Objective　To investigate the feasibility of osteoid callus allograft as a kind of bone healing promoting materials. Methods　The osteoid callus was obtained at one week after bilateral femoral fracture of a SD rat, then was kept at -196℃ for 2 weeks. The bone defect model which bone repair was in intra-membranous osteogenesis was made at bilateral tibial shaft in 5 rats, and filled with the osteoid callus in the left defect area, the right side was filled with allogenous cancellous as control group. The specimen were processed with undecalcified technique and the sections were staining with light blue and sofranin T. Results　After 2 weeks ,there were cartilage and bone formation in the defect area of osteoid callus graft group(3/4), medullary cavity formation in bone tissue with cartilage arround it, fibrous tissues between new bone and host bone. While there were no cartilage or bone formation in the control group. Conclusion　The allograft osteoid callus is not absorbed by immunological rejection, but changed into bone tissue through endochondral osteogenesis. It is inspiring to develop osteoid callus allograft as a kind of material for bone healing.

Objective To investigate the diagnostic value and safety of thoracoscopy routine pleural biopsy combined with frozen biopsy for pleural effusion. Methods A retrospective analysis was made on the pathological diagnosis rate of pleural effusion. Results 120 cases in thoracoscopy, 103 cases were confirmed with routine biopsy specimens (85.8%), 16 cases found in the lesions with conventional clamp not satisfactory tissue specimens, combined with frozen cut obtained satisfactory specimens, the diagnostic accuracy rate of 16 cases of cryobiopsy was 100.0%, and the total diagnostic accuracy rate of medical thoracoscopy combined with pleural biopsy and cryobiopsy was 95.0%. There was significant difference between conventional biopsy and cryobiopsy (P < 0.05). Conclusion Medical thoracoscopy combined with pleural biopsy and cryobiopsy can achieve a higher rate of pathological diagnosis, and the complications are mild, so it is worthy of clinical promoting.

Birth defects are the abnormalities in structure,function or metabolism of embryonic or fetal development.They are the main cause of early abortion,stillbirth,perinatal mortality,infant mortality and congenital disabilities.Birth defects affect not only the health and life quality of children,but also the population quality of the whole country.This paper reviews the current epidemic situation and possible causes and risk factors of birth defects.It also expounds on the importance of epidemiological study on birth defects,possibility of primary prevention of birth defects,and necessity of interdisciplinary and collaborative research.It may provide reference for prevention and control of birth defects.

Objective To compare the clinical effect and safety evaluation of three different dose regimens for treating children with viral encephalitis.Methods Totally 126 cases treated in Xi'an Central Hospital from January 2010 to December 2015 were randomly divided into observation group 1 (ganciclovir combined with gangliosides,42 cases),observation group 2 (ganciclovir combined with gamma globulin,43 cases),and control group (39 cases).The clinical effect and levels of NSE,inflammatory cytokine were compared in the three groups.Results The total effective rate in observation group 1 was 95.24％ and that of observation group 2 was 93.02％,which were significantly higher than that of control group (79.48％).The disappearance time of headache,fever,convulsions,clouding of consciousness,meningeal irritation sign,cerebrospinal fluid abnormalities,and length of stay in observation groups (both 1 and 2)were significantly shorter than those in control group (P ＜ 0.05);After therapy,the levels of NSE in three groups were obviously decreased compared with those before therapy (P ＜ 0.05),and those in observation group were significantly lower than the control group (P ＜ 0.05);the levels of inflammatory cytokine in all three groups were obviously decreased compared with those before therapy (P ＜ 0.05),and that of observation group 1 had no statistical difference with the normal group,whereas that in control group was significantly higher than the normal group (P ＜ 0.05).Conclusion Ganciclovir combined with gangliosides as well as ganciclovir combined with gamma globulin were both effective methods in treating children with viral encephalitis and could decrease levels of inflammatory cytokine.Ganciclovir combined with gangliosides could effectively repair nerve damage,which deserves clinical expansion.

