Objective To explore the new method for the differential diagnosis of malignant and non-malignant ascites. Methods 126 patients with ascites including 39 cases of liver cirrhosis,15 cases of tuberculous peritonitis,33 cases of hepatocellular carcinoma and 39 cases of other malignant tumors were enrolled in this study.The levels of serum C-12 tumor markers were measured. Results The levels of serum CEA, AFP, CA19-9 and CA242 were remarkably higher in malignant ascites than thos in non-malignant ascites(P

Objective To understand the incidence of abnormal glucose metabolism during pregnancy and the maternal and neonatal outcomes after standard management.Methods A retrospective study of maternal and neonatal outcomes was conducted in 1490 pregnant women who were diagnosed and treated for abnormal glucose metabolism and delivered in the Department of Obstetrics and Gynecology of First Hospital of Peking University from Jan 1995 to Dec 2004 by reviewing the medical records.The selected cases consisted of 79 women with diabetes mellitus(DM group),777 with gestational diabetes mellitus(GDM group),including 355 cases of A1,316 with A2 and 106 cases unclassified,and 634 with gestational impaired glucose test(GIGT group).Maternal and fetal outcomes were analysed in comparison with the controls of 19 013 pregnant women with normal glucose metabolism who delivered during the same period.Results(1)The total incidence of gestational abnormal glucose metabolism was 7.3% and increased gradually from 1995 to 2004.The first stage,from Jan 1995 to Dec 1999,saw a slow increase in the incidence [4.3%(376/8739)];the second stage,from Jan 2000 to Dec 2001,showed a fast increasing trend.The average incidence was 10.8%(445/4133).The incidence in the third stage kept stable at 8.9% (678/7640)from Jan 2002 to Dec 2004.(2)The incidence of macrosomia,preeclampsia and preterm birth were 12.1%(180/1490),9.5%(141/1490)and 9.4%(140/1490),which were significantly higher than those women with normal glucose metabolism(P0.05).(3)The perinatal mortality rate(PMR)of abnormal glucose metabolism group was 1.19%(18/1513)which was significantly higher in the DM group (4.93%)than GDM(1.14%)and GIGT groups(0.78%,P

Aim To observe the timed analgesic effects by butabital (B), acetaminophen(A) and caffeine (C) in combination (BAC), in which the proportion was fixed as1. 25∶ 8. 1∶1. Method Three types of experimental methods, including the tailflicking method, the hot plate method and the pressurizing tail method, weretaken to determine indices at different times after the animals were adminstered(ig) high, median and low BAC dose. Results and conclusion BAC had a stronganalgesic effect in three types of experiments. The effect began 30 min after ad-ministration, arrived maximum at 1 h, decreased at 2 h and disappeared at 4 h.There was a dose-effect relationship between large and little BAC dose.

0.05) . Conclusion An acceptable image quality can be achieved for pediatric patients by reducing the mA value to 40 to 80mA used for conventional temporal bone, and the low dose CT scanning ought to be extended in the temporal bone decease for children.

Objective To assess whether dynamic arterial elastance (Eadyn)can be used to predict the reduction of arterial pressure after decreasing norepinephrine (NE) dosage in patients with septic shock.Methods A prospective observational cohort study was conducted.Thirty-two patients with septic shock and mechanical ventilationwere enrolledfrom January 2014 to December 2015 in ICU of Wuxi People's Hospital of Nanjing Medical University.Hemodynamic parameters were recorded by pulse contour cardiac output(PiCCO) monitoring technology before and after decreasing norepinephrine dosage.Eadyn was defined as the ratio of pulse pressure variation (PPV) to stroke volume variation (SVV).Mean arterial pressure (MAP) variation was calculated after decreasing the dose of NE.Response was defined as a ≥ 15％decrease of MAP.AUC was plotted to assess the value of Eadyn in predicting MAP response.Results A total of 32 patients were enrolled in our study,with 13 responding to NE dose decrease where as the other 19 did not.Eadyn was lower in responders than in nonresponders (0.77 ± 0.13 vs 1.09 ± 0.31,P ＜ 0.05).Baseline Eadyn was positively correlated with systolic blood pressure variation,diastolic blood pressure variation,systemic vascular resistance variation and MAP variation (r =0.621,P =0.000;r =0.735,P =0.000;r =0.756,P =0.000;r =0.568,P =0.000 respectively).However,stoke volume variation,baseline level of systemic vascular resistance and NE baseline dose were not correlated with Eadyn baseline value (r =0.264,P =0.076;r =0.078,P =0.545;r =0.002,P =0.987 respectively).Eadyn ≤ 0.97 predicted a decrease of MAP when decreasing NE dose,with an area under the receiver-operating characteristic curve of 0.85.The sensitivity was 100.0％ and specificity was 73.7％.Conclusions In septic shock patients treated with NE,Eadyn is an index to predict the decrease of arterial pressure in response to NE dose reduction.

