Objective To evaluate the feasibility and utility of three different assays on early diagnosis and monitoring of neonatal congenital cytomegalovirus infection. Methods Ninety-eight neonates whose mother was CMV-IgM positive during pregnancy were examined on the 14th days after birth for CMV antigen in blood and PCR-CMV-DNA in the saliva. Three different methods were applied including CMV antigenemia assay, PCR for CMV-DNA and ELISA for serum CMV-IgM. Neonates were followed up for six months. Results (1) Forty-eight of the 98 neonates were diagnosed as congenital CMV infection including 7 symptomatic infection and 41 asymptomatic. None of the 98 subjects was CMV-IgM positive. Among the 7 symptomatic cases, the positive rates of CMV antigen and PCR-CMV-DNA were 100%(7), 71.4%(5), and 70.7%(29/41), 46.3%(19/41) in the asymptomatic group, respectively. The sensitivity of CMV antigenemia assay and PCR was 75.0% and 54.2%, respectively. The CMV antigenemia index of the symptomatic cases was significantly higher than that of asymptomatic ones [(16-52)/50 000 vs (3-31)/50 000 white blood cells, P

Objective To examine the expression of cell cycle regulatory protiens in renal tubulointerstitial cells of human glomerulonephritis. Methods Immunohisochemieal studies were performed on 19 specimen from renal biopsy to detect cyclin Dl, cyclin A, p21 and proliferating nuclear antigen (PCNA) . Results Cyclin Dl, cyclin A and p21 were positive in some of tubulointerstitial cells, and showed significant correlations with positive PCNA cells. The numbers of tubular positive cells in both groupsofⅠand Ⅱ degree of histopathological change were more than those of other groups. The numbers of interstitialpositive cells showed significant correlations with the degree of tubulointerstitial histopathological change and the value of urine NAG. Conclusion Cell cycle regulatory proteins regulate the proliferation of tubular and interstitial cells, and correlate with the interstitial fibrosis.

Objective To investigate the safety,diagnostic value and clinical impact of double balloon enteroscope (DBE) in elderly patients (aged ≥75 years).Methods Clinical data and DBE findings of elderly patients in the Department of Gastroenterology in Remin Hospital of Wuhan University from January 2010 to January 2013 were retrospectively analyzed and compared with those of younger patients.Results The diagnostic rate,complication rate and clinical impact rate were 69.0％ (29/42),0％ (0/42) and 76.2％ (32/42) in elderly patients.There were no statistically significant differences on those parameters between elderly patients and younger patients (all P＞0.05).For elderly patients,the leading causes of obscure gastrointestinal bleeding (OGIB) were tumor (30.0 ％,9/30) and ulcer (16.7 ％,5/30),while angiectasis (6.7 ％,2/30) was uncommon.Conclusions DBE is an effective and safe method for diagnosis of small bowel disease in elderly patients.Tumor is the most common cause of OGIB,while angiectasis was uncommon.

Objective To assess the value of double balloon enteroscopy (DBE) in etiological diagnosis of small bowel ulcer.Methods The clinical and endoscopic data of patients undergoing DBE at the Department of Gastroenterology, Renmin Hospital of Wuhan University from January 2010 to January 2016 were reviewed.For patients with small bowel ulcer revealed by DBE, the etiologic diagnosis was retrospectively analyzed.Results One hundred and three patients with small bowel ulcer were included in the analysis.The initial diagnosis based on morphology of ulcer was Crohn's disease (58.3%, 60/103), intestinal tuberculosis (18.4%,19/103), etiology unknown (24.3%, 25/103).The final diagnosis comprehensively based on pathology, clinical data and disease outcome was Crohn's disease (44.7%,46/103), intestinal tuberculosis (18.4%,19/103), lymphoma (3.8%,4/103), eosinophils enteritis (1.9%,2/103), non-steroidal anti-inflammatory drug enteritis (1.9%,2/103), adenocarcinoma (1.0%,1/103), stroma tumor (1.0%,1/103),ischemic enteritis (1.0%,1/103), vascular malformation (1.0%,1/103), Henoch-Schonlein purpura (1.0%,1/103), etiology unknown (24.3,25/103).The accurate diagnosis rate and misdiagnosis rate for Crohn's disease by DBE were 73.3%(44/60)and 10.0%(6/60).The accurate diagnosis rate and misdiagnosis rate for intestinal tuberculosis by DBE were 14/18 and 2/18.Conclusion There are diversity and complexity in etiologic diagnosis of small bowel ulcer.The diagnosis should be based on the comprehensive analysis of morphology of ulcer, endoscopic and surgical pathology and clinical data.Follow up of small bowel ulcer by DBE may provide important information for etiologic diagnosis.

