Objective To develop an ion chromatogram method for determination of fluoride in the sea food and meat. Methods Under the acid condition,fluorine could be separated by distillation,then fluorine is absorbed by washing liquid. The electricity lead detection-ion chromatogram with Ionpac AS14 column was employed to determine the content of fluoride,3.5 mmol/L of sodium carbonate-1.0 mmol/L of soda as the washing liquid at 1.2 ml/ min. Results The linear range was 0.05-1.0 mg/L,the relative coefficient (r) was more than 0.999 7 (n=6),the lowest detection limit was 0.3 mg/kg,the relative standard deviation was 1.00%-3.85%,the recovery rates were 88.1%-99.0%. Conclusion This method presents a good effect of pretreatment and fluorine ion seperation and with a satisfactory recovery rate,precision and detection limit.

Objective To explore the reason of serious interference red blood cell(RBC)parameters in blood routine test and correct method.Methods 30 cases of patients whose results of blood routine RBC parameters obviously abnormal ,According to the interference factors were divided into four groups:cold agglutination (7 cases),severe hemolysis(13 cases),high triglycerides (8 cases),high white blood cell(WBC)(2 例).Take appropriate corrective action for processing respectively.The difference of red blood cell parameters were compared with t test.Results To analysis of interference factors and take appropriate corrective meas-ures,RBC parameters could be more close to the real results.Conclusion We should pay attention to the changes of the RBC pa-rameters,analysis of interference factors,and to take appropriate measures to correct,in order to avoid clinical misdiagnosis and mi-stherapy.

Objective To explore the molecular and cytogenetic abnormalities in multiple myeloma (MM).Methods The la-boratory data of bone marrow smears were retrospectively analyzed in 61 patients of MM.24 hours short-term culture of bone marrow and R banding technology were performed in 31 patients.Among these patients,10 cases were selected for de-tecting the IgH gene expression by the interval FISH method.Results The proportions of myeloma cells were 0.19~0.94 in bone marrow smears of 61 patients.In 31 patients,25 patients had enough metaphases for analysis,in which 19 cases (71.3%)had abnormal clones,8q24,11q13,13q14 and 17p13 were important structural abnormalities,where 14q32 rear-rangement was the most characteristic abnormal structure,6 patients were detected IgH gene rearrangement.Conclusion Bone marrow smear combined with other laboratory examinations could make the diagnosis of MM,chromosomal abnormali-ties may help to explore the pathogenesis of MM,and provide a theoretical basis for the early diagnosis,treatment and prog-nosis of this disease.

Objective In order to examine the value of the combination of carotid artery ultrasound and Transcrani-al Doppler (TCD) in the evaluation of carotid artery stenosis stenting. Methods Seventy-one carotid stenosis cases con-firmed by digital subtraction angiography (DSA) who had cerebral ischemia symptoms and received stent implantation were reviewed. Carotid artery ultrasound and TCD were adopted to measure the vessel diameter, peak systolic velocity (PSV) of the narrow segment, PSV and pulsatility index (PI) of ipsilateral middle cerebral artery (MCA) before and after the treatment of intravascular stents, and a comparison analysis was made. Results Carotid stent implantation significant-ly improved the inner diameter, PSV of the narrow part, PSV and PI of the MCA on the stenotic side. Inner diameter of the narrow part was 3.13±0.83, 4.77±0.51 and 4.64±0.52 mm at before, one week and one year after the implantation, re-spectively (P<0.05). The PSV of the narrow part was 190.69±113.65, 86.15±30.52 and 90.28±29.79 cm/s at before, one week and one year after the implantation, respectively(P<0.05).PSV of the MCA on the stenotic side was 77.68±14.66, 115.62±22.32 and 108.89±20.29 cm/s at before, one week and one year after the implantation, respectively(P<0.05). PI of the MCA on the stenotic side was 0.81±0.01, 1.07±0.01 and 1.06±0.02 at before, one week and one year after the implantation, respectively (P<0.05). Conclusions The present study demonstrates that the combination of carotid artery ultrasound and TCD can quantitatively detect the vascular structural and hemodynamic improvements following the endo-vascular stenting, indicating that the combination of carotid artery ultrasound and TCD can be used for the accurate as-sessment and follow up of carotid artery stenting treatment.

