ObjectiveTo observe the clinical effects of Jianwei yuyang capsule combined with triad-therapy of western medicine on helicobacter pylori-related peptic ulcer in elderly.MethodsEighty patients above 60 years with peptic ulcer infected with helicobacter pylori were divided into two groups by random,and were treated with Jianweiyuyang capsule combined with triad-therapy of western medicine or triad-therapy of western medicine for 4weeks.The endoscopy and biopsy staining were used to analyze the cure rate and the helicobacter pylori eradication rate at the 6th week after the end of the treatment,and the main symptom improvement were observed.ResultsIn the treatment group,the cure rate,the helicobacter pylori eradication rate and total effective rate were significantly higher than control group.The two groups were significantly different ( P ＜ 0.05).ConclusionJianweiyuyang capsule combined with triad-therapy of western medicine was a more ideal treatment program for helicobacter pylori-related peptic ulcer in elderly.

ObjectiveTo compare the clinical value of contrast-enhanced ultrasonography (CEUS) and conventional ultrasonography in diagnosing polypoid lesion of gallbladder (PLG).MethodsThe postoperative pathology and clinical manifestation of 49 PLG patients were retrospectively analyzed in the First Afifliated Hospital of Harbin Medical University. Of them, 7 cases were maligant lesions, 4 cases were adenomas, 24 cases were polyps of gallbladder and 14 cases were adenomyomatosis of gallbladder. With postoperative pathology as golden standard, the sensitivity, speciifcity and PLG speciifcity were calculatedfor conventional ultrasonography, CEUS and conventional ultrasonography plus CEUS.ResultsThe sensitivity, specificity and PLG specificity were 33.3%, 74.3% and 68.3% for conventional ultrasonography, and 66.7%, 85.7% and 82.9% for CEUS respectively. The conventional ultrasonography plus CEUS were 83.3%, 88.6% and 87.8%.ConclusionCEUS could signiifcantly improve the diagnostic accuracy.

Objective To study the effects of genistein(GST) on the expression of estrogen receptor ?(ER?) and the expression of c-fos gene in the aorta of ovariectomized rats.Methods Forty female Wistar rats were randomly divided into four groups:sham-operated(control),ovariectomized(OVX),ovariectomized with 17?-E2 replacement(OVX+E2),ovariectomized with genistein replacement(OVX+GST) group.After 8 weeks' replacement therapy,the rats were sacrificed and the expression of ER? and c-fos in the aorta was studied by immunohistochemistry.Results Ovariectomy significantly decreased ER ? expression and increased c-fos expression in aorta;while replacement therapy,GST and E2,attenuated the effect of ovariectomy manifested by increasing ER expression and decreasing c-fos expression in aorta.Conclusion GST may modulate the expression of ER? in the arteries of ovariectomized rats and play a beneficial effects on cardiovascular system which was associated with decreases in expression of c-fos gene in aorta.

Objective To investigate the role of r-aminobutyric acid B receptor in the development of liver fibrosis.Methods Thirty-two Sprague-Dawley (SD) rats were divided into four groups including a control group,a model group,a baclofen group,and a CGP35348 group.Liver fibrosis was then induced by carbon tetrachloride (CCl4).Baclofen and CGP35348 treatment were carried out after the formation of liver fibrosis,followed by complete extraction of the eyeball to obtain blood sample to test liver function.Liver tissue specimens were cut and stored for histological staining,histochemistry,real-time polymerase chain-reaction (RT-PCR),and western blot analysis.Results Histological staining indicated that the degree of liver fibrosis was more severe in the CGP35348 group than in the baclofen group (P＜0.001).The levels of alanine transaminase (ALT),aspartate aminotransferase (AST),gamma-glutamyl transferase (GGT),total bilirubin (TBil),and direct bilirubin (DBil) were significantly lower in the baclofen group than in the CGP35348 group (P＜0.01).The levels of ALT,AST,GGT,TBil,and DBil were significantly higher in the CGP35348 group than in the model group (P＜0.05).Immunofluorescence results show that the hepatic cell migration was inhibited in the baclofen group.Western blot results showed that the expression levels of α-SMA protein were significantly lowered in the baclofen group when compared to that of the CGP35348 group and model group (P＜0.01).Conclusion GABAB receptor might play a role in the liver protection by inhibition of migration of hepatic cells in liver fibrosis.Further studies into the mechanism behind this function are further needed and may be a potential source of future anti-fibrotic treatment.

