Objective To analyze the association of polymorphisms of estrogen receptor (ER) α and β genes with systemic lupus erythematosus (SLE) in Chinese Han cohort of Yunnan Province.Methods XbaⅠ and Pvu Ⅱ of ERα gene,Rsa Ⅰ and Alu Ⅰ of ERβ gene were typed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) in 697 SLE patients and 638 healthy controls.The frequency distribution of the alleles and genotypes were analyzed by Hardy-Weinberg equilibrium test and x2 test.Results ① For ERα gene,the frequency of minor allele of Pvu Ⅱ C in SLE patients was significantly higher than healthy controls (x2=15.427,P=0.001);the allele frequencies of XbaⅠ in SLE patients showed no significant difference compared with healthy controls (P＞0.05).The frequency of minor genotype of Pvu Ⅱ CC in SLE patients was significantly higher than healthy controls (x2=17.371,P=0.011).The frequency of two locus haplotype AATT in SLE patients was significantly lower than healthy controls (x2=6.333,P=0.012);the frequency of the two locus haplotype AACC in SLE patients was significantly higher than healthy controls (x2=7.771,P=0.038).② For ERβ gene,the frequency of minor allele RsaⅠ A in SLE patients was significantly lower than healthy controls (x2=12.595,P=0.013);the allele frequencies of Alu Ⅰ in SLE patients showed no significant differences compared with the healthy controls (P＞0.05).The frequency of minor genotype AA of Rsa Ⅰ in SLE patients was significantly higher than healthy controls (x2=41.456,P=0.000).The frequency of two locus haplotype AAGG in SLE patients was significantly higher than healthy controls (x2=37.063,P=0.000).The frequency of the two locus haplotype AAGA in SLE patients was significantly lower than healthy controls(x2=21.086,P=0.001).③ Pvu Ⅱ C was related with splenomegaly (x2=4.212,P＜0.05).The two locus haplotype AGTC of Xba Ⅰ and Pvu Ⅱ was related with edema (x2=7.898,P＜0.05).Conclusion There are associations between the polymorphisms of ERα and ERβ genes and SLE.The ERα and ERβ genes may be the susceptible genes for SLE in Yunnan Han Chinese Cohort.

Objective To investigate the patients' radiation dose received in digital radiography (DR) and provide basic data for developing diagnostic reference levels.Methods The patient' s ESD was estimated using the TLDs and DAP was measured by the dose-area product meter.The E values were then calculated by the DAP using Monte Carlo data and RefDose software.Measurements were made for twelve types of examination:skull PA,skull LAT,chest PA,chest LAT,abdomen AP,pelvis AP,cervix spine PA,cervix spine LAT,thoracic spine PA,thoracic spine LAT,lumber spine PA and lumber spine LAT.Results Both kV and mAs varied in the same type of examination for ESD,DAP and E(F =33.47,24.68,43.19,P ＜ 0.05).The dose each time for lumber spine LAT was the highest,reached 4.62 mGy in ESD and 2.26 Gy·cm2 in DAP,respectively.The E of abdomen AP averaged as 0.59 mSv,higher than that of lumber spine LAT.Even for the same type of examination,the dose from each equipment was different.Conclusions DR has the potential to reduce the patients' radiation doses.The guidance levels suitable for Chinese population should be established as soon as possible.

Objective To evaluate the clinical value of 64-slice spiral CT,MRI + magnetic resonance cholangiopancreatography (MRCP) on suspected biliary obstruction.Methods Eighty-five patients with suspected biliary obstruction were examined by 64-slice spiral CT,MRI + MRCP,compared with the pathological results.The accuracy rate of CT,MRI + MRCP,CT + MRI + MRCP in evaluating the sites and nature of obstruction were calculated.Results The accuracy rate of evaluating the site of obstruction in CT was 96.5％ (82/85),MRI + MRCP was 97.6％ (83/85),difference was not statistically significant (P ＞ 0.05).The accuracy rate of evaluating the nature of obstruction in CT was 81.2％ (69/85),MRI + MRCP was 87.1％ (74/85),CT +MRI + MRCP was 94.1％ (80/85),there was no statistically significant difference between MRI + MRCP and CT with CT + MRI + MRCP (P ＞ 0.05),difference was statistically significant between CT and CT + MRI + MRCP (P ＜ 0.05).Conclusion A comprehensive analysis of CT,MRI + MRCP can increase the accuracy of diagnosis biliary obstruction.

