Objective:To investigate the clinical and diagnostic value of liver stiffness measurement (LSM) for the evaluation and comparison of aspartate aminotransferas/platelet ratio index (APRI), fibrosis 4 indexes (FIB-4) and NAFLD fibrosis score (NFS) with liver fibrosis staging in relation to nonalcoholic fatty liver disease (NAFLD).Methods:103 cases with NAFLD who met the inclusion criteria confirmed by liver biopsy were selected for retrospective analysis. The results of serological tests and LSM were recorded. The APRI, FIB-4 and NFS were calculated. The accuracy and applicability of four liver fibrosis models in the diagnosis of liver fibrosis in NAFLD patients were compared with the receiver operating characteristic curve (ROC), and the diagnostic cut-off value of LSM was established.Results:Varying degrees of LSM, APRI, FIB-4 and NFS had shown positive correlations with the increasing degree of liver fibrosis. Among them, LSM was positively correlated with the degree of liver fibrosis, and the correlation coefficient was r = 0.727, P < 0.0001. Consistent with this, the area under the receiver operating characteristic curve, sensitivity, and specificity of LSM diagnosis of liver fibrosis in different stages was significantly higher than APRI, FIB-4 and NFS. Area under receiver operating characteristic curve of LSM was 0.862 and 0.928 for significant liver fibrosis ( f ≥ 2), and advanced liver fibrosis ( f ≥ 3). Conclusion:LSM has a good diagnostic exclusion value for NAFLD-induced fibrosis, and its sensitivity and specificity are better than APRI, FIB-4 and NFS.

Gouty arthritis is a clinical common joint disease caused by metabolic disorder. TCM therapy has unique advantages, such as good efficacy and few adverse reactions. Professor WEI Zi-xiao advocates differential treatment for this disease. In his opinion, acute gouty arthritis is equivalent to TCM damp-heat arthralgia, and therapy of eliminating dampness and heat should be used. During the intermission, therapy of reinforcing spleen and nourishing kidney is appropriate because of deficiency of them. Deficiency of liver and kidney and phlegm and blood stasis are basic pathogenesis in chronic phase of the disease, therefore, activating blood, reducing phlegm and nourishing liver and kidney should be adopted. In addition, Professor WEI pays attention to pharmacological research achievement of TCM, disease differentiation and life and diet regulating in treatment of the disease.

Objective To investigate the diagnostic value of the acoustic radiation force impulse (ARFI) technology and AST/PLT ratio index (APRI） for the assessment of the liver fibrosis in chronic hepatitis C patients.Methods 107 patients with chronic hepatitis C were included,the subjects were underwent liver biopsy,liver function,blood count,as well as real-time acoustic elastography examination.The APRI was calculated according the following formula,APRI =AST (ULN)/PLT (109/L).ARFI and APRI were compared by correlation with liver fibrosis stage in chronic hepatitis C.Referring to the histologic fibrosis stage on liver biopsy,all the ARFI and the APRI value were assessed by using ROC curve analysis.The corresponding cut-off values,sensitivity and specificity were also calculated and compared.Results The mean values of ARFI and APRI were (1.26 ± 0.27)m/s and 0.30 ± 0.46 for the patients with S1,(1.45 ± 0.51)m/s and 0.29 ± 0.21 for those with S2,(2.03 ± 0.54) m/s and 0.59 ± 0.56 for those with S3,(2.29 ± 0.82) m/s and 0.63 ± 0.35 for those with S4,respectively.ARFI (r =0.61,P ＜0.001) had a better correlation with liver fibrosis stage in chronic hepatitis C than APRI (r =0.49,P ＜0.001).Cut-off points of ARFI and APRI were 1.529 m/s and 0.170 for S≥2,1.780 m/s and 0.277 for S≥3,1.780 m/s and 0.446 for S =4,respectively.Accordingly,the areas under the ROC curves for ARFI and APRI were 0.779 and 0.724 for S≥2,0.866 and 0.786 for S≥3,0.790 and 0.779 for S=4,respectively.Conclusions As a non-invasive technology,ARFI is more accurate when applied to evaluate liver fibrosis in patients with chronic hepatitis C than APRI.ARFI technology has potential value for quantitatme evaluation of the liver fibrosis for chronic hepatitis C.

