Objective To explore the value of the combined detection of serum AFU and AFP on predicting postoperative recurrence of hepatocellular carcinoma. Methods Three groups were classified as pathological observation group, pathological control group and health control group. AFU was detected by ratio colorimetric method with the AFU>40 U/L defined as positive values. AFP was detected by microparticle enzyme immunoassay with AFP> 13.6 μg/L defined as positive values. Results AFU and AFP level of the pathological observation group were significantly different compared with the pathological control group and health control group(P <0.001). AFU and AFP level of the pathological control group were higher than those in the health control group, but no significant difference (P >0.05). For the pathological observation group, the level of AFU and AFP after recurrence were significantly different than that before (P <0.001). As to the sensitivity and accuracy of method, AFU + AFP and AFU or AFP were significantly different (P <0.001). There was no significant difference between AFU and AFP(P >0.05). As to the specificity of method, there was no significant differences among AFU+AFP, AFP and AFU (P >0.05). Conclusion The combined detection of serum AFU and AFP levels significantly raised the diagnostic value of liver cancer recurrence. They may applied as a predictor or indicator of postoperative recurrence of hepatocellular carcinoma.

[Objective]To explore the dependability between heredity and hallux valgus.[Method]A total(1 491) cases of family heredity of hallux valgus patients were investigated,the ages of these patients,ages of onset,ages of aggravation,hallux valgus angles were analyzed statistically.[Result]Conclusive family medical history exists in 69.48% of the(1 491) hallux valgus patients.There was distinguished difference between the patients with family history and those without heredity background on visiting ages,ages of onset,ages of aggravation;but no any difference between these two groups of patients on hallux valgus angles.[Conclusion]Heredity factor is the main cause of hallux valgus.It can influence only the onset of hallux valgus,but not the severe degree of latter.The patients with family history are earlier than those without heredity background about visiting ages,ages of onset,ages of aggravation.

Objective To research the surgical technique and curative effect of the posterior cruciate ligament(PCL) anatomical reconstruction with double-bundle hamstring tendons absorbable interference screw fixation via double-tunnel in femoral under arthroscopy. Methods 24 patients, average age of 32 years ranged from 17 to 42 years old, were treated with anatomical reconstruction of PCL through double-tunnel in femoral and one tunnel in tibia with double-bundle hamstring tendons fixed with absorbable interference screw under arthroscopic. The anterolateral bundle was reconstructed with multistranded autograft semitendinosus tendon grafts and was tightend and fixed, at knee flexion 15?-30?. The posteromedial bundle was reconstructed with multistranded autograft gracilis tendon grafts, and was tightened and fixed, at knee flexion 60?-70?. Results All the patients were followed up for a mean time of 9.4 months (6 months-19 months). All the knee joint motion were in normal range, no exhibition of pain and distinct trauma arthritis. The postoperative posterior drawer test, reverse Lachman test, tibia sags sign and reverse pivot shift test were all negative. The postoperative Lysholm score was (92.7?6.4) points, and the postoperative score increased significantly compared with the preoperative (t=3.12, P

Objective To determine the relationship between HBeAg and HBV DNA levels and grading of liver inflammation in patients with chronic hepatitis B. Methods Serum HBeAg and HBV DNA were assayed by MEIA and PCR in 74 patients with HBeAg-negative and 73 patients with HBeAg-positive chronic hepatitis B who had undergone liver biopsy and pathological grading. Results The serum HBV DNA levels in 27 patients(36%) HBeAg-negative chronic hepatitis B were higher 10~5 copies/ml.The number of patient at the HBV DNA level increase along with G1～G4 grading ascendant.The correlation between two factors has statistically remarkable significance.Those serum HBeAg quantitative levels are 0～29 PEIU/ml. The number of HBeAg quantitative-positive patients increase also along with G1～G4 grading ascendant and the correlation between two items has statistically significance.However,there are no relationship between serum HBeAg and HBV DNA and G1～G4 grading in 73 patients with HBeAg-positive chronic hepatitis B whose HBV DNA levels are higher than 10~5 copies/ml. Conclusions Serum HBV DNA level is the indicator by which grading of liver inflammation can be judged in the patients with HBeAg-negative chronic hepatitis B and former is positively interrelated with latter significantly.That Serum HBeAg level is low but HBV DNA duplicate actively may indicate that there is C-zone mutation in 36% patients with HBeAgnegative chronic hepatitis B.Serum HBV DNA level cannot reflect grading of liver inflammation in the patients with HBeAg-positive chronic hepatitis B.

