0.05). Conclusion The quality of life of SARS patients was not high one month after discharged. The patients needed the further rehabilitation treatment including restoration of function and appropriate psychological treatment.

Objective To investigate the value of endoscopic ultrasonography (EUS) and abdominal CT (CT) in diagnosis of periampullary lesions and to make comparison between the two procedures. Methods The patients suspected of surrounding lesions of ampullary from 2009 to 2013 in our hospital were included in this study. All the patients received both EUS and abdominal CT. The accuracy rate of these two examination methods was compared. Results 151 patients were confirmed as surrounding lesions of ampullary, including choledocholithiasis, ampullary tumors, ampullary inflammation, tumors of the pancreatic head and pancreatic cysts. The accuracy rate of these diseases was 83.6%, 90.6%, 6.5%, 100.0%, and 100.0%for EUS;while was 52.2%, 56.3%, 43.5%, 91.3%, and 100.0%for abdominal CT. The tatal accuracy rate for diagnosing periampullary lesions by EUS was significantly higher than that by abdominal CT (84.1% vs. 59.6%). Conclusions Endoscopic ultrasonography has higher value in diagnosis of periampullary lesions, and its accurate rate was higher than that of abdominal CT.

Objective To study the histopathological changes and biological behavior of bowenoid papulosis and its relationship with apopotosis.Methods 20 bowenoid papuloses and 5 normal skin tissues were examined by DNA nick end labeling(TUNEL) technique and the pathological changes of bowenoid papulosis were observed by Hematoxylin-eosin-stained.Results Bowenoid papulosis exhibited disordered maturation and scattered,large,highly atypical cells mitoses throughout all layers of epithelium;and there were few apoptotic cells in 5 normal skin tissuese and many apoptotic cells in bowenoid papuloses.The apoptotic index(27.1?15.1) in bowenoid papulosis patients was significantly higher than that in control group(6.8?3.5)(P