Objective To examine the feasibility of olfactory detection of lung cancer by trained sniffer dogs. Methods Three police dogs, one Labrador Retriever and two Springer Spaniels, went through the same training course on detecting odor markers of cancer and were subsequently used to differentiate 52 lung cancer patients and 30 healthy subjects. The sensitivity(true-positive rate)and specificity(true-negative rate)of the olfactory detection were calculated. The consistency of the sniffing outcomes was also compared. Results The Labrador Retriever had a sensitivity of 88. 46% and a false-positive rate of 16. 60%. The two Springer Spaniels exhibited an equal ability to detect cancer patients with a sensitivity of 86. 54% and a false-positive rate of 20%. There was no statistically significant difference between the three dogs in detecting lung cancer(P =0. 994). Conclusion Olfactory detection of lung cancer by trained sniffer dogs may be used to assist clinical diagnosis andenhance diagnostic efficacy.

Objective To investigate the prevalence of vitiligo in China through a multi-center and larse-population epidemiological survey.Methods A community-based survey was conducted in 6 cities from 6 provinces.Cluster sampling method was used.Subjects were required to fulfill the self-report questionnaires and received physical examination by dermatologists.EpiData and SPSS11.5 were utilized for statistical analysis. Results Totally,19 974 patients participated in this study,and 17 345 valid questionnaires were retrieved with a return rate of 86.84%.Of them,122 were found to have vitiligo.The prevalence and standardized prevalence of vitiligo was 0.70% and 0.56% in all patients,0.95% (75) and 0.69% in male patients and 0.50% (47) and O.45% in female patients.respectively.A significant elevation was observed in the prevalence of vitiligo in males than in females (P<0.01).The prevalence of vitiligo was increased with age and peaked in patients aging from 60 to 69 years and those over 70 years.The age at onset of vitiligo varied from 0 to 19 years in 21.85% of these patients,from 20 to 49 years in 47.05%.The most connnon type was focal vitiligo,which accounted for 36.06%,while the rarest type wag segmental type (2.46%).The pesitivity rate of family history of vitiligo was 9.84% in patients and 1.31% in community population (P<0.01).About 31.97% of the patients complained of negative influence of vitiligo on quality of life.Conclusions The standardized prevalence of vitiligo is 0.56%in 6 provinces from China.Males seem to have a higher prevalence of vifiligo than females.

OBJECTIVETo study the clinical results of posterior pedicle screw fixation, transpedicular bone grafting and vertebral canaloplasty with ilium autografting in treating serious burst thoracolumbar fracture.

METHODSFrom March 2004 to March 2008,10 patients with serious burst thoracolumbar fracture, including 7 males and 3 females with age for 24-58 years (mean 41 years)were treated by posterior pedicle screw fixation, transpedicular bone grafting and total laminectomy with preservation of spinal process and vertebral canaloplasty with ilium autografting. The operative effects were assessed according to Frankel classification and radiologic results.

RESULTSAll patients were followed up from 1 to 4 years. There was no loosening or broken in instrumentation. The anterior edge height of the fractured vertebrae body was restored from (21.00 +/- 12.00)% to (95.00 +/- 4.20)%, and the posterior edge height of the fractured vertebrae body was restored from (70.00 +/- 15.00)% to (96.00 +/- 3.20)% postoperatively, which both demonstrated improvement compared with preoperative instance (P < 0.01). The Cobb angle was restored from (32.80 +/- 8.20) degrees to (4.20 +/- 1.60) degrees which also demonstrated improvement compared with the preoperative Cobb angle (P < 0.01). At least one grade recovery was observed in all cases except one patient with preoperative Frankel A degree. The result of Denis classification, P1, had 4 cases, P2 had 4, P3 had 1, P4 had 1.

CONCLUSIONPosterior pedicle screw fixation, transpedicular bone grafting and vertebral canaloplasty can obtain satisfactory results treating serious burst thoracolumbar fractures. It is a feasible method with advantages of simple operation, good efficacy, preservation of structure of posterior column which should be applied clinically.

Adult ; Bone Screws ; Bone Transplantation ; Female ; Fracture Fixation, Internal ; Humans ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Radiography ; Spinal Fractures ; diagnostic imaging ; surgery ; Thoracic Vertebrae ; injuries ; surgery ; Young Adult

BACKGROUNDTo explore the clinical and pathological characteristics and pathogenesis of autoimmunohepatitis (AIH).

METHODSThe serum and liver biopsy specimens and clinical data of 26 cases with patients with AIH were analyzed and scored according to the criteria of International autoimmune hepatitis (IAIHG, 1999). The changes of dendritic cells (DC) in the liver tissues were observed with a panel of DC markers (CD-80/B7-1, CD-86/B7-2, CD-1a and HLA-DR) and immunohistochemistry, and the activation of hepatic stellate cells (HSC) and the expression of TGF-alpha were also detected. Liver tissue specimens from 10 patients with chronic viral hepatitis B and C respectively and 5 normal liver specimens were chosen as controls.