BACKGROUND:Mechanical signal has close correlation with the growth, development, repair and reconstruction of the skeletal system and the development of disease, the effect and the mechanism on bone marrow mesenchymal stem cel s is worthy to concern.
OBJECTIVE:To explore the effect and mechanism of hydrostatic pressures on the differentiation of bone marrow mesenchymal stem cel s.
METHODS:Short-term experiment:the human bone marrow mesenchymal stem cel s were incubated into the normal Dulbecco’s modified Eagle’s medium, osteogenic medium or the Dulbecco’s modified Eagle’s medium containing extracel ular signal-regulated kinase 1/2 inhibitor U0126, respectively. Homemade pressure loading system was used to impose 0, 40 and 80 kPa hydrostatic pressure for 1 and 4 hours. Long-term experiment:human bone marrow mesenchymal stem cel s were incubated into the normal Dulbecco’s modified Eagle’s medium or osteogenic medium respectively, and then 40 kPa hydrostatic pressures was loaded for 4 hours per day, and lasted for 14 days. The cel s without hydrostatic pressure were regarded as the control group.
RESULTS AND CONCLUSION:Real-time quantitative reverse transcription PCR results showed that after osteogenic induction and simulated with 40 kPa hydrostatic pressure for 4 hours, the mRNA expressions of core binding factorα1 and osteocalcin in the bone marrow mesenchymal stem cel s were increased, while the mRNA expressions of peroxisome proliferator-activated receptorγ2 and adipsin were decreased, and the 80 kPa hydrostatic pressure did not cause such reactivity. The osteogenic induction effect of 40 kPa hydrostatic pressure could be partial antagonized with U0126. Histochemical staining showed that after simulated with 40 kPa hydrostatic pressure for 7 days, the expression and activity of alkaline phosphatase of bone marrow mesenchymal stem cel s were increased;after lasted for 14 days, the mRNA expressions of peroxisome proliferator-activated receptorγ2 and adipsin were increased. Certain intensity and duration of hydrostatic pressure stimulation can regulate the differentiation of bone marrow mesenchymal stem cel s, and the mechanism is only partly mediated by the extracel ular signal-regulated kinase 1/2 signaling pathway.

AIM: To investigate the protective mechanism of extract of Ginkgo biloba (EGB) on apoptosis of hippocampus neuronal cells in type 1 diabetic encephalopathic rats. METHODS: Thirty-six male Sprague-Dauley rats were divided into 3 groups: control group, diabetic group and EGB-treated group. Streptozotocin was injected intraperitoneally to the animals in later two groups to induce diabetes. The rats in EGB-treated group were injected intraperitoneally with EGB, and the same volume of normal saline was injected to the rats in other groups. At the end of the 12th week, the spatial learning and memory abilities of rats in each group were examined by Morris water maze test. Blood glucose and serum insulin concentration were measured. The neuron densities in hippocampus were measured by Image-Pro Plus 6.0 software. The expressions of Bax, Bcl-2, caspase-3 were assayed by Western blotting and immunohistochemistry. RESULTS: Compared to control group, the level of blood glucose (P<0.01), the protein expression of Bax (P<0.01) and caspase-3 (P<0.01) in hippocampus neuronal cells, and the ratio of Bax/Bcl-2 (P<0.01) and the escape latency (P<0.01) in diabetic group, were significantly increased, while the serum insulin concentration (P<0.01), the neuronal density (P<0.05) in CA1,CA2 hippocampal regions and the platform searching score (P<0.01) were significantly deceased. After treated with EGB, the serum insulin concentration (P<0.05), the neuronal density (P<0.05) in CA1,CA2 hippocampal regions and the platform searching score (P<0.01) were significantly increased, while the level of blood glucose (P<0.01), the protein expression of Bax (P<0.05), caspase-3 (P<0.05) in hippocampus neuronal cells, the ratio of Bax/Bcl-2 (P<0.01) and the escape latency (P<0.05) were significantly deceased than those in diabetic group. The protein expression of Bcl-2 in hippocampus neuronal cells did not alter in any experimental rats. CONCLUSION: EGB improves the spatial learning and memory capacity in diabetic rats by decreasing the expression of Bax, Bax/Bcl-2 ratio and down-regulating caspase-3 to reduce neurocyte apoptosis and increase the neuron density in CA1, CA2 hippocampal regions, suggesting that effective regulation of neuron apoptosis associated genes may be one of the mechanisms for EGB to treat diabetic encephalopathy.

