AIM: To study the action of NF-?B p65 in tubule-interstitium in rats with active Heymann nephritis(AHN). METHODS: Twenty female Wistar rats in 6-8 weeks of age were divided into two groups. The nephritis was induced with Fx1A/CFA by subcutaneous injection and with CFA as control. After rats were killed, the activation of NF-?B p65 in renal tissue was observed by immune histochemistry. RESULTS: The lesion score of renal interstitium and activation of NF-?B p65 of renal tubule in rats with AHN was higher than those of control group(P

Objective To investigate the clinical effect of using ambroxol hydrochloride and dexamethasone by nasal spray inhalation after endoscopic sinus surgery in treating chronic sinusitis.Methods One hundred and forty patients with chronic sinusitis receiving endoscopic sinus surgery in our hospital from January 2014 to December 2014 were selected as the research subjects.After surgery,the control group was given dexamethasone nasal spray inhalation,while the observation group was given ambroxol hydrochloride and dexamethasone by nasal spray inhalation.The curative efficacy,the score of visual analogue scale(VAS) was adopted to evaluate the subjective symptoms severity and the nasal endoscopy and CT examination results were evaluated by the Lund-Kennedy score.The serum levels of IL-5 and IL-12 were detected in the two groups.Results All cases were successful completed surgery and no severe adverse reactions appeared after surgery.The observation group had a total effective rate of 97.1 ％,which was signif icantly higher than 88.6 ％ in the control group,the difference was statistically significant(P＜0.05).In the aspects of sinusitis related symptoms after operation,compared with the control group,the VAS scores of nasal discharge,nasal obstruction,cheek pain,headache and hyposmia in the observation group were significantly decreased,the difference was statistically significant(P＜0.05).In the postoperative re-examination process,the score of assessment of nasal endoscopic score and paranasal sinuses CT score in the observation group were significantly decreased,the difference was statistically significant(P＜0.05).In the serological indicator determination,serum levels of IL-5 and IL-12 after treatment in the observation group were significantly lower than those in the control group,the difference was statistically significant(P＜0.05).Conclusion Using ambroxol hydrochloride combined with dexamethasone by nasal spray inhalation after endoscopic sinus surgery has good efficacy in treating chronic sinusitis,can decrease serum levels of IL-5 and IL-12.

Background: Myoclonic epilepsy with ragged-red fi bers (MERRF) is a type of mitochondrial encephalomyopathy, clinical experience with the antiepileptic treatment for myoclonus in MERRF is still limited. Myoclonus appears to be intractable, and some antiepileptic drugs may change the blood lactate level. Objective: In this study, we report on two patients, a girl and her mother, both with MERRF in a Chinese family. We aimed to study their myoclonus attack, response to AEDs and blood lactate level. Methods: The diagnosis was based on muscle biopsies and a genetic test. We recorded their myoclonus and detected alterations of blood lactate when the patients received antiepileptic drugs. Results: The patients displayed substantial differences in their responses to antiepileptic drugs. The mother exhibited a good response to valproic acid, although valproic acid is not recommended for mitochondrial disease; however, her daughter was refractory to many antiepileptic drugs until she received a combination treatment of levetiracetam and topiramate. We did not fi nd valproic acid, levetiracetam or topiramate affected the blood lactate levels. Conclusion: These fi ndings imply that not all MERRF patients are resistant to antiepileptic drugs, and for those who are intractable, combination treatment involving levetiracetam and topiramate may be effective for treating myoclonus in MERRF and does not worsen lactic acidosis.

Objective To understand the clinical features of candidemia.Methods A retrospective analysis was performed based on the data of 88 candidemia cases treated in Huashan Hospital during the period from 2007 to 2012.The clinical data were re-viewed in terms of species distribution,underlying diseases,clinical manifestations,treatment and outcomes.The prognostic factors were analyzed by chi-square test or Fisher exact probability test.Multivariate analysis was conducted by multiple Logis-tic regression.Results Candida albicans (40/88,45.5%)was the most common pathogen isolated from these candidemia ca-ses,followed by Candida tropicalis (20/88,22.7%),Candida parapsilosis (17/88,19.3%),Candida glabrata (10/88, 11 .4%),and Candida krusei (1/88,1 .1 %).Solid malignancy,diabetes,and surgical procedure were the most frequently identified underlying diseases.Fatal or deteriorative outcome was reported in 28 cases.The attributable mortality was 18.2%. Multivariate prognostic analysis indicated that presence of central venous catheter (OR:6.322,95% CI :1 .055-37.891 ,P =0.044)was independently correlated to increased mortality.Appropriate antifungal therapy was an independent predictor of de-creased overall mortality (OR:0.137,95% CI :0.039-0.480,P =0.002).Conclusions The pathogen distribution of candi-demia has changed slightly.Appropriate antifungal therapy plays a key role in the treatment of candidemia.

