OBJECTIVE:To observe therapeutic efficacy of ursodeoxycholic acid(UDCA)combined with S-adenosyl methio-nine (SAMe) in the treatment of mild intrahepatic cholestasis (ICP) of pregnancy. METHODS:213 pregnant patients with mild ICP were selected and randomly divided into combination group (107 cases) and single drug group (106 cases). Combination group received UDCA combined with SAMe,and single drug group was given UDCA alone. Therapeutic efficacy and pregnancy outcome were compared between 2 groups. RESULTS:Compared to before treatment,TBA,CG,DBIL,ALT and AST of 2 groups were decreased after treatment,and the decrease of combination group was more significant than that of single drug group, with statistical significance(P<0.05). The time of itching control [(3.8±1.4)d] in combination group was lower than(5.3±1.5) d in single drug group,with statistical significance (P<0.05). After 3 and 5 days of treatment,itching degree score of combina-tion group was lower than that of single drug group,with statistical significance(P<0.05). There was no statistical significance in fetal distress rate,neonatal asphyxia rate,amniotic fluid contamination rate,cesarean section rate and neonatal 1 min Apgar score between combination group and single drug group(P>0.05);the preterm birth rate of combination group was 11.22%,which was significantly lower than 20.75% of single drug group,with statistical significance(P<0.05). CONCLUSIONS:Compared to UD-CA alone,UDCA combined with SAMe in the treatment of patients with ICP can control the clinical symptoms timely,recovery laboratory index as soon as possible and obtain better therapeutic efficacy.

Objective:To observe the impact of compound glycyrrhizin combined with triamcinolone acetonide on clinical effects and immune function in the patients with oral lichen planus ( OLP) . Methods:Totally 100 patients with OLP were randomly divided into the control group (50 cases) and the study group (50 cases). The control group was locally injected with triamcinolone acetonide, and the study group was treated with compound glycyrrhizin tablets additionally. The treatment course was 4 weeks. Visual analogue scale ( VAS) and REU scoring system were used to assess pain and symptoms of OLP, the clinical effects and cellular immune function were compared, and the adverse reactions were recorded as well. Results:After the treatment, the VAS score and REU score respec-tively lower than those for the control group, and there were differents between the two groups (P<0. 05). The total effective rate was 84. 0% in the study group, which was higher than that in the control group (66. 0%) (P<0. 05). The percentage of CD3+ and CD4+ cells was increased, that of CD19+ cells and the ratio of CD4+/CD8+ were decreased, and there were significant differences be-tween the two groups (P<0. 05). The adverse reactions in both groups were mild. Conclusion:Compound glycyrrhizin combined with triamcinolone acetonide is effective for OLP and can improve the immune function in the patients.

Objective To investigate whether cochlear hair cells occur apoptosis following kanamycin treatment in guinea pigs. Methods It was comprised of two groups of six animals each. Experiment group and control group were subjected to administration of kanamycin,im,400 mg?kg -1 ?d -1 ,and saline respectively for successive 10 days. One week later, animals were sacrificed. Left cochlea and right cochlea were taken for cochlea preparation and cochlea section respectively. Apoptosis was detected by terminal deoxynucleotidyl transferase(TdT)-mediated deoxyuridine triphosphate(d-UTP) nick end-labling(TUNEL) method.Results Apoptosis was present in cochlear hair cells, supporting cells as well as marginal cells of stria vascularis except for the spiral ganglion cells in kanamycin treatment guinea pigs. No apoptosis was detected in control animals. Conclusion Apoptosis of cochlear cells play important role in kanamycin ototoxicity.

BACKGROUND: Long-term follow-up of the patients undergoing anterior cervical discectomy and fusion (ACDF) shows some incidence of degeneration at the segments adjacent to the fusion level. Cervical total disc replacement may resolve this problem. OBJECTIVE: To compare the effects of cervical total disc replacement versus ACDF on the biomechanics of the segment adjacent to the operation level. DESIGN, TIME AND SETTING: The randomized controlled trial was performed at biomechanical laboratory in Beijng Trauma and Orthopaedic Institute from August 2007 to February 2008. MATERIALS: Eighteen samples of fresh goat cervical spine; Bryan artificial cervical disk (Medtronic); CSLP-VA cervical plate (Synthes); coral bone (Beijing Yihuajian Science And Trade Co., Ltd.). METHODS: The goat spines were divided into 3 groups: control group with no specific treatment; total disc replacement group, in which C5/6 segment underwent Bryan artificial cervical disk replacement and fusion; internal fixation group, in which the C5/6 segment underwent cervical discectomy, coral bone implantation and internal fixation with CSLP-VA cervical plate. MAIN OUTCOME MEASURES: The adjacent intervertebral disk pressure (IDP) was measured in flexion, extension, rotation and lateral bending under certain loading, and the pressure changes were compared among three groups. RESULTS: At level C4/5, the IDP between total disk replacement group and the control group had no statistical significances in flexion (P 0.05) but internal fixation group was significantly higher than control group (P=0.014). There were no significant differences among the three groups in IDP in extension, rotation and lateral bending. CONCLUSION: Compared with ACDF, the total disk replacement can reduce the adjacent segment IDP and may avoid the degeneration in adjacent cervical segment.

