Objective To apply the theory basis for effectively preventing and treating rotavirus infection by studying on specific humoral immune response in children with rotavirus diarrhea. Methods Seventy-five patients of children (diarrhea group ) and 45 controls (control group) were selected. The antigen and specific antibody in plasma and stool were detected by ELISA method;the type of viral gene was confirmed by reverse transcription PCR method;the expression of mRNA in peripheral blood mononuclear cell was measured by fluorescent light quantitation PCR method. Results In diarrhea group, rotavirus G typing to G3 dominated, accounting for 77.3% (58/75), P sub-type to P8 mainly, accounting for 82.7% (62/75). Rotavirus-specific antibody titers of plasma in diarrhea group were significantly higher than those in control group, IgA antibody titers of stool increased significantly, not only higher than that in control group and plasma. The percentage of CD19+ cells in diarrhea group [(30.8 ± 7.9)%] was significantly higher than that in control group [(23.1 ± 7.7 )%] (P = 0.009 ). And the proportion of CD4+ cells decreased significantly (P = 0.005 ), the expression level of IL- 12p40 mRNA in the entire process in diarrhea group was significantly higher than that in control group(P＜ 0.01 ). Conclusion Children with acute rotavirus infection early in the immune response to specific humoral immunity, especially mucosal immune to significantly improve the main features.

Objective Two Chinese pedigrees with congenital factor Ⅻ(FⅫ)deficiency were enrolled in the present study,and studies on the clinical manifestations,family survey,biochemical examinations and gene diagnosis of these pedigrees were performed.Methods In October 2014-2015 March,two cases of hereditary FⅫ deficiency patients were included in Xinhua hospital.Activated partial thromboplastin time(APTT),FⅫ procoagulant activity(FⅫ:C),FⅫ antigen(FⅫ:Ag)and other parameters of coagulant were detected.The FⅫ deficiency pedigree members,exons 1-14,boundary introns including the splice junctions of the F12 gene were amplified with polymerase chain reaction(PCR).Direct sequencing was exerted to purified PCR product to detect the gene mutation.If the gene mutations were found,polymorphism should be ruled out by directing sequence.One hundred and three healthy persons as normal controls.Results The two probands were manifested prolonged APTT(101 s and 143 s).They showed lower FⅫ activity and FⅫ antigen(2％and 6％,0.4％and 4％,respectively).FⅡ:C,FⅦ:C,FⅧ:C,FⅨ:C,FⅩ:C and Fg are normal in the two probands.LAC is negative.Proband 1 has c.1285C>T(p.Q429 stop)mutation.His parents and son have the heterozygous mutation in the same position.Proband 2 has c.1556T>C(p.L519P)mutation.Her two sons have the heterozygous mutation in the same position.In the promoter regions of F12 gene,there were common 46C/T and 619 G/C polymorphisms in two pedigrees.Conclusion c.1285C>T(p.Q429 stop)and c.1556T>C(p.L519P)are the cause of FⅫ deficiency.

Objective To retrospectively investigate the effects of CYP3A5 * 3,CYP3A4 * 18B and CYP3A5-CYP3A4 phenotype on the C0,D and C0/D of tacrolimus (Tac) in renal transplantation recipients.Methods The CYP3A5 * 3 and CYP3A4 * 18B genotypes of the 61 patients were detected by DNA direct sequencing,and the C0 was detected by ELISA.The differences of C0,D and C0/D on the day 14,and month 1,2 and 3 after transplantation were compared among different genotypes of recipients treated with Tac.Results The frequency of the CYP3A5 * 3 and CYP3A4 * 18B was 74.6％ and 26.2％ respectively.When the D of the recipients with CYP3A5 * 1 ( * 1/* 1 + * 1/* 3)was 1.3-1.6 times to theCYP3A5*3/*3,theC0 of *3/*3 group was 1.1-1.5 times to the * 1group,and the C0/D was 1.8 2.4 times to the CYP3A5 * 1.For CYP3A4,the D of CYP3A4 * 18B group ( * 1/* 18B+ * 18B/* 18B) was 1.2-1.5 times to the CYP3A5 * 1/* 1,but the C0 of 1/* 1was 1.2-1.4 times to the * 18B,the C0/D was 1.5-1.8 times to the * 18B.For the CYP3A5 CYP3A4 phenotype,the D of the recipients with AAAA was 1.3-1.7 times to the GG-GG,the C0 of GG-GG was 1.5-2 times to the AA-AA,the C0/D of the recipients with G@GG was 2.5-3 times to the AA-AA.In the recipients with C0/D above or below the median of C0/D,the distribution of CYP3A5,CYP3A4 and CYP3A5-CYP3A4 phenotypes was different significantly.Conclusion There is a significant correlation between the CYP3A5,CYP3A4 and pharmacokinetics of Tac.It's more powerful evaluating the CYP3A5-CYP3A4 phenotype rather than just one genotype of the recipients.So detecting the CYP3A5 * 3 and CYP3A4 * 18B genotypes prior to transplantation is meaningful for us to determine an appropriate initial and long-time dosage of Tac.

