10%～20% of acute clinical sporatic hepatitis is hepatitis E (HE). HE has a severe diaease low mortality in general population of about 0.5～1.5%. It has been reported as severe disease and the mortality increased to 20% in pregnant women and old people. China is high-epidemic for hepatitis E virus (HEV). HEV is mainly transmitted through faecaloral route,data also showed that HEV could be transferred through blood donation. The epidemiology,diagnostics and vaccine development of HE is reviewed in this paper.

Objective:To explore grouping methods of subdividing adjacent diagnosis related groups(DRGs) by introducing patient clinical complexity level(PCCL) principle and provide references for exploring DRG grouping method in line with context in China.Methods:Clinical complexity level of each complication was assigned by clinicians.PCCL model was selected to calculate the scores of clinical complexity cases.Each adjacent DRG was subdivided into DRG groups by classification and regression trees(CART) model.The rank-sum test was applied to test the statistical significances of the grouping results.Results:9 surgical adjacent DRGs were subdivided into 18 DRG groups.There were statistical significances in the differences of hospitalization expenses and length of stay among different DRG groups in each adjacent group.Conclusion:PCCL model showed high performance in DRG subdivision.The unification of the quality of medical records and coding were the key factors to ensure the reasonable grouping results.

Objective The purpose of this study was to evaluate the effect of prostaglandin E 1 (PGE 1) on blocking the development of acute respiratory distress syndrome (ARDS) induced by acid aspiration. Methods Twenty new Zealand rabbits were used. Dilute HCl was instilled into right bronchus of the rabbits. The rabbits were then divided randomly into two groups: injury group and treatment group. In injury group (n=10) rabbits received no treatment except mechanical ventilation. In treatment group (n=10) immediately after acid instillation the rabbits received an intravenous bolus of PGE 1 followed by a continuous infusion. Blood gas, airway pressure and dynamic and static compliance were measured before and after acid instillation. Blood samples were taken from artery for determination of 6-k-PGF 1?, TXB 2,NO 2 -/NO 3 - and ET-1. The animals were killed and the wet/dry lung weight (W/D) ratio and total protein of bronchoalveolar lavage fluid(BALF) of right lung were measured. Microscopic examination of the lung was done. Results In treatment group PaO 2 was significantly higher than that in injury group after acid instillation. Plasma 6-k-PGF 1? and NO - 2/NO - 3 levels were significantly higher in treatment group while plasma TXB 2 and ET-1 levels were significantly lower. W/D ratio and TP of BALF of right lung were significantly lower in treatment group. The inflammatory changes were diffuse in injury group while in treatment group they were localized and less severe. Conclusions PGE1 can lessen severity of ARDS induced by acid aspiration. It may protect pulmonary vascular endothelial cells through maintaining the balance between PGI 2 and TXA 2 and that between NO and ET-1 .

Objective To explore the changes of frequency, BAFF expression and sensitivity to apoptosis of CD19 + CD5 + B cells in endometriosis patients and investigate the relationship between CD19 +CD5 + B cells and endometriosis. Methods Flow cytometry and quantitative PCR were used to assess the frequency, BAFF expression and sensitivity to apoptosis of CD19+ CD5 + B cells in the peripheral blood,peritoneal fluids and endometrium biopsies of 39 patients with endometriosis and 31 patients with myoma of uterus ( control subjects). Results: All 39 endometriosis patients had higher frequencies ( all P ＜ 0. 01 ) of CD19 + CD5 + B cells in the peripheral blood, peritoneal fluids and endometrium biopsies than that in 31 control subjects. CD19 + CD5 + B cells from endometriosis patients expressed higher BAFF, and were more resistant to CD95L-induced apoptosis than the cells from control subjects ( P ＜ 0. 01 ). Conclusion CD19 + CD5 + B cells might play an important role in the pathogenesis of endometriosis through higher BAFF expression and more resistance to CD95L-induced apoptosis.

ObjectiveThe purpose of this study was to evaluate the effect of prostaglandin E1 (PGE1) on blocking the development of acute respiratory distress syndrome (ARDS) induced by acid aspiration. MethodsTwenty new Zealand rabbits were used. Dilute HCl was instilled into right bronchus of the rabbits. The rabbits were then divided randomly into two groups: injury group and treatment group. In injury group ( n = 10) rabbits received no treatment except mechanical ventilation. In treatment group ( n = 10) immediately after acid instillation the rabbits received an intravenous bolus of PGE1 followed by a continuous infusion. Blood gas, airway pressure and dynamic and static compliance were measured before and after acid instillation. Blood samples were taken from artery for determination of 6-k-PGF1α, TXB2, NO2-/NO3- and ET-1. The animals were killed and the wet/dry lung weight (W/D) ratio and total protein of bronchoalveolar lavage fluid(BALF) of right lung were measured. Microscopic examination of the lung was done. ResultsIn treatment group PaO2 was significantly higher than that in injury group after acid instillation. Plasma 6-k-PGF1α and NO2-/NO3- levels were significantly higher in treatment group while plasma TXB2 and ET-1 levels were significantly lower. W/D ratio and TP of BALF of right lung were significantly lower in treatment group. The inflammatory changes were diffuse in injury group while in treatment group they were localized and less severe. Conclusions PGE1 can lessen severity of ARDS induced by acid aspiration. It may protect pulmonary vascular endothelial cells through maintaining the balance between PGI2 and TXA2 and that between NO and ET-1 .

