Primary biliary cirrhosis (PBC) is a slowly progressive autoimmune disease of the liver.Studies on the pathphysiology of this disease have demonstrated the immune-mediated destruction of the intrahepatic bile ducts and portal infammation seem to be the result of an intense autoimmune response directed against the autoantigens located in the biliary epithelium.Immunologically,PBC is characterized by the presense of antimitochodrial antibodies,elevated serum IgM and lymphoid infiltration in the portal tract.Indeed,the relationships between IgM and PBC have been a major focus of research on its pathphysiology,which lead to an increased understanding of the abnormal immune responses involved in PBC.This review summarizes data on the biological and clinical significance of Hyper-IgM in PBC,and highlights the potential role of IgM for the diagnosis and treatment of PBC.

Objective To observe the incidence of acute radiation pneumonitis (RP)after intensity modulated radiation therapy,and to explore the relationship between the incidence of RP and the parameters from dose-volume histogram (DVH)in the patients with non-small cell lung cancer (NSCLC).Methods By Pinnacle 7.6c TPS, 46 patients with NSCLC were treated by IMRT.The values of the percentages of the lung volumes receieved 5, 10,20,and 30 Gy radition to the total lung volumes (V5 ,V10 ,V20 ,V30 )and mean lung dose (MLD)were observed,and its correlation with acute RP was analyzed.Results The incidence of acute RP of the patients with NSCLC was 37.0% (17/46),among then there were 29 cases (63.0%)of Grade 0 (non-pneumonitis group), 12 cases (26.1%)of Grade 1,5 cases (10.9%)of Grade 2,and there were no Grade 4 and 5 RP.The values of V5,V10,V20,V30,and MLD of lung were 53.34 %,43.12%,24.15%,15.36 %,and 16.02 Gy.The values of V5,V10,V20,V30,and MLD in pneumonitis group were 57.81%,48.91%,31.34%,17.83%, 21.71 Gy,and they were 49. 81%,39.78%,21.82%,13.12%,and 13.71 Gy in non-pneumonitis group, there were significant differences between two groups (P<0.05).Conclusion The intensity modulated radiation therapy in treatment of NSCLC can protect the lung tissue,and the parameters of DVH such as V5 ,V10 ,V20 , V30 and MLD can predict the occurrence of RP.

Objective To observe the therapeutic effect of Tanreqing Injection in treatment of acute irradiation oropharyngeal mucositis in the patients with head and neck cancer, and to provide reference for its clinical application.Methods Fifty patients with head and neck cancer were randomly divided into treatment group and control group(n=25).The patients in treatment group received concurrently intravenous infusion of Tanreqing Inj ection during irradiation course.The patients in control group received daily regular oral nursing;oropharyngeal mucositis was evaluated according to the protocol proposed by RTOG.Results The patients in treatment group with Ⅰ and Ⅱ oropharyngeal mucosal injury accounted for 76%,and the patients in control group with Ⅲ,Ⅳoropharyngeal mucosal injury accounted for 60%,there was statistically significant difference between two groups (P<0.05).The scores of the patients with oropharyngeal pain in treatment group were 0-3 (mild),in control group they were 4- 6 (moderate).The patients with mild,moderate,and severe oropharyngeal pain in treatment group and control group after radiotherapy accounted for 72%,24%,4% and 12%,64%,24%;there were statistically significant differences between two groups (P<0.05).Conclusion Tanreqing Injection has a good therapeutic effect on acute radiation stomatitis and layngopharyngitis, and it has the effects of relieving oral and pharyngeal mucosa inj ury,anti-inflammatory and analgesic and accelerating wound healing.

OBJECTIVE: To explore the regularity and characteristics of ADR induced by levofloxacin. METHODS: Retrieved from, CHKD of CNKI and Wanfang database, a total of 205 literatures about levofloxacin-induced ADR were collected and analyzed statistically in respect of patients’ gender, age, case history, administration route, clinical manifestation and result of treatment. RESULTS: 483 cases(92.9%) were given levofloxacin intravenously in total of 520 ADR cases. 156 cases were characterized with lesion of skin and its appendants (30.0%), followed by lesion of nervous system (n=133, 25.6%), lesion of cardiovascular system (n=65, 12.5%) and anaphylactic shock (n=45, 8.7%). The earliest ADR occurred within 2 min after administration while the latest occurred in 34 d after administration. 514 cases recovered when drug withdrawal or treatment were taken. However, there were 2 cases of sequelae, 4 cases of death and 62 cases of unexpected serious ADRs. CONCLUSION:ADRs induced by levofloxacin present complicated and various symptoms caused by several factors in which the most serious result in death. Clinical doctors should pay more attention to levofloxacin-induced ADRs.

