Objective To investigated the significance of serum B7-H3 in differential diagnosis of patients with benign and malignant obstructive jaundice.Methods The B7-H3 levels in 60 patients with obstructive jaundice who were divided into benign (32 patients) and malignant (28 patients) obstructive jaundice group were tested by enzyme-linked immunosorbent assay before and after operation.Results The serum B7-H3 levels of malignant obstructive jaundice group were significantly higher than that of benign group (9334.57 ± 1009.57) pg/mL vs (4450.81 ± 406.92) pg/mL,(P ＜ 0.01).The B7-H3 levels of benign and malignant obstructive jaundice group after operation were significantly lower than those before operation (2531.03 ± 415.64) pg/mL vs (4450.81 ±406.92) pg/mL,(5833.00 ± 2190.87) pg/mL vs (9334.57±1009.57) pg/mL,(P＜0.01).Conclusion B7-H3 participate in the inflammatory immune and tumor immune response,The serum B7-H3 can be used as differential diagnosis index of benign and malignant obstructive jaundice.

Purpose Blast lung injury is severe, and is the main causes of death in explosion. This paper aims to explore the imaging features of blast lung injury, and to provide reference for clinical diagnosis and care. Materials and Methods The clinical data of 37 patients with primary blast lung injury stricken in the 8.2 Kunshan explosion in 2014 were retrospectively studied, with regard to the degree of burn, area, auxiliary emergency treatment and medical history. The imaging manifestations of X-ray and/or CT were also analyzed. Results ① The X-ray and/or CT findings of chest showed that 6 cases (16.2%) presented no obvious abnormality of lung parenchyma, 14 cases (37.8%) manifested increase of lung markings and spot-like clouding opacity, 6 cases (16.2%) presented ground glass opacity, 7 cases (18.9%) manifested patchy shadow, 4 cases (10.8%) showed diffuse consolidation. 6 cases (16.2%) with pleural effusion, 6 cases (16.2%) complicated with pneumothorax and hydropneumothorax, 4 cases (10.8%) with enlarged podoid and pericardial effusion, 2 cases (5.4%) with mediastinal hematoma, 9 cases (24.3%) with rib fracture. The positive rate of X-ray film inspection was 72.2% (13/18), yet that of CT reached 92.9% (13/14). ② Five patients who had not been seen obvious abnormal in emergency lung examination appeared mottling shadows or flake fuzzy shadows in the examination on the second day; 9 cases with aggravated symptoms and infection signs displayed relieved signs, expanded or changed primary lesions. Conclusion Imaging examination is an important tool in the diagnosis of primary blast lung injury. CT is superior to X-ray film on the detection of lesions; therefore, CT examination on chest should be carried out as soon as possible if conditions are allowed.

Objective:To establish a method for the content determination of triptolide, total diterpenoids and total alkaloids in Leigongteng oral solution to provide basis for the quality control. Methods:An HPLC analysis was used to detect the content of triptol-ide, which was carried out on an Eclipse XDB-C18 column (150 mm × 4. 6 mm, 5μm) with the mobile phase consisting of acetonitrile-water with gradient elution. The flow rate was maintained at 1. 0 ml·min-1 , the column temperature was kept at 40℃ and the detec-tion wavelength was set at 218 nm. Using triptolide and wilforine as the contrast, the total diterpenoids and total alkaloids were deter-mined by UV-Vis spectrophotometry. Results:There were good linear relationship in the determination of triptolide, total diterpenoids (caculated as triptolide) and total alkaloids (caculated as wilforine) (r≥0. 999 8), the average recovery were 91. 96%, 90. 56%, 99. 18%, and the RSD were less than 3%. Conclusion:The method is with good reproducibility and stability, which can be used for the quality control of Leigongteng oral solution.

Objective To investigate the effects of vacuum suction stereo-dynamic interferential electrotherapy and McKenzie therapy on lumbar disc herniation in aged patients.Methods 70 aged patients with lumbar disc herniation are randomly divided into two groups,experiment group and control group.Each contained 35 patients.Both are treated 15 min daily with the SD5101 therapeutic.For the experiment group,McKenzie therapy is employed 3～4 times per day additionally.They were evaluated with Graded Efficacy For Relieving Lumbar Pain before and after treatment.Follow-up observation lasted for 10 months to record the time of treatment and recurrence rate of both groups.Results For short-term curative effect,no statistical differences were observed between these two groups(P>0.05).For the curative effects on single-segment or multi-segment lumber disc herniation,statistical differences were observed before and after treatment in each group(P<0.05),but were not between them(P>0.05).The curative effects are negatively correlated with the course of treatment(For experiment group:r=-0.72;For control group:r=-0.64).No statistical differences were observed between these two groups in terms of the total correlation coefficient(P>0.05).The time of treatment in experiment group is shorter than that in control group(P<0.05).The recurrence rate in experiment group is lower than in control group(P<0.01).Conclusion Vacuum suction stereo-dynamic interferential electrotherapy combining with McKenzie therapy is an efficient method in treating aged patients with lumbar disc herniation.

