0.05).Conclusions The level of plasma Hcy in BD patients are higher than that of in the controls.Hyperhomocysteine may take part in the pathogenesis of BD, but the MTHFR gene C677T genotypes are not associated with BD.

Objective To analyse the clinical features,predisposing risk factors and treatment of hematologic diseases complicated by pulmonary fungal infection(PFI).Methods The medical records of 97 cases of PFI were retrospectively analyzed.Results Totally 201 fungal strains were obtained from 97 cases of hematologic diseases.The candida strains were 147(73.1%).Two-fungal infection was 17.5%,and secondary bacterial infection was 71.8%;relative death rate was 23.4%.Cure rate of Amphotericin B deoxycholate and Itraconazole was 67.7% and 63.7%.Conclusion Fungal infection is one of the main pathogens in hematologic diseases complicated by infection.Early diagnosis and treatment is the key to beneficial release and long time survival.Amphotericin B deoxycholate and Itraconazole were effective medicines for treated fungal infection.

Objective To understand the typing and clinical significance of M-protein,to raise the understanding and diagnostic level through analysis of 639 patients with M-protein.Methods To analysis age,sex and disease of M-protein positive patients,charateristic and content difference of multiple myeloma(MM)and monoclonal gammopathy of undeterminal significance(MGUS).Results In 639 patients with M-proteinemia,there were 409 patients with IgG-type(64%),80 IgA-type(12.5%),79 IgM-type(12.4%),4 IgD-type(0.6%),9 ? light chain(1.4%),18 ? light chain(2.8%),27 double clone(4.2%),oligoclone(2.0%).There were 115 MM(18.0%),13 Waldenstrm's macroglobulinemia(2.0%),1 primary amyloidosis of kidney,19 non-Hodgkin's lymphoma(NHL)(3%),5 chronic lymphocytic leukemia(CLL)(0.8%),473 MGUS(74.0%).Conclusion M-proteinemia is a clinical phonomenon,mainly in MM and lymphocytic proliferative disease.There is an improving tendency in MGUS detectable rate.

OBJECTIVE:To establish a RP-HPLC method to determinate the plasma concentration of paclitaxel in tumor patients.METHODS:Paclitaxel was extracted from plasma with organic phase(ethyl-acetate)by two-step extraction on Tianhe Kromasil C18 column(250 mm?4.6 mm,5 ?m)with a mobile phase consisted of acetonitrile-methanol-water(40∶25∶40)at a flow rate of 1 mL?min-1.The detective wavelength was set at 227 nm and the column temperature was maintained at 35 ℃.RESULTS:The linear range of paclitaxel was 0.05～5.00 mg?L-1(r=0.999 7)with average recovery rate at 98.75%～100.44%.Both intra-day RSD and inter-day RSD were less than 5%(n=5).The plasma concentration-time profile in 11 patients after iv infusion of paclitaxel was in line with a two-compartment model.CONCLUSION:This established method is simple,accurate,reproducible and applicable for clinical determination of blood drug concentration and pharmacokinetic studies.

OBJECTIVE:To establish an RP-HPLC method for the determination of doxorubicin hydrochloride concentration in human plasma.METHODS:Tianhe Kromasil C18 was used as column,A solution of methenol-0.01 mol?L-1ammonium dihydrogen phosphate-acetic acid(30200.1) was used as the mobile phase at a flow rate of 1.0 mL?min-1.The detection of wavelength was set at 233 nm.The sample size was 20?L and the column temperature was 35℃.The internal standard was daunorubicin.RESULTS:The calibration curve was linear in the range from 0.25～20.16 ?g?mL-1(r=0.999 6);the average methodological recovery was 96.45%(RSD=2.16%).CONCLUSIONS:The method is rapid,accurate,reproducible and easy to use in clinical detection of blood concentration.

Partial pancreatectomy was performed in a female patient with islet cell nodular hyperplasia, who repeatedly suffered from hypokalemia and hypoglycemia without diarrhea.After surgical operation,her symptoms were relieved.

Objective To explore the diagnosis and Fogarty catheter embolectomy operation management of acute arterial embolism in the extremities.Methods The clinical data of 87 cases of acute arterial embolism in the extremities treated by Fogarty catheter was ana- lyzed retrospectively,Results All cases were diagnosed through asking patient history and symptom,physical examination and the check of color Doppler while the results were proved by operation.No one case received vasography.After operation,78 cases blood stream of limb had been resumed and cure rate of 87.6% was achieved while 4 cases improved(4.5%),and no occurrence of ischemic necrosis and amputated ex- tremity.5 cases(5.6%)received amputation at the relative level and there were 2 cases(2.3%)of perioperative death.Those cases who re- ceived operations within 48 hours from the time of morbidity achieved cure rate of 100%,while those cases more than 48 hours achieved cure rate of 47.6%,improvement rate of 19.0%,amputation rate of 23.8% and mortality of 9.6%.Conclusion First,Ultrasound Doppler exami- nation should be taken for avoidance of misdiagnosis when acute extremity arterial embolism is suspected.Second,The key Intraarterial embo- lectomy using Fogarty catheter is an effective method for the treatment of acute arterial embolism in the extremities,is significant in application,Third,as soon as the diagnosis is established,embolectomy with Forgarty catheter must be carried out to avoid clot extension and necrosis of the extremity.Satisfactory therapeutic efficacy can be got,if the patient receive operation within 48 hours from onset.

