Objective To explore imaging features of IgG4-related diseases (IgG4-RD)and to evaluate curative effect after treatment with steroid.Methods Imaging data were reviewed retrospectively in thirteen patients with pathologically proved IgG4-RD.CT scans were performed in all patients,while MR scans in five of them.Six patients were examined before and after steroid treatment in 3-6 months. Imaging data were analyzed with regard to the shape,distribution and characteristics of the lesions.The image changes between pre-and post-treatment with steroid were analyzed as well.Results The IgG4-RD occurred in the lacrimal gland in 1 case,submandibular glands in 1 case,biliary duct in 1 case,pancreas in 3 cases,kidney in 4 cases,retroperitoneum in 2 cases and lung in 1 case.Multiple organs including the retroperitoneum,kidney and pancreas were involved in two patients.Diffusely swelling organ or soft tissue mass, which manifested as low density on CT and low signal intensity on T2-weighted images on MR,were characteristics of IgG4-RD.All lesions mildly enhanced with contrast media administration.The lesions decreased in size accompanied by raised signal intensity on T2 WI after treatment with steroid in six patients.Conclusion Diffusely swelling organ,low density and low signal intensity on T2 WI with mildly homogenous enhancement are characteristics of IgG4-RD.CT and MR plays a vital role in diagnosis of IgG4-RD and monitoring the curative effect with steroid treatment.

[Objective] To study the effect and reliability of fluoxetine on depression and symptoms in cancer patient,and to assess the overall quality of life before and after treatment.[Methods]We treated 54 cancer patients with depression by Fluxetine for 8 w,at the same time,evaluated their emotion state,change of quality of life and the adverse effect with HAMD,HAMA,TESS and laboratory tests.[Results]After 8 w,patients’ scores of anxiety and depression decreased significantly from the baseline,effective rates were 82.4% and 96.3% respectively.3 domains of quality of life (physiology,psychology and independence) became much better than those of baseline.The side effect of fluxetine was small.[Conclusion]This study shows that fluoxetine can reduce the depression and anxiety symptoms in cancer patients.

BACKGROUND:Treatment of complex tibial plateau fracture is a difficulty in orthopaedic trauma. Comprehensive assessment and appropriate surgical plan before surgery are the key points of surgery.
OBJECTIVE:To investigate the application value of three-dimensional reconstruction and virtual surgical techniques in assessing and surgical planning of complex tibial plateau fracture before surgery.
METHODS:The CT scan data of 30 patients with tibial plateau fracture were imported into the Mimics 13.0 software to establish the three-dimensional digital models of complex tibial plateau fracture, and three-dimensional measurements and reclassification was performed according to three-column classification were made. Virtual surgeries such as bone window operation, reduction of the fracture and bone grafting were made in these models.
RESULTS AND CONCLUSION:Reconstructed three-dimensional digital models of complex tibial plateau fracture could indicate the characteristics of fracture accurately, could be observed at any direction, and could help doctors to reclassify the fracture according to three-column classification. Virtual surgeries of bone window operation, reduction of the fracture and bone grafting made in computer by Mimics 13.0 were confirmed to be vividly simulate the clinical surgery, and helpful in estimating the amount of bone grafting. Three-dimensional reconstruction and virtual surgical techniques play an important role in assessing and surgical planning of complex tibial plateau fracture before surgery, which should be a conventional step in the management of complex tibial plateau fracture.

Objective To observe the protection effect of ischemic preconditioning to small intestines injury after limbs ischemia reperfusion ,and investigate the role of nitrogen monoxidum in the process .Methods 52 male Wistar rats were randomly divided in-to Sham group ,limbs ischemia-reperfusion (IR) group ,IPC + IR group and Nω-nitro-L-arginine methylester (L-NAME) group . The value of diamine oxidase (DAO) and nitrogen monoxidum (NO) in plasma and gut tissue ,the content of fluorescein isothiocya-nate lipopolysaccharide (FITC-LPS) in plasma ,and the value of cyclic guanosine monophosphate (cGMP) and malondialehyde (MDA) in gut tissue were measured ,respectively .The expression of P-selection and Caspase-3 were measured by immunohisto-chemistry .The apoptosis of intestinal cells was detected by terminal deoxynucleotidyl transferase -mediated dUTP nick end labe-ling (TUNEL) and the results were analysed quantitatively by automatic image analytical system .Results Compared with the LIR group ,the values of DAO and FITC-LPS in plasma decreased obviously in the IPC group ,and the level of NO in plasma increased obviously (P<0 .01) .The values of DAO ,NO and cGMP in gut tissue increased obviously ,the level of MDA and the expression of Caspase-3 and the apoptosis index (AI) were significantly decreased in IPC group (P<0 .01) .Compared with the IPC group ,the value of DAO and FITC-LPS were higher and the level of NO was lower in plasma of the L-NAME group (P<0 .01) .The values of DAO ,NO and cGM P in gut tissue obviously decreased ,the level of MDA significantly increased ,and the expression of Caspase-3 and the AI significantly upregulated in L-NAME group than those in IPC group (P<0 .01) .Conclusion IPC can improve the small intestine injury and the apoptosis following hind limbs ischemia reperfusion which may correlated with the increase in the level of NO .

