Objective To evaluate the diagnostic values of enzyme‐linked immunosorbent assay (ELISA ) and colloidal gold im‐munochromatographic assay in detecting serum anti‐cyclic citrullinated peptide(anti‐CCP) antibody .Methods Colloidal gold immu‐nochromatographic assay and ELISA were used to detect serum anti‐CCP antibody in 110 RA patients and 110 healthy cases . Results The data were analysed with the paired Chi‐Square Test (χ2 = 174 .354 ,P < 0 .01) ,the difference was significant .The K ap pa value was 0 .890(P< 0 .01) ,indicating that the coincidence between the two kinds of methods was good .The sensitivity , speciality of ELISA were 83 .64% and 92 .73% respectively .Conclusion In detecting serum anti‐CCP Antibody ,there was dife‐rence between colloidal gold immunochromatographic assay and ELISA according to statistics analysis .The sensitivity and speciality of ELISA were higher than those of colloidal gold immunochromatographic assay .

Objective To investigate the diagnostic value for rheumatoid arthritis(RA) by using combined detection of anti‐cy‐clic citrullinated peptide antibody (anti CCP ) ,anti keratin antibody (AKA ) and the antiperinuclear factor (APF ) in serum . Methods A total of 110 RA patients(RA group) ,50 patients with other autoimmune diseases(non RA group) and 110 healthy subjects (control group) were enrolled in the study .The concentrations of AKA ,APF were detected by using indirect immunofluo‐rescence assay and anti CCP by using ELISA .Results The positive rates of anti‐CCP ,AKA ,APF in RA group were higher than those in non RA group and control group(P<0 .05) .In the series detection of the three indicators ,the sensibility and specificity were 44 .55% and 99 .38% respectively ;in the parallel detection of the three indicators the sensibility and specificity were 93 .64%and 85 .63% respectively .Conclusion Anti CCP detection exhibits relatively higher sensitivity and specificity in the diagnosis of RA .Series detection of the 3 indicators can improve the specificity ,reduce the rate of misdiagnosis;parallel detection of the 3 indica‐tors can improve the sensitivity ,reduce the rate of misdiagnosis .The Combined detection of anti CCP ,AKA and APF has better di‐agnostic efficiency than single detection .

Objective To investigate the ultrastructural characteristics of amelanotic melanocytes (AMMCs). Methods Individual hair follicles from normal human scalp were digested with collagenase type V, then washed in phosphate buffer saline. Hair-follicle cell suspensions were prepared by trypsin and cultured in a medium suitable for melanocyte growth. The keratinocytes were removed by differential trypsinization. Geneticin (100?g/mL) was used to eliminate contaminating fibroblasts. After 3 passages the cells were trypsinized, washed in phosphate buffer saline, and finally processed for transmission electron microscopy. Results Under transmission electron microscope, the cultured cells were round or oval-shaped with a single large nucleus and double-layered karyotheca. Abundant euchromosome but sparse heterochromosome was observed within the nucleus. There were various organelles in the cytoplasm, including mitochondria, rough endoplasmic reticulum (RER), ribosomes and abundant melanosomes of nearly uniform size. The electronic density granules distributed in a concentric pattern in most of the melanosomes. Colgi complexes were inconspicuous in the cells. Conclusions Compared to epidermal melanocytes, AMMCs from human hair follicles have different ultrastructural characteristics which implies their functional immaturity. AMMCs may serve as the depot for mature melanocytes.

[ABSTRACT]OBJECTIVETo evaluate the clinical value of ultrasound guided fine-needle aspiration (US-FNA) in the diagnosis of thyroid nodules with different size.METHODSThe clinical data of 122 thyroid nodules of 109 cases referred to FNAC for diagnosis were retrospectively reviewed. The final operating histological results of 122 nodules were considered gold standard. RESULTSNon-diagnostic FNAC results occurred in 17 nodules (13.9%). FNAC achieved a sensitivity of 78.6%, a specificity of 93.9%, a positive predictive value of 93.6%, a negative predictive value of 78.3%, and a total accuracy of 85.7%. There was no significant difference between the diameter of the nodule≤1 cm group and>1 cm group, except negative predictive value. The non-diagnostic results rate was no significant difference between groups of different nodule size, benign or malignant nodules, and different operators. CONCLUSIONFNAC is a sensitive, specific and accurate method for differential diagnosis of thyroid nodules.

