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 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 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 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.

ObjectiveTo explore the changes of the frequency and cytokine production of CD19 + CD5 + B cells in Endometriosis before and after treatment.MethodsFlow cytometry and quantitative PCR were used to assess the frequency,cytokine expression of CD19 + CD5 + B cells in the peripheral blood,peritoneal fluids and endometrium biopsies of 35 patients with Endometriosis and 29 patients with myoma of uterus (control subjects).Changes in the CD19+ CD5+ B cell compartment in the peripheral blood were compared before and after treatment.ResultsAll 35 endometriosis patients had higher frequencies(all P ＜0.01 ) of CD19+ CD5 + B cells in the peripheral blood,peritoneal fluids and endometrium biopsies [ (13.1 ± 1.9)％,(12.1 ±2.0)％,(11.7 ± 1.7)％] than 29 control subjects[ (2.9 ±0.8)％,(2.6 ±0.9)％,(2.8 ±1.1 )％ ].CD19 + CD5+ B cells from endometriosis patients expressed higher IFN-γ[ (7.2 ± 1.0) × 103,(7.9±1.3) ×103,(7.4±1.1) ×103 copies] than control subjects [ (1.9±0.7)×103,(2.2±0.8)×103,(2.0 ±0.5) × 103 copies).The endometriosis patients also had higher IL-10 production of CD19 + CD5 + B cells [ (6.4 ±0.9) × 103,(6.8 ± 1.2) × 103,(6.1 ±0.8) × 103 copies] than control subjects [ ( 1.7 ±0.5) × 103,(2.1 ±0.9) × 103,( 1.6 ±0.4) × 103 copies].Compared with control subjects,the endometriosis patients had a clinical response to treatment demomtrated a significant decrease in CD19 + CD5 + B cells in the peripheral blood[ ( 13.1 ± 1.9)％ vs (7.3 ± 1.2)％ ],expressed lower IFN-γ [ (7.2 ± 1.0)×103 copies vs (3.3 ±0.6) × 103 copies],produced less IL-10 [(6.4 ±0.9) × 103 copies vs (3.2 ±0.7) × 103 copies].ConclusionsCD19+ CD5 + B cells might play an important role in the pathogenesis of endometriosis through higher IFN-γand IL-10 expression.

Objective To investigate the therapeutic efficiency of intravenous implanted endothelial progeni-tor cells (EPCs) pretreated with stromal cell derived factor-1 (SDF-1) in rat model of acute myocardial infarction (AMI). Method The bone-marrow derived EPCs were cultured. The effects of SDF-1 on the migration and sur-rival of EPCs were evaluated in vitro. The rat models of AMI were produced and randomly divided into SDF-1 +EPCs group (n=12), EPCs group (n=12) and control group (n=12). EPCs pretreated with or without SDF-1 were infused via tail vein 24 hours after AMI modelled. The EBM-2 culture medium without cell was infuaed in control group. Vessel density, cardiac function and infarct area were measured on 14 days and 28 days after cell implantation. Results Fourteen days after cell implantation, the vessel density of SDF-1+EPCs group was higher than that of EPCs group and control group. Twenty-eight days after cell implantation, the cardiac function of SDF-1+EPCs group was better than that of EPCs group and control group. Conclusions EPCs pretreatment with SDF-1 can improve the survival and migratory capacity of EPCs, and increase the therapeutic efficiency for myocardial infarction.

Objective To evaluate the distribution of neuropeptide Y and its receptors in the cardinal ligament and uterosaeral ligaments in women with and without pelvic organ prolapse(POP).Methods Sixteen patients with pelvic organ prolapse entered the study.All patients were evaluated by pelvic organ prolapse quantitation(POP-Q).Group A consisted of six patients with grade Ⅰ,Ⅱ POP,and group B comprised ten patients with grade Ⅲ,Ⅳ POP.Eight nonfunctional ovarian tumor patients without POP were recruited as control subjects.Biopsies of cardinal ligament and uterosacral ligament were obtained from each woman during surgery.Immunohistochemical study with polyclonal antibody against a general nerve marker S-100 and neuropeptide Y was performed on paraffin-embedded sections of all the samples.In addition,mRNA levels of the human NPY-Y1 and NPY-Y2 receptors were assessed in both patients and controls.Results (1)NPY immunoreactivities were identified in both cardinal ligament and uterosacral ligament. NPY immunoreactive nerve fibers were insignificantly lower in POP patients(P＞0.05).The distribution pattern of NPY was similar in cardinal ligament and uterosacral ligament ( P＞0. 05 ). (2)mRNAs encoding the NPY-Y1 and NPY-Y2 receptors were detected in the pelvic supporting tissues. Besides the expected NPY-Y1 PCR products, an additional 97 bp long amplicon originating from an alternative splicing event was found in most tissues studied. (3)In cardinal ligaments, mRNA encoding NPY-Y1 receptor had a significant difference between group A(3.9±1.0)and B (6. 0±1.5), and between control (3.4±0.9) and group B (P = 0. 019,P = 0. 004), while there was no significant difference between group A and controls(P =0. 082). In uteresacral ligaments, mRNA encoding NPY-Y1 receptor had no significant difference between Group A(6. 0±1.1) and B (6. 3±0. 7), or between group A and controls(4. 8±0. 7;P = 0. 151 ,P = 0. 690);while there was a significant difference between group B and controls (P = 0. 016).(4) mRNA encoding NPY-Y2 receptor had no significant difference between controls (0. 49±0. 34, 0. 61±0. 15 ), group A (0. 56±0. 21,0. 67±0. 13) and group B (0. 85±0. 43, 0. 69±0. 21 ) patients in cardinal ligament and uterosacral ligaments ( P＞0. 05 ). (5) mRNA encoding NPY-Y1 ( P = 0. 084 ) and NPY-Y2 (P=0.470) receptors had no significant difference between cardinal ligament and uterosacral ligament.Conclusions There are NPY and NPY receptors in cardinal and uterosacral ligaments. The increased expression of NPY Y1 receptor may be related to local blood flow reduction and structural changes of pelvic supporting tissue.