To provide a scientific basis for determining the health surveillance period of dust-exposed workers, data of a retrospective cohort study was re-analyzed with emphasis on natural course of silicosis. 33640 workers exposed to silica dust who were employed for at least 1 year from 1972 to 1974 in twenty Chinese mines or pottery factories were included as subjects, and were followed up till December 31, 1994. The cohort included subjects from 8 tungsten mines, 4 tin mines and 8 pottery factories. Our results showed that the mean latency of silicosis, for all the cases of the cohorts, was 22.9 +/- 9.8 y. 52.2 % of silicosis was diagnosed approximately 9.1 +/- 5.7 y after the dust exposure had ceased. The progression rates of silicosis from stage I to II and from stage II to III were 48.2 % and 18.5 %, and the duration was 4.1 +/- 0.2 and 6.8 +/- 0.2 y, respectively. The survival times of silicosis stage I , II and III, from the year of diagnosis to death, were 21.5, 15.8 and 6.8 years, respectively. There was 25 % of the silicosis patients whose survival time was beyond 33 y. The mean death age of all silicosis cases was 56.0 y. The death age increased to 65.6 y in the middle of 1990s. Among dust-exposed workers, subjects who became suspected case (0+ ) accounted for 15.0 %. 48.7 % of the suspected silicosis cases developed to silicosis, and the average year from the time of being suspected of the disease to the first stage of silicosis was 5.1 y. The natural characteristics, as mentioned above, varied with different mines and factories. We are led to conclude that silicosis is chronic in nature, but progress quickly. As a serious occupational disease it significantly reduces the life span of exposed workers. The study of its natural history is of importance for the development of health surveillance criteria for dust-exposed workers.

Objective To observe the prevention effect of glutathione on acute radiation enteritis in pelvic radiation therapy.Methods All 80 pelvic tumor patients treated with radiotherapy were randomly assigned to the control group (40 patients)and the treatment group (40 patients)by the number table method.40 cases in the con-trol group treated with radiation were not treated with preventive drugs,but the patients in the treatment group were treated with glutathione.The occurrence time of acute radiation enteritis and the severity of acute radiation enteritis after treatment were evaluated.Results 15.0% of the treatment group suffered from acute radiation enteritis in the second week and 72.5% in the third week.however,62.5% of the control group were suffered from acute radiation enteritis in the second week and 27.5% in the third week.The difference was statistically significant (χ2 =18.775, 15.998,all P <0.001).Glutathione delayed the occurrence time of acute radiation enteritis.The grade 1 and grade 2 acute radiation enteritis effective rate in the treatment group were 77.5% and 17.5%,and that in the control group were 20.0% and 72.5%,the difference between the two groups was significant(χ2 =26.136,24.139,all P <0.001).The glutathione could reduce the incidence of acute radiation enteritis extent.Conclusion Glutathione could delay the occurrence time of acute radiation enteritis and reduce the incidence of acute radiation enteritis extent.It is worth clinical application.

Objective To establish the normal reference intervals of whole blood trace elements among pregnant women in Han‐gzhou area to provide the clinical diagnostic basis for ensuring the health of pregnant women and their fetuses .Methods A total of 122 whole blood samples in pregnant awaiting delivery in a general hospital of Hangzhou City during 2015 were collected randomly . The levels of lead(Pb) ,cadmium(Cd) ,copper(Cu) ,zinc(Zn) ,nickel(Ni) ,chromium(Cr) ,beryllium(Be) ,manganese(Mn) ,cobalt (Co) ,arsenic(As) ,molybdenum(Mo) ,thallium(Ti) and thallium(Tl) were determined with ICP‐MS .And the results were statisti‐cally analyzed .Results The detection results of whole blood Cu ,Cr ,Mn and Ti showed a normal distribution .The 5% -95% refer‐ence interval was determined according to x ± 1 .96s ,the normal reference intervals for these 4 elements were 255 .37 -668 .23 , 56 .09-151 .93 ,18 .46-54 .60 and 800 .90 -2 632 .02 μg/L respectively .Conclusion Formulating the normal reference values of whole blood microelements levels has an important significance for clinical doctors to provide the nutritional health care guidance and master the heavy metal pollution level .

