Objective To study whether ANCA liter is sensitive serological marker reflecting vasculitis disease activity. Methods MPO-ANCA and IF-ANCA tilers variation in five sera specimen with active MPA diseases were studied after methylprednisolone and cyclophosphamide pulse therapy. The clinical and pathological features of 5 patients with MPA were investigeted comparing pre-treatment with post-treatment. Results (1) Serum ANCA were found positive and increased liter in 5 patients wilh active MPA disease. (2) Titer decreased after Ireatment, while renal function improved. (3) After half year, MPO-ANCA was negative in 5 patients, IF-ANCA was negative in 2 patients. Conclusion There is a close correlation between serum ANCA titer and MPA renal disease activity.

Objective To investigate the safety and validity of Neptune 3D-RTPS-A treatment planning system compared to Prowess TPS.Methods A total of 30 clinical tumor cases with radiotherapy planning on Prowess TPS from September 2009 to May 2010 were used.The contours, organs at risk and target volumes in Prowess TPS were transported into Neptune TPS, the same parameters setted in the two treatment planning systems.The results of comparison of the two TPS were calculated.Results All cases of clinical treatment planning were completed successfully by Neptune TPS, and the various functions of the design were achieved for fitting tumor conformal radiation therapy.The key parameters on radiation treatment were compared.The results are as follows:the differences of source skin distance ( SSD ) ＜0.5% , differences of Monitor Unites ＜0.5%, the differences of dose at isocenter ＜2%, the differences of five isodose lines surrounding area ＜ 3%, and the mean difference of distances of five isodose lines was 0.43 mm, the differences of the volume of PTV on 90% isodose line ＜ 2%, and the differences in V30of organs at risk ＜ 3%.Conclusions Neptune TPS could be qualified for clinical validity and safety by clinical verification.

ObjectiveTo evaluate result of palliative operation for hilar cholangiocarcinoma. Methods The clinical data of 179 cases of cholangiocarcinoma during the last 20 years were analysed retrospectively. Results The operative mortality rate was 10 1%, there was no significant difference between the groups. The rate of cholangitis after operation in the Roux en Y choledochjejunostomy group (15 1%) and bridge internal drainage group (10 0%) was significantly lower than that of PTCD (or ERBD) internal drainage group (35 7%, P

Objective To explore the influence of different lengths and contents of glass-fiber post on the fracture resistance of teeth, and to investigate the optimal length and content of glass-fiber post used for restorative treatment. Meth-ods Forty-two intact single canal mandibular premolars were collected from orthodontic patients and were divided into three experimental groups (A, B and C). All the teeth were endodontically treated after cut off the crowns from the 2 mm above cemento-enamel junction. The post lengths were10 mm in A group, 8 mm in B group, and 6 mm in C group.There were two subgroups for each experimental group (A1, A2, B1, B2, C1, C2 ), 7 teeth for each subgroup.The 42%glass fiber post was used in A1, B1 and C1 groups. The 75%glass fiber post was used in A2, B2 and C2 groups. All of groups were restored with resin cores and metal crowns. The fracture resistance was measured with universal testing machine and recorded the root frac-ture pressure data and the mode of all the teeth. Results The fracture resistance was significantly higher in group A than that of group B and group C (P<0.05), and the fracture resistance was significantly higher in group B than that of group C (P<0.05). The fracture resistance was significantly higher for 75%glass fiber post than that of 42%glass fiber post (P<0.05). Conclusion Within a certain range, the longer the length of glass fiber post, the greater the tooth fracture resistance. The fracture resistance of fiber content is better for 75%glass fiber post than that of 42%glass fiber post.