Objective To observe the morphology, cell viability and secretion function of catecholamine of the alginate-polylysine-alginate (APA) microencapsulated bovine chromaffin cells (BCCs) before and after cryopreserving with liquid nitrogen. Methods The APA microencapsulated BCCs were cryopreserved with dimethyl sulfoxide as cryopreservative agent by slow cooling and rapid rewarming for revivification. The change of cell function was observed by detecting the cell viability and secretion of catecholamine. Results As compared with the precryopreseving cells, the morphology and cell viability of the resuscitated APA microencapsulated BCCs showed no significant change. The catecholamine secretion volume of BCCs remained 80% of that by the precryopreserving cells. Conclusion It demonstrates that the resuscitated cryopreserved APA microencapsulated BCCs still remained good morphology, cell viability and secretion function of catecholamine.

Objective To explore the diagnosis and treatment of iatrogenic bile duct injury during choledochocystectomy. Methods Clinical data of 24 cases of iatrogenic bile duct injury were analyzed retrospectively from 2005 to 2009. Results Eight patients underwent early repair of bile duct within 4 days after the injury. 14 patients with later recognized bile duct injury underwent selective operations, and two patients were discharged after their jaundice were relieved without any surgical treatment. Supporting T tubes were left in place in 22 patients for 8 to 14 months after operations, without any biliary obstruction found after one year and six months to five year follow-up. Conclusions Early bile duct injury within 4 days was easily treated, but later bile duct injury should have selective operation. The patients with jaundice could be diagnosed with PTCD and ERCP to observe the bile duct injury. During operation membrane-to-membrane wide hepatojejunostomy helps prevent later anastomotic stenosis. The left in drainage tube in anastomotic stoma for more than 8 months improves success rate in the process of injuried bile duct repair.

Objective To investigate the protective effect of taurine on HK-2 cells exposed to oxalate (Ox) and calcium oxalate monohydrate crystal (COM) in vivo.Methods HK-2 cells,a proximal tubular epithelial cell line,were cultured.Five groups were divided in this study:control group (only HK-2 cells) ; Ox and COM group (HK-2 cells + Ox + COM) ; Taurine group (HK-2 cells + Ox + COM + Taurine) ; Apocynin group (HK-2 cells + Ox + COM + Apocynin) ; Catalase group (HK-2 cells + Ox + COM +Catalase).After 6 hrs,the cultures medias from each group were tested for LDH,H2O2,8-isoprostane,and MCP-1 protein.Cellular expression of MCP-1 mRNA and P47phox mRNA were determined by reverse transcriptase-polymerase chain reaction.After 24 hrs,cells livability was investigated by MTT.Results Compared with the control,cells livability was reduced when exposed to Ox and COM (P ＜ 0.05),Treatment with Taurine,Apocynin and Catalase significantly increased the cells livability (P ＜ 0.05).Compared with the control,the expression of LDH,H2O2,8-isoprostane,and cellular expression of MCP-1 mRNA and P47phox mRNA were increased following exposure to Ox and COM (P＜0.01,P＜0.01,P＜0.01,P＜0.01,P ＜0.05).Treatment with Taurine,Apocynin and Catalase significantly reduced the expression of LDH,H2O2,8-isoprostane,as well as the cellular expression of MCP-1 mRNA.Expression of P47phox mRNA in Taurine group was not reduced significantly (P ＞ 0.05).Conclusions This study showed that Taurine protected the HK-2 cells from oxidative injury exposed to Ox and COM by the pathway that may not be in relation to the inhibition of P47phox mRNA expression.

Objective To investigate the diagnostic value of anti-cyclic citrullinated peptides ( CCP ) antibodies combined rheumatoid factors (RF) on elderly patients with rheumatoid arthritis.Methods From January 2012 to December 2014, 29 cases of elder patients in our hospital with rheumatoid arthritis (elder RA group, age >60 year), 47 cases of elderly health control group (elder RA group, age≥60), and 48 cases of elder patients without rheumatoid arthritis (non-elder RA group, age<60 year) were selected.The anti-CCP antibodies and rheumatoid factor (RF) levels of three groups were detected, and the significance of anti-CCP antibody combined RF on the diagnosis of elderly rheumatoid arthritis was analyzed.Results Diagnostic positive rate of anti-CCP antibodies +RF was significantly higher than that of anti-CCP antibodies, and the difference was significant (χ2 =7.632, P =0.006).Diagnostic positive rate of anti-CCP antibodies +RF was higher than that of RF, but the difference was not statistically significant (χ2 =3.107, P=0.078).The diagnostic positive rate of anti-CCP antibodies, RF, and anti-CCP antibodies +RF for diagnosis of elderly rheumatoid arthritis had no statistically difference with that of non-elderly RA group.The sensitivity and negative predictive value of anti-CCP antibodies +RF was higher than that of only anti-CCP antibodies and RF.The area under the ROC curve of detecting anti-CCP +RF was 0.786, which was higher than that of anti-CCP antibodies (0.699) and RF (0.663), indicated that the reliability of anti-CCP antibodies +RF was higher than that of anti-CCP antibodies and RF.Conclusion The anti-CCP antibodies and RF can diagnose elderly rheumatoid arthritis, and anti-CCP antibodies combined RF has more clinical significance.

