Objective To investigate etiology of the 18 -45 years young ischemic stroke and risk factors .Methods We retro-spectively analyzed clinical data of 106 cases patients with ischemic stroke ,carotid ultrasound ,MRA ,CTA ,DSA results analyzed e-tiology ,type .compared patients and the same period youth for the medical check with risk factors .Results The proportion of LAA、SOE in low ages had significant differences with high age(P<0 .05) .The proportion of LAA was 29 .2% and the proportion of SUE was 25 .4% ,On hypertension ,hyperlipidemia ,drinking ,smoking ,obesity ,diabetes ,heart disease ,high homocystine ,young stroke group had significant differences with young control group (P<0 .05) .Conclusion Youth main cause of ischemic stroke is large artery atherosclerotic stroke and unknown cause of stroke .The main youth ischemic stroke risk factors are smoking ,hyperten-sion ,hyperlipidemia ,diabetes ,drinking ,heart disease .

Objective To assess the diagnostic value of the CT-guided percutaneous lung biopsy in diffuse lung diseases. Methods CT-guided percutaneous lung biopsy was performed using 18G or 20G biopsy needle in 68 patients with diffuse lung diseases. The main imaging changes of these patients included network of diffuse nodular or nodular, diffuse reticular lines shadow and diffuse ground-glass density in the lungs. Results Punctures were successful in all 68 patients, and the diseases were clearly diagnosed, including 19 patients with malignant (9 bronchioloalveolar carcinoma and 10 metastatic carcinoma) and 49 with benign (27 disseminated pulmonary tuberculosis, 8 sarcoidosis, 7 silicosis and coal worker's lung, 2 interstitial pneumonia, 4 pulmonary alveolar proteinosis allergic and 1 pneumonia) lesions. The major complications of puncture were pneumothorax and bleeding, and the incident rate of complications was 17.65%. Conclusion CT-guided percutaneous lung biopsy is a useful, safe technique with low complications, high accuracy rate for the diagnosis of diffuse lung diseases.

Objective To investigate the selection of operative method and peri operative managements for osteoporotic femoral intertrochanteric fracture in elderly patients aged over 75 years.Methods A total of 132 consecutive patients aged 75-91 years with osteoporotic intertrochanteric fractures from July 2009 to July 2012 were retrospectively analyzed.47 patients were treated with dynamic hip screw (DHS group),44 patients with proximal femoral nail anti-rotation (PFNA group) and 41 patients with Gamma Ⅲ nail (Gamma Ⅲ group).The peri-operative managements,operation circumstance,the time for fracture union,postoperative complications and the degree of functional recovery were analyzed and compared between the 3 groups.Results The mean surgical time was shorter in Gamma Ⅲ nail and PFNA groups than in DHS group [(68.7±9.1) min,(80.5±11.3) min vs (112.2±18.4) min,both P＜0.01].The mean blood loss was less in the Gamma Ⅲ nail and PFNA groups than in DHS group[(156.9±18.5) ml,(183.4±21.3) ml vs (296.2±29.6) ml,both P＜0.01].The mean time for fracture healing was shorter in Gamma [Ⅲ nail and PFNA groups than inDHSgroup [(12.6±2.4) weeks,(13.1±2.4) weeks vs (15.3±3.2) weeks,both P＜ 0.05],and it has no obvious difference between Gamma Ⅲ nail and PFNA groups (P＞0.05).There were significant differences in postoperative complications between Gamma Ⅲ nail,PFNA groups and DHS group (2 cases,3 cases vv 11 cases,P＜0.05,respectively).The mean Harris hip score had no significantly difference among DHS,Gamma Ⅲ nail and PFNA groups (87.4±11.6,90.2±13.0 vs 88.9±12.3,both P＞0.05).Conclusions The 3 operative methods for stable intertrochanteric fracture are feasible and effective in elderly patients,but for unstable intertrochanteric fractures,the treatment with Gamma Ⅲ nail and PFNA has advantages.

