Objective To study the prediction value of C-reactive protein (CRP) level to ankylosing spondylitis disease activity score (ASDAS),the most widely used activity score in ankylosing spondylitis (AS).Methods A total of 386 patients with AS were enrolled and divided into 2 groups by CRP≥3.5 mg/L (n =266) and CRP ＜ 3.5 mg/L(n =120).ASDAS-CRP was evaluated in patients with CRP below the normal range (3.5 mg/L) in different subgroups.Three methods were used to test the consistency between ASDAS-CRP and ASDAS-erythrocyte sedimentation rate (ESR).Results The ASDAS-CRP showed a good correlation with the ASDAS-ESR when CRP level was ≥ 3.5 mg/L (r =0.899,P =0.000).In the group of CRP ＜ 3.5 mg/L,ASDAS-ESR showed better consistency with ASDAS-CRP when CRP level was below 1.5 mg/L(intra-class correlation coefficient 0.902;kappa coefficient 0.70).By the evaluation of variant gradient matrix,CRP 1.5 mg/L coincided with disease activity states.Conclusion There is good consistency between ASDAS-CRP and ASDAS-ESR.When CRP level is below the normal range,1.5 mg/L could be a cut-off value to calculate the optimal ASDAS-CRP score.

Objective To analyze antimalarial assosiated retinopathy detected by different methods with of modern ocular fundus examination, and explore screening strategy and the diagnosis of hydroxych-loroquine assosiatedretinopathy according to clinical experience and international guidelines. Methods Full fundus examination was performed in two patients with antimalarial retinopathy. The related literature were reviewed. Results Two patients had bull's eyes maculopathy and abnormal visual fields. Conclusion Clin-icians' alertness to hydroxychloroquine related retinopathy may improve early diagnosis of hydroxychloroquine toxicity. New objective tests are more sensitive than visual fields examination. Visible bull's-eye maculopathy is a late change, and the goal of screening is to recognize toxicity at early stage.

Objective To explore the the role of fraction exhaled nitric oxide(FeNO) in airway inflammation of Mycoplasma pneumoniae pneumonia(MPP).Methods Inpatients with low respiratory tract infection were enrolled from August to November in 2012,69 patients had MPP and 33 had no MPP(non-MPP).Patients with MPP were further grouped into a bronchopneumonia group and the lobar pneumonia group.Fifty-four inguinal hernia patients without respiratory tract infection during the last 2 weeks were enrolled as a control group.FeNO was measured by nitric oxide analyzer.Eosinophile level was detected by blood cells analysator.Results The level of FeNO in patients with MPP [(6.28 ±3.00) ppb] was lower than that of patients of non-MPP [(10.85 ± 2.86) ppb] and the control group [(9.74 ± 3.10) ppb] (t =7.30,6.26,respectively,all P ＜ 0.000 1) ; the level of FeNO between the bronchopneumonia group [(5.78 ± 3.06) ppb] and the lobar pneumonia group [(6.48 ± 2.98) ppb] with infection of Mycoplasma pneumoniae (MP) had no statistical significance(t =0.88,P ＞0.05).The proportion of blood eosinophile in patients with MPP [(0.60 ±0.51) ％] was lower than that of non-MPP group [(1.15 ± 0.76) ％] (t =4.14,P ＜ 0.000 1) ; the proportion of blood eosinophile between bronchopneumonia group [(0.61 ± 0.57) ％] and lobar pneumonia group [(0.60 ± 0.55) ％] with infection of MP had no discrepance (t =-0.05,P ＞0.05).Conclusions MP infection decreases production of FeNO.The possible mechanism for this phenomenon is that the cilia loss and hyperimmune response to MP may affect the production of FeNO.The airway inflammation of mycoplasma pneumonia is associated with cilia loss and hyperimmune response.