Objective To discuss whether it is necessary to integrate metabolic indices into diagnosis of polycystic ovary syndrome(PCOS).Methods Taking ESHRE /ASRM diagnosis standard as gold standard,the case group composed of 51 women with PCOS and the control group composed of 47 women without PCOS were selected.By using classification tree C5.0,significant variables chosen by single factor analysis were used to establish a new diagnostic model which combined reproductive indices and metabolic indices.The validity and reliability of the new diagnostic model by using ROC curve analysis were evaluated.Finally,the consistence and difference between the new diagnostic model and the gold standard were analyzed.Results Single factor analysis chose 13 significant variables. ROC analysis showed an area under the curve of 0.930(P =0.000)and the optimal cut -off point was 0.190 with a sensitivity of 94.10%,a specificity of 91.50% and a consistency of 92.86%,which told us the new diagnostic model had superior validity and reliability.The two diagnostic methods had excellent consistence (Kappa =0.857,P =0.000)and there was no statistically significant difference (P =1.000).Conclusion Considering that whether metabolic indices are integrated into diagnosis of PCOS doesn′t change the diagnosis result,and it is unnecessary to integrate metabolic indices into diagnosis of PCOS.

Objective To investigate the characteristics of personal injuries in motorcycle accidents in Chongqing area to provide the reliable information and reference basis for reducing the injury and death risk of the motorcycle accidents.Methods Two hundreds and thirteen cases of motorcycle traffic accident occurred in Chongqing area from January 2015 to June 2016 were deeply collected,the collected contents included the basicinformation,driver information and personal injury,etc.Then accident data were statistically analyzed.Results The death rate of motorcycle drivers was higher than that of the pillion passengers.The death causes of craniocerebral injuries and craniocerebral injuries complicating thoracic and abdominal organ injuries accounted for 58.8％ and 20 ％ respectively,the proportions of head and neck,chest and back,lower extremity,upper extremity,abdominal and pelvic part and perineal part MAIS ≥2 were 71％,59％,33％,25％,20％ and 7％ respectively.The perineal injury rate of motorcycle drivers was higher than that of the pillion passengers.The ratio of occurrence rates between lower extremity fracture to upper extremity fracture was 1.8 ∶ 1,the persons in motorcycles-trucks accidents were easier to suffer from vehicle crushing.Conclusion Head and chest injuries are important causes leading to motorcycle drivers and pillion passengers' death and injury.The perineal injury can serve as an important basis for identifying the drivers and pillion passengers in partial motorcycle accidents.

Neuromyelitis optica (NMO) is an inflammatory-demyelinating disease of central nervous system that is characterized by severe attacks of optic neuritis (ON) and longitudinally extensive transverse myelitis (LETM).Conventional MRI is the most sensitive method in detection of NMO lesions in brain,spinal cord and optic nerve,which can objectively show the site,number,size and distribution of lesions.The MRI features of NMO lesion in brain,spinal cord and optic nerve lesions were reviewed in this article.

Objective:to culture excellent bachelor majoring in anesthesiology.Methods:to make teaching plan for practice in anesthesiological department with emphasis on following aspects:culture of emotional intelligence;development of the sense of responsibility for work;training of clinical thought to combine theory and practice and training of basic techniques;formation of good relationship and communication with the others and culture of scientific research ability.Results:All faculties execute the plan carefully,and all the interns graduate with clinical and research ability as expected.Conclusion:It is very important for ability improvement of interns to make and execute available plan,keep strict and careful attitude,train their clinical thought and basic techniques,and emphasis the sense of responsibility for work.

