OBJECTIVEThe effect of Kou Yan Qing Ke Li on the prevention and treatment of radiation-induced oral mucositis was investigated in patients with nasopharyngeal carcinoma.

METHODSSixty patients with nasopharyngeal carcinoma to be treated with radiotherapy were randomized into two groups: the experimental and control groups. The experimental group (30 patients) was treated with Kou Yan Qing Ke Li during the full course of radiotherapy. The control group (30 patients) rinsed their mouths in the same way with mouth washes containing 0.9% sodium chloride injection, lidocaine, dexamethasone, vitamin B2 and B2 gargle liquid mixture, when grade 2 and above radiation-induced oral mucositis appeared in the process of radiation. Radiation-induced oral mucositis was assessed according to the radiation therapy oncology group criteria. The time of occurrence and degree of pain grade were compared between the two groups.

RESULTSThe first onset of oral mucositis in the experimental group (12.40 d ± 2.74 d) was later than that in the control group (9.46 d ± 1.39 d) (t = 5.241, P < 0.001), whereas the grade of pain and acute radiation mucositis was lower in the experimental group than that in the control group. The difference was statistically significant.

CONCLUSIONKou Yan Qing Ke Li could delay the time of occurrence of radiation-induced oral mucositis, reduce the severity of radiation stomatitis, alleviate the pain of patients, improve the clinical symptoms of patients, and effectively prevent and treat radiation-induced oral mucositis in patients with nasopharyngeal carcinoma.

Objective To increase the awareness of thyroid diseases through observing the relationship between ultrasound indications of thyroid and thyroid disease,and to enhance the understanding of thyroid disease through outpatient data.Methods Two hundred women aged 25 to 50 with thyroid imaging data were selected from the Department of Ultrasonography,the First Affiliated Hospital of Harbin Medical University.Seven indications including age,body weight,thyroid volume,the number of nodules,nodule size,nature of nodules and thyroid disease were recorded.Thyroid cases were divided into four groups based on their sonographic changes of color Doppler ultrasound:normal group (136 cases):sonographic changes of thyroid were approximately normal ; mild degree group (9 cases):consisting of patients with mild thyroid disease,diffused thyroid enlargement or combined cystic nodules; moderate degree group (38 cases):consisting of patients with moderate thyroid disease,hyperthyroidism or hypothyroidism; severe degree group (17 cases):consisting of patients with severe thyroid disease,thyroiditis and/or with hemorrhage and calcification.Data were analyzed using the method of clinical case observation and SPSS 16.0.Results We found that in mild degree group the discriminant coefficients of thyroid volume,the nature of thyroid nodules and nodule size were 0.085,0.169 and 0.695; but in sever degree group the corresponding values were 0.158,0.344 and 0.484,respectively,and the difference between the two groups was statistically significant (x2 =43.3,df =18,P ＜ 0.01).Conclusions The nature,size and area of thyroid nodules are closely related to the progression of thyroid disease.The color Doppler ultrasound data of outpatients as a part of hospital statistics have important theoretical and practical value.