Objective To evaluate the feasibility of dual energy spectral CT with 270 mg/ml iodixanol in coronary CT angiography (CCTA).Methods A total of 60 patients with suspected coronary heart disease underwent CCTA.They were randomly divided into 3 groups.Prospectively ECG gated CCTA with 120 kVp were performed on the controlgroup (Group A,n=20).In group B (n=20) and group C (n=20),gemstone spectral imaging(GSI) technique were used and monochromatic images from 60 to 80 keV with increment of 5 keV were obtained to divide into 5 subgroups(B1-B5,C1-C5).Group A and group B used the same contrast medium (iodixanol 350 mg/ml) while Group C used low concentration contrast medium (iodixanol 270 mg/ml).One-way ANOVA analysis was used to compare objective evaluation indices (CT values,image noise,signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the left main coronary artery,proximal segment of left anterior descending branch,proximal segment of left circumflex branch and proximal segment of right coronary artery) of group A and B1-B5.Statistical t-test was performed between group A and C2(with optimal keV).Results CNR of the group B1-B5[(21.2± 3.4),(21.5 ±4.0),(21.5 ±4.0),(21.8 ±4.2),(20.7 ± 3.5)]were increased significantly than group A(16.6± 3.8).No significant differences were found among groups B 1-B4 (P＞0.05).Compared withgroup A,group B2 showed higher CT values of the vessels [(481.4±43.2),(466.7±69.3),(434.1±48.8),(436.3±42.5),(427.4±48.6)HU] and decreased image noise[(28.2±7.3)HU versus (31.1±9.9) HU,P＜0.01].The optimal keV was 65 keV.Compared with group A,group C2 showed no significant differences in CT values[(396.3± 76.3),(390.4 ± 74.4),(359.5±83.1),(358.3±67.7),(365.4±68.2)HU)],image noise[(29.1±5.6)HU],SNR(14.6±4.2) and CNR [(18.4±4.8),t=-1.29-1.40,P＞ 0.05].Conclusion Dual-energy spectral CT with monochromatic reconstruction at 65 keV can provide same good image quality as the routine method while reduce iodine concentration to 270 mg/ml.

Objective To discuss combined detection of pleural biopsy under medical thoracoscopy and pulmonary serum tumor markers in diagnosis of pleural effusion with unknown reason.Methods 76 patients with pleural effusion caused by unknown reason from January 2014 to March 2016 were retrospectively analyzed. Pleural biopsy was conducted under medical thoracoscopy and sent for pathological examination, and 10 ml venous blood was collected from these patients upon admission for testing serum tumor markers (CEA, SCC-AG, ProGRP and CYFRA21-1).Results Among the 76 patients, there were 32 cases with benign lesions (14 with pulmonary tuberculosis, 9 with inlfammatory lesions, 6 with granulomatous inlfammation, 2 with empyema and 1 with hamartoma) and 44 cases with malignant lesions (18 with adenocarcinoma, 13 with squamous carcinoma, 6 with small cell lung cancer, 3 with adeno-squamous carcinoma, 2 with mesothelioma, 1 with large cell carcinoma and 1 with thymoma). The detection of serum tumor markers showed statistically significant differences in the levels of CEA, SCC-AG, ProGRP and CYFRA21-1 in serum between the malignant pleural effusion group and benign pleural effusion group (P = 0.021,P = 0.006,P = 0.003 andP = 0.010). The levels of various serum tumor markers in the malignant pleural effusion group were obviously higher than those in the benign pleural effusion group. According to the pathological results, patients with pleural effusions not caused by lung cancer (2 with mesothelioma and 1 with thymoma) were eliminated from 44 patients with malignant pleural effusions. The rest 41 patients with pleural effusions caused by lung cancer were divided into non-small cell lung cancer and small cell lung cancer according to the pathological types. The results showed that there were statistically signiifcant differences in the levels of CEA, ProGRP and CYFRA21-1 between non-small cell lung cancer and small cell lung cancer (P = 0.036,P = 0.005 andP = 0.008), while there was no statistically signiifcant difference in the level of SCC-AG (P = 0.811).Conclusions Due to high detection rate and high accuracy in detecting pleural effusions caused by unknown reason, medical thoracoscopy is of great signiifcance, especially for the diagnosis of malignant pleural effusions of pleural metastases. However, serum indicators may provide important reference values for us before the pathological results are available. Thus, it is an important means of diagnosing malignant pleural effusions caused by lung cancer and should be promoted in clinic.