Objective To examine the pathological changes in the liver of an AIDS patient with complicated infection of Pneumocystis carinii(PC). \ Methods\ A liver biopsy was made. The tissue was stained with HE, PAS, Giemsa, GMS, and acid\|fast staining, and examined under light microscope and transmission electron microscope. \ Results\ Granulomas (acid\|fast negative) in the tissue and numerous pathogens (PAS positive) in hepatic sinusoids were detected. Giemsa and GMS staining and electron microscopy all confirmed that the pathogen was Pneumocystis carinii. \ Conclusion\ The pathological findings revealed a diffuse extrapulmonary infection of Pneumocystis carinii in the patient of AIDS.

Clinical Information System(CIS)is a new period of hospital information system(HIS).The construction of CIS can improve doctors and nurses' work.The traditional CIS includes doctor-workstation,PACS,LIS,RIS,etc.By establishing clinical coding system,PASS,online information gathering system and PDA,the information quality and application level of CIS can be elevated.

Objective To explore the effect and clinical significance of expression of nuclear factor-?B((NF-?B)),ICAM-1 and COX-2 on the occurrence and metastasis of gastric carcinoma.Methods The(expression) of NF-?B,ICAM-1 and COX-2 in 142 patients with gastric carcinoma was examined by(immunohistochemical) SP technique.The adjacent gastric tissue(30 cases) served as a control group.Results The expression of NF-?B was 62.0% in gastric carcinoma tissue,much higher than that of the control group(P

ObjectiveTo estimate the value of transthoracic coronary flow Doppler imaging to detect coronary flow reserve (CFR) changes in patient with obstructive sleep apnea syndrome (OSA). Methods Fifty patients with OSA who hospitalized or were outpatient in Aerospace 731 Hospital during the period of 2010 March to 2013 December were enrolled in this study and were divided into three groups according to apnea hypopnea index (AHI). Eighteen cases of patients which AHI was greater than 5 and less than 20 were defi ned as mild group, 16 cases of patients which AHI was more than 20 and less than 40 were defi ned as middle group, 16 cases of patients which AHI was greater than 40 were defi ned as severe group. The diastolic peak velocity (PDV) and meanfl ow velocity (MDV) of the distance segment of left anterior descending coronary (LAD) were measured by transthoracic echocardiography at rest and after intravenous infusion of adenosine triphosphate (ATP). Meanwhile, CFR was calculated. Forty healthy persons were chosen as control group. Thettest was used to compare the difference of PDV, MDV and CFR between OSA group and healthy controls. The single factor analysis of variance was used to compare the difference of PDV, MDV and CFR in patients with different AHI. SNK -q test was used to compare in different OSA groups. Thet test was used to compare the difference of PDV, MDV among OSA group, healthy control and OSA groups with different AHI at rest and after intravenous infusion of ATP.ResultsCoronaryfl ow velocity Doppler signals were successfully obtained in all the groups. PDV ([92.78±7.68] cm/s) and MDV ([85.93±6.98] cm/s) after intravenous infusion of ATP in control group were significant higher than those at rest ([28.09±4.55] cm/s and [21.76±5.09] cm/s) (t=49.687 and 58.259, bothP<0.001). PDV ([82.73±6.91] cm/s) and MDV ([77.39±6.73] cm/s) after intravenous infusion of ATP in OSA group were signifi cant higher than those at rest ([29.93±3.66] cm/s and [22.28±4.15] cm/s) (t=55.381 and 47.700, bothP<0.001). There was no statistically signifi cant difference between PDV and MDV at rest in OSA group and control group. The difference of PDV and MDV between OSA group and normal group was statistically signifi cant after intravenous infusion of ATP (t=6.524 and 5.884, bothP<0.01). There was no statistically signifi cant difference between OSA groups with different AHI at rest. There were statistically signifi cant difference between OSA groups with different AHI after intravenous infusion of ATP (5≤AHI<20:t=-32.903 and-32.771, both P=0.000; 20≤AHI<40:t=-37.122 and-32.623, bothP=0.000; AHI>40:t=-28.197 and-20.184, both P=0.000). PDV and MDV of patients with AHI>40 were less than those of patients with 5≤AHI <20 and 20≤AHI<40 and the differences were statistically signifi cant (PDV:q=21.048 and 15.667, bothP<0.05; MDV:q=12.958 and 18.182, bothP<0.05). However, the differences of PDV and MDV was not statistically signifi cant between patients with 5≤AHI<20 and patients with 20≤AHI<40.The CFRmax and CFRmean in OSA group were lower than those in control group (t=5.310 and 6.430, bothP=0.000). There were statistically signifi cant difference for CFRmax and CFRmean in patients with different AHI and the difference decreased with severity of OSA increased. The CFRmax and CFRmean in patients with 5≤AHI<20 were higher than those in patients with 20≤AHI<40 and AHI>40 (CFRmax:q=2.889 and 4.142, bothP<0.05; CFRmean:q=3.080 and 4.204, bothP<0.05). There was no statistical signifi cant difference for CFRmax and CFRmean between patients with 20≤AHI<40 and patients with AHI>40.ConclusionsIn patients with obstructive sleep apnea syndrome, transthoracic coronaryfl ow imaging combined with intravenous infusion of adenosine triphosphate shows impaired in CFR. It means the patients with OSA have a coronary artery microcirculation impairment in early stage. Assessing CFR in the patients with OSA is of important clinical value for the evaluation of treatment effective of medicine and surgery and follow-up.