Objective To explore the clinical efficacy of laparoscopic inguinal hernia repair (LIHR) in elderly patients.Methods The retrospective cohort study was adopted.The clinical data of 3 203 patients with inguinal hernias (3 847 sides) who were adnitted to the Ruijin Hospital of Shanghai Jiaotong University School of Medicine between January 2001 and December 2013 were collected.Of 3 203 patients,979 (1 107 sides) with age ＜ 60 years and 2 224 (2 740 sides) with age ≥ 60 years were respectively allocated into the under 60 years group and 60 years or older group.The surgical procedures including transabdominal preperitoneal (TAPP) approach,total extraperitoneal (TEP) approach and intraperitoneal onlay mesh (IPOM) approach were selected and performed by doctors in the same team.There were light-weight and heavy-weight patches.Observation indicators included (1) overall operation situations,(2) surgical comparison between the 2 groups,(3)comparison of postoperative indicators between the 2 groups,(4) follow-up.Follow-up using telephone interview and outpatient examination was performed to detect the recovery time of non-restricted activity,recurrence of hernia and complications.Measurement data with normal distribution were represented as ~ ± s and comparison between groups was done by the t test.Comparisons of count data were analyzed using the chi-square test or Fisher exact probability.Ranked data were compared by the nonparametric rank sum test.Results (1) Overall operation situations:3 203 patients with inguinal hernias (3 847 sides) underwent LIHR,including 1 475 (1 677 sides) using TAPP approach,1 718 (2 154 sides) using TEP approach and 10 (16 sides) using IPOM approach (6 using TAPP and IOPM approaches in each side).The light-weight patch was used in 2 206 sides and heavy-weight patch was used in 1 641 sides.Operation time was (31 ± 12) minutes in all 3 203 patients,(27 ±9)minutes in 2 559 patients with unilateral hernia and (44 ± 12)minutes in 644 patients with bilateral hernia,respectively.Duration of postoperative hospital stay was (1.5 ± 1.2) days.(2) Surgical comparison between the 2 groups:TAPP approach,TEP approach,IPOM approach,light-weight patch and heavy-weight patch were performed to 567,538,2,751,356 sides in the under 60 years group and 1 110,1 616,14,1 455,1 285 sides in the 60 years or older group,respectively,with statistically significant differences in above indicators between the 2 groups (X2 =37.976,70.022,P ＜ 0.05).Operation time in unilateral hernia and bilateral hernia and total operation time were (27 ± 9)minutes,(42 ± 10)minutes,(29 ± 10)minutes in the under 60 years group and (27 ± 10)minutes,(44 ± 12)minutes,(3 1 ± 13)minutes in the 60 years or older group,respectively,with no statistically significant difference between the 2 groups (t =-0.106,-1.768,-4.445,P ＞ 0.05).(3) Comparison of postoperative indicators between the 2 groups:the pain score at postoperative day 1 and duration of postoperative hospital stay were 2.4 ± 1.1,(1.5 ± 1.1) days in the under 60 years group and 2.3 ± 1.0,(1.5 ± 1.3) days in the 60 years or older group,respectively,with no statistically significant difference between the 2 groups (t =1.419,-0.126,P ＞0.05).(4) Follow-up:all the patients were followed up for 23-60 months,with a median time of 43 months.Cases with non-restricted activity recovery at postoperative week 2 and 4 were 973,978 in the under 60 years group and 2 208,2 222 in the 60 years or older group,respectively,showing no statistically significant difference between the 2 groups (X2=0.113,P ＞0.05).The recurrence of hernia,severe complications,serum tumescence,paresthesia and enteroparalysis were detected in 1,0,49,5,1 sides in the under 60 years group and 11,3,132,16,2 sides in the 60 years or older group,respectively,with no statistically significant difference between the 2 groups (x2=1.556,0.269,0.254,P ＞ 0.05).The urinary retention in the under 60 years group and 60 years or older group was respectively detected in 6 and 44 sides,showing a statistically significant difference between 2 groups (x2=6.956,P ＜ 0.05).Conclusion LIHR is safe and effective in elderly patients,and it can achieve good clinical efficacy under selecting reasonable operation procedures and patches.

Objective To establish a method of quantiying trace α-galactosidase from Bacteroides fragilis in enzymatic conversion of blood group B to O red blood cells ( B-ECO RBCs) .Methods BALB/c mice were immunized with purified recombinant B.fragilisα-galactosidase ( the purity>90%) to prepare monoclonal antibodies.The ascites were prepared using hybridoma cell lines stably secreting antibody and purified by HiTrap rProtein A column.The antibody titer and spe-cificity were detected by ELISA and Western blotting, respectively.Purified monoclonal antibody and rabbit polyclonal an-tibody were applied to detect residual enzyme in B-ECO RBCs and the washing solution was analyzed by indirect ELISA. Results A high titer and purity antibody was obtained.Western blotting showed that the antibody specifically reacted with B.fragilisα-galactosidase.Moreover, indirect ELISA was sensitive enough to detect the minimal amount of residualα-gal-actosidase at the concentration of 1 ng/ml.After four repeat washing cycles with 1∶4 ( v/v) phosphate-buffered saline, the amount of residual enzyme in B-ECO RBCs was less than 10 ng/ml.Conclusion An effective method of detecting the min-imal amount of residual α-galactosidase in blood conversion is established for safety evaluation of universal RBCs prepara-tion by enzymatic treatment.