Objective To develop a method for measuring serum total glycerol by isotope dilution (ID)liquid chromatography tandem mass spectrometry(LC/MS/MS).Methods Serum samples were mixed with [13C3]-glycerol(internal standard)and treated with alcoholic potassium hydroxide to hydrolyze serum glycerides to glycerol.The natural glycerol and the internal standard were benzoylated with the Schotten-Baumann reaction and the benzoates were analyzed by LC/MS/MS.Results The correlation coefficients between the peak area ratios and glycerol concentrations were 0.999 9 and higher.The withinrun coefficients of variation(CV)for serum total glycerol analysis averaged 0.94%(ranged 0.21%～2.62%)and the total CV 1.15%(0.62%～2.00%).Results on certified reference materials(SRM 909b Level Ⅰ and LevelⅡ;GBW 09146 and GBW 09147)showed an averaged bias of 0.20%(-0.20%～1.06%).Conclusions An ID-LC/MS/MS method for serum total glycerol has been developed.The method iS highly specific and precise and may be used as a candidate reference method for serum total glycerol measurements.

Objective To explore the risk factors related to the development and progression of lumbar degenerative spondylolisthesis (LDS).Methods A total of 71 patients with LDS or degenerative spinal stenosis (DSS) were retrospectively.Thirty-six patients with LDS (group LDS) and 35 patients with DSS (group DSS) were enrolled.Spinopelvic parameters including pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), thoracic kyphosis (TK), regional lumbopelvic lordosis angles (PR-LI, PR-L2, PR-L3, PR-L4, PR-L5), pelvic morphology (PR-S1), lumbar 4 slope (L4 S) and lumbar 5 slope (L5 S) were assessed on whole spine lateral radiographs in a standing position.All the parameters from LDS will compared with those of DSS and normal population respectively, Student's t-test was used to compare each parameter among the LDS, DSS and normal population.Results PI [ (57.67±11.78) °], SS [ (37.83±9.17) °] and LL [ (54.65±11.45) °] in group LDS were significantly greater than those of group DSS [ (44.47±8.75) °, (28.18±9.02) °, (38.97±15.59) °] and normal reference value [ (44.75±9.01) °, (33.57±7.64) °, (48.75±10.03) °] (P＜0.05).L4 S [ (8.18±9.98) °] and L5 S [ (19.96±8.33) °] in group LDS were greater than the group DSS[ (3.32±7.95) °, (10.87±8.02) °] (P＜0.05).The PR-L4 [ (57.63±13.44) °], PR-L5 [ (45.76±10.92) °] and PR-S1 [ (27.91±10.41) °] in group LDS were significantly smaller than those of group DSS [ (65.48±10.70) °, (56.33±9.15) °, (38.63±7.29) °] (P＜0.05).Conclusion Greater PI may lead to the development and progression of lumbar degenerative spondylolisthesis.L5 S is a parameter that can be used to predict the risk of LDS.The lower regional lumbopelvic lordosis angles in LDS were smaller than those of DSS.

Objective To develop a candidate reference method for the measurement of serum glucose based on isotope dilution liquid chromatography tandem mass spectrometry(ID-LC/MS/MS)Methods An internal standard [~(13)C_6]glucose was added to serum samples and equilibrated with endogenous glucose.Serum proteins were removed by a precipitation with anhydrous ethanol.Serum glucose and the internal standard were then reacted with 1-phenyl-3-methyl-5-pyrazolone and the formed derivatives were analyzed by liquid chromatography tandem mass spectrometry with multiple reaction monitoring(MRM).The method was calibrated with bracketing calibrators and serum glucose concentrations were calculated by comparing the peak area ratios of samples with that of the calibrators.Results The within-run,between-run and total coefficients of variation averaged 0.36%,0.47%and 0.61%,respectively.The analytical recoveries ranged from 99.0% to 100.9%.Results of analyzing the certified reference material SRM 965a showed an average biases of-0.20%.Conclusions An ID-LC/MS/MS method for measuring serum glucose has been developed.The method is highly precise and accurate and may be used as a candidate reference method.

