Objective To evaluate the interference of occult blood in urine (urinary hemoglobin) and to determine the protein in urine by benzethonium chloride .Methods By reference to EP7‐A2 of CLSI ,urine containing different concentrations of hemoglobin were preparated to produce the dose‐effect curve,while 50 cases of clinical urine with varying degrees of occult blood were col‐lected for clinical sample bias test.Urinary protein was quantified by benzyl chloride in DPP roche comparing with sulfosalicylic acid method .Results When the urinary hemoglobin was 0 .2 g/L or higher ,the determined result of urinary protein of urinary pro‐tein would be significantly interfered by benzethonium chloride method .The clinical sample bias testshowed that clinical urine with different degrees of occult blood caused positive interference to the determination of protein by benzethonium chloride .Conclu‐sion Urine samples with occult blood and /or containing red blood cells should be emphasized and evaluate the accuracy when the urinary protein is quantified by benzyl chloride .If necessary ,it should be confirmed by sulfosalicylic acid .

Objective To study the expression of clusterin (CLU) and P-glycoprotein (P-gp) in hepatic cell carcinoma (HCC) and its relationship.Methods The expression of CLU gene in the tissue of H CC (41 cases),cirrhosis(10 cases) and normal liver (10 cases) and the expression of P-gp in the tissue of HCC were detected by immunohistochemical method.Results The positive expression rate of CLU was 82.93％(34/41) in HCC,and negative or weak positive were detected in cirrhosis and normal liver tissue.The positive expression rate of CLU was significantly correlated with Edmondson's histological grade (P ＜ 0.05),but had no correlation with patients' age,sex and cirrhosis (P ＞ 0.05).The positive expression rate of P-gp in HCC was 70.73％(29/41).There was significant correlation between the expression of CLU and P-gp (P ＜ 0.05).Conclusions The over expression of CLU is significantly associated with clinical multidrug resistance in HCC.It should be a potential target for treatment of HCC.

Objective To investigate the application value of ultrasonography in the differential diagnosis of benign and malignant thyroid nodules in the elderly.Methods The ultrasonography data of 117 elderly patients with thyroid nodules confirmed by surgery and pathology were analyzed retrospectively from Jan.2013 to Feb.2015.Their sonogram features were summarized.Results Among 117 cases,there were 82 cases (70.1 ％) with benign thyroid nodules and 35 cases (29.9％) with malignant thyroid tumors according to pathological diagnosis.The accordance rate of ultrasonography for diagnosing the benign and malignant thyroid nodules was 88.0％,and only 14 cases were misdiagnosed.Conclusions Ultrasonography has a good application value in the differential diagnosis of benign and malignant thyroid nodules in the elderly.

Objective To evaluate the effect of imatinib in improving myocardial fibrosis in uremic rats through regulating the expression of PDGFRα.Methods Seventy two rats were divided into three groups ,which were Sham group ,5/6 group and 5/6+I group .All The rats in 5/6 group underwent the 5/6 nephrectomy and the rats in 5/6+I group were given imatinib by ga‐vage after the operation of 5/6 nephrectomy .Hearts were harvested for HE and Sirius red staining at 8 weeks post surgery .The ex‐pression of PDGFRαwas assessed with immunohistological staining .The real‐time PCR was employed to detect the PDGFRαmR‐NA level in hear samples .Results The urine protein ,Scr ,BUN of the 5/6 group and 5/6+I group were higher than that of Sham group(P<0 .01) .The myocardial pathological score in Sham group was significantly lower than that of 5/6 group (P<0 .01) ,and the score in 5/6+I group was significantly lower than that of 5/6 group (P<0 .01) .The collagen volume fraction (CVF) in 5/6 group was significantly higher than that in Sham group (P<0 .01) .And the CVF in 5/6+ I group was higher than that in Sham group (P<0 .05) ,but lower than that of 5/6 group (P<0 .05) .The expression ratio of PDGFRαmRNA and staining rate in 5/6 group and 5/6+I group were both much higher than that in Sham group (P<0 .01) ,and the expression in 5/6+I group was signif‐icantly lower than that in 5/6 group (P<0 .05) .Conclusion These data suggest that the tyrosine kinase inhibitor imatinib reduces heart injury and attenuates myocardial fibrosis in uremic rat by mechanisms associated with the inhibition of the expression of PDGFRα.

