ABSTRACT Atherosclerosis (AS) is the principle cause of cardiovascular disease. For many years, AS was regarded as irreversible. However, recent accumulated evidence suggests that AS can regress with proper manipulation. Studies from animal models show that low cholesterol diet can induce obvious regression of AS plaques; Drugs, such as probucol, clolestyramine, lovastatin, isradipine, fosinopril, etc, can reverse the AS respectively by manipulating plasma lipoprotein, scavenging free radicals, blocking calcium channel or inhibiting an-giotensin converting enzyme. Clinical trials furthersubstantiate that good lifestyle and effective control of plasma lipoprotein can reduce clinical events and cause AS plaques regression. Although, AS plaques can regress is no longer in doubt, the mechanism is still unknown. The HDL-mediated reverse cholesterol transport system, apoptosis of the plaque cells may play an important role.

Objective To understand the difference of serological characteristic between alloantibodies,'simple'Rhspecific autoantibodies and autoantibodies mimicking alloantibodies by studies of a patient who produces alloantibodies and autoantibodies that to distinguish Serologically them in order to more appropriate RBC component transfusion administration would be performed for patients.Methods Several serological methods were performed to the patient's serum samples for identification of antibodies by using two antibody screening cell reagents from different manufacturers.Using adsorption of the patient's Rh antibodies in the presence of LISS with the antibody was similar to that of the antigen negative cell from a donor who had a ccDEE Rh type and O type,and to detect antibodies in the absorbed serum and the eluting solution.Results The patient had a ccDEE Rh type with a positive direct antiglobulin test (DAT).Serum antibodies were identified as IgM anti-C,anti-e and IgG anti-e;the possibility of anti-Ce antibody is not excluded.After absorption,serum antibodies were identified as IgM anti-C,anti-e and IgG anti-e;anti-Ce antibody is not excluded.The antibody in patient's RBC elution was identified as IgG anti-e antibody.Conclusion Alloantibody and mimicking alloantibody can be distinguished by comprehensive analysis of patient's Rh phenotype,DAT result and antibody specificity in the serum and absorbed serum and elution of RBC.The low affinity antibody can be better absorbed by adding low ionic liquid (LISS).

AIM To observe the effects of the combination of heparinoid, aspirin and losartan on the experimental vascular intima hyperplasia induced by squeezing carotid artery in rats. METHODS Rats except the normal control group were under operation after two days oral administration once a day. At the second hour after injury, blood coagulation time(CT), time of arterial thrombus formation by electrical stimulus(ATFTES) and the level of TXB_2 in plasma were measured. At the fourteenth day after the surgery, the following indexes were examined: intima/media ratio, intima area ratio, PDGF-B and PCNA immunohistochemistry in carotid artery. RESULTS CT, TATFES increased and the level of TXB_2 decreased in the groups of Hep, Asp and Hep+Asp. The PDGF-B content, the positive ratio of PCNA and the inti- ma/media ratio also decreased in the groups of Hep, Asp, Los, Hep+Asp, Hep+Los and Asp+Los. Compared with single drug or two drugs combination, PDGF-B, positive ratio of PCNA, intima/media ratio and intima area ratio decreased significantly in the group of three drugs combination( P

[Objective]To evaluate the clinical efficacy and side effects of DHAOx±R regimen in the patients with relapsed and refractory non-Hodgkin's lymphoma(NHL).[Methods]Twenty patients with relapsed or refractory NHL were enrolled into this study in Cancer Center of Sun Yat-sen University.These patients were treated with DHAOx±R regimen(Dexamethasone 20 mg/day intravenous(Ⅳ)on day 1 to day 4,cytarabine 2 000 mg/m~2 3 h Ⅳ,every 12 hours on day 2;oxaliplatin 130 mg/m~2 2 h Ⅳ on day 1;with or without rituximab 375 ms/m~2 on day 0).Six patients were followed by high dose chemotherapy with autologous peripheral blood stem cell transplantation.Response to treatment wag assessed according to The International Working Group Criteria,including CR,PR,SD and PD.Side effects were graded according to WHO criteria,including 0-Ⅳ grades.[Results]Twenty patients received 47 cycles chemotherapy,13 patients(65%)received DHAOx chemotherapy and 7(35%)received DHAOx+R.The response rate(RR)for the whole group was 55%(11/20)with comeplete response(CR)rate 35%(7/20).The response can also be obtained in the patients who were already treated by platinum-based regimen before.The major toxicity Wag myelosuppression.The incidence of grade Ⅲ～Ⅳ neutropenia Wag 35%(16/47),and febrile neutropenia was 17%(8/47).The incidence of grade Ⅲ～Ⅳ thrombocytopenia was 20%(9/47).Eight cycles(17%)occurred mild neumtoxicity.With median follow-up of 12 months,1 and 2-year overall survival rate were 70.6%.[Conclusion]DHAOx was an effective regimen for recurrent and relapsed NHL patients with mild side effects and further investigation is needed.

