Objective To explore the value of tubercular antibody (TBAb) in the diagnosis of tuberculous pericarditis (TBP).Methods The TBAb in 38 patients were determined by colloidal gold (CG) and compared with 64 healthy control. Results The positive ratio in TBP group was significantly higher as compared with control group. The hydropericardium was significantly decreased or disappeared after 6 months of antituberculotic treatment by color Doppler ultrasonography. It seemed that patients were rehabilitated and electrocardiogram (ECG) was normal. Conclusion TBAb is valuable in the diagnosis,differential diagnosis or treatment of TBP.

Objective To apply a complete evaluation system for clinical teaching quality and improve the objective and method of the quality control of clinical teaching procedure. Methods Clinical teachers and staff from four clinical medical colleges(Ruijin,the Sixth,the Ninth,and Tongji) were investigated.The data of their cognition about clinical teaching,weakness in teaching procedure,situation,and quantity and quality control of clinical teaching were collected and analyzed. Results The appraisal system for clinical teaching quality was established in all four clinical medical colleges.The improvement was required in evaluation of executive supervision of the present system.The quality control about clinical ability teaching was the key point to perfect the system. Conclusion It is necessary to further discuss consummation of system,establishment of evaluation method and standard so as to perfect the evaluation system of clinical teaching.We should begin with the weakest procedure,and then improve the present condition step by step.

BACKGROUND: Application of traditional osteoarthritis animal models was limited by long duplicated time, poor stability, different successful rate, and rough analysis of osteoarthritis.OBJECTIVE: To observe clinical and pathological features of osteoarthritis by modified Hulth modeling way and to determine the stages of ostecarthritis.METHODS: A 2-cm medial longitudinal incision was resected to expose knee joint. Anterior and posterior cruciate ligament and medial collateral ligament were cut off, and medial meniscus was fully cut to reserve articular cartilage., The injured limb was not fixed postoperatively. Animals were allowed to move freely. At one week after surgery, 800 000 U penicillin was used to avoid from infection, 30 mind, twice per day, for 12 successive weeks. The normal group was treated without any treatments. Pathological features were observed using Mankin scores under electron and optic microscope at 4, 6, 8, 10, and 12 weeks postoperatively.RESULTS AND CONCLUSION: Changes of osteoarthritis were observed in the model group at 4 and 6 weeks after operation,showing synovial hyperemia and hyperplasia, increased synovial fluid effusion, cartilage surface roughness, matrix stained tinge,and Mankin score of 3.5-3.8. Intermediate stage changes of osteoarthdUs were found in the model group at 8 weeks after operation, showing synovial hyperplasia, less synovial fluid, flssuration reaching cartilage surface, cartilage cells with tangled and uneven staining matrix, Mankins score of 8-9. Advanced osteoarthritis changes were observed in the model group at 12 weeks after operation, showing severe nodular synovial hyperplasia, less and turbid synovial fluid, osteophyte formation of serious exposure of subchondral bone, cartilage calls reducing the majority of loss of matrix staining, and Mankin score of 12-14. Electron microscopy indicated a coincidence with the histological observation of cell mutation. The rabbit model by Hulth suggested that early change of osteoarthritis occurred at 6 weeks after operation, intermediate stage at 8 weeks, and advanced stage at 12 weeks.This model could be more comprehensive response to osteoarthdtis cartilage degeneration from early compensatory hypertrophy to decompensation after the cartilage cells and matrix reduction, cartilage softened to endarterectomy missing characterized the late changes in the entire process.

