Objective To investigate the changes of anti-cyclic citrullinated peptide antibody ,rheumatoid factor (RF) ,erythrocyte sedimentation rate(ESR) and C reactive protein(CRP) levels in the patients with early rheumatoid arthritis (RA) and their applica-tion value in the diagnosis and treatment.Methods A total of 210 cases of early RA in sixth affiliated hospital of Guangzhou Medi-cal University from December 2015 to June 2016 were selected as the RA group ,including 28 males and 182 females ,at the same time 115 cases of other rheumatism were selected as the non-RA group ,male ,including 38 males and 77 females.85 persons under-going the healthy physical examination were taken as the health group ,including 46 males and 39 females.The latex enhanced im-mune turbidimetry was adopted to quantitatively detect anti-cyclic citrullinated peptide antibody.The RF and CRP levels were quan-titatively detected by using the immune turbidimetry.The Westergren method was used to test the ESR ,their content changes in RA ,non-RA arthritis and other autoimmune diseases were detected.Results The sensitivity ,specificity ,positive predictive value , negative predictive value and Youden index of anti-cyclic citrullinated peptide antibody in the RA group were 60.95% ,97.64% , 98.46% ,50.30% and 0.59 respectively ,which of RF test were 52.38% ,95.29% ,96.49% ,44.75% and 0.48 respectively ,which of CRP test were 30.48% ,89.41% ,87.67% ,87.67% ,34.23% and 0.20 respectively ,which of ESR test were 49.52% ,87.06% , 90.43% ,41.11% and 0.37 respectively.Anti-cyclic citrullinated peptide antibody detection in the RA group was obviously higher than that of the RF test ,their test results were obviously higher than those of the non-RA group and healthy group ,the differences were statistically significant (P<0.05).CRP and ESR detection had no statistical difference between the RA group and non-RA group (P>0.05).Conclusion Anti-cyclic citrullinated peptide antibody level is higher in the patients with RA ,which is signifi-cantly superior to the RF test ,and anti-cyclic citrullinated peptide antibody detection has higher value for early diagnosis of RA.

BACKGROUND: Shape memory polyurethane (SMPU) may be employed for bone repair capable of resisting stress shielding and bone non-union due to the shape memory effect responding to changed external temperature. Evaluating the cytocompatibility of SMPU is important for its further in vivo experiments and applications. However, few have been done to investigate the cytocompatibility of SMPU after encounted from deforming and shape recovering.OBJECTIVE: To evaluate the osteoblast compatibility of SMPU before and after stretching-shape recovering process. METHODS: Solvent casting method was used to fabricate SMPU films; the obtained SMPU films were stretched to 200%, and then fixed and finally recovered to its odginal shape at T_g+15 ℃, T_g-15 ℃ and T_g+15 ℃, respectively. Atomic force microscope (AFM) with tapping mode was employed to probe the surface morphology and phase separation of SMPU. Primary osteoblasts at 3-5 passages were seeded on SMPU films in vitro to evaluate the adhesion, proliferation and spreading of osteoblasts. RESULTS AND CONCLUSION: There were obvious and regular phase separation resulted from soft segments and hard segments in SMPU, and some groove-ddge architectures within a scale of micrometers were produced by the stretching-shape recovering process. These special micropatterned structures promoted osteoblast adhesion and proliferation, and also resulted in partially oriented cell growth along the grooves. Shape memory process, i.e. stretching-shape recovering process may obviously change the surface morphology of SMPU films, and suggesting better biocompatibility with osteoblasts.

To assess the effectiveness and safety ofinside-out (TVT-O) vs. outside-in transobturator-tape procedures (TOT) in the surgical management of female stress urinary incontinence (SUI).A total of 8 randomized controlled trials were retrieved from the literature and analyzed by metaanalysis with RevMan 5.0 software.Meta-analysis showed that no statistical differences existed in objective cure rate,objective failure,postoperative voiding dysfunction,groin/thigh pain and sling exposure in both procedures (P ＞ 0.05).These preliminary results suggest there is no evidence of significant differences in the efficacy and safety between TVT-O and TOT.

Objective To investigate the charateristics and prognostic value of computed tomography (CT) of retropharyngeal lymphadenopathy (RLN) in nasopharyngeal carcinoma (NPC).Methods From 1991 to 2006, CT images were analyzed for 588 patients with histologically proven NPC treated with radiation therapy in our hospital.The survival rate was evaluated by Kaplan-Meier method.Results RLN metastases were presented in 392 patients, with unilateral side in 254 patients and bilateral sides in 138 patients.The 5-year distant metastasis-free survival (DMFS) rate of patients with and without RLN metastasis was 66.6% and78.6%(χ2 = 10.78,P=0.005) ,with 69.7% and 62.2%(χ2 =2.31,P=0.129) for patients with unilateral and bilateral sides involvement.The DMFS rate was similar between the mild and moderate enhancement of RLN (67.6% and 58.9% ,χ2=2.77,P =0.096).The survival rate of RLN with homogeneous density was better than heterogeneous density (71.5%, 53.3% and 32.5%,respectively, χ2= 10.51, P = 0.001, χ2= 24.28, P = 0.000).The survival rate of patients with well boarded RLN was better than those with ill boarded RLN and obviously adjacent tissue involvement (65.5%, 51.8%and 50.0% , χ2 =8.20,P=0.004, χ2 =5.31 ,P=0.021).Conclusions The prognosis is poor with RLN metastasis, lymph node enhancement, heterogeneous density in nodes and ill boarded RLN.