Objective To explore the imaging findings of branch duct intraductal papillary mucinous neoplasms (BD-IPMNs). Methods A total of 45 BD-IPMNs were confirmed by pathology after surgery.The clinical data and imaging findings were retrospec-tively reviewed.Image analysis included characteristics and the nature of the lesions.Finally,an ROC curve was performed to evaluate the differential diagnostic efficacy between benign and malignant lesions using the imaging findings.Results There were statistically significant differences for differential diagnosis of malignant and benign BD-IPMNs in the maximum diameter of the lesions and the MPD,walls,wall nodules,shape,and the atrophy of pancreatic parenchyma (P < 0.05 ).The diagnostic sensitivity,specificity, AUC and Kappa value of benign and malignant BD-IPMNs were 94.3%,90%,92.1% and 0.81 (P =0.000 1)respectively.Conclu-sion The imaging technology is valuable in diagnosing and differentiating malignant from benign BD-IPMNs.

Objective To analyze the imaging features of Castleman disease (CD) and its correlation with histopathologic and clinical features. Methods The images of 20 patients with CD were retrospectively reviewed and compared with their clinical and pathological findings. All the patients received CT or MRI plain scan and dynamic enhanced scan. 12 patients underwent CT examination and 8 underwent MRI examination. Results Locations of the lesions were found in the neck (n=6), abdomen and pelvis (n=6), mediastinum (n=3), retroperitoneum (n=2),multiple locations (n=2) and left subclavicular region (n=1). The clinical subtypes included unicentric type (n=17) and multicentric type (n=3). Histopathologic classification was as follows: hyaline-vascular type (n=16), plasma cell type (n=3) and mixed cell type (n=1). The lesions were manifested as homogeneous masses and well-defined margins of soft-tissue attenuation on the plain scan, apart from three cases with lobular, three cases with unclear margins, five cases with multiple masses and one case with heterogeneous texture. After contrast administration, 19 cases showed marked or persistent enhancement, one showed slight enhancement; 14 showed homogeneous enhancement, six showed heterogeneous enhancement; and 17 showed enlarged blood vessels within or around the mass. Conclusion Imaging features of CD are closely correlated with its clinical and pathological subtypes. A good knowledge of imaging features can contribute to a better understanding of the lesion before operation and a suitable therapeutic regimen.

Objective To explore the value of multislice spiral computed tomography ( MSCT ) in predicting the resectability of pancreatic cancer ( PC) .Methods The MSCT images of 102 PC patients ( 62 men, mean age, 61 ±9 years;40 women, mean age, 60 ±9 years) confirmed by postoperative pathology were analyzed retrospectively .The images were analyzed and evaluated by 2 senior radiologists who were double blinded.The relationship between tumor and vessels was investigated based on consensus statement on the radiological diagnosis of PC of the Society of Abdominal Radiology and the American Pancreatic Association in 2014 .The diagnostic criterion on the resectability of PC was based on the 2015 NCCN Clinical Practice Guidelines on PC . Image analysis included the lesion location , size and density , the characteristics of pancreatic and bile ducts , relationship of tumor and adjacent vessels , the extrapancreatic findings as well as T staging and resectability.Results The locations of PC were found in the pancreatic head (n=71,69.6%), body (n=23, 22.5%) and tail (n=8, 7.8%).The long-and short-axis diameter were (28.9 ±8.8)mm and (23.8 ±8.0)mm in head, and respectively, (31.2 ±11.0)mm and (23.8 ±6.3)mm in body and tail, respectively.The imaging findings included hypo-(n=98, 96.1%) and iso-density masses (n=4, 3.9%) on pancreatic phase, intra-and extrahepatic bile duct dilation (n=63, 61.8%), main pancreatic duct cut-off with dilation (n=46, 45.1%), the pseudocyst (n=4), acute pancreatitis (n=1) and chronic pancreatitis (n=2).T staging evaluation by MSCT observed T1 (n=3), T2 (n=7), T3 (n=78) and T4 (n=14), respectively.MSCT assessment for T staging was correct in 98 (96.1%), but wrong in 4 (3.9%), which was quite consistent with pathological T staging (K=0.88, P<0.05).MSCT assessment for the resectability was correct in 98 (96.1%), but wrong in 4 (3.9%).Sensitivity, specificity, positive and negative predictive values, and area under curve of MSCT in the assessment of the resectability were 96.8%, 87.5%, 98.9%, 70.0%and 92.2%, respectively.Conclusions MSCT could improve the diagnostic accuracy for T Staging and resectability of PC .