Purpose　The aim is to investigate the hemostatic and protective effect of fibrin sealant(FS) on liver trauma in rats.Methods　On the surface of cracked wound(type Ⅰ) and resected wound(type Ⅱ)，spraying of FS or thrombin or direct suturation, was used receptively. Natural hemostasis was used as control.During postoperation the hemostatic time and the state of wound healing on 1st, 4th, 7th,14th, 50th day were observed.Results　Compared with the natural hemostasis,the hemostatical time of the FS group was shorter 86.0%(P＜0.01)in liver trauma type Ⅰ and 79.0%(P＜0.01)in liver trauma type Ⅱ.Compared with the thrombin group,the hemostatical time of the FS group was shorten 45.0%(P＜0.01)in liver trauma type Ⅰ and 84.0%(P＜0.05) in liver trauma type Ⅱ.The wound surface of FS group was healed faster than that of other groups.Conclusion　FS was an effective hemostatic and healing-promoter on liver trauma of rats.

Objective To investigate the potential clinical factors associated with the prognosis and relapse of adult onset Still's disease(AOSD).Methods The factors possibly influencing the prognosis and relapse of AOSD were analyzed by logistic regression and COX regression in the cohort study.Ninety-six con- secutive inpatients of AOSD diagnosed based on Yamaguchi criteria in the hospital from March 1996 to September 2004 were included in the study.Results Nine cases(9.4%)were lost during the follow-up. Eleven patients(12.6%)were diagnosed as other diseases(5 with other rheumatic diseases,4 with tumor and 2 with infections)in the 87 follow-up cases.In 76 cases,3 patients(3.9%)died and 33 patients(43.4%) got remission over one year after treatment.Splenomegaly(OR=3.14,95%CI=1.01～9.74)and treated with methotrexate(OR=0.22,95%CI=0.07～0.67)were associated with the prognosis from the logistic regression analysis of the 76 cases.The serum ferritin(RR=I.05,95%CI=1.01～1.08)and treated with methotrexate (RR=0.13,95%CI=0.02～0.76)were associated with relapse from the COX regression analysis of the 61 remis- sion cases.Conclusion We need to be very cautious in the follow-up of AOSD patients because some of them may change to other diseases.Methotrexate may be an importent therapy of AOSD not only in improve- ment the prognosis but also in reduction of relapse.

Objective Establish a method for measuring the activities of Galactocerebrosidase (GALC), α-Glucosidase(GAA), α-Galactosidase (GLA) and α-L-Iduronidase (IDUA) in dried blood spots specimen by tandem mass spectrometry ( MS/MS ).Methods A total of 2175 dried blood spot samples forinborn errors of metabolism in neonatalscreening center of Shanghai Xinhua hospital were collected in July and November, 2013.And twenty dried blood spot samples from patients withlysosomalstorage disorders( LSDs) of Shanghai Xin Hua Hospital were collected from September 2012 to January 2014.The extraction of DBS was incubated with enzyme substrates and internal standards.After liquid-liquid and solid-phase extraction, the extraction solution was dried under nitrogen and reconstituted.Then enzyme reaction products and internal standards were analyzed by MS/MS.Linearity, precision, accuracy and the limit of detection were evaluated.2175 dried blood spot samples were detected to establish the normal reference range for the activities of four enzymes according to 0.5th to 99.5th percentiles.20 specimens from patients withLSDs were detected to verify the reference range inclinical judgment.Results The intraassay and interassay precisions ranged from 1.7%to 11.8%, and the intraassay and interassay accuracies ranged from 85%to 115%.The linear coefficients for measured concentration of enzyme products/internal standards and theoretical concentration were 0.997-0.999.The limits of detection forGALC, GAA, GLA and GLA were 0.03 μmol/(L· h), 0.09 μmol/(L· h), 0.12 μmol/(L· h) and 0.16 μmol/(L· h) .The normal reference values for GALC, GAA, GLA and GLAwere 0.51-8.51μmol( L· h) ,1.99-22.22μmol/( L· h),1.68-41.59 μmol/(L· h) and 2.36-19.21 μmol/(L· h).The enzymes of 20 patients with LSDs were remarkably decreased compared to the normal range.The Krabbe, Pompe, Fabry, MPSⅠpatients can be effectively detected by this MS/MS method.Conclusions A MS/MS method for measuring GALC, GAA, GLA and IDUA enzyme activities in DBShas been established.

