Objective To evaluate the value of joint inspection of rheumatoid factor ( RF) and anti-cyclic citrullinated peptide antibodies(anti-CCP antibody) in rheumatoid arthritis( RA). Methods 125 patients with rheumatic disease were selected,including RA 78 cases,non-RA 47 cases. The quantitative ELISA to detect anti-CCP antibody, latex agglutination to test RF,and the data was analyzed. Results Anti-CCP antibody positive rate was 66. 7% ,RF was 74.4% Joint detection was 62.8% , single positive rate of joint detection was not statistically significant, but the specificity of joint detection was 98.6%,positive likelihood ratio was 29.2, significantly improved compared to individual testing;Sensitivity was 49.6%,negative predictive value was 54% ,significantly lower compared to test a-lone. Conclusion Combined detection was able to improve the specificity,positive likelihood ratio and reduce sensitivity , negative predictive value. It was more useful.

BACKGROUND:Clinical limb ischemia-reperfusion with no reflow phenomenon after vascular injury repair seriously affects the prognosis of patients. Therapeutic effect of hyperbaric oxygen in myocardial ischemia reperfusion is exactly confirmed, but hyperbaric oxygen is rarely reported in the treatment of limb ischemia-reperfusion.
OBJECTIVE:To detect the expression of vascular endothelial growth factor and intracellular adhesion molecule 1 and to investigate the effect of hyperbaric oxygen on the prognosis of limb ischemia-reperfusion with no reflow phenomenon.
METHODS:By clinical screening, cases of main arterial injury of the limbs were selected and subjected to vascular repair for restoring limb blood supply. After surgery, al the cases were randomly divided into two groups (Combined treatment group and surgical group), 16 cases in each group. Combined treatment group was treated with hyperbaric oxygen combined with clinical anticoagulant, antiplatelet treatment;surgical group treated with only postoperative clinical treatment. Another 16 adult healthy volunteers were selected to receive hyperbaric oxygen as hyperbaric oxygen group. Expressions of vascular endothelial growth factor and intracellular adhesion molecule 1 were detected using enzyme-linked immunosorbent assay at 8, 72 hours and 7 days after surgery.
RESULTS AND CONCLUSION:In the combined treatment and surgical groups, patients exhibited higher expressions of vascular endothelial growth factor and intracellular adhesion molecule 1 than those in the hyperbaric oxygen group (P<0.01). After 72 hours, the expression of vascular endothelial growth factor was significantly higher in the combined
treatment group than the surgical group (P<0.01). At 8 and 72 hours, the expression of intracellular adhesion molecule 1 was lower in the combined treatment group than the surgical group (P<0.05). These findings suggest that hyperbaric oxygen can induce high expression of vascular endothelial growth factor and inhibit intracellular adhesion molecule 1, which is crucial for improving growth of blood capil ary, formation of endothelial cells, reducing no reflow phenomenon.

Objective　To observe the changes of the concentration of Ca2+, contents of cAMP, CaM and activity of Ca2+/CaM-PK II in pheochromocytoma PC12 cells after combined soman and hypoxia injury. Methods　The changes of ［Ca2+］, and activity of CaM, cAMP and Ca2+/CaM-PK II in PC12 cells were studied after combined soman and hypoxia injury with radioimmunoassay. Results　The changes of ［Ca2+］, the contents of CaM, cAMP were significantly higher in hypoxic and soman intoxicated group than in soman intoxicated group and control group under hypoxia; but the activity of Ca2+/CaM-PK Ⅱ were significantly decreased. Conclusion　［Ca2+］, CaM, cAMP and Ca2+/CaM-PK Ⅱ exert important role in the damage of PC12 after combined soman and hypoxia injury.

