Objective To evaluate the value of Epstein-Barr virus (EBV) IgG antibody to EBV Rta protein(Rta-IgG),IgA antibody to EBV early antigen (EA-IgA) and IgA antibody to EBV viral capsid antigen(VCA-IgA) for nasopharyngeal carcinoma (NPC) diagnosis.Methods From May 2012 to July 2013,serum samples from 8 884 healthy donors,1 546 clinical screening patients and 155 NPC patients in Fujian Medical University Union Hospital were collected,and EBV Rta-IgG,EA-IgA and VCA-IgA were detected by ELISA.The ROC curve analysis and correlation analysis were performed to assess the value of Rta-IgG,EA-IgA and VCA-IgA for NPC diagnosis.The positive rate among three kinds of antibodies were compared with chi-square test.Results Positive rates of EBV Rta-IgG,VCA-IgA and EA-IgA in NPC patient group were 81.9％ (127/155),90.3％ (140/155) and 48.3％ (75/155),respectively,which were higher than those in clinical screening patient group and healthy donor group (x2 =1 538.6,479.3 and 643.3 respectively,P ＜ 0.01).The sensitivity of VCA-IgA (90.3％,140/155) and the specificity of EA-IgA (95.1％,9 915/10 430) were the highest in all groups.Further analysis showed that negative predictive value of EBV Rta-IgG,VCA-IgA and EA-IgA for NPC diagnosis were 99.7％ (9 826/9 854),99.8％ (8 168/8 183),99.2％ (9 915/9 995),respectively,suggesting that three anti-EBV antibodies showed very good negative predictive value for NPC diagnosis.Next,combined detection of three anti-EBV antibodies could improve the sensitivity (94.1％,146/155) and specificity (98.9％,10 469/10 585) for the NPC diagnosis.Conclusion The EBV Rta-IgG,VCA-IgA and EA-IgA all show the clinical value for NPC diagnosis,and combined detection for Rta-IgG,VCA-IgA and EA-IgA is more suitable to screen NPC and can improve the sensitivity and specificity of NPC diagnosis.

Objective To investigate the clinical and pathological features of Churge-Strauss syndrome(CSS) combined leukocytoclastic vasculitis.Methods The clinical data of 1 patient with CSS combined leukocytoclastic vasculitis was analyzed retrospectively.Results The main symptoms of the case were peripheral nerve damage,violation of the skin lesions,gastrointestinal tract,lung,and central nervous system;peripheral blood eosinophil count was high.The pathological examine showed vessel wall and skin organizations had a large number of eosinophils infiltration,small vessel walls,as well as granuloma formation around multiple segmental fibrinoid necrotizing vasculitis.Eventually died of multiple organ failure.Conclusion The clinical manifestations of CSS combined leukocytoclastic vasculitis have vasculitis and peripheral neuropathy mainly;the pathological features are that vessel wall and skin organizations have a large number of inflammatory cells infiltration;the late multi-system are involved,and the prognosis is poor.

To culture creative persons with ability,experimental teaching systems has to be revolutionized.Comparatively concentrated and appropriately dispersed experimental managing pattern can be adopted to build up a new experimental teaching system,which combines systematic teaching and further exploration.The questions on how to develop open laboratory,change traditional experimental teaching pattern,improve the use of instrument and laboratory,pool fund to avoid repeated construction,and achieve fully share of resources are discussed in this article.