Objective To investigate the risk factors for early hypoglycemia and its relationship with prognosis of patients with cerebral infarction.Methods A total of 273 patients with cerebral infarction were divided into the normal blood glucose(NBG) and severe hypoglycemia (SHG)and mild hypoglycemia(MHG) groups in our hospital.Biochemical indicators,the National Institute of Health stroke scale(NIHSS)and mortality were compared between the three groups.According to prognosis,patients were divided into death group and survival group.The NIHSS score,blood glucose concentration and incidence of hypoglycemia were compared between death and survival groups.Pearson relationship between hypoglycemia and NIHSS score,and spearman rank correlation between hypoglycemia severity and mortality were analyzed.Results Levels of lactic acid (6.3 ± 2.8) mmol/L,creatinine(268.7 ± 63.9) mmol/L,urea nitrogen (13.8 ± 3.7) mmol/L,albumin (25.6 ±4.9) g/L,alanine aminotransferase (150 ± 19.7) U/L,NIHSS (22.3 ± 9.2) scores,and mortality rates (38.1 ％)were higher in severe hypoglycemia group than in both NBG group and severe hypoglycemia group[(lactic acid:4.7±2.3 mmol/L and 3.3±1.5 mmol/L),(creatinine 134.8±51.3 mmol/L and 78.7±40.8 mmol/L),(urea nitrogen 7.9±4.2 mmol/L and 7.7±3.3 mmol/L),(albumin 36.9±3.8 g/L and 35.6±4.3 g/L),(alanine aminotransferase 85.8± 18.3U/L and 46.3± 13.8U/L),(NHISS 14.6±5.9 scores and 10.5 ± 5.4 scores)and(mortality rates 20.8％,11.0％)] (all P＜0.01).There was a negative correlation between hypoglycemia and NIHSS score(r=-0.45,P＜＜0.05).There was a positive correlation between hypoglycemic severity and mortality (r =0.41,P ＜ 0.05).Multiple Logistic regression showed that creatinine and alanine aminotransferase were correlated with hypoglycemia and prognosis of patients with cerebral infarction(both P＜0.05).Conclusions Early hypoglycemia in patients with severe cerebral infarction is closely correlated with the liver and kidney insufficiency,and a severe cerebral infarction combined with hypoglycemia often indicate a poor prognosis.

Adaptor Proteins, Signal Transducing ; metabolism ; Carcinoma, Hepatocellular ; metabolism ; pathology ; Case-Control Studies ; Humans ; Liver Neoplasms ; metabolism ; pathology ; Membrane Proteins ; metabolism ; RNA, Messenger ; genetics

Objective: To evaluate the efficacy and toxicity of rituximab combined with cyclophosphamide, pirarubicin, vincristine, and prednisone (R-CTOP regimen) for B cell non-Hodgkin's lymphoma and to analyze the influential factors for patient response.Methods: The clinical data of patients with CD20 antigen treated with R-CTOP regimen were reviewed and the influence of sex, age, clinical stage, pathological type, and level of LDH and IPI on patient response was analyzed.Results: A total of 33 patients were evaluated for objective response.The complete response (CR) rate was 51.5%, the par-ticel response (PR) rate was 33.3%, and the overall response rate was 84.8%.For the 23 de novo patients, the CR rate was 56.5 %, the PR rate was 34.8%, and the OR rate was 91.3%.While in the 10 recurrent patients, the CR rate was 40%, the PR rate was 30%, and the OR rate was 70%.Sex, clinical stage, pathological type, and the level of LDH and IPI were not significantly related to clinical response.While patient age was related to clinical response.None of the patients died of therapy-related side effects.The most frequent adverse event was myelosuppression (Ⅲ-Ⅳ decrease of leukocyte account-ed for 32.1%).Cardiotoxicity and alopecia were mostly grade Ⅰ to grade Ⅱ.Other side effects can be tolerated after symp-tomatic treatment.Conclusion: R-CTOP regimen is a highly effective and well-toleraed therapy and should be the first choice in the treatment for B cell non-Hodgkin's lymphoma (NHL), especially for senior patients.

Objective To compare the concordance of five automated 25OHD immunoassays with liquid chromatography tandem mass spectrometry method ( LC-MS/MS) .Methods During May to July in 2014, 245 clinical serum samples that requested 25OHD tests were selected, with a total 25OHD range of 2.8 ng/ml-64.0 ng/ml, in which 154 samples did not contain 25OHD2 and 91 samples contains both 25OHD2 and 25OHD3 .To used a LC-MS/MS method that built in our laboratory to measure 25OHD, five commercial automated chemiluminescent immunoassays from Abbott Diagnostics ( A ) , DiaSorin LIASON (B), IDS-iSYS(C), Roche Diagnostics(D), and Siemens ADVIA Centaur(E).Taking the reference method LC-MS/MS as a standard , to compared the concordance and performance of the five automated 25OHD immunoassays.And used the commonly accepted cutoffs for 25OHDdeficiency (<20 ng/ml), and insufficiency ( 20 -30 ng/ml ) , and sufficiency (≥30 ng/ml ) to compare the uniformity of different methods .Statistical analysiswere performed by MedCalc software , Passing & Bablok regression , Bland &Altaman plots and Box and whisker plots were performed to compare the differences of the methods .Results The medium ( range:2.5% -97.5%) 25OHD of the 245 serum samples of the six methods was 23.5 (5.8-44.2) ng/ml(LC-MS/MS),20.6 (7.1-43.5)ng/ml(A),19.0 (5.4-38.0) ng/mL (B),23.0 (10.0-38.1) ng/ml(C),20.1 (5.1 -46.0) ng/ml (D),31.3 (12.3 -71.1) ng/ml (E), respectively .Passing and Bablok regression showed that method B had the best correlation coefficient with LC-MS/MS (r=0.894), while methods A, C and D had relatively small bias compared withLC-MS/MS and method E had the large bias .If the serum samples did not contain 25OHD2 , all the five automated immunoassays correlated well with LC-MS/MS with a correlation coefficient higher than 0.84, and B has the best correlation with LC-MS/MS ( r=0.930 ) .While all the correlation coefficient between immunoassays and LC-MS/MS decreasedwhen analyzing the samplescontaining 25OHD2.Using the clinical cutoffs, A, B, C, D and E had a concordance of 68.6%, 64.9%, 67.8%, 70.6% and 51.8% compared with LC-MS/MS, respectively .Conclusions There are significant differences between different detection systems of 25OHD.All the immunoassays results were affected by the existence of 25OHD2 .The concordance of serum 25OHD resultswas poor between different methods , and it may be necessary to built exclusive cutoffs for different methods.

