Magnetic resonance diffusion-weighted imaging (MR-DWI) is a functional technology at the molecular level.Compared to other imaging exams (such as DSA,CT,US),DWI is non invasive,has no radiation,and objective.Thus,it is widely accepted in clinical settings.As a means to assess the therapeutic efficacy of intervention,DWI has a promising prospect.In this article,we review the application of MR-DWI in evaluating the therapeutic efficacy of hepatocellular carcinoma intervention.

Objective To analyze and summarize the clinical , pathological features of 16 patients with centronuclear myopathy.Methods All of the 16 patients performed clinical examination and sporadic patients and a proband with family history ( n=6 ) performed serum creatine kinase , electromyography and open muscle biopsies , and the specimens were used for a standard series of histological and histochemical stainings.The clinical and pathological features of these patients were analyzed.Results The proportion of centronuclear myopathy in suspected myopathy cases was 0.127%(6/4 724) in our department.The onset time ranged from infancy to adulthood.The common initial symptoms included mild to moderate weakness of lower limbs and bilateral ptosis ( n =4 ).The other symptoms were facial weakness ( n =1 ) and ophthalmoplegia (n=1).There were 12 patients performing distal weakness exceeding proximal weakness . One family with autosomal dominant inheritance of 11 patients had a later age of onset than the sporadic ones and manifested bilateral ptosis , bilateral lower limbs weakness , especially in distal muscle.Muscle biopsies showed pronouncedly increased amount of fibers with centrally placed nuclei with predominant type Ⅰfibers and a clear perinuclear halo surrounding the centrally placed nuclei and an appearance of spoke of a wheel in some fibers.Conclusions This series of centronuclear myopathy patients manifest clinical heterogeneity.Muscle biopsies show features of centralized nuclei pronounced increase , type Ⅰfibers predominance , etc.These can provide evidences for the diagnosis of the disease.

Objective To determine the optimal volume proportion of iodize d oil (Lipiodol)-ethanol mixture by comparing the clinical efficacy of transhepatic arterial embolization-ablation therapy using different volume proportion of Lipiodol-ethanol mixture in treating experimental rabbit models with VX 2 liver cancer. Methods VX2 tumor was implanted in eighteen adult male New Zealand white rabbits. The 18 VX 2 rabbit models were randomly and equally divided into the following six groups according to the Lipiodol-ethanol volume ratio ∶ group A (3 ∶ 1), group B (2 ∶ 1), group C (1 ∶ 1), group D (1 ∶ 2), group E (1 ∶ 3) and group F (1 ∶ 4). One week after the treatment, all the rabbits were sacrificed and their livers were removed and sent for pathologic examination. The tumor growth rate, the microvascular density, the apoptosis index (AI) of tumor tissues and the injury of the hepatic tissue adjacent to the tumor were evaluated. Results After the treatment, the tumor’s size was increased in group A, E and F. The tumor growth rate of group A was significantly higher than that of the other five groups , and the difference was statistically significant (P<0.05). The tumor’s size of groups B, C and D was decreased, although the difference was not significant when compared with the tumor’s size of groups E and F (P > 0.05). The proportion of ethanol in Lipiodol ∶ethanol mixture bore a negative relationship to the microvascular density counts (R2= 0.840, F = 89.432, P < 0.001). AI of group A was strikingly lower than that of groups C, D, E and F (P < 0.05). The difference in AI between group A and group B was not significant (P > 0.05), while the difference in AI between group B and group C or between group B and group F was statistically significant (P<0.05), and no significant difference in AI existed between each other among other groups (P > 0.05). The injury extent of the hepatic tissue adjacent to the tumor in group A and B was remarkably milder than that of other groups (P < 0.05). Conclusion When considered in terms of safety, the optimal volume proportion of Lipiodol-ethanol mixture should be 2 ∶ 1. Successful super-selective catheterization of the tumor feeding artery, strict and close fluoroscopic monitoring of the injection and proper increase in the proportion of ethanol can definitely improve the therapeutic efficacy.