Objective To evaluate the feasibility and the effect of the early postoperative enteral nutrition on improving the nutritional status, cost of nutrition and hospital stay after operation in abdominal surgery.Methods 48 patients who underwent abdominal operation were allocated into 2 groups: enteral nutrition group(EN group,23 cases) and parenteral nutrition group(PN group,25 cases). It was isonitrogenous and isocaloric intake in both groups. Each day nitrogen intake (0.18±0.02)g/kg,104.6—125.52 kJ(25—30kCal/kg). EN was given at postoperation 8 hours by naso intestinal tube which was placed 30 cm distal to ligament of Treitz or jejunal export loop. PN was provided by peripherally inserted central venous catheters(PICC). The nutritional indices were investigated. A visual analogy scale was used to estimate the infection related complication, cost of nutrition and hospital stay. These parameters were evaluated preoperatively and on the 8th day after operation.Results Early postoperative enteral nutrition showed significant nutrition effect in the patients undergoing abdominal surgery. In the EN group,the nitrogen balance became positive at the postoperative day 4,whereas the nitrogen balance still remained negative in the PN group. The EN group decreased their hospital stay and cost of nutrition compared with that of the PN group(P<0.05). Conclusion The early postoperative enteral nutrition is safe and feasible. It cannot only improve the nutritional status and intestinal function obviously, but also decreased the hospital stay and cost of nutrition compared with parenteral nutrition.

BACKGROUND:Clinical work shows that there are a large proportion of patients suffering from osteoerthritis(OA)and osteoporosis(OP),therefore establishing OA+OP models to simulate the clinical disease in postmenopausal women addreasing the basic characteristics of lesions,will offer better prevention and treatment of OA+OP in clinical practice.OBJECTIVE:To attempt to create OA+OP animal model.DESlGN,TIME AND SETTING:Randomized controlled animal expedment in terms of call pathology was perforrned between August 2008 and January 2009 in the Scientific Research Center and Traditional Chinese MediciRe Hospital of Xinjiang Medical University.MATERIALS:Forty 4-month-old female SD rats,weighing(210±10)g,were randomly divided into normal control group,OA group,OP group,OA+OP group.METHODS:In the OA+OP group,rats underwent abdominal incision 1.5 cm longitudinal on both sides of lumbar spine on back,followed by bilateral ovarian resection and ovarian artery ligation,to establish OP models.One month after the skin incision,left knee skin,subcutaneous tissue and fascia were cut,then joint capsule was given a vertical incision.Anterior cruciata ligament was cut off in orthophoria,meniscus was removed,followed by subcutaneous tissue and skin suture,OA model was prepared and placed under warm environment.antibiotic subcutaneous injection for 3 days,and the displacement of one month.OA group and OP group were produced in accordance with the above method of OA.OP model.Normal control rats received no treatment.MAIN OUTCOME MEASURES:When the rats were 6 months old,the left knee femoral condyle articular cartilage were examined by light microscopy and electron microscopy,left femur was used to measure proximal femoral bone mineral density.RESULTS:In three groups of model rats,articular cartilage become thinning and degeneration.In the OP model group and OA+OP model group,trabecular was sparse and arranged in disorder.In the OA model group and OA+OP model group,the incision layer was chiefly deleted,transferring layer was greatly injured,call hypertrophy and colony were observed,a large amount of blood capillary invaded into cartilage and calcification layer,even break through tidal line;in OP model group,incision layer of articular cartilage became thinning and appeared bilateral tidal line.In the OA model group and OA+OP model group,knee condylar number of special-shaped cartilage cells increased,manifested as irregular nuclei,reduced cell organelle,nuclear shnnkage,chromatin uneven distdbution,mitochondrial swelling,rough expansion of endoplasmic raticutum,accumutation of cytoplasmic microfilaments,showing lipid droplets and glycogen granules,gliel fibdllary fracture,disorder arrangement,a large number of cartilage calls were apoptotic.Three groups of model rats exhibited a dramatically decreased bone mineral density compared with control rats(P＜0.05).CONCLUSION:The animal modal of OA+OP was successfully established.

Objective To raise the awareness of adrenal Castleman′s disease by analyzing the clinical features and management of a patient with adrenal Castleman′s disease. Methods A case of adrenal Castleman′s disease of our hospital was retrospectively analyzed, including clinical feature, laboratory findings, pathology, treatment, and follow-up. All the data and pertinent literatures were reviewed and analyzed. Results An incidentaloma measuring 4. 8 cm × 6. 3 cm in the right adrenal gland was observed in a 30-year-old men in a ultrasonography examination performed due to a medical check-up. Laboratory analysis showed that the lesion was not hyperfunctioning. The patient subsequently underwent an exploratory laparotomy. Pathological examination revealed retroperitoneally localized Castleman′s disease of the hyaline vascular type. Conclusion Adrenal Castleman′s disease is a rare cause of lymph node hypertrophy, and it is necessary to keep in mind the possibility of its occurrence and take it into consideration in the differential diagnosis of any solitary, heterogeneous, and hypervascular retroperitoneal mass. The proper cooperation between the clinician and pathologist allows early diagnosis and suitable therapy.

