Objective To investigate the influence of MDR polymorphism on CsA-associated hepatotoxicity. Methods PCR/RFLP was used to analyze the genotypes of MDR exon26 in 187 recipients. CsA-associated hepatotoxicity was evaluated among groups being classified according to the genotypes. Results MDR exon26 takes 3 genotypes:CC,CT and TT, in the following ratio: 29.4%(55/187), 40.1%(75/187), 30. 5%(57/187). Among the same range of whole blood CsA concentration, incidence of CsA-associated hepatotoxicity is markedly higher in the CT/TT group than that in in patients with CsA-associated hepatotoxicity between the CC group and the CT/TT group is signifiimportant role in the development of CsA-associated hepatotoxicity.

Acute blood loss anemia is the most common surgical complication of total knee arthroplasty. Currently, alloge?neic transfusion has been the major method of managing postoperative anemia. Although allogeneic transfusion can correct anae?mic condition temporarily, it can lead to severe complications, such as postoperative infection, prolongation of physical recovery, increased length of hospital stay, and increased mortality. Perioperative blood management can effectively reduce blood loss and transfusion rate. These strategies mainly focus on three parts:therapy for anemia and autologous blood donation before operation;application of a tourniquet, antifibrinolytic drugs, topical hemostatic agents and acute normovolemic hemodilution during opera?tion; selection of reinfusion systems, restrictive transfusion thresholds, drainage and knee position after operation. Perioperative blood management should run throughout the perioperative period, which mainly aims at reducing blood loss and blood transfu?sion, improving prognosis, promoting the postoperative recovery and lowering the medical cost. Depending on the actual situations of patients, surgeons should combine different major characteristics of each strategy and weigh the pros and cons to make effective and reasonable individualized treatment plan.

Objective To investigate the interest,cognition degree,participation degree and current situation of the advanced undergraduate clinical students in our college,to discuss the reason for low level of students' scientific research quality,in order to provide the reference to making research training programs for them.Methods The advanced undergraduates of seven-year and five-year clinical program interned in orthopedics department from January to June in 2014 were selected with cluster sampling method,and investigated anonymously by questionnaires and interview.120 students were investigated by questionnaire,and 120 effective questionnaires were taken back.30 students were interviewed.Results The results showed that 90.0 percent (n=108) of students were interested in scientific activity,and 47.5 percent (n=57) of students had participated in scientific lectures.In interviews,students think factors hindering the research on the participation in scientific research are:1)too many courses and heavy school tasks;2) absence of relative knowledge;3) lack of support from college;4) tough condition for scientific training;5) immature management system.Conclusion The advanced undergraduate clinical students had great interest in scientific activity,but had few opportunities to take part in,leading to their low level of scientific research quality.A variety of measures should be taken to bolster their scientific training.

Objective To investigate the clinical characteristic,diagnosis and treatment of familial adenomatous polyposis (FAP).Methods According to family history of the proband,we surveyed the pedigree and retrospectively analyzed the clinical characteristics of 10 FAP patients in 3 generations of the family.Result Among all 10 cases,3 died of colorectal cancer including two of whom had history of intestinal obstruction.Seven people of the third generation were all diagnosed as FAP.Among them,only 2 patients had clinical symptoms.Colonoscopy was done in all 7 patients before 35 years old.However,none of them had polyps or evidence of cancer.Surgical operation was performed on 1 patient and high frequency electric cutting under endoscopy was performed on 6 patients.Conclusions The early clinical manifestations of FAP are nonspecific.Pedigree investigation and colonoscopy screening for high-risk population are important to find early asymptomatic FAP patients.

Adenolymphoma ; metabolism ; pathology ; surgery ; Carcinoma, Squamous Cell ; metabolism ; pathology ; surgery ; Cell Transformation, Neoplastic ; Humans ; Keratins ; metabolism ; Ki-67 Antigen ; metabolism ; Male ; Metaplasia ; pathology ; Middle Aged ; Parotid Neoplasms ; metabolism ; pathology ; surgery

The effects of highly active antiretroviral therapy (HAART) to patients with AIDS in Hubei province of China were investigated in order to provide scientific evidence to reinforce the management of HAART. Self-made questionnaires and descriptive method of epidemiology were used to collect and describe the changes of clinical symptoms, HIV RNA concentration, and immune function of patients with AIDS. After HAART, the effective rate of fever, cough, diarrhea, lymphadenectasis, weight loss, tetter, debility and fungous infection was 92.4%, 90.85%, 92.91%, 90.73%, 93.69%, 89.04%, 92.34%, and 83.1%, respectively. Of 117 patients with detected HIV RNA concentration, 41.03% had declined over 0.5 log, and 52.99% less than 0.5 log. CD4(+)T cell count was obviously increased: the average number after HAART for 3 or 6 months was 237/microL (26-755/microL) and 239/microL (17-833/microL), respectively. HAART can improve AIDS patients' clinical symptoms, reduce HIV RNA concentration, and maintain immune function. It is very important for the effectiveness of HAART to raise clinical adherence of patients with AIDS and have a persistent surveillance.