According to the supply and demand equilibrium research on stomatological professionals, a conclusion could be drawn that the stomatological professionals are in serious shortage. Some strategies to support the demand of stomatological professionals are raised in this essay, such as widening the teaching objectives, stratified recruiting, enhancing the school-running ability of the main stomatological university and so on.
China ; Humans ; Oral Medicine

Objective To determine,the clinical significance of serum myocardial enzymes (Mb,cTNI, CK,CK-Mb,AST,LDH) in the classification of the disease severity of non-cardiogenic critically-ill patients. Compared with APACHEⅡscore concerned as the standard diagnosis of the critical ills,these biomarkers were investigated for the evaluation possibility of the degree and the prognosis of the critical ills.Method Patients admitted to our EICU were consecutively collected for the research from April to December in 2005 and the myocardial enzymes,and routine serum biochemical test and APACHEⅡscore were detected simultaneously.All the patients were classified to three groups according to the APACHEⅡscore (mild group,APACHEⅡ25) and two groups (survive group and death group) according to the prognosis.All the patients were followed up till recovery/discharge or death. Covariance,Wilcoxon and x~2 were used for the statistical analysis.Results The myocardial enzymes rose when the disease deteriorated and the APACHEⅡscore went up.AST,LDH,CK,CK-Mb,Mb were significantly different in the three groups according to the APACHEⅡscore (P

Objective To systematically evaluate the comprehensive effect of subglottic secretion drainage (SSD) on patients with mechanical ventilation (MV) in intensive care unit (ICU). Methods The randomized controlled clinical trials (RCTs) comparing SSD (intervention group) versus non-SSD (control group) in adult patients with MV in ICU was collected through the databases such as the PubMed database of the National Library of Medicine, CNKI, Wanfang database and the Chinese journal of science and technology database (VIP). The subjects were ICU patients with MV, and the retrieval time ranged from January 2006 to December 2016. Two reviewers independently screened the studies according to the inclusive and exclusive criteria, extracted the data, and assessed the quality. Then RevMan 5.3 software was used for Meta-analysis. Sensitivity analysis was performed using Stata 11.0 software. Funnel plot was used to analyze publication bias. Results In the 1004 documents obtained from preliminary screening, a total of 13 studies involving 2052 patients were enrolled after excluding duplicated documents and literature did not meet the inclusion criteria, with 1021 patients in intervention group, and 1031 in control group. Meta-analysis showed that compared with control group, the application of SSD in patients with MV could contribute to the reduction of the incidence of ventilator-associated pneumonia [VAP; risk ratio (RR) = 0.54, 95% confidence interval (95% CI) = 0.46-0.64, P < 0.00001], the duration of MV [mean difference (MD) = -3.29, 95%CI = -4.53 to -2.05, P < 0.00001] and length of hospital stay (MD = -4.27, 95% CI = -7.36 to -1.18, P = 0.007) were shortened, while there was no significant difference in ICU or hospital mortality rate between the intervention group and control group (RR = 0.89, 95%CI = 0.73-1.09, P = 0.25). The sensitivity analysis for studies enrolled in Meta-analysis of MV duration showed that individual research results were stable through step remove of the included literatures and combined calculation of the remaining literature value, suggesting that individual research results were stable, and would not have a significant impact on the overall results. The results of the funnel analysis showed that there was a symmetry in the inclusion studies, and no significant publication bias was found. Conclusions SSD did have effect in reducing the incidence of VAP, shortening the duration of MV and length of hospital stay, while there was no significant effect on reducing mortality rate. Effective use of SSD is an important measure to prevent VAP. It is necessary to objectively evaluate the clinical effect of SSD.

