Objective To study the immune function of the subpopulation of T helper lymphocyte(Th), including Th1 and Th2 cells in myasthenic thymus and peripheral blood (PB).Methods Enzyme-linked immunospot (ELISPOT) method is adopted to detect the acetylcholine receptor (AChR)-reactive interleukin-2(IL-2)-, interleukin-4 (IL-4)-, interleukin-10 (IL-10)-, interferon-gamma(IFN-?)-secreting cell numbers in thymus and peripheral blood (PB). Results The AChR-reactive IL-2-,IL-4-,IL-10-, IFN-?-secreting cell numbers were increased in thymus as well as the AChR-reactive IL-10-, IFN-?-secreting cell numbers in PB. There is a positive correlation between thymus and PB in MG for the AChR-reactive IL-4-, IL-10-secreting cell numbers. After treatment, the AChR-reactive IL-2-,IL-4-, IFN-?-secreting cell numbers were decreased in PB, while there were 1 case and 2 cases showing a decrease and an increase in AChR-reactive IL-10-secreting cell number, respectively.Conclusions The immune dysfunction of the Th1 and Th2 subpopulation existed in the thymus and PB of MG, and the AChR-reactive IL-4-, IL-10-secreting cell numbers might be served as parameters to evaluate the degree of the immune dysfunction in the MG thymus. The role of the IL-10 in pathogenesis of MG needs further study.

Objective To describe the method and clinical result of super sural neuromusculocutaneous flap grafting plus catheter irrigation in the treatment for chronic lateral malleolus osteomyelitis. Methods From March 2000 to March 2008, 17 cases, male 14, femal 3, 21 to 75 years old (average 43-year-old),were underwent reversed saphenous musculocutaneous island flap after wide excision of lateralmalleolus lesion. The cause of lateral-malleolus lesions was trauma. The smallest flap was 5 cm× 6 cm and the largest was 7 cm × 11 cm. Catheter irrigation was used in all cases. Results Follow-up ranged from 12 to 96 months, average 49 months. After operation, the wounds were irrigated with sensitive antibiotics 1 to 2.5 months(average 49 days), and all flaps were survived. Except 2 cases, the other 15 were healed in 1 month.The 2 cases were not healed at first stage. According to the lab result,we changed the antibiotic, and in 2.5 months, we took off the catheter. Conclusion To deal with the chronic traumatic lateral-malleolus osteomyelitis, super sural neuromusculocutaneous flap grafting plus catheter irrigation is approprite and effective.

Objective To explore the effect of task-driven teaching methodology based on the action research on cardiopulmonary resuscitation training. Methods The 80 nurses recruited in 2011 were assigned in the control, receiving routine training while another 80 nurses recruited in 2012 were in the study group, where task-driven teaching methodology was used based on the action research. The two groups were compared in terms of results of theoretical and operational examinations. Result The study group was significantly better than the control group in the scores of theoretical and operational examinations ( P < 0 . 05 ) . Conclusion The task-driven teaching methodology based on the action research not only increases the examination results, but also improves the effect of teaching.

Objective To investigate the relationship between infection of Helicobacter pylori (HP) and early renal damage in type 2 diabetes.Methods Materials of 223 customer cases who received physical examination in our department were collected and analyzed.They were divided into two groups:HP positive group and HP negative group according to the HP infection.The basic information,blood lipid,lipoprotein,albuminuria of 24 hours,fibrinogen,C-reactive protein,erythrocyte sedimentation rate,and blood urea nitrogen and creatinine were compared between two groups,respectively.Results There was no significant difference in basic information,blood glucose,glycosylated hemoglobin and blood lipid (P ＞ 0.05).The results of lipoprotein,albuminuria of 24 hours,fibrinogen,C-reactive protein,and erythrocyte sedimentation rate in HP positive group were higher than those in HP negative group (P ＜ 0.05).Conclusions The infection of Helicobacter pylori played a part in the early renal damage of type 2 diabetes.

Objectives To explore the brain white matter integrity among the patients with buprenorphine tables,scopolamine and promethazine solution(BSP) dependence after abstinence.Methods BSP-dependent patients( n=16)and age/eduction-matched healthy control subjects ( n=18) were assessed by diffusion tensor imaging (DTI) after 3 days,1 month and 2 months of abstinence.White matter (WM) integrity was measured with DTI as fractional anisotropy ( FA),an index of intravoxel orientational coherence of white matter fibers.Results Compared with health controls,FA values were significantly lower in frontal,parietal,temporal and corpus callosum in the BSP addicts after 3-day withdrawal (P＜0.001,uncorrected).Increased FA values in left superior frontal cortex,right medial frontal gyms and fight inferior parietal gyrus were found in BSP users after 2 months of abstinence (P ＜0.001,uncorrected).However,no significant difference was found between these BSP addicts after 1-month abstince.Compared with health controls,BSP dependent subjects still exhibited significantly lower FA in the corpus callosum,frontal,parietal and temporal WM after 2-month withdrawal (P ＜ 0.001,uncorrected ).Conclusion The abnormalities showed less recovery in BSP dependent individuals with abstinence in white matter that suggests that rehabilitation time should be further prolonged for BSP addicts and emphasis cognitive-behavioral therapy to assist BSP abusers rebuild social functions.

