Objective To study whether ANCA liter is sensitive serological marker reflecting vasculitis disease activity. Methods MPO-ANCA and IF-ANCA tilers variation in five sera specimen with active MPA diseases were studied after methylprednisolone and cyclophosphamide pulse therapy. The clinical and pathological features of 5 patients with MPA were investigeted comparing pre-treatment with post-treatment. Results (1) Serum ANCA were found positive and increased liter in 5 patients wilh active MPA disease. (2) Titer decreased after Ireatment, while renal function improved. (3) After half year, MPO-ANCA was negative in 5 patients, IF-ANCA was negative in 2 patients. Conclusion There is a close correlation between serum ANCA titer and MPA renal disease activity.

Objective To investigate the safety and validity of Neptune 3D-RTPS-A treatment planning system compared to Prowess TPS.Methods A total of 30 clinical tumor cases with radiotherapy planning on Prowess TPS from September 2009 to May 2010 were used.The contours, organs at risk and target volumes in Prowess TPS were transported into Neptune TPS, the same parameters setted in the two treatment planning systems.The results of comparison of the two TPS were calculated.Results All cases of clinical treatment planning were completed successfully by Neptune TPS, and the various functions of the design were achieved for fitting tumor conformal radiation therapy.The key parameters on radiation treatment were compared.The results are as follows:the differences of source skin distance ( SSD ) ＜0.5% , differences of Monitor Unites ＜0.5%, the differences of dose at isocenter ＜2%, the differences of five isodose lines surrounding area ＜ 3%, and the mean difference of distances of five isodose lines was 0.43 mm, the differences of the volume of PTV on 90% isodose line ＜ 2%, and the differences in V30of organs at risk ＜ 3%.Conclusions Neptune TPS could be qualified for clinical validity and safety by clinical verification.

ObjectiveTo evaluate result of palliative operation for hilar cholangiocarcinoma. Methods The clinical data of 179 cases of cholangiocarcinoma during the last 20 years were analysed retrospectively. Results The operative mortality rate was 10 1%, there was no significant difference between the groups. The rate of cholangitis after operation in the Roux en Y choledochjejunostomy group (15 1%) and bridge internal drainage group (10 0%) was significantly lower than that of PTCD (or ERBD) internal drainage group (35 7%, P

Objective To explore the influence of different lengths and contents of glass-fiber post on the fracture resistance of teeth, and to investigate the optimal length and content of glass-fiber post used for restorative treatment. Meth-ods Forty-two intact single canal mandibular premolars were collected from orthodontic patients and were divided into three experimental groups (A, B and C). All the teeth were endodontically treated after cut off the crowns from the 2 mm above cemento-enamel junction. The post lengths were10 mm in A group, 8 mm in B group, and 6 mm in C group.There were two subgroups for each experimental group (A1, A2, B1, B2, C1, C2 ), 7 teeth for each subgroup.The 42%glass fiber post was used in A1, B1 and C1 groups. The 75%glass fiber post was used in A2, B2 and C2 groups. All of groups were restored with resin cores and metal crowns. The fracture resistance was measured with universal testing machine and recorded the root frac-ture pressure data and the mode of all the teeth. Results The fracture resistance was significantly higher in group A than that of group B and group C (P<0.05), and the fracture resistance was significantly higher in group B than that of group C (P<0.05). The fracture resistance was significantly higher for 75%glass fiber post than that of 42%glass fiber post (P<0.05). Conclusion Within a certain range, the longer the length of glass fiber post, the greater the tooth fracture resistance. The fracture resistance of fiber content is better for 75%glass fiber post than that of 42%glass fiber post.