Objective To discuss the effect of three-dimensional conformal hypofractionated high-dose radiotherapy on non-small cell lung cancer in the elderly. Methods All patients were treated by the same way of fraction radiotherapy,with a prescription dose of 4-5?Gy,every other day,to a total dose of 48-55?Gy. Results Complete response was observed in 23(51.1%) patients,partial response in 15(33.3%) patients, with the overall response rate of 84.4%. The overall 1-,2-,3-year survival rates were 66.7%,48.9% and 39.1%.Conclusions Three-dimensional conformal hypofractionated high-dose radiotherapy is safe and effective, giving mild untoward side-effects.

In this article,the connotation of the knowledge management and services as well as the relationship between them were introduced.The specific measures about how to carry out these management and services were described.

Objective To analyze risk factors for the perioperative heart failure following hip fracture surgery in the aged patients.Methods The present study included 186 elderly patients(≥ 65 years)who had received hip fracture surgery from August 2009 to Janurary 2014 in our department.Their clinical data were analyzed to define risk factors for perioperative heart failure.Results Factors significantly affecting the perioperative heart failure included age,gender,hypertension,time from injury to operation,general health before injury,pain score,perioperative blood transfusion,perioperative human serum albumin transfusion,fluid infusion during operation,perioperative balance between daily fluid intake and output,perioperative temperature changing and heart diseases.A multivariate Logistic regression analysis revealed that the independent risk factors for perioperative heart failure included general health before injury (OR =21.967,P=0.000),perioperative balance between daily fluid intake and output (OR =19.349,P =0.005),heart diseases (OR =6.009,P =0.006).Conclusions In aged patients undergoing hip fracture repair operations the independent risk factors for perioperative heart failure include general health before injury,perioperative balance between daily fluid intake and output,heart diseases.Perioperative risk assessment and prevention are the keys of better prognosis.

Objective To evaluate the gene therapeutic effects of guinea pigs model with immune -mediated inner ear disease(IMIED)after locally injection of bone -marrow mesenchymal stem cells(BMSCs) decorated by in-terleukin-4 gene .Methods Guinea pigs were immunized with keyhole limpet hemocyanin (KLH) and caused 55 animal models ,divided into five groups ,each group with 11 animals :groupA(BMSCs carrier) ,group B(BMSCs emp-ty -carrier control group) ,group C(recombinent lentivirus IL -4 gene) ,group D(lentivirus empty -carrier control group) ,group E(simulation operation control group) .Groups were all injected with the corresponding suspension (20 μl)[includs BMSCs ceas of (1 .5~2 .0) × 106 ,the concentration of (entivirus) is 0 .5 × 108 pfu] by the scala tympani window into the inner ear .The fluorography immunohistochemistry test and enzyme immunohistochemistry test for the situation of IL -4 gene express and productive protein distribution in inner ear .Auditory functions and the KLH level of guinea pigs blood were monitored respectively by auditory brainstem responses (ABRs) and ELISA test .Results The threshold of ABR wave Ⅲ decreased in group A ,group B and group C .The result were more significant in group A and group B than that in group C ,but results in group A was more prominent (P<0 .05) . The results of immunohistochemistry test showed that fluorescence positive BMSCs mainly scattered in scala tymani and scala vestibule .The microscope results showed that for the group A ,B and C ,there were only few foccule and red and white blood cells in scala tympani floc ,but for group D and group E ,with different levels of labyrinthine hy-drops and some mononuclear cells around the spiral ganglion and small blood vessels .Conclusion Restructuring lentiviral vector with IL -4 gene can be successfully transfected into BMSCs in vitro ,compared to inplangting into inner ear in scala tympani approach ,the cells can migrate and generate gene product of IL -4 ,to significantly im-prove the auditory functions and inflammatory reaction of inner ear disease ,and BMSCs can be used as a carrier to migrate to the damaged part with therapeutic gene .

N-3 and n-6 unsaturated fatty acids are essential fatty acids. It is necessary for human health. At present, the diet contains a disproportionally high amount of n-6 PUFAs and low amount of n-3 PUFAs, and the resulting high n-6/n-3 ratio is thought to contribute to cardiovascular disease, inflammation, and cancer. This article is about the polyunsaturated fatty acid uptake and metabolism in its study on the impact of progress in cancer and inflammatory diseases and its mechanism of action and clinical research.