0 05).Among the 13 patients with liver damage,AKP and ? GT were raised in 6,and AKP,? GT,TBIL and DBIL all elevated in 4 In 8 patients anti SMA and AMA were detected,and 5 showed AMA positive.Liver biopsy in 6 patients showed 3 with chronic active hepatitis among which 2 were complicated with liver cirrhosis,1 chronic persistent hepatitis and 2 cholangitis.Of the 6 patients 5 showed different degrees of infiltration of mononuclear cells in the portal tracts.Conclusion The occurrence of liver damage in pSS is rather high.The liver damage may be related to primary biliary cirrhosis (PBC).Patients′ response to corticosteroid treatment is favourable and their prognosis appears good.

0 05).Conclusion The standards of Amor and ESSG have higher sensitivity and specificity to diagnose spondyloarthropathy in China.The two standards have no difference in statistics.

The essay explained the application of objective structural clinical examination (OSCE) in the graduation examination for clinical medical students.It also summarized the preparation before the examination on OSCE and the flow process,analyzed the existing question of OSCE and the OSCE circumstance of the students,and put forward some suggestions about consummating OSCE and promoting clinical practice teaching reformation.

By studying the physician-related factors in physicianpatient relationship,authors put forwards that excellent medical skill,good medical ethics,favorable communication ability,and adequate knowledge on relevant legal regulations are four key points to handle the physician-patient relationship harmoniously.This article will supply reference from the above aspects for the all-around quality-based education for medical students.

Objective To evaluate the role of several traditional laboratory examinations in identifying the cause of WBC count increase,which might be the adverse reaction of glucocorticoid or infection.Methods 74 patients treated in the hospital from Jan. 2011 to Dec.2012 were recruited in the study.Glucocorticoid without Infection(n =15 ),Infection without Glucocorticoid(n =29) and Infection with Glucocorticoid(n=30)Group were devided according to the type of disease and therapies.After being treated for 0,3,7 d,respectively venous blood samples of patients were collected to determine the concentration of CRP,WBC count,leukocyte classification and NAP score.CRP was used as the Judgment index for the degree of infection,the changes of other indexes were compared.Results Compared with the Infection without Glucocorticoid Group,the CRP concentration of the Infection with Glu-cocorcoid Group was becoming lower(P >0.05).The Non-infection with Glucocorticoid Group applied glucocorticoid for 3 days and 7 days respectively,the count of neutrophilic granulocyte and NAP score increased significantly compared with that before glucocor-ticoid application(P <0.01)while the count of lymphocyte reduced(P <0.05)and no significant change in the count of eosnophils (P >0.05).Conclusion The increase of WBC after glucocorticoid can not be identified whether it is the adverse reaction of glu-cocorticoid or aggravated infection by using classification of leukocyte,the increasing amount of WBC and NAP score.

A rapid method has been developed based on the sample preparation procedure named as QuEChERS (Quick,Easy,Cheap,Effective,Rugged and Safe),combined with reversed-phase high performance liquid chromatography with fluorescence detector and C18 column after precolumn derivatization using o-phthalaldehyde and 2-mercaptoethanol to determine dopamine in porcine muscle.Methanol and deionized water (0.1％ acetic acid,v/v) with a ratio of 60∶40 was used as mobile phase.The flow rate was 0.8 mL/min and dopamine was eluted within 15 min.The linearity range was 0.003-8 μg/mL with r=0.9992.The detection limit for dopamine was 4 μg/kg and the quantification limit was 9 μg/kg.Recovery studies were carried out at 0.1,0.5 and 1.0 mg/kg fortification levels and the average recoveries obtained ranged from 90.4％ to 98.2％ with relative standard deviations between 3.5％ and 8.1％.The method was found to be suitable for detection of dopamine in animal product tissues at the maximum residue level.

Objective To evaluate the impact of vagal denervation (VD) that is derived from circumferential ablation of pulmonary vein ostium for paroxysmal atrial fibrillation (AF) on the therapeutic results. Methods A total of 50 patients with paroxysmal atrial fibrillation were enrolled in this study. Circumferential ablation of pulmonary vein ostium was carried out in all the patients. The end point of ablation was pulmonary vein electricity isolation. The patients in whom VD occurred during the performance of ablation were regarded as VD- positive group (n = 19), and the remaining patients were used as VD- negative group (n = 31). The recurrence rate of AF six months after the treatment was recorded, and the results were compared between the two groups. Results The end point of ablation was successfully achieved in all the fifty cases. Six months after the ablation, the therapeutic effect of VD- positive group was significantly better than that of VD- negative group (84.21% vs 64.51%, P ≤ 0.05). Conclusion The vagal denervation effect that is derived from circumferential ablation of pulmonary vein ostium in treating AF can significantly increase the success rate of radiofrequency ablation for AF.