Objective To evaluate the matrix effects in serum urea measurements of external quality assessment(EQA)materials and commercial reference materials(calibrators or controls)on enzymatic methods and to verify the trueness of the enzymatic methods.Methods The Clinical and Laboratory Stadards Institute(CLSI)EP 14-A2 protocol was used for the evaluation of matrix effect.An isotope dilution gas chromatography mass spectrometry method was used as the comparative method.Twenty five fresh patient serum samples,15 EQA materials and 13 calibrators or controls were analyzed with 7 enzymatic methods (evaluated methods)and the comparative method and results were processed according to the protocol. The trueness of the evaluated methods were also assessed by comparing the fresh sample results obtained with the evaluated and comparative methods.Results Eight of 15 EQA materials and 3 of 13 calibrators or controls showed no matrix effects on all the 7 routine methods.One processed sample showed matrix effect on all the routine methods.Method dependent matrix effects of other materials were observed on other materials.Calibration biases were also observed on some enzymatic methods.Conclusions Matrix effects and calibration bias have been observed in serum urea measurements.Continued efforts are needed for improving the accuracy and the comparability of serum urea measurements.

Objective To review the performance of the IFCC enzyme reference methods in China laboratories and to evaluate the competence of enzyme reference measurement in China.Methods The Intemational Federation of Clinical Chemistry and Laboratory Medicine(IFCC)enzyme reference methods were performed in 8 China laboratories.Reference procedures were developed by each laboratory and the performances were evaluated.The Clinical and Laboratory Stadards Institute(CLSI)EP-5 protocol was used for the evaluation of precision and certified reference materials(CRMS)were used for the verification of trueness.Seven of the 8 laboratories participated in the 2006 IFCC external quality assessment program for reference laboratories(RELA)for the assessment of the measurement performance.Results Within-run CVs of less than 1.5%and between-run CVs of less than 2%were achieved bv all the China laboratories.Results on CRMs by some of the laboratories agreed with the certified value within the stated uncertainty.In the 2006 RELA,the averages and the interlaboratory CVs of the China laboratories were similar to those of international laboratories.Conclusion A preliminary enzyme reference method laboratory network has been established in China.

Objective To conduct a Meta-analysis for assessing the therapeutic efficacy and safety of doxorubicin-eluting bead transcatheter arterial chemoembolization (DEB-TACE) vs conventional TACE (C-TACE) in the treatment of hepatoeellular carcinoma (HCC).Methods The relevant studies on DEB-TACE and C-TACE for HCC were searched from PubMed,Web of Science and CK1N databases.The tumor responds and adverse events in the selected studies were analyzed with RevMan5.0 statistical software.Moreover,publication bias was assessed by a funnel plot.Results Thirteen studies with 1 325 HCC patients were finally included in this analysis.The tumor response to DEB-TACE was better than that to C-TACE (OR:2.28;95％CI [1.75,2.96];P＜0.001 0).The risk of adverse events in DEB-TACE group was also lower than that in C-TACE group (RR:0.56;95％ CI [0.32,0.97];P=0.04).Conclusion Compared with C-TACE,DEB-TACE is more effective and has lower risk of adverse events in the treatment of HCC.

Objective To study the relationship between socioeconomic status (SES) and esophageal squamous cell carcinoma(ESCC) in Taixing city,Jiangsu province.Methods A populationbased case-control study was carried out to collect data including demography,socioeconomic status indicators and possible risk factors.Unconditional logistic regression was used to compare different SES indicators and composite wealth scores constructed between cases and controls,using the principal component analysis methodology.Results Factors as:having received high school or higher education (OR=0.66,95％CI:0.46-0.96),living space over 67 m2 per-capita (OR=0.71,95％CI:0.54-0.94),drinking tap water longer than 5 years (OR=0.76,95％ CI:0.59-0.98) and wealth score ＞0.93 (OR=0.63,95％CI:0.48-0.83) were associated with increased risk of ESCC.Compared to those worked in farming,forestry,animal husbandry,fishery and water conservancy,the individuals who worked in business-service industry were at lower risk of ESCC (OR =0.65,95％CI:0.43-0.97).Conclusion An inverse association of low SES and ESCC were found in Taixing people that called for further explanation.