OBJECTIVE:To compare the healing effect of traditional therapy versus the traditional therapy in combination with additional externally applied agent on the traumatic tympanic membrane perforation with a focus on the effect of recombinant human epidermal growth factor(rhEGF) in promoting healing of tympanic membrane perforation.METHODS:A total of 90 patients with traumatic tympanic membrane perforation were randomly divided into two groups:one group received traditional therapy in which the anti-inflammatory drug was given plus nasal administration with water not allowed entering in the external acoustic meatus;another group was treated with traditional therapy plus rhEGF cotton applied externally.The healing of the tympanic membrane perforation and the auditory acuity improvement in two groups were monitored.RESULTS:In rhEGF group(58 cases),the cure rate reached 100%,with an average healing time of 5.3 days;Of the 32 cases in the traditional therapy group,7 were not failed,and 25(78%) healed,with an average healing time of 28.4 days.The healing time of tympanic membrane perforation in rhEGF group was significantly shorter than in traditional group,showing significant difference(P

Objective To establish a polarographic method for detecting fluoroacetamide.Methods On the condition of strong basic solution with high temperature fluoroacetamide was decomposed to form a decomposed product ALC-La-F - complex.In a pH4.90buffer solution containing KNO 3 and hexamethylenetetramine,the decomposed product was determined with com-plex-adsorptive wave at-0.67V by polarography.Re sults The detection limit and linear range of the method was2.0?10 -8 mol/L and5.0?10 -8 -1.2?10 -6 mol/L respectively.The regressive equation was y=3.49x+0.042with a correlation coefficient r=0.9996.The method had been applied to the determination of fluoroacetamide in wheat flour samples satisfyingly.Conclu-sion This method was simple and suitable for the determination of fluoroacetamide in flour.

0.05～0.2?l of HRP (Sigma Ⅵ) were introduced into the periaqueduetal gray (PAG) of 45 rats at the superior collicular level, each brain was sectioned and processed with DAB, BDHC, O-D and TMB reactions. 29 were chosen for analysis and according to the locations of the injection center and the extent of reaction, were divided into 3 groups:1. The injection center was found in the lateral part of PAG; the reaction only involved a small area within PAG (11 rats), labeled cells were seen in PAG, tectum, reticular formation (RF) and dorsal raphe nucleus.2. The injection center was in the dorsolateral part of PAG; the reaction area extended out of PAG to the nearby RF and tectum (9 rats); labeled cells were seen in the structures mentioned in group 1 as well as in habenular nucleus (hn), parafascicular nucleus (PFN), hypothalamic nuclei (anterior, posterior, ventromedial, dorsomedial, lateral), thalamic nuclei (lateral, reticular, medial part of ventral nucleus), paraventricular gray (PVG), nucleus of the optic tract, nucleus of posterior commissure (NPC), parabigeminal nucleus (PBN), locus ceruleus, ventral nucleus of lateral geniculate body, entopeduncular nucleus.3. The injection center was in the lateral or ventrolateral part of PAG, the reaction area extended to the nearby RF, tegmentum and part of tectum (9 rats), labeled cells were seen in the structures mentioned in group 1 as well as in substantia nigra, H_1, H_2, zona inserta, HN, PFN, PVG, NPC, PBN, locus ceruleus, pretectral area and nuclei of hypothalamus. In this group 3 rats were processed with TMB reaction. Labeled cells were seen not only in the above-mentioned structures but also in the deep layers of anterior cingulate cortex (areas 23 and 24), nucleus raphe magnus, nucleus reticularis gigantocellularis, periventricular gray of 4th ventricle, dentate nucleus of cerebellum, lamina Ⅴ～Ⅶ of cervical spinal cord (the other segments were left out), preoptic and supraoptic nuclei, suprachiasmatic nucleus, anterior nucleus of mammillary body, medial nucleus of amygdaloid nucleus, spinal nucleus of nerve Ⅴ. The labelled cells were seen chiefly in the ipsilateral side. Neuronal connections also were analysed according to the disparity in labelled structures.

