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.

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.

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.

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.

Objective To analyze the risk factors of voiding dysfunction after mid-urethral sling surgery for stress urinary incontinence.Methods Clinical data of 573 consecutive patients undergoing midurethral sling surgery from January 2003 to December 2010 were collected and analyzed retrospectively.All relative risk factors were evaluated by univariate and multivariate Logistic analysis to identify risk factors of voiding dysfunction.Results Voiding dysfunction occurred in 28 patients,with an incidence of 4.9％ (28/573).Univariate analysis showed that age,previous pelvic surgery,pre-operative postvoid residuals,maximum flow rate,average urine flow rate,Valsalva leak point pressure,concomitant anterior pelvic repair and operator performing＜50 procedures were the relative risk factors (P＜0.05) for voiding dysfunction.Multivariate logistic regression analysis revealed that the maximum flow rate (Qmax) ≤ 15 ml/s (OR=3.782,P=0.003) was an independent risk factor for voiding dysfunction and surgery experience was its protection factors (OR=0.295,P=0.016).Conclusions Qmax ≤ 15 ml/s on preoperative urodynamic study is an independent risk factor for voiding dysfunction after mid-urethral sling procedure.Improving skill of surgery and strengthening technical training will help to reduce the incidence of this complication.

Objective To evaluate the diagnostic value of MR in carotid artery involvement using surgery and pathology as gold standard.Methods 37 patients with suspected neck masses underwent MR scan.One radiologist unaware of the pathological results measured the nine indexes as following:axial surrounding angle(AXA),long axis angle(LAA),the adjacent length of tumor long axis(LLA),the tumor long axis length(TLAL),the ratio of the adjacent length of tumor long axis and the tumor long axis length (LLA/TLAL),the perivascular fatty gap,vascular displacement,vascular deformation and magnetic resonance angiography(MRA) evaluation of artery involvement.The comparison of diagnostic value used ROC curve,sensitivity,specificity and accuracy.The cat-egorical data used Fisher orχ2 test,and measurement data used t test.Results Four indexes (AXA,LAA,LLA/TLAL and MRA) had significantly statistical value for evaluating the arterial invasion.The AUC of AXA,LAA,LLA/TLAL were 0.910,0.775 and 0.766 (P <0.05),respectively.Using 145°,61°,0.553 and MRA to indicate invasion for diagnostic value,the sensitivity and spe-cificity of those four indexes were 100.0% and 89.2%,66.7% and 89.2%,100.0% and 59.5%,33.3% and 100.0%,respective-ly.Conclusion The four indexes including AXA,LAA,LLA/TLAL and MRA evaluation of artery involvement have statistic value but with poor stability.MRA had limited diagnostic value although it’s beneficial to observe the carotid artery.

Objective To analyze the genetic characteristics of echovirus type 25( Echo25) strains isolated from patients with viral encephalitis in Longyan city. Methods Cerebrospinal fluid(CSF) specimens were collected from hospitalized patients with viral encephalitis or central nervous system infection in Longyan,2012. Enteroviruses(EV)were isolated from the specimens and then identified. Four strains of Echo25 were screened out by using serum neutralization test. Coding sequence of the VP1 region of the 4 Echo25 strains were amplified by RT-PCR and then sequenced. A phylogenetic tree was constructed to ana-lyze the nucleotide sequence homology between those sequences and the sequences of reference Echo25 strains available in the GenBank database. Results The VP1 nucleotide sequences of Echo25 strains isola-ted in Longyan were 498 bp in length,encoding 166 amino acid residues. The homology analysis showed that the VP1 nucleotide sequences of 3 strains were identical,sharing 97% homology in nucleotide with the rest strain. The Echo25 strains isolated in Longyan were highly similar to KJ957190( Beijing,2010)and HM031189(Henan,2008)strains. Phylogenetic analysis revealed that the Echo25 strains isolated in Longyan belonged to genotype B1. Conclusion Echo25 was one of the pathogens causing viral encephalitis in Longyan in 2012 and different transmission chains of Echo25 had emerged. This study indicates that it is necessary to strengthen the surveillance for EV and understand the genetic variation of the Echo25 for provi-ding better supportive evidences for the prevention and control of related diseases.

Objective To analyze and summarize the CT features of medullary thyroid carcinoma (MTC).Methods 30 patients with MTC proved by surgery and pathology were scanned by CT.And the CT manifestations were analyzed retrospectively.Results In a total of 30 patients,a single lesion in 25 (83.3%)patients and multiple ones in 5 (16.7%)were found with irregular shape in 27 (90.0%),unclear border in 26 (86.7%),heterogenous enhancement with irregular internal hypodensity in 27 (90.0%),cal-cifications in 4 (13.3%)and invasion of trachea in 4 (13.3%).As for the 29 patients underwent the neck surgery ,26 (89.7%) were pathologically confirmed with lymph nodes metastasis.CT showed the metastatic lymph nodes with well-defined border in 1 2 (46.2%)and ill-defined one in 14 (53.8%),calcifications in 5 (19.2%)and heterogenous enhancement with irregular internal hy-podensity in all (100.0%).Conclusion CT features of MTC and metastatic lymph nodes appeared as heterogenous enhancement with irregular internal low attenuation area,which can improve the accuracy of preoperative diagnosis.

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.

Objective To study the role of autophagy in the curcumin (Cur) enhancing the chemosensitivity of the colorectal cancer LoVo cells to irinotecan (CPT-11). Methods The LoVo cells were separated into 4 groups:the control group,the Cur group,the CPT-11 group and the Mix group.Western blot assay was applied to determine the expression of autophagy-related protein LC3-Ⅱ and P62. LC3-Ⅱ was detected by immunofluorescence method. Transmission electron microscopy was used to detect the autophagosome. CCK-8 assay was applied to detect the cell growth inhibitory rate of LoVo cells ,which were pre-treated with autophagy inhibitor 3-MA before 24-h treatment of Cur and/or CPT-11. Western blot assay was applied to detect the expression of LC3- Ⅱ and P62. Results The mixed treatment significantly increased the expression of LC3-Ⅱwhile decreased P62 expression,compared with the Cur and CPT-11 treatments. The autophagosomes in cells of Mix group were significantly more than those in cells of the Cur and Cpt group. Pre-treatment of 3-MA significantly reduced cell growth rate in the Cur group,the Cpt group and the Mix group. Pre-treatment of 3-MA significantly decreased the expression of LC3-Ⅱ,while increased P62 expression,compared with the Mix group. Conclution Combinations of curcumin and CPT-11 could enhance the chemosensitivity of LoVo cells to CPT-11,which might be related to the activation of autophagy.