Medical equipment plays a critical role in the development of modern hospital,which should be exerted all effects so that they could bring more economic and social benefits.Scientific ways of management are put forward.In practice,the problems in management system are solved,and the target of "the quality and benefit via management" is met.

Objective To investigate the pregnancy outcome of gestational intrahepatic cholestasis.Methods 70 pregnant women with intrahepatic cholestasis were selected as the study group.70 healthy pregnant women during the same period were selected as the control group.The pregnancy outcomes of two groups were compaind.Results (1) The maternal serum levels of bile acid,alanine aminotransferase,aspartate aminotransferase in study group were (65.61 ± 13.5) μmol/L,(134.31 ± 24.7) U/L,(97.35 ± 21.54) U/L,which were higher than those of the control group (3.34 ± 0.41) μ mol/L,(36.16 ± 4.15) U/L,(23.34 ± 4.45) U/L,and the differences were statistically significant(P ＜0.01).(2) In study group,the incidence rate of maternal gestational hypertension was 21.42％,premature rupture of membranes was 17.14％,incidence rate of postpartum hemorrhage was 15.71％,which were significantly higher than 7.14％,5.71％,4.29％ in the control group,the differences were statistically significant(P ＜ 0.05).(3) In study group,the incidence rate of neonatal asphyxia was 27.14％,therate of amniotic fluid contamination was 35.71％,fetal distress was 22.86％ and 30.00％ of the childrenwith low birth weight,whichwere higher than those of the control group,the differences were statistically significant(P ＜0.01).Conclusion Pre gnancy intrahepatic cholestasis can increase the incidence rate of perinatal complications,has serious impact on the prognosis of the fetus,and to strengthen the monitoring of pregnancy intrahepatic cholestasis has important clinical significance.

Objective To explore the effect of Radix Isatidis( indigowoad root,RI) polysaccharide on NO and ET-1 in orthopotic liver autotransplantation of rats.Methods The rats used in the experiment were randomly divided into three groups:normal control group (NC), autotransplantation group (AT) and RI polysaccharide group (RIPS).At 1, 6, 12 and 24 hours after autotransplantation, the content of NO,ET-1, alanine aminotransferase ( ALT), and aspartate amin-otransferase ( AST) in serum was assayed.Morphological observation of hepatic tissues was also performed.Results The serum level of ET-1 in RIPS group was significantly lower than that of AT group (P<0.05), and NO content in serum of RIPS group was increased significantly compared with AT group ( P<0.05) at 1, 6, 12 and 24 hours after autotransplanta-tion.The serum level of ALT and AST in RIPS group was lower than that of AT group (P<0.05) at each measurement point.The morphology of hepatocytes changed abnormally under light microscopy.The blood stasis and swelling of hepatic tissues, denaturalization and necrosis of hepatocytes in RIPS group were milder than that in AT group.Conclusion RIPS has a protective effect on hepatic ischemia reperfusion injury after orthotopic liver autotransplantation, which may be related to increased NO levels and lower levels of ET-1.

OBJECTIVETo explore the clinical efficacy and effect mechanism on chronic urticaria treated with moving cupping therapy combined with autohemotherapy with acupaint injection for desensitization at acupoints.

METHODSOne hundred and four patients of chronic urticaria were randomized into a comprehensive therapy group and a medication group, 52 cases in each one. In the comprehensive therapy group, the moving cupping therapy along the governor vessel and bladder meridian of foot-taiyang was applied combined with autohemotherapy with acupaint injection for desensitization at acupoints. The self-venous blood was injected at bilateral Quchi (LI 11) and Zusanli (ST 36), 1 mL at each acupoint, once every 3 days. In the medication group, cetirizine tablets, 10 mg were prescribed for oral administration, once every day, and the compound dexamethasone acetate cream was used externally, once to twice a day. The clinical efficacy: was observed in 30 days of treatment in the two groups. The changes of serum interleukin 4 (IL-4) and immunoglobulin E (Ig E) before and after treatment were observed. The recurrence rate was compared between the two groups in 3 months after treatment.