Objective To analyze the risk factors and prognosis of Clostridium difficile infection (CDI) among hospitalized patients with inflammatory bowel disease (IBD).Methods From March 2014 to February 2015,216 first-time hospitalized patients with IBD were enrolled.Once hospitalized,stool samples were obtained for Clostridium difficile culture immediately,and at the same time toxins of Clostridium difficile (tcd) A and tcdB were detected by polymerase chain reaction(PCR).The incidence and risk factors of CDI in enrolled patients were analyzed.Chi square test and nonparametric test were performed for statistical analysis.Results Among the 216 IBD patients,there were 73 patients with ulcerative colitis(UC) and 143 patients with Crohn's disease(CD).The positive rate of CDI was 13.9 ％ (30/216) in IBD patients.The positive rate of CDI was 24.7 ％ (18/73) in UC patients,which was higher than that of CD patients (8.4％,12/143),and the difference was statistically significant (x2 =10.690,P＜0.01).As the severity of the disease increased,the rate of CDI positive patients in UC patients increased.Among three patients at remission period,17 patients at mild active stage,23 patients at moderate active stage and 30 patients at severe active stage,the CDI positive patients were zero,two,five,11,respectively,and the difference was statistically significant (x2 =4.820,P=0.028).In UC patients,the incidences of patients with hospitalization history in other hospitals within three months before admission in CDI positive group and negative group were 6/18 and 7.3％ (4/55),respectively,and the difference was statistically significant (x2 =5.740,P=0.020).In 30 days before admission,the rates of patients with proton pump inhibitor (PPI) taking history of two groups were 7/18 and 7.3％ (4/55),and the difference was statistically significant (x2=8.270,P=0.004).The length of hospital stay in CDI negative UC patients was 7.0 d (5.0 d,12.0 d),which was shorter than that of CDI positive patients (10.5 d (8.8 d,18.2 d)),and the difference was statistically significant (U=277.000,P=0.005).The rate of patients underwent intestinal operation in CDI negative CD patients within three months after CDI examination was 10.7 ％ (14/131),which was significantly lower than that of CDI positive patients (5/12) (x2 =4.520,P=0.010).Conclusions The incidence of CDI in hospitalized IBD patients was high,especially in UC patients;the risk factors included disease severity,prior hospitalization history within three months before admission and PPI taking history within 30 days before admission.CDI was correlated with poor prognosis.

Objective To investigate the value of ultrasound-guided core needle biopsy in diagnosing precancerous lesions of breast cancer.Methods Totally 605 cases were enrolled.Ultrasound characteristics were recorded.The pathological diagnosis on ultrasound-guided core needle biopsy was compared with the findings of the excisional biopsy and follow-up results.Results In all of the 605 cases,3 cases were failed on ultrasound-guided core needle biopsy because of less biopsied tissue.The accuracy of ultrasound-guided core needle biopsy was 97.84％ (589/602),the Kappa value was 0.96 (P=0.01).In biopsy,42 cases were precancerous lesions of breast cancer,and divided into according group (n=32) and upgrading group (n=10) according to surgical pathology or follow-up results.The rate of underestimation was 23.81 ％ (10/ 42).Compared to according group,microcalcification,acoustic attenuation,rich vascular and suspicious axillary lymph nodes had statistical difference in upgrading group (all P＜0.05).Conclusion Ultrasound-guided core needle biopsy is ac curate in the diagnosis of breast neoplasm,however,ultrasound-guided core needle biopsy diagnosis of precancerous lesions are partly underestimated.To some degree,ultrasound characteristics of precancerous lesions of breast cancer could predict the underestimation.

Objective To explore the applied value of static and dynamic of virtual defecography technology in the etiological diagnosis of constipation.Methods 50 patients with constipation were included.Conventional cleaning enema was performed firstly.Then they were injected the virtual defecography agentwith lateral position,filling the rectum,sigmoid and descending colon.Thirdly,siting on the qualities commode,adjusting height coincides with the left and right femur,displaying the pubic symphysis and coccyx dynamic acquisition image acquisition with the speed of 4/s,the dynamic changes of the rectum and anal canal were analyzed and measured.Results Among 50 patients,32 cases with rectocele,1 case with rectal bend,2 cases with anal canal stenosis,7 cases with rectal prolapse,4 cases pelvic floor spasm syndrome,and 4 cases with no cause.Conclusion Static and dynamic virtualdefecography was an important method in the etiological diagnosis of patients with constipation.

Objective To observe the effect of Zhixuebao particles combined with Marvelon in the treatment of dysfunctional uterine bleeding in adolescent.Methods69 cases from October 2013 to March 2015 were randomly divided into observation group with 34 cases and control group with 35 patients.The control group was treated with Marvelon and observation group was another treated with Zhixuebao particles.Related indicators of two groups were compared.ResultsEndometrial thickness, menstrual volume and menstrual period of observation group were lower than that of control group(P<0.05).The bleeding time, stop bleeding time of observation group were shorter than that of control group (P<0.05).After treatment,hormone LH, FSH, P levels of observation group were lower than that of control group(P<0.05);Total effective rate of bservation group was 94.12%, higher than control group 74.29%(P<0.05).ConclusionZhixuebao particles combined with Marvelon is effective in treating dysfunctional uterine bleeding in adolescent, can improve hormone levels and it is worthy of further research and application.

