Objective To investigate the histological injury as well as the risk factors for the course of HBeAg-negative chronic hep-atitis B virus( HBV)-infected patients with persistently normal alanine aminotransferase ( ALT) levels ( PNAL) . Methods Ninty four patients of HBeAg-negative chronic HBV-infected with PNAL were performed liver puncturing. The ALT, HBV markers, and liver histo-logical changes were detected. The gender, age, family history, HBV-DNA and HBsAg levels were compared between different patients with liver inflammation and fibrosis. And the Logistic model was used during the analysis of independent risk factor. Results Among 94 cases, patients with inflammatory necrosis classification≥G2 accounted for 74. 5%, fibrosis grading≥S2 accounted for 27. 7%. Patients in the group of inflammatory necrosis classification≥G2 was older than the group of < G2, and the ALT level of≥G2 group was higher, as well as a higher HBV-DNA. What is more,Patients in the group of inflammatory necrosis classification ≥G2 were mainly male, and were associated with a family history of hepatitis B. Patients in the group of fibrosis stage ≥S2 was older than < S2 group, and the ALT level of fibrosis stage ≥S2 group was higher. And those patients were often associated with a family history of hepatitis B, but there was no significant difference among the HBV-DNA level and gender constitution. HBV-DNA and family history were the independent risk fac-tors of liver inflammation necrosis≥G2, and family history was the only independent risk factor of fibrosis stage≥S2. Conclusion The patients of HBeAg-negative chronic HBV-infected with PNAL, regardless of the ALT and HBV-DNA, must have a liver biopsy. The pa-tients with high level of HBV-DNA and with a family history of hepatitis B should be performed liver puncturing accordingly.

BACKGROUND: The early symptoms of amyotrophic lateral sclerosis (ASL) are usually located at a certain part of the body, and are similar to the clinical manifestations of cervical spondylotic myelopathy (CSM). However, their treatment and prognosis differ greatly. Therefore, multiple-part electromyography and electroneurography possess an important value of reference, particularly electromyography of thoracic paraspinal muscles can be used as an objective parameter for differentiation between ASL and CSM.OBJECTIVE: To investigate the electrophysiological changes in ASL and CSM.DESIGN: A retrospective clinical analysis.SETTING: Neurological Department of Second Hospital Affiliated to Jiangxi Medical College.PARTICIPANTS: Totally 30 inpatients and outpatients with ASL and 30 patients with CSM were selected from the Neurological Department of the Second Hospital Affiliated to Jiangxi Medical College between December 2001 and November 2004.METHODS: Totally 30 inpatients and outpatients with ASL as well as 30 inpatients and outpatients with CSM were subjected to routine electromyographic and electroneurographic examination. Routine electromyography examining three limb muscles + sternocleidomastoid + thoracic paraspinal muscles intended to observe the spontaneous potential at resting stage, time limit and wave-amplitude of motor unit potential, and recruit-ment phase during energetic contraction. Electroneurography was used to detect motsr conduction velocity and sensory conduction velocity,as well as the terminal latency and wave-amplitude of motor evoked potential.limb muscles, sternocleidomastoid and thoracic paraspinal muscles in paASL and SCM.RESULTS: Data of all the 60 patients entered the final statistical analysis.in patients with ALS and CSM, and were more severe in the former. The abnormality rate of spontaneous potential of thoracic paraspinal muscles reached 93.3% (28/30) as compared to 3.3% (1/30) in patients with CSM (P ＜ 0.001). The average time limit and abnormal increment of wave amplitude of motor unit potential were significantly different in patients with conduction velocity: The decrease rate of motor evoked potential amplitude of complex muscles was obviously higher in ASL than in CSM (75.6% and 86.7%, ~=7.25, P ＜ 0.01). So was the decrease rate of motor conduction sory nerve conduction velocity: It was not affected either in ASL or CSM.ALS and CSM, but the abnormality rate of spontaneous potential of thorography indicates that nerve conduction velocity was not affected in both playing decreased conduction velocity and wave amplitude than those with CSM.