Objective To evaluate prognostic value of pentraxin3 (PTX3) content combining with extravascular lung water index (EVLWI) in patients with sepsis.Methods A retrospective analysis of complete clinical data of septic patients admitted to Department of Critical Care Medicine of the First Affiliated Hospital of Zhengzhou University from February 2013 to February 2014 was conducted.These patients were divided into two groups,survival group and death group,according to the outcome on the 28th day.Pulse index continuous cardiac output (PiCCO) was used to record the levels of EVLWI on the 1st,2nd and 3rd day of intensive care unit (ICU) admission.The plasma level of PTX3 was measured simultaneously by enzyme-linked immunosorbent assay (ELISA).At the same time,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and sequential organ failure assessment (SOFA) were calculated.Correlation analysis between plasma PTX3 and EVLWI values was performed,receiver operating characteristic curve (ROC) was drawn,and the prognostic value of each parameter was assessed finally.Results A total of 74 septic patients were enrolled,with 41 cases in the survival group and 33 cases in the non-survival group.Blood lactate,APACHE Ⅱ,SOFA scores in the non-survival group were significantly higher than those of the survival group at ICU admission,and the length of ICU stay was significantly shorter than that of the survival group,while differences of the other clinical characteristics between two groups were not statistically significant.The plasma PTX3 level gradually declined with time in both groups,and plasma PTX3 at 1,2,3 days after ICU admission in non-survival group were significantly higher than those in survival group [PTX3 (μg/L) at 1 day:46.3± 10.5 vs.19.4±6.5,t =-13.486,P =0.000; 2 days:34.8± 10.7 vs.17.7±8.4,t =-8.284,P =0.000; 3 days:23.9± 11.2 vs.15.6 ± 7.9,t =-5.036,P =0.000].EVLWI gradually declined in survival group,but increased in death group.EVLWI at 1,2,3 days after ICU admission in non-survival group were significantly higher than those in survival group [EVLWI (mL/kg) at 1 day:12.12 ± 4.31 vs.10.02 ± 2.87,t =-2.502,P =0.023; 2 days:13.67 ± 4.95 vs.9.08 ± 2.89,t =-5.188,P =0.000; 3 days:14.51±5.06 vs.8.09±2.50,t =-7.126,P =0.000].PTX3 at 1,2,3 days after ICU admission showed a significant positive correlation with EVLWI (r1 =0.747,r2 =0.719,r3 =0.705,all P =0.000).ROC curve analysis showed that the area under the ROC (AUC) of PTX3 at 1 day was 0.845 ± 0.045,at the cut-off point of 23.0 μg/L,PTX3 showed a sensitivity of 84.8％,a specificity of 74.1％,a negative predictive value of 85.81％,and a positive predictive value of 72.42％.AUC of EVLWI at 3 days was 0.838 ± 0.048,at the cut-off point of 10.5 mL/kg,EVLWI showed a sensitivity of 83.9％,a specificity of 82.9％,a negative predictive value of 86.45％,and a positive predictive value of 79.79％.Their sensitivities and specificities were found to be better than APACHE Ⅱ,SOFA score.AUC of PTX3 combined with EVLWI at 1 day was 0.886 ± 0.038.On the 1st day after ICU admission,with combination of the two indicators,cut-off point was found to be 0.312,a sensitivity of 86.8％,a specificity of 85.4％,a negative predictive value of 88.93％,and a positive predictive value of 82.72％.On the 3rd day after ICU admission,AUC of PTX3 combined with EVLWI was 0.856 ± 0.046,and showed a cut-off of 0.471 for the prognosis of sepsis,a sensitivity of 85.8％,a specificity of 85.4％,a negative predictive value of 87.97％,and a positive predictive value of 82.50％.Compared with other single index,a combination of above mentioned two indexes showed a better sensitivity and specificity.Conclusions PTX3 can serve as a novel prognostic indicator at early stage in septic patients.Combined with EVLWI,it shows important value in predicting prognosis of septic patients,and it also provides guidance in treatment of high-risk patients.

The full name of the polycystic liver disease is autosomald ominant polycystic liver disease.Surgical treatment is the main method to deal with it at present.With the deep study of the polycystic liver disease into the molecular genetic level,it is possible for molecular diagnostics to achieve presymptomatic and prenatal diagnosis.The article mainly introduce the research progress of the polycystic liver disease's etiology,pathogenesis,diagnosis,treatment,and so on.