Objective To explore the effects and the possible mechanism of Gingko biloba on liver injury due to arsenic poisoning in rats,and to provide experimental evidence for prevention and treatment of arsenic poisoning.Methods The corn powder baked by high arsenic coal was served as the main raw material to make feed containing arsenic.Forty healthy Wistar rats were randomly divided into 5 groups according to their body weights,including control group A,arsenic poisoning group,control group B,natural recovery group and Ginkgo biloba treatment group,eight rats in each group,half male and half female.The control group A rats were fed with normal diet ad libitum for 3.0 months;the arsenic poisoning group rats were freely given feed containing arsenic (100 mg/kg) for 3.0 months;the control group B rats were fed with normal diet ad libitum for 4.5 months;the natural recovery group rats were freely given arsenic (100 mg/kg) feed for 3.0 months,and then given a normal diet for 1.5 months;Ginkgo biloba treatment rats ingested arsenic feed for 3.0 months,and then give Ginkgo biloba solution (25 mg/kg) orally,6 d/week for 1.5 months,then back to normal diet.The content of arsenic in urine,liver,as well as the liver function indices [alanine aminotransferase (ALT),aspartate transaminase (AST),total bile acids (TBA),gamma glutamyl aminopeptidase (GGT),glutathione S-transferase (GSTs)] and the oxidative stress indexes [superoxide dismutase (SOD),glutathione peroxidase (GPx),thiol (-SH),malondialdehyde （MDA)] of liver homogenate,were measured.Results The arsenic content of urine and liver (geometric mean) of the rats in arsenic poisoning group (2 991.24 μg/g Cr,4.29 μg/g) were significantly higher than those in control group A (91.59 μg/g Cr,1.00 μg/g).Urinary arsenic and liver arsenic levels of rats in natural recovery and Ginkgo biloba treatment groups (467.39,334.48 μg/g Cr;,3.15,1.88 μg/g) were higher than those in control group B (99.54 μg/g Cr,0.85 μg/g).The arsenic contents of urine of the rats in natural recovery group,the arsenic contents of urine and liver of rats of Ginkgo biloba treatment group were all lower than those in arsenic poisoning group.The differences were significant (all P ＜ 0.05).The activity/contents of AST,TBA,GGT,GSTs of rats in arsenic poisoning group [(212.88 ± 29.76) U/L,(19.19 ± 4.33) μmol/L,(1.73 ± 0.50) U/L,(196.21 ± 47.38) U/L] were all significantly higher than those in control group A [(142.63 ± 24.20) U/L,(6.23 ± 2.95) μmol/L,(0.77 ± 0.32) U/L,(142.86 ± 28.58) U/L].The activity/contents of TBA,GGT,GSTs in natural recovery group were (17.07 ± 3.92) μ,mol/L,(1.47 ± 0.57) U/L and (178.06 ± 27.37) U/L;and the contents of TBA in Ginkgo biloba treatment group were (13.60 ± 3.00) μmol/L;which were all higher than those in control group B [(7.55 ± 2.45) μmol/L,(0.74 ± 0.51) U/L,(145.17 ± 28.59) U/L].The activity of AST in natural recovery group [(137.44 ± 23.20) U/L],the activity/contents of AST,TBA,GGT and GSTs in Ginkgo biloba treatment group[(129.63 ± 31.25) U/L,(13.60 ± 3.00) μmol/L,(1.15 ± 0.48) U/L,(155.64 ± 20.79) U/L,respectively] were all lower than those in arsenic poisoning group.The content of TBA in Ginkgo biloba treatment group was lower than that of natural recovery group.The differences of those indexes were all significant (all P ＜ 0.05).The activity/contents of SOD,GPx and-SH in arsenic poisoning group [(46.34 ± 11.39),(275.16 ± 92.00) U/mg prot and (0.08 ± 0.02) μmol/mg prot] were all significantly lower than those in control group A [(75.52 ± 8.72),(1 351.01 ± 395.96) U/mg prot,(0.13 ± 0.01) μmol/mg prot].The activity of SOD and GPx in natural recovery group [(42.44 ± 9.58),(694.87 ± 187.01) U/mg prot] were all lower than those in control group B [(68.17 ± 11.11),(1 342.80 ± 185.04) U/mg prot].The activity of GPx in natural recovery group,the activity/contents of SOD,GPx,-SH in Ginkgo biloba treatment group [(63.90 ± 10.44),(1 283.28 ± 373.87) U/mg prot,(0.12-± 0.02) μmol/mg prot] were all higher than those in arsenic poisoning group.The contents of SOD,GPx,-SH in Ginkgo biloba treatment group were higher than those of natural recovery group.The content of MDA in arsenic poisoning group [(3.05 ± 0.94) nmol/mg prot] was higher than that in control group A [(1.67 ± 0.55) nmol/mg prot].The content of MDA of rats in natural recovery and Ginkgo biloba treatment groups were (2.22 ± 0.93),(1.77 ± 0.37) nmol/mg prot,which were lower than those in the arsenic poisoning group.The differences of the above indexes were all significant (all P ＜ 0.05).Conclusion Ginkgo biloba can reduce the accumulation of arsenic in the liver and ameliorate lipid peroxidation,relieve liver injury effectively in rats caused by coal-burning arsenic.

Objective To establish the immunoprecipitation method to detect the activity of ?-glutamyltransferase (GGT) complexed to low-density-lipoprotein and very-low-density-lipoprotein in serum (LDL-LDL-GGT) and to observe the diagnostic efficiency in discriminating liver malignancies from other hepatopathy diseases.Methods Using apo B antibody as a precipitant to precipitate the parts of GGT which connected to LDL and VLDL. 65 cases of liver malignancies, 53 cases of cirrhosis, 32 of chronic hepatitis and 75 of health people were analysed. Results Apo B antibody can precipitate LDL and VLDL thoroughly with various serum samples. The withinrun CV are 3 6%～8 2% and the betweenrun CV are 5 5%～9 8%. The linearity range is 0～587 U/L. With the cut off value of 10 U/L, the sensitivity for liver malignancies is 86 2%, the specificities for discriminating liver malignancies from cirrhosis and chronic hepatitis is 67 9% and 81 3% respectively. Conclusion It has important significance for the diagnosis of liver malignancies with the immunoprecipitation method for determination of serum LDL-VLDL-GGT activity.