Objective To evaluate the effects of inhalation sevoflurane in the early ischemia and reperfusion on pulmonary inflammatory response in patients undergoing cardiac surgery with extracorporeal circulation (ECC). Methods Forty patients with rheumatic heart disease scheduled for elective valve replacement were randomly assigned into 2 groups (20 patients in each group): control group and sevoflurane group. In sevoflurane group, 2% sevoflurane was inhaled for 15 min before and after the ascending aorta was blocked, and also before and after the ascending aorta was opened. Paitents in control group didn′t inhale sevoflurane. Time was defined as the followings: after anesthesia and before skin incision (T0), immediately before ECC (T1), immediately after ECC (T2), 2 h after ECC (T3), 6 h after ECC (T4) and 24 h after ECC (T5). At T0, T2, T3, T5, the radial artery blood was obtained to detect the levels of plasma tumor necrosis factor-α(TNF-α), interleukin-8(IL-8) and soluble intercellular adhesion molecule-1(sICAM-1). At T1, T2, the pulmonary artery and pulmonary vein blood was obtained to detect the neutrophil count and calculate the differences between the vein and artery. At T0, T2, T3, T4, T5, the arterial blood gas was detected and differences of alveoli-arterial oxygen pres [P(A- a)O2], oxygenation index (OI), static compliance (Cst) were calculated. Results The levels of plasma TNF-α, IL-8 and sICAM-1 were higher at T2, T3, T5 than those at T0 in two groups (P<0.05). The levels of plasma TNF-α, IL-8 and sICAM-1 were decreased in sevoflurane group at T2 and T3, compared with those in control group (P<0.05). The neutrophil counts of pulmonary artery, pulmonary vein and the differences between the vein and artery were higher at T2 than those at T0 in two groups (P<0.05). The neutrophil counts of pulmonary artery, pulmonary vein and the differences between the vein and artery were decreased in sevoflurane group at T2 compared with those of control group (P<0.05). The level of P(A- a)O2 was higher at T2, T3, T4 and T5 than that at T0 in two groups (P<0.05). The level of OI was decreased at T2, T3, T4 and T5 compared with that at T0 in two groups (P<0.05). The level of Cst was decreased at T2, T3 and T4 compared with that at T0 in two groups (P<0.05). The level of P(A-a)O2 was decreased in sevoflurane group at T2, T3 and T4 compared with that in control group (P<0.05). The levels of OI and Cst were higher in sevoflurane group at T2, T3 and T4 compared with those in control group (P<0.05). Conclusions Severe pulmonary inflammation often occurs during cardiac surgery with ECC, and it can be relieved by inhalation of sevoflurane in the early ischemia and reperfusion.

Objective:To research the correlation of serum levels of IL-21,TGF-β1,TNF-α and IgA1 in children with allergic purpura and the purpura nephritis.Methods:57 cases with allergic purpura who were treated in our hospital from November 2015 to May 2016 were selected and 29 cases were diagnosed with general allergic purpura,and another 28 cases were diagnosed with purpuric nephritis.30 healthy children were selected as the control group.Then the serum levels of IL-21,TGF-β1,TNF-α,IgAl,immunoglobulin A (IgA),C3 and C4 between the three groups were observed and compared.Results:The serum levels of IL-21,TGF-β1,TNF-α,IgA1 and IgA in the purpuric nephritis group were higher than those of the control group and the general allergic purpura group,and the differences were statistically significant (P＜0.05);The serum levels of IL-21,TGF-β1,TNF-α,IgA1 and IgA in the general allergic purpura group were higher than those of the control group,and the differences were statistically significant (P＜0.05);There was no statistically significant difference about the C3 and C4 in the three groups (P＞0.05).Conclusion:The serum levels of IL-21,TGF-β1,TNF-α and IgA1 may be involved in the development ofhenoch-schonlein purpura and purpura nephritis.

Objective To investigate the clinic characteristics of hepatosplenic γδT cell lymphoma (γδ HSTCL) and analyze the important role of morphology,immunology,cytogenetics and molecular(MICM) in the early diagnosis of γδHSTCL.Methods The clinical features of MICM of a rare case of childhood γδHSTCL had been analyzed,and the related literatures were reviewed.Results Bone marrow aspiration showed approximately 0.365 abnormal cells infiltrated.The immune phenotype analysis displayed 0.245 of the nuclear cells were abnormal ones,which possessed CD2/CD3/CD7/CD19/CD3s/cCD3 and TCRγδ expression.The immunohistochemical staining of spleen tissues showed clusters of differentiation (CD) 3/CD45 RO/CD8/Cytotoxic-granule associated protein (TIA-1)/leukocyte common antigen (LCA)/Granzyme B positive,CD4/CD20/T cell receptor (TCR) β/CD79 α/CD30/terminal deoxynucleotidy transferase (TdT) /CD10/ myeloperoxidase (MPO)/anaplasticlymphoma kinase (ALK) negative and 80.00％ of tumor cells displayed Ki-67 positive.The detection of spleen tissues by flow cytometry displayed that 72.26％ of the karyocytes were lymphocytes,with 88.90％ T lymphocytes.And 92.09％ of the T lymphocytes showed Ki-67/CD7dim,TCRγδ/CD2/CD8/CD34 positive,and TCRαβ/CD5/CD4/CD56 negative.And about 59.16％ of these karyocytes were abnormally matured T lymphocytes.The cytogenetic karyotype of bone marrow showed 46,XY.The detection of T cell receptor gene rearrangement showed TCRβ,TCRγ and TCRδ positive.The patient had been given prednisone of 60 mg/m2 when the diagnosis of γδHSTCL affirmed.But his parents discontinued chemotherapy for him and died.Conclusions MICM has shown a significant value in the diagnosis of γδHSTCL,a rare lymphoma in childhood.