Objective The aim of this prospective observational study was to analyze the prevalence and the predictive factors of hemorrhagic events after abdominal paracentesis in patients with acute-on-chronic liver failure (ACLF).Methods ACLF patients who received at least one episode of abdominal paracentesis were prospectively enrolled between January 2010 to December 2013. Prevalences of intraperitoneal and abdomen hemorrhage complications were examined. t test was performed for continuous variables and chi-square test was performed for categorical variables.Binary Logistic regression was used to analyze the risk factors of hemorrhage.Results A total of 525 abdominal paracenteses were carried out on 185 ACLF patients within a 4-year period,with 289 (55 .0%)for diagnostic purpose and 236 (45 .0%)for therapeutic purpose.A total of 16 (3.0%)hemorrhagic complications were identified, with 4 cases of abdominal wall hematomas and 12 cases of intraperitoneal hemorrhage.Patients were divided into hemorrhage group and non-hemorrhage group according to this complication.Age,gender, Child-Pugh score,volume of ascitic fluid removed,underlying cirrhosis,platelet count and thrombin time were not significantly different between two groups (all P > 0.05 ).Patients with bleeding events had lower fibrinogen levels and higher prothrombin time,international normalized ratio,activated partial thromboplastin time and model for end-stage liver disease score (all P <0.05).After adjustment of other factors,multivariate regression analysis indicated that low fibrinogen level was the only independent predictor of hemorrhagic complication (OR=0.105,95%CI :0.018-0.608,P =0.012).Conclusion Low fibrinogen level is the independent predictor of severe hemorrhagic complications following paracenteses in patients with ACLF.

ObjectiveTo evaluate liver reserve function in patients with hepatitis B cirrhosis using indocyanine green (ICG) clearance test, and to investigate the correlation of ICG clearance test with Child-Turcotte-Pugh (CTP) class and the Model for End-Stage Liver Disease (MELD) score in evaluating liver function. MethodsA total of 127 patients with hepatitis B cirrhosis who were hospitalized in The First Affiliated Hospital of Fujian Medical University from January 2012 to January 2015 were enrolled. ICG clearance test was performed for all the patients, and the ICG plasma clearance (K value), effective liver blood flow (EHBF), and ICG retention at 15 minutes (ICG R15) were calculated. CTP class and MELD score were also determined. An analysis of variance was used for comparison between groups, the least significant difference t-test was used for comparison between any two groups, Spearman rank correlation was performed for correlation analysis, and the area under the receiver operating characteristic (ROC) curve was used to compare liver reserve function. ResultsAmong all the patients with hepatitis B cirrhosis, 63 had CTP class A, 45 had CTP class B, and 19 had CTP class C hepatitis B cirrhosis. With the increasing CTP class, ICG R15 gradually increased, while EHBF and K value gradually decreased (F=14696，9126 and 4094，P=0001,0003 and 0005). In the evaluation of liver function, ICG R15 was positively correlated with MELD score and CTP class (r=0.525 and 0.838, both P＜0.01) and was negatively correlated with EHBF and K value (r=-0.703 and -0.901, both P＜0.01). The area under the ROC curve was 0.85 for ICG R15 and 065 for MELD score. ConclusionICG test can accurately and dynamically reflect liver reserve function, and ICG R15 can evaluate liver reserve function better than CTP class and MELD score.

