Objective To investigate the feasibility, safety and clinical effect of percutaneous transhepatic bipolar radiofrequency catheter ablation in treating malignant obstructive jaundice. Methods Twenty patients with inoperable malignant biliary obstruction were enrolled in this study. Of the 20 cases , 2 had biliary stent re-occlusion. Percutaneous transhepatic bipolar radiofrequency catheter ablation was carried out in all patients. The ablation power was 5 - 12 W, single ablation time was 60 - 120 s, the average duration of ablation was 4.66 min (1.5 - 8.5 min), and the mean effective ablation extent was 5.76 cm (4 -10 cm). After ablation, balloon catheter was inserted to dilate the occluded segment, which was followed by implantation of biliary metal stent. The clinical efficacy , safety and complications were recorded. Results Percutaneous transhepatic bipolar radiofrequency catheter ablation was successfully completed in all the 20 patients. Implantation of biliary metal stent was performed in 17 patients , among them balloon dilatation was employed in 11 patients before stent implantation , simple balloon dilatation with no stent implantation was employed in one patient, and ablation was adopted after biliary stent re-occlusion occurred in two patients. After the ablation, no complications such as biliary fistula, biliary tract infections, liver penetrating injuries, peritonitis, etc. occurred. Biliary drainage was successfully completed in all patients. The median follow-up period was three months(0.5-10 months); the stent patency rate at the end of one and three months was 100% (19/19) and 79% (11/14) respectively. The one-month and 3-month survival rate was 95% (19/20) and 93% (14/15) respectively. During the follow-up period, 8 of the 20 patients were alive and 12 died. The median survival time was 144 days (13 - 330 days) and the median time of stent patency was 60 days (30-210 days). Of the 12 fatal patients, 8 died of cachexia with multi- system failure although their total bilirubin level was not elevated during the follow- up period. Conclusion For the treatment of malignant obstructive jaundice, percutaneous transhepatic bipolar radiofrequency catheter ablation is a newly-developed, safe and feasible means. Clinically, this technique has already achieved some certain effect although its long-term results need to be further evaluated.

Atherosclerosis is the pathological basis of ischemic stroke. Peripheral blood leukocytes are involved in the occurrence and progression of atherosclerosis and cause vascular endothelial injury. A series of changes of peripheral immune cel take place after acute ischemic stroke and cause inflammatory cel infiltrating into the brain tissue. The elevated leukocyte count is closely associated with the occurrence and prognosis of coronary atherosclerotic heart disease. Studies have also shown that the elevated leukocyte count may influence the occurrence of ischemic stroke, neurological deficit, recurrence, and death. This article reviews the relationship between peripheral blood leukocytes and ischemic stroke.

Induced pluripotent stem cell is a landmark in the stem cell study field, which has rapidly developed in the past 10 years.By obtaining induced pluripotent stem cells from somatic cell, and then differentiating into cardiomyocyte, various cardiomyocyte disease models could be established,which can be used for research of disease mechanisms, drug screening and gene therapy.This review introduces the successfully established cardiomyocyte disease models from human induced pluripotent stem cells, and points out the problems and prospects.

Objective To evaluate the sensitivity and specificity of anti-cyclic citrullinated peptide antibody(anti-CCP)and rheumatoid factor(RF)in patients with rheumatoid arthritis(RA).Methods Anti-CCP antibody was measured in sera from 75 human,including 27 RA patients,40 other rheumatic diseases and 8 healths.Anti-CCP was measured by enzyme-linked immunosorbent assay(ELISA).Results The sensitivity of anti-CCP antibody was 70.4%,with a high specificity(93.8%)in RA.The positive rates of anti-CCP antibody have no difference in the patients within 2 years and exceed 2 years from onset.Anti-CCP antibody wasn't correlated with RF,ESR and CRP.Conclusion Anti-CCP antibody has better sensitivity and specificity for rheumatoid arthritis,combining anti-CCP antibody and RF can increase diagnosis sensitivity and specificity of RA,indicating it is a useful laboratory marker for early diagnosis of rheumatoid arthritis.

Objective:To determine aristolochic acid A. in Caulis Aristolochiae Manshuriensis and its preparation. Methods: TLCS Refleciton Saw Tooth Method was used. ? s=323nm. narrow slot: 0.4?0.4nm S X=3.Results: The recovery was 99.86%. RSD was 2.04%. Conclusion: This method is suitable for the content determination of aristolochiae acid A in various traditional Chinese medicine comprising Caulis Aristolochiae Manshuriensis.

Retrospective study was carried out in 93 cases of endometrial carcinoma admitted to our hospital since Jan. 1985 to Dec. 1994. Thirty five cases were older than 60 years, and 24 cases were younger than 50 years. All of the cases had pathological diagnosis and were staged according to FIGO. When compared with the younger group, the rate of older patients with stage Ⅰa was higher (11.4% in younger and 45.4% in older, P