Objective To explore the anesthesia effect and influence of combined spinal epidural anesthesia (CSEA)with head -up of 10°on maternal hemodynamics during cesarean section.Methods 120 pregnant women undergoing cesarean section were selected,and were randomly divided into group A,B and C,40 cases in each group. Three groups were all given CSEA,yet pregnant women in group A were taken supine position,group B was taken head-up of 10°,and group C was taken head -up of 20°.Hemodynamic parameters of three groups of the following time points were compared,including before anesthesia(T0 ),5min after anesthesia(T1 ),skin incision(T2 ),fetal disen-gagement immediately(T3 ),and operation at the end(T4 ),also anesthesia effect was recorded,and usage of ephedrine and local anesthetic was noted,and adverse reactions were compared.Results Compared with T0 ,group A's hemody-namics in T1 decreased,including systolic blood pressure (SBP),diastolic blood pressure (DBP),and increased in T2 and T3 ,yet there were no statistical differences on hemodynamics in three groups in T4 .Compared with group B and C,there were statistical differences on hemodynamics in T1 ,T2 and T3 in group A(t =3.63 -7.25,P <0.05 or P <0.01),yet there were no statistical differences on hemodynamics in group B and C(t =0.00 -0.93,all P >0.05). Anesthesia block scores in group A,B and C were (2.0 ±0.3)points,(2.5 ±0.2)points,(2.6 ±0.2)points,and scores of B and C were higher than that in group A(t =3.92,4.01,all P <0.05).Cases and total usage of ephedrine in group A were higher than those of group B and C(χ2 =31.43,50.61,t =16.27,20.17,all P <0.01).Cases of adjusting surgical position,and addition of local anesthetic in group C were significantly higher than those of group B (χ2 =23.85,28.47,all P <0.01).Conclusion It has better anesthetic effect of taking CSEA by head -up of 10°, and maternal hemodynamics are more stable,can better meet operation's requirements,also with easier operation,so it is superior to supine position and head -up of 20°.

Objective:To study the feasibility of surgical techniques and clinical experience of the airbag-free separation of nail and the whole extraperitoneal laparoscopic hernia repair(TEP).Methods:Ninty-three cases of inguinal hernia.Patients were treatecl in our hospital from March 2005 to January 2009,with 39 cases of regular.Free air and non-stapling of mesh TEP and 54 cases of routine open tension-free hernioplasty.Results:The operation times were as follows:TEP Group,unilateral hernia(101.3?15.6 min),bilateral hernia(138.4?17.3 min);Open Group,unilateral hernia(81.6?7.6 min),bilateral hernia 175.8?22.0 min.The couplications in TEP Goup inclucled 3 cases of retroperitoheal rupture,3 cases of intra-operative vascular injury,and 2 cases of postoperative scrotal hematoma.Nine cases of sacrotal hematoma,4 cases of infective and 6 cases of long-term pain in the groin area happened in open Group.Conclusion:TEP of free balloon separator with no stapling patch is safe,reliable,less post-operative complications and especially suitable for bilateral hernia.

Objective To investigate the effect of methylation of the APC gene on expression and the correlation with clinical data in pancreatic cancer.Methods Sixty postoperative tissue samples with pancreatic cancer were collected in the First Affiliated Hospital of Zhengzhou University from August 2010 to January 2011,20 benign pancreatic disease tissues were collected as control groups.APC promoter methylation and gene expression levels were detected by Methylation Specific PCR (MSP),Real Time PCR (RT-PCR) and Western blot in 60 pancreatic carcinoma,42 metastasis and 20 benign pancreatic disease tissues,then analyze the relation between methylation of the APC gene and the clinical data.Results APC promoter methlation was observed 48.53％,46.67％ and 1.16％ in pancreatic carcinoma,metastasis and benign pancreatic disease tissue,respectively.Methylation of APC in pancreatic carcinoma and metastasis increased significantly compared with control tissues (x2 =12.903,14.402; P ＜ 0.05).There were no statistically significant differences of APC expression in these tissues (P ＞ 0.05).There was a significant correlation between methylation of APC and clinicopathological stage (x2 =6.801,P ＜ 0.05),but no correlation with gender,age,tumor size,histological grade and metastasis (x2 =0.727,1.311,0.372,0.148,0.017 ; P ＞ 0.05).Conclusion The methylation of APC gene is closely related with pancreatic carcinoma inogenesis and the clinicopathological stage,but do not effect the expression of APC in tissues.

