Objective To increase the appreciation of manifestations in autoimmune pancreatitis (AIP) and to decrease misdiagnosis rate by investigating the clinical characteristics of AIP. Methods Clinical data were collected and laboratory ,imaging and histopathology were analyzed from the Chinese PLA General Hospital from 1995 to 2009. Patients with AIP were included in the study. Results Eight patients (male 6, female 2) aged 35-69 (52.4 ±9.4) years were diagnosed as AIP from 2006 to 2009. The main clinical manifestations include intermittent jaundice in 6 cases (6/8), abdominal pain in 5 cases (5/8),weight loss in 4 cases (4/8), and accompanied with other diseases of immune system in 4 cases (4/8).The imaging showed head of pancreas enlargement in 3 cases (3/8) and whole pancreas enlargement in 5 cases (5/8). There is a "banana-peel like" ring around the pancreas and irregular stenosis of pancreatic duct. Massive lymphocytes and plasma cells infiltration and parenchymal fibrosis were shown in pancreatic tissues, bile duct,salivary gland and liver in pathology. Clinical manifestations, laboratory examinations and images in 7 cases (7/8) were improved after treatment with prednisone. Twenty-two of them were misdiagnosed as pancreatic or biliary carcinoma and 21 were performed laparotomy in the period of 1995-2005 ( 23 cases). After 2006, however, the misdiagnosis rate significantly decreased from 95.7% ( 22/23 ) to 0. Conclusions AIP seems to be a systemic autoimmune disease rather than an isolated disorder,markedly overlapping with other autoimmune diseases. Definitive diagnosis can be improved by the detection of immune parameters and pathological examination.

Objective To investigate the expression and the roles of Angiopoietin 1(ang-1) and Angiopoietin 2(ang-2) in the endometrium of women with abnormal bleeding after medical abortion. Methods Analyzing endometrial pathological change of 1087 patients with abnormal bleeding after medical abortion in early pregnancy,and the endometrial specimens from 40 patients were randomly chosen for the study. The endometrial specimens from 20 women without abnormal bleeding after medical abortion were used as control group.Immunohistochemistry was used to detect the levels of Ang-1 and Ang-2 proteins in endometria. Results The percentage of patients with both the residul decidua and villus was 80.5%; positive immunoreactive signals of Ang-1 and Ang-2 were found in the endometrial glandular epithelium, stromal cells and the endothelial cells of vessels; the expression rate of Ang-1 and Ang-2 in the patients with abnormal bleeding were higher than that in the control group(P

Objective To investigate the efficacy of the clinical pathway introduced in children with Mycoplasma pneu-moniae pneumonia (MMP). Methods Based on a retrospective study, the length of hospital stay, hospital expenses and curative rate were compared between 145 MMP patients managed according to clinical pathway and other 45 MMP patients. The causes of variation were analyzed in the clinical pathway group as well. Results The length of hospital stay in clinical pathway group [9 (6~10) days] was significantly shorter than that in the control group [10 (7-12.5) days] (P=0.003). The curative rate (93.8%) was significantly higher than that in the control group (84.4%) (P=0.043). The hospital expenses [4 696.5 (3 608.3-5 677.6) CNY] was significantly higher than that in the control group [3175.3 (2490.8-4585.0) CNY] (P<0.001). The variation rate of clinical pathway was 48.3%(70/145 cases) in clinical pathway group. Conclusions The curative rate is improved and the length of hospital stay is shortened after the clinical pathway is introduced in MMP children. However, there is a high variation rate in the clinical pathway. It is necessary to optimize the clinical pathway before it is adapted in clinic.

Objective To investigate facial-cervical index difference in undergraduates of different height or weight in Han nationality to provide an additional reference for plastic surgery of facialcervical region.Methods Subjects consisted of 200 college undergraduates of Han nationality,aged 20 to 24 years,with average 22.9 ± 1.7,of whom 100 were male and 100 were female.Their height,weight,bizygomatic breadth,facial height,cervical height,neck circumference,neck breadth,shoulder width,cervical-mandibular angle,thorax-cervical angle,shoulder-cervical angle,pulvinar-cervical angle and back-cervical angle were measured and calculated.Results The differences among the indices mentioned above were of statistical significance (P＜0.05);the indices of female subjects of different height were significantly different (P＜0.05);the differences in indices of male subjects of different weight were of statistical significance (P＜0.05);the indices of female subjects of different weight were also statistically different (P＜0.05).The facial-cervical indices in both male and female subjects of different height or weight were of no stistical difference (P＞0.05).Conclusions Male subjects of different height or weight have different cervical height,cervical-mandibular angle,neck height and facial height indices are different;hence,the indices are related to body height;female subjects of different body height have different neck height.Subjects of different weight have different neck circumference,neck breadth,should breadth,shoulder-cervical angle and pulvinar-cervical angle.