Objective To investigate clinical interns' mastery and understanding status of medical core systems in order to provide reference for formulating training programs. Methods The questionnaires including medical core systems trained and self-assessment and test paper were de-signed. Then survey was carried out among 188 clinical interns of Grade 2009 of Zunyi Medical Col-lege at the end of training. All data were obtained, collected and analyzed with Excel and a SPSS 17.0. The result was described with percentage. Results ①78/41.34% and 117/62.33% clinical interns accepted training of medical core systems respectively before or during clinic training. 74/39.43%hos-pitals or 70/37.30% departments were systematically trained by medical core systems and the propor-tion of teachers who systematically or non-systematically explained medical core systems for clinical interns was 42/22.29%and 61/32.37%respectively.②The clinical interns who mastered first diagnosis responsibility systems, patient communication system, and systems of discussing difficult cases were 178/94.68%, 178/90.43%or 168/89.36%. The clinical interns who mastered rescue systems in critically ill patients, surgical classification management systems and audit system in clinical blood transfusion were 84/44.68%, 67/35.64%or 34/18.28%respectively.③8/6.90%interns fully grasped the core system of the medical situation. 165/87.71% and 165/83.43% clinical interns believed medical core systems should be mastered and 157 interns (83.43%) thought that mastering medical core system can help them better adapt to clinical medical work. Conclusion Systematic training of medical core system should be enhanced for clinical interns and mastering medical core systems is better for their future.

Objective To analyze the factors which influence the treatment compliance of hypertensive patients in health management. Methods Data of 6 325 hypertensive patients who received physical examination in our department were collected; 4 132 male cases and 2 193 female were included, their ages ranged from 28 to 84 years old;the average age was 61.2 ± 5.8 years. The patients of the health intervention group were randomly divided into 3 groups (group 1, group 2 and group 3). They were provided with regular health management (including weight management, catering management, sports management, medication management and monitoring of blood pressure), respectively, given different frequency of telephone follow-up (1 time per 2 months, 1 time per month, and 1 time per month), evaluating treatment compliance. All the results were analyzed and compared respectively according to the level of education, age and mental status. Data of 1 892 hypertensive patients who received outpatient services were enrolled as the control group. Among them, 4 132 were male and 2 193 were female, aged 28-84 years old, average (61.2 ± 5.8) years old. They received the traditional outpatient follow-up (outpatient service review and health education), their treatment compliance, timely correcting unhealthy lifestyle and medication method and self-testing blood pressure were evaluated. ANOVA and chi square test were used to analyze the treatment compliances and blood pressure control rates of the two groups. Result Compared with the control group, health intervention for hypertension patients could significantly improve the treatment compliance and blood pressure control rate(64.8%vs. 41.3%, 56.7%vs. 29.6%;χ2=2.827,1.382;P=0.032,0.007). Comparing the results of telephone follow-up frequency, the treatment compliance and blood pressure control rate of the 3 intervention groups were higher than those of the two other groups(77.3%vs. 65.4%, 51.7%,χ2=3.414,P=0.041;69.6% vs. 57.3%, 43.2%,χ2=2.763,P=0.028). The treatment compliance of patients with high education level was significantly higher than that of patients with low education level(68.7% vs. 59.1%, 46.4%,χ2=3.257,P=0.037;60.1%vs. 47.2%,32.8%,χ2=1.234,P=0.009). And the treatment compliance of patients with good mental state was significantly higher than that of patients with anxiety(Intervention group1:64.3%vs. 55.1%,41.9%,31.0%,χ2=2.257, P=0.016;59.4%vs.46.1%,20.9%,21.8%,χ2=3.34 5 P=0.021;Intervention group2:75.5%vs. 64.3%,51.8%,41.2%,χ2=2.932, P=0.030;68.3%vs.57.1%,39.2%, 32.1%,χ2=2.382, P=0.032;Intervention group3:86.5% vs.73.2%,62.6%,52.4%,χ2=2.435, P=0.026;75.2% vs. 68.0%,51.7%,43.3%,χ2=3.251, P=0.036). Conclusion More frequently follow-up can improve the treatment compliance and control rate of blood pressure in hypertensive patients;education, age and psychological condition are factors influencing treatment compliance in hypertensive patients.