RESULTSMean aggregate scores of 26 AIH cases, including 21 cases of type B (80.8%) and 5 cases of type C (19.2%), which were 18.6 +/- 1.4 and 19.1 +/- 2.1 respectively. There were significant differences between the type B and type C in the average age levels of serum ALT and AST, and alpha-Glo (P <0.001 or P< 0.01 or P <0.05). Histological features of all the AIH liver tissues showed the lesions of chronic active hepatitis such as interface hepatitis/piecemeal necrosis (100%), obvious lobular inflammation (type B 95.2%, type C 100%), bridging necrosis (57.1% type B, 80.0% type C, P<0.05), rosetting of liver cells (71.4% type B, 100% type C, P<0.01), central lobular confluent necrosis (33.3% type B, 80.0% type C, P<0.001), predominant plasmacytic infiltration (type B 95.2%, type C 20.0%, P<0.001). The rates of increased and concentrated DC in the portal and lobular areas, especially in the active lesions in type B and type C AIH were 85.7% (18/21) and 5/5 respectively. It was found that DC and lymphocytes surrounded the hepatocytes which partly expressed HLA-DR antigen, while there were no or a few HLA-DR positive hepatocytes in controls. Meanwhile, the number of alpha-SMA positive HSC and the expression of TGF- were obviously increased in AIH liver tissues.

CONCLUSIONSSeveral clinical and pathological features of AIH were identified in this study. As an antigen-presenting cell, DC might play an important role in the pathogenesis of AIH. In China, sub-type B of AIH might be more frequent than sub-type C and there were differences in clinical aspects, serology and pathology between the two types.

Adolescent ; Adult ; Child ; Dendritic Cells ; immunology ; Female ; Hepatitis, Autoimmune ; blood ; pathology ; Humans ; Liver ; pathology ; Male ; Middle Aged

Objective To study the feasibility and availability of uterine arterial embolization for hysteromyoma with pingyangmycin,lidocaine,iodipin emulsion and absorbable gelatine sponge granules immersed with lidocaine.Methods The observation of pain sensation change of clinical symptoms,size of hysteromyoma,change of uterus volume together with the specimens and pathological features of 68 cases of hysteromyoma during and after the embolization by using pingyangmycin,lidocaine,iodipin emulsion and absorbable gelatine sponge granules immersed with lidocaine were carried out and compared.Results Intramuscular analgesic injection couldn't control the pain in 13 cases,covering 19.1% symptom remission rate was 92.3%,including 89.2% menstruation recovery,90.8% disappearance of pelvic pain,abdominal distension and compression symptoms,78.8% average shrinkage of tumor size and 47.5% reduction of uterus volumes.Conclusion Pingyangmycin,lidocaine,iodipin emulsion and absorbable gelatine sponge granules immersed with lidocaine are the ideal embolization material for treating hysteromyoma.

Objective To observe the efficacy and safety of Tangmoning Granule(TMG)in treating diabetic peripheral neuropathy with Qi-deficiency and collateral stagnation syndrome.Methods A randomized,positive drug parallel controled,multi-center clinical trial was adopted.The tested group was treated with TMG orally and the control group received Mikebao tablet orally.Treatment course of each group was 8 weeks.Results The marked effective rate and total effective rate on electromyogram was 60.06 %and 68.47 %respectively in the tested group,and those on TCM Syndrome were 23.12 %and 90.99 %respectively.Non-inferiority test with the criterion of 15 %was conducted on the efficacy of electromyogram and TCM Syndrome,and the result showed statistical significant.Conclusion TMG has good efficacy and safety in treating diabetic peripheral neuropathy with Qi-deficiency and collateral stagnation syndrom.

AIM: To establish an extraction method of emodin from Radix polygoni multiflori . METHODS: Emodin in Radix polygoni multiflori was taken as an evaluating marker and determined by HPLC, the effects of different solvents and extraction models on extraction ratio of the emodin were systematically investigated. And also the orthogonal test was further used to optimize extracting conditions. RESULTS: The refluent extraction with 80% alcohol as much as seven times of the medicine amount for 2hs and twice was more effective. CONCLUSION: The kinds of solvent and models of extraction have a great influence upon the extracting efficiency of emodin.