Objective To explore the clinical value of 256-slice CT whole hepatic perfusion imaging in transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).Methods Twenty-three patients with hepatocellular carcinoma underwent whole hepatic perfusion with the JOG technique one week before TACE.The scanning data of cancer and liver tissues were analyzed using the perfusion software.The cancer tissue perfusion was repeated 4 to 6 weeks after treatment and was compared with that before treatment.Results (1) Before TACE,the HCC lesions were shown on the hepatic arterial perfusion (HAP) map as homogeneous hyper-perfusion lesions in 8 patients and as inhomogeneous hyper-perfusion lesions in 15 patients.The HAP and hepatic arterial perfusion index (HAPI) values of the tumor were higher than those of the liver tissues,while the hepatic portal perfusion (HPP) values of the tumor was lower than that of the liver tissues.The differences were all significant (P ＜ 0.05).(2) Mter TACE,the tumors were totally filled with lipiodol in 3 patients,partially filled with lipiodol in 13 patients,and sparsely filled with lipiodol in the remaining 3 patients.There was no blood perfusion in the lipiodol-filled areas and in the cancer necrotic tissues,but in the sparsely or partially lipiodol-filled areas blood perfusion could still be seen.21 patients received another session of TACE 6 to 8 weeks later.The results between the hepatic arterial digital subtraction angiography (DSA) and the CT perfusion were 100％ matching.The HAP and HAPI values of the tumor decreased when compared with before treatment,and the difference was significant (both P ＜0.05).The HPP values decreased slightly with no significant difference (P ＞ 0.05),while higher HAP and HPI and lower HPP were observed in the active cancer tissues when compared with the liver tissues after treatment (P ＜ 0.05).Conclusion 256-slice MSCT whole liver perfusion imaging can quantitatively reflect abnormal perfusion of hepatocellular carcinoma tissues and postoperative active tissues,and has important guiding significance in the preoperative evaluation,and the postoperative follow up of patients treated with TACE.

ObjectiveTo investigate the effect of interstitial brachytherapy with 125Ⅰon human esophageal carcinoma implanted in nude mice. MethodsAnimal model simulating human esophageal carcinoma was established by subcutaneous implantation of cultured Eca-109 cell lines into nude mice.The mice were randomly divided into 3 groups,namely control group (saline plus empty seed),125Ⅰ seed group (22.2 MBq×1 seed),and DDP group (cisplatin at the dose of 1 mg/kg),to receive corresponding treatment.The growth rate and the pathological changes of esophageal carcinoma were observed.ResultsThe animals were sacrificed 16 days after irradiation.The average tumor weight in control group,125Ⅰ seed group,and DDP group were (0.20±0.06) g, (0.12±0.03) g and (0.12±0.05 ) g,respectively (P<0.05).Pathological findings included degeneration and necrosis of the tumor cells.Compared to the control group,the necrosis areas in 125Ⅰ seed group and DDP group were significantly larger than those in control (P<0.05).Conclusion125Ⅰ seed brachytherapy in esophageal carcinoma could cause degeneration and necrosis of the tumor cells and had inhibitory effect on tumor growth.

To evaluate the effect of dexmedetomidine on prognosis after cardiac surgery with cardiopulmonary bypass (CPB) in the patients.For this retrospective study,753 patients of both sexes,aged 18-84 yr,who underwent cardiac surgery with CPB from September 2013 to May 2015,were divided into 2 groups depending on whether or not dexmedetomidine was used during surgical procedures:control group (group C,n=548) and dexmedetomidine group (group D,n =205).Propensity score matching analysis with preset caliper width was used.A total of 197 matched pairs were selected from the patients.The development of postoperative arrhythmia,in-hospital mortality,pulmonary infection after operation,and acute renal injury,length of intensive care unit stay,length of hospital stay and 30-day readmission to the hospital were collected.Compared with group C,the incidence of postoperative tachyarrhythmia and inhospital mortality rate were significantly decreased (P＜0.05),and no significant changes were found in the incidence of postoperative bradyarrhythmia,pulmonary infection after operation and postoperative acute renal injury,length of intensive care unit stay,length of hospital stay and rate of 30-day readmission to the hospital in group D (P＞0.05).Dexmedetomidine can effectively improve prognosis after cardiac surgery with CPB in the patients.

