Objective To select the indexes of forensic identification in digital orthopantomogram and formulate the full dentition pattern code.Methods To collect randomly 620 samples with dental interventions and 150 samples with dental pathological changes but without therapy.Then to observe and compare them respectively,select indexes for full dentition patterns according to the dental physiological variations,pathological changes and interventions Finally the diversity of the full dentition patterns in two groups would be evaluated by statistical analysis.Results The group with dental interventions had 619 kinds of dental pattern in 620 samples,its diversity of full dentition patterns was 99.84%.The group with dental pathological changes but without therapy had 146 kinds of dental pattern in 150 samples,thus its diversity of full dentition patterns was 97.33%.Conclusion These full dentition pattern indexes were valuable in the forensic identification of persons with abnormal teeth.

Objective To evaluate the effect of endoprostheses for short and long term management of common bile duct stones in elderly patients(70 89 years). Methods Fifty two patients over 70 years with common bile duct stones undergone endoscopic biliary stenting(Group S, 28 cases) or common bile duct exploration (Group D, 24 cases) were followed up for 14 85 months. The two groups were similar to each other in clinical manifestations. Results One patient (4 2%) died because of breath and circulation exhausting on the 3rd day postoperation in Group D. Early complications were 14 4% and 33 3% respectively ( P

Objective To explore the feasibility and short-term efficacy of combined use of laparoscopic and thoracoscopic Ivor Lewis esophagectomy for the treatment of esophageal carcinoma.Methods A case of esophageal carcinoma was treated in our hospital in December 2007.Five trocars were used via laparoscopy to free the stomach and create a tube-like stomach.Afterwards,thoracoscopy was carried out via 4 trocars to remove the lesion and open the diaphragm,and then the tube-like stomach was pulled into the chest cavity and anastomosed to the chest wall.Results The operation time was 330 min,and the intraoperative blood loss was 200 ml.The lesion was removed completely with negative cutting edges.Postoperative pathological examination showed squamous cell carcinoma(stage T2N0M0).Follow-up was available for 3 months,during which no recurrence was found.Conclusion Laparoscopic and thoracoscopic Ivor Lewis esophagectomy is feasible and safe for the treatment of esophageal carcinoma.

The hospital grade assessment is an effective approach to measure the comprehensive strength and the overall level of a hospital, and it is also an effective carrier which can promote the standardized management , improve the quality of connotation and accelerate the development of the hospital .This article aims to expound the effective and concrete methods for preparation in the hospi -tal grade assessment by introducing the practice and experience of Jinling Hospital in grade assessement .It also points out that:defi-ning the purpose of the assessment is the fundation , having a thorough grasp of the assessment criteria is the basis , having a compre-hensive knowledge of the hospital is the premise , establishing and implementing the plan strictly is the crux .All these might be helpful to promote the hospital grade assessment .

Objective To quantify the concentration of peripheral blood plasma neutrophil gelatinase-associated lipocalin (NGAL) in patients with acute pancreatitis (AP) and to explore its value in assessment of the severity of AP.Methods From June 2011 to March 2012,83 patients with AP were selected,among those 43 cases were mild acute pancreatitis (MAP) and 40 were severe acute pancreatitis (SAP).The control group included 30 healthy individuals.The peripheral blood of patients with AP and healthy controls was collected,and plasma was isolated after centrifuged.The concentration of NGAL in plasma was detected by enzyme-linked immunosorbent assay (ELISA).The t-test was performed for comparison between groups.The correlation between the concentration of NGAL in plasma and clinical parameters of AP was analyzed by Spearman rank order correlation analysis.The diagnosis value of the concentration of NGAL in SAP was evaluated by receiver operating characteristic (ROC) curve and area under the curve (AUC).Results The concentration of plasma NGAL in AP group ((10.30± 5.97)nmol/L) was higher than that in healthy control group ((1.94±1.35) nmol/L) and the difference was statistically significant (t=11.924,P＜0.01).The concentration of plasma NGAL in SAP group ((14.61 ±5.28) nmol/L) was higher than that in MAP group ((6.27±-3.09) nmol/L) and healthy control group,the differences was statistically significant (t=8.677 and 14.539,both P＜0.01).The concentration of plasma NGAL of AP patients was positively correlated with acute physiology and chronic health evaluation-Ⅱ score,Ranson score,bedside index for severity in acute pancreatitis score,computed tomography (CT) severity index,C-reactive protein,white blood cells and the days of hospitalization (r=0.651,0.556,0.514,0.620,0.320,0.458 and 0.346,all P＜0.05).The area under the ROC curve of plasma NGAL concentration in diagnosis of SAP was 0.926 (95％CI:0,870-0.983).The cutoff value of plasma NGAL level in diagnosis of SAP was 8.44 nmol/L.The sensitivity and specificity was 87.5 ％ and 88.9％,respectively.Conclusions Plasma NGAL level is correlated with the severity of patients with AP.NGAL may be one of the markers for the early diagnosis of SAP.