ObjectiveTo investigate the delineation of gross tumor volume (GTV) in locally advanced nasopharyngeal carcinoma (LANC) according to imageological changes before and after induction chemotherapy (IC) in order to decrease high dose area and protect normal tissue better.MethodsBetween Mar 2010 to Jan 2011,11 patients with LANC were enrolled and treated with TPF regimen followed by intensity-modulated radiotherapy (IMRT) with concurrent chemotherapy,target volumes were delineated based on fused CT imaging before and after IC following project determination.Tumor target volumes after and before IC were respectively delineated according to imaging tumor residues and were overlaid by CTVnx in order to ensure radical doses for the imaging tumor volume before IC,the resulting differences of tumor target volumes of IC before and after were measured and analyzed by paired t-test.ResultsBefore and after IC,the average volumes of GTVnx were respectively 44.72 cm3 and 28.87 ( t =3.89,P =0.003 ),the average volumes of GTVnd were respectively 32.76 cm3 and 19.82 cm3 ( t =2.47,P =0.033 ),the volumes of maximum dose area in brainstem and spinal cord as well as eyeball decreased ( t =2.93-4.59,all P ＜0.05).ConclusionsLANC treated by 3 cycle TPF regimen followed by IMRT with concurrent chemotherapy showes significant shrinkage of tumor volume.The volume of high dose region which caused by normally recovered tissues were decreased by re-delineation of target volume in brainstem and spinal cord as well as eyeball of CT images after IC.

ObjectiveTo determine the correlation of human leukocyte antigen-G (HLA-G)expression with CMV active infection after kidney transplantation. MethodsA total of 215 first-time kidney transplantation recipients in one transplantation center were divided into CMV ( + ) group and CMV ( - ) group according to whether they had active CMV infection. mhla-g1 expression on leukocytes was analyzed by flow cytometry. The concentrations of soluble HLA-G5 were detected by using ELISA. The sHLA-G5 cutoff levels by ROC curve was employed to predict the active CMV infection. The expression of sHLA-G5 mRNA and protein in leukocytes was analyzed by using RTPCR and Western blotting respectively. Immunohistochemical staining was used to detect the HLA-G expression in kidney biopsies of 12 cases. ResultsThe expression of mHLA-G1 in peripheral blood was low in both CMV ( + ) group and CMV ( - ) group. Also when CMV-PP65 was positive, there was no significant change in mHLA-G1. In CMV ( + ) group, the proportion of CD14+ mHLA-G1 +cells[(45. 53 ± 17.32)％]in peripheral blood was increased as compared with that in CMV (-)group[(10. 22 ± 5.78)％]. The expression of sHLA-G5 was increased significantly in CMV ( + )group. The optimal cutoff value of sHLA-G5 predicting the active CMV infection was 202. 9 μg/L,with high diagnostic accuracy. HLA-G was positive in the kidney tissue of 10 patients out of 12 patients with active CMV infection. Both RT-PCR and Western blot analysis showed that sHLA-G5 was significantly higher in CMV ( + ) group than that in CMV ( - ) group. ConclusionROC curve analysis of sHLA-G5 with the cutoff value of 202. 9 μg/L can be used to predict the active CMV infection. The HLA-G levels in peripheral blood were significantly increased and HLA-G expression in the tubular epithelial cells of the graft could be a protection mechanism of the kidney function.

Objective To study the correlation of HLA-G levels with acute rejection and CMV active infection post-kidney transplantation.Methods A total of 132 initial kidney transplantation recipients were divided into kidney function stable group (F),acute rejection group (AR),CMV group according to whether they had active CMV infection and acute rejection.Forty-one healthy donors served as control group (H).HLA-G levels and mRNA expression were analyzed by using flow cytometry,ELISA,RT-PCR and Western blotting.Immunohistochemical staining was used to detect the HLA-G expression in kidney biopsies.Results The expression levels of mHLA-G1 were low in all 4 groups pre-transplantation.Only CMV group had significantly more CD14+ mHLA-G1+ cells post-transplantation (P＜0.05).sHLA-G5 levels were higher in F group than in H group (P＜0.05),but there was no significant difference among other groups pre-transplantation (P＞0.05).sHLA-G5 levels were increased significantly in CMV group as compared with F group (P＜0.05),and those in F group were higher than in H and AR groups (P＜0.05).Renal tissue biopsies from 21 renal transplantation recipients with AR indicated that HLA-G5 was expressed negatively in 17 patients,positively in 3 patients and 1 weakly positively.HLA-G was positive in the kidney tissue of 9 patients out of 9 patients with active CMV infection.In total 132 recipients,AR incidence was significantly lower in CMV ( + ) group (7.1 ％,2/28) than that in CMV ( - ) group (24.0 ％,25/104).Conclusion The sHLA-G5 may contribute to predict AR and CMV active infection; AR and CMV active infection may be correlation with immune balance in kidney transplantation recipients.