A rapid method has been developed based on the sample preparation procedure named as QuEChERS （Quick, Easy, Cheap, Effective, Rugged and Safe）, combined with reversed-phase high performance liquid chromatography with fluorescence detector and C18 column after precolumn derivatization using o-phthalaldehyde and 2-mercaptoethanol to determine dopamine in porcine muscle. Methanol and deionized water （0.1% acetic acid, v/v） with a ratio of 60：40 was used as mobile phase. The flow rate was 0.8 mL/min and dopamine was eluted within 15 min. The linearity range was 0.003-8 μg/mL with r=0.9992. The detection limit for dopamine was 4 μg/kg and the quantification limit was 9 μg/kg. Recovery studies were carried out at 0.1, 0.5 and 1.0 mg/kg fortification levels and the average recoveries obtained ranged from 90.4% to 98.2% with relative standard deviations between 3.5% and 8.1%. The method was found to be suitable for detection of dopamine in animal product tissues at the maximum residue level.

Aim To investigate the effects of Ginkgo biloba extract(EGB)on tumor necrosis factor-alpha(TNF-?)in TNBS-induced colitis in rats and its mechanisms.Methods Colitis in rats was induced by colonic administration with 2,4,6-trinitrobenzene sulfonic acid(TNBS).Wistar rats were randomly divided into four groups,10 in each:normal group,model group,5-aminosalicylic acid(5-ASA group)and Ginkgo biloba extract group(EGB group).The levels of nitric oxide(NO),and glutathion peroxide(GSH-Px)were measured by biochemical methods.The expressions of TNF-? and nuclear factor kappaBp65(NF-?Bp65)in the colon tissues of colitis rats were detected by means of immunohistochemistry.The expressions of induce nitric oxide synthase(iNOS)in the colon tissues of colitis rats were detected by reverse transcription polymerase chain reaction(RT-PCR).The effects of EGB on colonic inflammation and macroscopic and histological damage were evaluated as well.Results Compared with the model group,treatment with EGB for 4 weeks significantly reduced colon macroscopic and histological damage,elevated the activities of GSH-Px and reduced the contents of NO,inhibited the protein expressions of TNF-? andNF-?Bp65,and decreased the mRNA levels of iNOS in the colon tissues of experimental colitis.Conclusions The probable mechanisms of EGB was that it ameliorated inflammatory injury in TNBS-induced colitis in rats by its reduction of TNF-?,NF-?Bp65 and iNOS levels.Then EGB could curb the inflammatory cascade effects of inflammatory mediators to protect ulcerative colitis.

Objective To distinguish the increase of white blood cells after glucocorticoid is the adverse reaction of glucocor‐ticoid or infection aggravated .If we can analyse it properly ,the abuse of antimicrobials and waste of medical could be avoid re‐source .Methods 74 patients which were in our hospital from 2011 .1 to 2012 .12 were recruited into this study .They were divided into three groups ,including non‐infection with glucocorticoid(n=15) ,infection without glucocorticoid(n=29) and infection with glucocorticoid(n=30) according to disease and therapies .After being treated 0 day ,3 days ,7 days ,venous blood of patients were collected to detect white blood count ,CRP and morphology of leukocyte .Results The group of non‐infection with glucocorticoid applied glucocorticoid after 3 days and 7days ,WBC was increased significantly(P<0 .01 ,respectively) .And compare with the group of infection without glucocorticoid ,more band neutrophils could be seen in peripheral blood smear of the other two(P< 0 .05) . While there was no difference on level of CRP between the groups of infection without glucocorticoid and infection with glucocorti‐coid(P>0 .05) .Conclusion Glucocorticoid rise the count of WBC in peripheral blood especially the neutrophil .We can evaluate in‐fectious status by the level of CRP and the count of band neutrophils in peripheral blood smear .