Objective This is a feasibility study of rabbit meniscus regeneration evaluated with the use of autologous bone marrow derived mesenchymal stem cells(MSCs) and collagen glycosaminoglycan(GAG). Methods Autologous MSCs were prepared from the rabbit proximal tibial bone marrow and stimulated in vitro to start fibrocartilage differentiation lineage by bFGF and TGF ? 1. Then, collagen GAG templates enriched with these MSCs were implanted in vivo to the menisci excised rabbit knees as the substitute for the excised meniscus. After 3, 6, 12, 24 weeks postoperatively, the implants were evaluated by the gross, histological and ultrastructural observations. Results The MSCs enriched collagen GAG implants underwent inflammation, degradation, MSCs division and remodeling stages in vivo, and consequently formed a meniscus like fibrocartilage tissue. Special staining and electronic microscope observation proved that the regenerated fibrocartilage were chondrocyte like fibrochondrocytes; in contrast, the results of the control group showed that both collagen GAG implants without MSCs and no substitute had limited regenerating tissue, further evaluations by histological and electronic microscope showed no evidence of fibrochondrocytes, and hence these regenerated tissue were fibrous rather than fibrocartilaginous. Conclusion The inducing of rabbit meniscus regeneration by the autologous bone marrow derived MSCs and porous collagen GAG template is proved to be feasible in this study. However, further studies to improve the biomaterial design, to evaluate the biomechanical properties of the regenerated tissue and to ensure clinical safety etc are needed prior to its clinical application.

Objective To investigate the clinical significance of central venous oxygen saturation (ScvO2) monitoring in the patients after cardiac operation.Methods Fifty patients after cardiac operation were randomly selected into this study.After the patients entered ICU 2 h,ScvO2,mixed venous oxygen saturation (S(v)vO2),lactate (Lac) were detected at the same time and oxygen extraction rate (O2ER) was calculated.Fifty patients were divided into three groups according to the level of ScvO2,group A (ScvO2 ＜0.65,23 patients),group B (ScvO2 0.65-0.75,18 patients),group C (ScvO2 ＞ 0.75,9 patients).The correlation among ScvO2,S(v)vO2,O2ER were analyzed.The correlation between ScvO2 and Lac in each group were calculated.The level of Lac in three groups were compared.The incidence rate of complications,ventilator time and ICU stay time were compared.Results The level of ScvO2,S（v）O2,O2ER,Lac in 50patients were 0.656 ±0.086,0.639 ±0.081,0.356 ±0.084,(2.6 ± 1.3) mmol/L.The level of ScvO2 had significantly positive correlation with S(v)O2 (r =0.688,P ＜ 0.01),and had significantly negative correlation with O2ER (r =-0.640,P ＜0.01).In group A,the level of Lac had significantly negative correlation with ScvO2 (r =-0.772,P ＜ 0.01).In group C,the level of Lac had significantly positive correlation with ScvO2 (r =0.717,P ＜ 0.05).In group B,the level of Lac had no significant correlation with ScvO2 (r =-0.358,P ＞0.05).The level of Lac in group A and group C was significantly higher than that in group B [(2.0 ± 0.9),(4.8 ±2.1) mmol/L vs.(1.6 ±0.5) mmol/L] (P ＜0.05 or ＜0.01).The incidence rate of hyoxemia,low cardiac output syndrome and renal functional lesion in group A were significantly higher than those in group B (P ＜ 0.05).The incidence rate of liver functional lesion and renal functional lesion in group C were significantly higher than those in group B (P ＜ 0.05).The ventilator time and ICU stay time in group A andgroup C were significantly longer than those in group B (P ＜ 0.05).Conclusions ScvO2 is an ideal index to judge oxygen equilibrium in early period after cardiac operation.The lower and supranormal ScvO2 both suggest tissue hypoxia,resulting in increased postoperative complications and prolonged treatment.

0.05). CONCLUSION: There are no significant differences in cell characteristics and transplantation outcome using OB-OEC and OM-OEC transplantation for repairing neurological function.