Objective To investigate the effects of Mycobacterium vaccae vaccine on immunological function and clinical character in elderly patients with stable chronic obstructive pulmonary disease (COPD). MethodsA total of 100 elderly patients with stable COPD were randomly divided into immunotherapy group (group A, n= 50) and non-immunotherapy group (group B, n= 50), and normal control group (group C, n = 50). The levels of peripheral blood T-lymphocyte subsets (CD3+ , CD4+, CD8+ , CD4+/CD8+ ratio), natural killer cells (NK cells), immunoglobulins (IgG, IgA, IgM) and cytokines (IL-6, IL-8, TNF-a) were measured respectively before and after therapy. Group A and B were followed up for 1 year, then the times of acute outbreak and hospitalization of patients in the two groups were also compared. Results The levels of CD4 + ,CD4+/CD8+ ratio and NK cells in group A, B were significantly lower before therapy (P＜0. 05～0. 01＝, and the levels of IL-6, IL -8, TNF-a and IgA were significantly higher than in group C (P＜0. 01＝. After treatment with Mycobacterium vaccae vaccine in group A, the levels of CD4+ , CD4+/CD8+ ratio and NK cells were significantly higher (P＜0. 05-0. 01＝ and IL-6, IL-8, TNF-a and IgA were significantly lower than before treatment (all P＜0. 01＝. These levels showed no significant changes in group B after treatment (P＞0. 05). After 1-year follow-up, the times of acute outbreak and hospitalization on patients were statistically lower in group A than in group B (P＜ 0. 01 ).ConclusionsMycobacterium vaccae vaccine can improve cellular immunity function and reduce the times of acute outbreak and hospitalization in patients with stable COPD, so it has a higher clinical application value.

Objective To evaluate the effect of low-dose colonic CT scanning in image quality and lesion revealing with different noise idex.Methods Model group:in order to find the optimal scanning parameter range,small simulated polyps in pig colon was prepared and mA was modulated by regulating noise index.Images were reprocessed with CT colonography and Raysum reconstructions.Image quality and the lesion revealing situation were evaluated and scored based on both reconstructive and axial images.The study of patient group was prospective and continuous.All positive cases were comfirmed by biopsy or surgery pathology.Two groups of patients were enrolled.First group(39 cases from January 2007 to June 2007):patients were divided into three sub-groups randomly(15 cages with NI=10,13 cases with NI:13,11 cases with NI=16),while NI was not changed with position.Second group(32 cases from Jury 2007 to January 2008):patients were scanned and NI was changed with different position(NI=10,20).The average X-ray radiation values of two patient groups were compared with standard values.All data were processed with rank sum tesL Results First group:when NI=10,the average scores of axial and constructive images were 4.2 and 2.4 respectively,when NI=13,those were 3.2 and 2.5 respectively,When NI=16.those were 2.9 and 2.7 respectively.and the average CTDlw were 17.51,12.90 and 5.94 mGy respectively.When NI increased,the average scores of axial decreased(H=20.01,P＜0.01),the average scores of constructive images did not changed(H=0.81,P＞0.05).Second group:when NI=10,the average scores of axial and constructive images were respectively 3.6 and 2.3,when NI=20,those were 2.2 and 2.3 respectively,and the average CTDIw was 11.63 mGy.When NI increased from 10 to 20,the average scores of axial decreased(H=20.84,P＜0.01),the average scores of constructive images did not decreased(H=0.29,P＞0.05).In the first group,the average CTDIw wag reduced by 35.0%,52.1%and 77.9%respectively when NI was 10,13 and 16.In the second group,the average CTDIw Was reduced by 56.8%.Conclusions Auto-mA low-dose CT scanning could reduce X-ray radiation obviously,while not affecting image quality.

Objective To investigate the changes of serum apolipoprotein A-I and its clinical significance to acute respiratory infection.Method Totally 44 patients with acute respiratory infection were divided into three groups according to various concentration of Serum apolipoprotein A-I.They were procaleitonin(PCT)＜0.5 ng/ml group,0.5 ng/ml≤PCT＜2 ng/ml group and PCT≥2 ng/ml group.We measured apolipoprotein A-I,C-reactive protein,procalcitonin and albumin within 24 hours after admission.Results With the increase of serumPCT,the production of ApoA-I and albumin were down-regulated,while CRP up-regulated.Conclusions Apolipoprotein A-I has a sound relationship with the acute respiratory infection.It can be used as one of the diagnostic criteria in severe infection patients who have disorders of lipometabolism.