Objective To investigate molecular typing and drug resistance patterns of 98 Klebsiella pneumoniae (K.pneumoniae) isolated from type 2 diabetes patients complicated with maxillofacial infection,to research the virulence and resistance mechanisms.Methods The study was a prospective study that adopted the method of continuous sampling from fixed location,from March 2010 to October 2012.The maxillofacial surgery patients diagnosed with type 2 diabetes complicated with maxillofacial infection were chosen in 7 hospitals in Zhengzhou as the research object,and a total of 431 pus sample were collected continuously,in which 98 strains K.pneumoniae were isolated and identified.The Kirby-Bauer disk diffusion test was conducted in 98 strains to determine the resistance to 19 antibacterial agents.K.pneumoniae chromosomal DNA were digested by restriction endonuclease Xba Ⅰ and analyzed by pulsed-field gel electrophoresis (PFGE).PFGE patterns of K.pneumoniae strains were analyzed using Fingerprinting software.The relationship between the molecular types and resistance phenotype was observed.The extended spectrum β-1actamase-producing K.pneumoniae were screened out by the double disc synergy test (DDST)Polymerase chain reaction (PCR) was used to detect resistant genotypes,serotype and virulence genes.The purified PCR products of resistant genes were cloned and sequenced.Hypermucoviscosity phenotype of all strains were determined by string test.Results Much severer drug-resistance for K.pneumoniae was identified and the result of extended-spectrum beta-lactamase producing rate was 57.1 ％.Ninety-eight strains were dispatched into 13 groups by PFGE.No dominant bands and specific extended-spectrum beta-lactamase DNA bands were found.The results of PCR showed that among the 56 strains of extended spectrum β-lactamase-producing K.pneumoniae,40 were positive for blaSHV (accounting for 71.4％),28 positive for blaTEM (accounting for 50.5％),21 positive for blaCTX-M (accounting tor 37.5％).The sequencing results were as follows:TEM-1,CTX-M-3 and a variety of SHV.Serotype K1,K2,K3,K5,K20,K54 and K57 and 3 kinds of virulence genes were detected,but not in strong toxicity-based.Hypermucoviscosity positive rate was 31.6％ (31/98).Conclusion Much severer drug resistance of K.pneumoniae in this study was identified and resistant mechanism was complex,in which strong toxicity serotype and virulence geues exist,which need more attention from clinical.

Objective: To investigate changes in species and amounts of intestinal flora after reconstruction of upper digestive tract, and the relationship with the infective complications.Methods: 52 patients with advanced malignancy being performed reconstruction of upper gastrointestinal tract was prospectively observed .The species of bacteria and counts of the colony forming units(CFU) were measured from juice taking from the upper jejunum through nasointestinal tube during operation, the second day and the fifth day after operation. Meanwhile, the plasma endotoxin concentration was determined with the modified chromogenic limulus assay.Results: There weren't significant changes of intestinal flora in species and amounts between groups (P＞0.05.) No any signs of bacterial translocation were seen. There was no significant difference for the level of plasma endotoxin between groups.Conclusion: There is no disorder of intestinal flora and bacterial translocation during the perioperative period after upper digestive tract reconstruction successfully.

BACKGROUND:MATLAB has capabilities of large numerical calculation, mathematical drawing and simple finite element analysis. It can establish models rapidly and can be able to identify the grayscale with BMP and JPG
format, and it can directly transform the identified data into ANSYS finite element software-readable format, thus avoiding personal error produced by the repositioning and secondary treatment in the Autocad software.
OBJECTIVE:To find a simple, convenient and accurate method to construct the model of lumber fusion and to analyze the biomechanics of lumbar motion segment after lumbar fusion.
METHODS:Lamel ar CT and Matlab (Matrix Laboratory) scientific computing software combining Ansys finite
element software was used to construct the models of lumber fusion. Then the models were loaded to analyze the biomechanical change of the fusion model.
RESULTS AND CONCLUSION:The established models were loaded with axial, bending and stretching loads, and the biomechanical analysis showed that interbody fusion had the best stability among al the fusion models. Combined with joint fusion, the axial displacements of interbody, rear side and rear fusion models were
decreased by 5%, 1%and 4%than that of simple interbody fusion, posterolateral fusion and posterior fusion models. Under the stretch-buckling load conditions, the rotation angles were reduced by 23%, 11%and 45%. Stress concentration to the fusion parts showed fusion block could increase the load displacement. The
technology of lamel ar CT, Matlab software and Ansys finite element software can accelerate the construction of lumber fusion model and make the model more accurate. Facet joint fusion combined with interbody fusion,
posterolateral fusion and posterior fusion can get better lumbar stability, and this increased stability is more significant in the rear fusion. Stress distribution of posterior fusion is more reasonable.