Objective To investigate the effects of biatrial infusion on pulmonary artery pressure (PAP)after cardiopulmonary bypass (CPB) in patients undergoing mitral valve replacement.Methods Twenty NYHA Ⅱ or Ⅲ patients aged 22-53 yr weighing 34-57 kg undergoing mitral valve replacement complicated by pulmonary hypertension (mean pulmonary artery pressure (MPAP) ＞ 50 mm Hg) were randomly divided into 2 groups ( n = 10 each): infusion via right atrium group (group R) and infusion via both atria group (group B). After induction of anesthesia, a three cavity floating Swan-Ganz catheter was placed via right internal jugular vein to monitor CVP,PAP, pulmonary capillary wedge pressure (PCWP) and CO. The patients received infusion of prostaglandin E1 30-150 ng· kg- 1 · min - 1 and phenylephrine 0.2-0.6 μg· kg- 1 · min- 1 via central veins in group R and infusion of prostaglandin E1 30-150 ng·kg-1 ·min-1 via central veins and phenylephrine 0.2-0.6 μg·kg-1 ·min-1 via left atrium in group B. MAP, HR, MPAP, PCWP, CVP and CO were recorded 5 min before administration (T0), and 5,10, 30 and 60 min after administration (T1-4). Pulmonary vascular resistance index (PVRI), systemic vascular resistance index (SVRI) and CI were also calculated. Results D:\1111111111\MDB\zhmzxzz98201008.mdbCompared with the value at T0, MAP, MPAP, PCWP and PVRI were significantly decreased, while CI was increased at T1-4 in group R, and MAP, CI and SVRI were significantly increased, while HR, MPAP, PCWP, CVP and PVRI decreased at T1-4 in group B ( P ＜ 0.05).MAP, CI and SVRI were significantly higher, while HR, MPAP, PCWP, PVRI and CVP lower in group B than in group R ( P ＜ 0.05). Conclusion Biatrial infusion can effectively reduce PAP and pulmonary vascular resistance after CPB in patients undergoing mitral valve replacement.

The simulator testing in vitro and computational simulation of the artificial knee joint wear are important methods to evaluate the wear performance of the prosthesis in vitro and to predict the clinical performance of knee joint products. Based on the method of literature search, this paper compares the mechanical and kinematic loading input curves carried out by Chinese scholars in recent years, standard curves, and Chinese measurement curves of two typical movements of gait. Data of vitro simulator test and computational simulation model are compared, summarized, and analyzed. The results show that the measured data of motion and load cannot be directly used as the loading conditions for the simulator wear test and computational simulation. The mechanics and kinematics data of Chinese people are different from the international standards. The domestic artificial knee joint in vitro simulator wear test methods are similar but the results of different test institutions are somewhat different. The computation wear prediction research is basically synchronized with foreign countries, but the problem that the calculated wear results are lower than that in vitro test is still unsolved. The artificial knee joint wear performance evaluation system based on Chinese knee joint mechanics and kinematics data is the forward direction of the research.