Objective To explore the value of FIB-4 and APRI index on evaluating the severity of liver fibrosis among patients with chronic hepatitis B(CHB).Methods A total of 218 CHB were enrolled in the study.Based on the staging of liver fibrosis,the patients were divided into 2 groups as S0-S2 group(n=120) and S3-S4 group(n=98).Differences in clinical data,laboratory indexes,FIB-4 and APRI index were compared between two groups.The correlation between FIB-4 index,APRI index and liver fibrosis were analyzed by Spearman correlation test.Receiver operator curve(ROC) test was used to determine the evaluating value of FIB-4 index and APRI index for the severity of liver fibrosis.Results To evaluate the staging≥S2 of liver fibrosis,the value of FIB-4 index was better than APRI index(Z=1.998,P=0.046).And to evaluate the staging≥S3 and S4 of liver fibrosis,the value of FIB-4 index for evaluating the staging≥S3(Z=1.177,P=0.239) or S4(Z=0.267,P=0.789) was the same as APRI index.Conclusion FIB-4 index and APRI index are both effective on evaluating the severity of liver fibrosis among patients with CHB,but the value of FIB-4 index is better than APRI index for evaluating early liver fibrosis.

Most researchers consider that high exposure to heavy metals can result in hemorrhagic gastritis,hepatonecrosis,cancer,even death.There are many routes for heavy metals to get into human body,for instance absorption by gastrointestinal tract,cutaneous absorption etc.In this paper,the author reviewed the recent researches on brain function damage induced by heavy metals via olfactory pathway.Some heavy metals have especial affinity with brain tissue and cause functional disorder and death of nerve cells,and the mechanisms were discussed in detail.

OBJECTIVE:To develop a method for simultaneous determination of chlorogenic acid,baicalin,aloe emodin,rhe-in,emodin,chrysophanol and physcione in Kangjun xiaoyan tablets. METHODS:RP-HPLC method was adopted. The determina-tion was performed on Agilent Extend C18 with mobile phase consisted of acetonitrile-0.5% phosohoric acid solution(gradient elu-tion)at the flow rate of 1.0 mL/min. The detection wavelengths were set at 327 nm(chlorogenic acid),280 nm(baicalin)and 450 nm(aloe emodin,rhein,emodin,chrysophanol,physcione). The column temperature was 30℃,and sample size was 10μL. RE-SULTS:The linear ranges of chlorogenic acid,baicalin,aloe emodin,rhein,emodin,chrysophanol and physcione were 0.2094-4.1880μg(r=0.9999),0.3720-7.4400 μg(r=0.9999),0.0063-0.1262 μg(r=0.9999),0.0116-0.2322 μg(r=0.9999),0.0053-0.1060 μg(r=0.9998),0.0128-0.2564 μg(r=0.9999),0.0165-0.3303 μg(r=0.9998),respectively. The limits of quantita-tion were 2.01,1.93,0.76,1.25,1.24,0.53 and 1.53 ng;the limits of detection were 0.98,0.65,0.25,0.42,0.41,0.18 and 0.52 ng,respectively. The recoveries were 98.41%-100.40%(RSD=0.76%,n=9),96.17%-100.10%(RSD=1.58%,n=9), 96.11%-100.10%(RSD=1.33%,n=9),96.29%-100.80%(RSD=1.85%,n=9),96.88%-100.10%(RSD=1.22%,n=9), 97.81%-101.90%(RSD=1.64%,n=9),96.46%-101.30%(RSD=1.85%,n=9),respectively. CONCLUSIONS:The method is accurate,reliable and reproducible. It can be used for simultaneous determination of 7 components in Kangjun xiaoyan tablets.

Objective To investigate the effect and possible mechanism of oxytocin on the expression of NO and ET-1 in precon-ditioning myocardium of rats with ischemia .Methods The rats were randomly divided into ischemic reperfusion group(I/R) ,ische-mic reperfusion + oxytocin pretreatment group(I/R+OT) ,sham operation group(SH) and nomal control group(N) .The myocar-dial ischemia-reperfusion model was induced by 25 min coronary occlusion and 120 min reperfusion in opened-chest anesthetized rats ,rats of SH group were not conducted with ligation but threading only .Group I/R+ OT were administered oxytocin(0 .03 g/kg ,i .p)25 min prior to ischemia ,the other three groups were given the same amount normal saline .After reperfusion ,nitric oxide (NO) ,endothelin-1(ET-1) ,creatin kinase isoenzyme(CK-MB)and lactate dehydrogenase(LDH)in blood serum were measured .At the end of reperfusion ,HE stain was used to observe the morphology of the cardiac muscular tissue .Results Pathological observa-tion showed that the myocardial cell in group SH and in X ranged in order ,with no fibers fractured ,myocardial fibers in I/R group were fractured and disorganized ,interstitial edema ,neutrophil infiltration were also observed .It was more serious in group I/R than in group I/R+OT .Compared with SH group ,the CK-MB ,LDH ,ET-1 of the I/R group and I/R+OT group increased ,the NO de-creased(P<0 .05) ,and it had no difference in group N and group SH (P>0 .05) Compared with the I/R group ,in I/R+OT group the expression of CK-MB ,LDH ,ET-1 were decreased ,the level of NO increased(P<0 .05) .There was a negative correlation be-tween NO and ET-1 in group I/R and I/R+ OT (P< 0 .05) .Conclusion Oxytocin pretreatment on rat myocardial ischemia and reperfusion has protective effect ,and its action mechanisms maybe associated with the increase of the content of NO and the de-crease of the content of ET-1 in blood serum .