BACKGROUND: Severe acute respiratory syndrome (SARS) is caused by a genetically novel coronavirus that is caused by acute infectious disease. It is not yet clear for the immunology function of SARS patients in their convalescent stage.OBJECTIVE: To study the effects on T lymphocyte, and the titer profiling of 24 T cell receptor (TCR) V β subfamilies expressions in SARS convalescent patients.DESIGN: A self-control observation.SETTING: Central Laboratory, Guangdong Provincial Hospital of Traditional Chinese Medicine.PARTICIPANTS: Seventy-six cured SARS patients who received treatment in the Second Hospital Affiliated to Guangzhou University of Traditional Chinese Medicine between January and April 2003. All the patients corresponded to "clinical diagnostic criteria of atypical pneumonia", " diagnostic criteria of severe atypical pneumonia and discharge criteria" and "clinical diagnostic criteria and discharge criteria of severe acute respiratory syndrome". The involved patients, 30 male and 46 female, averaged (32±11 (years old. Another 10 subjects who simultaneously received health examination in the same hospital, 5 male and 5 female, aged (32±7(years, were involved in the study. Informed consents of detected items were obtained from all the subjects.METHODS：①Detecting the expression of 24 T cell receptor(TCR)V β subfamilies in SARS convalescent patients：Peripheral blood(2 mL) was collected from the healthy convalescent subjects,and EDTA-K2 was used as anticoagulant．In the flow cytometry delection tubes．10 μL various fluorescein-labeled mAb，such as anti-CD3,anti-CD4，anti-CD8,anti-CD25，anti-CD28，anti-HLA-DR，anti-CD3mAb conjugated with PC5，TCR Vβ1(PE+FITC)．Vβ2(PE+FITC)。Vβ3 (FITC)，Vβ4(PE+FITC)，Vβ5．1(PE+FITC),Vβ5．2(PE),Vβ5．3(PE)，Vβ7．1(PE+FITC)，Vβ7．2(FITC),Vβ8(FITC),Vβ9 (PE)，Vβ11(PE)，Vβ12(FITC)，Vβ13．1(PE),Vβ13．2(PE),Vβ13．6(PE+FITC)，Vβ14(FITC),Vβ16(FITC),Vβ17 (PE+FITC)，Vβ18(PE)，Vβ20(FITC)，Vβ21．3(FITC),Vβ22(PE+FITC)and Vβ23(PE)，was added in special flow tubes,and then 50 μL whole blood was added．The mixed solution was incubated away from light for 15 minutes．After erythrocytolysin being added，mixed solution was washed．Finally．cell deposit was dissolved in 300 μl phosphate buffer solution (PBS)．Coulter ESP flow cytometer was used for detection．For the analysis of TCR expression,an electronic gate was set on these cells and at least 5000 events per sample were collected．Three-color cytofluodmetric analysis was performed using a Coulter ESP flow cytometer．②Detecting the T cell subset,activated T and B cells,and the percentage of Ts and Tc cells：5000 cells were collected and used to calculate the expression of T cells (CD3,CD4 and CD8),the activated T and B cells(CD3+／CD25+,CD3+/HLA-DR+ and CD3-／HLA-DR+),as well as the percentage of Ts and Tc cells by Coulter ESP flow cytometer and its software．