BACKGROUND:Baloon kyphoplasty is effective in the treatment of osteoporotic vertebral compression fractures, but it is unclear that which one is proper, unilateral or bilateral approach, with better efficacy and fewer
complications.
OBJECTIVE:To assess the efficacy and safety of unilateralversus bilateral baloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures.
METHODS: We searched the electronic bibliographic databases including Cochrane Library, PubMed, EMBASE, ISI Web of Knowledge, CBMdisc and other databases to colect clinical trials concerning unilateral versus bilateral baloon kyphoplasty. Two estimators independently evaluated the quality of these included studies and analyzed data by Cochrane Colaboration’s RevMan 5.2 software.
RESULTS AND CONCLUSION:Fourteen trials involving 876 patients were included. There were 442 cases of unilateral approach and 434 of bilateral approach. The meta-analysis showed that there were no significant
differences in pain score by visual analog scale, vertebral height, and kyphotic angle; while the unilateral approach had less operating time, lower amount of cement injected and lower risk of cement leakage
than the bilateral approach [mean difference (MD)=-19.33, 95% confidence interval (CI) (-24.42,-14.24);
MD=-2.07, 95%CI (-2.42,-1.71); odds ratio=0.47, 95% CI (-24.42,-14.240)]. These findings indicate that the unilateral baloon kyphoplasty can reduce the leakage rate of bone cement.

Objective To investigate the role of deoxycholic acid (DCA) in the pathogenesis of Barrett esophagus.Methods Normal human esophageal mucosal epithelial cells were cultured in vitro with defined keratinocyte serum-free media (D-KSFM).The cultured cells were treated with different concentrations of DCA and specific p38 mitogen activated protein kinase (MAPK) inhibitor. The expression of p38,phosphorylated p38 (p-p38) and caudal-related homeodomain transcription 2 (CDX2) at protein level were assessed by Western blot.The correlation between p-p38 and CDX2 was analyzed.The data were analyzed by one way ANOVA and LSD test.Results After being cultured with DCA for 24 h,the expression of p-p38 and CDX2 increased along with the increasing of DCA concentration.Compared with the control group (p-p38 was 13.7％ ± 1.0％ and CDX2 protein was 0),the difference was statistically significant (P＜ 0.05).When DCA was at 500 μmol/L,the expression of p-p38 and CDX2 reached the highest level (44.0％ ± 1.7％ and 8.59± 1.25).After pretreated with SB203580 for two hours and then 500 μmol/L DCA was added into cell culture,both expression level of p-p38 and CDX2 decreased compared with 500μmol/L DCA group (p-p38:28.3％ ±2.2％ vs50.5％±9.5％,CDX2:0.94±0.13 vs 2.31±0.41) after 24 h.Conclusions DCA can induce the expression of CDX2 in normal human esophageal mucosal epithelial cells,which is related with the activation of p38.The phosphorylation of p38 maybe involved in the pathogenesis of Barrett esophagus.

Objective To investigate prevention and treatment of cerebrospinal fluid leakage (CSFL)in anterior cervical spine surgery for severe ossification of posterior longitudinal ligament (OPLL).Methods A retrospective analysis of 47 patients with severe cervical OPLL (thickness of the ossified mass ＞ 5 mm,spinal stenosis ＞50％),who had undergone anterior cervical surgery between January 2008 and May 2011,was conducted.Fifteen cases of dural defect were found intraoperatively,including 11 males and 4 females,aged from 40 to 68 years (average,55.6 years).Preoperative CT scans were earefully analyzed.During the operation,the ossified mass was excised or floated and the arachnoid was reserved in order to reduce dural damage.Dural defects were repaired by suturing or covering with muscle.After surgery,patients were confined to bed rest to allow for drainage or puncture.Results All 15 patients were followed up for 12 to 18months (average,14.8 months).After operation,10 patients recovered fully without CSFL.Five patients developed CSFL,including 4 cases of spinal dural mater injury that healed within 4-6 days with bed rest and pressure dressing,and 1 case of cerebrospinal fluid pseudocyst that disappeared within 3 weeks with repeat puncture and aspiration treatment.No cases required secondary operations or shunt placement.All cases exhibited good neurological improvement.Conclusion During anterior surgical treatment for severe cervical OPLL,CSFL can be effectively prevented through eareful analysis of preoperative CT images,meticulous operative technique,reasonable handling of the ossified mass and positive repair of dural damage.Moreover,postoperative bed rest and drainage are effective to treat CSFL.

Objective To observe the clinical efficacy of modified Sanzi Yangqin Decoction for the treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods Totally 80 cases of OSAHS patients were randomly divided into treatment group and control group, with 40 cases in each group. Both groups received intervention of diet and life. The control group was given vitamin C, 100 mg each time, 3 times a day orally. Treatment group was given modified Sanzi Yangqin Decoction, 1 dosage per day, twice a day, orally, for 14 d. The scores of TCM symptoms, sleep apnea (AHI), lowest oxygen saturation (LSaO2) and longest apnea were observed before and after treatment. Results The overall effective rate of TCM syndrome was 90% (36/40) in the treatment group and 65% (26/40) in the control group, with statistical significance (P<0.05). Compared with before treatment, there was statistical significance in the scores of TCM symptoms, AHI, LSaO2, and longest apnea (P<0.05,P<0.01). After the treatment, compared with the control group, there was statistical significance in the scores of TCM symptoms, AHI, and LSaO2 in the treatment group (P<0.05,P<0.01). Conclusion Modified Sanzi Yangqin Decoction can effectively treat OSAHS and improve the life quality of patients.

