Objective To carry out a systematic evaluation for the diagnostic accuracy of Des-γ-carboxy-prothrombin(DCP) in primary hepatocellular cancer(PHC) by Meta-analysis.Methods The published international and domestic studies on DCP in the diagnosis of PHC were searched in multiple databases from its inception until December 2016.A total of seventeen studies were finally selected,among which 1 970 cases of PHC group and 2 588 cases of control group were included.The control group was composed of chronic hepatitis,cirrhosis,tumors in other systems and healthy subjects with physical examination.A meta-analysis was performed using Stata 12.0.Results The overall pooled results of the analysis and the 95％ confidence intervals were as follows:the sensitivity(SEN) was 0.79 (0.74 to 0.83),the specificity (SPE) was 0.90 (0.87 to 0.93),the positive likelihood ratio(PLR) was 8.1 (5.8 to 11.1),the negative likelihood ratio(NLR) was 0.24(0.19 to 0.29),the diagnostic odds ratio(DOR) was 34(21 to 55) and the area under the summary receiver operator characteristic curve (SROC) was 0.91 (0.89 to 0.93).The sensitivity combined the detections of AFP and DCP in the diagnosis of PHC was 0.90 with 0.94 of AUCROC and 56 of DOR.Conclusion The serum DCP may exhibit a relatively higher diagnostic specificity for PHC.The combined detections of AFP and DCP could improve the sensitivity and diagnostic accuracy.

Objective To establish a method for simulataneous determination of 18 free amino acids in snake venom. Methods Preparation of free amino acid samples by membrane. HPLC analysis was performed after derivatization by using phenyl isothiocyanate (PITC) as a derivative reagent, samples were analyzed on Ultimate LP-C18 column with gradient elution column of 0.05 mol/L sodium acetate buffer and methanol-acetonitrile- water (40:40:20), and current speed was1.0 mL/min, and the column temperature was set at 35℃, and detection wavelength was 254nm. Results The 18 kinds of amino acids showed a good linearity with the correlation coefficients ≥0.99. The recovery rate was 74.59%~110.62%. Snake venom contained 17 kinds of amino acids, the total content of amino acids was 0.2%. Conclusion The method was accurate, reproducible and reliable, and can be used for the determination of amino acids in snake venom and related products.

0.05) . Time consumed for registration and waiting for consultation, average medical care cost, time consumed for dispensing prescription and average total patients' visit time except for diagnosis and treatment were significantly less in primary-care hospitals than those in secondary-care ones( P 0.05) . Conclusions Quality of medical care service process in primary and secondary-care hospitals was perceived good by the outpatients. In general, phenomena of long queues for registration, waiting for consultation, payment, getting drugs and short time for diagnosis and treatment in outpatient departments have been improved a little bit. Medical doctors in primary-care hospitals could provide medical care service as nearly the same as that in secondary-care ones, while time consumed for registration, waiting for consultation, payment and getting drugs, as well as for a total visit was much less in primary-care hospitals.

Aged ; Antiphospholipid Syndrome ; pathology ; Face ; pathology ; Granuloma ; pathology ; Humans ; Male

BACKGROUND: As indicated by clinical research, if cerebral infarction could be effectively treated at early stage, especially normal specific therapy provided within 6 hours or even earlier after attack, the prognosis would be significantly better than delayed therapy. However, it is still unclear that whether the changes of cellular apoptosis-inducing or -inhibiting indicators could be used as criteria in the judgment of prognosis.OBJECTIVE: To test the content of cell apoptotic factor and to investigate the prognosis in hospitalized patients with cerebral infarction who received treatment at different time for further verification of the therapeutic timing for the disease.DESIGN: A same term randomized controlled study based on patients.SETTING: Department of neurology of a general hospital of a military area command of Chinese PLA.PARTICIPANTS: Totally 144 male patients admitted in the Second Department of Neurology, General Hospital of Jinan Military Area Command of Chinese PLA between 2000 and 2002 were divided into four groups including 6 hours, 24 hours, 72 hours and 96 hours group according to different time of therapy provided.METHODS: Oral administration of 400 mg Lumbrokinase, 2 tablets of heparin sodium, 60 mg of nimodipine, and 100 mg of vitamin E, three times a day. 150 mL of normal saline(NS) containing 52.5 mg of Ginkgo biloba L extractive(Jin Na Duo) and 150 mL of NS containing 10 mL of Cerebroprotein Hydeolysate were used through intravenous drop once a day. Ten days were set as one therapeutic course and 2 courses were given. 200 g/L of mannite was given to dehydrate for patients with large area infarction(＞ 7 cm2) . Platelet membrane Fas, Apo2.7 and Bcl-2 percentage and prognostic assessment were tested in patients of four groups before and after therapy.MAIN OUTCOME MEASURES: Peripheral platelet membrane Fas,Apo2.7 and Bcl-2 percentage in patients of different group and prognosis evaluation.RESULTS: Percentage of platelet membrane Fas, Apo2.7 and Bcl-2 of 6 hours group was significantly higher or lower after therapy than before therapy ( P ＜ 0.05 ), and moreover, the difference with other groups was significant( P ＜ 0.05), As revealed in the analysis of prognosis, the effectiveness of patients who received therapy within 6 hours was significantly better than that of 96 hours group and the mortality reduced significantly.CONCLUSION: Normal hospitalizing therapy provided within 6 hours after attack could surely improve the prognosis and reduce the disability rate, and the abnormity and extent in Fas, Apo2.7 and Bcl-2 are closely correlated with prognosis.