Objective To develop a optimized rehabilitation protocol for acupuncture, Tuina and ultrasonic treatments of upper limb motor dysfunction after cerebral infarction.Methods An orthogonal design with three factors (acupuncture as factor A, Tuina as factor B and ultrasound as factor C) and two levels was used. Eighty cerebral infarction patients with upper limb motor dysfunction were randomly allocated to eight groups, 10 cases each. The National Institute of Health Stroke Scale (NIHSS) score and the simplified Fugl-Meyer Assessment (FMA) score for upper limb motor function were recorded after four weeks of treatment. Results There were no statistically significant pre-treatment differences in the NIHSS score and the FMA score for the upper limb between the groups (P>0.05). For an improvement in NIHSS, factors A and B were both significant (bothP<0.05); there was no statistically significant difference in factor C between the two levels (P>0.05). Factors A, B and C were all significant for an improvement in the FMA score for the upper limb (P<0.05,P<0.01,P<0.05). A2B1C1 was the optimal protocol.Conclusions A combination of bilateral acupuncture, Tuina and ultrasound is an optimized protocol for treating upper limb motor dysfunction after cerebral infarction. It can effectively reduce upper limb motor dysfunction.

Objective To investigate the clinical effects of tube flushing in donor duodenum to prevent the hematuria post combined pancreas-kidney transplantation(SPK)with pancreatic fluid drainage through bladder.Methods 18 cases of diabetic patients associated with end-stage renal disease were subjected to combined pancreas-kidney transplantation with pancreatic fluid drainage through bladder,within which 12 cases were pre-placed douche tube in donor duodenum,while the other six were not.As for the cases in group with the tube,T tube of No.10 was put in the donor duodenum through the abdominal wall and then bladder.After that the tube was fixed using 5-0 absorbable suture,then the bladder sutured if the tube was smooth confirmed by flushing with saline.After the operation,flushing was maintained using saline consecutively with the speed of 500 ml/h through the douche tubes of these 12 patients.Then the speed was changed to 250 ml/h 3 days later if the flushing fluid was limpid.One week later,changed to rinse intermittently and prolonged the flushing interval gradually.Till 14 days post the operation,flushing was ceased.After 2 days' survey,the urethral catheter was removed.As for the other 6 cases without douche tube,the urethral catheter was removed during 7-10 days after the operation if hematuria didn't occur.Results In the 12 cases with douche tube,there was only one patient(8.3 %,1/12)having slight hematuria on the 7th day after the cessation of the bladder washout.Through strengthening the flushing,the hematuria disappeared.The urethral catheter was removed on the 14th day after the operation and the hematuria never happened again.In the group without the douche tube,4 cases(66.7 %,4/6)had serious hematuria complicated with bladder obturation.The incidence of that was obviously higher than in the group with the douche tube(P＜0.05).Only one patient(1/12,8.3%)in the group of regular insertion of douche tube had urinary system infection,but in the group without the tube,the incidence of urinary system infection was 66.7 %(4/6)(P＜0.05).Conclusion The tube flushing in donor duodenum can significantly reduce the occurrence of hematuria after combined pancreas-kidney transplantation with pancreatic fluid drainage through bladder.

Objective To study the diagnostic and distinguishing diagnostic value in primary hepatic carcinoma (PHC)and metastatic hepatic carcinoma (MHC)by the serum sialic acid (SA)detection.Methods During January 2012 to June 2014, 100 cases of patients with PHC,91 cases of patients with MHC,155 cases of benign liver disease patients,and 139 healthy people in Wuyi Traditional Chinese Medicine Hospital were included into the study.The concentration of serum SA and AFP were detected by chemical enzymatic method and chemiluminescence method,SPSS1 9.0 was used to analysis the results.Re-sults The concentration of serum SA in PHC patients (701.08±189.33 mg/L)were significantly higher than benign liver disease patients (588.38±98.51 mg/L)and healthy people (572.37±89.13 mg/L),there was statistical significance (P=0.000),the significantly statistical differences were also in MHC (790.20±162.29 mg/L)and PHC patients (P=0.027). Serum SA in the diagnosis of MHC sensitivity,specificity and AUC were 84.6%,85.2% and 0.895,compared with serum AFP (sensitivity 22.2%,specificity 29.6% and AUC 0.301)had statistically significance (P=0.000).Conclusion The se-rum SA has important clinical significance in the diagnosis and distinguishing diagnosis of PHC and MHC.