Objective To investigate the relationship between hepatic steatosis and virological markers in patients with chronic hepatitis B (CHB ) during immune clearance (IC ) phase.Methods Pathology proven CHB patients in IC phase were collected from the Liver Center of the First Affiliated Hospital of Fujian Medical University from January 2009 to October 2016 .Patients were divided into non-to mild fatty liver (F0 －F1) group and moderate to severe fatty liver (F2 －F4) group according to the liver steatosis degree .The relationship between liver steatosis and virological markers in serum was compared .The measurement data were analyzed using independent sample t test ,and the count data were analyzed by chi-square test .Results A total of 298 patients were included ,including 237 males (79 .5%) and 61(20 .5%) females ,and the average age was (32 .4 ± 10 .3) years old .The 23 .5%(70／298) of these patients had liver steatosis .A total of 273 (91 .6%) cases were in F0－F1 group ,and the remaining 25 (8 .4%) cases were in F2 －F4 group.The patients in F2 － F4 group had higher body mass index ([25.90 ± 2.70] vs [21 .68 ± 2.90] kg／m2) ,serum triglyceride ([1.52 ± 0.77] vs [1.11 ± 0.55] mmol／L) and cholesterol ([4 .88 ± 1 .15] vs [4 .33 ± 0 .92] mmol／L) than F0－F1 group ,and the differences were all statistically significant (t＝ －7 .007 ,－2 .667 ,and －2 .751 ,respectively ,all P＜0 .05).In addition , the serum levels of HBsAg and HBV DNA in F2 －F4 group were also significantly higher than F0 －F1 group (t＝ －3 .291 and －2 .831 ,respectivelt ,both P＜0 .01).According to the grading of inflammation and fibrosis ,the differences of HBsAg and HBV DNA levels between F0 －F1 group and F2 －F4 group were statistically significant only in patients with more severe inflammation (t＝ －2 .738 and －2 .135 , respectively ,both P＜0 .05) or less severe fibrosis (t＝ －2 .258 and －2 .333 ,respectively ,both P＜0 .05).Conclusion Among CHB patients experiencing immune clearance ,serum HBsAg and HBV DNA levels are positively correlated with the severity of hepatic steatosis ,and this phenomenon is closely related to the degree of liver inflammation.

Objective To investigate the association between interleukin-22 (IL-22) single nucleotide polymorphisms (SNPs) and the prognosis of hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF).Methods The patients with HBV-ACLF from the First Affiliated Hospital of Fujian Medical University were retrospectively studied.Seven SNP genotypes of IL-22 gene,including rs2227478,rs2227491,rs1179251,rs1179249,rs2227473,rs2227484,and rs11611206,were detected using imLDRTM multiple SNP typing kit and the distribution features of SNP genotypes were described.The relationship between the distribution of SNP genotypes and alleles and the prognosis of ACLF was analyzed.Comparison of genotypes and allele frequencies between groups were performed by chi-square test of R × C table or Fisher's exact tests.Binary logistic regression analysis was used to analyze whether IL-22 gene polymorphisms was an independent prognostic factor for patients with ACLF.Results A total of 122 patients with HBV-ACLF were included in this study.Ninety-two (75.1％) were male and 30 (24.59 ％) were female.Patients were stratified as survival group (90 cases) and non-survival group (32cases) according to the Results of three months follow-up.The genotype distribution of rs2227484 of IL-22 gene was significantly different between the two groups (x2=6.128,P=0.033).The A allele frequency in the non-survival group (15.6％) was significantly higher than that in the survival group (5.6％) with statistically significance (OR=0.318,95％ CI=0.126-0.804,P=0.012).There was no significant difference in the other six SNP genotypes of IL-22 gene between the two groups (all P＞0.05).However,binary logistic regression showed that rs2227484 of IL-22 gene was not an independent risk factor for the short-term mortality in HBV-ACLF patients (adjusted OR=3.102,95％ CI:0.939-10.250,P=0.063).Conclusions The A allele and AA genotype of rs2227484 of IL-22 gene may be associated with a short-term prognosis in patients with HBV-ACLF.

