Objective To investigate the effects of CO 2 pneumoperitoneum on circulation, P ET CO 2 and blood gas during laparoscopic hepatectomy. Methods Fourteen patients underwent laparoscopic hepatectomy with CO 2 pneumoperitoneum. The MAP, HR, CVP, P ET CO 2 , airway pressure and blood gas were monitored respectively before, 30min, 60min, 120min after pneumoperitoneum, and 10min and 30min after deflation of the abdomen. Results The HR, P ET CO 2 , PaCO 2 , and plood K + were significantly higher 30min after pneumoperitoneum compared with the values before pneumoperitoneum (P

Objective:To evaluate the significance of the combination of rheumatoid factor (RF) and anti-filaggrin antibodies (AFAs) in the diagnosis of rheumatoid arthritis (RA). Methods:Sera from 266 RA patients and 186 controls were studied. RF and some kinds of AFAs (including antikeratin antibodies, anti-perinuclear factor and anticyclic citrullinated peptide antibodies) were detected using immunofluorescence and ELISA respectively. The distributions of these antibodies were compared to determine the significance of the combination of RF and AFAs. Results:The sensitivity and secificity of RF for the diagnosis of RA were 65.8% and 81.8% respectively, as compared with those of anti-CCP or RF positive were 86.5% and 80.6% respectively. Only a slight change was found in the secificity and negative predictive value between them. RF could not be detected in 91 patients while 64.8% of them could be found to have at least one kind of AFAs. Conclusion:AFAs, particular anticyclic citrullinated peptide antibodies, could be helpful for the diagnosis of RA especially in RF-negative patients.

Objective To evaluate the diagnostic specificity and sensitivity of anti-p68 antibody in rheumatoid arthritis (RA), and to analyze the relationship between anti-p68 antibody and the activity of RA . Methods Anti-p68 antibody was tested in the serum of 183 RA patients and 195 controls by indirect immunofluorescence (IIF). The clinical characteristics of RA between anti-p68 positive group and negative group were compared. Results ① The positive rate of anti-p68 antibody was 67.8% (124/183) in RA, 14.9% (17/114) in other rheumatic diseases and none in normal controls (0/81). Anti-p68 antibody was different from other auto-antibodies found in RA. ② Its sensitivity was 67.8% and specificity was 91.3% for RA, positive prediction rate was 87.9% and negative prediction rate was 75.1%. ③ There was statistic difference between the positive group and negative group in disease duration, RF and degree of X-ray changes. Conclusion ① Anti-p68 antibody is a new and specific serum maker for diagnosis of RA. ② The antibody is correlated with disease duration, RF and X-ray changes.

Objective To examine the role of synthetic cyclic citrullinated peptide (CCP) in T cell autoreactivity in rheumatoid arthritis (RA) by detecting T cell proliferation. Methods Twenty-nine RA, 8 primary Sjo gren syndrome (pSS) and 16 osteoarthritis (OA) patients were included in this study. Proliferation of T cells was measured by methyltetiazolium incorporation following incubation with CCP. Results T cell response to CCP was more common in RA patients than in controls. The response rate to CCP was higher in late RA than in early RA. However, the response wasn′t associated with disease activity. A strong association between T cell proliferation and RF, anti-CCP antibody was observed. Conclusions T cell proliferation in response to CCP was found in the majority of RA patients, even in early RA, suggesting that the citrullinated peptide play an important role in the pathogenesis of RA.

Objective To understand the clinical profiles of arthritis after human parvovirus B19(B19) infection.Methods Four cases were described and the clinical and laboratory characteristics were analyzed. Results The median onset age of the 4 patients(2 females and 2 males)was 34 years old.Typical clinical manifestations included joint symptoms,flu-like malaise and erythematous rash.Anti-Bl9 IgM antibodies were all positive in 4 patients.B19 DNA was detected in blood samples of 3.Other types of arthritis were excluded. No relapses were noticed after followed-up of 1～3 years.Conclusion The Anti-B19 lgM and B19 DNA should be detected in patients suffer from arthritis with unknown origin.

Neonatal brain damage including hypoxia-ischemia encephalopathy(HIE) and intracranial haemorrhage,may cause adverse neurodevelopmental outcome such as cerebral palsy.Earlier diagnosis is very important for the treatment of brain damage.This review is to elucidate the relationship between imaging changes(CT,MRI and ultrasonography) and prognostic assessment,thus provide reference for clinicians,the objective is focus on imaging changes of HIE and intracranial haemorrhages,which are 3 of the most frequently reported cases.

Objective To explore the diagnostic value of anti-cyclic citrullinated peptide (CCP) 3.1 IgG/IgA antibody detected by enzyme-linked immunosorbent assay (ELISA) in patients with rheumatoid arthritis (RA).Methods The ELISA was used to measure the anti-CCP3.1 antibody in the serum of 169 RA patients,100 patients with other rheumatic diseases (including systemic lupus erythematosus,Sjogren's syndrome and osteoarthritis) and 72 healthy controls.The diagnostic value of CCP3.1 was assessed and compared with the second generation of anti-CCP IgG (CCP2) antibody,the correlations between anti-CCP3.1 antibody and the clinical and laboratory parameters were analyzed.Two-independent samples t test,chi-square test and Spearman's correlation were adopted for statistical analysis.Results ① The average cut-off concentration of anti-CCP3.1 antibody was (1122±1429) U/ml in RA,(13±14) U/ml in other rheumatic diseases and (6±5) U/ml in healthy controls.② The area under curve of ROC for anti-CCP3.1 antibody and anti-CCP2 antibody were 0.923 and 0.936 respectively.There was no difference between the sensitivity (82％ vs 79％)and specificity (97％ vs 99％) of anti-CCP3.1 antibody and anti-CCP2 antibody.The Kappa values between anti-CCP3.1 antibody and anti-CCP2 antibody was 0.763.③ We also found that anti-CCP3.1 antibody was positive in 20％(7/35) of anti-CCP2 antibody negative,43％(18/42) of RF negative,62％(47/76) of AKA negative,71％(49/69) of APF negative and 13％ of autoantibodies negative patients,indicated that antiCCP3.1 antibody had a potential value in the diagnosis of serum negative patients with RA.④ The presence of anti-CCP3.1 antibody was correlated with RF,HRF-IgG,APF,AKA,GPI and IgA (P＜0.05),except disease activity.Conclusion The sensitivity of anti-CCP3.1 antibody is slightly higher than anti-CCP2 antibody.The Anti-CCP3.1 antibody is a very valuable parameter for the diagnosis of RA,especially in serum negative patients.

