Objective To investigate the clinical application value of Anti -CCP antibody ( CCP) levels in patients with in rheumatoid arthritis ( RA) .Methods 132 patients with rheumatoid arthritis , 42 patients of other categories of connective tissue dis-ease, 40 health cases were collected as the research object.The anti-CCP antibody titers were detected in sera of three patients, and the anti CCP antibody in rheumatoid arthritis in the diagnostic process was calculated .Anti -CCP antibody titers were detected in three group patients, and the specific of anti CCP antibody in diagnosis of rheumatoid arthritis was counted .Results Anti-CCP an-tibody has high specificity for the diagnosis of rheumatoid arthritis , and was correlated with clinical symptoms in patients with rheuma-toid arthritis.Combination detection of anti -CCP antibody and C reaction protein can improve the diagnostic specificity , and the difference was statistically significant (p<0.05).Conclusion The specificity of anti-CCP antibody in diagnosis of rheumatoid ar-thritis is higher and its specificity is higher than that of RF .The combined detection of anti -CCP antibody and RF both can improve the diagnostic specificity of rheumatoid arthritis , and anti-CCP antibodies are related with the degree of clinical symptoms .

Objective To investigate the relationship between helicobacter pylori (H. pylori) infection and reflux esophagitis (RE). Methods H.Pylori infection rates of RE in patients with simple chronic gastritis(CG),which was confirmed by gastrospcope combined with pathological diagnosis were researched.The relationship between HP infection and RE classifications using gastroscope and pathology was explored.Results ⑴H.pylori infection was found in 29(27.1%) in 107 cases of RE and 43(40.2%) in 107 cases of simple CG patients respectively,HP infection positive in RE patients less than that of simple CG patients.RE of class Ⅰ,Ⅱand Ⅲ using gastroscopy classification were 62.1%, 10.3% and 27.6% in H. Pylori-positive cases respectively, while they were 56.4%, 6.4% and 37.2% respectively in H. Pylori-negative ones. However, mild, moderate and severe RE identified by pathohistology were 72.4%, 13.8% and 13.8% in H.Pylori-positive cases respectively, and they were 57.7%, 17.9% and 24.4% respectively in H.Pylori-negative ones.Conclusions All above results suggested that H.Pylori possibly has prevention role in some extent to pathogenesis of RE. RE more commonly was seen in H.Pylori-negative cases.RE could inhibit the H.Pylori survive,So that,the RE was occurred frequently in H.Pylori-negative patients.The inflammatory extent of RE is not serious in H.Pylori-positive patients.

Objective To detect the best phase and best tube voltage for the diagnosis of small (diameter ≤ 3 cm) clear cell renal cell carcinoma with dual-energy dual-phase CT.Methods Image manifestations of 27 patients with small (diameter ≤ 3 cm) ccRCCs confirmed by pathology were retrospectively analyzed.All subjects underwent dual-energy biphase (early corticomedullary and delayed phase) scan preoperatively.Two senior radiologists analyzed the images in consensus.The definition of images in different phases and with different tube voltage was classified into 4 levels and was compared by Wilcoxon and Friedman test.The attenuation of the lesions and the adjacent renal parenchyma,the SD value of the anterior abdomen fat were measured.The contrast noise ratio (CNR),lesion kidney ratio (LKR) and the early corticomedullary phase and delayed phase value were calculated.They were all compared with oneway ANOVA.Results The score of definition of lesions in early corticomedullary phase at 80 kV,140 kV and average-weighted 120 kV were 3.30 ± 0.87,2.81 ± 0.92 and 3.11 ± 0.85,respectively,which in delayed phase were 3.70 ±0.54,3.30 ±0.82 and 3.52 ±0.64,respectively.Definition of lesions was better in delayed phase than that in early corticomedullary phase (Z =-2.296,-2.446 and-2.392,respectively; P ＜ 0.05).Either in early corticomedullary phase or in delayed phase,CT value,noise value and CNR were the highest on 80 kV images,which were(302 ± 80)HU,(16.2 ± 2.2) and (4.1 ± 3.4) in corticomedullary phase and (152 ± 31) HU,(16.4 ± 2.7) HU,and (4.7 ± 1.7) in delayed phase.The change of lesion attenuation between early corticomedullary phase and delayed phase on 80 kV,140 kV and averageweighted 120 kV images were (150 ± 76),(72 ± 33) and (96 ± 46) HU,respectively.There was significant difference among the three groups (F =4.541,P ＜ 0.01).Conclusions Delayed phase scan is in favor of small clear cell renal cell carcinoma display.80 kV images are the best for detecting and qualitation of small clear cell renal cell carcinoma when compared with 140 kV and the average-weighted 120 kV images.

