Objectives To investigate the immune effect of hepatitis B vaccine under the influence of congenital human cytomegalovirus (HCMV) infection. Methods The newborn rat model of congenital HCMV infection was developed by intra-peritoneally inoculating pregnant rat with HCMV suspension,while the offsprings of healthy rats were used as the control group. Offspring rats in all groups were inoculated with hepatitis B vaccine in the postnatal 1st, 3rd and 5th week and were taken blood from hearts separately in 3rd, 5th, 7th and 11th week. Antibody to Hepatitis B surface antigen (HBsAb) titer in all groups was de-tected by ELISA method. Results The serum HBsAb titer in both groups all showed a trend of increasing gradually with added vaccinating times and decreased differently with time extending after completed vaccinations. Differences among changes of HBsAb titer along with prolonged time in each group were all statistically significant (P<0.001). At all time points (3rd, 5th, 7th, 11th week), the titer of serum HBsAb in congenital HCMV infection group was lower than that in the control group respectively, and there were statistically significant differences (P<0.01). Conclusions Congenital HCMV infection could weaken the im-mune effect of hepatitis B vaccine.

OBJECTIVE:To initiate punitive compensation system in drug field to make up the insufficiency in the legislation of legal liability of drug injury events,regulate unlawful act of pharmaceutical enterprises and enhance supervision efficiency in drug field. METHODS: The definition and function,etc. of the punitive compensation system were studied by reviewing the pertinent legal clauses both at home and abroad,furthermore,the necessity of initiating the punitive compensation system in China was analyzed and the application conditions of the punitive compensation system was put forward. RESULTS & CONCLUSIONS: It is urgent to initiate the punitive compensation system in drug field and establish a punitive system with Chinese characteristics. It is advisable to initiate the related contents in Pharmaceutical Administration Law of the People’s Republic of China and define the application conditions of the punitive compensation system as well as the way to establish the amount of compensation,etc.

Objective To investigate the efficacy of 50% acetic acid as a renal cyst sclerotherapy agent, and with further comparison to that of absolute alcohol. Methods Eighty five patients with renal cyst were undergone sclerotherapy through spiral CT guidance including 43 cases with absolute alcohol and the others with 50% acetic acid as sclerosing agents. All the cysts were aspirated under CT-guidance, beforehand. The sclerosising agents were withdrawn from the cysts after a definite period of retention. Results The disappearance rates of cyst cavity with absolute alcohol and acetic acid were 55.81% and 71.42%, respectively. Complication occurence rates with absolute alcohol and acetic acid were 16.28% and 4.76% , respectively. The average retention periods of absolute alcohol and acetic acid in cyst were (20?4)minutes, and (10?2)minutes, respectively. Statistical analysis demonstrated that all the data in two groups were significantly different. Conclusion Using 50% acetic acid as sclerosising agent in treating renal cyst possesses the better effect and less side effect, providing a tendency to replace the traditional therapy.

Objective: To acquire the expression of E2F3 protein and mRNA in bladder transitional cell carcinoma (BTCC) tissue and normal bladder epithelial tissue, and the relationship between E2F3 expression and the biological behaviors of BTCC thereof. Methods: Immunohistochemistry was used to detect the expression of E2F3 in BTCC(n = 64) and normal bladder mucosa(n = 10). Immunohistochemistry result was analysed by Image-pro Plus software and the expression result was indicated by integrated optical density (IOD). The expression of E2F3 mRNA was investigated using RT-PCR analysis in fresh bladder tumor tissues and normal bladder mucosa. Results: The expression rate of E2F3 in BTCC (32.8%) was higher than that of normal bladder mucosa(P < 0.01). The expression rate of E2F3 was strongly correlated with the pathological grade and clinical stage (P < 0.05;P < 0.01). Immunohistochemistry result indicated that the IOD of E2F3 was significantly higher in BTCC than that of normal bladder mucosa (P < 0.01). The expression level of E2F3 was strongly correlated with pathological grade (P < 0.01). Conclusion: E2F3 was the diagnostic and prognostic index of BTCC, and provided theory basis about the gene target therapy in BTCC.