Objective To analyze the utility of MRI with multiple contrast and dynamic contrast weightings enhancement(DCE) in evaluation of vulnerable atherosclerotic plaques. Methods Forty male New Zealand white rabbits were fed with hypercholesterolemic diet,and right iliac arteries including the common and external iliac arteries were examined by multiple contrast and DCE MRI at intervals 6 to 20 weeks after balloon denudation.For multiple contrast weightings scanning,T1-,T1-/T2WI with fat suppression,proton density weighted and double invention recovery were used.Meanwhile,post DCE T1-with fat suppression images were obtained in 1,5,15 and 25 min after a bolus injection of Gd-DTPA contrast agent.Then a comparative analysis of plaque morphology and components to images was performed. Results There were 34(42.5%) vulnerable plaques and 46(57.5%) stable plaques amomg the 80 atherosclerotic lesions located at the right common or external iliac arteries.The accuracy,sensitivity and specificity of MRI with multiple contrast weightings and DCE for the detection of vulnerable plaques were 87.5%,94.1% and 82.6%,respectively,significantly higher than those only with multiple contrast weightings,which were 73.8%,82.3% and 67.4%,respectively(P

AlM:To study the treatment effect of traditional Chinese medicine in the treatment of high myopia macular hemorrhage, using Chinese medicine etiology and pathogenesis, syndrome differentiation treatment, and provide the basis for the clinical treatment. METHODS: Eighty patients ( 135 eyes ) with high myopia macular hemorrhage were selected in the hospital from January 2012 to september 2014 as treatment group, and applied traditional Chinese medicine treatment. Forty-five patients (64 eyes) with the same period, as the control group, received routine western medicine treatment. After 1mo treatement, the treatment effect and vision improvement situation of two groups were observed, and after 6mo follow-up, the relapse was observed.RESULTS: The total effective rate of treatment group was 85. 19% (115/135), higher than the control group 78. 13% (50/64) (P<0. 05). The average corrected visual acuity of treatment group was 0. 48±0. 11, higher than the control group 0. 36 ± 0. 09, the difference was statistically significant (P<0. 05). The average diopter and macular bleeding scope of the treatment group were -9. 81±0. 85D and 0. 51 ± 0. 27PD, lower than the control group -10. 76 ± 0. 91D and 0. 78 ± 0. 23PD, the differences were statistically significant ( P < 0. 05 ). The eye ground hemorrhage absorption time of treatment group was 25. 34±2. 28d, less than the control group 29. 72 ± 2. 13d, the difference was statistically significant (P<0. 05). The bleeding again of the control group 7. 81% ( 5/64 ), higher than the treatment group was 5. 19% (7/135), the difference was statistically significant (P<0. 05).CONCLUSlON: Evidence-based treatment of traditional Chinese medicine for high myopia macular hemorrhage has good clinical effect, can shorten the treatment time, and is beneficial to the recovery of postoperative vision, worthy of clinical popularization and application.

Objective To reduce immunogenicity of porcine skin by removingα-Gal epitopes expressed in cell surface and extracellular matrix using recombinant α-galactosidase produced by Bacteroides fragilis.Methods The porcine skin was harvested from healthy 2-month-old pigs without any skin disorders before being sterilized by iodine and 75%alcohol, respectively.Enzymatic removal of α-Gal antigen was followed by washing with PBS.The α-Gal antigen in the prepared porcine skin was measured with immunofluorostaining of cryosections and the residual enzyme was measured with a double-antibody sandwich ELISA method.Enzymatic removal procedures were optimized by detecting residual enzyme and the effi-cacy ofα-Gal removal under different enzymatic and washing conditions.Results Efficient enzymatic and washing methods were established to removeα-Gal antigen.Theα-Gal removal efficacy was above 90% and residual enzyme was undetect-able (αprescribed minimum ofα-galactosidase detection with indirect ELISA was 1 ng/ml) .Conclusion It is feasible to efficiently removeα-Gal antigen under these enzymatic and washing conditions, and a method of producing low-immunoge-nicity pig skin dressing for burn is established.