Objective To investigate the correlation between the stage of hepatic fibrosis and the diameter of portal vein (DPV) and middle hepatic vein (DMHV) in patients with chronic hepatitis B.Methods 320 patients with chronic hepatitis B were evaluated by ultrasonography.The DPV and DMHV were measured,and their correlation with the degree of hepatic fibrosis was analyzed after liver biopsy.Results DPV was positively related with the degree of hepatic fibrosis(r =0.384,P =0.032),while DMHV was negatively related with the degree of hepatic fibrosis (r =-0.521,P =0.015).The DPV and HMDV in S4 were bigger than those of S0,S1,S2 and S3,and statistical differences existed among them (DPV∶z =0.334,P =0.032 ; DMH∶z =0.161,P =0.015).The best value of S4 diagnosing by DPV was 13mm.The best value of S4 diagnosing by DMHV was 6mm.The area under the curve of ROC for DPV and DMHV in ≥S2 was 0.753 and 0.758 respectively.It in≥S3 was 0.795 and 0.802 respectively.It in ≥S4 was 0.797 and 0.828 respectively.The area under the curve of ROC for combination of DPV and HMDV was 0.866,which was higher than that of DPV and HMDV.Conclusion There is a good correlation between DPV,DMHV and the stage of hepatic fibrosis in patients with chronic hepatitis B.Combination of DPV and HMDV has clinical significance for diagnosing early hepatic fibrosis.

AIM:To probe into the toxicological mechanism of sulfur dioxide (SO2) and its derivatives on cardiovascular system.METHODS: Effects of tea polyphenols (TP) on the increase in sodium current (INa) induced by SO2 derivatives in the cardiomyocytes were studied using the whole cell patch-clamp technique.RESULTS: ① The increase in INa induced by SO2 derivatives was inhibited by treating the cells with TP at different concentrations (10, 20 or 50 mg/L) in a dose dependent manner. At concentration of 50 mg/L, TP completely inhibited the increase in INa by SO2 derivatives. ② SO2 derivatives led to shift left of the activation curve. After application of TP at dose of 50 mg/L, the curve showed resumed significantly. ③ TP changed the inactivation process significantly. Before and after the application of SO2 derivatives, the half-inactivation voltage of INa was -(71.94?0.23) mV and -(65.79?0.69) mV (n=8, P0.05).CONCLUSION: TP inhibits the incremental effects of SO2 derivatives on INa, suggesting that the toxicity of SO2 on cardiomyocytes of rat is induced by free radical.

Objective To evaluate the suitability of cognitive behavioral therapy (CBT) techniques for obsessive-compulsive disorder (OCD),and analyze the domestic application status of CBT techniques for OCD and lay a foundation of standard CBT in China.Methods Delphi method was adopted to evaluate 30 CBT techniques on four dimensions,including operability,frequency,contribution of treatment and acceptability,and calculated the final scores of all techniques on different dimension and their comprehensive rank.Results After two rounds of experts consulting,Kendall coefficients of four dimensions were 0.249,0.269,0.234,0.250 (P＜0.01),coefficient of variation ranged from 0.05 to 0.31 of each technology on different dimension.The operability score of thought stopping,cost-benefit analysis and pie chart belonged to general suitability.The frequency and treatment contribution score of thought stopping and pie chart belonged to occasional use and small.The acceptation score of socratic question,thought stopping,in vivo exposure and behavior prevention belonged to partial acceptation.Weight coefficients of four dimensions were 0.26,0.18,0.27,0.29 and techniques ranking in the top three were information collection and evaluation,therapeutic alliance foundation and psychological education.Conclusion Most CBT techniques for OCD are suitable in China but some techniques still need to be improved.

Objective To evaluate the clinical significance of the changes of microalbunminuria(MAU) levels in mechanical ventilated patients with severe pneumonia. Methods According to the ratio between the microalbunminuria and the urine creatinine (MAU/CR) (ACR), setting 25mg/mmol as the threshold, 78 mechanical ventilated patients with severe pneumonia were divided into two groups :ACR increasing group and ACR Non-increasing group,then the clinical significance of changes of MAU levels in 72 hours on prognosis of these patients was observed. Results MAU increased in 64 cases(82. 1%) ,of which 46 cases in ACR increasing group and 18 cases in ACR non-increasing group. There showed statistically significant differences on APACHE Ⅱ score, CPIS score,PCT、the success of getting out of mechanical ventilation and the mortality between two groups, (t = 3.50、2. 19 、x~2 = 3. 95、6. 70、5.38 ,P = 0.01,0.03,0.04,0.01,0.02, all P ＜ 0.05). Conclusion Changes of MAU levels have the clinical significance on prognosis of the mechanical ventilated patients with severe pneumonia.