Objective To evaluate prognostic value of pentraxin3 (PTX3) content combining with extravascular lung water index (EVLWI) in patients with sepsis.Methods A retrospective analysis of complete clinical data of septic patients admitted to Department of Critical Care Medicine of the First Affiliated Hospital of Zhengzhou University from February 2013 to February 2014 was conducted.These patients were divided into two groups,survival group and death group,according to the outcome on the 28th day.Pulse index continuous cardiac output (PiCCO) was used to record the levels of EVLWI on the 1st,2nd and 3rd day of intensive care unit (ICU) admission.The plasma level of PTX3 was measured simultaneously by enzyme-linked immunosorbent assay (ELISA).At the same time,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and sequential organ failure assessment (SOFA) were calculated.Correlation analysis between plasma PTX3 and EVLWI values was performed,receiver operating characteristic curve (ROC) was drawn,and the prognostic value of each parameter was assessed finally.Results A total of 74 septic patients were enrolled,with 41 cases in the survival group and 33 cases in the non-survival group.Blood lactate,APACHE Ⅱ,SOFA scores in the non-survival group were significantly higher than those of the survival group at ICU admission,and the length of ICU stay was significantly shorter than that of the survival group,while differences of the other clinical characteristics between two groups were not statistically significant.The plasma PTX3 level gradually declined with time in both groups,and plasma PTX3 at 1,2,3 days after ICU admission in non-survival group were significantly higher than those in survival group [PTX3 (μg/L) at 1 day:46.3± 10.5 vs.19.4±6.5,t =-13.486,P =0.000; 2 days:34.8± 10.7 vs.17.7±8.4,t =-8.284,P =0.000; 3 days:23.9± 11.2 vs.15.6 ± 7.9,t =-5.036,P =0.000].EVLWI gradually declined in survival group,but increased in death group.EVLWI at 1,2,3 days after ICU admission in non-survival group were significantly higher than those in survival group [EVLWI (mL/kg) at 1 day:12.12 ± 4.31 vs.10.02 ± 2.87,t =-2.502,P =0.023; 2 days:13.67 ± 4.95 vs.9.08 ± 2.89,t =-5.188,P =0.000; 3 days:14.51±5.06 vs.8.09±2.50,t =-7.126,P =0.000].PTX3 at 1,2,3 days after ICU admission showed a significant positive correlation with EVLWI (r1 =0.747,r2 =0.719,r3 =0.705,all P =0.000).ROC curve analysis showed that the area under the ROC (AUC) of PTX3 at 1 day was 0.845 ± 0.045,at the cut-off point of 23.0 μg/L,PTX3 showed a sensitivity of 84.8％,a specificity of 74.1％,a negative predictive value of 85.81％,and a positive predictive value of 72.42％.AUC of EVLWI at 3 days was 0.838 ± 0.048,at the cut-off point of 10.5 mL/kg,EVLWI showed a sensitivity of 83.9％,a specificity of 82.9％,a negative predictive value of 86.45％,and a positive predictive value of 79.79％.Their sensitivities and specificities were found to be better than APACHE Ⅱ,SOFA score.AUC of PTX3 combined with EVLWI at 1 day was 0.886 ± 0.038.On the 1st day after ICU admission,with combination of the two indicators,cut-off point was found to be 0.312,a sensitivity of 86.8％,a specificity of 85.4％,a negative predictive value of 88.93％,and a positive predictive value of 82.72％.On the 3rd day after ICU admission,AUC of PTX3 combined with EVLWI was 0.856 ± 0.046,and showed a cut-off of 0.471 for the prognosis of sepsis,a sensitivity of 85.8％,a specificity of 85.4％,a negative predictive value of 87.97％,and a positive predictive value of 82.50％.Compared with other single index,a combination of above mentioned two indexes showed a better sensitivity and specificity.Conclusions PTX3 can serve as a novel prognostic indicator at early stage in septic patients.Combined with EVLWI,it shows important value in predicting prognosis of septic patients,and it also provides guidance in treatment of high-risk patients.

The full name of the polycystic liver disease is autosomald ominant polycystic liver disease.Surgical treatment is the main method to deal with it at present.With the deep study of the polycystic liver disease into the molecular genetic level,it is possible for molecular diagnostics to achieve presymptomatic and prenatal diagnosis.The article mainly introduce the research progress of the polycystic liver disease's etiology,pathogenesis,diagnosis,treatment,and so on.