Objective To evaluate the efficacy and toxicity of SMILE regimen for NK/T-cell lymphoma. Methods From November 2006 to February 2008, 5 patients with relapsed and 5 with first treatment NK/T-cell lymphoma were involved in this study. These patients were treated with SMILE regimen including methotrexate, isofosfamide, L-asparaginase and etoposide.1 patient were treated with autolognus hematopoietic stem cell transplantation (AHSCT), and 2 patients received local regional radiation following SMILE. Results Among 10 patients, 8 were eligible to response evaluation. The overall response rate for whole group was 50 %(4/8) without complete remission. The overall response rate for both previously untreated and relapsed patients were 50 %(2/4). Major toxicity were bone marrow supression and transient transaminase elevation, the incidence of grade Ⅲ -Ⅳ neutroponia was 65 %, and febrile neutropenia was 25 %, Grade Ⅲ transaminase elevation was 10 %. Other toxicities were mild, no treatment-related mortality occurred. 26.1% cycles discontinued due to severe side effect. Conclusion SMILE may be an effective regimen for relapsed or refractory NK/T-cell lymphoma while significant toxicities were observed. Further investigation is requried before SMILE become a standard combination for relapsed or refractory NK/T-cell lymphoma.

Objective:To study the possible immune escape mechanisms of HCoV-OC43 from human dendritic cells(DC).Methods:HCoV-OC43 was isolated from clinical specimen using BSC-1 cells and identified by Real-time PCR,and the cytopathic effect was observed by phase contrast microscope.DCs were induced in vivo using hu-GM-CSF and IL-4 cytokines,and after 7 days of differentiation,DCs were infected by HCoV-OC43.The morphology of HCoV-OC43 infected DC was observed by transmission electron microscope,and the cytokines related to DC functions were detected by Real-time PCR after infection.DC proportion and function related co-stimulatory molecules were analyzed by flow cytometry.Results:In vitro HCoV-OC43 infected human DC model was successfully built.HCoV-OC43 can infect DC and generate immune response of DC in vitro,but no virus nucleonic acid could be detected in culture supernatant.The DC expression of IFN-α,IFN-β,CCL3 and CCL5 were significant decreased when infected with HCoV-OC43,but the expression of costimulatory molecules including HLA-DR,CD1c and CD86 were not affected by HCoV-OC43 infection.Conclusion:Human DC could be infected by HCoV-OC43 and generate immune response,but could not produce progeny virus.HCoV-OC43 may escape from immune response by suppressing the expression of IFN-α and other inflammatory cytokines and chemokines in DC.

AIM To establish a model of vascular intima hyperplasia for study the restenosis after angioplasty. METHODS Carotid artery of rat was exposed under general anesthesia. Two pieces of steel slides(13 mm?5 mm?1 mm) were set on and under the carotid artery separately. Then the slides were squeezed by two surgical forceps paralleling to the artery for 25 min. Histomorphological study was performed at the second hour or on the fourteenth day after operation. RESULTS At the second hour after operation, the loss of endothelial integrity and platelet deposition were seen under the scanning electromicroscopy. Under the light microscopy, there were infiltration of inflammatory cells in vessel wall andthrombus formation in the vessel cavity. At the fourteenth day after operation, PCNA positive cells in vessel wall of squeezed artery were significantly higher, the ratios of intima, medium and intima areas of squeezed artery were significantly increased and the ratio of cavity area of squeezed artery was significantly decreased compared with those of uninjured artery.The vascular intima hyperplasia and PCNA positive cells in squeezed arterial wall were inhibited by oral administration of heparinoid and aspirin. CONCLUSION With squeezing carotid artery in rats the vascular intima hyperplasia as restenosis after angioplasty was established.

OBJECTIVETo retrospectively compare combined endovascular intervension with traditional bypass operation for the treatment of Budd-Chiari syndrome (BCS).