OBJECTIVE:To provide reference for clinical prevention and treatment of ceftizoxime-induced hemolytic anemia by investigating the situation of ceftizoxime-induced hemolytic anemia. METHODS:Using Chinese and English“ceftizoxime”“he-molysis”and other words as key words,related literatures during 1986-2015 were retrieved from CNKI,Wanfang database and PubMed database. Those literatures were analyzed statistically in respects of general information,clinical drug use and manifesta-tion,occurrence time and outcome,etc. The mechanisms of hemolytic anemia were analyzed to put forward prevention and treat-ment measures. RESULTS & CONCLUSIONS:A total of 11 literatures were retrieved,including 4 foreign literatures and 7 domes-tic ones. There were 15 cases in total,including 5 foreign cases and 10 domestic cases. According to the patient’s age,there were 7 cases of infants,4 cases of the elderly,3 cases of middle-aged people and 1 case of youth. The hemolytic anemia often occurred on the 2-7 day(8 cases). Most of the patients were improved after treatment,but there were 3 patients who died. The mechanism of hemolytic anemia mainly included the production of immune complex and non-immunologic protein adsorption. It is suggested to investigate allergic reaction history,pay attention to sensitization test on skin,select suitable drug dosage and avoid drug combina-tion. The patient’s medications should be monitored closely. Once hemolytic anemia occurs,it should be immediately stop using the drug and take appropriate measures as hormone treatment,comprehensive treatment,blood transfusion treatment,to avoid en-dangering the life safety of patients.

To observe the analgesic effects of morphine and bupivacaine for the patient controlled epidural analgesia (PCEA) after prostatectomy. Methods: 21 patients after receiving prostatectomy were treated with PCEA including morphine and bupivacaine, and 24 patients were treated with routine analgesia as control. The effects of analgesia with visual analogue scale (VAS) were evaluated indirectly, and episodes of bl adder spasm were recoreded. Results: The effects of PCEA on postoperative analgesia and controlling bladder spasm were much better than that of routine analgesia. Conclusion: Effects of morphine and bupivacaine used in PCEA for post-prostatectomy analgesia are confirmed adm inistration is slimple. Because of their dosage is smalller and side effects are fewer, this treating protocol is beneficial for the recovery of the patients re ceiving prostatectomy.

Aims To study the effects of diterpenoid pekinenal of Euphorbia pekinensis Rupr. on cell prolif-eration, cell cycle phase and apoptosis of hepatoma SMMC-7721 cells and to probe into its anti-cancer mechanisms. Methods MTT assay was used to inves-tigate the effect of pekinenal on proliferation of SMMC-7721 cells; TUNEL method, Annexin V/PI staining and electron microscopy were employed to observe the cell apoptosis; Flow cytometry was applied to analyze the distribution of cell cycle. Results Proliferation of SMMC-7721 cells was markedly inhibited by pekinenal in a dose-dependent manner; Annexin V/PI staining showed that with the increase of pekinenal concentra-tion, apoptotic rate of SMMC-7721 cells increased sig-nificantly, compared with control group, the difference has significant statistical significance ( P < 0. 01 ) . TUNEL method test results showed that different con-centrations of pekinenal in SMMC-7721 cells could in-duce liver cancer cell apoptotic and apoptotic index ( AI) increased significantly ( P <0. 01 ) with the in-crease of drug concentration. Compared with control group, electron microscope found that after the treat-ment, hepatocyte mitochondrial swelling, endoplasmic reticulum expansion, cytoplasm inclusion body forma-tion, part of the nucleus apoptosis, and the more obvi-ous apoptosis appeared with the increase of drug con-centration. Flow cytometry analysis showed that differ-ent concentrations of pekinenal could all make the cell block in S phase. Conclusion Pekinenal has an obvi-ously inhibitory effect on the human liver cancer cells, and there is significant concentration dependence; Pe-kinenal probably inhibits cancer cell DNA synthesis for the human liver cell cycle arrest in S phase and inhibits the proliferation . It plays a role in liver cancer inhibi-tion by inducing liver cancer cells apoptosis, etc.