Objectives To evaluate the value of computed tomography (CT) features of non-thyroidal masses of the neck (NTMN).MethodsThe clinical data of 264 patients with NTMN proved by histology from 2005 to 2010 in our hospital were collected retrospectively.Among them,benign lesions were found in 159 patients (60.2％ ),malignant ones in 105 patients (39.8％ ),and in lymphadenopathy in 111 patients (42.0％ ),non-lymphadenopathy in 153 patients (58.0％).The CT features including lowdensity areas,low-density areas of enhancement ratio,the edge of lesion,lesion morphology and the clinical baselines including the sex,single or multiple lesions,lymphadenopathy or non lymphadenopathy were compared for appreciating the sensitivity and specificity of the diagnosis.Categorical variables were tested with the x2 or Fisher exact tests.Results Independently using each of those four radiological signs ( CT value of low density area,the enhancement ratio of low density area,border and morphology of lesion)and three clinical indexes (sex,single or multiple,lymphadenopathy or non lymphadenopathy) to diagnose the malignant tumors,the sensitivity and specificity were 77.1％ ( 81/105 ),81.9％ ( 86/105 ),71.4％(75/105),56.2％ ( 59/105 ),64.8％ ( 68/105 ),75.2％ ( 79/105 ),82.9％ ( 87/105 ) and 50.9％(81/159),44.7％ ( 71/159 ),73.0％ ( 116/159 ),67.3％ ( 107/159 ),51.6％ ( 82/159 ),73.0％(116/159),84.9％ (135/159) respectively.When four or more signs were showed,the sensitivity and specificity were 86.7％ (91/105) and 74.8％ (119/159) respectively.The special CT features were included mottled high density sign in schwannoma ( P =0.000,25/41 )and regular calcification in hemangioma(P =0.000,7/18 ).Carotid body tumor was often occurred at carotid artery (P =0.000,23/24),and the most of mass of paravertebral was neurogenic tumor(P =0.001,9/50).ConclusionsThe diagnosis of NTMN can be improved by combining CT features and clinical baseline.

AIM: To investigate the protein patterns of bone marrow mesenchymal stem cells(MSCs) induced by 5-azacytidine and Shuanglong Formula(Radix et Rhizoma Ginseng,Radix et Rhizoma Salviae Miltiorrhizae) and molecular mechanism of induced differentiation was discussed at the level of proteome. METHODS: MSCs extracted from Chinese miniswine were induced by 5-azacytidine and Shuanglong Formula.Proteins were separated by two-dimensional gel electrophoresis,and were detected by silver staining method.The image was analyzed by PDQuest software,and the intensities of spots in the gels were used to quantify the expressions of proteins.Proteins of interest were chosen for in-gel digestion and MALDI-TOF-MS analysis,and then further identified by peptide mass fingerprinting(PMF). RESULTS: 16 altered proteins were identified by PMF and their regulation might be caused by the addition of medicate sera containing the active components of Shuanglong Formula.The effects of medicated sera containing Shuanglong Formula on the induced-differentiation could be discussed from the regulated expression of functional proteins; CONCLUSION: Shuanglong Formula may promote the 5-azacytidine-induced differentiation of bone marrow MSCs in vitro,and our study indicate that proteomics can be used for the analysis of molecular mechanism for different cell process.