Objective To study the characteristics of immune function,Epstein-Barr virus(EBV) antibodies and EBV-DNA in children with different clinical types of EBV infection,which provide basis for prevention and treatment of EBV infection.Methods Clinical data of 103 patients suffering from EBV infection were retrospectively analyzed in Xijing Hospital of the Fourth Military Medical University.A total of 103 children were divided into infectious mononualeosis(IM) group(n=68),chronic active Epstein-Barr virus infection(CAEBV) group(n=13) and Epstein-Barr virus-related hemophagocytic lymphohistiocytosis(EBV-HLH) group(n=22).The changes of EBV antibodies,EBV-DNA,immunoglobulin levels,lymphocyte subpopulation and complement series were detected and compared among the three groups.A total of 26 healthy children at the same stage were enrolled as a control group,immunoglobulin levels,lymphocyte subpopulation and complement series were detected in control group,then compared with the rest of the three groups.Results The levels of C3 and C4 in CAEBV group and EBV-HLH group were significantly decreased than those in the control group(P<0.05).The levels of IgA,IgG and IgE in EBV-HLH group,CAEBV group,IM group and control group gradually increased(P<0.05,respectively).The levels of IgA,IgG and IgE in EBV-HLH group and CAEBV group significantly decreased than those in control group(P<0.05,respectively).The levels of IgA,IgG and IgE in IM group decreased than those in control group,while there were no statistically significant differences(P>0.05).CD8+T cells in IM group significantly increased than those in the rest of the three groups(P<0.05,respectively).T cells,CD8+T cells,CD4+ T cells,CD4+/CD8+ ratios,NK cells,B cells of EBV-HLH group significantly decreased than those in the rest of the three groups(P<0.05).The positive rates of EBV antibodies in CAEBV group and IM group were significantly higher than those in EBV-HLH group(P<0.05).EBV-DNA in EBV-HLH group were significantly higher than those of CAEBV group and IM group(P<0.05).Conclusion EBV-DNA levels in the serum are positively correlated with disease types and severity,the pathogenesis of IM,CAEBV and EBV-HLH induced by EBV infection are associated with immune dysfunction.Dynamic monitoring of EBV load and cell immune function can reflect disease status and progress risk.

Objective To investigate the effects of different doses of 1 ,25(OH)2D3 on rat Thy‐1 nephritis mesangial cell ap‐optosis .Methods 120 clean SD rats were divided into the blank control group(group A) and the experimental group .The experi‐mental group was re‐divided into the nephritis group(group B) ,0 .25μg 1 ,25(OH)2D3 intervention group(group C) and 0 .50μg 1 , 25(OH)2D3 group(group D) ,30 cases in each group .The group C and D were performed the medication intervention after success‐fully constructing the model .6 rats were randomly killed in each group on 1 ,3 ,7 ,14 ,21 d after intervention .The renal tissues were taken for determining the renal pathological injury classification after hematoxylin and eosin staining and PAS staining .The expres‐sion of Caspase‐3 in the renal tissues was detected by the immunohistochemistry method ,and the glomerular cell apoptosis was de‐tected by TUNEL .Results The immunohistochemistry results showed that compared with the group A ,the Caspase‐3 expression in the group B was increased (P<0 .05);compared with the group B ,the Caspase‐3 expression in the group C and D was increased , but there was no statistical differences between them (P> 0 .05);the Caspase‐3 expression in the group D was highest ,but the difference was not statistically significant compared with the group C .The TUNEL results showed that compared with the group A ,the apoptotic glomerular cells in the group B were increase obviously (P<0 .05) ,which was gradually enhanced over time ;com‐pared with the group B ,the apoptotic glomerular cells in the group C and D were increased significantly (P<0 .05) ,reaching a peak on 3 d ,then decreasing gradually on 7 ,14 d and tending to be normal on 21 d(P<0 .05);the comparison between the group C and D showed that the apoptotic cells in the group D were increased significantly ,but the difference between these two group ,was not statistically significant(P>0 .05) .Conclusion 1 ,25(OH)2D3 has the effect for inducing glomerular mesangial cell apoptosis in rat , which participates in the regulation of Caspase‐3 ,induces glomerular mesangial cell apoptosis ,promotes the recovery of nephritis and could delay the progression of renal disease .