Objective To study the present situation of misdiagnosed acute pancreatitis(AP)in China and to im prove the identification of AP.Methods One hundred and forty.four documents of Chinese-language cases studies involving the misdiagnosis of AP published from 1988 to 2007 were identified by searching in the China National Knowledge Infrastructure(CNKI).Retrospective study of misdiagnosed diseases,clinical manifestations,risk fac tors and accessory examinations etc,Was made in 1098 patients with AP.Results(1)The patients related to the departments of internal medicine,surgery,obstetrics and gynecology,and pediatrics and so on.The misdiagnosed diseases were over 63 kinds.The first five places successively were:cholelithiasis combined with biliary infection (182 times),acute gastroenteritis(158 times),coronary heart disease(108 times),acute appendicitis(102 times),and intestinal obstruction(90 times).(2)Abdominal pain(878 cases)is the main manifestation in AP, and the first five regions of abdominal pain successively were:upper-middle abdomen(434 cases),whole abdomen (220 cases),right lower quadrant(79 cases),right upper quadrant(74 cases),left upper quadrant(71 cases). (3)Cholecystolithiasis(145 cases)was the first risk factor,and followed the order of fat meal(106 cases)＞chronic cholecystitis(72 eases)＞alcohol(67 times).(4)The number of cases diagnosed by operation was the most,up to 378;others successively were serum and urine amylase examinations(35 1 CtLSe8)and abdominal CT scan(135 cases),and abdominal ultrasound imaging(59 cases).Conclusions(1)The main causes of misdiag nasis were superficial understanding of predisposing condition,lack of correct analysis on clinical manifestations, and mistakes in the analysis Oil the accessory examinations.(2)Although amylase in serum or urine has limitation in diagnosis,it still Was the main method of diagnosis;and it Was necessary to be examined by abdominal CT or sur gical exploration for patients who were highly suspected as having AP but could not be diagnosed.

BACKGROUND: Nowadays, the scaffold for tissue engineering have low properties of physical mechanics, poor biocompatibility and has not free regulating degradation as matrix materials.OBJECTIVE: To develop a composite of scaffold for cartilage tissue engineering with higher porosity and good mechanical characteristic, biocompatibility and free regulating degradation as matrix materials.DESIGN, TIME AND SETTING: This experiment was conducted at the Research Institute of Engineering Materials, Lanzhou Jiaotong University from June 2006 to June 2008.MATERIALS: Gelatin, calcium polyphosphate fiber (diameter 10-20 μm) and rosin (size: 355-450μm) were used in the present study.METHODS: Calcium polyphosphate fiber was selected as reinforced materials and gelatin as matrix materials. The calcium polyphosphate/gelatin composite of the scaffold for cartilage tissue engineering were fabricated with a solvent-casting,particulate-leaching method.MAIN OUTCOME MEASURES: The microstructures, properties of physical mechanics and degradation were tested.RESULTS: ①Microcosmic observation: The composites had the 3-D, connectivity network microstructures. ②Physical and mechanical properties of scaffold composite: The experimental value of calcium polyphosphate/gelatin composite of the scaffold was consistent with calculated value. Experimental value of porosity was 60%-80%, meeting the requirement of porosity of tissue engineering scaffold composite. The compress modulus of scaffold would be increased with the crossllnkage increasing; ③The degradable rate of the scaffolds composites deteriorated quickly during 0-2 weeks, and slowly after 2 weeks and reduced with increased crosslinkage; the degradable liquid pH value was maintained between 5 and 7.CONCLUSION: The mechanical property and biodegradable property of calcium polyphosphate/gelatin composite can meet the demand of cartilage tissue engineering. This composite might be one of cartilage scaffold materials for cartilage tissue engineering with potentially broad applicability.