Objective To analyze the risk factors of hypoxemia after coronary artery bypasses grafting (CABG) along with cardiopulmonary bypasses and to understand the regular pattern and characteristics of hypoxemia after CABG. Methods The risk factors of hypoxemia were studied by one way analysis and multivariate logistic regression analysis in 86 patients with hypoxemia after CABG along with cardiopulmonary bypass. Results One way analysis indicated that hypoxemia after CABG along with cardiopulmonary bypass was related to senility ( ≥ 65 years ), smoking history, diabetes mellitus, chronic obstructive pulmonary disease ( COPD), left ventricular ejection fraction ( LVEF ＜ 45 % ), obesity before operation, transfusion ( ≥ 1000 ml );multivariate analysis indicated that pulmonary dysfunction before operation, longer extracorporeal circulation time ( ≥2 h), hypoalbuminemia and pulmonary infection were independent risk factors of hypoxemia after CABG along with cardiopulmonary bypass. Conclusion Multiple risk factors contributed to hypoxemia after CABG along with cardiopulmonary bypass. Increase the awareness of risk factors of perioperative hypoxemia may guide the prevention and treatment, even alleviate or avoid the hypoxemia postoperatively.

Objective: To synthesize the collagen-GAG template and to evaluate its feasibility to be used as the MSCs vehicle for meniscal tissue engineering. Methods: The collagen-GAG template was synthesized from rat tail type Ⅰ collagen and GAG using Yannas method. Then the post-stimulated MSCs by bFGF and TGF-β1 were added in. The MSCs-enriched collagen sponges were cultured in vitro， two weeks later the histological and ultrastructure detection was performed. Results: The histological and ultrastructure of the collagen-GAG template remained intact after 2 weeks' culture, and the MSCs in it remained viable. Conclusion: The collagen-GAG template synthesized in this experiment is suitable for the meniscal tissue engineering reconstruction as the vehicle for MSCs seed cells.

Objective To study the impacts of variation of folate metabolic component including folic acid (FA), riboflavin (RF) and MTHFR C677T polymorphism on chromosome 8 and 17 segregation. Method RPMI1640 medium was modified with different combinations of low (LF) and high (HF) concentrations of folic acid (20, 200 nmol/L) and low (LR) and high (HR) concentrations of riboflavin (1 and 500 nmol/L). The lymphocytes with different MTFHR C677T genotype were cultured in the mentioned media for 9d. Cytokinesis was blocked by cytochalasin B and the slide was prepared as usual. The frequencies of aneuploidy of chromosomes 8 and 17 were determined by dual-color fluorescence in situ hybridization (FISH). Results The frequencies of both chromosome aneuploidy were significantly higher in low FA (LFLR+LFHR) than that in higher FA (HFLR+HFHR) (P