Objective To explore the clinical efficacy of laparoscopic left hemihepatectomy for the treatment of intrahepatic bile duct stones.Methods The clinical data of 30 patients with left intrahepatic bile duct stones who were admitted to the Second Affiliated Hospital of Nancbang University from June 2013 to June 2014 were retrospectively analyzed.All the patients underwent laparoscopic left hemihepatectomy by the Glisson intra-and extra-pedicles vascular inflow occlusion techniques together with the removal of choledocholithiasis and right bile duct stones,and T tube placement or laparoscopic primary suture of common bile duct were selected according to the condition of bile duct.All the 30 patients were readmitted to hospital and detected by color Doppler ultrasound (CDUS),computed tomography (CT) and T tube cholangiography at postoperative month 1,and then received CDUS reexamination every 3 months.CT and MRI reexaminations were applied to patients with complication of residual stones if necessary.All the patients were followed up till July 2014.Results All the 30 patients were treated by laparoscopic hepatectomy with left hemihepatic vascular inflow occlusion,including 5 with conversion to open surgery and 25 with successful operation.The Glisson extra-and intra-pedicel vascular inflow occlusion techniques were used in 11 and 14 patients,respectively.The operation time and volume of blood loss were (158 ± 85) minutes and (405 ± 215) mL.Two patients received intraoperative blood transfusion.There were no residual stones in the 8 patients with choledocholithiasis by intraoperative choledochoscope,and primary suture of bile duct and T tube placement were done in 5 and 3 patients,respectively.No patients died.After operation,there were 2 patients with bile leakage and 1 with pleural effusion,and they were cured though drainage.One patient with subphrenic effusion was cured by B ultrasound-guided puncture and drainage.One patient had bleeding with the volume of blood loss of 500 mL,and was cured by conservative treatment.The duration of hospital stay in all the patients was (8.5 ± 2.3)days.No bile leakage and abdomen infection were detected by outpatient examination.The time of followup was 1-12 months,without recurrence of stones.Conclusion Laparoscopic left hemihepatectomy for the treatment of left intrabepatic bile duct stones is safe and feasible with satisfactory outcome.

Purpose To investigate the clinicopathological and immunohistochemical features of primary renal lymphomas ( PRL) , and to discuss the diagnosis, differential diagnosis, treatment and prognosis of the tumors. Methods Clinical data of 19 patients with PRL from January 2005 to October 2014 were retrospectively analyzed. Result The 19 patients in this study, there were 11 males and 8 females and the age ranged from 37 to 85 years old (averaged 55). Patients were mainly presented with unilateral renal masses, with lumbodynia as the main symptom. 13 patients underwent nephrectomy, 6 patients underwent renal biopsy and 17 patients received CHOP or R-CHOP chemotherapy. All of them were diagnosed as non-Hodgkin’ s lymphoma, with 14 cases of diffuse large B cell lym-phoma (DLBCL) (73. 684%, 14/19), 4 cases of B cell small cell lymphoma (21. 053%, 4/19), and 1 cases of T cell lymphoma (5. 263%, 1/19). Follow-up information was available in 15 patients. 12 were still alive and survived for 1~78 months, while the other 3 were dead with 1 case who died of cerebral infarction, and survived for 3~38 months ( averaged 23 months) . Conclusion PRL is an extranodal lymphoma which is rare in kidney and is often misdiagnosed as renal carcinomas due to its nonspecific clinical manifestations. The diagnosis of PRL can be confirmed by histopathological examination, immunohistochemistry and molecular analy-sis. The majority of the lymphomas are B cell lymphomas and most of them are DLBCL. The recommended treatment is surgery com-bined with chemotherapy and the prognosis is associated with the age, clinicopathological characteristics, tumor types and treatment.