Objective: To construct siRNA plasmid expression vector in order to knockdown E2F-3 activity. Methods: Sixty-four base-pair oligos for hairpin RNA expression, which targeted E2F-3 gene, were chemically synthesized and annealed. The pRNAT-U6.1/Neo vector was linearized with Bam HI and HindⅢ. Finally, the annealed oligos were inserted into the lined pRNAT-U6.1/Neo to construct RNAi plasmid(pRNAT-U6.1-E2F-3/Neo). The reconstructed RNAi plasmids were i-dentified by electrophoresis after digestion with BamHI and Hind Ⅲ, and were confirmed by sequencing analysis. Results: The recombinant pRNAT-U6.1-E2F-3/Neo vector was identified by polymerase chain reaction, and confirmed by sequencing analysis. The results demonstrated that 64 bp had been inserted into the expected site. Furthermore, the insertion sequence was exactly correct and no mutation site was found. Conclusion: The pRNAT-U6.1-E2F-3/Neo RNAi system was constructed successfully. This will facilitate the study of E2F-3 in bladder cancer cell lines.

Objective To research the effect to the semen quality of the three operation methods of superiority of highly selective varicocele high ligation,transinguinal canal and laparoseopic of renovated polomo management of varicocele.Methods 561 patients in our hospital who charged by infertility had the operation were analyzed retrospectively and were recruited with primary varicocele above grade II for this study.These patients were divided into three group according to three kinds of operation methods of varicocele :group A was treated with highly selective varicocele high ligation and had 300 patients;group B was treated with transinguinal canal operation and had 181 patients; and group C was treated by laparescopic of renovated polomo operation with 80 patients.Through the comparing of the fertility ability of the three operation methods,to evaluate the therapeutic effect of the three methods.Results The increasing rates of the quality of semen in group B was higher than other groups if patients' ages were lower than 30.The increasing rates of the quality of semen in every group was also higher if patients' ages were lower than 30.No difference was found between three groups in natural conception rate (P＞0.05).Conclusion The methods of highly selective varieecele high ligation would be a better choice in the management of patients with primary varicecele because of higher quality of semen.

OBJECTIVETo investigate the clinical and pathologic features of middle ear adenoma (MEA).

METHODSEight cases of MEA were collected from Beijing Tongren Hospital, Capital Medical University between 2004 and 2014, and immunohistochemical staining was performed.

RESULTSThe patients included five women and three men (mean age, 37.5 years; median 37 years; range, 21-51 years). All patients had unilateral lesions. Five MEA occurred on the left side, and three on the right. In seven patients the MEA was primary, and they presented with hearing loss (6 cases), tinnitus (5 cases), sense of ear blockage (3 cases), otalgia (1 case) and facial nerve paralysis (1 case). The remaining patient had recurrent MEA, and presented with otorrhea, aural fullness and tinnitus. Histologically, the tumor cells were arranged in a variety of patterns, including solid sheets, nests, glands, ribbons or trabeculae. Glandular structures were prominent in one case only. Immunohistochemically, the tumor cells were diffusely positive for keratin (8/8) and vimentin (8/8), and focally positive for CK 7(8/8) and CK5/6(8/8). CK7 and CK5/6 were predominantly positive in tumor cells with glandular growth pattern; CK7 was positive in the luminal cells while CK5/6 was positive in the abluminal cells. Both were also expressed focally in scattered tumor cells with non-glandular pattern. The tumor cells were also diffusely positive for synaptophysin(8/8), diffusely but weakly positive for NSE (5/8), and were diffusely or focally positive for chromogranin A (4/8). Both S-100 protein and calponin were negative in all cases. The proliferation rate was low, about 1%-2%. Six cases were followed up for one year and three months to ten years and six months, with an average follow-up period of four years and two months. Two patients developed recurrence, but there were no regional or distant metastases.

CONCLUSIONSDiagnosis of MEA requires pathologic confirmation since the clinical symptoms are non-specific. MEA can show a variety of histologic patterns, and should be distinguished from other space-occupying lesions at this site. Immunohistochemical staining has greatly contributed to the diagnosis and differential diagnosis of MEA. The prognosis of this tumor is good. Patients with MEA require long-term follow-up for recurrences.