Purpose To evaluate the value ofintravoxel incoherent motion (IVIM) imaging in diagnosis of liver fibrosis staging in rats.Materials and Methods Rabbit models of liver fibrosis at different stages were established.All rabbits were divided into four groups based on the pathological results of fibrosis grading as S1-S4.The 1VIM imagings with 8 b-values (0,50,100,200,300,800,1000,1200 s/mm2) were performed.The diffusion coefficient (D),perfusion-related coefficient (D*),and perfusion fraction (f) were calculated and compared between control (only injection of saline) and S 1 group,S2 and S3 group.Results The D value was significantly lower in S1 group compared with control group (P＜0.05),but the D* and f values showed no significant difference between the two groups (both P＞0.05).With the progression of liver fibrosis,the D,D* and f value decreased gradually;the D* value showed significant difference between S2 and S3 group (P＜0.05),but the D and f values showed no significant differences between the two groups (both P＞0.05).Conclusion The D value is useful for differentiation of normal liver and hepatic fibrosis of S1 stage,while the D* is valuable for differentiation of hepatic fibrosis of S2 and S3 stage.However,the f value neither could detect early fibrosis,nor could differentiate hepatic fibrosis staging.IVIM imaging provides a noninvasive method for early and accurate staging of liver fibrosis,which may be of great help in clinical diagnosis and treatment.

OBJECTIVE:To evaluate the economics of azithromycin vs. amocillin clavulante in the treatment of lower respirato-ry tract infections. METHODS:System evaluation was adopted to retrieve the randomized controlled trials(RCT)about azithromy-cin(test group)vs. amoxicillin clavulanate(control group)in the treatment of lower respiratory tract infections. Information was col-lected and Meta-analyses were performed. On this basis and short-term decision tree model,cost factors were added to conduct the pharmacoeconomics by the principle of PICO of Treeage Pro 2011 edition software. RESULTS:Totally 18 RCT were enrolled,in-volving 3 365 patients. Results of Meta-analysis showed that there were no significant differences in the effective rate [RR=0.93, 95%CI(0.55,1.55),P=0.77] and incidence of adverse reactions [RR=0.79,95%CI(0.62,1.0),P=0.05] between 2 groups. The av-erage treatment cost in test group and control group was respectively 790.4 yuan and 884.4 yuan,and cost-effectiveness ratio was respectively 216.0 and 245.7,and the incremental cost-effectiveness ratio(ICER)was -1 392.59. CONCLUSIONS:Azithromycin has similar efficacy and safety to amoxicillin clavulanate in the treatment of lower respiratory tract infection,however,azithromy-cin has better cost-effectiveness.

Objective To evaluate the value of mean platelet volume (MPV) in identifying the location of infarct at left circumflex artery (LCX) in patients with non-ST-elevation myocardial infarction (NSTEMI).Methods In this retrospective study,184 consecutive patients with NSTEMI were eligible to be enrolled from January 1,2009 to June 30,2011 and laboratory examinations including platelet count,B-type natriuretic peptide (BNP),troponins test (TnI),C-reactive protein and serum creatinine (SCr) were done.The demographics and detailed history of patients were documented.In addition,left ventricular ejection fraction (LVEF) test and coronary angiography to determine the culprit vessel implicating in infarction were carried out in all enrolled patients.The patients were categorized into LCX group and N-LCX group according to culprit vessel.Results Of 184 patients,68 patients were in LCX group and 116 patients had left anterior descending artery (LAD) lesion or right coronary artery (RCA) lesion.High percent of LCX infarction were found in patients with high MPV level and low BNP level,and in smokers.And lower proportion of those patients had previous percutaneous coronary artery intervention.The results showed that MPV was larger in patients with LCX infarction than that in patients with LAD or RCA.Receiver operating characteristic curve showed the area under curve was 0.75 (95％ CI:0.675-0.826).An optimized cut off point at 9.15 fL of MPV showed 83.8％ sensitivity and 63.8％ specificity for prediction of LCX infarction.Multivariate analysis also showed that MPV was the only independent predictor of a LCX infarction in patients with NSTEMI [OR=1.32,(95％ CI:1.031-1.688),P＜0.05].Conclusions MPV was the only independent factor associated with LCX infarction in patients with NSTEMI.