Objective To explore the influence of TAC protocol (pirarubicin,cyclophosphamide and docetaxel) and AC-T protocol (pirarubicin,cyclophosphamide and sequential docetaxel) on T lymphocytes cell subsets (included CD3+ T cells,CD3+ CD4+ T cells,CD3+ CD8+ T cells,CD3+ CD4+/CD3 + CD8+),natural killer (NK) cells and part of the quality of life in the peripheral blood of patients.Methods A total of 66 patients with breast cancer included 31 cases for TAC protocol (6 cycles of chemotherapy) and 35 cases for AC-T protocol(8 cycles of chemotherapy).Collected respectively before and after the last chemotherapy of peripheral blood,used flow cytometry technique to detect the proportion of T cell subsets and NK cells in peripheral blood,and compared the change of the part of the quality of life before and after chemotherapy.Results After chemotherapy of total of 66 patients CD3+ T cells,CD3+ CD4+T cells and NK cells of peripheral blood ((68.58± 11.03) ％,(33.53 ± 8.84) ％,(18.27 ± 10.65) ％) significantly lower than before chemotherapy ((74.03±13.04)％,(38.42±9.79)％,(19.83± 10.19)％),the differences were statistically significant(t =4.296,3.387,4.092,P＜ 0.05).Grouping was TAC protocol with AC-T,T cell subsets and NK cells before chemotherapy differences had no statistical significance.But after chemotherapy,CD3+ T cells,CD3+ CD4+T cells,CD3+CD8+ T cells and Karnofky score((64.63±10.01)％,(31.19±7.41)％,(24.66±7.40)％,(68.63± 5.100)％) of peripheral blood on TAC protocol were more decreased than AC-T protocol((72.29± 10.78)％,(35.74± 9.60) ％,(30.15 ± 11.12) ％,(77.29 ± 4.58) ％),the differences were statistically significant (t =2.99,2.15,2.35,2.237,P＜0.05).CD3+ CD4+/CD3+ CD8+ and NK cells were also decreased,but without statistical significance.The body quality of 66 patients was slightly increased after chemotherapy,but without statistical significance.Conclusion The body's immune function and the part of quality of the breast cancer patient's life have declined by chemotherapy drugs in varying degrees.Compared TAC,AC-T protocol has less influence on the immunological function and the part of living quality of patients with breast cancer.

Objective To assess whether the plaque volume of carotid artery evaluated by three-dimensional ultrasound can predict the risk of cardiovascular events earlier in patients with coronary heart disease, in comparison with plaque thickness.Methods A total of 99 patients were enrolled, including 66 patients with asymptomatic carotid plaque and 33 patients with coronary heart disease (CHD) and carotid plaque.Three-dimensional ultrasound was performed in all the patients.Coronary angiography was performed in all the patients in CHD group.Coronary artery Gensini score was calculated.Plaque thickness, plaque area and plaque volume were compared between the two groups.We analyzed the relationship of plaque volume with Gensini score and other cardiovascular risk factors.Results Plaque volume was significantly higher in CHD group [(1312.38±513.70)mm3] than in asymptomatic group [(947.54±321.41)mm3] (P=0.023).However, plaque thickness and plaque area were not significantly different between the two groups (P>0.05).Plaque volume was positively correlated with Gensini score (r=0.519, P=0.002), homocysteine (r=0.569, P=0.002), and cardiovascular risk factors such as diabetes, blood glucose and glycosylated hemoglobin.There was a negative correlation between plaque volume and high-density lipoprotein (HDL), a factor protecting against cardiovascular events (r=-0.387, P=0.038).Conclusion Compared with plaque thickness, the volume of carotid plaques assessed by three-dimensional imaging technique may be a better predictor of the risk of cardiovascular events in patients with coronary heart disease.