Objective To study a new operative method for treatment of hepatic venous occlasion without (associated) pathologic change of inferior vena cava or long-segment stricture. Methods A total of 44 cases of Budd-chiari syndrome with hepatic venous occlusion without pathologic change or long-segment stricture of (inferior) vena cava underwent combined mesocaval C-shunt, ligation of splenic artery, and esophagogastric (devascularization).Results Pre-shunt portal venous pressure was 36cmH2O(31~45 cmH2O, 1cmH2O=0.0098kPa) and post-shunt pressure fell to 26 cmH2O(21~33 cmH2O),the mean reduction was 10 cmH2O. One patient died of liver failure. A slight degree of hepatic encephalopathy occurred in 2patients who recovered after conservative treatment.Chylorrhea occurred in 4 patients, and it spontaneously disappeared 7d to 3.5months after operation. 39 patients(88.6% follow up) were followed up for 6months to 7years , and there was no case of recurrent bleeding nor hepatic encephalopathy. Ascites disappeared in 31cases,and was markedly reduced in 7 cases .The prosthetic grafts were patent as shown by color Doppler ultra sound in all followed-up patients.Conclusions This operation is simple and effective for B-CS with hepatic venous (occlusion) but not associated with inferior vena caval pathologic change or long-segment stricture.

ObjectiveTo compare liver pathology changes of patients with Budd-Chiari syndrome (BCS) and intrahepatic portal hypertension (IPH) after portosystemic shunt surgery. MethodsFrom January 2010 to December 2011,liverbiopsy was taken during shunt surgery (9 BCS patients,4 IPH patients),and 6-9 months after surgery on follow-up.Collagen type Ⅳ ( Col Ⅳ ),procollagen m (PC Ⅲ ),matrix metalloproteinase (MMP-1),tissue inhibitors of metalloproteinase(TIMP-1) were tested using SABC (immuonohistochemistry) method,and HE staining to observe the morphology of liver tissue.Free portal vein pressure before and after shunt was measured. ResultsIn BCS group,Col Ⅳ,PC 1Ⅲ and TIMP-1expression downregulated after surgery (127 ±15) vs.(137 ±16),t =4.896,P-0.013; (115.2 ± 10.6) vs.(127.3±9.5),t=4.877,P=0.003; (119.2±11.3) vs.(131.2±l9.6),t=2.841,P=0.023.MMP-1expression did not change ( P ＞ 0.05 ),while MMP-1/TIMP-1was not significantly correlated with liver fibrosis (0.95 ±0.16) vs.(0.98 ±0.15),t =-0.710,P =0.504.In IPH group,the expression of Col Ⅳ,PCⅢ,MMP-1,and MMP-1/TIMP-1did not change significantly after surgery (P ＞0.05).Compared with that in IPH group the expression of PC Ⅲ,Col Ⅳ and TIMP-1downregulated significantly in BCSgroup (127±15) vs.(150 ±12),U=3.000,P=0.038; (115.2 ±10.6) vs.(128.1±2.8),U=2.000,P=0.023; (119.2 ± 11.3) vs.(131.4 ±2.5),U=3.000,P =0.038.By HE staining in BCS group there was significant intrahepatic congestion which alleviated after surgery.While in PHT group liver pathology did not change significantly after surgery.FPP in BCS and IPH patients significantly decreased after shunt surgery (25 ±8) vs.(41±8) cmH20,t=17.816,P=0.000;(31±8) vs.(45 ±9) cmH20,t =5.745,P =0.010 ). Drop of FPP of BCS group plays a key role in reversal of liver fibrosis.ConclusionsIn BCS group liver pathology improved after shunt surgery probably by removing the intrahepatic obstruction,but in IPH group liver pathology remained unchanged after shunt.

Objective To investigate the role of Hedgehog pathway in hepatic fibrosis and its association with activation of hepatic stellate cells. Methods Twenty male Spragur-Dawley rats were divided into control and model groups with 10 each. The animal models were induced by injection with CCl4 and fed with fat-rich diet. The rats in both groups were sacrified at the 8 week with 5 each and the liver tissues were removed for HSC-T6 culture. The deposition of collagen fiber in liver was detected with HE and Masson staining. RT-PCR was used to detect the expressions of Sonic hedgehog (Shh), smoothened (Smo), patched (Ptc), Gli-1 and α-smooth muscle action (α-SMA) mRNA in HSC-T6 and liver tissues. The influence of cyclopamine (Cyc) and lipopolysaccharide (LPS) on HSC-T6 proliferation were assayed by MTT. The expressions of Shh, Smo, Ptc, Gli-1 and α-SMA mRNA after intervention with Cyc (100μmol/L) and LPS were measured by real-time PCR. Results A lot of lipo and collagen deposited in liver of model rats. The Shh,Smo,Gli-1 and α-SMA mRNA were highly expressed in model rats than those in control group (2-△△Ct were 20.45±3.31 vs. 1, 12.78 ± 0. 53 vs. 1, 10.88 ± 2.41 vs. 1, 4.91 ± 2. 59 vs. 1, respectively, all P value <0. 05). In vitro Cyc inhibited HSC-T6 proliferation in dose dependant manner (F=636.81, P<0.01). Compared to the control group, the mRNA expressions of Smo, Ptc, Gli-1,α-SMA in HSC-T6 were significantly reduced after Cyc intervention (2△△Ct, were 0. 20±0. 11, 0. 21 ± 0. 08, 0. 28 ± 0. 05,0. 27±0.10,respectively, all P values<0.01). Conclusion The expression of members of Hedgehog pathway are increased in the progress of hepatic fibrosis, which may accelerate the hepatiee fibrosis by activating HSC.