The cardiovascular and cerebrovascular diseases have become a main category of disease which affects human health today.It is helpful to search for its causes and main risk factors for scientific prevention and control of these diseases.Now,we have already paid close attention to effect of the airborne contaminant and meteorological factors on the cardiovascular and cerebrovascular diseases.Some reports about solo affect of two types factors have given a clear results;however,a little of unification evidences have been provided.This article reviews the solo and unification effects of pollutants and meteorological factors in the cardiovascular and cerebrovascular diseases.

In the present study, a risperidone loaded microsphere/sucrose acetate isobutyrate (SAIB) in situ forming complex depot was designed to reduce the burst release of SAIB in situ forming depot and to continuously release risperidone for a long-term period without lagime. The model drug risperidone (Ris) was first encapsulated into microspheres and then the Ris-microspheres were embedded into SAIB depot to reduce the amount of dissolved drug in the depot. The effects of different types of microsphere matrix, including chitosan and poly(lactide-coglycolide) (PLGA), matrix/Ris ratios in microspheres and morphology of microspheres on the drug release behavior of complex depot were investigated. In comparison with the Ris-loaded SAIB depot (Ris-SAIB), the complex depot containing chitosan microspheres (in which chitosan/Ris = 1 : 1, w/w) (Ris-Cm-SAIB) decreased the burst release from 12.16% to 5.80%. However, increased drug release rate after 4 days was observed in Ris-Cm-SAIB, which was caused by the high penetration of the medium to Ris-Cm-SAIB due to the hydrophilie of chitosan. By encapsulation of risperidone in PLGA microspheres, most drugs can be prevented from dissolving in the depot and meanwhile the hydrophobic PLGA can reduce the media penetration effect on the depot. The complex depot containing PLGA microspheres (in which PLGA/ drug=4 : 2, w/w) (Ris-Pm-SAIB) showed a significant effectiveness on reducing the burst release both in vitro and in vivo whereby only 0.64% drug was released on the first day in vitro and a low AUC0-4d value [(105.2± 24.4) ng.mL-1.d] was detected over the first 4 days in vivo. In addition, drug release from Ris-Pm-SAIB can be modified by varying the morphology of microspheres. The porous PLGA microspheres could be prepared by adding medium chain triglyceride (MCT) in the organic phase which served as pore agents during the preparation of PLGA microspheres. The complex depot containing porous PLGA microspheres (which were prepared by co-encapsulation of 20% MCT) (Ris-PPm-SAIB) exhibited a slightly increased AUC0-4d of (194.6±15.8) ng.mL-1d and high plasma concentration levels from 4 to 78 days [Cs(4-78d)=(7.8±1.2) ng.mL-1]. The plasma concentration on 78 day C78d was (9.0 2.5) ng.mL-1 which was higher than that of Ris-Pm-SAIB [C78d= (1.6 ± 0.6) ng.mL-1]. In comparison with Ris-Pm-SAIB, the AUC4-78d of Ris-PPm-SAIB increased from (379.0±114.3) ng.mL-1.d to (465.0 ±149.2) ng.mL-1.d, indicating sufficient drug release from the Ris-PPm-SAIB. These results demonstrate that the risperidone loaded porous PLGA microsphere/SAIB in situ forming complex depot could not only efficiently reduce the burst release of SAIB depot both in vitro and in vivo, but also release the drug sufficiently in vivo, and be capable to continuously release the drug for 78 days.

Post competency is a kind of necessary ability for professional working.In order to train the students' excellent professional skills,we have conducted exploration and reform in post competency oriented experiment teaching,through reforming experimental courses,changing teaching methods and means of examination,constructing the laboratory etc.,so that we have built a new professional training model in pathological diagnosis and technology specialty experimental teaching.The experimental teaching reform results have improved the experimental teaching quality and the talents capability.