Objective To investigate the clinical effect of pegylated interferon(IFN)on chronic hepatitis C and its effect on cellular immune function.Methods A total of 92 patients with chronic hepatitis C were enrolled in our hospital from June 2013 to October 2016.They were randomly divided into study group and control group by single and double numbers(admission order),with 46 cases in each group.The control group was treated with recombinant human interferon alpha-2b on the basis of conventional treatment.The study group was treated with pegylated interferon alpha-2a on the basis of conventional treatment.Results After treatment, the rates of RVR, EVR, ETVR and SVR in the study group(52.17%, 71.74%, 76.09% and 54.35%, respectively)were significantly higher than those in the control group(34.78%, 50%, 58.70%, 39.13%, respectively), The difference was statistically significant(P<0.05).There were no significant difference in the cellular immune function index between the two groups before treatment;After treatment,the CD3+, CD4+, CD4+/CD8+ and other immune function indexes of the study group were significantly higher than those before treatment, while the results of CD8+ were significantly lower than before treatment(P<0.05);There was no significant difference in the cellular immune function in the control group compared with before, and the difference of the cellular immune function between the 2 groups after treatment was statistically significant(P<0.05).Conclusion Pegylated interferon(IFN)on the basis of routine treatment can improve the virologic response and cellular immune function in patients with chronic hepatitis C.

Objective:To study the expression and clinical significance of serum neutrophil elatinase-associated lipocalin (NGAL), monocyte chemoattractant protein-1 (MCP-1) and tumor necrosis factor-like weak inducer of apoptosis (TWEAK) in patients with lupus nephritis (LN).Methods:97 LN patients who received treatment in Hanzhong 3201 Hospital from January 2016 to December 2019 were selected as study objects. Among them, 38 cases were in the active group and 59 cases were in the inactive group, and 51 cases for physical examination were selected as the control group. The levels of serum NGAL, MCP-1, TWEAK and LN renal function was examined and compared in each group. The diagnostic value of serum NGAL, MCP-1 and TWEAK expression on LN disease activity was evaluated by receiver operating characteristic (ROC) curve.Results:The levels of serum NGAL, MCP-1 , TWEAK, serum creatine (Scr), blood urea nitrogen (BUN), 24 h urinary protein and dsDNA in the active and inactive groups were higher than those in the control group, and the above indexes in the active group were higher than those in the inactive group ( P<0.05). Pearson correlation analysis showed that serum NGAL, MCP-1 and TWEAK levels in LN patients were positively correlated with systemic lupus erythematosus disease activity index (SLEDAI) score, Scr, BUN, 24 h urine protein and dsDNA levels ( P<0.05). ROC curve analysis showed that the area under curve (AUC) of combined serum NGAL, MCP-1 and TWEAK in predicting disease activity of LN patients was 0.865, and the specificity, sensitivity, AUC and Youden index were higher than single index. Conclusions:The expression of NGAL, MCP-1 and TWEAK in LN patients during the active period is increased and closely related to the activity of disease. It is of high application value for predicting LN activity, and can be used as biomarkers for clinical prediction of LN activity.

Objective To discuss the effect of the application of anti-reflux venous indwelling needle after gastrointestinal polyps endoscopic resection.Methods 400 cases of patients after gastrointestinal polyps endoscopic resection were selected in our department.200 cases of patients using ordinary venous indwelling needle were set as the control group.In addition,200 cases of patients chose anti-reflux indwelling needles which were produced by a certain medical instrument Co.,Ltd were set as the experimental group.The incidence rate of phlebitis,tube blocking,blood return and indwelling time in the process of using anti-reflux indwelling needle were observed in two groups.Results During the indwelling time of two kinds of indwelling needles,the incidence rates of phlebitis,tube blocking and blood return of anti-reflux indwelling needle in the experimental group were significantly lower than those of the control group.The average indwelling time of the experimental group was 1.2 days,longer than that of the control group.Conclusions Anti-reflux indwelling needle can effectively protect the blood vessels,ensure the patients to use drugs in time,improve the work efficiency of nurses,reduce the damage to patients and effectively reduce the burden of patients.

Objective To study which is more advantage between comfortable care and functional care.Methods There are 49 case.We divided them into two groups,countrast group (function mode) and experimental group (comfortable mode) according to the preoperation case and postopreation case.Count the operative complication rate of two groups.Results Satitical analysis was performed using χ2,P<0.05.Conclusions Comfortable care mode was significantly advantage than functional care mode.