Objective To predict the response of induction chemotherapy in advanced nasopharyngeal carcinoma (NPC)by using pretreat-ment apparent diffusion coefficient (ADC)values.Methods 35 patients with advanced NPC underwent DWI examination prior to 2-week in-duction chemotherapy.The patients were divided into CR (complete response)group,PR (partial response)one and SD (stable disease)one according to the tumor response of treatment.The effective responders included CR and PR groups.The patients were divided into children-adolescents(below 20 years)group and adults one according to the age,into non-keratinizing undifferentiated carcinoma group and non-kera-tinizing differentiated carcinoma one according to the pathological type,and also into T2,T3 and T4 groups according to the T-staging (UICC2010).Statistical analysis was used to compare the pretreatment ADC values between different groups.Results The average pre-treatment ADC values of CR,PR,responders and SD groups were (0.70±0.06)×10 -3 mm2/s,(0.72±0.04)×10 -3 mm2/s,(0.71± 0.04)×10 -3 mm2/s and (0.85±0.02)×10 -3 mm2/s respectively.The average pretreatment ADC value of the SD group was signif-icantly higher than that of PR group and responders,and the differences were significant (P <0.05).The average pretreatment ADC value of children-adolescents and adults groups were (0.73±0.07)×10 -3 mm2/s and (0.75 ±0.07)× 10 -3 mm2/s,which showed no significant differences.The average pretreatment ADC value of non-keratinizing undifferentiated carcinoma and non-keratinizing dif-ferentiated carcinoma groups were (0.76 ±0.08)×10 -3 mm2/s and (0.74±0.06)×10 -3 mm2/s,which showed no significant differ-ences.The average pretreatment ADC values of T2,T3 and T4 groups were (0.78±0.05)×10 -3 mm2/s,(0.77 ±0.07)×10 -3 mm2/s and (0.75±0.08)×10 -3 mm2/s.Although there were no significant differences between T2,T3 and T4 groups,a trend towards lower ADC was observed with increasing tumor T-staging.Conclusion Pretreatment ADC value is a valuable quantitative parameter,and it can be used for predicting induction chemotherapy response in advanced naso-pharyngeal carcinoma.

Objective To evaluate the discrepancy of parameters generated on dual-energy spectral CT (DECT)imaging in the different pathological grade of laryngeal and hypopharyngeal squamous cell carcinoma (LHSCC),and to provide helpful information of the prognosis and the guide of clinical treatment.Methods 61 patients with pathologically confirmed LHSCC who underwent contrastenhanced DECT before therapy were retrospectively analyzed.The enhanced monochromatic data were analyzed with workstation.Iodine concentration of lesion (IC),water concentration of lesion (WC)and slope of spectral HU curve (s-SHC)were acquired.According to cell differentiation,all patients were divided into well,moderately and poorly differentiated groups.The difference of IC,WC,s-SHC,constituent ratio of T stage were compared among different groups.Results The IC and s-SHC had significant difference among well,moderately and poorly differentiated groups(F =3.56,3.96 respectively,P <0.05).The two-two paired comparisons demonstrated that there were significant difference of IC between poorly and well differentiated group(P <0.05).The others two-two paired comparisons demonstrated no significant difference (P>0.05).There were no significant difference of WC among three groups respectively (H =0.84,P >0.05).χ2 test showed that there was no significant difference for the constituent ratio of T stage among three groups (P >0.05).Conclusion IC and s-SHC can help to judge the pathological grade of LHSCC,and they may be useful to evaluate the prognosis of LHSCC.

Objective To summarize the CT features of anaplastic thyroid carcinoma (ATC).Methods CT manifestations of 12 patients with ATC confirmed by surgery or biopsy were analyzed retrospectively.Results 1 1 (91.7%)patients had single lesion. The lesions appeared as low attenuation mass with cord-like,flocculent or patchy high attenuation areas.The lesions had mild to moderate enhancement in 1 1 cases (91.7%).Coarse calcifications were detected in 8 cases (66.7%),4 of them were incomplete rim or eggshell.11 cases (91.7%)showed invasion into adjacent structures,including trachea (6 cases,50%),esophagus (4 cases,33.3%),strap muscles (7 cases,58.3%),larynx (2 cases,1 6.7%),blood vessels (6 cases,50%).5 cases (41.7%)had tumor thrombus in the internal jugular vein.10 cases (83.3%)had lymph nodes metastasis.The enhancements of lymph nodes were divided into 3 types:mild homogeneous enhancement (4 cases,40%),mild enhancement with internal low-attenuation areas (7 cases,70%)and ring-like enhancement without internal enhancement (7 cases,70%).Conclusion CT features of ATC include low-density mass with cords,flocculent and patchy high-density areas,coarse calcification and mild to moderate enhancement,invasion to adjacent structure and lymph node metastasis with necrosis are common.

The evaluation of the immunosuppression state in liver transplanted recipients is vital for a correct posttransplantation management and a major step towards the personalized treatment of the immunosuppression.To date,immunological monitoring after liver transplantation relies mainly on clinical judgment and pathological examination of the graft,without a proper assessment of the actual state.Previous studies have ever identified many markers for acute rejection(AR) and immune tolerance after liver transplantation.Many markers for AR are pro-inflammatory or immunoregulatory cytokines and other proteins related to inflammation.However,many markers have been proved to be also able to predict other diseases and only a few of the markers for AR have been validated.Standard liver tests cannot be used as markers for graft rejection due to the low sensitivity and specificity.This review summarized the potential markers for AR and immune tolerance after liver transplantation based on published literatures in recent years and to provide evidence for clinical application.