Objective To investigate the possibility of plastic and cosmetic operation incorporating epicanthoplasty with the double-eyelid procedure in one stage to achieve a more subtle scar in epicanthus patients with single eyelid. Methods After designing incision line of the epicanthic flap, double-eyelid line and the lower eyelid incision curved line, we cut the medial canthus skin transversely to reach a new medial canthus point, incised the part of front angle of medial palpebral ligamentum longitudinally and fixed the end point of front angle of medial palpebral ligamentum to nasal dorsum fascia firmly. Double eyelid operation was routinely performed to remove redundant small triangle skin as well as some patchy of orbicularis on the new medial canthus point. Along with eyelid edge about 1 to 2 mm to eyelash, the temporal side was cut with curved line till its disappearance by eyelid's "cat ear". The lower eyelid flap was separated downward and the superfluous flap and some patchy of orbicularis cut. The skin was su-tured to make postoperative scar hidden, blepharophimosis increased and the fold disappeared. Results 46 eyes (23 cases) were operated and satisfactory aesthetic results were obtained. Palpebral fissure was enlarged to 2 to 4 mm with epicanthic scar disappearance and formation of double-eyelid. Conclusions This is a simple and effective procedure with hidden epicanthic scar and the double-eyelid blepharoplasty could be performed simultaneously. Most patients receive satisfactory results during the 0.5 to 2 years' follow-up period except 2 cases with mild proliferation of epicanthus in half a year. It is especially suitable to correct the severe epicanthus palpebralis or epieanthus tarsalis.

Objective To explore the expressions of lectin-like oxidized low-density lipoprotein receptor-1(LOX-1)and apoptosis related genes caspase-3,Bax and bcl-2 in placenta,and their associations with the pathogenesis of preeclampsia.Methods Thirty preeclampsia patients(preeclampsia group),hospitalized in Department of Obstetrics,Shengiing Hospital of China Medical University from June 2005 to December 2006,were selected as the subject group,and 40 normal pregnant women as control group.The expressions of LOX-1 and apoptosis related genes caspase-3.Bax and bel-2 in different gestational weeks'placenta tissues were examined using immunohistochemistry.RT-PCR and western-blot.Results (1)Immunohistochemical detection in preeclampsia group:at 20 w+1-24 w,24 w+1-28 w,28 w+1-32 w.32w+1-36 w+1-36 w+1-40 w,respectively,the results of LOX-1 were 20.1±1.8,25.6±1.3,32.8±1.6,34.3 ±1.5,39.9±1.2;in the control group they respectively were 11.2±0.6,18.5±1.6,26.1±1.8,28.3 4-1.6,32.3±1.6;the difierence was significant(P<0.05).In preeclampsia group,the results of easpase-3 were 12.3±0.9,16.3±0.9,24.4 4-0.8,28.3±0.5,36.3±1.1.and in the control group they respectively were 8.5±1.0,12.3±1.1,17.4±1.2,20.4±stronger than those in normal pregnant women at different gestational weeks(P<0.05).However,the expression tendency of bcl-2 mRNA and proten was converse to the expression tendency of Bax.Conclusion The expressions of LOX-1,caspase-3,and Bax are upregulated in placentas of preeclampsia patients,while bcl-2 iS downregulated,both of which are associated with the pathogenesis of preeclampsia.

