Objective To explore the value of human leucocyte antigen-DR53 (HLA-DR53),anti-Sa antibody and anti-cyclic citrullinated peptide antibody(anti-CCP) factors combination in rheumatoid arthritis.Methods 170 patients with rheumatoid arthritis and 50 healthy individuals in the hospital were chosen.The levels of HLA-DR53 by PCR-SSP,the levels of anti-Sa and anti-CCP by ELISA,compared their diagnostic value by consistency analysis and joint detection analysis.Results The sensibility of anti-Sa,HLA-DR53 and anti-CCP in RA were 44.07％ (P =0.00,x2 =165.214),68.65 ％ (P =0.00,x2 =9.837) and 79.45 ％ (P=0.00,x2=48.028).Consistency analysis in RA,HLA DR53,anti-CCP and anti-Sa highly consistent,OR were 3.94,38.6 and 184.52.The sensitivity and Youden index of anti-CCP were the highest.The sensitivity of anti Sa and anti-CCP parallelled was 88.51 ％.The sensitivity of HLA-DR53 and anti-CCP parallelled was 93.56％,and the spe cificity of anti-Sa and anti-CCP of RA were 100％.Conclusion There is a certain correlation between HLA-DR53,anti-Sa and anti-CCP antibody,which are related risk factors of RA,co-detection will improve the diagnosis of RA.

OBJECTIVE:To study the effect of tween-80at different concentrations on the dissolution of ipriflavone capsules.METHODS:Different concentrations of tween-80ipriflavone capsules were prepared with contents and dissolutions of ipriflavone capsules determined by UV spectrophotometry,parameter values of T d ,T 50 and m were calculated and compared among each other.RESULTS:When tween-80were at a concentration range of1%～3%,the T 50 and T d diminished with the increase of concentration of tween-80,its optimal concentration was2.5%.CONCLUSION:The dissolution of ipriflavone capsules can be markedly increased if the preparation was added with optimal amount of tween-80(P

Objective To investigate the change of homocysteine (Hcy),high sensitive C-reactive protein (hs-CRP)and Inter-leukin 6 (IL-6)in patients with Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS)complicated by Cerebral Infarction (CI).Methods Chose 55 patients with OSAHS and 56 patients with CI.All patients with OSAHS were divided into mild group,moderate group and severe group by polysomnography,and all patients were divided into simple OSAHS group,sim-ple CI group and OSAHS complicated by CI group.All the patients’sleep apnea hypoventilation index (AHI),the lowest oxygen saturation (LSpO2 ),average blood oxygen saturation (MSpO2 ),sleep apnea the longest (LAT)and the level of Hcy,hs-CRP,IL-6 were determined,and compared with 30 cases of control group.Results The AHI,LAT,Hcy,hs-CRP and IL-6 of simple OSAHS group and simple CI group were obviously higher than that in control group,LSpO2 ,MSpO2 were obviously lower,the differences were statistical significant (P<0.05).The AHI,LAT,Hcy,hs-CRP and IL-6 of OS-AHS complicated by CI group were obviously higher than that in simple groups,but LSpO2 and MSpO2 were obviously low-er,and the differences were statistical significant (P<0.05).With the aggravation of OSAHS,Hcy,hs-CRP and IL-6 were gradually increased.Hcy,hs-CRP and IL-6 were positively correlated with AHI in patients with OSAHS,correlation coeffi-cient were 0.751,0.678 and 0.635,respectively (P<0.001).Conclusion OSAHS was closely related to the occurrence and development of CI,the dynamic monitoring of Hcy,hs-CRP and IL-6 levels has a certain reference value for evaluation of therapeutic effect.