Objective To investigate the therapeutic effects of Saussurea involucrate injection in severe acute pancreatitis (SAP) in rats.Methods A total of 80 healthy Sprague-Dawley rats were divided into eight groups:SAP group (three hours、48 hours),Saussurea involucrate treated group (three hours、48 hours),ulinastatin control group (three hours、48 hours) and sham operation group (three hours、48 hours),10 rats in each group.After modeling,the rats of SAP group were regularly feeded and the rats of other three group were treated with Saussurea involucrate injection (1.04 mL/kg) intraperitoneal injection,ulinastatin 10 000 U/L tail vein injection,and saline femoral vein injection,respectively and injected every 12 hours.At three hours and 48 hours after treated,blood and pancreatic tissue samples were obtained.The mortality rate,serum amylase level and pathological changes of the pancreas of each group were observed.Serum tumor necrosis factor alpha (TNF-α),interleukin (IL)-6 and IL-10 levels were detected by enzyme linked immunosorbent assay (ELISA).The content of malondialdehyde (MDA) in pancreatic tissues was determined by chemical colorimetry.The level of TNF-α mRNA,IL 6 mRNA and IL-10 mRNA in pancreatic tissues were measured with reverse trascription-polymerase chain reaction (RT-PCR).The activity of nuclear factor kappa B p65 (NF-κB p65) in the pancreatic tissue was tested by immunohistochemistry.Single factor analysis of variance was used to compare multiple groups,and the least significant difference (LSD) method was used in the multiple comparisons between groups.Fisher's exact probability method was performed for rates comparison.Results At 48 hours,there was no statistically significant difference in mortality rate among Saussurea involucrate treated group,SAP group and ulinastatin groups (all P＞0.05).At 48 hours,the histopathology score (8.13 ± 0.64),levels of serum amylase ((2 597.0±214.0) U/L),TNF-α ((254.4±11.6) ng/L),IL-6 ((441.4±14.6) ng/L),levels of pancreatic tissues MDA ((311.0±10.6) mmol/L),TNF-α mRNA(2.04±0.08),IL-6 mRNA (1.77±0.04)and activity of NF-κB p65 ((25.90±2.90)％) of Saussurea involucrate treated group were all lower than those of SAP group (11.40±0.89,(4 780.0±101.0) U/L,(396.0±7.4) ng/L,(664.4± 7.6) ng/L,(418.0± 10.6) mmol/L,2.94±0.03,2.63±0.08 and (51.60±5.27) ％;however level of serum IL-10 ((133.5±6.9) ng/L vs (95.1±5.2) ng/L) and IL-10 mRNA of the pancreatic tissue (1.38±0.06 vs 0.85±0.03) significantly increased (F=253.07、441.63、489.40、2 465.00、196.65、477.89、562.79、131.70、560.18、570.04,all P＜0.01).There was no significant differences in all above parameters between Saussurea involucrate treated group and ulinastatin groups (7.56±0.88,(2 607.0±239.0) U/L,(252.2 ±9.2) ng/L,(443.4±9.6) ng/L,(308.4±9.2) mmol/L,2.10±0.12,1.74±0.04,(26.00±3.67)％,(134.5±7.8) ng/L and 1.42±0.06) at 48 hours (all P＞0.05).Conclusion Saussurea involucrate injection can eliminate oxygen free radicals and prevent to xidation,inhibit NF-κB activation,regulate synthesis and release of cytokines,and alleviate pancreatic injury in SAP rats,but it can not decrease mortality.

Objective To analyse the differences of indirect immuno‐fluorescence (IIF) ,enzyme‐linked immunosorbent assay (ELISA) and immunoblotting technique(IBT) for the determination of anti‐dsDNA antibody ,and evaluate the value of joint detec‐tion of the three methods for diagnosing systemic lupus erythematosus(SLE) .Methods From January 2012 to March 2015 ,50 ca‐ses of patients with SLE ,100 cases of patients with other autoimmune disease(AID)and 100 healthy individuals were selected .Ser‐um levels of anti‐dsDNA antibody were detected by using IIF ,ELISA and IBT respectively .Then ,compared the sensitivity and spe‐cificity of the three methods ,and analysed the sensitivity and specificity of joint detection .Results The IIF method had the highest specificity(99 .5% ) ,while ELISA had the highest sensitivity(74 .0% ) .There were statistically significant differences in the positive detection rates of serum anti‐dsDNA antibody in patients with SLE between IIF and ELISA ,IIF and IRT ,ELISA and IBT(χ2 values were 11 .435 ,13 .994 and 4 .539 ;P<0 .05) ,and the Kappa values were 0 .411 ,0 .522 and 0 .278 respectively .The specificity of three methods joint in series was increased to 99 .5% ,and the sensitivity of parallel combined detection of the three methods was in‐creased to 82 .0% .Conclusion Among the three methods for detecting anti‐dsDNA antibody ,ELISA has the highest sensitivity , and IIF has the highest specificity .Moreover ,joint detection could increase the sensitivity and specificity .