MAIN OUTCOME MEASURES：①The change of T cell subset(CD3，CD4，and CD8)from SARS convalescent patients．②The change of activated T and B cells(CD3+／CD25+，CD3+／HLA-DR+ and CD3-／HLA-DR+)．③The percentage of Ts and Tc cells(CD8+／CD28+，CD8+/CD28-)in convalescent patients．④Analysis of the 24 TCR V β subfamilies from SARS patients in convalescence．RESULTS：All data were explored to analyze the expression profiling of 24 TCR Vβ subfamilies,the data from 74 SARSpatients and 10 healthy controls were explored to other result analysis．①The detecting results of T celI subset：The percentage of CD4+T cell mean value was lower than the reference value[(33．33±6．64)％ vs．(43±9)％，P＜0．01]．The percentage of CD8+T cell mean value was higher than the refefence value[(34．07±6．40)％ vs．(30±9)％,P＜0．01]．② The expression of activated T and B cells：Percentage of HLA-DR+ T and B cell was Increased while the percentage of CD25+ T-cell was decreased compared with reference values．In 53 out of 74 patients,the percentage of CD25+ T cells was lower than the reference value,and 64 patients had a lower percentage in CD3+/CD25+ T cells．The percentages of CD3+/HLA-DR+ and CD3-／HLA-DR+ cells were higher than the normal reference value．T cells expressing higher CD3+／HLA-DR+ were found in 36 patients，and T cells expressing higher CD3-/HLA-DR+ were found in 30 patients．③The ratios of Ts and Tc cells：The percentage of Ts cells which expressed CD8+／CD28- was increased compared with reference value [(28．75±7．31)％ vs．(15．99±5．1)％，P＜0．01],while the percentage of Tc cells which expressed CD8+／CD28+ was decreased [(5．99±3．60)％ vs．(13．2±4．1)％，P＜0．01]．Thirty-nine patients were found to possess the lower Tc cells and forty-eight patients were found to possess the higher Ts cells．The ratios of both CD4+ and CD8+ T cells were in the normal reference value．④24 TCR Vβ subfamilies expressions in T cells：It was noteworthy that Vβ14 had a highest percentage in all 24 Subfamilies,and followed by Vβ 5．3,and Vβ 23 in the convalescent patients．The percentage of Vβ 14 was the highest in the normal controls,which was consistent with the results of SARS patients．But the other subfamilies expression patterns were different．There were significant differences between Vβ1,Vβ5．2,Vβ5．3,Vβ7．2，Vβ9，Vβ11,Vβ13．1,Vv13．2，Vβ17,Vβ18，Vβ22 and Vβ23．In the convalescent period，each TCR Vβ expression of SARS patients was higher than that of controls(P＜0．05-0．01)．CONCLUSION:In SARS convalescent patients,the increased CD8+CD28- T cell may elevate CD8+ T cell number;Meanwhile.the reduced CD3+ and CD4+ T cell number may be corresponding to the increased Ts cell number．For some inhibiting factor secreted by Ts cell was also increased．The usage pattern of 24 TCR Vβ subfamilies in SARS patients is different from that of control group．The increase of percentage of CD3+／HLA-DR+ and CD3-／HLA-DR+ T cell may be related to the late response of activated T and B cells.

