As a series of multifunctional cells,recent studies indicate that most of the CD4 + T lymphocyte subsets involve in the tumor angiogenesis and invasion,the apoptosis of tumor cells,and the expressions of acute phase proteins and cancer-promoting genes by activating or inhibiting the innate immune cells,the adaptive immune cells and non-immune cells,thus function as tumor promoters or inhibitors in hepatocellular carcinoma (HCC).

0.05). There was a higher prevalence of IBS in Heilongjiang province (14.02%) than that in Shanghai (11.72%, P

Objective Assaying HBV cccDNA in periphral blood lymphocyte and discuss its clinical significance.Methods Using lymphocyte isolating solution to isolate lymphocytes in the peripheral blood, and quantitative florescent realtime PCR was used to detect HBV cccDNA.Results 29 cases of 36 CAH patients was detected positive(80.56%),32 cases of 61 CPH patients was detected positive(52.46%) and 1 case of 59 ASC was detected positive(0.02%) respectively.All 47 healthy people specimen was found negative by the method.CAH group,CPH group and ASC & negative control group show significance statistically(P

The medical students, Shanghai Jiaotong University School of medical from 5- year,7-year, 8-year to general of academic, received evidence-based medicine (EBM) education. The students' background and attitudes about EBM were different. Teaching EBM should pay attention to the relationship of EBM and basic courses, especially for deferent students. Teaching EBM should transform from imparting basic knowledge to learning skills on their own initiative.

Objective To compare the efficacy and survival of patients with malignant obstructive jaundice using either endoscopic self-expandable metallic stents or surgery,and to evaluate the compounding factors influencing prognosis.Methods 56 patients with malignant obstructive jaundice treated with endoscopic self-expandable metallic stents (the endoscopic group) were compared with 90 patients who received surgery (the surgery group) during the same study period.Clinical data and survival of the 2 groups of patients were retrospectively analyzed.Results The success rate was 100％ in the endoscopic group.The serum bilirubin,alkaline phosphatase (ALP) and γ-glutamyl transferase (γ-GT) decreased significantly by using either therapeutic endoscopy or surgery (P＜0.01).There was no significant difference between the two groups in the reduction of serum total bilirubin.The mean survival of the endoscopic and surgery groups were 340 d and 795 d respectively.The accumulative survivals of the endoscopic group at 3,6 and 12 months as evaluated by the Kaplan-Meier method were 82.6 ％,61.1％ and 46.6 ％,respectively,and for the surgery group were 97.0％,90.9 ％ and 65.4％ respectively. There was a significant difference in survival between the two groups (P＜0.01).Survival after therapeutic endoscopy was similar to surgery for patients with metastasis and hilar biliary obstruction.Conclusions Self-expandable metallic stents gave similar palliation in the relief of jaundice in patients with malignant biliary obstruction.The stents had no effect on the primary tumor.Therapeutic endoscopy with self-expandable metallic stents is a safe and effective method for the relief of jaundice in patients with obstructive jaundice caused by non-resectable malignant tumors.

This thesis analyzed the inevitability of medical negligence according to the nature of medical behavior,particularity of medical profession and psychological factors of medical staff.How to control the occurrence of medical errors is an important social problem which is the whole community has been looking forward to solve.This thesis proposed methods to reduce medical negligence from the aspects of service concept,medical education and healthy psychology.