RESULTSThe cured and markedly effective rate was 90.4% (47/52) in the comprehensive therapy group, which was higher obviously than 78.8% (41/52, P < 0.05) in the medication group. The levels of serum IL-4 and IgE were reduced in the patients of the two groups, indicating the significant difference in comparison before and after treatment (all P < 0.01) and the reducing degree in the comprehensive therapy group was much more significant than that in the medicine group (both P < 0.01). The recurrence rate was 19. 1% (9/47) in the comprehensive therapy group in the 3-month follow-up after treatment, and apparently lower than 51.2% (21/41, P < 0.01).

CONCLUSIONThe moving cupping therapy combined with autohemotherapy with acupaint injection for desensitization at acupoints achieves the better efficacy on chronic urticaria compared with the routine western medicine treatment and the recurrence rate is low. The effect mechanism is possibly related to the down-regulation of serum IL-4 and IgE in the patients.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Biological Therapy ; Chronic Disease ; therapy ; Combined Modality Therapy ; Female ; Humans ; Immunoglobulin E ; blood ; Interleukin-4 ; blood ; Male ; Urticaria ; blood ; therapy ; Young Adult

Objective To investigate characteristics of endometriotic lesions clone with various pathological subtypes by analyzing the polymorphism of X chromosome linked human androgen receptor allele (HUMARA). Methods Eight frozen tissues of endometriotic leisons were collected from 6 patients who received laparotomy or laparoscopy surgery in Peking Union Medical College Hospital from Nov. 2008 to Jun. 2009. Fifty specimens of epithelial cells from single endometrial glands were isolated and collected from endometriotic lesions by using laser capture microdissection. HUMARA was applied as the gene marker of clonal analysis. Nested palymerase chain reaction, double-enzyme digestion reaction with two methylationsensitive restriction endonuclease (Hha Ⅰ and Hpa Ⅱ), and the automated gene sequencing technique were utilized in this study to evaluate the characteristics of endometriotic lesions clone. Results Of 50 specimens of isolated glands, 34 were informative for clonal analysis, and all of which showed monoclonality. Of 3 ovarian endometriotic tissues, one tissue of HUMARA showed unuseful information, the other 2 ovarian endometriotic tissues respectively had 4 and 7 informative specimens of gland epithelial cells, and all of the glands from each tissue showed uniform clonal pattern. Two peritoneal endometriotic tissues had 1 and 5 informative specimens from individual glands, respectively; and the clonal patterns in 5 glands from the single lesion were divergent. Two abdominal wall endometriotic tissues had 7 and 6 informative specimens,respectively; and variable clonal patterns were seen in different glands from each lesion. One deep infiltrating endometriotic lesion had 4 informative specimens of isolated glands, and all of them showed unique clonal pattern. The disparate clonal patterns were found in endometriotic lesions with variable pathological subtypes, even arising from the same patient. Conclusions The epithelial cells from individual endometriotic gland showed monoclonality , and different glands from the same endometriotic lesion might show divergent patterns.