Objective To examine the effect of risperidone on the mental symptoms after frontotemporal brain contu?sion. Methods Sixty cases with mental symptoms after frontotemporal brain contusion were recruited from Jan 2009 to Dec 2011 and were randomly divided into control group and treatment group. The patients in the control group were giv?en vitamin B1 60mg/d, while the patients in the treatment group were given risperidone 1mg/d. Both groups were treated for 1 month. Positive and negative symptom scale (PANSS) and symptom scale (TESS) were used to evaluate the efficacy and adverse reactions of treatment. Results The PANSS score was significantly lower in the treatment group than in con?trol group at 1, 2, 3 and 4 weeks following treatment(difference between groups:F=48.12 ,P<0.0001;Time difference:F=290.99 ,P<0.0001; Interaction between group and time: F=11.91,P<0.0001 ). After time-adjustment, the PANSS score was significantly lower in the treatment group than in control group at 2, 3 and 4 weeks following treatment. In the course of treatment, the patients in both groups had varying degrees of headache, nausea, weight gain and Beckoning. These side effects were alleviated through symptomatic treatment. Conclusion Risperidone can significantly improve psy?chiatric symptoms in patients with frontotemporal brain contusion with satisfactory safety.

In order to investigate the species and categorization of Gasterophilus in Ili horse.We analysised the COI gene of the identified Gasterophilus dominant species and constructed NJ phylogenetic tree in the study.The results showed that infection rate was 100％ in total of 16 775 the third phase Gasterophilus instar larvae.Four Gasterophilus species were identified,and showed serious mix infections.Dominant species were Gasterophilus nasalis,its relative dominance were 53.17％,and prefer to live in the cardia,others to irregular live in the pylorus of the horses.COI gene homology of GasterophiIus nasalis,Gasterophilus intestinalis,Gasterophilus pecorum,Gasterophilus haemorrhoidalis (GenBank Accession No.:GU265752.1,KR230402.1,KU578262.1,KT946620.1) were 99％,99％,99％ and 100％ respectively.Phylogenetic analysis results showed that the data were clustered with the Gasterophilus app.which publshed on the GenBank.G.intestinalis and G.haemorrhoidalis cluster together first,and then cluster with G.nasalis,at last all three kinds of Gasterophilus cluster with G.pecorum.When the COI gene is the target,in-group and out-group of the Gasterophilus can forms an independent evolutionary branch.This study provides useful parameters for the classification of Gasterophilus.

Objective:To analyze and summarize the clinical features of pyogenic liver abscess (PLA) patients treated in 10 years, so as to provide evidence to improve current diagnosis and corresponding treatment strategies of PLA.Methods:The clinical symptoms, signs, laboratory and imaging findings, etiology and different treatments as well as corresponding efficacy and prognosis of PLA patients treated in Xiangya Hospital of Central South University during January 2010 to December 2019 were retrospectively analyzed.The chi-square was used to evaluate the differences of the categorical variables.Results:A total of 528 PLA cases were included in this study.Diabetes mellitus (46.8%, 247/528), biliary tract diseases (34.7%, 183/528) and previous hepatobiliary surgery history (19.7%, 104/528) were three most common risk factors leading to PLA. Fever (80.9%, 427/528), loss of appetite (53.6%, 283/528) and abdominal pain (51.9%, 274/528) were most common clinical manifestations. The accuracies of ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) were 95.5%(472/494), 97.0%(384/396), and 96.8%(92/95), respectively. The positive rate of pus culture (70.9%, 168/237) was higher than that of blood culture (20.0%, 42/210), and the difference was statistically significant ( χ2=115.746, P<0.01). The top three most common bacteria were Klebsiella pneumoniae (122 strains), Escherichia coli (29 strains) and Enterococcus faecium (10 strains). The drug resistance rate of Klebsiella pneumoniae to ampicillin was as high as 97.4%(112/115). The treatment programs included 200 cases of sole antibiotic treatments. Based on the antibiotic treatment, imaging guided percutaneous puncture therapy was the most commonly used treatment (45.6%, 241/528), included imaging guided percutaneous puncture and drainage (29.0%, 153/528) and imaging guided percutaneous catheterization (16.7%, 88/528). The surgical treatments included surgical catheter drainage (5.5%, 29/528) and surgical hepatectomy(11.0%, 58/528). The total number of cured cases was 495, and the cure rate was 93.8%. Conclusions:The common clinical manifestations of PLA are fever, loss of appetite, abdominal pain. Ultrasound is a routine and effective method to detect liver abscess. Klebsiella pneumoniae is the most common pathogen. Imaging guided percutaneous puncture is the most common treatment.