The clinical and laboratory data of 116 cases of severe hepatitis were evaluated by stepwise regression analysis, and the prognostic multiple regression discriminant equation of adult severe hepatitis was obtained. The formula is Y=0.0081X2+0.3039X3-0.2902X6-0.0219X9+0.1851X10+0.1628X12+0.2187X13+ 0.2403X14+0.3364X15-0.4619. It was found that the discriminant correspondence rate was 97.4% in retrospective evaluation. In prospective test for 53 cases of severe hepatitis the discriminant correspondence rate was 81%. The quantitative evaluation of prognosis in severe hepatitis is also discussed.

BACKGROUND:An ideal scaffold material needs appropriate degradation rate and certain mechanical properties, but the traditional colagen sponge scaffold has rapid degradation velocity and low mechanical strength, which is easy to colapse and difficult to maintain its natural form. Traditional cross-linking methods also have the problems of cytotoxicity or colagen denaturation, severely limiting the application of colagen. OBJECTIVE:To design a new cross-linking method for colagen and to optimize the self-assembly process so as to develop a colagen sponge scaffold with good mechanical properties and resistance to degradation. METHODS:Colagens were modified by self-assembly technology to prepare colagen fibrils which were then freeze-dried into fibrilar colagen sponges. Meanwhile, we optimized the conditions of self-assembly by using orthogonal experiment based on univariate analysis of the effect of initial colagen mass concentration, final phosphate concentration and pH value on the conversion yield of colagen self-assembly. RESULTS AND CONCLUSION:We optimized the conditions of self-assembly revealed that the optimum conditions to prepare colagen fibrils were determined as pH=8.0, initial colagen concentration=2 mg/mL, and final concentration of phosphate=15 mmol/L. The results of scanning electron microscope showed that fibrilar colagen sponges were characterized by refined porous structure which was connected by colagen fibrils. In addition, the fibrilar colagen sponges showed better equilibrium-sweling ratio, water retaining property and mechanical strength compared with unmodified colagen spondages (P < 0.05), to solve the problems in rapid degradation.

Objective To analyze the treatment effect and factors affecting the prognosis in young people of papillary thyroid carcinoma (PTC).Methods A total of 69 PTC patients were reviewed retrospectively in Sun Yatsen University Cancer Center from Dec 1996 to Oct 2005.The prognostic status were compared using the Kaplan-Meier methods,the factors were analyzed by Log-rank test and the multiple factors were estimated by the Cox regression models.Results There were 26 males and 43 females.The median age was 24 years (mean:23.1 years).The average follow-up time was 113 months ranging from 73 to 174 months.20.3％ patients (14/69) experienced recurrence during follow-up time and 1.4％ patient (1/69) died.All the patients received levothyroxine after operation.The 10 year disease-free survival (DFS) rate of patients with or without extra thyroidal extension (ETE) of PTC was 29.6％ and 80.1％,respectively (P ＜ 0.01).Multivariate analysis showed that young PTC people with ETE had a worse prognosis (P =0.004).Conclusions Young papillary thyroid carcinoma patients had a favorable outcome.Surgical procedure was the first choice for this kind of patients.ETE was an independent factor for the recurrence of young PTC patients.

Objective To investigate the application of hematology analyzer in cell counting of serous cavity effusion .Methods Humoral mode of Sysmex XE-5000 automated hematology analyzer and manual microscopy were employed to perform cell counting in 85 samples of serous cavity effusion .Results Compared with the manual method and instrument method ,differences of mononu-clear cells and multinucleated cells of serous cavity effusion showed no statistical significance (P>0 .05) ,while those of leukocytes , erythrocytes were found statistical significance (P<0 .05) .Conclusion Sysmex XE-5000 automated hematology analyzer has advan-tages of simple ,stability and accuracy ,however ,its application in the effusion cell counting can not completely replace the manual microscopy .

T-6 specific IFN-γ ELISPOT has higher specificity, sensitivity, the positive and negative predicative value. Therefore, the ELISPOT warrant for further improvement and clinical application.

Objective:To assess the characteristics change of sleep architecture in drug naive patients with schizophrenia,compared with healthy control.Methods:The key words including schizophrenia and sleep architecture (or sleep structure or sleep disturbance or polysomnogram and so on) were used to search literatures in MEDLINE,Embase,Springer,PsychINFO,google scholar,Wanfang data,published from 1980 to 2015.Fifteen studies that compared sleep architecture in drug naive patients with schizophrenia and healthy control were included.Literature quality evaluation was performed with the Newcastle-Ottawa Scale.The meta-analysis was performed by using Stata13.0 software.Results:Compared to healthy control,the total sleep time decreased (P ＜ 0.01),the sleep latency increased (P ＜ 0.01),the sleep efficiency decreased (P ＜ 0.01),and the rapid-eye-movemem (REM) sleep latency increased (P ＜ 0.01) significantly in drug naive patients with schizophrenia.The proportion of stage1 was increased,and the proportions of stage4 and slow wave sleep stage were decreased,the differences between case and control were statistically significant.Conclusion:In the control of drug effects,patients with schizophrenia may have poorer sleep quality of be poorer than healthy controls,such as the decreased total sleep time,specifically slow wave sleep,prolonged sleep latency and decreased sleep efficiency.