Objective To evaluate the hearing function of pilots under physical examination for modification to equipment of high performance aircraft,using pure tone audiometry(PTA) and distortion product otoacoustic emission(DPOAE).Methods Analyzed were all the results of PTA and DPOAE of 75 pilots (150 ears) which accepted physical examination for modification to equipment of high performance aircraft in our department from March 2008 to February 2009.75 cases were divided into two groups according to their flight time.The difference between these two groups was studied.Results According to the Equipments of Physical Constitution for Flying Persons of Air force,PLA,all 75 pilots passed the ENT assessments as being qualified for flying.Of all 150 ears,abnormal DPOAEs were obviously higher than that of abnormal PTA tests.128 ears had normal PTA results.92 ears had normal DPOAE results.36 ears (27.6&) showed abnormal DPOAEs at one or more frequencies,especially at 1,3 and 4 kHz.22 ears had abnormal PTA results.20 ears had noticeable V or U shaped thresholds at 3 kHz and/or 4 kHz.The DPOAE amplitudes showed similar curves.The other two ears showed depressions at all frequencies,in both PTA and DPOAE tests.No statistically significant difference was found between the two groups in DPOAE.But statistical difference was found in DPOAE at 4 kHz compared with other frequencies.No statistically significant differences were found between the two groups in DPOAE amplitudes at 1,2,3 and 4 kHz.but at 6 and 8 kHz.Conclusion The application of DPOAE test helped find pilots who were on the early stage of noise-induced hearing loss.These pilots were the most important objects for us to follow up.

Objective To investigate the performance of left ventricular torsion (LVtor) or twist with cardiac dysfunction patients by speckle tracking imaging (STI). Methods Standard left ventricular short-axis views images were acquired by rountine two-dimensional echocardiography in thirty-two healthy humans and twenty-four patients with cardiac dysfunction. LVtor angle,left ventricular rotation (LVrot) angle,the peak value and time of LVtor and LVrot were measured respectively. The data were compared and analyzed between the two groups. Results Compared with normal group,the peak of LVtor and LVrot angle was decreased in cardiac dysfunction group at both apical and basal planes (P<0.05). The peak time of LVtor in patients with cardiac dysfunction was delayed (P<0.05). The peak time of clockwise rotation at the apical level segments was longer than control group (P<0.05). Conclusions There is a temporal sequence difference of left ventricular rotation between basal and apical planes during left ventricular contraction and decreased LVtor has been demonstrated to influence left ventricular function.

Background and purpose: Although crizotinib could manifest marked antitumor activity in anaplastic lymphoma kinase (ALK)-rearrangement-positive non-small cell lung cancer (NSCLC) patients, but brain metastases is always occured in such patients. This study aimed to explore the efifcacy and treatment mode of crizotinib for brain metastases in ALK-rearrangement-positive NSCLC. Methods: The clinical data of 6 patients with brain metastases in ALK-rearrangement-positive NSCLC treated in 81 Hospital of PLA from Jan. 2011 to Aug. 2014 were analyzed retrospectively. Results: Three patients had brain metastases before crizotinib administration, 1 obtained partial response (PR) and 2 obtained stable disease (SD) in intracraninal tumors. The median progression free survival (PFS)for the ifrst period of crizotinib administration were 5.7 months, and the sites of ifrst disease progression were brains. All the 6 patients continued to receive crizotinib after radiotherapy with the median PFS of 4 months. One patient even experienced a median PFS of 23.3 months for the second period of crizotinib administration, and her brain tumors obtained complete response (CR). Conclusion:The data of this study suggest that crizotinib is effective for brain metastases in ALK-rearrangement-positive NSCLC, and continued administration of crizotinib after radiotherapy for isolated intracraninal tumor progression is a elective treatment option for such patients.