Objective To improve the understanding of blastic plasmacytoid dendric cell neoplasm (BPDCN). Methods The clinicopathological features of 2 cases with BPDCN diagnosed in the Department of Pathology in Cancer Hospital of Chinese Academy of Medical Sciences and Peking Union Medical College were analyzed retrospectively. The relevant literatures were reviewed as well. Results The two BPDCN patients were both elderly men with skin nodules. The tumor cells infiltrated diffusely into the whole dermis with sparing the epidermis. BPDCN cells were small to medium size with round or oval irregular nuclei and small nucleoli. Numerous mitoses figures were seen. Immunohistochemistry stain showed that CD4 and CD56 were positive and CD20 and CD3 were negative in the 2 BPDCN cases. Only 1 case was positive for CD123. Conclusions BPDCN is a rare malignant hematopoietic tumor, which is likely to involve skin. The features of morphology and immunophenotype are crucial to make correct diagnosis.

In this study ,we detected the positive rate of anti‐HBs and anti‐HBc antibody among the subject population in Fujian Medical University Union Hospital ,and to evaluate different detection methods of anti‐HBc antibody .The positive rate of anti‐HBs and anti‐HBc antibody were detected by chemiluminescent microparticle immunoassay (CMIA) and one‐step com‐petitive enzyme‐linked immunosorbent assay (ELISA) from the year 2012 to 2013 .The subject population was divided into three groups :group 1 with the age of less than 2 years old ,group 2 with the age of 2‐20 years old ,and group 3 with the age of more than 20 years old .The positive rates of anti‐HBV antibody in the different groups were analyzed .Furthermore ,anti‐HBc antibody of 92 samples selected from the immunized population was detected by CMIA and three kinds of ELISA reagents . Meanwhile ,the detection of anti‐HBc antibody by the same ELISA reagent but different operating modes were performed in these samples .The highest positive rate of anti‐HBs antibody was detected in group 1 ,and there was no significance difference of positive rate between two detection methods of anti‐HBs antibody among three groups .The positive rate of anti‐HBc anti‐body using CMIA was significantly lower than those with ELISA among group 1 and 2 .Among the 92 samples ,the positive rate of anti‐HBc antibody was 2 .2% using CMIA .With three kinds of method of ELISA reagent ,the positive rate of anti‐HBc antibody were 79 .3% ,82 .6% and 94 .6% ,respectively ,and there was no statistical significance among the results of three ELISA reagents .Anti‐HBc was not detected from 19 samples using ELISA methods with different operating modes .It's con‐cluded that the anti‐HBs antibody declined with the increase of age ,and it is necessary to discriminate the specific population to strengthen immune system .The obviously higher positive rate of anti‐HBc antibody was found by ELISA in immunized popula‐tion than that by CM IA . Concerning on the false positive of ELISA , specimen sampling with one specific test item or the CMIA method was recommended to detect the anti‐HBc antibody .

PurposeTo evaluate the value of combined employment of thyroid imaging-reporting and data system (TI-RADS) and ultrasound elastography (UE) in the differentiation of benign and malignant thyroid nodules.Materials and Methods The clinical data of 174 patients with 232 thyroid nodules confirmed surgically or pathologically with puncture biopsy were retrospectively analyzed. All nodules were examined by ultrasound and UE. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of TI-RADS, UE and the combination of the two methods were calculated respectively, and the receiver operating characteristic curve (ROC) was drawn to evaluate the value of each of the three methods in differentiating benign and malignant thyroid nodules by comparison of area under curve (AUC).Results The diagnostic sensitivity, specificity and accuracy of UE (number of benign nodules: 155, number of malignant nodules: 77) were 88.9%, 91.8% and 90.9%, respectively; those of TI-RADS (number of benign nodules: 153, number of malignant nodules: 79) were 76.4%, 85.0% and 82.3%, respectively. The values measured by UE were significantly higher than those by TI-RADS (χ2=3.920 and 7.446,P<0.05). The sensitivity, specificity and accuracy measured by the combined use of the two methods (number of benign nodules: 155, number of malignant nodules: 77) were 93.0%, 93.7% and 93.5%, respectively, which were higher than either of the methods, and the difference was statistically significant (χ2=7.725, 6.450 and 13.728,P<0.05). The areas under the curve (AUC) were 0.833 and 0.812 respectively for UE and TI-RADS; the AUC for the combination of the two methods was 0.914, which had significantly higher diagnosis accuracy than that by any single method, and the difference was statistically significant (Z=1.95 and 2.55,P<0.05). Conclusion Compared with gray scale ultrasound, the combination of TI-RADS and UE has higher diagnostic sensitivity and accuracy for excluding malignancy in diagnose of thyroid nodules.