Objective To establish a liquichip method for detecting 6 sub-genotypes of hepatitis C virus(HCV),including 1a, 1b,2a,3a,3b and 6a.Methods The coupling method of PCR amplification and nucleic acid probe was established.The PCR product and the microspheres mixture of the coupled nucleic acid probe were hybridized for establishing the liquichip detection method.The sensitivity and specificity of the established liquichip detection method were evaluated.Nucleic acid in 93 serum samples was detec-ted by this method..Results The established HCV nuclei acid liquichip genotype detection method had the higher specificity and sensitivity,which could detect and classfy 6 HCV sub-genotypes.The sensitivity for HCV 1a,3a and 6a sub-genotypes was 1× 105 copies/PCR;the sensitivity for HCV 1b,2a and 3b sub-genotypes was 1×104 copies/PCR.The detection results in 93 serum samples showed that the this genotyping method had the characteristics of high throughput,rapidness,sentsitivity and specificity. Conclusion This method can be used for the simultaneous and quick detection of 6 HCV sub-genotypes and provides a new meth-od for the genotyping detection of HCV.

Objective To explore the causes of upper gastrointestinal rebleeding after devascularization operation for portal hypertension and the therapeutic effect of shunt operation.Methods The clinical data of 56 cases of upper gastrointestinal rebleeding after devascularization operation for portal hypertension in our hospital from 1996 to 2006 were retrospectively analyzed.Shunt operation was done in 54 ceses including emergency operation shunt in 5 cases,and elective operation in 49 cases.C-type Mesocaval shunt was done in 45 cases,inferior mesenteric vein-cava shunt in 4 cases,H-type and portacaval in 5 cases.Results Chylorrhea occurred in 13 cases after operation and all recovered;hepatic encephalopathy occurred in 5 cases,and 4 cases recovered,1 died;and 1 case died of liver function failure on the third day after operation.Fifty-two cases were followed-up from 6 months to 9 years,and none had recurrence of upper gastrointestinal bleeding,but 7 died(2 cases died of primary hepatic carcinoma,3 cases died of liver function failure and hepatic encephalopathy,and 2 cases died of non-correlated disease).Conclusions Patients with upper gastrointestinal rebleeding after devascularization operation for portal hypertension should undergo non-operative treatment at first,and elective surgery is done later.If aggressive non-operative treatment for 48h is not successful,then emergency operation should be performed.In elective cases,the operation of first choice is mesocaval interposition synthetic graft shunt,which is particularly applicable in patients with portal vein thrombosis or portal hypertensive gastropathy.

Objective To invetigate the correlation between Kawasaki disease (KD) and mycoplasma pneumomiae (MP). Methods The medical records of 84 children diagnosed as KD in our hospital from March 2012 to February 2014 were retrospectively analyzed, and according to whether with mycoplasma infection or not ,they were divided into observation group and control group. The observation group included 43 cases with mycoplasma infection, and the control group in-cluded 41 KD patients without MP infection. White blood cell count (WBC), high sensitive C reactive protein (CRP), erythrocyte sedimentation rate (ESR), hemoglobin (HB), platelet count (PLT) were detected and analyzed in two groups. Patients of the two groups were compared in whether the existence of coronary artery lesions. Results Patients of the observation group without coronary artery injury accounted for 34.9%(15/43), significantly lower than that of the con trol group 58.5%(24/41), and the observation group with coronary lesions accounted for 65.1%(28/43), significantly higher than that of the control group 41.5%(17/41). The differences were statistically significant (P<0.05); CRP of the observation group was (68.9±14.7) mg/L, significantly higher than that of the control group (52.8±8.2) mg/L, and ESR of the observation group was (42.6 ±15.9) mm/h, significantly higher than that of the control group (21.6 ±6.1) mm/h. The differences were statistically significant (P<0.05). Conclusion MP is one of the causes of KD and has positive corre-lation with coronary artery injury of patients. The injury and inflammation reaction mediated by autoimmune reaction caused by MP is an important way to KD.