BACKGROUND:From the biological structure, the posterior cruciate ligament is surrounded by the synovial folds of posterior capsule, arising from the inner side of the medial femoral condyle to the posterior part of tibial intercondyloid spine. The main traditional treatment method for posterior cruciate ligament tibial avulsion fracture is open operation, but it is difficult in anatomic reduction, cannot ful y restore knee joint stability and has a great negative impact on the normal function of posterior cruciate ligament. OBJECTIVE:To investigate the effects of arthroscopic implant internal fixation in the treatment of tibial avulsion fracture of the posterior cruciate ligament. METHODS:120 patients with tibial avulsion fracture of the posterior cruciate ligament were randomly assigned into treatment group and control group, with 60 cases in each group. The control group was given the traditional open surgery, and the treatment group was given the arthroscopic surgery. After 3 months, International Knee Documentation Committee (IKDC) scores and Lysholm scores were detected in the two groups;the knee joint range of motion was determined before and 3 months after treatment. RESULTS AND CONCLUSION:Wounds were healed at stage I in al patients with no serious complications. There was no difference in the knee joint range of motion between the two groups before treatment, but the range of motion was increased significantly in both two groups at 3 months after treatment (P<0.05), meanwhile which was higher in the treatment group than the control group (P<0.05). At 3 months after treatment, the excel ent knee function rate was significantly higher in the treatment group (97%) than the control group (88%) according to the Lysholm scores;the IKDC scores were significantly higher in the treatment than the control group in terms of claudication, support, pain, swel ing, and squat (P<0.05). These results indicate that the arthroscopic implant fixation of tibial avulsion fracture of the posterior cruciate ligament has better short-term effects to promote recovery of knee joint function, but no serious complications.

Objective To investigate the expression and clinical significance of serum high-mobility group box 1 (HMGB1) in the patients with spinal cord injury (SCI).Methods A total of 87 cases of acute SCI treated in the Aksu Corps First Division Hospital from January 2007 to January 2014 were collected as the SCI group.The SCI severity was evaluated according to the damage grade by the American Spinal Cord Injury Association(ASIA).Venous blood was collected on 1,3,7 d after SCI.Other 87 healthy adults served as the control group.The expression levels of serum HMGB1,inter1eukin-6 (IL-6),IL-1β and tumor necrosis factor alpha (TNF-a) in the two groups were measured by ELISA.Then the correlation between the HMGB1 expression level with IL-1β,IL-6 and TNF-α and the relation between HMGB1 with SCI severity were analyzed.Results The HMGB1,IL-6,IL-1 and TNF-α levels on 1,3,7 d after SCI in the SCI group were higher.The expression levels of serum HMGB1 and IL-6 on 1 d after SCI in the SCI patients were significantly increased,and reached the peak value on 3 d;the levels of IL-1β and TNF-α on 1 d after SCI were highest,and gradually decreased on 3,5 d.The correlation analysis showed that the expression levels of HMGB1 on 1,3 d after SCI were positively correlated with the IL-6,IL-1β and TNF-α expression levels(P＜0.05).The serum HMGB1 expression level on 1,3 d after SCI was closely correlated with the SCI severity (P＜0.05).The severe the SCI severity,the higher the serum HMGB1 expression level.Conclusion The expression level of serum HMGB1 in the patients with early SCI is significantly increased,and can be used as one of indicators for assessing the severity of early SCI.