Objective To evaluate the correlation between low choledochal joint and common bile duct stones(CBDS)by magnetic resonance cholangiopancreatography(MRCP).Methods The clinical data of 129 patients without intrahepatic calculus after cholecystectomy receiving MRCP from March 2008 to August 2009 were retrospectively analyzed.MRCP images and T2WIs were analyzed independently by 2 doctors to classify anatomic variants of cystic duct and calculus.Results CBDS was found in 49 and low insertion of the cystic duct in 31 of the 129 patients(38% vs.24%).For the latter 31 patients, low insertion of the cystic duct with CBDS was found in 17.The analysis showed that low choledochal joint were associated with CBDS(x2 =4.921, P=0.027).Conclusion There is a certain correlation between low insertion of the cystic duct and CBDS.The low insertion of the cystic duct is one of the risk factors for calculus of the common bile duct.

Objective To evaluate the feasibility and clinical significance of magnetic resonance cholangiopancreatography (MRCP) in the diagnosis of anatomic variants of the extrahepatic biliary tract. Methods The MRCP images of 535 patients who were admitted to The Second Affiliated Hospital of Suzhou University from March 2008 to March 2009 were retrospectively analyzed by two reviewers independently. The anatomic variants of the extrahepatic biliary tract were evaluated by studying the T2-weighted magnetic resonance images. Results The consistency between the two reviewers in the diagnosis of low choledochal joint, medial cystic duct insertion, aberrant hepatic duct, accessory hepatic duct and other anatomic variants was 98% , 99% , 89% , 90% and 100%, respectively (K = 0.86, 0.93, 0.81, 0.82, 1.00). The extrahepatic biliary system was clearly displayed by MRCP in 500 patients, and anatomic variants were observed in 240 patients, including low choledochal joint in 85, parallel cystic duct in 37, medial cystic duct insertion in 82, aberrant hepatic duct in nine, accessory hepatic duct in 10, choledochal cyst in three and high cystic duct in seven. A total of 259 patients underwent operation, and 168 patients had anatomic variants of the extrahepatic biliary tract. Conclusion MRCP imaging enables the accurate assessment of anatomic variants of the extrahepatic biliary system and avoids bile duct injury.

The effects of exopolysaccharides from Aphanothece halophytica(.EAH) on immunological function were studied by immunological techniques. The results showed that EAH could not only enhance the mitogenic response of mice's thymus cells, murine bone marrow cells proliferation,murine mixed lymphocyte reaction and the activity of NK cells in mice,but promote the interleukinl(IL-1)production and increase the activity of 1L-2 as well. The study suggests that EAH can improve the immunological function of mice.

The PBL Teaching Method has implemented in the department of gynecology and obstetrics of Fudan University since 2004.This new method cultivates the students'ability to ask and answer the questions to collaborate,to comiderate problems conpletely and the ability to consult information and solve problems quickly.Teachers and department should improve the teaching and manage level.

Objective:To find out the problems still existing in the teaching reform through the investigation and research of eight-year program graduates of clinical medicine.Methods:In 2017, 118 questionnaires were issued to Batch 2005-2006 graduates of eight-year program in clinical medicine, and 103 valid questionnaires were retrieved. The questionnaire was based on that of the Fuyi Design of the Education Department in Zhongshan Hospital affiliated to Fudan University. The questionnaire was revised on the basis of the pre-survey and the statistical analysis was carried out on the data using Excel 2010.Results:We found that 60.2% of the graduates were satisfied with the training mode of eight-year program, 69.9% of the graduates gave a satisfactory evaluation on the teaching quality in the teaching hospital, and 63.1% of the graduates believed that the curriculum still need partial adjustment.Conclusion:Based on the finding, medical talent training mode is relatively mature in Batch 2005-2006 eight-year program of clinical medicine. The future medical education reform of the eight-year program should be more embodied in innovating the grafting mode of professional medical degree system, strengthening enrollment publicity, adopting diversified enrollment, strictly controlling procedure, carrying out integrated curriculum reform, enhancing clinical teaching design, at the same time further improving teachers' comprehensive quality, and speeding up the construction of clinical teaching staff.

BACKGROUND:Mechanical experiment of finite element numerical simulation is the effective method to research the biomechanical structure of human body. OBJECTIVE:To establish the three-dimensional finite element model of a normal 6-year-old child’s humerus. METHODS:CT images of a 6-year-old child volunteer were imported to the Mimics 10.01 software. The threshold segmentation method was used to rebuild the humerus three-dimensional model. The surface optimization treatment and surface patches dicision were performed on the surface of the model with Geomagic Studio 12.0 software. Then the mesh generation was completed in the software TrueGrid. Final y, the material properties were set and the finite element model was completed. The boundary conditions and constrains were exerted to simulate the three-point-bending test of humeurs. After the simulation, the results were outputted. RESULTS AND CONCLUSION:The humerus finite element model included 3 024 nodes and 18 758 nodes-hexahedron elements. The 0.01 m/s and 3 m/s dynamic loads were loaded respectively, then the central humerus fracture occurred and the load-displacement curve was close to the cadaver test results. The simulation results show that the simulation results of children humerus finite element model are close to the cadaver’s test, and the finite element simulation method can simulate the physical properties of the human skeleton very wel .