Objective To evaluate the clinical value of bedside index for severity in acute pancreatitis (BISAP) and APACHEⅡ score in predicting the severity and organ failure of acute pancreatitis (AP).Methods One hundred eighty-five patients of AP admitted to Department of Gastroenterology of First affiliated Hospital of Soochow University from January 2012 to December 2014 were studied retrospectively.According to BISAP score, patients who were ≥3 points were considered as high risk group, while ＜3 points were considered as low risk group.According to APACHEⅡ score, patients who were ≥ 8 points were considered as high risk group, while ＜ 8 points were considered as low risk group.According to the criteria of Pancreatic Diseases Group of Chinese Society of Gastroenterology of Chinese Medical Association, the patients were diagnosed as mild acute pancreatitis (MAP), moderately severe acute pancreatitis (MSAP), and severe acute pancreatitis (SAP).The BISAP, APACHEⅡ scores were calculated and compared between MAP group and MSAP + SAP group, respectively.The incidence of MSAP + SAP between high risk group and low risk group was also compared.The area of ROC curve (AUC) was used to evaluate the ability of BISAP and APACHEⅡ scoring system for predicting the severity of AP and the multiple organ dysfunction syndromes (MODS).Results Among 185 patients, MAP was identified in 101 patients, MSAP in 76 patients and SAP in 8 patients.Twenty-five MSAP patients developed organ dysfunction, and all the 8 SAP patients developed organ dysfunction.The BISAP scores of MSAP + SAP group and MAP group were (1.43 ± 0.89), (0.38 ± 0.61),andAPACHⅡ scores were (2.45± 1.36), (0.87± 0.62), the scores of MSAP+ SAP group were significantly higher than those in MAP group (P ＜0.01).In the 137 patients of low risk BISAP group, there were 47 MSAP + SAP patients (34.3％), while in the 48 patients of high risk BISAP group, there were 37 MSAP + SAP patients (77.0％);in the 153 patients of low risk APACHEⅡ group, there were 56 MSAP + SAP patients (36.6％), while in the 32 patients of high risk APACHEⅡ group, there were 28 MSAP + SAP patients (87.5％);the incidence of MSAP + SAP patients was significantly higher in high risk group than that in low risk group (P＜0.01).The AUC of BISAP, APACHEⅡ for MSAP+ MAP was 0.804 (95％ CI 0.738 ～ 0.870), 0.794 (95％ CI 0.725 ～ 0.863), and the AUC for organ dysfunction was 0.758 (95％ CI 0.686 ～0.830), 0.781 (95％ CI 0.710 ～0.852) , and the difference between BISAP and APACHE Ⅱ was not statistically significant (P ＞ 0.05).Conclusions The BISAP has the prediction ability for AP severity and prognosis similar to APACHEⅡ , and it consists of only 5 parameters and can be completed in the first 24 h of admission, therefore it is worth of clinical application.

Objective To investigate the relationship between interleukin-18(IL-18)and the pathogenesis of type 2 diabetes melli-tus.Methods 72 healthy Sprague-Dawlay male rats were randomly divided into four groups, NC group,NCS group,HF group and HFS group.At the end of the 8th week,NCS group and HFS group were injected with STZ(25mg/kg)into abdominal cavity.At the end of the 10th week,diabetic rats were screened by oral glucose tolerance test(OGTT).The blood sample was collected when the rats were killed at the end of the 14th and 20th week.The levels of serum IL-18,IL-6 and tumor necrosis factor-α(TNF-α)were assayed with ELISA.Results Most rats in HFS group were achieved the diagnostic standard of diabetic rat, and their insulin sensitivity index(ISI)were decreased.At the end of the 14th week and 20th week,the levels of serum IL-18,IL-6 and TNF-α in HFS group were significantly higher than those in NC group(P＜0.01).In HFS group,the levels of serum IL-18,IL-6 and TNF-α at the end of the 20th week were higher than those at the end of the 14th week,but it had no statistic significance(P＞0.05).Pearson linear correlation analysis showed that the level of serum IL-18 in HFS group was positive correlated with FBG,IL-6,and TNF-α(r=0.90,P＜0.01 or r≥0.73,P＜0.05),and negative correlated with ISI(r=-0.86,P＜0.01).Condusions Our results show that IL-18 is related with the pathogenesis of type 2 diabetes mellitus and chronic inflammation plays an important role in the development of type 2 diabetos mellitus.