Objective To implement hypothermia during blood purification to investigate its effect and risk in the treatment of postoperative cardiogenic shock in valvular heart disease.Methods A non-blinded prospective randomized controlled trial (RCT) was conducted.Patients with valvular heart disease suffering from postoperative cardiogenic shock admitted to intensive care unit (ICU) of Wuhan Asian Heart Hospital from January 2011 to December 2014 were enrolled,and they were randomly divided into normothermic continuous blood purification (CBP) group (NT group) and hypothermia C BP group (HT group) according to random number table and envelope enclosed method.The patients in both groups were given continuous renal replacement therapy (CVVH),the blood temperature in NT group was remained at 36.5-37.3 ℃,and it was controlled at 34.0-35.0 ℃C in HT group.The data were collected before and 1,2,3 days after treatment,including cardiac index (CI),the oxygen supply/oxygen consumption ratio (DO2/VO2),acute physiology and chronic health evaluation 1Ⅲ (APACHE Ⅲ) score,multiple organ dysfunction (MODS) score.The length of ICU stay,duration of mechanical ventilation,duration of CBP,ICU mortality and the incidence of complication were recorded.Results A total of 95 patients were enrolled,with 47 patients in NT group,and 48 in HT group.There was no significant difference in gender,age,preoperative cardiac function,cardiothoracic ratio and type of valve replacement between two groups.Compared with those before treatment,no significant difference Was found in CI,DO2/VO2 ratio,APACHE Ⅲ score,MODS score on 1,2,3 days after treatment in NT group (all P ＞ 0.05).But in HT group,DO2/VO2 ratio was significantly improved on 1 day after treatment (2.5 ± 0.7 vs.1.8 ± 0.4,P ＜ 0.05),CI (mL·s-1·m-2:50.01±8.34 vs.31.67±11.67),APACHE Ⅲ score (50.6±6.2 vs.77.5±5.5),and MODS score (6.0± 1.5 vs.9.3±3.4) were significantly improved 3 days after treatment (all P ＜ 0.05).Compared with those in NT group,DO2/VO2 ratio in HT group was significantly increased from 1 day after treatment (2.5 ± 0.7 vs.1.8± 0.4,P ＜ 0.05),and CI (mL·s-1·m-2:38.34 ± 10.00 vs.35.01 ± 6.67),APACHE Ⅲ score (68.9 ± 7.1 vs.81.2 ± 7.3),and MODS score (8.9± 2.7 vs.10.6 ± 2.4) were significantly improved from 2 days after treatment (all P ＜ 0.05).In respect of clinical outcomes,compared with NT group,the length of ICU stay (days:6.9 ± 3.4 vs.12.5 ± 3.5,t =2.024,P =0.017) and duration of mechanical ventilation (days:4.2± 1.3 vs.7.5±2.7,t =1.895,P =0.034) in HT group was significantly shortened,duration of C BP was also significantly shortened (days:4.6 ± 1.4 vs.10.5 ± 4.0,t =2.256,P =0.019),and ICU mortality was significantly lowered (12.50％ vs.23.40,x2 =1.987,P =0.024),but there was no significant difference in incidence of infection (54.17％ vs.53.19％,x2 =0.689,P =0.341),ventricular arrhythmia (31.25％ vs.36.17％,x2 =0.772,P =0.237),and muscle fibrillation (14.58％ vs.8.51％,x2 =0.714,P =0.346),and blood loss (mL:617.0±60.7 vs.550.9±85.2,t =1.290,P =0.203) between HT group and NT group.The incidence of bradycardia in HT group was significantly higher than that of the NT group (29.17％ vs.14.89％,x2 =2.368,P =0.029).Conclusion Blood purification under hypothermia is a safe and effective therapeutic procedure for postoperative cardiogenic shock in patients with valvular heart disease,and it may improve the prognosis of postoperative patients.

Objective To explore a more effective way to enhance the clinical efficacy of cluster immunotherapy for perennial allergic rhinitis. Methods A total of 60 perennial allergic rhinitis patients were evenly randomized into treatment goup and control group. The two groups were given cluster immunotherapy, and the treatment group was given daily vesiculating moxibustion additionally . Before and after treatment, the scores of traditional Chinese medical constitution and the rhinitis quality of life ( QOL) were observed, and one year after treatment, the therapeutic effect and safety were evaluated. Results ( 1) One year after treatment, the treatment group showed better total clinical efficiency than the control group ( 96.67% vs 80.00%, P<0.05). ( 2) After treatment, the average scores of Qi deficiency constitution, yang deficiency constitution and special constitution were significantly lower than those before treatment in the treatment group ( P<0.01). The improvement of Qi deficiency constitution and yang deficiency constitution in the treatment group was superior to that in the control group ( P<0.05). ( 3) The total QOL scores and the scores of each dimension of QOL scale were improved in both groups, and the differences were significant except for the emotion dimension ( P<0.01). Insignificant differences were shown between the two groups after treatment ( P>0.05). ( 4) Two cases had grade 1 general adverse reaction and 5 cases had local adverse reaction during cluster immunotherapy. During vesiculating moxibustion, 3 cases had blistering and the blistering disappeared after symptomatic treatment. Conclusion Daily vesiculating moxibustion combined with cluster immunity therapy is effective for the treatment of allergic rhinitis, showing good effect on improving Qi deficiency constitution, yang deficiency constitution and special constitution as well as the quality of life of the patients.