Objective To analyze the clinical characteristics of severe fever with thrombocytopenia syndrome (SFTS) so as to improve the recognition of the emerging infectious disease.Methods A retrospective analysis was performed upon clinical manifestations,laboratory test results and prognostic features of 169 patients with SFTS admitted to the 154 Hospital,Chinese People's Liberation Army from October 2010 to May 2011.The patients were divided into moderate disease group and severe disease group according to the prognosis.The differences between two groups were compared to explore the prognostic indicator of severe type.Results All patients with SFTS inhabited in hilly ground with history of field work.The main clinical symptoms were severe fever (98.8％,167/169),headache (52.1％,88/169),muscle soreness (95.9％,162/169),nausea (73.4％,124/169),vomiting (67.5％,114/169),coughing (61.5％,104/169),etc.Superficial lymph node enlargement with haphalgesia was observed in 45.0％(76/169) patients.Petechia or ecchymosis was observed in 36.7％ (62/169) patients.Critical patients were mainly aged ＞ 60 years,associated with nerve and circulatory system syndrome,prominent hemoptysis,dyspnea,and nearly 73.3％ (22/30) of severe thrombocytopenia.Serum levels of aspartate aminotransferase,creatinine and urea nitrogen were significantly higher in severe disease group than those in moderate disease group [235 (47-1750) U/L vs 88 (14-2000) U/L,997 (281-2601) U/L vs 399 (26-2633)U/L,101 (62-291) μmol/L vs 70(26-205) μmol/L,7.0(2.2-20.0) mmol/L vs 4.8(1.4-18.5) mmol/L,all P values ＜0.001].Conclusion Nerves system syndrome,transaminase and urea nitrogen are risk factors of prognosis of severe SFTS to whom deserves paying attention.

ObjectiveTo observe the changes of the blood lipid levels in patients with sepsis,and reveal the clinical significance of the blood lipid level in the prognosis of patients with sepsis.MethodsThe blood lipid levels and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ) of 40 patients with sepsis(sepsis group) were recorded.The blood lipid levels were compared with those of 25 healthy people (control group).The correlation of the blood lipid level with APACHE Ⅱ score and prognosis of sepsis was analyzed.ResultsIn sepsis group,plasma total cholesterol(TC),high density lipoprotein (HDL),low density lipoprotein (LDL),apolipoprotein B (ApoB) was (3.92 ±0.96) mmol/L,(1.10 ±0.39) mmol/L,(2.44 ± 0.81 ) mmol/L and ( 1.03 ± 0.27) g/L respectively,which were significantly decreased compared with those in control group [ ( 4.40 ± 0.55 ) mmol/L,( 1.61 ± 0.42) mmol/L,(2.79 ± 0.47 ) mmol/L,( 1.13 ± 0.12 ) g/L] (P ＜0.05).In sepsis group,26 cases survived and 14 cases died.TC,triacylglycerol (TG),HDL,LDL,apolipoprotein A Ⅰ (ApoA Ⅰ ),ApoB,platelet count and albumin level of death patients was (3.33 ±0.92) mmol/L,(0.81 ±0.39) mmol/L,(1.03 ±0.27) mmol/L,(1.83 ±0.68) g/L,(1.03 ±0.27) g/L,(0.86 ±0.27) g/L,(140.0 ±82.3) × 109/L,and (32.00 ±5.52) g/L,respectively,which were significantly decreased compared with those of survival patients [ (4.24 ± 0.84) mmol/L,( 1.21 ± 0.44) mmol/L,( 1.25 ±0.30) mmol/L,(2.77 ±0.68) mmol/L,(1.25 ±0.13) g/L,(1.13 ±0.23) g/L,(215.9 ± 101.0) × 109/L,(36.12 ±6.30) g/L](P＜0.05).APACHEM Ⅱ score of death patients was (20.5 ±4.2) scores,which was increased compared with that of survival patients [ ( 13.8 ± 4.8) scores ] ( P ＜ 0.05 ).Multivarisble Logistic regression analysis showed plasma HDL and APACHE Ⅱ score was independent risk factor (standard regression coefficient,HDL =-6.222,APACHE Ⅱ score =0.337).Conclusions Disorders of lipid metabolism exist in patients with sepsis.Plasma HDL level is a good indicator in assessment of prognosis in patients with sepsis and it shows better results combined with APACHE Ⅱ score.

Objective To construct a self-assessment system of patient safety by nurses.Methods Using self-designed questionnaires of self-assessment system of patient safety by nurses,29 nursing safety management experts were selected.Delphi method was adopted to carry out two rounds of interview.The self-assessment system of patient safety by nurses was built.The importance of the indicators went on weight analysis with specialist sorting.Results The system included 3 first-level indicators,9 secondlevel indicators,48 third-level indicators.The coefficient of variation of the indicators was ＜ 0.20,and the coordination coefficient was 0.25.Conclusions The initial construction of system of self-assessment patient safety by nurses has the advantages of focused expert advice,with scientific results,and is reliable.It can be used for nurses' self-assessment of the security situation in patients.

Objective To study the effect of interleukin 2(IL-2)of clinical dose range,on the proliferation of human peripheral blood T cells,with special emphasis on the number and functional phenotype of γδT cells.Methods Human peripheral blood mononuelear cells(PBMCs)were isolated by density gradient centrifugation and cultured for 2 weeks at different IL-2 concentrations.Ratio and phenotype of different T cell subpopulations before and after in vitro expansion were explored by immunofluorescence staining.Cell number was estimated by trypan blue staining and cell counting.Results Within the four functional phenotypes of Vδ1 as well as Vδ2 γδT cells,CD27~+cells(including CD27~+CD45RA~+and CD27~+CD45RA~-subsets)expressed lymphoid tissue homing receptor CCR7,whereas CD27~-cells(including CD27~-CD45RA~+and CD27~-CD45RA~-subsets)had the peripheral tissue homing potential.All the studied γδT functional subsets showed the expression of activity related receptors,and the ability of a rapid production of various amount of cytotoxicity related effectors following mitogen stimulation.Although IL-2 at high concentration suppressed the proliferation of CD4 T cells,it may promote the proliferation of γδT cells.The proliferated γδT cells were mainly CD27~-CD45RA~-effector cells.Conclusion IL-2 of the clinical dose range may promote proliferation of human peripheral blood γδT cells,which might have important biological significance in IL-2 based anti-tumor therapy.