AIM: To prepare α-tricalcium phosphate (α-TCP)/calcium polyphosphate (CPP) fiber and to study the feasibility of CPP fiber to reinforce calcium phosphate bone cement composites. METHODS: Firstly,α-TCP powder was synthesized using chemical sediment method. Secondly, the α-TCP was mixed with CPP fiber according to different contents and lengths. Finally, bone cement was tempered with firming agent. Solidification time and mechanical property of the samples were measured. Microstructure of hardened sample was observed with scanning electron microscope. RESULTS: When the amount of CPP fibers was 10% and the length was 2 mm, the compressive strength reached 62.5 MPa and the rupture strength reached 12.4 MPa. Scanning electron microscope suggested that CPP fibers with great associativity were well distributed in bone cement. After immersing in Ringer fluid for two months, the CPP fibers did not biodegrade obviously and still had certain function to increase strength and toughness. CONCLUSION: To a certain extent, the CPP fiber can increase strength and toughness of bone cement. Furthermore, α-TCP/CPP composites have good mechanical properties and biocompatibility.

BACKGROUND:When bone cement solidifies fast,the bone cement consistency will be decreased.resulting in difficulty in molding.DESIGN,TIME AND SETTING:Open experiment,performed in the Laboratory of Department of Materials,Lanzhou Jiaotong University between March 2005 and August 2006.gelatin were mixed with citric acid to produce hardening liquid.Then bone cement power and hardening liquid were mixed to form a paste,I.e.,bone cement.METHODS:Setting time of bone cement was determined using a Vicat apparatus.The compressive strength of bone cement at different proportions was tested using MTS-810 material tester.After 2 months of physiological saline soaking at 37℃.the microstructure of solidified bone cement was observed using scanning electron microscope.MAIN OUTCOME MEASURES:Setting time and compressive strength of bone cement,pH value of hydrated bone cement and the microstructure.RESULTS:After adding chitosan and gelatin in the hardening liquid.the consistency of the concoction obviously increased,the setting time became a little longer and the water-resistance of samples was enhanced.therefore the samples could be easily molded.But the compressive strength of the bone cement decreased a little.The pH value of the hydrated bone cement increased gradually with time and was close to the pH value of physiological saline at hour 24.The compressive strength of bone cement was achieyed at 24 hours and it almost did not change after 48 hours.the drawback of ceramic HA,including sintering and difficulties in shaping.It has the characteristics of simple-producing,easy application and low heat energy.

Secondary hyperparathyroidism (SHPT) is the common complication in chronic kidney disease patients,especially in those with hemodialysis,which is associated with cardiovascular events and mortality.Active vitamin D and its analogues are classic treatment for SHPT,but some patients are resistant to active vitamin D,and ablation would be a choice for such cases.The purpose of this review is to provide current progress in ablation for SHPT.

Objective:To investigate the variations o f mitochondrial D-loop region in gastric cancers. Methods:The D-loop region of 12 gastric cancers together with th e adjacent normal tissues were amplified by PCR and sequenced. Results: Among the 12 cases,16 mutations and 28 polymorphisms were identified with the mutations rate of 50%.There were 3 new polymophisms which we re not reported previously in the GeneBank among the 28 polymorphisms. Conclusion:We think that the mitochondrial DNA D-loop region is a highly polymorphric and mutable region and the mutation rate is relatively high in patients with gastric cancer.

Objective To improve the sensitivity of detection of protein P16 by FCM.Methods Protein P16 of blood cells and tumor cells in biopsy samples were labeled simultaneously with anti-CD45 and anti-P16 fluorescent antibody.The rates of CD45+P16+ cells and CD45-P16+ cells were calculated by FCM.Results The low expression rates of protein P16 in normal blood cells and in tumor cells in biopsy samples were 15.39%(6/39) and 69.23%(27/39),respectively, which had a significant differences (P

The target value of intact parathyroid hormone (iPTH) in main international guidelines is not consistent completely.Furthermore,the evidence levels of clinical studies these guidelines based on are generally low and most of them are based on observational studies.Some studies even showed that there was no association between iPTH level and clinical outcomes.This review focuses on the following three points for reassessing iPTH target value: comparison of iPTH target value in main international guidelines,the difference of iPTH target value in large clinical studies and reasons for the difference.