Objective To determine the median effective dose (ED50) of hemocoagulase agkistrodon (HCA) inhibiting the bleeding after trans-bronchial lung biopsy (TBLB).Methods ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 45-75 yr,body mass index 19-24 kg/m2,scheduled for elective TBLB,were enrolled in this study.TBLB was performed after routine anesthesia.HCA diluted in normal saline 5 ml was locally injected into the biopsy site at 2 min before surgery.The initial dose of HCA was 1.4 U.The dose of HCA was determined by up and down sequential method.Each time the dose of HCA increased/decreased in the next patient depending on whether nor not the bleeding was observed in the biopsy wound under fiberoptic bronchoscope.The ratio between the two successive concentrations was 1.2.The ED50 and 95 ％ confidence interval of HCA were calculated by Dixon's up-and-down method.Results ED50 of HCA inhibiting the bleeding after TBLB was 0.9 U,and 95 ％ confidence interval was 0.7-1.1 U.Conclusion ED50 of HCA inhibiting the bleeding after TBLB is 0.9 U.

Objective:To investigate the changes and the adjusting effects of brain-gut peptides (BGP) on immunologic function in the rats before and after relief of biliary obstruction.Methods:One hundred Wistar rats were randomly divided into five groups,including sham common bile duct ligation group (group A),common bile duct ligation group (group B),sham relief of biliary obstruction + normal saline group (group C) ,relief of biliary obstruction + normal saline group (group D) and relief of biliary obstruction + Sandostatin (group E).At 1d,7d after the operation of each group,the changes of plasma vasoactive intestional peptide (VIP),substance P(SP),serum interleukin-2(IL-2) and serum T-lymphocytic subsets (CD4 +,CD8 +)were determinded by radioimmunoassay and flowcytometry .Results:Plasma VIP and SP were increased in group B compared with group A(P

The factors influencing the long-term survival of patients with proximal gastric cancer (PGC) after curative resection were investigated. Data from 171 patients who underwent curative resection for PGC were retrospectively analyzed. The patients were grouped according to the clinicopathological factors and operative procedures. The tumor depth (T stage) and lymph node metastasis (pN stage) were graded according to the fifth edition of TNM Staging System published by UICC in 1997. The metastatic lymph node ratio (MLR) was divided into four levels: 0%, <10%, 10%-30% and >30%. The data of survival rate were analyzed by Kaplan-Meier method (log-rank test) and Cox regression model. The 5-year overall survival rate of 171 patients was 37.32%. The univariate analysis demonstrated that the survival time of the postoperative patients with PGC was related to tumor size (chi (2)=4.57, P=0.0325), gross type (chi (2)=21.38, P<0.001), T stage (chi (2)=27.91, P<0.001), pN stage (chi (2)=44.72, P<0.001), MLR (chi (2)=61.12, P<0.001), TNM stage (chi (2)=44.91, P<0.001), and range of gastrectomy (chi (2)=4.36, P=0.0368). Multivariate analysis showed that MLR (chi (2)=10.972, P=0.001), pN stage (chi (2)=6.640, P=0.010), TNM stage (chi (2)=7.081, P=0.007), T stage (chi (2)=7.687, P=0.006) and gross type (chi (2)=6.252, P=0.012) were the independent prognostic factors. In addition, the prognosis of patients who underwent total gastrectomy (TG) was superior to that of patients who underwent proximal gastrectomy (PG) for the cases of tumor >/=5 cm (chi (2)=6.31, P=0.0120), Borrmann III/IV (chi (2)=7.96, P=0.0050), T4 (chi (2)=4.57, P=0.0325), pN2 (chi (2)=5.52, P=0.0188), MLR 10%-30% (chi (2)=4.46, P=0.0347), MLR >30% (chi (2)=13.34, P=0.0003), TNM III (chi (2)=14.05, P=0.0002) or TNM IV stage (chi (2)=4.37, P=0.0366); and combining splenectomy was beneficial to the cases of T3 (chi (2)=5.68, P=0.0171) or MLR >30% (chi (2)=6.11, P=0.0134). It was concluded that MLR, pN stage, TNM stage, T stage, and gross type had advantages in providing a precise prognostic evaluation for patients undergoing curative resection for PGC, in which MLR was the most valuable index. TG and combining splenectomy were useful to improve the prognosis to patients with PGC of TNM III/IV stage, serosa invasion, or extensive regional lymph node metastasis.