Objective To analyze the complications,treatments and prognosis of simultaneous pancreas-kidney transplantation,especially on surgical complications and treatments.Method The causes and outcomes of surgical treatment in 70 cases of simultaneous pancreas-kidney transplantation performed between Dec.1999 and June 2012 were retrospectively analyzed in our center.Result Sixteen patients (22.9％) underwent one or more reoperations.The causes for reoperation were as follows:2 cases of hematuria,4 cases of abdominal hemorrhage,4 cases of abdominal infection,4cases of pancreatic thrombosis,2 cases of renal graft's artery rupture,1 case of renal allograft rupture,1 case of intestinal fistula,and 1 case of pancreatic fistula.Eight pancreas grafts were lost in the first year.Pancreatectomy was performed on the other 5 cases:4 cases of pancreatic thrombosis,1 case of intestinal fistula,accounting for 43.8％ of the patients subject to reoperation.The recipients,kidney,pancreas survival rate in reoperation group at 1 year was 87.5％,75％,and 56.3％ respectively; and that in control group at 1 year was 98.1％,98.1 ％,and 98.1 ％ respectively.There was significant difference in kidney survival rate (P＜0.01,chi-square =6.79),and pancreas survival rate (P＜0.01,chi-square =17.47) between two groups.Conclusion Although simultaneous pancreas-kidney transplantation provides a successful and effective treatment for diabetics with end-stage renal disease,surgical treatment due to complications is still an important factor in short-term survival on the grafts.

Objective To study the expression and the clinical significance of glyican-3 (GPC3)in hepatocellular carcinoma (HCC)tissues.Methods Immunohistochemical method was performed to evaluate the expression of GPC3 in 54 cases of HCC tissues,46 cases of para-carcinoma tissues,22 cases of cirrhosis tissues,12 cases of normal liver tissues,the correlation between expression levels of GPC3 and clinicopathologic factors was analyzed.Results GPC3 protein was not expressed in normal livers tissues,the levels of GPC3 (7.39±3.64)and the positive rate (81.48%)in HCC tissues were significantly higher than para-carcinoma tissues (1.15±0.99,13.04%),cirrhosis tissues (0.32±0.56,4.54%),the difference was sta-tistically significant (P <0.05);with the increase of clinical stage ofHCC,the levels of GPC3 were increased,stage Ⅲ/Ⅳ(10.05±3.59)compared with stage Ⅰ (4.31±3.41),stage Ⅱ (7.14±3.63),and the difference was statistically signifi-cant (P <0.05).The positive rate of GPC3 was also increased(stage Ⅰ 69.23%,stage Ⅱ 81.81%,stage Ⅲ/Ⅳ 89.47%) and the difference was not statistically significant (P >0.05);the positive rate in HCC tissues was independent of sex,age, serum HBsAg,alpha-fetoprotein (AFP),tumor diameter,metastasis,clinical stage (P >0.05),only related to the cirrhosis (P <0.05).The high expression rate of GPC3 in HCC tissues was correlated with AFP,tumor diameter,cirrhosis,metasta-sis,clinical stage (P <0.05).Conclusion GPC3 has important clinical significance in the diagnosis of HCC,the expression level of GPC3 associated with the progression of HCC.

Objective To explore the indications of simultaneous pancreas-kidney (SPK) transplantation for type 2 diabetes mellitus (DM) combined with end-stage renal disease by comparing the outcome of patients with type 1 and type 2 DM combined with end-stage renal disease after renal transplantation.Methods 109 patients accepting SPK from January 2008 to July 2016 in our center were divided into two groups according to the types of DM:T1DM (n =36),and T2DM (n =73).The basic characteristics of recipients,outcome,and pancreas and kidney functions after operation were compared between two groups.Results There was no significant difference in 5-year survival rate and surgical complications between two groups although recipients of T2DM group were older and had higher BMI than T1DM group.But rejection rate was higher in T1DM group.Conclusion SPK for T2DM recipients will not increase the surgical risk and can get good long-term outcome.