Objective To evaluate the timing of postoperative parenteral nutrition support for gastrointestinal tumor patients with a definite nutritional risk.Methods Using a randomized control clinical research methods,80 gastrointestinal cancer patients were randomly divided into study group (40 cases) and control group (40 cases).In the study group parenteral nutrition support started on postoperative day 2,while in the control group it started on postoperative day 1.Flatus passing,the rate of infectious complications,the rate of systemic inflammatory response syndrome,postoperative nutrition support related expenses,and the duration of postoperative hospital stay were recorded.Results There was no significant differences between the two groups (P ＞ 0.05) in age,sex,body mass index,use of glutamine,disease and type of surgery.Compared with the control group,patients in the study group had earlier postoperative flatus passing [(3.33± 1.10) d vs.(4.03 ± 1.51) d,P =0.020],less systemic inflammation response syndrome (8/40 vs.17/40,P =0.030),shorter postoperative hospital stay [(3.33±1.10) d vs.(4.03±1.51) d,P=0.020] and lower nutrition support costs [(2144.49 ±1210.96) RMB vs.(2915.99 ± 1615.68) RMB,P =0.018].There was no significant difference in postoperative nutrition index,peristalsis recovery time and infectious complications between the two groups (all P ＞ 0.05).Conclusions In patients undergoing surgery for GI tumors,parenteral nutrition support started on post-op day 2 promotes the recovery of gastrointestinal function,while decreasing medical cost.

The medical education has long paid great attention to students' specialized knowledge education and neglected the humanities education for all-around development excessively. Diagnostics is a bridge curriculum between basic medicine and clinical medicine. Enhancing the quality education by fully combining the process of diagnostics teaching plays an important role in qualified medical talents training.

Objective To evaluate the diagnostic value of the ultrasonography in greater omentum lesions.Methods The ultrasonic findings in 33 patients with greater omentum lesions were compared with the pat hological result of operation,celioscope or ascites cytology.Results The lesions in 27 of 33 patients(81.8%)were localed within the treater omemurn,and pathological changes of 26/33(78.8%)were found by ultrasonography.These greater omentum lesions appeared as characteristics of thickened,shifted and peculiar-echo.Conclusion The lOcation and pathological nature of the primary affection can be approximately estinlated according to the localizatiOn and sonographic appearance of the greater omentum by experienced physicians.

Objective To investigate the occurrence of intraoperative occupational exposure to blood among sur-geons in a hospital,so as to make effective precaution measures.Methods Combined with questionnaires,the mo-nitoring data of occupational exposure to blood among surgeons from June 2011 to June 2013 were analyzed statisti-cally.Results A total of 49 surgeons sustained 115 times of occupational exposure to blood,including 42 times (36.52%)in general surgery surgeons,36 (31 .30%)in orthopedic surgeons,31 (26.96%)in obstetrics and gyne-cology surgeons,and 6(5.22%)in urinary surgery surgeons.The main occupational exposure were sharp injuries (n=71 ,61 .74%),blood and body fluid splashing were 44 times (38.26%);the top two exposed sites were hands (49.57%)and faces (17.39%).88.70% of exposed cases were given emergent treatment,and 55.65% of exposed cases were reported.The follow-up found no surgeons were infected after the prompt and correct treatment. Conclusion Surgeons are at high risk of occupational exposure.Occupational precaution should be strengthened, occupational awareness and ability of HCWs should be enhanced,and post-exposure treatment should be improved.

Sixty patients with piriformis syndrome were treated mainly by electroacupunture, Tuina plus TDP irradiation. After 10 treatments, among 60 patients, 41 cases were cured and 19 cases were improved.

Selective protein degradation by the ubiquitin 26S proteasome pathway has emerged as a key regulatory mechanism in a wide variety of cellular processes.The ubiquitin/26S proteosome pathway mainly consists of ubiquitin activating enzyme(E1),ubiquitin conjugating enzyme(E2),ubiquitin protein ligase(E3),and 26S proteasome.In an ATP-dependent reaction,uibquitin(Ub) is conjugated to E1,the activated Ub is then transferred to an E2.Finally,the Ub-E2 intermediate delivers the Ub to the target protein by E3 recognition.Polyubiquinated proteins are eventually degraded by the 26S proteasome.In plants,regulated protein degradation by /26S proteasome pathway contributes significantly to development by affecting a wide range of progress,including hormone signaling,photomorphogenesis,self-incompatibility and cell cycle.The recent progress towards understanding the role of the Ub/26S proteasome pathway during plant development was reviewed.