Objective To evaluate the effectiveness of using adipose-derived stromal cells (ADSCs)into a tissue-engineered peripheral nerve on bridging sciatic nerve gaps.Methods Forty-eight F344 female rats weighing 200 - 220 g were randomly divided into 6 groups of nerve grafting to repair 15 mm long asiatic nerve lesions,with 8 mrs in each group.Group A:ADSCs-laden acellular nerves;group B:differentiated ADSCs-laden acellular nerves;group C:Schwann cells-laden acellular nerves;group D:acellular nerves without cells;group E:autografts;group F:nonimplanted grafts.The effects were evaluated in terms of electrophysiulogy,Fluorogold retrograde tracing,histology and tracking studies.Results At 12 weeks after surgery,there was no graft bridging nerve gap in nonimplanted grafts.All the examinations of group A and B were better than group D,respectively (P＜0.05 or P＜0.01).But there were no statistically significant differences among group A,B,C,and D (P＞0.05).Conclusion ADSCs and differentiated ADSCs could promote nerve regeneration when used as seed cells to build tissue-engineered peripheral nerves with acellular nerve scaffolds.

Objective To explore clinical characteristics of alveolar soft part sarcoma(ASPS) and prognosis factors related to surgical treatment.Methods This study retrospectively analyzed 29 ASPS consecutive cases between Sep.1982 to Sep.2010,including 18 males and 11 females,with average 24.4 and median 21 years old (ranging 9 to 58).26 patients with surgery were enrolled in this study,with 23 cases primarily ocurred in soft tissue and 3 cases in bone.There were 17 cases with painless mass (65.4％,17/26) and 9 cases with pain (36.4％,9/26).Demographics,tumor size,stage,surgical margin,adjuvant chemotherapy provided,local recurrence,metastatic rate and overall survival probability were evaluated.We used multivariate analysis of logistic regression and Cox regression for local recurrence and survival rate respectively,and univariate analysis for tumor size,surgical margin,adjuvant chemotherapy and local recurrence.Results According to the Enneking classification,we distinguished stage Ⅱ 14 cases and stage Ⅲ 12 cases.Marginal excision was obtained in 9 cases as well as wide resection in 17 patients.The average and median follow-up time was 45.9 and 31 months (ranging 5 to 226) respectively,12 cases eventually survived (46.2％).The 5-year survival rates for stage Ⅱ and Ⅲ cases were 79.5％ and 23.4％ respectively.We found significant difference for local recurrence with surgical margin.However,there was no significant difference for prevention of metastatic progression with or without adjuvant chemotherapy.For tumor size,5-year survival rate of ＞ 5 cm and ＜ 5 cm group were 40.7％ and 80.0％ respectively.Multivariate analysis of logistic regression showed the surgical marginal was the only significant risk factor for local recurrence,while Cox regression showed both stage and tumor size were independent prognostic indicators for survival.Conclusion Although presenting as a slowly growing and painless mass,ASPS is an aggressive tumor with high risk of metastasis.Prognosis of ASPS is basically related to the characteristics of tumor size,surgical stage and quality of surgery.With limited improvement of adjuvant chemotherapy for metastasis control and survival,new agents are eagerly needed to complement surgery to eradicate this disease.

Objective: To investigate the trends in incidence and mortality of prostate cancer in Huangpu District, Shanghai Municipality from 2002 to 2019, so as to provide insights into the prevention and treatment of prostate cancer. Methods: The incidence and mortality of prostate cancer among men in Huangpu District from 2002 to 2019 were collected from the Shanghai Cancer Registry System. The crude incidence, crude mortality, truncated age-standardized incidence (aged 35 to 64 years) and cumulative incidence (aged 0 to 74 years) of prostate cancer were calculated. The Chinese Fifth National Population Census in 2000 and the Segi's world standard population in 1960 were used to calculate Chinese-standardized rate and world-standardized rate. The trends in incidence and mortality of prostate cancer were evaluated using annual percent change (APC) and average annual percent change (AAPC). Results: A total of 2 672 cases of prostate cancer were reported in Huangpu District from 2002 to 2019, and the crude incidence was 33.35/105, the Chinese-standardized incidence was 14.93/105 and the world-standardized incidence was 12.37/105 (AAPC=7.675%, 4.886% and 4.983%, all P<0.05). The incidence of prostate cancer among males at ages of 60 to <70 years and 70 to <80 years appeared increasing trends (AAPC=4.554% and 5.045%, both P<0.05). A total of 1 214 deaths of prostate cancer were reported, and the crude mortality was 15.15/105, the Chinese-standardized mortality was 6.01/105 and the world-standardized mortality was 4.61/105 (AAPC=5.500%, 2.057% and 1.784%, all P<0.05). The mortality of prostate cancer among males at ages of 80 years and above appeared an increasing trend (AAPC=4.220%, P<0.05). Conclusions The incidence and mortality of prostate cancer appeared increasing trends in Huangpu District from 2002 to 2019, and the incidence among males at ages of 60 years and above also increased. The screening for prostate cancer among males at ages of 60 years and above should be strengthened.