AIM: To improve the prevent efficacy of peptide p277 in autoimmune diabetes. METHODS: The recombinant expression plasmid pET28-Hsp65-6×p277 was constructed by inserting 6×p277 which were amplified by PCR into the vector pET28-Hsp65. The plasmid pET28-Hsp65-6×p277 was transformed into E.coli BL21 (DE3) and the fusion protein (Hsp65-6×p277) was expressed effectively as soluble protein after inducing by lactose. The fusion protein was purified and then used to immunize 4-week old female NOD mice with three times of i.n. inoculations in the absence of adjuvants. Serum samples from the immunized mice were collected at monthly interval. The concentrations of blood glucose and antibodies were measured by automatic analyzer. RESULTS: Administration with the Hsp65-6×p277 to NOD mice could prevent the development of diabetes. CONCLUSION: The fusion protein Hsp65-6×p277 might be further developed to a vaccine against insulin-dependent diabetes mellitus.

Objective Comparing three screening schemes of colorectal cancer in general population to provide scientific basis for coiorectal cancer screening in communities. Methods Questionnaire screening among high-risk population and immunoassay fecal occult blood test (FOBT) were used for colorectal cancer detection. Colonescopy and pathological test were considered as gold standard of screening results. Results Nine coloreetal cancers and 796 colorectal adenomas were detected in 68 953 participants. Mean onset age of coloreetal adenoma was 7. 7 years earlier than colorectal cancer. For questionnaire and FOBT,the sensitivity was 44.4% ,77.8% and 100.0% ,while the specificity was 98.6%, 95.5% and 94.4%, respectively. The Youden index of questionnaire, FOBT, and questionnaire-FOBT sequential method was 0.4,0.7,and 0.9,and the likelihood ratio ( +/- ) was 32.7/0.6,17. 2/0.2,and 17.8/0.0,respectively. When 50 was used as initial age of screening, screening receivers accounted for 9.7% ,and 66. 7% colorectal cancer could be detected. When 40 was used as initial age of screening, screening receivers and cost increased by 57.1% ,and only 11.1% more patients with colorectal cancer could be detected. Conclusions Questionnaire-FOBT sequential method has high sensitivity and specificity of colorectal cancer screening. Screening at 50 year-old may be better for community residents. The time of colorectal adenoma developed to colorectal cancer is about 8 years.

ObjectiveTo explore the effects of insomnia on heart rate variety(HRV) in aged hypertension patients. Methods259 subjects were divided into healthy group (74 cases),simple hypertension group (71 cases),coexisting hypertension and insomnia group (114 cases) which was sub-grouped to ＜5 years,5-9 years and ≥-10 years according to the duration of insomnia.All subjects had 24 h recordings of ECG.The data of HRV time domain (SDNN,SDANN and ASDNN) were collected and compared.ResultsHRV time domain was lower in healthy group than in the other two groups (F=12.02,10.54 and 4.27,P＜0.01),and decreased more significantly in coexisting hypertension and insomnia group compared with simple hypertension group(P＜0.01).The values of SDNN and SDANN in 5-9 years and ≥ 10 years subgroups decreased as compared with ＜ 5 years subgroup (F=8.63 and 4.54,P＜0.01),and these values further lower in ≥10 years subgroup than in 5-9 years subgroup (P＜ 0.01 ). ConclusionsInsomnia may lead to more serious disorder of automatic nervous system and further aggravated disorders appear in the elderly with hypertension along with increasing years of insomnia.

ObjectiveTo investigate the clinical efficacy of bidirectional Glenn shunt with noncardiopulmonary bypass(CPB) for treating congenital heart disease.MethodsThe clinical data of forty-four patients receiving bidirectional Glenn shunt from August 2005 to August 2011 were analyzedretrospectively,twenty-three cases of which were treated by bidirectional Glenn shunt with non-CPB (non-CPB group) and twenty-one with CPB (CPB group).The duration of ventilator-assisted breathing,chest drainage volume,amount of blood product usage,postoperative hospital stay and pulse oxygen saturation (SpO2) before leaving the hospital were compared and analyzed between two groups.ResultsForty-four patients were all cured.The duration of ventilator-assisted breathing,chest drainage volume and the amount of blood product usage of non-CPB group were less than those of CPB group [ (4.5 ± 1.3 ) h vs.(6.7 ± 1.5 ) h,(4.6 ± 1.4 ) ml/kg vs.(7.7 ± 3.1 ) ml/kg,( 221.8 ± 97.6 ) ml vs.( 423.4 ± 149.7 ) ml,P ＜ 0.05 ].There was no significant difference of the postoperative hospital stay and SpO2 before leaving the hospital between non-CPB group and CPB group[ (7.4 ± 2.3 ) d vs.(7.8 ± 1.9) d,0.91 ± 0.05 vs.0.88 ± 0.39,P ＞ 0.05 ].Conclusion Bidirectional Glenn shunt with non-CPB is a safe and feasible surgical approach,which is worthy of promotion.