OBJECTIVE To explore the sterilizing effect of low-temperature vacuum formaldehyde.METHODS The test group used the own-produced 140 L low-temperature vacuum formaldehyde sterilizer for sterilization;and the control group used "Xinhua" hydrogen peroxide plasma sterilizer.Sterilization effect of the two groups was monitored by biological indicator.RESULTS After 50 sterilization procedures run in test group,the biological indicators the bacterial were all killed,the qualification rate of sterilization was 100%.But after 30 sterilization procedures run in control group,only 8 procedures were qualified,the qualification rate of sterilization was 26%.The sterilizing effect of the two groups was significantly different(P

Objective To observe the dynamic changes of heme oxygenase 1,NAD(P)H:quinine oxidoreductase 1 and Nuclear factor-E2-related factor 2 in the lung tissue of acute H2S-intoxicated rats and intervention effects of ulinastratin(UTI).Methods A total of 96 SD rats of clean grade were divided randomly(random number)into four groups:normal control group(NS group,n =8),UTI control group(UTI group,n =8),H2S-intoxicated model group(H2S group,n =40,rats were exposed to H2S(200 × 10-6)for 1 h to establish the H2S-intoxicated model)and UTI treatment group(H2S +UTI group,n =40,rats were intraperitoneal injected with the dose of UTI 105 U/kg).H2S group and H2S + UTI group were sacrificed 2,6,12,24 and 48 h after modeling.The activity and mRNA expression of HO-1 and NQO-1 in the lung tissue were measured by ELISA and RT-PCR methods,and the expression of Nrf2 mRNA and protein in the lung tissue was detected by RT-PCR and Western Blot methods.Pathological changes of lung tissue were observed by lightmicroscope and the lung injury score was used to evaluate inhalation injury.Results The pulmonary HO-1 activity and mRNA expression in rats of H2S group at 2,6,12 h(P ＜ 0.01)after intoxication were markedly increased than that in NS group:In comparison with H2S group,the pulmonary HO-1 activity and mRNA expression increased at 6,12,24,48 h(P ＜0.01).The pulmonary NQO-1 activity and mRNA expression in rats of H2S group at 2,6,12,24 h(P＜ 0.01)after intoxication were markedly increased than that in NS group; In comparison with H2S group,the pulmonary NQO-1 activity and mRNA expression increased at 6,12,24,48 h(P ＜ 0.01).The pulmonary Nrf2 mRNA and protein expression in rats of H2S group at 2,6,12 h(P ＜0.01 or P ＜0.05)after modeling were markedly increased than that in NS group and reached peak 2 hour after modeling; In comparison with H2S group,the pulmonary Nrf2 mRNA and protein expression increased at 6,12,24,48 h(P ＜0.01).At 24 h after modeling,the degree of lung damage were also decreased in H2S group compared with H2S + UTI group in the lightmicroscope.Histopathological examination showed that the degree of lung injury in H2S + UTI group was less severe than that in H2S group especially in the 12,24 and 48 h (P ＜0.01).Conclusions HO-1,NQO-1 and Nrf2 are involved in the pathogenesis of acute lung injury induced by H2S-intoxicated in rats.UTI may improve the imbalance in redox and activate HO-1,NQO-1 and Nrf2 can reduce lung injury and protect the lung injury induced by H2S in rats.