Objective Midkine ( MK ) and nuclear factor-kappa B ( NF-kB ) play pivotal roles in tumorigenesis, which are considered as promising cancer biomarkers. The efficacy of MK and NF-kB as markers for diagnosis and prediction of synchronous metastasis in papillary thyroid cancer ( PTC ) was the aim of present investigation. Methods Seventy six cases of PTC and seventy cases of multi-nodular goiter ( MNG ) were retrieved. The PTC group was further divided into subgroup 1 (16 cases with synchronous metastasis) and subgroup 2 (60 cases without metastases). A retrospective review of clinical information, radiological examinations,131 I treatments and post-131 I-therapy scans were done. Immunohistochemistry of MK, NF-kB p65, and Ki-67 was performed on paraffin-embedded specimens and results were quantified. Diagnostic values of the parameters were conducted by receiver operating characteristic (ROC) curves. Diagnostic sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were determined. Protein levels of MK and NF-kB p65 were then confirmed by Western blot. Results Immunoreactivities of MK and NF-kB p65, and positive percentage of Ki-67 were significantly higher in PTC group than in MNG group (all P<0. 01). ROC showed good differential diagnostic capabilities of all three parameters with diagnostic accuracies of 82. 192% , 80. 137% , and 84. 091%respectively. Moreover, all three parameters were significantly higher in subgroup 1 than those in subgroup 2 (all P<0. 01). ROC showed good predicting efficacies in synchronous metastasis of all three parameters with diagnostic accuracies of 82. 895% , 80. 263% , and 76. 316% respectively. By one-way analysis of variance, Western blot showed that MK and NF-kB p65 protein levels in lesions from subgroup 1 were significantly higher than those from subgroup 2, both were significantly higher than those in MNG lesions ( P<0. 01). Conclusion MK and NF-kB immunohistochemistry can potentially be used for differential diagnosis between PTC and MNG, and for prediction of synchronous metastases.

Multiple sclerosis (MS) is an idiopathic inflammatory demyelinating diseases of the central nervous system, the underlying cause of which has not been cleared. Previous studies have shown that the pathogenesis of MS is related to the destruction of blood brain barrier, furthermore the drugs used to treat MS have a certain protective effect on the function of blood brain barrier. Therefore, this review combines the research progress at home and abroad to clarify the relationship between the blood brain barrier and MS in pathogenesis and treatment, proposing possible orientation of development.

Objective: To investigate the correlation between interleukin-6 (IL-6) single nucleotide polymorphism (SNP) and the occurrence and prognosis of hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF). Methods: Patients with chronic hepatic diseases diagnosed as HBV infection in the Hepatology Center of the First Affiliated Hospital of Fujian Medical University from July 2012 to March 2018 were divided into HBV-ACLF and non-ACLF group. SNP genotyping of eight loci in IL-6 gene (rs1524107, rs1800795, rs1800797, rs2069827, rs2069830, rs2069837, rs2069840 and rs2069845) was determined by the improved multi-temperature ligase detection reaction (imLDRTM) technique. Simultaneously, case data were reviewed with the 3-months followed up survival condition of the ACLF group. Normally distributed data were expressed as arithmetic means and SDs, and t-test was adopted. Data with skewed distribution were expressed as medians with interquartile range, and were measured by non-parametric test. Multivariate logistic regression analysis was used to analyze the relative risk of genetic polymorphism and HBV-ACLF as well as the relationship between IL-6 SNPs with the occurrence and prognosis of HBV-ACLF. Results: Four hundred patients were included in the study, with 122 (30.5%) in the HBV-ACLF and 278 (69.5%) in the non-ACLF group. There were significant differences in total bilirubin, albumin, and white blood cell count, percentage of neutrophils, platelet count, alanine aminotransferase, aspartate aminotransferase, prothrombin time and international standardized ratio, creatinine and the model for end-stage liver disease score between the two groups (P < 0.001). The genotype of IL-6 genes (rs1800795, rs1800797, rs2069827, and rs2069830) of all subjects showed no mutation or the mutation rate under 1%. There was no significant difference in the genotype of IL-6 (rs1524107, rs2069837, rs2069840 and rs2069845) between the two groups (P > 0.05). Multivariate logistic regression analysis showed that the SNPs in the above four loci of IL-6 gene was not associated with HBV-ACLF risk, nor had significant correlation with the 3-months prognosis. Conclusion The SNP genotyping of eight loci in IL-6 gene (rs1524107, rs1800795, rs1800797, rs2069827, rs2069830, rs2069837, rs2069840 and rs2069845) is unrelated to the occurrence and short-term prognosis of HBV-ACLF.