Objective To explore the application value of transient elastic wave scanner in the diagnosis of chronic hepatitis B (CHB) patients with liver fibrosis.Methods 124 patients with CHB were randomly selected.The instantaneous elastic wave scanner (LSM) was taken in patients with liver stiffness measurement,an average of 10 consecutive measurements of the value,and the abdominal MRI examination and the indicators of serum fibrosis of the patients were checked.The coincidence rate of the diagnosis of the two kinds of examination was compared.Results The LSM value of patients with severe liver fibrosis was (24.65 ± 8.54),which was significantly higher than (5.46 ± 2.11) of patients with mild liver fibrosis and (8.96 ± 6.75) of patients with moderate hepatic fibrosis,the differences were statistically significant(t =12.871,8.254,all P ＜ 0.05).The LSM value between serum liver fibrosis and spectrum diagnosis rate was 87.8％,with abdominal MRI examination of patients,results suggested that the two cirrhosis diagnosis coincidence rate was 79.2％,the difference was statistically significant (x2 =2.866,P ＜ 0.05).Conclusion The clinical value of the instantaneous elastic wave scanner is high in the diagnosis of hepatic fibrosis in patients with CHB,with no trauma to the patients,the diagnosis coincidence rate is high,easy to be accepted,it is worthy of widely used.

Objective Using microcentrifugation method (method 1) as the reference method ,to evaluate the consistency of the hematocrit (HCT ) results detected by different types of blood cell analyzers[Sysmex800i (method 2) ,Sysmex1000i (method 3) , XE-2100D (method 4)] .Methods 63 cases of fresh whole blood samples were collected and detected by three blood cell analyzers and method 1 .And the three blood cell analyzers had been calibrated before the tests .Results The correlation analysis of HCT re-sults of method 2 ,method 3 ,and method 4 with method 1 showed the coefficients were 0 .874 4 ,0 .951 2 and 0 .955 5 ,respectively . Using method 1 as the reference method ,the clinical acceptability of three blood cell analyzers were evaluated .The HCT result de-tected by method 4 was unacceptable at two clinical decision levels .Conclusion Investigating the comparability among different blood cell analyzers regularly can effectively guarantee the reliability of test results .

Objective To investigate the correlation between vitamin E and community acquired pneumonia (CAP) .Methods A total of 128 cases of CAP(CAP group) and 135 people undergoing the healthy physical examination (excluding CAP ,control group) in our hospital from Jan .2016 to Dec .2016 were chosen .Each group was divided into the age subgroups of 0-17 years old ,18-40 years old and 41-65 years old .Vitamin E ,Chlamydia pneumoniae(CPn) and mycoplasma pneumoniae(MP) were detected in all the subjects .Then the obtained data were statistically analyzed .Results The average vitamin E was (15 .43 ± 4 .37)mg/L in the control group and (6 .37 ± 3 .24)mg/L in the CAP group ,the difference between the two group was statistically significant(P<0 .05) .In the control group ,there were 7 cases of MP positive and 6 cases of CPn positive .In the CAP group ,there were 32 cases of MP posi‐tive and 25 cases of CPn positive .The differences of MA and CPn positive between the two groups were statistically significant(P<0 .05) .The vitamin E levels in the 0 -17 years old ,18 -40 years old and 41 -65 years old subgroups of the control group were (14 .75 ± 4 .12) ,(16 .42 ± 4 .35) ,(16 .42 ± 4 .35)mg/L respectively ,while which in the various subgroups of the CAP group were (5 .43 ± 3 .18) ,(7 .74 ± 3 .65) ,(7 .74 ± 3 .65)mg/L respectively ,the difference in different age groups between the two groups was statistically significant(P<0 .05) .Conclusion Maintaining a high level of serum vitamin E level could effectively prevent CAP .

Objective To assess the effect of nicotinic acid on hyperphosphatemia in maintenance hemodialysis (MHD) patients.Methods Twenty-six MHD patients with stable disease condition and hyperphosphatemia that could not be successfully controlled by conventional methods were selected.All patients were treated with oral nicotinic acid for 20 weeks.The changes of serum calcium,high sensitivity Creactive protein (hs-CRP),albumin (ALB),aspartate aminotransferase (AST),alanine aminotransferase (ALT),gamma-glutmyltransferase (GGT),total bilirubin (TBIL),derect bilirubin (DBIL),high density lipoprotein cholesferol (HDL-C),low density lipoprotein cholesferol (LDL-C),triacylglycerol (TG),total cholesterol (TC),intact parathyroid hormone,hemoglobin,platelet count,etc were observed before and after treatment.Results Two patients withdrew from this study because.of pruritus and diarrhea after two weeks of oral nicotinic acid.In 24 cases,compared with that before treatment,the serum phosphate,calcium-phosphorus product was decreased [(1.49 ± 0.19) mmol/L vs.(2.13 ± 0.16) mmol/L,(4.40 ± 0.49)mmol2/L2 vs.(5.45 ± 0.36) mmol2/L2] and HDL-C was increased [(1.45 ± 0.14) mmol/L vs.(1.18 ± 0.15)mmol/L] after treatment,and there was significant difference (P ＜ 0.05).There was no significant difference in the serum calcium,iPTH,LDL-C,TG,TC,ALB,AST,ALT,GGT,TBIL,DBIL,hs-CRP,platelet count,hemoglobin between before and after treatment (P ＞ 0.05).Conclusions Nicotinic acid is effective as all adjuvant measure in control of hyperphosphatemia in patients on MHD and can increase HDL-C.It provides a new approach for the treatment of hyperphosphatemia.