Objective To summarize the experience of establishing the stable rat model of chronic allograft nephropathy. Methods We used Fisher rats as donors and Lewis rats as recipients.After the left kidney of the donor perfused in situ under hypothermic condition, the left renal vein,abdominal aorta and bladder flap of the donor was anastomosed with the left renal vein, renal artery and bladder of the recipient, respectively. The recipients were given cyclosporin oral solution 10 mg/kg every day by gavage for 10 days after transplantation. The blood and urine samples were collected 1 month, 2 months and 4 months after transplantation and renal function and total urine protein were examined. The pathological changes of the renal allograft were observed 2 and 4 months after transplantation. Results Forty-five rats received operation and achievement ratio was 85%. The renal transplantations were finished in 120 ± 20 min. The Scr, BUN, Cycs and total urine protein demonstrated a significant increase one month after transplantation. On the second and fourth month,with the exception of urine protein continued to increase, the other indicators did not change significantly. Two months after transplantation renal pathology demonstrated light to moderate interstitial fibrosis, infiltration of lymphocytes and plasma cells. At 4th month the renal allografts showed extensive interstitial fibrosis, a large number of infiltrating interstitial cells, thickening,hardening, occlusion of glomerular basement membrane, and renal tubular atrophy that were consistent with pathological changes of chronic allograft nephropathy. Conclusion Through adequate surgical training and improvement, and specification for rat nephrectomy, transplantation surgery,and postoperative management in every detail, the model with high success rate and stability can be achieved.

Objective To evaluate the MR imaging and CT appearances of focal nodular hyperplasia (FNH) of the liver and improve the accuracy of diagnosis in FNH. Methods 6 patients with solitary FNH underwent MR exiamnation. Dynamic Gd-DTPA enhancement were performed in all the lesions. Of the 6 patients, three underwent CT plain and dynamic contrast scan; one underwent CT plain scan. More attention was payed to the atypical appearances. Results Atypical lesion appearances ineludod:apparent hypointensity on T1 WI and hyperintensity on T2WI,diffusly heterogeneous enhancement in arterial phase, pseudocapsule enhancement in delayed phase;the dynamic contrast MR and CT appearance in each phase were not all similar. Conclusion MR and CT especially dynamic contrast enhancemenl is of great value to the diagnosis of FNH. The atypical appearances of FNH shoud keep in mind to avoid misdiagnosis.

Objective To evaluate the influence of long-term nucleotide reverse transcriptase inhibitors (NRTIs) on lipids metabolism in HIV/AIDS patients and correlating clinical factors.Methods A total of 118 HIV/AIDS patients were divided into 3 groups:untreated group (40 patients),highly active antiretroviral therapy(HAART) for 1-2 years group (37 patients) and HAART over 5 years group (41 patients),with 20 healthy individuals as the control group.Clinical lipodystrophy (LD) was defined as concordance between patient's report of change and physical examination.Fat mass (FM) was measured by dual-energy X-ray absorptiometry (DXA).Results There was no significant difference in the incidence of LD between HAART for 1-2 years group and HAART over 5 years group (51.2％ vs 40.5％,P =0.345).The prevalence of LD was 2.4 folds with strvudine (d4T) treatment compared with zidovudine (AZT)-containing regimens (61.6％ vs 23.5％,P =0.001).Based on DXA measurements,FM of total body and limbs were significantly lower in the HAART over 5 years group than that in the control group,the untreated group and the HAART for 1-2 years group (P ＜ 0.05).Trunk FM was significantly lower in the HAART over 5 years group than the untreated group and the HAART for 1-2 years group (P ＜ 0.05).FM of total body and trunk were significantly lower in patients without LD in the HAART over 5 years group than patients without LD in the HAART for 1-2 years group (P ＜ 0.05).FM was correlated positively with body weight and BMI.Limbs FM was correlated negatively with peripheral blood triglyceride concentration.Conclusions HIV/AIDS patients with NRTIs therapy have high prevalence of LD,which mainly occurs 1-2 years after therapy,and increases with d4T treatment compared with AZT-containing regimens.There was no significant difference in the incidence of LD between the HAART for 1-2 years group and the HAART over 5 years group.FM was significantly decreased after long-term HAART in the patients with or without LD.DXA can evaluate LD objectively and guide further clinical treatment.