Objective:To establish an LC-MS/MS method for the simultaneous determination of acetaminophen and its five metabolites in mice plasma,and investigate the metabolism of acetaminophen by using the method.Methods:Para aminobenzoic acid was used as the internal standard.The plasma samples were precipitated by methanol,and then separated on a C18 column with the mobile phase of methanol and 5 mmol·L-1 ammonium acetate buffer solution containing 0.1% formic acid (55∶45).The flow rate was 0.5 ml·min-1,and the column temperature was 25℃.An electrospray ionization source was applied and operated in a positive ion mode using MRM:APAP,-,m/z 152.0→110.0;APAP-cys,-,m/z 271.2→140.1;APAP-glut,-,m/z 457.0→328.0;APAP-NAC,-,m/z 313.4 →208.0;APAP-sulf,-,m/z 232.4→152.1;APAP-gluc,-,m/z 328.2→152.1;IS,-,m/z 138.2→120.0.Results:The method exhibited good linearity over the concentration range of 0.2-10 μg·ml-1for APAP,1.0-20 μg·ml-1 for APAP-gluc,1.0-20 μg·ml-1 for APAP-sulf,1.0-20 μg·ml-1 for APAP-glut,0.4-15 μg·ml-1 for APAP-NAC and 0.2-10 μg·ml-1 for APAP-cys (r≥0.990 0).The inter-day accuracy and precision of acetaminophen and its five metabolites were all below 15%.The average recovery was between 85% and 115%,and RSDs were all below 15%.Conclusion:The LC-MS/MS method is proved to be quick,sensitive and accurate,and suitable for the determination of acetaminophen and its five metabolites in mice plasma.

Objective:To study the curative efficacy of transabdominal ultrasound-guided Lauromacrogol combined with radiofrequency ablation in the treatment of fibroid and its effects on the serum estradiol (E2),luteinizing hormone (LH),follicle stimulating hormone (FSH) levels.Methods:90 patients of fibroid who were treated from June 2014 to June 2015 in our hospital were selected as the research objects.According to random number table,those patients were divided into the observation group (n=45) and the control group (n=45).Both groups were routinely examined before operation,the control group was treated with transabdominal ultrasound radiofrequency ablation,while the observation group was treated with transabdominal ultrasound-guided percutaneous radiofrequency ablation combined with radiofrequency ablation,Then visual analogue scale (VAS),menstrual volume,uterine fibroid volume,uterine volume,E2,LH,FSH levels,myoma symptoms and quality of life score,curative effect were compared between two groups.Results:After treatment,the total effective rate of observation group was significantly higher than that of the control group [95.55％(43/45)vs75.55％(34/45)] (P＜0.05);the VAS score,menstrual volume were significantly lower than those of the control group[(1.05± 0.23)score vs.(3.62± 0.50)score,(192.35± 22.10)mL 1 vs.(236.54± 24.57)mL](P＜0.05);The myoma volume,uterine volume were significantly lower than those of the control group[(32.13± 13.20)cm3 vs(40.81± 14.11)cm3,(101.93± 9.89)cm3 vs(118.36±11.20)cm3](p＜0.05);the serum E2,LH,FSH levels were significantly lower than those before treatment,but there was no difference between the two groups (P ＞0.05);the fibroid symptoms score was significantly lower than that of the control group [(4.50 ± 1.02)score vs.(10.34± 2.21)score] (P＜0.05),the quality of life score was significantly higher than that of the control group [(95.36± 14.29)score vs.(80.84 ±14.06)score] (P ＜ 0.05).Conclusion:Transabdominal ultrasound-guided lauromacrogol combined with radiofrequency ablation could enhance the efficacy of fibroid,which might be related to the decrease of serum levels of E2,LH,and FSH.