Objective To study the values of apparent diffusion coefficient (ADC) changing with time and space in cerebral infarction,and to provide the evidence in defining the infarction stages.Methods 117 work-ups in 98 patients with cerebral infarction (12 hyperacute,43 acute,29 subacute,10 steady,and 23 chronic infarctions) were imaged with both conventional MRI and diffusion weighted imaging.The average ADC values,the relative ADC (rADC) values,and the ADC values or rADC values from the center to the periphery of the lesion were calculated.Results The average ADC values and the rADC values of hyperacute and acute infarction lesion depressed obviously.rADC values in hyperacute and acute stage was minimized,and progressively increased as time passed and appeared as "pseudonormal" values in approximately 8 to 14 days.Thereafter,rADC values became greater than normal in chronic stage.There was positive correlation between rADC values and time[ (174 ±3.47)% vs (58±6.75)%,t =2.03,P ＜0.05 ].The ADC values and the rADC values in hyperacute and acute lesions had gradient signs that these lesions increased from the center to the periphery.The ADC values and the rADC values in subacute lesions had adverse gradient signs that these lesions decreased from the center to the periphery.Conclusion The ADC values of infarction lesions have evolution rules with time and space.The evolution rules with time and those in space can be helpful to provide the evidence in guiding the treatment or judging the prognosis in infarction.

BACKGROUND: There is still no satisfactory therapy for thetreatment of cerebral infarction at present. Although sub-hypothermia is effective in the treatment of cerebral infarction, its side effect is relatively more. Local sub-hypothermia might have favorable effects in the treatment of cerebral infarction.OBJECTIVE: To observe the protective effects of local sub-hypothermia on the ischemic brain tissues in rats to further explore its mechanism.DESIGN: A randomized controlled basic study based on the experimental animals.SETTING: Institute of neurology of a university hospital.MATERIALS: The study was conducted in the Animal Laboratory of Neurology, the First College for Clinical Medicine, Harbin Medical University between April 2000 and January 2002. Fifty male Wistar rats(cleanness grade) with a bodyweight of(250 ± 25) g were selected.INTERVENTIONS: Ten rats were randomly selected from the 50 rats and divided into normal group and sham-operation group with 5 rats each. The rest 40 rats were randomly divided into normal temperature cerebral ischemia group and local hypothermia cerebral ischemia group with 20 rats each. Rat cerebral middle-sized arterial ischemia model was established for local sub-hypothermia disposal.MAIN OUTCOME MEASURES: Impacts on cerebral infarction volume,nerve function, and neuron-specific enolase(NSE) of rats in each group.RESULTS: The cerebral infarction volume at 48 hours after embolism in rats was ( 128.95 ± 13.42) or (84.90 ± 11.36) mm3 respectively, nerve function evaluation was( 1.60 ± 0. 24) or (0. 95 ± 0. 17), and serous NSE concentration was(13.55±4.07) or(9.19±3.42) μg/L in either sub-hypothermia group or normal temperature group, which were significantly different from each other.CONCLUSION: Local sub-hypothermia therapy has protective effects on ischemic cerebral neurons.