Objective To investigate the expression of vascular endothelial growth factor(VEGF)in synovium of rats with adjuvant arthritis and the relationship between the histopathologic score and the expression of VEGF.Methods Adjuvant arthritis was established in Wistar rats by inoculating complete Freund's adjuvant(CFA). We calculated the arthropathologic score and the expression of VEGF mRNA and protein at different stages after CFA inoculation.Results In model group the arthropathologic score and expression of VEGF protein in synovium increased significantly all the time (P

OBJECTIVETo study the percutaneous lag screw internal fixation of LX technique for sacroiliac joint diseases or injuries.

METHODSThere were 38 patients (25 male and 13 female) with an average age of 35.6 years ranged from 18 to 59 years. Among them, thirty-one cases with trauma of Tile B type, five cases with sacroiliitis and two cases with sacral cystis degeneration. There were 11, 15, 5 cases of Tile B1, B2, B3 type respectively. Pelvic anterior-posterior radiography and spiral computed tomography (CT) were undertaken for all patients. Axis planar, coronal planar, sagittal planar and curve planar of sacral reconstruction of spiral CT images were obtained for every patient. There were 28 cases with delitescence posterior ring injury. All these patients were performed percutaneous lag screw fixation procedures of LX technique under epidural anesthesia. Localization with spiral CT guidance was performed by the radiologist using spiral CT followed by the orthopaedic surgeon. Percutaneous fusion of sacroiliac joint was performed for seven patients who suffered from sacroiliac joint diseases.

RESULTSThe blood loss were from 25 to 70 ml (means 36 ml) during operation. All patients were followed up for 3 to 39 months (means 15.6 months). There were no postoperative complications such as infection, fracture nonunion, iatrogenic injuries of nerve and blood vessel, breakage and slippage of fixtors. According to the evaluation of pelvic injuries, the results of imageology were excellent in 34 cases and good in 4, the results of clinical were excellent in 32 and good in 6.

CONCLUSIONPercutaneous lag screw internal fixation of LX technique minimizes operation injury during a short procedure with few subsequent complications and allows early mobilization of the patients. That is an ideally safe and effetive operation technique for the sacroiliac joint diseases and injuries.

Adolescent ; Adult ; Bone Screws ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; Humans ; Internal Fixators ; Male ; Middle Aged ; Sacroiliac Joint ; diagnostic imaging ; injuries ; surgery ; Tomography, Spiral Computed ; Treatment Outcome

OBJECTIVETo study the effect of the submarine training on the antioxidant ability of the submarine men.

METHODS50 sea-training submarine men, 50 land-training submarine men and 50 resting submarine men were randomly selected from some submarine troops. The blood routine, the total antioxidative capacity (T-AOC), the content of malondialdehyde (MDA) and the levels of IFN-gamma in blood plasma, the hemolytic degree of RBC, the proliferation of peripheral-blood lymphocyte (PPL) of them were detected in each group.

RESULTSThe T-AOC of the sea-training submarine men, the land-training submarine men and the resting submarine men significantly increased by turns [(15.38 +/- 3.11), (18.81 +/- 2.45), (20.93 +/- 2.95) U/ml], but MDA and the hemolytic degree of RBC significantly decreased by turns [(2.56 +/- 0.70), (2.12 +/- 0.53),(1.77 +/- 0.56) nmol/ml and 25.72% +/- 1.67%, 21.45% +/- 1.02%, 18.28% +/- 1.37%] (P < 0.05). Compared with the land-training submarine men and the resting submarine men, IFN-gamma [(31.89 +/- 3.52) pg/ml] and the proliferation of PPL of the sea-training submarine men were significantly lower, whereas the red blood count (RBC) and hemoglobin (Hb) were significantly higher (P < 0.05).

CONCLUSIONSubmarine training, especially sea training, may decrease the antioxidant ability.

Adolescent ; Antioxidants ; physiology ; Erythrocyte Count ; Humans ; Interferon-gamma ; blood ; Male ; Malondialdehyde ; blood ; Military Personnel ; Submarine Medicine ; Young Adult