OBJECTIVE:To study the relevance between HLA-B27 gene and ankylosing spondylitis in Jiangxi province,and to discuss the diagnostic significance to ankylosing spondylitis.METHODS:A total of 1246 patients with suspected ankylosing spondylitis and related diseases were collected from the First Affiliated Hospital of Nanchang University from October 2007 to December 2008.Among all cases,323 were diagnosed as ankylosing spondylitis,and other 923 were rheumatoid arthdtis or related diseases.A total of 135 healthy subjects were collected as control group.Sequence-specific primer-polymerase chain method(PCR-SSP)was used to detect HLA-B27 gene in 1246patients and 135 healthy controls.The distribution of HLA-B27 gene,correlation between HLA-B27 gene and age,and relation between ankylosing spondylitis and HLA-B27 gene were studied.RESULTS:Total positive rate of HLA-B27 gene was 32.5%in 1246 patients with suspected ankylosing spondylitis.3.7%in 135healthy controls.and 91.6%in 323 patients with ankylosing spondylitis,respectively.The positive rate and incidence rates of male were significantly higher than female(P＜0.01)and mainly concentrated in the age of adolescence.The sensitivity of HLA-B27 genewas 91.64%and the specificity was 88.19%in patients with ankylosing spondylitis.CONCLUSION:HLA-B27 gene was highly correlated with ankylosing spondylitis in Jiangxi province,which was the same as other regions,suggesting that HLA-B27 gene is significance for diagnosis of ankylosing spondylitis in an eedy phase.

Objective To examine the effect and mechanism of different targets of glucose control on liver damage in rats with sepsis .Methods The rat sepsis model was established by cecal ligation and puncture (CLP) .Forty Sprague‐Dawley rats were randomly divided into five groups (eight rats to each group):sham operation (sham group) ,sepsis (CLP group) ,glycemic control A group (glucose target 4 .6‐6 .1 mmol/L ) ,glycemic control B group (glucose target 6 .2‐8 .3 mmol/L ) and glycemic control C group (glucose target 8 .4‐10 .0 mmol/L) .The animals were sacrificed 12 hours after CLP .Venous blood was sampled for testing alanine transaminase (ALT ) , aspartate transaminase (AST ) and free fatty acid (FFA ) . Peroxisome proliferator activated receptor‐α (PPAR‐α) and liver carnitine palmitoyltransferase 1 (CPT‐1 ) protein were determined by immunohistochemistry .The pathological changes of liver tissue was observed under an optical microscope .Results The levels of ALT ,AST and FFA in venous blood and the pathological tissue injury score in sepsis groups were higher than those in sham group and all glycemic control groups (P<0 .05) .However ,the level of these markers significantly decreased in group A than those in group B or group C (P<0 .05) ,and lower in group B than those in group C (P< 0 .05) .PPARα and liver CPT‐1 expression levels were lower in sepsis group than those in sham group and all glycemic control groups except group C (P>0 .05) .The levels of PPARαand liver CPT‐1 were significantly higher in group A than in group B or group C (P<0 .05) ,and lower in group C than in group B(P<0 .05) .Conclusions The lowest target of glucose control(4 .6‐6 .1 mmol/L)shows better protective effects on liver damage in rats with sepsis ,the mechanism of which may be related to upregulation of PPARα and liver CPT‐1 expression .

OBJECTIVE Study the role of mycoplasma infection and expression of Ki67 protein in the pathogenesis, development and prognosis of laryngeal carcinoma. METHODS Immunohistochemistry method was used to study 145 specimens of laryngeal carcinoma tissues, 25 specimens of precarcinoma tissues, 31 specimens of vocal cord polyps and 15 specimens of normal tissues adjacent to laryngeal carcinoma. RESULTS ①The positive rates of PD4 and Ki67 were 45.52%(66/145) and 82.76 % (120/145) in laryngeal carcinoma tissue, 16.00 % (4/25) and 32.00 % (8/25) in precarcinoma tissue, 12.90 % (4/31) and 22.58 % (7/31) in vocal cords polyps, 6.67 % (1/15) and 0 (0/15) in normal tissues adjacent to laryngeal carcinoma. ②The positive rates of PD4 and Ki67 were higher in the advanced laryngeal carcinoma cases than that in the early laryngeal carcinoma cases. The positive rates of PD4 and Ki67 were higher in laryngeal carcinoma cases with cervical metastasis than that laryngeal carcinoma cases without cervical metastasis(P