Aim To investigate the interactions be-tween the neuroinflammation caused by lipopolysaccha-ride(LPS) and brain CYP2E1.Methods The human cholinergic neuroblastoma cell line IMR-32 was treated with LPS ( 0.1 mg · L-1 , 1.0 mg · L-1 ) , and the LDH and SOD activities were determined after 24 h in-cubation .In order to determine the roles of MAPK sig-naling pathway in the regulation of CYP 2E1 by LPS, the IMR-32 cells were treated with p38 pathway inhibi-tor SB203580 or ERK pathway inhibitor U 0126 for 45 min before the incubation with LPS .The human do-paminergic neuroblastoma cell line SH-SY5Y with CYP2 E1 over-expression was established . The LDH and SOD activities were determined in SH-SY5 Y cells over-expressed CYP2 E1 and control cells treated with LPS(0.1 mg· L-1 , 1.0 mg· L-1 ) for 24 h.Results
The levels of LDH in IMR-32 cells treated with high-dose LPS were increased by 1.38-fold ( P <0.01 ) compared with the control group , and the levels of SOD reduced by 15.0%( P <0.01 ) .Compared with the control, CYP2E1 mRNA and protein levels in IMR-32 cells treated with high-dose LPS were increased by 1.25-fold(P<0.01) and 1.19-fold(P<0.05).The up-regulation of CYP2E1 by LPS could be attenuated by SB203580 and U0126 pretreatment.Compared with the control cells, the CYP2E1 over-expression in-creased LDH levels by 1.28-fold ( P<0.01 ) and de-creased SOD levels by 3.53-fold ( P<0.01 ) after the low-dose of LPS treatment .The CYP2E1 over-expres-sion increased LDH levels by 1.54-fold ( P <0.01 ) and decreased SOD levels by 2.17-fold( P<0.01) af-ter the high-dose of LPS treatment , compared with the control cells.Conclusions LPS can induce CYP2E1 mRNA and protein levels , and the p38 and ERK sig-naling pathway may be involved in the regulation .The elevated CYP2 E1 levels aggravate the damage to neuro-nal cells caused by LPS .Brain CYP2E1 may be an im-portant contributing factor to the pathological process of neuroinflammatory injury .

BACKGROUND:Bone marrow mesenchymal stem cel s have a low survival rate after implanted into the ischemic myocardium. However, hypoxia preconditioning (HPC) may enhance bone marrow mesenchymal stem cel proliferation and promote its survival rate. OBJECTIVE:To explore whether Pim-1 is involved in HPC protecting against apoptosis of bone marrow mesenchymal stem cel s and the relevant mechanism. METHODS:Bone marrow mesenchymal stem cel s were respectively subjected to HPC for 0, 6, 12, and 24 hours. The expression of Pim-1 and apoptosis-related genes were detected by RT-qPCR and western blot. Then, the best hypoxic preconditioning time was determined as 12 hours. Then, bone marrow mesenchymal stem cel s were assigned to one of the fol owing groups:control (without HPC), 12-hour HPC, 12-hour HPC+Pim-1 inhibitor groups. Flow cytometry analysis was used to detect the cel apoptosis, Transwel assay to analyze the cel migration ability in each group, and JC-1 kit to detect mitochondrial membrane potential. Animal models of myocardial infarction were established. One week after modeling, bone marrow mesenchymal stem cel s were given via multi-point injection around the infarct zone of rats. Two weeks after modeling, heart tissues of rats were taken and sliced fol owed by DiI staining to calculate the survival rate of bone marrow mesenchymal stem cel s. Additional y, rat cardiac function was assessed by echocardiography prior to and after modeling as wel as at 4 weeks after cel transplantation. RESULTS AND CONCLUSION:At 12 hours after HPC, the expression of Pim-1, p-Akt and Bcl-2 gene in the infarct region was significantly increased, but the expression of caspase-3 and Bax was significantly decreased. Compared with the control group, cel viability in the 12-hour HPC group was increased very significantly at 1 week after cel transplantation (P<0.001), the migration and anti-apoptosis ability were enhanced significantly (P<0.01) and the cardiac function of rats was significantly improved in the 12-hour HPC group (P<0.05). Al of these protective effects were blocked by the Pim-1 inhibitor. These findings indicate that HPC can protect bone marrow mesenchymal stem cel s from apoptosis through activating Akt and up-regulating Pim-1, and thereby improve the therapeutic effect of bone marrow mesenchymal stem cel transplantation on ischemic heart diseases.