Objective To evaluate the clinical results of surgical treatment of isolated fractures of the sustentaculum tali of calcaneus via medial approach.Methods The data of 23 patients with isolated fractures of the sustentaculum tali of calcaneus was retrospectively analyzed who were treated with open reduction and internal fixation with cannulated screw or Kirschner wire via medial approach from September 2006 to March 2011.There were 19 males and 4 females,with an average age of 26.3 years (range,17-41 years).Associated injuries included 4 cases of talus fracture,4 of metatarsal fracture,and 3 of cuboid fracture.The functions of hiudfoot were assessed by American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores pre-operation and post-operation respectively.Results Fifteen patients got followed up with an average 20.5 months (10-56 months).Thirteen patients were rated as good,2 as excellent,and the excellent and good rate was 100％(15/15).All the fractures were stabilized reliably,and got clinical union with no obvious complications occurred.Time of fracture union was 8-10 weeks,with an average of 8.5 weeks.Three patients felt mild transient pain during the recovery of walking,but their pain disappeared quickly after physical therapy.No patients developed wound infection,nonunion and other complications.Conclusion For isolated fractures of the sustentaculum tali of caleaneus with articular surface displaced greater than 1 mm or involving the articular surface of middle subtalar joint,open reduction and internal fixation operation via medial approach under direct visualization is recommendable.

Objective To investigate prevalence of associated diseases in patients with gout as well as their diagnoses and treatment. Methods Two hundreds out-patients diagnosed with gout from April to October 2008 were investigated at Peking University People's Hospital, and information collected included their general characteristics, associated diseases, diagnoses and treatment, as well as blood lipid profiles, serum creatinine, uric acid, results of routine urine tests and glomerular filtration rate estimated by MDRD formula in the past three months. Results Among patients with gout, prevalence of associated hypertension, obesity, renal calculi, coronary heart disease, cerebral infarction and diabetes were 54.5% (109/200), 23.2% (42/181), 20.0% (40/200), 12.0% (24/200), 8.0% (16/200) and 7.0% (14/200), respectively, and 53.7% (101/188) of them associated with hypertriglyceridemia, 63.7% (114/179) with impaired renal function and 15.1% (27/179) with chronic kidney disease. In acute attack of gout, 124 (62.0%) of them were treated with non-steroidal anti-inflammatory drug (NASID), 72 (36.0%) with colchicines, 12 (6.0%) with corticosteroid and 30 (15.0%) with urate-lowering drugs, respectively, and during its intermittent period, 69. 8% (81/116) of them received urate-lowering therapy with indications generally accepted internationally, but serum level of uric acid could be maintained below 0.06 g/L in only 8.6% (10/116) of them. And 73.8% (48/65) of the patients with no therapy indications also were treated with urate-lowering drugs. Conclusions The most commonly associated diseases in gout patients are hypertension, hyperlipidemia and obesity, followed by renal calculi, chronic kidney disease and coronary heart disease, and so on. At present, oral NSAID is the first choice of drugs for its acute attack. Indications for urate-lowering therapy in this hospital usually are not consistent with those by generally international acceptance, with lower therapeutic effectiveness achieved.

Objective To evaluate the efficacy and safety of combination therapy of oxaliplatin and S-1 vs oxaliplatin and docetaxel for advanced gastric cancer (AGC)patients.Methods From April 201 1 to Janu-ary 201 3,62 cases of AGC were collected in the Fifth People′s Hospital of Qinghai Province.All cases were randomly divided into group A (31 cases)and B (31 cases)by random number table.In group A,oxaliplatin plus S-1 was administered,and in group B,oxaliplatin plus docetaxel was applied.The response rate (RR), time of diseases controlled rate (DCR),progression-free survival (PFS),overall survival (OS)and adverse reactions of the two groups were observed and compared.Results There were no statistically differences between group A and group B in RR (48.4% vs 54.8%),DCR (67.7% vs 77.4%),mPFS (5.4 months vs 6.2 months),mOS (9.0 months vs 9.8 months),and the statistical values were as follows:χ2 =0.26,P =0.71 1 ;χ2 =0.73,P =0.393;χ2 =0.51 ,P =0.473;χ2 =0.03,P =0.829.The incidence of degrees Ⅰ-Ⅱperipheral neuropathy (9.7% vs 22.6%),nausea and vomiting (1 2.9% vs 32.3%)in group A were signifi-cantly lower than those in group B (χ2 =5.78,P =0.002;χ2 =4.63,P =0.01 6).Conclusion Both the two chemotherapies are similar in therapeutic effect for patients with AGC.Oxaliplatin plus S-1 treatment may be better than oxaliplatin plus docetaxel in the tolerance of patients.