Objective To study the clinical significance of tumor markers combined assay in the differential diagnosis of pleural effusion.Methods 165 serum and hydrothorax samples were collected from 165 in-patients with pleural effusion.Among them ,55 patients were suffered from malignant pleural effusion and 110 patients with benign pleural effusion.The concentration of CEA,and TSGF were determined by chemiluminescence assay.Results In malignant pleural effusion group,the positive rates of serum CEA and TSGF were 58.8% and 54.3% respectively,the positive rates of hydrothorax CEA and TSGF were 75.8% ,70.7% respectively.Among them,CEA and TSGF in malignant group were significantly higher than that in benign pleural effusion group(P < 0.01 ).So as did of the concentration.The sensitivity of combined assay with serum TSGF in diagnosing malignant pleural effusion was 85.7% ,with the specificity of 97.8%.Conclusion Tumor markers of CEA and TSGF have high clinical values in the differential diagnosis of pleural effusion.The combined assay with TSGF is recommended.

The philosophic mode of bi-cyclic and tri-cyclic mutual crosses have the connotations of the dynamic development and change,reciprocity and transformation,and the unity of opposites.It possesses the peculiarities of the brachylogy and straight view as a method for thinking and studying on the problems of the medicine and other scientific system.It can play an important role in training the students' innovative thinking,their ability to discover and solve problems.

This paper introduces the wavelet transform with multiresolution for liver cancer CT image enhancement. As the wavelet transform with compact support, orthogonality and approximately symmetry, SymletsA (sym4) wavelet family is applied to the two-layer multiscale decompose of the CT image. The decomposed wavelet coefficients are processed with the threshold values of 550, 350 and 250, with the low -frequency region intensified and the high-frequency one weakened. Then the image is reconstructed and thus the image is enhanced. Wavelet transform proves efficient in CT image enhancement.

Objective To study the effects of different nutritional support strategy on acute pancreatitis in rats induced by bile-pancreatic duct ligation. Methods Forty acute pancreatitic rats were divided into four groups and were given simple parenteral nutrition (PN, n=10), early enteral nutrition (EEN,n=10), mid term enteral nutrition(MEN, n=10), and late enteral nutrition (LEN, n=10) respectively. After seven-days of nutritional support, the weight changes and peritoneal dropsy were recorded, the zymologic index of serum biochemistry, pancreatic enzyme level, and malonaldehyde(MDA) concentration were detected, and the pancreatitic tissue were collected, stained with hematoxylin eosin, and histopathologically scored. Results Three rats died in EEN group, and one rat died in MEN group. The weight reduction and peritoneal dropsy in EEN and MEN groups were significantly larger compared with PN and LEN groups(P<0.05). The index of direct bilirubin in EEN rats was significantly higher than that in PN and LEN groups(P<0.05). The index of serum albumin of PN group was higher than those of the other three groups(P<0.05 ) ; the index of hemodiastase of PN group was lower than those of EEN and MEN groups(P<0.05 ) ; the index of hemolipase of PN group was lower than those of the other three groups(P< 0.05). The amount of pancreatic tissue amylase of PN and LEN groups was lower than those of EEN and MEN groups(P<0.05 ) ; the amount of pancreatic tissue lipase of EEN group was higher than those of PN and LEN groups (P<0.05). There was positive relationship between MDA concentration and histopathological score of pancreatic tissue(R=0.93, P<0.05) ; MDA concentration and histopathological score of EEN and MEN groups were significantly higher than those of PN and LEN groups (P<0.05).Conclusion Early enteral nutritional support exacerbates pathological changes of acute pancreatitic rats,which is unfavourable to the recovery of the pancreatitis.

Objective:To evaluate the efficacy and safety of amisulpride and risperidone in the treatment of schizophrenia. Meth-ods:The RCTs literatures on amisulpride and risperidone in the treatment of schizophrenia were retrieved and screened, and the quali-fied ones were analyzed by meta-analysis. Results:A total of 10 literatures were included involving 802 patients. Meta-analysis results showed that the difference between the two groups after the treatment was not statistically significant by comparing the clinical efficien-cy, PANSS score and TESS score. About the incidence of adverse reactions, amisulpride was better than risperidone in the endocrine function, extrapyramidal symptoms, weight gain and cardiovascular system. The incidence of nausea and vomiting of amisulpride was more than that of risperidone. There was no statistical significance in insomnia, headache, dizziness and the others. Conclusion:Ex-isting literature analysis shows that amisulpride is safe and effective in the treatment of schizophrenia.