With more and more non-affiliated hospitals of universities joining the clinical teaching of infectious diseases,there have been some dilemmas on clinical teaching,such as the shortage of staff,teaching experience,poor lecture art and teaching enthusiasm,textbook lag,the shortage of case teaching abd students'fear of infectious disease etc. Countermeasures such as perfecting the organizational structure,formulating preferential policy,clearing historical mission,increasing students' interest in learning,adding new academic progress,enriching teaching methods,setting up experts'supervision will ensure the effective teaching quality.

The significance for specialized hospital's resident physicians participating in the standardized clinical resident training in general hospital is expounded and its existing prob-lems are pointed out.It is suggested that the administration division should give full play to subjective initiative,coordinate problem solving and improve training quality,and meanwhile speciality hospitals should make an active effort in the application for national subspeciality physician training base.

Objective To evaluate the role of β-arrestin-1 in penehyclidine hydrochloride (PHC)-induced inhibition of lipopolysaccharide (LPS)-caused increase in pulmonary microvascular permeability in human pulmonary microvascular endothelial cells (PMVECs).Methods Human PMVECs were seeded in 6-well plates (2 ml/well) or in culture flasks (4 ml/flask) at the density of 1 × 105 cells/ml and divided into 5 groups (n=15 each) using a random number table:empty plasmid transfection group (group C),LPS plus empty plasmid transfection group (LPS group),PHC plus LPS plus empty plasmid transfection group (P+LPS group),LPS plus β-arrestin-1 short hairpin RNA (shRNA) transfection group (LPS+shRNA group) and PHC plus LPS plus β-arrestin-1 shRNA transfection group (P+LPS+shRNA group).In LPS and LPS+shRNA groups,the cells were transfected with empty plasmid 1.5 μg or with plasmid containing 15 nmol/L β-arrestin-1 shRNA,LPS with the final concentration of 0.1 μg/ml was added at 24 h of incubation,and the cells were then incubated for 1 h.In P+LPS and P+LPS+shRNA groups,the cells were transfected with empty plasmid 1.5 μg or with plasmid containing 15 nmol/L β-arrestin-1 shRNA,PHC with the final concentration of 2 μg/ml was added at 24 h of incubation,LPS with the final concentration of 0.1 μg/ml was added at 1 h of incubation,and the cells were then incubated for 1 h.The cell permeability was measured using Transwell chambers.The expression of heat shock protein (HSP27) was detected by immunofluorescence.The expression of β-arrestin-1,p38 mitogen-activated protein kinase (p38MAPK) and phosphorylated p38MAPK (p-p38MAPK) was detected by Western blot.The ratio of pp38MAPK/p38MAPK was calculated.Results Compared with group C,the cell permeability was significantly increased,the expression of HSP27 was up-regulated,p-p38MAPK/p38MAPK ratio was increased,and the expression of β-arrestin-1 was down-regulated in LPS,LPS + shRNA and P + LPS + shRNA groups (P＜0.05),and no significant change was found in the parameters mentioned above in group P+LPS (P＞ 0.05).Compared with group LPS,the cell permeability was significantly decreased,the expression of HSP27 was down-regulated,p-p38MAPK/p38MAPK ratio was decreased,and the expression of β-arrestin1 was up-regulated in group P +LPS,and p-p38MAPK/p38MAPK ratio was significantly increased (P＜0.05),and no significant change was found in the other parameters in group P+LPS+shRNA (P＞0.05).Compared with group P+LPS,the cell permeability was significantly increased,the expression of HSP27 was up-regulated,p-p38MAPK/p38MAPK ratio was increased,and the expression of β-arrestin-1 was down-regulated in group P+LPS+shRNA (P＜0.05).Conclusion The mechanism by which PHC inhibits LPS-induced increase in pulmonary microvascular permeability is totally related to β-arrestin-1 in human PMVECs.