Objective To evaluate the application of the binary Logistic regression model to analyze ultrasonographie indexes of the solid breast tumors. Methods The indexes of two dimensional gray scale ultrasonography,two dimensional color Doppler flow imaging,three dimensional gray scale ultrasonography, three dimensional color Doppler flow imaging and ultrasonic elastography were evaluated in 151 breast lesions confirmed by surgical pathology. A Logistic regression model for predicting breast rnalignaney on the basis of ultrasonographic indexes was obtained. A receiver operating characteristic (ROC) curve was used to assess the performance of the Logistic regression model. Results Six ultrasonic indexes were finally entering the Logistic regression model. They were elasticity score, shape,internal echo, RI, enhancement of posterior acoustic alteration and the converging pattern in the coronal plane. The area under the ROC curve was 0. 996. The percentage correct of prediction was 97.35 %. Conclusions The multivariate analysis model of binary Logistic regression can describe and analyze the process of differential diagnosis of malignant and benign solid breast tumors by ultrasonography and can select out the valuable indexes of differential diagnosis.

With the increase of the incidence and the refinement of clinical treatment,the clear preoperative staging and the assessment of tumor recurrence and metastasis of cervical cancer is particular important.Different results may be explained in the same tumor applied different methods of imaging examination,which influences the clinical diagnosis and treatment.So imaging examination plays a more and more important role in the assessment of preoperative staging and tumor recurrence.

OBJECTIVE: Comparative analysis of the clinical curative effect of manipulative reduction and TRV- CRP treatment of BPPV, comfort degree during reset and quality of life improvement. METHOD: One hundred and thirty-two patients with BPPV were randomly divided into two groups ,one group underwent the traditional manip- ulative reduction, the other group with TRV-CRP. DRI and VAS was evaluated in the pre and after treatment and evaluation of the efficacy was conducted. The results of two groups were compared. RESULT: The effective rate of manipulative reduction after a week treatment was 89. 23% and TRV-CRP.was 98. 51%, which was higher in TRV-CRP group than that of the manipulation reduction group(P<0. 05). The comfort degree of the manipulation reduction group was 4. 54±2. 48,higher than the TRV-CRP group which was 5. 48±1. 44 (P<0. 05). The score of DHI showed no significant difference before treatment between manipulation reduction group and TRV-CRP group(P>0. 05), the score of the two groups were decreased after a week of reduction, but the improvement of TRV-CRP group was higher than that of manipulation reduction group(P<0. 05). CONCLUSION The success rate of TRV-CRP was higher than that of manipulative reduction,but manipulative reduction comfort degree was higher than TRV-CRP, the two methods can both improve the quality of life of patients with BPPV. TRV-CRP has many advantages over manipulative reduction, but manipulative reduction is simple with low cost, and the effect is still a great advantage. In clinical work, we should reasonable combine the two methods,so as to improve the cure rate of RPPV.
Benign Paroxysmal Positional Vertigo ; therapy ; Humans ; Patient Positioning ; Quality of Life ; Treatment Outcome