Objective To study the pathophysiology of ankylosing spondylitis (AS)-related osteoporosis by investigating the relation between bone mineral density (BMD) and bone turnover markers.Methods Fortysix AS patients were included in this study,including 35 male and 11 female patients.Twenty-five gender and age matched healthy subjects were served as the healthy control group.Informed consents were obtained from all subjects.BMD of lumbar spine (L2-4),fermoral neck and radius were tested using dual-energy X-ray absorption method.Data about BASDAi,ESR,Ig was collected.Bone formation markers including procollagen type Ⅰ N-terminal peptide (PINP) and osteocalcin (OC) were included for analysis,the formal was measured by radioimmunoassay and the later was measured by immunoradiometric assay and bone resorption marker.β-Crosslaps was measured by electrochemiluminescence immunoassay.Independent-samples t test was used to compare normal distributed data between the two groups.Analysis of variance was used to compare the data between the three groups.For those data which were not normally distributed,Rank sum test was performed.Correlations were determined by Pearson or Spearman's ranking.Results ① 48％ of AS patients had bone loss,while the percentage in the healthy control group was 20％ (x2=5.32,P=0.021).BMD of lumbar spine,fermoral neck and radius of the AS patients were lower than the controls (t=-3.73,-3.68,-5.24; P＜0.05).② Bone density (BMD) of lumbar spine in patients at the late stage was higher than patients at early disease stage (t=2.26,P=0.034),however,the BMD in the femoral neck was not.③ The procollagen (PINP),OC and β-CrossLaps were not significantly different in patients at different stage of diseases (P＞0.05).④BMD of lumbar spine was negatively correlated with the β-CrossLaps and ESR(r=-0.325,P=0.047; r=-0.314,P=0.046),The BMD in fermoral neck was negatively correlated with β-CrossLaps and OC (r=-0.387,P=0.024; r=-0.371,P=0.034),but they were not correlated with disease duration and BADSAI.Conclusion Osteoporosis is common in AS.Bone turnover markers including bone formation and bone resorption are increased in AS.β-CrossLaps is likely to predict bone loss in AS.

Objective To investigate the relations and evaluation value of serum thymidine kinase 1 (sTK1) in the treatment of patients withacute exacerbation of chronic obstructive pulmonarydisease (AECOPD). Methods The retrospective treating studies were performed on 104 patients with AECOPD , sTK1 level was de-tected by chemiluminescence dot-blot assay before and after treatment , and the correlation between the expression of sTK1 and CRP after treatment in the two groups was analyzed. Results The levels of sTK1 and CRP in the ef-fective group significantly lowered after treatment (P < 0.05). The expression of sTK1 in the effective group and in the ineffective group after treatment was significantlycorrelated with CRP (P < 0.05). Conclusion sTK1 can be used as a valuable indicator to evaluate the severity of AECOPD and to estimate the efficacy of AECOPD thera-py.

Objective To establish a high performance liquid chromatography (HPLC) method for determining phenytoin concentration in epilepsy patients' plasma,and compare this method with chemiluminescence microparticle immunoassay (CMIA),and to evaluate the consistency of the two methods.Methods HPLC and CMIA methods were applied to determine the plasma concentration of phenytoin in 60 epileptic patients,respectively.The difference of results was analyzed by two-side paired t-test,and then the correlation and consistency of the two methods were investigated with Passing-Bablok regression and Bland-Altman method.Results There was no significant difference between the results of the two methods (P ＞0.05).The regression equation of the determination results by HPLC (Y) and CMIA (X) was Y=0.992 9X +0.143 7 (R2 =0.992 6,n =60),which indicated the correlation of the two methods was good.Bland-Altman analysis showed that the consistency of the two methods for determining was good.Conclusion HPLC and CMIA method in monitoring plasma concentration of phenytoin have good correlation and consistency.Both methods can be used for therapeutic drug monitoring of phenytoin.

Objective To detect anti-M_2 autoantibody using recombinant BCOADC-E_2.Methods We purified recombinant BCOADC-E_2 by Ni~(2+)affinity chromatography column and then detect anti-M_2 autoan- tibody in the sera of patients with primary biliary cirrhosis(PBC)by Western blot test(WBT)and enzyme linked immunosorbent assays(ELISA).Results Among 60 sera from PBC patients,33 were positive,all of controls were negative.Conclusion The recombinant BCOADC-E_2 can be used to detect anti-M_2 autoanti- body specifically and sensitively.It is helpful for the diagnosis of PBC.