Objective:To study the influence of protein transduction domain (PTD)-oligomerization domain (OD)-HA fusion proteins on apoptosis of bcr/abl-positive cell lines. Methods:bcr/abl-positive cells were treated with PTD-OD-HA protein. The apoptoses of the cells were detected by flow cytometry (FCM), DNA ladder and transmission electron microscopy (TEM), and the levels of apoptosis-related genes bax and bcl-2 were detected by RT-PCR and Western blotting. Results:FCM examination demonstrated that PTD-OD-HA protein induced the apoptosis of bcr/abl-positive cells; DNA ladder showed that the classic DNA ladders appeared in BaF3-P210 and K562 cells after 48 h treatment with PTD-OD-HA proteins; the apoptoses of BaF3-P210 cells were observed by TEM; the levels of bax in mRNA and protein increased in BaF3-P210 and K562 cells, and bcl-2 decreased. Conclusion:PTD-OD-HA proteins specifically induced the apoptosis of bcr/abl positive cells.

Objective To assess the surgical treatment of iatrogenic biliary strictures. Methods The clinical data of 235 patients with iatrogenic biliary injuries and strictures who had been admitted to our hospital from January 1989 to December 2006 were reviewed retrospectively. Cholangio-jejunal Roux-en-Y anastomosis (n=182), surgical repair with pediele flap of autogenous tissues (n=34), end-to-end choledocho-choledo-chostomy (n= 12), common bile duct incision and figuration +T-tube drainage ( n =6) and liver transplanta-tion ( n = 1 ) were applied to the patients. Results A total of 189 patients were followed up for 1 to 10 years. The total excellent and good rate was 94.7% (179/189). The recurrence rate of the biliary stricture was 5.3% (10/189), and the main cause of which were biliary cirrhosis, selerosing cholangitis and calculus. One patient with severe biliary cirrhosis and portal hypertension died of liver failure postoperatively. Conclusions The cholangio-jejunal Roux-en-Y anastomosis is a reliable and effective method. Surgical repair of the bile duet with pedicle flap of autogenous tissues could preserve the function of the sphincter of Oddi, but the long-term effect needs further investigation. Biliary stent is not usually necessary to install. Liver transplantation is efficient for the patients with end stage of biliary diseases caused by biliary stricture.

Background:Colonoscopy is considered as a standard method for detecting various kinds of colorectal polyps. However,conventional colonoscopy( CC)still has the chance to miss some lesions. Literatures have already reported that transparent hood assisted colonoscopy( THAC)can improve the detection of colorectal polyps. However,the effect of black hood assisted colonoscopy( BHAC)on detection of colorectal polyps is still unclear. Aims:To evaluate the effect of BHAC on detection of colorectal polyps. Methods:A total of 1 076 patients underwent CC and BHAC from Sept. 2014 to April 2015 at Huadong Hospital Affiliated to Fudan University were enrolled in this prospective randomized controlled study. Baseline characteristics,cecal intubation time,withdrawal time,number of polyps,detection rate of polyps,location, size,morphology and pathological diagnosis of polyps between two groups were compared. Results:Compared with CC group,cecal intubation time was significantly shorter in BHAC group than in CC group[(6. 31 ± 3. 51)min vs.(7. 05 ± 4. 15)min,P=0. 002]. No significant differences in withdrawal time and rate of cecal intubation were found between two groups(P>0. 05). Detection rate of polyps was significantly higher in BHAC group than in CC group(65. 4% vs. 48. 7%,P=0. 004). No significant differences in size,morphology of polyps were found between two groups(P>0. 05). Conclusions:Compared with CC,BHAC could significantly improve the detection of colorectal polyps,and shorten cecal intubation time.