Objective To investigate the prevalence of undernutrition, nutritional risks, and the application of nutrition supports in different hospitals in Shandong province, and to estimate the related complication rate.Methods Totally 2792 patients from different hospitals in Shandong were enrolled, and their nutritional risks were assessed using Nutritional Risk Screening (NRS) 2002. The application of nutritional supports, the length of hospital stay, and the incidences of infectious and non-infectious complications were documented. Results The incidences of undernutrition and nutritional risk among patients in large hospitals were significantly higher than those in middle and small hospitals (5.6%, 1.6%, 2. 7%; 27.3%, 15.4%, 18.3%; P =0. 000). The overall rate of nutritional support was 43. 60%, and there were significant difference among patients in different hospitals (51.5 %, 30. 8 %, 20.9 %, P = 0. 000). Parenteral nutrition was most widely applied. Among the 483 patients in large hospitals, the incidence of complication in patients with nutritional risks was significantly higher than those without nutritional risks (31.3% versus 13.7%, P =0. 000). Of the "with nutritional risk" patients, the infectious complications were significantly lower in the nutritional support group (P = 0. 000). Of the patients without nutritional risks, there was no statistical difference between the nutritional support group and the non-support group. (P ＞ 0. 05). Conclusions NRS 2002 is a useful tool for the assessment of nutritional status among inpatients. Proper nutritional support can reduce the incidence of complications for patients with nutritional risks.

Objective:To study the function of transcription factor 4 (TCF4) and to prepare TCF4 polyclonal antibody.Methods:pET-41/TCF4 was transformed into E.coli BL21(DE3) and induced by IPTG.The purified GST-TCF4 fusion protein was applied to immunize rabbit to produce antiserum. The specificity of the affinity of purified anti-TCF4 antibody was examined by Western blotting analysis of the eukaryotic expressed products of TCF4. Dig-labeled probe and antibody against TCF4 were used to examine the expression of TCF4 in Saos-2 cells under mechanical stretch. Results:Western blotting showed that the antibody could bind to TCF4 specifically. The expression of TCF4 mRNA and protein were significantly increased in Saos-2 cells under mechanical stretch. Conclusion: TCF4 antibody has been prepared successfully.

Objective To quantitatively analyze the coronary artery ostia by three-dimensional trans-esophageal echocardiography (3D-TEE).Methods The full-volume images of aortic root and coronary artery ostia were acquired by 3D-TEE in 95 adult patients.The Philips QLab 3DQ measurement technology was employed to determine three mutually perpendicular planes:(1) The transverse plane cross the bottom of three coronary artery sinus.(2) The sagittal plane perpendicular to sino-tubular junction.(3) The coronal plane perpendicular to the aforementioned two planes .The following relevant parameters were measured and recorded:(1) Length, width, height and area of bilateral coronary artery ostia .(2) The angle between coronary arterial outflow tract and aortic root in sagittal plane .(3) The spatial distribution of coronary artery ostia, aortic root and coronary artert sinus .Results The shape of left coronary artery ostia were more regular (round or oval) than right coronary artery ostia ( teardrop-shape or oval ).Calcification was more frequent in right coronary artery ostia (81/95, 85.26%) than that in left coronary artery ostia. There were statistical differences between left and right coronary artery in the parameters of ostial wide , area and height (t =3.85, 3.86, -4.49, all P<0.01).Most left coronary artery ostia were located inside the sinus (76/95, 80.00%), mainly in the upper third segment (69/95, 72.63%); while more than half of the right coronary artery ostia were found outside the sinus ( 53/95, 55.79%).The difference was statistically significant( χ2 =25.91, P<0.01).Conclusion The quantitative analysis of aortic root and coronary artery ostia based on the full-volume images originated from real-time 3D-TEE is feasible, which is helpful for further clinical research .

Objective To investigate the clinical value of color Doppler flow imaging (CDFI) for evaluating transplant renal artery stenosis (TRAS).Methods Clinical and ultrasonographic data of 216 kidney transplant recipients were collected by follow-up monitoring from September 2015 to July 2016.CDFI indexes included the peak systolic velocity (PSV) in the renal artery and resistant index (RI).Renal artery PSV and RI were measured.All suspected TRAS patients accepted transplant renal artery angiography (DSA).Results Fourteen patients with suspected TRAS accepted DSA,of which 12 patients were confirmed.The diagnostic accuracy of CDFI was 85.7％.When the POST-PSV ratio＞ 1 0,the sensitivity and specificity of diagnosis of TRAS were 91 ％ and 95 ％,respectively.CDFI indexes remarkably changed after the TRAS patients had undergone renal artery dilatation or stent implantation.PSV of the main renal artery and the POST-PSV ratio decreased significantly,and the PSV of interlobar arteries increased.Conclusions CDFI is a reliable first choice for screening transplant renal artery stenosis.The POST-PSV ratio has relatively higher sensitivity and specificity in the diagnosis of TRAS.

Objective To evaluate the clinical diagnostic value of pelvic floor sEMG in pelvic floor dyssynergia (PFD) by using receiver operating characteristic curve (ROC curve). Methods The pelvic floor sEMG of 90 patients with PFD and 101normal controls were determined by the Glazer protocol.Parameters including amplitude (AVG),coefficient of variance (CV),onset time and median frequency (MF),and the ROC curve werealso investigated. Results Compared to the control group,the PFD group had a higher AVG of pre-baseline (P < 0.05), a lower AVG during Flick and Tonic steps(P < 0.05), and ahigher CV duringTonic and Endurance steps(P < 0.05).The area under curve(AUC) of CV duringthe tonic step was 0.883 withthe best cut-off of 0.355, and with sensitivity of 88.4%and the specificity of 71.1%, respectively; The AUC of CV duringEndurance step was 0.825 withthe best cut-off of 0.305, and with the sensitivity of 84.9%and the specificity of 67.8% , respectively. Conclusion The CVs of the tonic and the endrnace phases can be used as valuable clinical values in diagnosis of PFD.