Objective To observe and analyze the clinical efficacy of docetaxel and S-1 in treatment of anthracycline-resistant triple-negtive breast cancer(TNBC).Methods 64 cases with TNBC admitted in People' Hospital of Shaoxing City from June 2009 to June 2011were selected as research object.The clinical data of these cases were analyzed retrospectively.Anthracycline had been used to treat the cases, but with no effect or recurrence.Then docetaxel combined with S-1 was applied to the cases.Clinical efficacy and adverse reactions of the chemotherapy were observed and analyzed. Results After treatment,the efficiency of 64 cases was 54.69%,and the disease control rate was 79.69%.During the treatment,the main adverse reactions were gastrointestinal reactions and bone marrow suppression,without death,and patients could tolerate the adverse event.Follow-up results showed that the median time of progression was 10.5 months.After two years,progression-free survival rate was 0.Conclusion Docetaxel combined with S-1 has good clinical efficacy for anthracycline-resistant triple-negtive breast cancer,with relatively mild side effects,which may be an ideal adjuvant chemotherapy method.

Objective To investigate the up regulation of captopril on the platelet nitric oxide(NO) synthase and clinical application in patients with ischemic stroke.Methods The washed platelets in vitro of the patients with acute ischemic stroke and healthy controls were added with oxidized LDL(oxLDL) and captopril followed by measurement of platelet NO synthase activity.Plasma oxLDL,NO sythase,NO and platelet NO sythase,NO in 40 patients were measured before oral captopril and after oral captropril 1 month,3 months.Results (1)After the washed platelets in vitro were added with oxLDL,the platelet NO synthase activities of the patients and controls were all significantly decreased( P

0.05), respectively, the antidiarrheal rates of which on the first 3 days were 94% and 71%(P

Objctive To investigate the zymogenic state and drug resistance of multi-drug resistant Pseudomonas aeruginosa (MDRP) for providing a laboratory basis of combined use of drugs against MDRP in clinical practice. Methods All isolates were isolated by routine procedures and identified by VITEK-2 automatic bacterial identification instrument. Following the CLSI instruction, doubling dilution in agar plates was performed for MIC detection. Results MDRP were 22.77% ( 86.96% for sputum) from 101 strains Pseudomonas aeruginosa, which were isolated from clinical specimens. Positive rates of MDRP producing metallo-?-lactmases were 91.3%, positive rates for producing induced Ampc and plasmid Ampc ?-lactamase were 52.17% and 21.74%, respectively. The ratio between Meropenem and Imipenem higher then 1 was 34.78%. The bacterial inhibitory rates of Polymyxin B and Imipenem were zero, that of Amikaein and Ceftaxidime were 4.35%, that of Ciprofloxacin and Cefoperazone/sulbactam were 43.48%, that of Pazufioxacin and Piperacillin/Tazobactam were 21.74% and 26.07%, and that of Meropenem was 47.83%. The combined use of Cefoperazone/sulbactam, Cefpirome, Piperacillin/Tazobactam with Amikacin resulted in bacteriostatic rate of 65.2%, 47.8%, 43.5%, respectively. Conclusoins MDRP is main micro-organism found in respiratory tract specimens. Drug resistance of MDRP is related to multiple drug-resistant mechanisms. Clinicians should first select enzyme inhibitory-drug (Cefoperazone/sulbactam or Piperacillin/Tazohaetam) with Amikacin or Polymyxin B to treat clinical MORP infection, and re-adjust the type of antibiotics rationally according to patients' symptoms, phenotype of the drug-resistant pathogen, the results of drug susceptibility test, and the effect on the patients.

Objective To explore differences of drug resistance of temozolomide(TMZ) on different CD133 immune prototype of glioma cells and study on the changes of their sensitivity to TMZ through increased PUMA. Methods CD133+-U87MG cells sorted by CD133 magnetic beads were cultured in serum-free stem cell medium respectively. The cells were infected with recombinant adenovirus, Ad-PUMA, diluted in cell culture medium with or without TMZ intervention.The inhibitory rate of cell proliferation was detected by MTT assay and 50 ％ inhibition concentration of TMZ was calculated. Apoptosis rates of CD133+-U87MG cells were assessed by flow cytometry (FCM) before and after intervention of exogenous PUMA and TMZ.Results The TMZ IC50 values of CD133+glioma cells were higher than that of CD133- glioma cells. There were significant differences in apoptosis rate between CD133+ glioma cell and CD133- glioma cell (all P＜0.05).Conclusion AdPUMA joint TMZ can promote glioma stem cells apoptosis, thus improve the sensitivity to chemotherapy of glioma.

A 38-year-old man complained of multiple papules and nodules in the left retroauricular region for 38 years. On physical examination, there were tens of irregularly sized, skin-colored or pink papules and nodules in the left retroauricular region. Pathological examination showed a large irregularly shaped unilocular cystic space surrounded by a fibrous pseudocapsule in the dermis. The cystic space was lined by a double layer of epithelial cells, including an outer layer of flattened vacuolated myoepithelial cells and an inner layer of cuboidal or columnar secretory cells with eosinophilic cytoplasm. Apocrine secretion was present. Numerous hyperplastic apocrine glands were seen in the deep dermis. A final diagnosis of multiple apocrine hidrocystomas accompanied by apocrine hyperplasia was rendered based on the clinical and pathological presentations.