Adenoma ; pathology ; Adult ; Beijing ; Diagnosis, Differential ; Ear Neoplasms ; pathology ; Ear, Middle ; pathology ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Young Adult

Objective: To compare the dosimetric differences among Target-Segmented Plan (TSP), Non-TSP, and conventional static 8-field intensity modulated radiation therapy (8F-IMRT) plan for post-mastectomy irradiation of left-sided breast cancer patients. Methods: This study enrolled thirty consecutive breast cancer patients who underwent radical mastectomy and treated with post-op radiation in Department of Radiation Oncology, Renmin Hospital of Wuhan University from June 2017 to November 2018.The clinical target volume (CTV) included the ipsilateral chest wall, supra/infra-clavicular, high-risk partial axillary in high risk, and internal mammary nodes (IMN). The organs at risk (OARs) near the targets, including ipsilateral lung, heart, contralateral breast, ipsilateral humeral head and spinal cord, were contoured as well. The maximum distance of PTV′s tangent to the outermost side of the affected lung was more than 2 cm. Depending on the maximum distance, the patients were classified into three groups: A(<3 cm), B(3~4 cm) and C(>4 cm), respectively. Three types of treatment plans (TSP, Non-TSP and 8F-IMRT) were created for each patient using the Eclipse treatment planning system with the same dose optimization objective . The dose-volume histograms were compared for the PTVs and OARs. Results: All plans achieved the intended dose criteria.The D_98% of TSP was lower than that of Non-TSP and 8F-IMRT (Z=-3.294, -3.266, P<0.05). However, the homogeneity index (HI) and conformal index (CI) of the three plans had no statistically significant difference among the three plans (P>0.05). Non-TSP required more Monitor Units (MUs)than the other two plans (Z=-3.04, -2.669, P<0.05). The D_mean of TSP was higher than that of 8F-IMRT (Z=-3.181, P<0.05). Compared with Non-TSP and 8F-IMRT plans, TSP significantly reduced V_{5 Gy}, V_{10 Gy}, V_{20 Gy} and D_meanof ipsilateral lung and heart in all patients (lung: V_{5 Gy}: Z=-3.408, -3.408; V_{10 Gy}: Z=-3.408, -3.408; V_{20 Gy}: Z=-3.408, -3.124; D_mean: Z=-3.408, -3.408, P<0.05; heart: V_{5 Gy}: Z=-3.408, -3.408; V_{10 Gy}: Z=-3.408, -3.408; V_{20 Gy}: Z=-2.499, -3.067; D_mean: Z=-3.408, -3.408, P<0.05). The D_mean of contralateral breast in Non-TSP was higher than that in TSP and 8F-IMRT (Z=-2.954, -2.215, P<0.05), and the D_maxhas no significant difference in (P>0.05). There was no significant difference in spinal cord D_max among the three plans, but the D_mean of humeral head in 8F-IMRT was higher than that in TSP and Non-TSP (Z=-3.01, -2.442, P<0.05). In the three groups, the mean amplitude of difference comparing Non-TSP and 8F-IMRT with TSP in ipsilateral lung(V_{5 Gy}, V_{10 Gy}, V_{20 Gy}) and heart(V_{5 Gy}, V_{10 Gy}, D_mean) satisfied the relation: D(N-T, A)<D(N-T, B) <D(N-T, C)和D(8F-T, A)<D(8F-T, B) <D(8F-T, C). Conclusions For post-mastectomy left-sided breast cancer patients, TSP is not only dosimetrically feasible as Non-TSP and 8F-IMRT treatment techniques, but also could effectively reduce the irradiation volume of the ipsilateral lung and heart in the low dose area with minimum adverse dosimetric impact on the treatment targets and other OARs.The advantage of TSP is more prominent with increasing curvature of the clinic target volume.

Hip fracture is considered as the most severe osteoporotic fracture characterized by high disability and mortality in the elderly. Improved surgical techniques and multidisciplinary team play an active role in alleviating prognosis, which places higher demands on perioperative nursing. Dysfunction, complications, and secondary impact of anaesthesia and surgery add more difficulties to clinical nursing. Besides, there still lack clinical practices in perioperative nursing for elderly patients with hip fracture in China. In this context, led by the Orthopedic Nursing Committee of Chinese Nursing Association, the Expert consensus on clinical practice in perioperative nursing for elderly patients with hip fracture ( version 2023) is developed based on the evidence-based medicine. This consensus provides 11 recommendations on elderly patients with hip fracture from aspects of perioperative health education, condition monitoring and inspection, complication risk assessment and prevention, and rehabilitation, in order to provide guiding advices for clinical practice, improve the quality of nursing and ameliorate the prognosis of elderly patients with hip fracture.