OBJECTIVE:To promote hospital rational drug use. METHODS:A total of 1 359 ADR cases submitted to State ADR Center by our hospital from 2005 to 2007 vial network system were analyzed statistically in respect of patients' age and sex,the drugs involved,routes of administration,ADR-involved organs or systems,and turnover etc. RESULTS:Of the total 1 359 cases,25.75% were induced by antimicrobial drugs and 55.33% were induced by intravenous route. The lesions of skin and its accessories were the predominant presentation of ADR,and the majority ADR cases had a good turnover. CONCLUSION:The incidence of ADR can be reduced by strengthening the education on and monitoring of ADR as well as the sense of responsibility of medical staff.

Objective To evaluate the influence of endoscopic sinus surgery on olfactory disorder caused by chronic sinusitis and nasal polyps by testing the olfactory function of fifty-two patients with chronic sinusitis and nasal polyps before and after endoscopic sinus surgery and then confirming the olfactory rehabilitation of the patients.Methods The olfactory function of the fifty-two patients with chronic sinusitis and nasal polyps was tested through the CCCRC olfactory testing method pre-operation and four weeks,twelve weeks,twenty-four weeks post-operation.The results were analyzed by matched t-test.Results All results of olfactory function after treatment were significantly better than that of pre-operation(P0.05).Conclusion Olfactory function of above patients was significantly improved within the first month post-operation.There was no further improvement in the following five months compared with the first month post-operation.

Objective To improve the understanding and diagnosis of pulmonary lymphangioleiomyomatosis (PLAM) by the comprehensive review of domestic literatures in the past ten years.Methods Three new cases with PLAM were reported and integraed with other 45 cases reported domestically in the past ten years for analysis of their clinical features.Results The newly reported three cases of PLAM were all women at child-bearing age, with initial symptom of dyspnea after activity. Two of them complicated with extra-pulmonary PLAM. All the three cases were free of chylous effusion. Forty-seven of 48 cases with PLAM were pathologically diagnozed, with ages of onset of 5~69 (mean?s of 34?10) years. Their clinical manifestations were mainly respiratory, including dyspnoea (95.8%), haemoptysis (52.1%), pneumothorax (45.8%), chylous effusion (33.3%),cough (31.3%) and chest pain (12.5%). Abnormal manifestations in abdomen, including renal mass, retroperitoneal mass and retroperitoneal lymphadenopathy, were detected in 16 cases. Thirty-nine cases had their high-resolution CT (HRCT) examined and appearance of multiple cysts distributed throughout the bilateral lung fields could be discerned in 38 of them. Obstructive ventilation disturbance could be observed in 23 of 30 cases with the data or conclusions on pulmonary function tests, and mixed ventilation disturbance in seven cases. Respiratory failure was complicated in 17 of 28 cases with the data of arterial blood gas analyses.Conclusions HRCT had confirmative value for diagnosis of PLAM. In practice, HRCT, as well as other routine abdominal and pelvic imaging examinations, should be performed in time for child-bearing-age women with progressive dyspnoea, haemoptysis, or spontaneous pneumothorax, to detect if they complicate with PLAM.

Objective To investigate the effects of isoflurane preconditioning on renal ischemia reperfusion (I/R) injury in rats and the role of TNF-α plays in the mechanism.Methods Male SD rats were used in the study.The animals were randomly divided into 3 groups ( n =12 each):shame operation group; I/R group; Isoflurane preconditioning group (inhaled 1.5％ isoflurane (1 MAC) for 30 min followed by 10 min washout before I/R).At 2 h reperfusion,blood samples were obtained for urea nitrogen (BUN) concentration and creatinine (Cr) content.The level of TNF-α in renal tissues were determined by enzyme-linked immunosorbent assay (ELISA).Observe the pathological changes in H.E.staining slides under microscope.Results BUN concentration and Cr content and the level of TNF-α in I/R group and isoflurane preconditioning group were significantly higher than in shame operation group[ BUN:( 17.69 ±0.99)mmol/L vs (8.37 ±1.12)mmol/L,t =-23.55,P ＜0.01; ( 12.26 ± 1.11 ) mmol/L vs (8.37 ±1.12 )mmol/L,t =- 19.09,P ＜ 0.01 ;Cr:( 103.22 ± 13.42)μmol/L vs (71.48 ± 8.59) μ mol/L,t =-21.45,P ＜0.01;(86.51 ± 11.49) μmol/L vs (71.48 ±8.59) μmol/L,t =-9.87,P ＜0.01 ;TNF-α:(0.51 ±0.07)ng/ml vs (0.43 ±0.00)ng/ml,t =-5.79,P ＜0.01;(0.47 ±0.03)ng/ml vs (0.43 ±0.00)ng/ml,t =-8.86,P ＜0.01 ].BUN concentration and Cr content and the level of TNF-α in Isoflurane preconditioning group were significantly lower than in I/R group [ BUN:( 12.26 ± 1.1 1 ) mmol/L vs ( 17.69 ± 0.99 ) mmol/L,t =15.67,P ＜ 0.01 ; Cr:( 86.51 ± 11.49) μmol/L vs ( 103.22 ± 13.42 ) μ mol/L,t =6.68,P ＜0.01 ;TNF-α:(0.47 ±0.03) ng/ml vs (0.51 ±0.07) ng/ml,t =2.61,P ＜0.05].Therenal I/R injury which located around kidney tubules was increased in I/R group and isoflurane precondi-tioning group compared to shame operation group [ ( 17.26 ± 1.45 ) vs (0.00 ± 0.00 ),t =- 72.38,P ＜0.01;(12.69±1.83) vs (0.00 ±0.00),t =-39.53,P ＜0.01].The renal I/R injury which located around kidney tubules was decreased in isoflurane preconditioning group compared to I/R group [ ( 12.69 ±1.83) vs (17.26±1.45),t =19.87,P ＜0.01].Conclusions Preconditioning with 1.5％ isoflurane 30 min can protect kidney from I/R injury in rats by regulating the level of TNF-α in renal tissues.