Objective To investigate the correlation of single nucleotide polymorphisms( SNP) of rs228648 and rs2890565 in urotensin Ⅱ (UTS2)gene with polycystic ovary syndrome(PCOS). Methods The genotypes of two SNPs in UTS2 gene were determined through polymerase chain reaction Tin-shift genotyping method. 101 Chinese Han families trios in Shandong Province consisting of fathers,mothers,and affected daughters with PCOS and 105 healthy women were recruited. The physiological and biochemical parameters including serum follicular stimulating hormone(FSH),luteinizing hormone( LH),testosterone,fasting plasma glucose,and insulin were also measured. Results The distributions of three genotypes and two alleles of SNP rs228648 in UTS2 gene were similar between PCOS group and control group. The distributions of genotypes of SNP rs2890565 in UTS2 gene differed significantly between PCOS group and control group (P<0. 05). The frequency of A allele of SNP rs2890565 in UTS2 gene was significantly higher in PCOS group than that in control group( P<0.05). Transmission disequilibrium test(TDT) did not show significantly biased transmission of two different alleles from parents to affected daughters at rs228648 locus (P>0. 05) ,but showed an excess transmission of A allele from heterozygous parents to affected offspring at rs2890565 locus (P<0. 05). The carriers with GG genotype of SNP rs228648 had significantly higher HOMA-IR compared to those with AA and AG genotypes. The carriers with AA or AG genotype of SNP rs2890565 had significantly higher fasting plasma glucose and fasting insulin compared to those with GG genotypes. HOMA-IR in cases with AA genotype was significantly higher than that with GG genotype. Conclusions There is no association of SNP rs228648 with PCOS, but exists association with insulin resistance. The genetic polymorphism of UTS2 gene rs2890565 may be associated with PCOS,and the higher frequency of A allele is likely to contribute to PCOS.

Objective To explore the correlation between quantitative parameters of blood perfusion with contrast-enhanced ultrasound (CEUS) and microvessel density (MVD),microvessel area (MVA) in papillary thyroid carcinoma (PTC).And to investigate the value of CEUS in evaluating the angiogenesis in PTC before operation.Methods Totally 69 cases of patients with papillary thyroid carcinoma were selected from April 2014 to October 2016 in the Affiliated Hospital of Qingdao University.The CEUS characteristics of 69 patients with papillary thyroid carcinoma confirmed by pathology were retrospectively analyzed.The patients were divided into three groups according to maximum diameter of lesions (＜ 1 cm group,1-2 cm group and ＞ 2.0 cm group),and two groups according to pathologic reports (neck lymph node metastatic and nonmetastatic groups).The blood perfusion parameters between or among different groups were evaluated by ttest or one-way ANOVA.Immunohistochemical staining were performed to evaluate the MVD,MVA in the surgical specimens,and the correlation of quantitative parameters with MVD,MVA were assessed by Spearman.Results (1) Peak Intensity (Peak),area under the curve (AUC),MVD and MVA of thyroid carcinoma were lower than the surrounding normal thyroid tissue (14.95 ± 4.96 vs 22.67±6.11,970.01±263.20 vs 1798.35±563.67,118.91±31.32 vs 206.27±39.58,8.58±-2.68 vs 18.47±3.13),and the differences were statistically significant (t=-8.700,-11.061,-14.377 and-20.532,all P ＜ 0.05).(2)With the increase of the lesion's maximum diameter,Peak,AUC,MVD and MVA increased,and the differences were statistically significant (t=0.000,0.000,0.000,0.000;t=0.027,0.044,0.033,0.000;t=0.027,0.044,0.033,0.000,all P ＜ 0.05).(3) Papillary thyroid carcinoma with lymphatic involvement had significantly higher values of Peak,AUC,MVD and MVA than those without lymphatic involvement (16.86±4.36 vs 13.80±3.55,1128.16±290.85 vs 874.39±192.27,114.12±30.69 vs 103.67±22.19,10.30 ± 2.44 vs 7.54 ± 2.29),and the differences were statistically significant (t=3.177,4.366,6.336 and 4.742,all P ＜ 0.05).(4) A positive correlation existed between the Peak,AUC and MVD,and the differences were statistically significant (r=0.506,0.478,all P ＜0.05).Peak,AUC and MVA showed positive correlation,and the differences were statistically significant (r=0.648,0.653,all P ＜ 0.05).TP,MTT and MVD,MVA showed no correlations (all P ＞ 0.05).Conclusions The values of Peak and AUC calculated from CEUS were correlated to MVD and MVA.CEUS may be used to evaluated the angiogenesis of PTC before operation.And CEUS is helpful for prediction of prognosis of PTC.