METHODSFrom July 1989 to June 2001, 49 patients undergoing surgery for BCS were studied. 32 operations were performed by traditional bypass (from superior mesenteric vein or inferior vena cava to right auricle), and 17 by combined endovascular operation.

RESULTSThe data demonstrated a high incidence of perioperative complications, longer hospital stay, and expensive cost in the former group than in the latter group (P < 0.01). The mid-term effects were significantly better in the latter than in the former (P < 0.05). Severe complications occurred in the bypass group included hepatoencephalopathy, obtinacy ascites, cardiac dysfunction, and embolization of vascular grafts.

CONCLUSIONSCombined endovascular intervention and shunting are the treatment of choice for BCS, with different combination according to its clinical type. This approach is simple, safe, effective, and economic.

Adult ; Budd-Chiari Syndrome ; surgery ; Female ; Follow-Up Studies ; Humans ; Intraoperative Complications ; Length of Stay ; Male ; Mesenteric Veins ; surgery ; Middle Aged ; Vena Cava, Inferior ; surgery

Objective To study the distribution of bacterium extended spectrum beta lactamases (ESBLs) in sputum samples from patients with lower respiratory tract infection in Panzhihua Hospital of Integrated Traditional Chinese and Western Medicine . Methods A total of 512 strains of gram negative bacterium were isolated from sputum samples of patients with lower respiratory tract infection from January 2014to January 2016 ,standard disk diffusion method was used to detected ESBLs ,drug sensitivity was performed by K-B disk diffusion method .Distribution and drug resistant status of ESBLs bacterium were analyzed .Results Detec-tion rate of ESBLs bacteriumin cadre ward and ICU were higher than that in department of respiration ,and the difference was sta-tistical significant(P< 0 .01) .Among ESBLs bacterium isolated from department of respiration ,Escherichia coli accounted for 37 .5% ,Enterobacter cloacae accounted for 25 .8% .Among ESBLs bacterium isolated from cadre ward ,Escherichia coli accounted for 58 .2% ,Enterobacter cloacae accounted for 45 .5% .The resistant rate of gram negative bacterium producing ESBLs to trime-thoprim was lowest .Conclusion It′s important to understand the distribution and drug resistant status of gram negative bacterium , so as to provide the basis for rational use of antibiotics .

Objective to investigate the clinical efficacy of decompression and pedicle screw fixation through posterior approach for complete thoracic spine fracture dislocation.Methods The clinical data of six patients with complete thoracic spine fracture and dislocation treated from September 2002 to June 2016 were analyzed retrospectively by case series study.There were five males and one female,aged 21-67 years old (mean,47.2 years).The injury segments were T3～4 dislocation in one case,T5～6 dislocation in two cases,T6 ～7 dislocation in two cases and T8 ～9 dislocation in one case.There was one case of ASIA grade E and five cases of Grade A,and all of six cases were associated with multiple rib fractures and hemopneumothorax.The companied status was one case of sternal fracture,one case of atlantoaxial complex fractures and three cases of pulmonary contusion.The posterior median incision decompression and pedicle screw system fixation were performed,and the intervertebral bone grafting was conducted after restoration.The surgery time,bleeding volume during surgery,fracture restoration,bone grafting fusion,failure of internal fixation and other complications were recorded.The Visual Analogue Scale (VAS) and American Spinal Injury Association (ASIA) classification were used to assess the pain and neurological function improvement between the preoperative visit and final follow-up visit.Results The surgery time was 150-240 minutes (mean,205 minutes).The bleeding volume during the surgery was 700-2 100 ml (mean,1167 ml).One case was died of pulmonary infection at one week after surgery,the others were followed up for 3-14 months (mean,7.4 months).After operation,five patients were satisfied with the reduction,and the lateral displacement was partially restored in one cases.Five cases of intervertebral bone grafting all had bone fusion.There was no fixation failure.The VAS was (7.4 ± 0.6) points before surgery,(4.5 ± 1.6) points at one week after surgery and (1.8 ± 0.3) points at final visit of follow-up,which had significant difference from the preoperative status (P ＜ 0.05).One case of ASIA grade E had no postoperative aggravation and four cases of grade A had no improvement.Conclusion Posterior decompression and pedicle screw fixation system is optimal choice of treatment for complete thoracic fractures and dislocations for it can attain reduction of fracture and dislocation as well as bone fusion,provide stability for spine and relieve pain.