Objective To investigate the growth inhibition and DNA damage of energized fusion protein anti-CD20(Fab)-LDM on B JAB cells in vitro.Methods The binding activity of fusion protein anti-CD20 (Fab)-LDP to B JAB cells was studied by flow cytometry and confocal laser scanning microscopy.MTT assay was used to study the energized fusion protein anti-CD20(Fab)-LDM on cell growth of B JAB cells.Comet assay was employed to detect DNA damage in B JAB cells.The cell growth cycle of BJAB was analyzed by FACS.Results The recombinant fusion protein anti-CD20 (Fab)-LDP possessed an significant target affinity towarded BJAB cells.The energized fusion protein anti-CD20(Fab)-LDM showed obvious inhibition on proliferation,as well as induced potent DNA damage in B JAB cells in vitro compared with lidamycin.B JAB cells treated with energized fusion protein anti-CD20 (Fab)-LDM showed S phase cell cycle.Conclusion The energized fusion protein anti-CD20 (Fab)-LDM could target binding to BJAB cells and significantly inhibit the proliferation of B JAB cells by inducing DNA damage and S phase arrest.

Objective To evaluate the effect of left gastric venous caval shunt in the treatment of portal hypertension. Methods Eight patients suffering from portal hypertension underwent left gastric venouscaval shunt. The graft was of autogenous vein in 5 cases and artificial vein in 3 cases. Results There was no mortality and major complication nor early rebleeding. All patients were followed up from 10 mos to 10 years with an average of 5 years and 2 mos.Postoperatively,5 cases retrieved active living style. Two cases died, and one was lost during the follow-up. Conclusion Left gastric venous caval shunt decreasesthe venous pressure of the portal system within pericardiac and lower esophageal area. The shunt is a safe and effective surgical treatment presenting less alterations to splanchnic hemodynamics and with an additionaladvantage for pericardial devascularization.

Objective To explore the effect of azelastine hydrochloride nasal spray combined with desloratadine to inflammatory factors, cell function and IgE of patients with allergic rhinitis.Methods 92 cases of allergic rhinitis patients treated in the first affiliated hospital of wenzhou medical college hospital from June 2014 to December 2015 were divided into experimental group(n=46) and control group(n=46) according to the random number table method.The control group was given oral loratadine tablets, one piece per time, one time per day, while the experimental group was given azelastine hydrochloride nasal spray on the basis of the control group,each nostril one spray, one time in the morning and night.The clinical efficacy of two groups of patients would be observed after 4 weeks,ELISA would be used to detect serum levels of IFN-γ, IL-4, IL-8 and IgE level, and IFN-γ/IL-4 was the value of Thl/Th2,flow cytometry instrument was used to the determination of T cell subgroup CD4 +,CD8 + cells.Results 4 weeks after treatment,stuffy nose, nasal itching, runny nose, sneezing and nasal cavity change points are lower than before the treatment in both the two groups.Experimental group obviously lower than the control group, the difference was statistically significant ( P <0.05 ).The total effective rate of treatment group is higher than the control group,the difference was statistically significant(χ2 =4.389,P=0.036).The serum level of IFN-γis higher than before treatment in both the two groups.IL-4, IL-8 inflammatory factor levels were lower than before treatment,the experimental group was better than control group,the difference was statistically significant(P<0.05).CD4 +,CD8 +of T cells and Thl/Th2 values are higher than before the treatment in both the two groups,the experimental group was higher than control group, the difference was statistically significant ( P<0.05 ).Serum IgE levels were lower than before the treatment in both the two groups,the experimental group was lower than control group,the difference was statistically significant (P<0.05).Conclusion The therapy of azelastine hydrochloride nasal spray combined with desloratadine can improve the clinical effect of the treatment of allergic rhinitis,reduce inflammation,strengthen the body's immune function, improve thelevel of serum IgE.