Objective To establish the solid phase extraction (SPE) with GC/MS technology for fish poi-soning cases to determine five pesticides in fishpond. Methods By three solid phase extraction column including Oasis HLB cartridge, Bond Elut C18 and SampliQ C18, the recovery rate was compared to ex-tract and purify five pesticides in fishpond. The effects of different kinds and dosages of eluents on ex-tract rate were also reviewed. Results Using Bond Elut C18 as solid phase extraction column and 3 mL benzene as eluent, the linear range of mass concentration of five pesticides in fishpond was 1-50 μg/mL, and the correlation coefficient was 0.996 2-0.999 6. The limit of detection was 3.4-26 μg/L and the re-covery was 61.49%-102.48%. The relative standard deviations was less than or equal to 3.01%. Conclu-sion With high sensitivity, good accuracy and precision, SPE -GC/MS has simple and quick operation and less solvent. It can be applied to determination of five pesticides in fishpond.

Objective To evaluated the feasibility and accuracy of obtaining the myocardial perfusion image and coronary artery image of pig models of acute myocardial infarction by the second generation dual-source CT dual-energy myocardial perfusion one-stop scanning. Methods The pig models of acute myocardial infarction was established by using the interventional gelatin sponge embolism method on 5 pigs. The myocardial perfusion scanning and coronary angiography were respectively used 20 min before and 24-48 h after modeling. The heart were taken out immediately after the inspection for multiple punch biopsy and HE staining, then the heart was sliced for triphenyltetrazolium chloride (TTC) staining. According to the gold standard of coronary angiography and pathological staining, the sensibility and speciifcity of the coronary artery image of acute myocardial infarction of pig reconstructed by myocardial perfusion scanning and the myocardial perfusion image were respectively evaluated, and the consistency of the results was veriifed by Kappa test. Results Compared with the pathologic gold standard, the sensitivity, speciifcity, of myocardial perfusion iodine image obtained by myocardial perfusion scanning were 93%, 91%; and Kappa value was 0.68. Compared with the coronary angiography gold standard, the sensitivity and speciifcity of coronary artery image obtained by myocardial perfusion scanning were 93%, 81%, and Kappa value was 0.71. Conclusions The second generation dual-source CT dual-energy myocardial perfusionone-stopscanning can accurately get the coronary artery and myocardial perfusion images of the pig models of acute myocardial infarction.

Objective To investigate the correlation between pancreatic nuclear factor-κB (NF-κB) activation, cell apoptosis and pancreatic injury. To determine effects of N-acetylcysteine (NAC) on pancreatic injury in rats with acute necrotizing pancreatitis (ANP). Methods Thirty-three Wistar rats were divided into five groups: normal group, normal saline (NS) group, ANP group, prophylactic and therapeutic groups with NAC randomly. ANP was produced by 3.5% sodium taurocholate retrograde injection. In the prophylactic group, rats received intravenous (i. v.) injection of NAC (300 mg/kg) 1 hour before taurocholate injection and in the therapeutic group, NAC i.v. injection was given 1 hour after sodium taurocholate injection. Animals were sacrificed at 12 hours after induction of pancreatitis. Activation of NF-KB in pancreatic tissues was determined by electrophoretic mobility shift assay(EMSA). Cell apoptosis was assessed by modified TUNEL method. The following parameters were also measured: plasma levels of amylase and lipase, pancreatic wet/dry weight ratio and histologic grading. Results Taurocholate pancreatitis is characteristic of necrosis, haemorrhage, and severe leukocyte infiltration in the pancreas. Plasma amylase and lipase levels, pancreatic wet/dry weight ratio increased in rats of ANP. NF-κB banding activity was higher after pancreatitis induction (6.03±0.41). When NAC was given 1 hour before induction of pancreatitis, the activation (3.28±0.42) of NF-κB was prevented with significantly decreased severity of pancreatitis as assessed by amylase, pancreatic wet/dry weight ratio. The number of apoptotic cells in pancreatic tissue sections was greater in rats treated with NAC than in rats not treated with NAC. There was a negative correlation between NF-κB banding activity and apoptosis of pancreatic cells (r=-0.96, P< 0.01) and there was a positive correlation between NF-κB activation and histopathological score (r=0.63, P<0.01). Histopathological score of pancreatic injury had negative correlation with apoptosis of pancreatic cells(r=-0.98, P<0.01). Conclusion Early blocked NF-κB activation with NAC increases cell apoptosis in pancreatic tissue and decreases edema of pancreas and severity of pancreatitis in rats with ANP.