Objective:To investigate the correlation of plasma D-dimer levels with the response to first-line chemotherapy and the prognosis of patients with serous ovarian cancer (SOC). Methods:The preoperative plasmic D-dimer levels of 143 patients with prima-ry SOC were retrospectively evaluated. The patients were admitted to Tianjin Medical University Cancer Institute and Hospital between January 2008 and May 2010. The patients were divided into two groups on the basis of plasmic D-dimer levels. Group A consisted of 100 patients with a normal plasmic D-dimer level of≤0.3 mg/L. Group B included 43 patients with an increased plasmic D-dimer level of>0.3 mg/L. The correlations of the different plasmic D-dimer levels with clinicopathological features, therapeutic effects, and surviv-al outcomes were further analyzed. Results:The plasmic D-dimer levels were positively correlated with the staging of the Federation of International Gynecology and Obstetrics, residual tumor size, presence of malignant ascites, preoperative serum CA125 level, and neo-adjuvant chemotherapy. Group B exhibited a significantly lower (P<0.001) complete response (CR) rate of 34.88%(15/43) than group A, which yielded a CR rate of 73.00%(73/100). The progression-free survival and overall survival rates of group B were significantly lower than those of group A (25.58%vs. 50.00%and 32.56%vs. 65.00%;P<0.05). Multivariate analysis revealed that the plasmic D-di-mer level is an independent prognostic factor associated with unfavorable prognosis. Conclusion:Increased preoperative plasmic D-di-mer levels may be a potential biomarker of weak responses to first-line chemotherapy and poor clinical outcomes in patients with SOC.

Objective:To investigate the effects of micropulse laser photocoagulation under threshold on serum malondialdehyde(MDA) and chemokine levels in patients with proliferative diabetic retinopathy(PDR).Methods:From October 2014 to February 2016, 102 patients with PDR who were treated in Lishui People's Hospital were selected and divided into two groups by random number table method, with 51 cases in each group.The patients in the control group were treated with traditional grating laser, and the patients in the observation group were treated with micropulse laser photocoagulation under threshold.The levels of MDA and chemokine were compared before and after treatment, and the changes of vision and clinical efficacy were observed.Results:The total effective rate of the observation group was 90.20%(46/51), which was higher than that of the control group [76.47%(39/51)](χ 2=19.585, P<0.01). Before treatment, there were no statistically significant differences in serum MDA, chemokine and visual acuity between the two groups(all P>0.05). After treatment, the serum MDA and chemokines in the observation group were (8.57±2.48)μmol/L and (1.58±0.51)ng/L, respectively, which were lower than those in the control group [(10.92±3.16)μmol/L and (2.83±0.92)ng/L]( t=4.178, 8.486, all P<0.05), which in both two groups after treatment were lower than those before treatment(all P<0.05). The visual acuity of the observation group was (0.66±0.19), which was higher than that of the control group(0.43±0.13)( t=7.135, P<0.05). Conclusion:Micropulse laser photocoagulation under threshold can effectively alleviate oxidative stress and reduce serum MDA and chemokine levels in patients with PDR.

Objective: To evaluate the effects of early mobilization combined with occupational therapy on delirium of mechanical ventilated patients. Methods: Sixty-eight patients who were undergoing mechanical ventilation and met the inclusion as well as exclusion criteria were randomized into an intervention group (35 patients) and a control group (33 patients). Patients in both group were provided with ICU routine care to prevent delirium, while early mobilization combined with occupational therapy was given in intervention group. Incidence rate of delirium, length of delirium, dosage of sedation, length of mechanical ventilation, length of ICU stay and physical restraint rate were compared. Occurrence of adverse events during intervention was also observed. Results: In intervention group,the incidence rate of delirium was 25.71%(9/35), length of delirium was (1.69±2.98) days, dosage of propofol was (2 189.71±1 222.23) mg, length of ventilation was (4.86±1.31)days, and physical restraint rate was 43.64%(146/275), all of which were significantly better than those in control group, which were 53.28%(17/33), (2 736.36±1 298.99) mg, (5.88±1.52)days, 53.28%(160/254) (χ²=4.788, 7.251, t=3.910, 2.980, P<0.05 or 0.01). There was no unpredicted issue occurred during intervention. Conclusions Early mobilization combined with occupational therapy is feasible which could alleviate ICU delirium, reduce the dosage of sedation, the length of mechanical ventilation, and the physical restraint rate.