Objective To study the clinic features and risk factors of bladder cancer occurrence after radical nephroureterectomy of urothelial carcinoma of the upper tract.Methods 61 cases of urothelial carcinoma of the upper tract from March 2013 to December 2013 in Beijing Friendship Hospital are retrospectively studied.31 patients are male,while the other 30 patients are female.Age of them ranges from 43 to 90 years old,and the average age is 69 years old.17 patients are accompanied with diabetes.32 patients are accompanied with hypertension.12 patients have the history of chronic nephrosis.7 patients have the history of renal transplation operation.47 patients have the symptom of hematuresis.16 patients have the symptom of lumbago.Body mass index ＜ 18.5 kg/m2 2 cases,18.5 ～ 22.9 kg/m2 25 cases,23.0 ～ 24.9 kg/m2 10 cases,25.0 ～ 29.9 kg/m2 20 cases,≥ 30.0 kg/m2 4 cases.25 patients' serum creatinine is abnormal,while the other 36 patients'is normal.36 patients have left tumors,while the other 25 patients have right tumors.39 patients have hydronephrosis before operation.25 patients go through ureteroscopy.11 patients have the concurrence of bladder cancer preoperatively.25 patients have renal pelvic carcinoma,while the other 36 patients have carcinoma of ureter.14 patients have multiple tumors,while the other 47 patients just have single tumors.The size of tumor ranges from 0.5cm to 8.0cm,and the average size is 2.9cm.27 patients have the cauliflower-like tumors,while the other 34 patients have other shaped tumors.28 cases have the positive results of cytology,while the other 33 cases donl have.6 patients go through cystoscopic operation of ureterovesical junction,while the other 55 patients go through open operation of ureterovesical junction.Kaplan Meier analysis is used to find univariate risk factors of the bladder cancer occurrence postoperatively,and Log-rank test is used after that.Cox regression analysis is used to identify the independent risk factor from all the univariate risk factors.Results Time of surgery ranges from 2.0 hours to 7.5 hours,and the average time is (4.9 ± 1.2) hours.39 patients' tumors are equal or greater than T2 stage,while the other 22 patients'tumors are less than T2 stage.2 patients have Ⅰ grade tumors,40 patients have Ⅱ grade tumors,and the other 19 patients have Ⅲ grade tumors.12 patients go through systematic chemotherapy,while the other 49 patients don l.23 patients go through intravesical instillation postoperatively,while the other 38 donl.Follow-up time of 61 cases ranges from 22 months to 31 months,and the average time is (27.3 ± 2.7) months.3 to 30 months after radical nephroureterectomy,21 cases(34.4％) have bladder cancer occurrence.4 of patients who have concurrence of bladder cancer preoperatively go through the occurrence of bladder cancer(57.1％,4/7),and 17 of patients who dont have concurrence of bladder cancer preoperatively go through the occurrence of bladder cancer(3 1.5％,17/54).8 of patients with multiple tumors go through the occurrence of bladder cancer(57.1％,4/7),while 13 of patients with a single tumor go through the occurrence of bladder cancer(27.7％,13/47).18 of patients who have tumors equal or greater than T2 stage have the occurrence of bladder cancer(46.2％,18/39),while 3 of patients who have tumors less than T2 stage have the occurrence of bladder cancer(13.6％,3/ 22).3 of patients with postoperative intravesical instillation have the occurrence of bladder cancer(13.0％,3/23),while 18 of patients without postoperative intravesical instillation have the occurrence of bladder cancer(47.4％,18/38).Single factor analysis shows that preoperative concurrence of bladder cancer(P =0.003),multiple tumors (P =0.044),T stage (P =0.023) and postoperative intravesical instillation (P =0.002) have significant influence on the occurrence of bladder cancer.And Cox proportional hazards regression model analysis shows that the preoperative concurrence of bladder cancer (RR =2.860,P =0.024,regression coefficient =1.051) and postoperative intravesical instillation (RR =0.201,P =0.011,regression coefficient =-1.065) are significantly related to the occurrence of bladder cancer after radical nephroureterectomy.Conclusions The preoperative concurrence of bladder cancer and postoperative intravesical instillation are the independent risk factors of the bladder cancer occurrence after radical nephroureterectomy.And the preoperative concurrence of bladder cancer is a risk factor,while the postoperative intravesical instillation is a protective factor.