Objective To compare the immunogenicity of pneumococcal surface adhesion A (PsaA) and pneumococcal surface protein A (PspA). Methods The variability of the genes and the expressed pneumococcal proteins PsaA and PspA was investigated by electrophoresis. Cross-reactivity of proteins with the antibodies induced by the corresponding proteins of Streptococcus pneumoniae serotype 5, 6B,1, 19F and 23F was researched by Western blot. The enzyme-linked immunosorbent assay (ELISA) was adopted to detect the antibody subclasses and the accessibility of antibodies induced by PsaA and PspA to the surface of the above intact strains. Cross-protection against challenging with Streptococcus pneumoniae strains was indagated in mice. Results Both proteins showed to induce the similar level of antibody subclasses.This study demonstrated that cross-reactivity of pneumococcal PspA was restricted in the same clade, which showed less extensive than pneumococcal protein PsaA. But antibody induced by pneumococcal protein PspA could be bound to the surface of the intact strains, which conduced the stronger cross-protection against inva sive strains. Conclusion The mice immunized with PspA protein cross-protected well against the invasive strains in which PspA belonged to the same clade 1 of family 1. It showed that pneumococcal protein PspA was more effective than PsaA in protection as composition of vaccine.

Objective To investigate the incidence of osteoporosis (OP) in patients with ankylosing spondylitis and the relationship between OP and the clinical data. Methods Serum levels of bone alkaline phosphatase (BALP) and tartrate resistant acid phosphatase 5b (TRACP5b) were detected by enzyme linked immunosorbent assay ( ELISA ) in 60 cases with ankylosing spondylitis, and it was compared with normal controls. Bone mineral density (BMD) was measured through dual-energy X-ray absorptiometry ( DXA), including lumbar ( L2 - L4), bilateral femoral neck and greater trochanter. Some clinical data was collected and analyzed at the same time. Results The incidence of OP in AS patients was 35%, and the incidence of OP in the femoral proximal end was higher than that in lumbar. Compared with normal controls[ ( 1.06 ±0. 18 )U/L ], the levels of serum TRACP5b in AS[ (1.31 ± 0. 82 )U/L] patients was significantly higher ( P <0. 05 ). The levels of serum BLAP in OP combined AS group[ ( 21.65 ± 5.41 ) U/L]were significantly lower than non-OP group[ (32. 37 ± 16. 5 ) U/L] ( P <0. 05 ). The disease duration was negatively correlated with the BMD of femoral neck ( P < 0. 01 ). Conclusions There was higher incidence of OP in AS patients, which were related with the abnormality of bone metabolism and the disease duration.Multiple factors participated in the regulation of bone metabolism of AS.

Objective To evaluate the influence of preoperative quitting time on coronary artery bypass grafting (CABG) patients with postoperative hypoxemia incidence.Methods 151 patients with coronary bypass surgery and preoperative history of smoking who preparation of CABG in hospital were recruited from September 2011 to September 2013.According to the preoperative smoking cessation time patients were divided into five groups:0 days,1-30 days,31-60 days,61-90 days,more than 90 days.Single factor regression and Logistic analysis were used to analyse the influence of preoperative quitting time on CABG patients with postoperative hypoxemia incidence.Results Age,weight,smoking habit,quitting time,hypertension,diabetes mellitus were risk factors of hypoxemia after coronary artery bypass grafting.Logistic regression analysis showed that age,body weight,smoking habit,smoking time were independent risk factors of hypoxemia after coronary artery bypass grafting.The incidences of hypoxemia of the five groups 0 days,1-30 days,31-60 days,61-90 days and more than 90 days were 55.56％ (15/27),59.26％ (16/27),27.58％ (8/29),22.73％ (5/22),15.63％ (5/32).The incidence of hypoxemia had significant difference (x2=19.212,P ＜ 0.05).Conclusions Age,weight,smoking habit,quitting time were independent risk factors of hypoxemia after CABG.With the quitting time increase,hypoxemia after CABG overall downward trend.Difference quitting time before the operation,the hypoxemia occurred difference rate influence,On the preoperative smoking CABG patients were smoking cessation intervention timely helps to reduce the occurrence of postoperative hypoxemia.

The body is exposed to various organic anions,so it is the best way to remove the toxic substances in the body quickly and effectively.Cross epithelial active transport mediated by organic anion transporter is the rate limiting process.Renal secretion and re-absorption of a variety of endogenous and exogenous organic anions are occurred in the proximal tubular epithelial cells of the organic anion transporter family.The expression of organic anion transporter-1 (OAT1) in proximal tubular epithelial cells plays an important role in the introduction of organic anion into the renal tubular epithelial cells.This article reviewed the renal expression,the substrate and the polymorphism of the organic anion transport protein OAT1,the renal toxicity of adefovir dipivoxil,the interaction between organic anion transporters and drug,and the influence of the renal toxicity on the renal toxicity of adefovir dipivoxil.