Objective: To investigate the clinical value of modified transperineal template-guided prostate biopsy (mTTPB) in the detection of prostate cancer. Methods: A total of 217 patients were enrolled in this study. All the patients were randomly divided into 2 groups. The control group (n=112) underwent transperineal template-guided prostate biopsy (TTPB) which was traditional transperineal template-guided 11-region biopsy. On the basis of the control group, the apex of prostate was divided into four areas for biopsy in the observation group (mTTPB). The positive rate of apex and the incidence of complications were analyzed. The prostatic specimens from the radical prostatectomy underwent whole mount sections examination. The prostate biopsy results were compared with the postoperative pathological results. Results: The average age of the control group and the observation group were (68.5±7.9) years and (67.3±8.5) years, PSA were (31.2±18.9) ng/ml and (29.7±19.5) ng/ml, prostate volume were (44.6±15.2) ml and (41.3±17.3) ml, respectively. In the control group, the positive rates of prostate cancer in 1-10 region were 24.1% (27/112), 27.7%(31/112), 23.2% (26/112), 28.6% (32/112), 26.8% (30/112), 25.0% (28/112), 26.8% (30/112), 19.6% (22/112), 25.9% (29/112), 25.0% (28/112), respectively, with an average of 25.3%. In the observation group, the positive rates in 1-10 region were 27.6% (29/105), 28.6% (30/105), 22.9% (24/105), 26.7% (28/105), 25.7% (27/105), 24.8% (26/105), 27.6% (29/105), 21.9% (23/105), 27.6% (29/105), 26.7% (28/105), respectively, with an average of 26.0%. There was no statistical difference between the two groups (P=0.904). The positive rate of apical prostate cancer in the control group and observation group was 37.5% (42/112) and 44.8% (47/105), respectively, and there was no statistical difference between the two groups (P=0.277). Patients were grouped according to PSA>20 ng/ml and PSA≤20 ng/ml. When PSA>20 ng/ml, the positive rate of apex was 58.6% (34/58) and 56.6% (30/53) respectively in the control group and the observation group, and there was no statistical difference between the two groups (P=0.830). When PSA≤20 ng/ml, the positive rate of apex was 14.8% (8/54) in the control group and 32.7% (17/52) in the observation group, with statistically significant differences (P=0.030). Before radical prostatectomy, 12 cases (57.1%) in the control group and 19 cases (73.1%) in the observation group showed apical invasion by biopsy. Results of whole mount sections examination in the control group showed that there were 19 cases (90.5%) with apical invasion, which was statistically different from that before surgery (P=0.035). The results of whole mount sections examination in the observation group showed that there were 23 cases (88.5%) with apex invasion, which had no statistical difference compared with that before surgery (P=0.291). There were no significant differences in the incidence of hematuria, fever, urinary retention and perineal discomfort between the observation group and the control group (all P>0.05). Conclusions mTTPB can significantly improve the detection rate of apical prostate cancer without increasing the incidence of complications, especially for patients with PSA≤20 ng/ml. Hence is safe and efficacious.

Objective:To analyze the risk of missed diagnosis in patients with PI-RADS score>3 and negative prostate initial biopsy and to explore its risk factors.Methods:The clinical data of 268 patients with negative prostate biopsy in Northern Jiangsu People's Hospital from May 2013 to December 2018 were retrospectively analyzed. The patients were divided into observation group (PI-RADS score>3) and control group (PI-RADS score≤ 3) according to different PI-RADS scores. There were insignificant differences in age [(67.4(60.0, 74.0)years and 65.6(66.5, 72.0)years], prostate volume of initial biopsy [62.4(40.0, 72.0)ml and 60.8(38.0, 77.0)ml], biopsy cores [ 20.6(18.0, 22.0)cores and 20.4(18.0, 22.0)cores] between the observation group (n=124) and the control group(n=144)(all P>0.05). But there were significant differences in PSA [17.5(6.5, 23.0)ng/ml and 11.5(6.3, 12.0)ng/ml], PSAD[0.316(0.128, 0.363)ng/ml 2 and 0.211(0.106, 0.256)ng/ml 2], prostate inflammation of the initial biopsy [70 (56.5%) and 32 (22.2%)] between the observation group and the control group(all P<0.05). According to the follow-up results after the initial biopsy, the two groups of repeated biopsy were compared.Furthermore, Logistic regression was used to conduct univariate and multivariate analysis to explore the risk factors of patients with PI-RADS>3 for positive repeated biopsy. At the same time, the receiver operating characteristic curve (ROC curve) was used to analyze the accuracy of the risk factors. Results:There were significant differences in repeated biopsy rate [ 27.4%(34/124)and 14.6%(21/144)], CsPCa detection rate[ 41.4%(14/34) and 4.8%(1/21)]between the observation group and the control group(all P<0.05). The positive rate of repeated biopsy in the observation group (41.1%) was higher than that in the control group (23.8%), but there was no statistical difference ( P=0.248). The risk of positive repeated biopsies in the observation group was 2.24 times than that in the control group. Univariate analysis found repeated biopsy PSA ( P =0.02, OR=1.438, 95% CI 1.161-1.896), PSA ratio (repeated biopsy PSA/initial biopsy PSA) ( P=0.011, OR=10.087, 95% CI 1.714-59.36) were risk factors for positive of repeated biopsy in patients with PI-RADS score >3. Multivariate analysis also found that repeated biopsy PSA ( P=0.017, OR=1.15, 95% CI 1.076-2.123), PSA ratio ( P=0.032, OR=10.2, 95% CI 0.883-116.168) were risk factors for positive repeated biopsy. ROC curve analysis, the accuracy of repeated biopsy PSA (AUC=0.971, P<0.001, 95% CI 0.926-1.000), PSA ratio (AUC=0.839, P=0.001, 95% CI0.707-0.971) to predict positive of repeated biopsy were high. The cut-off values were 21.3 ng/ml and 1.4, respectively. The accuracy was higher when combines repeated biopsy PSA with PSA ratio (AUC=0.993, P<0.001, 95% CI 0.974-1.000). Conclusions:Patients with negative PI-RADS score > 3 have a higher risk of missed diagnosis of CsPCa than those with PI-RADS score≤3. When PSA>21.3 ng/ml and PSA ratio>1.4 during follow-up, the possibility of missed diagnosis in the initial biopsy is high.