OBJECTIVE To observe bacterial distribution and drug resistance in Ningxia.METHODS The patients with nosocomial infection mornitored by Ningxia Hui Autonomous Region Nosocomial Infection Surveillance System from Jan 2003 to Dec 2007 were analyzed and summarized.RESULTS Amomg 3276 isolates,1752 strains(53.48%) were Gram-negative bacilli,1471 strains(44.9%) were Gram-positive cocci and,53(1.62%) fungi.The most common pathogens were Escherichia coli(909),Staphylococcus aureus(509),S.epidermidis(260),Enterococcus faecalis(258),and Pseudomonas aeruginosa(206).Most of them were multidrug resistant.Most strains of Gram-negative bacilli were highly susceptible to imipenem,while most strains of Gram-positive cocci were highly susceptible to vancomycin.CONCLUSIONS Most pathogens of nosocomial infection are multidrug resistant,the resistance detection of bacteria has an important significance to clinical treatment and infection control.

Objective To investigate the radioresistant effects of pprI gene of Deinococcus radiodurans on BALB/c mice.Methods Male BALB/c mice in SPF level were applied for this work.The pEGFP-c1 plasmid and pEGFP-c1-pprI gene recombinant plasmid were transferred into anterolateral muscle of mice with in vivo electroporation technology.The mice were irradiated by 6 Gy 60Co γ-rays in whole body and the mortality of mice was observed within 30 days after irradiation.In addition,the mouse were irradiated with 4 Gy γ-rays and then the peripheral blood cell number,apoptosis rates of thymocyte cells,spleen cells and bone marrow cells were observed in the days of 1,7,14,28 and 35 after irradiation while the histopathological changes of lung and testis were observed in the days 7 and 28 after γ-ray irradiation.Results The highest gene transfection efficiency of muscle cells was obtained in a Plasmid injection amount of 50 μg/50 μl and electric field strength of 200 V/cm.The acute radiation mortality of pEGFP-c1-pprI gene recombinant plasmid transfer group was 30％,lower than that of irradiation group (60.0％) and pEGFP-c1 plasmid transfer group (63.3％) after 6 Gy γ-ray irradiation (x2 =4.90,6.24,P ＜ 0.05).Compared with the irradiation group and pEGFP-c1 plasmid transfer group,the WBC count of pEGFP-c1-pprI gene recombinant plasmid group in peripheral blood of mice was significantly higher in the days of 1,7,14 and 28 (F =16.26,8.10,6.37,10.74,P ＜0.05),PLT count was significantly higher in days of 7 and 14 (F =7.36,5.71,P ＜ 0.05),meanwhile the lymphocyte percentage was increased significantly on the 7th day (F =18.43,P ＜ 0.05) after irradiation.On the other hand,the apoptosis rates of thymocyte cells and bone marrow cells were significantly decreased in the days of 1,7,14,28 and 35 (F =3.88,14.91,14.14,39.86,5.65,P ＜0.05 and F=53.70,11.75,21.78,41.40,4.54,P ＜0.05) while the apoptosis rate of spleen cells was significantly decreased in the days of 1,7,14 and 28 (F =97.95,56.61,33.55,14.71,P ＜0.05) after irradiation.Finally,the radiation histopathological changes of lung and testis of the pEGFP-c1-pprI gene recombinant plasmid group were slight and easy to recover.Conclusions Transfection of pprI gene of Deinococcus radiodurans by in vivo electroporation has significant protective effect on the acute radiation injury in BALB/c mice,which may have important clinical applications.

Objective To construct the eukaryotic expression vector of pprI gene from Deinococcus radiodurans R1 and investigate its radioresistant effects in eukaryotic cells.Methods A recombinant vector pEGFP-c1-pprI was constructed by DNA recombinant technique.The empty vector pEGFP-c1 and the pEGFP-c1-pprI were transferred into human lung epithelial cells Beas-2B by LipofectamineTM 2000,respectively.Then the infected cells were screened in order to develop a cell line with stable expression of pprI gene.Cell survival rate was tested by clone-forming assay.Cell cycle distribution and apoptosis were detected by a flow cytometry.The fluorescence intensity of reactive oxygen species (ROS) was observed by a fluorescent microscope.γ-H2AX foci in the irradiated cell was detected by immunofluorescence.Results The eukaryotic expression plasmid of pprI prokaryotic gene was constructed and PprI fusion protein was expressed in human lung epithelial cells successfully,and the cell line (2BG) with a stable pprI gene expression was established.After irradiation,the cell survival fraction of 2BG cells was significantly higher than Beas-2B cells so that the value of D0 、Dq and N of the survival curve were increased.Moreover,the fluorescence intensity of ROS and the number of γ-H2AX foci in 2BG cells were also lower than those of B eas-2B cells(F =16.73,19.47,6.94,P ＜ 0.05).Between these two cell lines,the apoptosis rate and cell cycle G2 arrest also had significant difference (F =139.73,237.92,P ＜ 0.05).Conclusions The pprI gene from Deinococcus radiodurans RI can be stably expressed in the eukaryotic cells and it allows the transferred cells to have a radioresistant function.