Objective To investigate the feasibility and application value of total enteroscopy with double balloon enteroscopy(DBE)for diagnosis and treatment of patients with obscure gastrointestinal bleeding(OGIB). Methods The clinical and endoscopic data of patients underwent DBE for OGIB in the Department of Gastroenterology,Remin Hospital of Wuhan University from January 2010 to December 2015 were retrospectively analyzed. Results Total enteroscopy was indicated in 36.3%(136/375)of patients. The success rate was 86.0%(117/136)and complication rate was 1.5%(2/136). Negative findings,non-small bowel lesions and small bowel lesions were detected in 44.4%(52/117), 6.8%(8/117), and 48.7%(57/117)of patients with total enteroscopy. Re-bleeding occurred in 8.9%(4/45)of patients with negative total enteroscopy,while 1 small bowel mesenchymoma and 1 gastric fundus Dieulafoy′s lesion were revealed subsequently. Re-bleeding occurred in 33.3%(5/15)of patients with incomplete enteroscopy,and 1 small bowel polyp and 1 small bowel angiectasis were revealed subsequently. Conclusion DBE can complete total enteroscopy within one day and provide important clinical information of OGIB. Non-small bowel lesions,small bowel lesion missed by DBE and potential bleeding lesions in small bowel beyond the reach of DBE should be considered in patients with negative enteroscopy.

were no significant differences in the detection rate of recto-sigmoid colon,mid colon,right colon and total detection of polyps among the 3 groups (P >0.05).Conclusion 4-L split-dose PEG is better than the oth-er 2 regimens in the colon cleansing quality,so it can better reach the intestinal cleaning standards before enteroscopy,which is a more suitable regimen for bowel preparation.

Objective To analyze the epidemiological characteristics of morning hypertension in people with eseential hypertension in Dali Bai autonomous prefecture,and to study the management model for morning hypertension. Methods From May 2015 to January 2017,302 patients with hypertension in the People's Hospital of Dali Bai Autonomous Prefecture were divided voluntarily into two groups,including single management group (group 1)and systematic management group (group 2 ).During six to twelve months follow －up,the changes in control rate of morning hypertension,serum biochemical indicators,KAP and Mofisky score were observed before and after intervention. Results The proportion of morning hypertension in people with hypertension was 62.25%,61.11% in men and 62.86%in females.The patients with morning hypertension had higher age,BMI,WC,TC,LDL－C,SBP,DBP,CRP, FBG,SCr,Sokolow－Lyon,Cornell,LVMI,UACR and MAU,more cervical plaque,and lower HDL －C and eGFR compared with non－morning hypertension(P＜0.05 －0.001).The number of patients with target organ damage was most in patients with morning hypertension by home blood pressure monitoring(HBPM),second in ambulatory blood pressure monitoring(ABPM),least in clinic blood pressure monitoring (CBPM)(P＜0.05 －0.001).After six to twelve months follow－up,compared with before intervention,the control rate of morning hypertension was increased (43.78%vs.61.39%),and SBP,DBP,HR,BMI,WC,TC,TG,UA,Scr were decreased in both two groups,which in the group 2 were lower than those in the group 1(P＜0.05 ).Compared with before intervention,the KAP score and Mofisky in the two groups after intervention were significantly improved(P＜0.05－0.01)[K score:(9.63 ±3.01)points vs.(14.26 ±2.89)points in the group 1,(10.11±2.34)points vs.(17.23 ±1.06)points in the group2;A score:(2.05 ±1.21)points vs.(2.98 ±0.25)points in the group 1,(2.08 ±1.65)points vs.(3.56 ±0.42)points in the group 2,P score:(4.39 ±2.36)points vs.(5.89 ±3.24)points in the group 1,(4.71±3.42)points vs.(7.26 ± 1.21)points in the group 2,Mofisky questionnaire score:(61.23 ±5.79)points vs.(72.36 ±6.18)points in the group 1,(60.89 ±6.47)points vs.(88.45 ±5.48)points in the group 2],which in the group 2 were higher than those in the group 1(P＜0.01).Conclusion The control rate of morning hypertension in patients with hypertension in Dali Bai autonomous prefecture is low,the HBPM is better way to predict the target organ damage,and systematic management model is effective to improve the control rate of morning hypertension and so do in KAP and Morisky score.