Objective To investigate the clinical value of transumbilical single-port laparoscopic colorectal operation.Methods The clinical data of 25 patients with benign or malignant carcinoma at the upper part of the colon or rectum who were admitted to the No.4 People's Hospital of Zigong from January 2010 to December 2012 were retrospectively analyzed,and the clinical experience of transumbilical single-port laparoscopic colorectal operation was summarized.Surgical procedure was selected according to the position and nature of the lesion.Patients were followed up via out-patient examination and phone call till March 2013.Results Partial colorectal resection was done on 14 patients,radical resection of right colon on 1 patient,radical resection of transverse colon on 1 patient,radical resection of left colon on 1 patient,radical resection of sigmoid colon on 2 patients and radical rectectomy on 6 patients.The operation was successfully carried out on 22 patients,2 patients received four-port laparoscopic colorectal operation,and 1 patient was converted to open surgery.The median length of the incision of single-port laparoscopic colorectal operation was 3.8 cm (range,3.5-4.5 cm),and the operation time was (192 ± 32) minutes.The intraoperative blood loss was (61 ± 21)mL,and the median diameter of the tumor was 2.7 cm (range,1.0-5.0 cm).The median number of lymph nodes dissected was 7 (range,3-22),the mean time of postoperative anal exhaust time was 2 days (range,1-5 days),and the mean time of postoperative hospital stay was 8 days (range,6-20 days).The incidence of postoperative complications was 8.0％ (2/25),including 1 patient with wound infection and 1 patient with anastomotic leakage.The circumferential resection margins of radically resected specimens were negative in 11 patients.Twenty-two patients who received transumbilical single-port laparoscopic colorectal resection were followed up,and the median time of follow-up was 12 months.Colorectal liver metastasis was detected on 1 patient at postoperative month 10,and the other patients survived without tumor recurrence or metastases.Conclusions Transumbilical singleport laparoscopic colorectal operation is safe,micro-traumatic and feasible,and it also has less complication and good cosmetic effect.

Objective This study was carried out to compare chnical efficiency of methylprednisolone (MP) and dexamethasone (Dex) and their effects on Th cytokines in asthmatic children.Methods A total of 39 children with moderate and severe asthma at acute exacerbation were randomly divided into two groups, one (A) with MP 1 -2 mg/kg (n=21) and the other (B) with Dex 0.25 -0.75 mg/kg (n= 18),every 12 -24 h by intravenous drip.Scores of respiratory effort and peak expiratory flow rate prior to and three days after treatment in the asthmatic children aged over five years were evaluated,respectively,as well as the time of wheezing vanishing after treatment.Serum levels of interleukin-2 (IL-2) and IL-4 were determined by radioimmunoassay (RIA) prior to and three days after treatment,respectively.Results There was statistically significant difference in the time of wheezing vanishing between groups A and B (P = 0.042).Three days after treatment,PEER was significantly higher in group A than that in group B (P = 0.025).No statistically significant difference in serum IL-2 and IL-4,as well as ratio of IL-2/IL-4,was found in group B prior to and three days after treatment (P>0.05).Statistically significant difference in serum IL-2 was not observed in group B prior to and three day after treatment (P>0.05),and serum IL-4 decreased significantly (P=0.001) and ratio of serum IL-2/IL-4 (P=0.027) increased significantly three days after treatment than those prior to treatment.No significant correlation between respiratory-effort scores and ratio of serum IL-2/IL-4 prior to treatment was found (P=0.613).Conclusions Up-regulation of IL-2,or inhibition of release of IL-4,probably is not the main anti-inflammatory mechanism of dexamethasone.Methylprednisolone has little effect on serum IL-2,but can effectively reduce serum IL-4, thus increasing the ratio of serum IL-2/IL-4 and counterbalancing function of the Thl/Th2 cells.