Objective To explore and discuss the safety and treatment effect in intraoperative and postoperative intracerebral an-eurysm clip occlusion .Methods Retrospective analysis of 285 cases from April 2010 to April 2012 which underwent aneurysm clip occlusion was conducted .All patients received lumbar drainage surgery after anaesthesia .All patient′s complications were statisti-cally analyzed .Results In 285 patients ,no aneurysm rupture happened after drainage ;brain retraction syndrome′s incidence rate was 3 .00% ;cerebral vasospasm′s incidence rate was 11 .60% ;hydrocephalus′s incidence rate was 2 .10% ;intracranial infection′s incidence rate was 9 .10% .The mortality rate was 1 .05% .Conclusion Lumbar drainage is a safe ,effective ,simple treatment .It can effectively reduce the risk of aneurysm clip occlusion ,prevention and treatment of postoperative complications ,and ultimately im-prove the prognosis .

Adenocarcinoma, Clear Cell ; Female ; Humans ; Middle Aged ; Nasal Cavity ; Nose Neoplasms

Objectives To investigate the clinical features of pneumonia in children with elevated alanine aminotransferase(ALT). Methods Clinical and laboratory data of 3 979 children with pneumonia admitted to the hospital were collected and retrospectively analysed, and ALT was detected in all cases. Results In 3 979 children with pneumo-nia, elevated ALT (13.78%) was found in 548 cases, most of which had mildly elevated ALT and were infants less than 6 months. The average age in elevated ALT group was less than that in normal ALT group (P=0.000). Apart from the symp-toms of pneumonia, most of them had non-specific clinical symptoms, 169 cases (30.84%) with anorexia or feeding dif-ficulties. 22 cases (4.01%) with poor spirit or weak, 10 cases (1.82%) with crying or abdominal pain;6 cases (1.09%) with dark urine; 4 cases (0.73%) with skin and/or sclera jaundice, 2 cases (0.36%) with bleeding tendency. Children in mildly elevated ALT group recovered faster than in moderate-to-severe elevated ALT group. Conclusions Mildly elevated ALT was most common in pneumonia with elevated ALT which was more likely to occur in younger age group. Clinical mani-festations were often non-specific with good outcomes.

Objective To investigate the influence of follow-up treatment compliance on prognosis after gastroesophageal varices treated under endoscopy.Methods Up to 416 liver cirrhosis patients after gastroesophageal varices treated under endoscopy were follow-up and divided into compliance group and control group according to whether the patients had follow-up treatment compliance condition.The factors caused the difference of follow-up treatment compliance were analyzed.The differences in the follow-up indexes such as rebleeding,mortality,rehospitalization were compared between the two groups.The differences in indexes between two groups were stratifiedly analyzed according to liver function Child-Pugh classification.Chi-square four data table test was for two independent samples comparison.Results The differences of education level,income and the medical condition of residential area determined the difference of follow-up compliance.After gastroesophageal varices patients treated under endoscopy,the total rebleeding rate was 35.1 ％ (146/416) and and the mortality rate was 9.4％ (39/416).The rebleeding rate and mortality rate of the compliance group were significantly lower than those of control group (26.1％ (61/234) vs 46.7％(85/182),x2=19.137,P＜0.01; 6.4％(15/234) vs 13.2％(24/182),x2=5.533,P=0.019).Among the 273 Child-Pugh A level patients,the detection rate of liver cancer (3.7％,10/273),liver transplantation rate (3.7％,10/273),splenectomy plus portal azygous disconnection rate (6.6％,18/ 273) of compliance group were higher than those of control group (x2 =4.086,P =0.043; x2 =4.086,P=0.043; x2 =5.515,P=0.019).Among the 102 Child-Pugh B level patients,there were statistical differences between compliance group and control group in rebleeding rate (x2 =21.297,P＜0.01),motality (x2=3.525,P=0.042),ascites (x2=4.451,P=0.035),life quality (x2 =10.454,P=0.001) and liver function (x2 =8.197,P=0.004).However,there were no statistical differences in all indexes between the two groups of Child-Pugh C level patients (all P＞0.05).Conclusion To improve the follow-up treatment compliance remarkably,decreased the rebleeding rate and mortality,contributed to early detection of liver cancer and early liver transplatation,thus the prognosis was improved consequently.