Objective To compare the short- and long- term effects and safety of endoscopic balloon dilatation vs. placement of specially designed reclaimable self-expanding anti-reflux esophageal stents for achalasia. Methods A total of 129 patients with achalasia were divided into 2 groups to receive either endoscopic scopic balloon dilatation(,l=63)or endoscopic placement of specially designed reclaimable self-expandinganti-reflux esophageal stents (n = 66). The dysphagia symptom scores were recorded before and 1-month,6-month and 12-month after the procedure, respectively. The change in width of esophagus, procedure related complications, length and costs of hospitalization were also analyzed. Results Dysphagia symptom score was significantly decreased after the treatment in both groups (P < 0.05). The effective rates evaluated at 1-month, 6-month and 12-month after the procedure in balloon dilatation group were 100. 0% , 96. 7% and 91.5% , respectively, which in stenting group were 100.0% , 98. 0% and 97.1% , respectively. There was no significant difference in changes of symptom score at 1-month and 6-month after treatment between the 2 groups (P > 0.05) , while at 12-month after treatment, the decrease of symptom score in stenting group was significantly higher than that in balloon dilatation group (P<0. 05). After the treatment, the significant widening of the stricture and narrowing of the dilated esophagus were achieve in both groups (P < 0.05),while no significant difference between these 2 groups was observed in changes of width (P > 0. 05). Procedure related complications in balloon dilatation group included esophageal perforation (n =1) and upper gastrointestinal bleeding (n=4) , which was not occurred in stenting group, but complications included hyperplasia of granulation tissue (n = 1), stent dislocation (n =2) and defulvium (n = 1) was observed inthe latter group. The length of hospitalization was similar in 2 groups (P > 0. 05) , and the cost of hospitalization in stenting group was significantly higher than that of balloon dilatation group (P < 0. 05). Conclusion Compared with endoscopic balloon dilatation, the specially designed reclaimable self-expanding antireflux stents is a more ideal method for achalasia, with similar short-term effect, but better long-term effect and safety.

Objective To study the clinical, histopathological and immunohistochemistric features of different types of primary cutaneous lymphomas.Methods 17 cases of primary cutaneous lymphomas were ret-rospectively reviewed.All cases were classified according to the WHO-EORTC(World Health Organization-Eu-ropean Organization for Research and Treatment of Cancer) classification system combined with morphology and immunobistochemistry.The clinicopathological features of each type were observed and summarized.Results Among the 17 cases, male were 10, female were 7.The average age was 51 years old (from 16 to 78).All pa-tients visited the doctor for skin diseases 14 cases were T-cell lymphoma including 5 cases of primary cutaneous anaplastic large cell lymphuma, 2 cases of mycosis fungoides, 4 cases of subcutaneous panniculitis-like T-cell lymphoma, and 3 cases of primary cutaneous peripheral T- cell lymphomas (including 1 primary cutaneous ag-gressive epidermotropic CD8+ cytotoxic T-cell lymphoma).3 cases were B-cell lymphoma including 2 diffuse large B-cell lymphoma, leg-type and 1 primary cutaneous follicle center lymphoma.Conclusion The clinical behaviors and pathological characteristics of primary cutaneous lymphomas were complicated and variant.Nei-ther of them could be neglected in the diagnosis.

Objective To evaluate conventional ultrasound combined with real-time elastography in differential diagnosis of metastatic axillary lymph nodes of breast cancer with a logistic regression model.Methods Conventional ultrasound and real-time elastography were performed in 112 breast cancer patients with 113 axillary lymph nodes.All the cases were confirmed with pathological examinations after surgery. A binary logistic regression model based on ultrasonographic features was developed.A receiver operator characteristic ( ROC) curve was constructed to assess the performance of the model.Results There were 28 nodes with no metastasis and 85 with metastasis in a total of 113 axillary lymph nodes.Three ultrasonographic features including the elastic strain ratio(SR), elastic score and shape were finally selected into the logistic regression model .The correct rate of the logistic regression model for predicting axillary lymph node metastasis was 93.8%, and the area under ROC curve was 0.962.Conclusion The binary classification logistic regression model has a good diagnostic efficacy in the diagnosis of benign and malignant axillary lymph nodes,while real-time elastography can improve the accuracy of conventional ultrasound in the diagnosis of axillary lymph nodes.