BACKGROUND:The infection after spinal internal fixation was its serious complications. A number of studies have shown that erythrocyte sedimentation rate and C-reactive protein are of great importance in judging infections. OBJECTIVE:To analyze the trend of change of erythrocyte sedimentation rate and C-reactive protein for patients without infection after the cervical fixation. METHODS:Total y 56 patients, who underwent cervical fixation from October 2013 to July 2014, were retrospectively analyzed, and then divided into anterior cervical group (n=29) and posterior cervical group (n=27). Patients in the anterior cervical group underwent anterior cervical decompression bone graft internal fixation. Patients in the posterior cervical group underwent posterior cervical unilateral open door decompression internal fixation. The peripheral blood was col ected before fixation and at the early morning of the 1, 3, 6, 9 days after fixation. Erythrocyte sedimentation rate and C-reactive protein values were determined. The fol ow-up of patients was more than one year. Signs of infection did not appear. RESULTS AND CONCLUSION:(1) General rule:After the cervical fixation, the erythrocyte sedimentation rate was increased significantly and reached a peak on postoperative day 6. The peak level gradual y decreased but has not returned to normal at the 9 postoperative days. The C-reactive protein increased significantly on the first postoperative day and reached a peak on postoperative day 3. The peak level rapidly decreased but has not returned to normal at the 9 postoperative days. The level of erythrocyte sedimentation rate of patients in the posterior cervical group was significantly higher than that in the anterior cervical group at 3, 6 and 9 days after internal fixation (P<0.05). There was no significant difference in the C-reactive protein between these two groups (P>0.05). (2) These results demonstrate that C-reactive protein is an important indicator of monitoring the inflammatory response of patients after cervical internal fixation, which was conductive to the judgment of early infection after internal fixation. The abnormal inflammatory indices of erythrocyte sedimentation rate and C-reactive protein do not suggest a presence of blade infection after internal fixation. C-reactive protein can reach the peak at 3 days after fixation. It is recommended to check blood at 2 and 3 days. If there is no apparent rebound, then the possibility of infection is smal . It may indicate the presence of infection if the inflammatory indices increased again or decreased slowly after the decrease.

Objective To investigate the clinical and imaging features of mild encephalitis/encephalopathy with a reversible splenial lesion of corpus callosum (MERS) in children.Methods Four patients of MERS, who were diagnosed and treated in the First Hospital of Jilin University during 2013-2014, were collected retrospectively.Their clinical, laboratory, radiologic data and the related literatures were reviewed.Results Four patients onsetted as gastrointestinal symptom (3 cases) or respiratory (1 case) symptom, in accompany with disturbance of consciousness (3 cases of drowsiness, 1 case of lethargy), convulsions (4 cases), headache (1 case) as the main symptoms.Abnormal neurological signs included positive cervical resistance (3 cases), positive bilateral Babinski sign (3 cases), bilateral chemosis (2 cases).Laboratory test showed the average blood sodium was 131.6 mmol/L, while the cerebrospinal fluid test only showed abnormality in 1 case.In etiology examination, 2 cases showed human rotavirus antigen positive, and Mycoplasma pneumoniae antibody was found positive in 2 cases.Cranial MRI showed reversible lesion in the splenium of corpus callosum (patchy iso-or hypo-intensity on T1 WI and apparent diffusion coefficient, hyper-intensity on T2WI, FLAIR and DWI, clear boundary).After active treatment, clinical symptoms disappeared within 1 week, and cranial MRI lesions disappeared within 2 weeks.Conclusion The clinical presentations of MERS, which is a clinical-radiological syndrome, are sudden onset and mild, with characteristic changes in brain MRI and good prognosis.