Objective To explore the cause of and treatment for psychiatric complications developed in the early stage after liver transplantation. Method The clinical data of 125 patients who underwent liver transplantation in our hospital were analyzed retrospectively. Results There was no significant difference in gender,age,liver function and the blood cyclosporine A level between psychiatric complication (PC) patients and those without PC. The anhepatic time and the total operation time of the PC group were longer than that of the non-PC group ( P

A total of 104 patients with polycystic ovarian changes on ultrasound were divided into polycystic ovary syndrome (PCOS) and polycystic ovaries (PCO) groups according to their clinical symptoms and endocrine examinations.And 40 women with normal ovulation served as the controls.Ovarian volume (OV),ovarian stroma area (SA),ovarian total area (TA) and SA/TA ratio were measured by transvaginal uhrasonography.Their endocrine hormone levels were determined.Patients with PCOS showed significantly higher OV,SA,TA and SA/TA than those of PCO and control groups.SA/TA was positively correlated with testosterone.The median serum levels of anti-Mullerian hormone (AMH) and inhibit B in the PCO group were intermediate between those in control and PCOS groups.AMH and inhibin B of PCOS were higher than the PCO and control groups.It indicated that the levels of AMH and inhibit B were associated with the degree of polycystic ovaries and they could be used to differentiate PCOS and PCO.SA/TA is associated with the elevated serum testosterone of PCO.And SA/TA is an important ultrasonic parameter for diagnosing PCOS.

OBJECTIVE:To investigate the improvement of the optimization of Hospital information system(HIS)for the hos-pital pharmacy. METHODS:Based on management practive of the hospital and relative national requirements,the improvement and optimization of HIS function was achieved by pharmacists and software engineers. The effects of its optimization on pharmaceu-tical care were also introduced,involving hospital drug supply,pharmaceutical administration and monitoring of rational drug use. RESULTS & CONCLUSIONS:HIS has new functions,such as web query of secondary drug inventory,electronic management of narcotic and psychotropic drugs,electronic prescription comments,color code for TCM incompatibility management,antibiotics re-porting,etc. Compared with previous system,optimized system is more perfect in terms of full inventory tracking,web query of the drug batch number,web query of supply information,electronic management of purchasing invoice,prescription comments and monitoring of rational drug use. It decreases workload of pharmacist greatly,and increases work efficiency and accuracy. Continu-ous optimization of HIS can improve pharmaceutical care,and play an importance role on the safety,rationality and effectiveness of drug use in patients.

Objective To analyze the clinical profile and short-term postoperative prognosis of mixed hepatocellular carcinoma and cholangiocarcinoma (mHCC-CC). Methods Clinical data of 17 mHCC-CC cases undergoing hepatectomy were retrospectively analyzed. Results Patients average age was 53 years (27～76 years).There were 11 males (64.7％) and 6 females.Ten patients (58.8％) were asymptomatic,twelve patients(70.6％ ) had positive serology for hepatitis B infection,serum AFP levels ＞25 ng/ml in 12 cases. Serum CA199 levels ≥ 37 U/ml in 4 cases. All patients underwent radical hepatectomy,including ＞ 1.5 cm safe margin and lymphadenectomy.The 6-,12-,and 18-months overall survival rate was 93.8％,86.5％ and 57.7％,respectively.The 100- and 200-day disease-free survival was 65.3％ and 43.5％.The median disease-free survival was 161 days. Conclusions mHCC-CC is difficult to diagnose preoperatively.The diagnosis depends on pathological examination.The main treatment was surgical resection.The prognosis of mixed primary liver cancer is poor and tends to recur early after hepatectomy.