorosis of rabbits by quantitative computed tomography (QCT),and analyze the possible relationship between bone mineral density and bone injury in rabbits with fluorosis.Methods A total of 16 rabbits,half male and half female,were randomly divided into control and experimental groups according to body weight.The two groups of rabbits were given drinking water containing NaF 0 or 300 mg/L,respectively,for 90 days.After the experiment,their bone fluoride content was determined via the fluorine ion-selective electrode method.The alkaline phosphatase (ALP) and osteocalcin (BGP) in serum were measured using enzyme-linked immunosorbent assay (ELISA).Femurl bone mineral density was detected with QCT in vivo.Histopathological changes of femur were observed under light microscope and trabecular acreage was calculated.The results were analyzed with independent-samples t test(t') and partial correlations.Results The bone fluoride content [(3 232.16 ± 927.85) mg/kg],ALP [(42.69 ± 3.28) U/L],BGP concentration [(2 504.19 ± 276.79) μg/L],bone density [(653.49 ± 167.81) g/cm3] and trabecular number [(39.02 ± 3.33)Tb.Ar] of the experimental group were higher than those of control group [(554.01 ± 376.51)mg/kg,(20.50 ± 4.90)U/L,(1 294.60 ± 191.86)μg/L,(540.40 ± 41.99)g/cm3,(8.15 ± 2.34)Tb.Ar],and the differences were statistically significant (t'=7.565,10.641,10.158,2.615,14.494,all P ＜ 0.05).The tissue sclerosis,bone sclerosis and bone texture coarsening were observed through bone mineral density imaging taken by QCT in experimental group.The number of trabeculae increased and the arrangement of tra bec ulae was disorganized.Bone mineral density was positively correlated with bone fluoride,trabeculae,BGP and ALP (r =0.702,0.627,0.614,0.567,all P ＜ 0.05).Conclusions QCT bone density measurement in skeletal fluorosis of rabbits can be used to compute the threedimensional bone density.And it has a good correlation with bone fluoride content,bone histopathological changes and index of bone metabolism in skeletal fluorosis,which suggests that QCT may provide a useful reference for application in patients with skeletal fluorosis.

Objective:To investigate the clinical significance of detecting Epstein Barr virus (EBV) infection in evaluating recent curative and long-term effects in patients with extranodal natural killer (NK)/T-cell lymphoma. Methods:The EBV-DNA copies in the plasma of 109 patients, who were pathologically and immunohistochemically diagnosed with extranodal natural killer/T-cell lymphoma in the First Affiliated Hospital of Zhengzhou University between January 2011 and April 2014, were monitored via quantitative re-al-time polymerase chain reaction. Subsequently, the difference in recent curative and long-term effects between EBV positive and EBV negative patients was compared. Results:Among the 109 patients with extranodal NK/T-cell lymphoma, 34 (64.2%) cases of EBV posi-tive patients were at the advanced stage (Ⅲ~Ⅳ stages), and 22 (39.3%) cases of EBV negative patients were at the terminal stage (Ⅲ~Ⅳstages). EBV positive patients who accompanied by B symptoms were 33 (62.3%) , and there were 21 (37.5%) cases with B symptoms in EBV negative patients, the differences between stages and B symptoms were statistically significant. The attained objec-tive response rate of the EBV-DNA negative patients (34, 60.7%) was significantly higher than that of the EBV-DNA positive patients (22, 41.5%) (P<0.05). Similarly, the 2-year progression-free survival (PFS) rate of EBV negative patients was better than that of EBV positive patients (P<0.05). Conclusion:Detecting EBV in plasma has clinical significance in evaluating the recent curative effect and the 2-year PFS rate in patients diagnosed with extranodal NK/T-cell lymphoma.