Objective To introduce the clinical experience and investigate the significance and safety of harmonic scalpel combined with meticulous capsular dissection technique in thyroidectomy.Methods A retrospective analysis was performed on 275 patients who underwent thyroidectomy among which 135 patients were treated by capsular dissection technique and harmonic scalpel (harmonic scalpel group),the other 140 patients were treated by electric knife and traditional ligation (traditional group).The thyroidectomy operative time,intraoperative bleeding volume,postoperative drainage volume and surgical complications were compared between two groups.Results In harmonic scalpel group,the thyroidectomy operative time of total thyroidectomy and subtotal thyroidectomy was significantly shorter than that in traditional group [(50.0±6.9) min vs.(82.0± 14.4) min,(39.9±6.6) min vs.(73.1 ± 14.5) min](P＜0.01).The intraoperative bleeding volume of total thyroidectomy and subtotal thyroidectomy in harmonic scalpel group was significantly lower than that in traditional group [(18.7 ± 10.9) ml vs.(41.9 ± 15.6) ml,(17.7 ± 9.3) ml vs.(42.2 ± 14.6) ml] (P ＜ 0.01).The postoperative drainage volume of total thyroidectomy and subtotal thyroidectomy in harmonic scalpel group was significantly lower than that in traditional group [(40.7 ± 11.7) ml vs.(53.9 ± 17.5) ml,(42.7 ± 14.5) ml vs.(61.8 ±22.9) ml](P＜0.01).The rate of temporary hypoparathyroidism and temporary recurrent laryngeal nerve palsy had no significant difference between two groups (P ＞ 0.05).Conclusions Application of harmonic scalpel combined with meticulous capsular dissection technique in thyroidectomy can significantly reduce thyroidectomy operative time,intraoperative bleeding volume,postoperative drainage volume and surgical complications.Harmonic scalpel combined with meticulous capsular dissection technique in thyroidectomy should be widely used.

Objective To assess the efficacy and safety of transurethral bipolar plasmakinetic resection of the prostate(TUPKRP) for the treatment of benign prostatic hyperplasia(BPH).Methods The operation was completed using a bipolar plasmakinetic resection system(CIRCON ACMI).Three trenches were created at 5,7,and 12 o'clock position,respectively,to divide the middle,left,and right lobes of the prostate gland for resection.The bladder neck was widened in overlapping vaporizing swathes to create a wide-necked funnel down to the level of the surgical capsule.The apical tissue was resected to the anterior border of the seminal colliculus.With a F_(20) or F_(22) three-cavity catheter indwelling for 3~5 d,normal saline irrigation was used for 1~2 d postoperatively.Results The duration of the procedure was 20~180 min(53.2?28.7 min),and resected tissue weighed 8~130 g(23.5?21.6 g).The intraoperative blood loss was 10~300 ml(65.4?46.8 ml) and no blood transfusion was required.No perforation of the prostatic capsule or transurethral resection syndrome occurred.The peak urinary flow rate(Qmax) increased from 8.4?1.9 ml/s preoperatively to 18.4?1.8 ml/s 1 month postoperatively(q=55.498,P﹤0.05).The residual urine(RU) decreased from 80.8?59.7 ml preoperatively to 19.5?10.0 ml postoperatively(q=17.287,P﹤0.05). The international prostate symptom score(IPSS) decreased from 25.7?5.5 preoperatively to 5.7?2.4 postoperatively(q=52.969,P﹤0.05).The scores of quality of life(QOL) decreased from 4.4?1.0 preoperatively to 1.1?0.2 postoperatively(q=42.146,P﹤0.05). Conclusions Transurethral bipolar plasmakinetic resection of the prostate for the treatment of benign prostatic hyperplasia is effective and safe,with few complications.