BACKGROUND:Studies have found that adipose-derived stem cells (ADSCs)/collagen complexes can promote the ADSCs differentiation and maturation into mature adipocytes and promote angiogenesis.OBJECTIVE:To explore the biological properties of the ADSCs/collagen sponge composite material and to detect its effect on angiogenesis.METHODS:(1) ADSCs were cultured on collagen sponge (experimental group) or cultured alone (control group).After 24 hours of culture,cell adhesive rate of ADSCs was determined with flow cytometry.After 2,4,6 days of culture,cell proliferation and level of vascular endothelial growth factor (VEGF) in the culture medium were detected.(2) Chick embryo chorioallantoic membranes were exposed and incubated for 7 days and then divided into four groups:0.2 mL of sterile PBS was added in the blank group,0.2 mL of 2× 108/L passage 3 ADSCs suspension was added in the ADSCs group,collagen sponge was added in the collagen sponge group,and collagen sponge with 0.2 mL of 2× 108/L passage 3 ADSCs suspension was added in the composite group.After 7 days of incubation,the microvessel count around the chorioallantoic membrane was measured.RESULTS AND CONCLUSION:(1) The cell adhesive rate of ADSCs to collagen sponge reached to (93.04±0.67)％.(2)The absorbance value (at 6 days of culture) and level of VEGF (at 4 and 6 days of culture) in the experimental group were significantly higher than those in the control group (P ＜ 0.01 or P ＜ 0.05).(3) Compared with the blank group,the number of microvessels was significantly higher in the ADSCs,collagen sponge and composite groups (P ＜ 0.05).Moreover,higher amount of microvessels were found in the composite group than the ADSCs and collagen sponge groups (P ＜ 0.05).To conclude,ADSCs can adhere well to the collagen sponge with good biocompatibility and their combined use can improve angiogenesis further by enhancing cell proliferation and VEGF secretion of ADSCs.

Objective To evaluate the limit of blank (LoB),limit of detection (LoD),limit of quantitation(LoQ)and functional sensitivity (FS)of prealbumin (PA)detected by the Roche Modular P automatic biochemical analyzer.Methods According to the EP17A file of the American Clinical and Laboratory Standards Institute (CLSI),saline as the blank sample and a series of low con-centration samples were detected by the Roche Modular P automatic biochemical analyzer for determining LoB,LoD and LoQ.And FS was determined based on the domestic universal method .Results LoB of PA was 16.35 mg/L,LoD was 18.23 mg/L,LoQ was temporarily unable to evaluate and FS was 25.00 mg/L.The report scope and the report mode in clinic were affirmed by combi-ning with the low value of the reportable scope.Conclusion LoD of PA detected by the Roche Modular P automatic biochemical an-alyzer is established,which provides more valuable information for clinical diagnosis and treatment.Conducting the comparison of different evaluation methods determines the advantages and limitation of the practical application of different methods.

Objective: To investigate the clinical effect of percutaneous transhepatic bile duct drainage guided by ultrasound. Methods: From June 2016 to June 2018, 100 patients with obstructive jaundice in Lishui Central Hospital were treated with ultrasound-guided percutaneous transhepatic bile duct drainage.The success rate and postoperative complications of the patients were analyzed. Results: Among 100 cases, 98 cases were successful, 2 cases failed, and the failure rate was 2%.The success rate of one-time catheterization in 0.5-2.0 cm patients with intrahepatic bile duct diameter(98.91%) was significantly higher than that in intrahepatic bile duct diameter 0.3-0.4 cm patients(87.50%), compared with two different diameter puncture catheterization, the difference was statistically significant(χ²=12.369, P<0.05). All 98 cases with successful puncture were followed up after operation (P<0.05), and there was no statistically significant difference between the two groups(P<0.05). The drainage tube was removed in 2 cases, bile duct infection was found in 2 cases, the remaining patients were unobstructed, and there were no obvious complications. Conclusion Ultrasound-guided percutaneous transhepatic catheterization and drainage for the treatment of obstructive jaundice caused by malignant tumor is simple, reliable, safe and effective, and has a certain clinical value.It is worthy of popularizing and application.

ObjectiveTo investigate the diagnosis and treatment of hepatic venous outflow obstruction(HVOO) after pediatric liver transplantation.MethodsFrom Jan.2000 to Dec.2009,48 children received liver transplantation in the Department of Liver Transplantation,First Central Hospital,Tianjin.There were 3 patients who developed HVOO (2 received liver transplantation in our center,while the third from another centre).The HVOO was diagnosed by color Doppler ultrasound (CDUS),computed tomography (CT),and angiography of inferior vena cava (IVC).The patients received balloon dilation and/or stent placement and followed-up with regular monitoring.ResultsIn our center,the incidence rate of HVOO was 4.17％ (2/48).The time of onset was 2 months to 1 year postoperatively.The pressure gradient between the hepatic vein and the right atrium was from 6 to 30mmHg.After treatment,the venous pressure gradient decreased from 4 to 10mmHg.Resolution of clinical symptoms was achieved in these patients.HVOO relapsed in two patients who received balloon angioplasty only.The clinical symptoms were relieved after repeated balloon dilation in one and stent placement in the other.There were no further complications after these procedures.All patients were alive at a follow-up from 2 months to 9 years.ConclusionThe incidence of HVOO after pediatric liver transplantation was not high,but HVOO led to serious consequences.Balloon dilation and/or stent implantation were safe and efficacious treatments for HVOO after pediatric liver transplantation.