Objective To develop the improved monitoring and evaluation system of adverse drug reaction during infusion in clinic and emergency department,and investigate the effect of this system.Methods To develop monitoring and evaluation system of adverse drug reaction,which was consistent with the medical safety (adverse) event reporting,and running it.The system consisted of organizational structure,knowledge training,event reporting and processing,data analysis,quality control and continuous improvement.We collected the observed indicators of the cases of adverse drug reaction,quality and network reporting time pass rate,which were compared with those of the conventional system.Results One year during the improved system running,the cases of adverse drug reaction in clinic and emergency department infusion was reduced,the quality of reporting and handling significantly improved,network report pass rate increased.Conclusions Improved monitoring and evaluation system of adverse drug reactions has some significance in safety management of clinic and emergency department infusion,which is worthy of promotion in clinical work applications.

Objective To investigate the expression of lung keratinocyte growth factor receptor (KGFR) in rats with acute spinal cord injury (ASCI) in different time points and its role in lung edema.Methods Thirty-two adult Wistar rats weighing 240 g to 260 g were assigned to experimental group (n =16) and control group (n =16) according to the random number table.Each group consisted of time points of 24 hours,3 days,1 week and 2 weeks after the modeling (4 rats per time point).A rat model of ASCI in experimental group was induced at C7 segment by dropping a weight of 10 g from the height of 2.5 cm (Allen' s method).In control group,laminas were removed only,leaving spinal cord at C7 intact.Rats were sacrificed at each time point for measurement of lung wet/dry weight ratio,Western blot analysis of expression of lung KGFR protein and RT-qPCR detection of lung KGFR mRNA expression.Results After ASCI in rats,the expressions of lung KGFR protein and mRNA began to drop at 24 hours (0.23 ±0.06,0,012 1 ±0.002 3),reached the trough at 3 days (0.17 ±0.04,0.008 5 ±0.001 7)and picked up at 1 week.Expression of lung KGFR mRNA in experiment group showed statistically significant difference from that in control group at 24 hours and 3 days (P ＜ 0.05),whereas in each time point the difference of KGFR protein expression between experiment and control groups was statistically significant(P ＜0.05).Variation trend of KGFR expression was in parallel with the severity degree of pulmonary edema.Conclusion Lung KGFR presents significant down-regulation in ASCI rats and this may be associated with the development of pulmonary edema after ASCI.

Objective To investigate incidence,diagnosis and treatment strategy of delayed esophageal complications after anterior cervical spine surgery.Methods The clinical data of 2316 patients who had undergone anterior cervical spine surgery from January 2001 to December 2011 were analyzed.The delayed esophageal complications were defined as esophageal perforation,esophago-tracheal fistula,esophago-cutaneous fistula,diverticulum of esophagus,esophagopleural fistula and esophageal stenosis that occurred 2 weeks after spine surgery.Results Delayed esophageal complications occurred in 4 patients,and the incidence was 0.17％.Esophageal perforation occurred in 2 patients; the incidence was 0.09％.Case 1 was a 31-year-old man who was found to have esophageal diverticulum and perforation 7 years after anterior cervical spine surgery.Then he underwent removal of implant,excision of diverticulum,and repair of esophagus with sternohyoid muscle flap and omohyoid muscle flap.Case 2 was a 46-year-old man who was found to have esophageal diverticulum 3 years after cervical spine surgery.He also underwent removal of implant,excision of diverticulum,and repair of esophagus with sternohyoid muscle flap and omohyoid muscle flap.Case 3 was a 58-year-old woman who was found to have esophageal diverticulum 5 years after cervical spine surgery.She underwent removal of implant,excision of diverticulum,and repair of esophagus with sternocleidomastoid muscle flap.Case 4 was a 56-year-old woman who was found to have esophageal perforation 3 years after cervical spine surgery.She underwent removal of implant and repair of esophagus with sternocleidomastoid muscle flap.All 4 patients recovered after operation.Conclusion The incidence of delayed esophageal complications after anterior cervical spine surgery is low,and the diagnosis is difficult.X-ray,digestive tract radiography,and gastrointestinal endoscopy are the main diagnostic tools.Surgical treatment is the main and effective management.