BACKGROUND: Presently used biological factors for inducing bone marrow mesenchymal stem cells (BMSCs) do not obtain mature chondrocytes. Cartilage tissue engineering using BMSCs as seeds does not collect tissue-engineered cartilage, which has value in the clinic. The obtained tissue is cartilage-like tissue. OBJECTIVE: To screen differentially expressed genes between rat BMSCs and chondrocytes by microarray. DESIGN, TIME AND SETTING: The cytology gene study was conducted at the Central Laboratory, First Affiliated Hospital, Dalian Medical University in July 2007. MATERIALS: A total of 8 healthy Sprague Dawley rats aged 2 months were obtained from Animal Experimental Center, Dalian Medical University. 27K Rat Genome Array chip was supplied by Bo’ao, Beijing, China. METHODS: Rat BMSCs and chondrocytes in the aural region were sterilely isolated and cultured in vitro. Total RNA was extracted and purified using Trizol one-step method, and transformed into double chain cDNA probe following reverse transcription. Cy5-dCTP and Cy3-dCTP were used to label BMSCs and chondrocytes, which were hybridized and washed. The fluorescent signals were scanned by a scanner. The values were analyzed and calculated by GenePix Pro 4.0 software. MAIN OUTCOME MEASURES: Gene expression spectrum chip hybridization results. RESULTS: Among the differentially expressed genes (2 times difference), BMSCs as controls, upregulated and downregulated genes were 1 226 and 888, respectively. There were many differential expression gene of BMSCs and chondrocytes. Cy5/Cy3 20 genes are defined as significant differential expression gene. Thus, two important cytokines were found: chondromodulin and connective tissue growth factor. CONCLUSION: The gene chip technique provides an ideal method for screening cytokines during study of tissue-engineered cartilage. Cartilage regulin and connective tissue growth factor highly express in chondrocytes, which indicated that the two have closely association with the differentiation of BMSCs into cartilage.

Objective To evaluate the efficacy of surgical repair for non-circumferential defect of bile duct in Mirizzi syndrome.Method The clinical data of 32 patients with Mirizzi syndrome with non-circumferential defect of bile duct were repaired using the patient's own tissues such as gallbladder pedicle flap,umbilical venous flap and omental flap.Results All the patients were operated success fully.There was no operative mortality.The defects in the bile duct were repaired using gallbladder pedicle flap in 25 patients,umbilical venous flap in 5 patients and omental flap in 2 patients.There were 2 patients who developed postoperative complications.There was one postoperative bile leakage in a patient who was repaired using an umbilical venous flap.The other complication was residual bile duct stones.The patient with postoperative bile leakage was drained through a drainage tube which was removed after 7 days.The residual bile duct stones were removed by endoscopy through a T-tube sinus after 9 months.All patients were confirmed by T-tube cholangiography after 9 to 12 months to have no stones,bile duct stenosis or any other abnormalities.The T-tube was then removed.All patients were followed -up for 1 to 5 years.All patients had no cholangitis,abdominal pain,jaundice or fever.Conclusions Using the patients' own tissues such as gallbladder pedicle flap,umbilical venous flap and omental flap to surgical repair the defect in the bile duct of patients with Mirizzi syndrome was effective.This surgical treatment is a good choice.

ObjectiveTo investigate the serum tumor markers level of carcinoembryonic antigen(CEA) ,cytokeratin fragment antigen21-1 (CYFRA21-1),neuron specific enolase (NSE) in patients with lung cancer, and the change after chemotherapy on them. Methods Radioimmunoassay was applied to detect the levels of CEA, CYFRA21-1 ,NSE in 45 patients with advanced NSCLC before and after chemotherapy,and the tumor markers were also detected in 20 patients with SCLC and 20 patients with benign lung diseases of control groups. ResultsThe levels of CEA, CYFRA21-1, NSE in lung cancer group before chemotherapy were much higher than benign group, but there was no difference of CYFRA21-1 between the SCLC group and benign group. The same result of NSE was found between NSCLC and benign group(P ＞0. 05). The value of NSE was lower in the patients with SCLC after chemotherapy than before(P ＜0. 01 ). The level of CYFRA21-1 was lower in squamous carcinoma than before( P ＜0. 01 ). But in the adenocarcinoma group only NSE's level was lower after chemotherapy( P ＞0. 05) ,there were no differences in CEA and CYFRA21-1 ( P ＞ 0. 05 ). ConclusionThe levels of the three tumor markers rise obviously in advanced NSCLC and decrease after chemotherapy. The differences were significant with NSE in SCLC and CYFRA21-1 in squamous cell carcinoma and CEA in adenocarcinoma. The levels of serum CEA,CYFRA21-1 and NSE could be a tumor marker in progressive lung cancer. And the decrease of the levels could be used to evaluate the chemotherapeutic response respectively in different pathologic types of lung cancer.