Objective To assess the diagnostic value of Manning's criteria, Rome Ⅰ criteria and Rome Ⅱ criteria in Chinese patients of irritable bowel syndrome. Methods 724 subjects were enrolled from the outpatient department of gastroenterology and the physical examination center of Xinhua hospital. Self designed questionnaire, routine physical examination and selective accessory diagnostic procedures were undergone in all subjects including 402 cases of irritable bowel syndrome,134 cases of non ulcer dyspepsia,90 cases of ulcerative colitis and 98 healthy controls. According to Manning criteria, Rome Ⅰcriteria and Rome Ⅱcriteria, the sensitivity, specificity, positive likelihood and negative predictive value(PV), positive likelihood and negative likelihood were calculated separately. Results The sensitivity and specificity of Manning's criteria, Rome Ⅰ criteria and Rome Ⅱcriteria were 96.02% (95%CI:95.06%-100.0%), 77.36% (75.31%-79.41%), 68.41% (66.14%-70.68%) and 47.51% (44.78%-50.23%), 73.29%(70.87%- 75.70 %) 83.23% (81.19%-85.27%),respectively. The positive PV and negative PV were 69.55%, 78.33% , 83.59% and 90.53%, 72.17%, 67.85%, respectively.The positive likelihood and negative likelihood were 1.83 , 2.90 , 4.07 and 0.08, 0.31, 0.38, respectively. Conclusion Irritable bowel syndrome could be positively diagnosed by taking an appropriate history and questionnaires,Rome Ⅱ criteria had higher validity in diagnosis of irritable bowel syndrome.

Objective To compare the operation modes of AP-960 full automated ELISA system.Methods Two models were tested: beginning with adding specimens(model 1) and beginning with adding enzymes(model 2).The following factors were compared: the consumption of suckers,usage of time,result of test and the usual alarm during the test.Results The consumptions of suckers were 564 and 84 respectively.The needing time of the former mode was 125 minutes and that of the latter mode was 90 minutes.Conclusion The mode beginning with adding enzymes(model 2) is better for the current status of our clinical laboratory.

Objective To study the diagnostic value of heart fat acid binding protein (h‐FABP) in myocardial damage of children with hand‐foot‐mouth disease (HFMD) .Methods From February 2012 to December 2014 ,100 children with HFMD were chosen as study objects .All children study were divided into 2 sub‐groups according to the severity of disease:71 in ordinary HFMD sub‐group ,29 in severe HFMD sub‐group .At the same time ,100 healthy children were chosen as control group .The routine blood test , rate of abnormal electrocardiography ,rate of abnormal cTnI and rate of abnormal h‐FABP were compared among all children .The cTnI and h‐FABP at different time were compared between ordinary HFMD sub‐group and severe HFMD sub‐group .Results The WBC ,RBC and L had significant difference among different groups/sub‐groups(P<0 .05) ,the difference of PLT had no statistical significance(P>0 .05) .In ordinary HFMD sub‐group ,rate of abnormal electrocardiography was 19 .72% (14/71) ,rate of abnormal cTnI was 4 .23% (3/71)and rate of abnormal h‐FABP was16 .39% (10/71);in severe HFMD group ,rate of abnormal electrocardio‐graphy was 72 .41% (21/29) ,rate of abnormal cTnI was 82 .76% (23/29) and rate of abnormal h‐FABP was 82 .96% (23/29);in control group ,rate of abnormal electrocardiography was 1 .00% (1/100) ,rate of abnormal cTnI was 2 .00% (2/100)and rate of ab‐normal h‐FABP was 0 .00% (0/100) ,the difference had statistical significance(P<0 .05) .The cTnI and h‐FABP at different time had significant difference between ordinary HFMD sub‐group and severe HFMD sub‐group(P<0 .05) .Conclusion Heart fat acid binding protein (h‐FABP) can reflect the early myocardial damage in children with hand‐foot‐mouth disease .

Objective To analyze the clinical presentation of functional dyspepsia in Chinese ado lescents.Methods A stratified,randomized study by cluster sampling was employed,which recruited 51 956 students from high and primary schools in six provinces and two cities.All students were requested to fill in a questionnaire.Functional dyspepsia was diagnosed according to Rome Ⅱ criteria.Results Among 51 956 students,10 174 were diagnosed as functional dyspepsia(accounted for 19.58%).Heart burn,hiccup and air swallowing to terminate hiccup were major symptoms of functional dyspepsia.The upper abdominal distention,epigastric pain,anorexia and insomnia were common in boys than girls with no significance(P＞0.05).The belching,early satiety,fatigue and anxiety were significantly higher in girls than boys.Conclusions Functional dyspepsia is a common disorder among the adolescents.Educa-tion and psychotherapy are important in the treatment of students with functional dyspepsia.