Objective To measure the body surface dose under different confinations of additional filters,tube voltage and tube current and discuss the lowest amount of different additional filters,tube voltage and tube current combination for crib side X-ray radiation dose while the quality of the image is guaranteed.Methods Japan Shimadzu wireless tablet mobile DR machine and Dutch Artinis CDRAD 2.0 phantom were used.The tube voltage and tube current for children's crib side X-ray normal work were 50 kV and 1.40 mAs to get the image quality figure inverse (IQFInv),respectively.Totally four filter combinations of 1 mm A1,2 mm A1,1+2 mm A1 and 0.3 mm Cu were added to the opening of collimator system by mobile DR machine.Phantom was shot by respectively combination of 50,66,83 and 100 kV tube voltages and different tube currents.All images to get the IQFInv value,Pearson correlation and regression analysis of the influence of tube voltage and current on IQFInv value were analyzed.The IQFInv value of the additional filter corresponds to the image quality of normal work.The combination of the additional filter with the tube voltage and the tube current was also found.Swedish RTI Barracuda diagnostic level dosimeter was used to measure the entrance surface dose of these combinations after filtration,20 times for each group.Results Comparisons among different filters,tube voltage and tube current combination with quality of daily work images:the tube voltage was positively correlated with IQFInv value in the test range(r=0.49,P＜0.05),and tube current was positively correlated with IQFInv value (r=0.36,P＜0.05).As the additional filters increase,it required greater tube current to acquire the desired value of images.Meanwhile,greater additional filters would increase the difference of IQFInv of tube voltage at each level.Comparisons among different filters,tube voltage and tube current combination with daily shooting dose,and after using additional filters,entrance surface dose changed from (30.58±0.21)to (10.49±0.09) μGy.There is a significant difference between each group (t=-15.306-514.585,P＜0.05).All additional filters effectively reduced entrance surface dose.Meanwhile,as the filter and tube voltage increased,entrance surface dose showed a more significant reduction.However,when the tube voltage exceeded 83 kV,all entrance surface dose of additional filters showed an increasing trend.Conclusions Additional filter is an effective method to reduce the crib side X-ray entrance surface dose.Under the premise of ensuring image quality,additional filter with high atomic number and second high kilovolt tube voltage with paired tube current is the best condition for crib side X-ray.

Objective: To study the the application characteristics of paediatric CT examination by investigating four main children′s hospital of Shanghai. Methods: All the CT scan cases of paediatric patients in this work were obtained from the radiology information system (RIS) database in four hospitals between 2011 and 2014. The distribution of using CT scans was analysed according to the age, gender, anatomical regions and the duplicated cases of the patient, then estimated the paediatric CT scan rates of four hospitals in Shanghai. Results: Retrospective review of RIS showed 249 350 CT examinations from 175 672 young patients were performed between 2011 and 2014 in the surveyed hospitals. More males (62%) were scanned than females (38%). The majority of children receiving the examinations were 1 to 5 years old, which amounted to 40.3% in all. Cardiac CT accounted for 14.5% among all children of ≤1 year old CTs and accounted for 63.0% among all cardiac CT scans. There were 33 634 (19.1%) individuals who had received 2 or more CT scans during the four years. The estimated paediatric CT scan frequencies of four hospitals in Shanghai from 2011 to 2014 were 37.9 examinations per 1 000 population in 2011, 43.3 examinations per 1 000 population in 2012, 43.3 examinations per 1 000 population in 2013 and 39.0 examinations per 1 000 population in 2014. Conclusions The CT scan frequencies of four hospitals in children and young adults was almost keeping stable in Shanghai.