Objective To investigate influence of exogenous insulin in all-in-one parenteral nutrition on blood glucose in infants with very low birth weight (VLBW). Methods Forty-two infants with VLBWI admitted to the department of pediatrics of Xuzhou Hospital affiliated to Southeast University during September 2005 to March 2009 were randomly assigned to Group Ⅰ ( n = 13 ) with exogenous insulin added to all-in-one parenteral nutrition at infusion rate of 0.4 U·kg-1·h-1,GroupⅡ(n = 13) with exogenous insulin at infusion rate of 0.1U·kg-1·h-1 and Group Ⅲ (n = 16) with no exogenous insulin added.Their blood glucose was monitored every two hours. Chi-square test was used for comparing difference in blood glucose abnormality between the three groups and association between blood glucose levels at admission and during hospitalization was analyzed with Spearman correlation. Results Incidence of hyperglycemia and hypoglycemia was 10. 9 percent (29/265) and 18. 1 percent (48/265) in Group Ⅰ, 20. 8 percent (59/284) and 14. 1 percent (40/284) in Group Ⅱ , and 20. 5 percent (61/298) and 11.7 percent (35/298) in Group Ⅲ, respectively. There was significant difference in incidence of hyperglycemia between Groups Ⅰ and Ⅱ ( x2 = 9. 844, P = 0. 002 ) and between Groups Ⅰ and Ⅲ ( x2 = 9. 478, P = 0. 002 ), but no significant difference in it between Groups Ⅱ and Ⅲ ( x2 = 0. 008, P = 0. 928 ). There was significant difference in incidence of hypoglycemia between Groups Ⅰ and Ⅲ ( x2 = 4. 526, P =0. 033 ), but no significant difference in it between Groups Ⅰ and Ⅱ (x2 =1.653, P=0. 199) or between Groups Ⅱ and Ⅲ (x2 =0.709, P =0.400).No significant correlation between endogenous blood insulin level at admission and during hospitalization( r = 0. 082, P = 0. 661 ) was found. Conclusions Blood glucose in infants with VLBW can not be regulated timely by their endogenous insulin itseff. Exogenous insulin added to all-in-one parenteral nutrition at infusion rate of 0. 1 U · kg-1 · h-1 may not significantly reduce incidence of hyperglycemia,while incidence of hypoglycemia can be reduced by exogenous insulin at infusion rate of 0. 4 U · kg- 1 · h -1 that can increase incidence of hypoglycemia Therefore, exogenous insulin is not recommended to be prophylactically added to all-in-one parenteral nutrition for infants with VLBW.

It is very important to obtain high yield mutant strains on the base of metabolic flux analysis of Actinobacillus succinogenes S.JST for the industrial bioconversion of succinic acid. The metabolic pathway was analized at first and the flux of the metabolic networks was calculated by matrix. In order to decrease acetic acid flux, the strains mutated by soft X-ray of synchronous radiation were screened on the plates with high concentration of fluoroacetic acid. For decreasing the metabolic flux of ethanol the site-directed mutagenesis was carried out for the reduction of alcohol dehydrogenase(Adh) specific activity. Then the enzyme activity determination and the gene sequence analysis of the mutant strain was compared with those of the parent strain. Metabolic flux analysis of the parent strain indicated that the flux of succinic acid was 1.78(mmol/g/h) and that the flux of acetic acid and ethanol were 0.60 (mmol/g/h) and 1.04( mmol/g/h), respectively. Meanwhile the metabolic pathway analysis showed that the ethanol metabolism enhanced the lacking of H electron donor during the synthesis of succinic acid and that the succinic acid flux was weakened by the metabolism of byproducts ethanol and acetic acid. Compared with the parent strain, the acetic acid flux of anti-fluoroacetic mutant strain S.JST1 was 0.024 (mmol/g/h), decreasing by 96%. Then the enzyme determination showed that the specific activity unit of phosphotransacetylase(Pta) decreased from 602 to 74 and a mutated site was founded in the pta gene of the mutant strain S.JST1. Compared with that of the parent strain S.JST1 the ethanol flux of adh-site-directed mutant strain S.JST2 was 0.020 (mmol/g/h), decreasing by 98%. Then the enzyme determination showed that the specific activity unit of Adh decreased from 585 to 62 and the yield of end product succinic acid was 65.7 (g/L). The interdiction of Adh and Pta decreased the metabolism of byproducts and the H electron donor was well balanced, thus the succinic acid flux was strengthened by the redundant carbon flux from these byproducts. The mutant strain S.JST2 obtained in this paper deserves being extended to application of industrial fermentation.
Actinobacillus ; enzymology ; genetics ; growth & development ; Alcohol Dehydrogenase ; metabolism ; Metabolic Networks and Pathways ; genetics ; Mutagenesis, Site-Directed ; Mutation ; Phosphate Acetyltransferase ; metabolism ; Succinic Acid ; metabolism