Objective We report the pathological features of lung in the dead patients with severe acute respiratory syndrome (SARS). Methods Post-mortem lung and pulomonary hilar lymph nodes tissues of 3 patients dead from SARS were studied by histology and immuhistochemistry with rabbit anti-Fas polyclonal antibody, mouse anti-PCNA, mouse anti- CD83,mouse anti-CD4 and mouse anti-CD8 monoclonal antibodies. Results The surface of lung from 3 cases were shown red or purplish red color. Histopathological examination showed that diffuse interstitial exudative or leakage inflammation and alveolar damages with a pronounced increase of of monocytes in the interval at various levels of progression and severity. There were hyaline-membrane formation, desquamation and apoptosis of type-2 pneumocytes in alveolar spaces. Fibrin thrombus and thrombo-embolism could be found in blood capillary and bronchial artery respectively. We observed some fibrin deposition in alveoli interval. No obviously giant-cell infiltrate within the alveolar lumen. The positive cell of proliferative cell nuclear antigen (PCNA) was rare. Fas antigen were expressed in a lot of type-2 pneumocytes, monocytes of the interval and pulomonary hilar lymph nodes. Comparison with the lymph nodes of chronic inflammation, there were obviously disorganization and attenuation of lymphocyte in lymph nodes of SARS. The proportion of CD4 positive lymphocytes were rare, but CD83 and CD8 positive lymphocyte seemed no decreased, relatively. The seminal changes such as decreased lymphocytes ,white pulp atrophy,hemorrhage and necrosis,and decreased expression of lymphocytes for CD4 antigen could also observe in spleen. Conclusions Severe damages of lung and immunological system damages might lead to death of patients with SARS.

Objective To observe pulmonary fibrosis in severe acute respiratory syndrome (SARS) and to discuss the mechanisms of pulmonary fibrosis in SARS. Methods Hematoxylin and Eosin staining (H&E), histology staining and immuno-histochemical staining (SP methods) were used to investigate the lungs from 4 autopsy cases. Antibodies against collagen type Ⅲ, ?-smooth muscle actin(?-SMA), Fas, FasL and transforming growth factor ?1(TGF-?1) were used for immunohistochemical studies. Results All these four lung tissues showed different degree of pulmonary fibrosis, including the organization of exudative fibrin, glomerulus-like fibrosis in alveolar spaces, the thickening of the alveolar septum, proliferation of fibroblasts, the hyperplasia of collagen fibers and the consolidation of lungs. Sirius red staining and collagen type Ⅲ staining showed the type Ⅲ and the type Ⅰ collagen fibers were the main components of the hyperplastic collagen fibers. ?-SMA were expressed in fibroblasts, immunoreactivity to Fas, FasL, TGF-?1 were all positive and located in plasma of pneumocytes, macrophages and lymphocytes. Conclusions The pulmonary fibrosis can be observed early in SARS patients and the pathogenesis may be involved in the co-effect of many effective cells, inflammatory mediators and cytokines.

AIM: To amplify and analyze the differential DNA fragment between pathogenic leptospira serovar lai and nonpathagenic leptospira serovar patoc I. METHODS: The previously subtractive DNA fragment only existing in leptospira serovar Lai was amplified by cassette ligation and semi-nested PCR.The obtained gene was sequenced and searched homologically. In addition, the deduced amino acid was analyzed and the secondary stracture of protein was predicted. RESULTS: The 580 bp DNA fragment, which deposited in GenBank (AF495587), was cloned, and four overlapping open reading frames (ORF) was contained. The high homology with conserved hypothetical protein streptococcus pyogenes was found. CONCLUSION: This study lays foundation for deeply exploring biological actions of new gene and pathogenic mechanism of leptospira serovar lai.

Objective To investigate the clinical, pathological and imaging features of sporadic Creutzfeldt-Jakob disease (CJD). Methods The clinical, pathological, electroencephalogram (EEG) and imaging data of 12 cases of CJD were analyzed retrospectively.Results (1) 7 cases of the enrolled patients were male and 5 were female. The average onset age of them was 49 years old. 3 cases were acute onset by visual loss and 9 cases were subacute onset by hypophrenia, mental and behavior disorder or cerebellar ataxia. All the cases showed dementia, myoclonus and extrapyramidal sign. (2) 9 cases showed typical triphasic wave on EEG and 1 case presented atypical triphasic wave. (3) 5 cases showed abnormal hyperintense lesions in basal ganglia on T 2-weighted images (T 2WI). 8 cases in occipital and/or frontal cortex showed the abnormal hyperintense lesions on diffusion-weighted images (DWI), and 5 of them accompanied symmetric diffuse hyperintense lesions in basal ganglia. (4) 1 case with postmortem and 6 cases with biopsy of brain showed classic pathological features of CJD.Conclusion On the base of typical clinic manifestations, EEG and DWI examinations are useful in early diagnosis of sporadic CJD.