Objective To evaluate the accuracy and value of measurement of left ventricular systolic function in dilated cardiomyopathy (DCM) and hypertrophic cardiomyopathy (HCM) patients with stereo three-dimensional echocardiography (S3 DE). Methods End-diastolic volume (EDV), end-systolic volume (ESV),stroke volume(SV) and ejection fraction(EF) of the left ventricle were measured with M-mode echocardiography(ME),two-dimensional echocardiography(2DE) and S3DE in DCM patientsC20 cases). HCM patients(20 cases),and normal controls(20 cases). The different results among the three groups or three methods were analyzed. Results (①In all the three groups,the results of EDV,ESV,and SV obtained with ME were significantly higher than those obtained with S3DE( P <0. 01). Only in normal group( P <0. 01) and HCM group ( P <0. 05) ,the results of EF obtained with ME and 2DE were significantly higher than that obtained with S3DE. ②By S3DE,compared with normal group,EDV,ESV were increased and EF was decreased obviously in DCM group (all P <0. 01); while in HCM group, only SV was significantly higher( P < 0. 01). ③EDV, ESV, and EF measured by S3DE were correlated and fit well with those measured by 2DE(r = 0.778,0.876, 0.932;R2 =0.605,0.767,0.869;all P <0.01). ④Within HCM group,excluding the impact of heart rate,cardiac output (CO) was highly correlated with SV( r = 0. 987,P < 0. 01). Conclusions S3DE can real-time display the stereo structure of the heart, and accurately and reliably assess the left ventricular systolic function, with a priority over traditional ME and 2DE methods. EDV,ESV, and EF are still effective indicators for the clinical assessment of left ventricular systolic function. SV obtained with S3DE will be expected to be the more sensitive and accurate value in assessing left ventricular systolic function in patients with early-stage cardiomyopathy.

OBJECTIVETo explore the effect of Jinwu Jiangu Recipe (JJR) on the expression of synovial cells' nuclear factor-kappaB (NF-kappaB) and serum interleukin 17 (IL-17) in collagen induced arthritis (CIA) rats.

METHODSTotally 60 Wistar rats were randomly divided into 6 groups, i.e., the blank control group, the model group, high, middle, and low dose JJR treatment groups, and the tripterygium control group, 10 in each group. Except rats in the blank control group, CIA model was established in rats of the rest 5 groups. Then they were treated from the 7th day of modeling. After 4 weeks of medication they were sacrificed, serum collected, and synovium of joints were isolated. The expression of serum IL-17 was detected in synovium of joints by enzyme linked immunosorbent assay (ELISA). And the expression of NF-kappaB/P65, Ikappabetaalpha and NF-KappaB/P50 were detected by Western blot.

RESULTSCompared with the blank control group, the serum IL-17 level increased in the model group (P <0. 01). Compared with the model group, the serum IL-17 level obviously decreased in high and middle dose JJR groups and the tripterygium control group (P < 0.01). Results of Western blot showed, when compared with the blank control group, protein activities of NF-kappaB/P65 and NF-kappaB/P50 were significantly enhanced in the model group (P < 0.01). Compared with the model group, protein activities of NF-kappaB/P65 and NF-kappaB/P50 significantly decreased in high and middle dose JJR groups and the tripterygium control group (P < 0.05, P < 0.01). All indices mentioned above were higher in the low dose JJR group than in the tripterygium control group (P < 0.05, P < 0.01).

CONCLUSIONJJR could lower the expression of serum IL-17 in CIA model rats, and inhibit protein activities of NF-kappaB/P65 and NF-kappaB/P50.

Animals ; Arthritis, Experimental ; drug therapy ; metabolism ; Drugs, Chinese Herbal ; chemistry ; Interleukin-17 ; blood ; NF-kappa B ; metabolism ; Random Allocation ; Rats ; Rats, Wistar ; Synovial Membrane ; drug effects ; metabolism ; Tripterygium ; chemistry