Objective To analyze the superiority of implanting operation with autoskull stored at ultrahypothermia over low temperature's and frozen skull bone of oneself.Methods 42 case were observed and followed up after operation.Results Incision is healing by firct intention.there were many advantages,such as good biological activity,beautiful appearance,no repellent response,no immunoreaction and hard to infection,etc. After storing 1,3,6 and 12 months,the histological structure of frozen skull observed by electronscope was similar to those of fresh skull.Pestroyed skull bone cells were not found.All cases had no complication during the period of 3 to 12 months(mean 6.5 months) follow-up after operation.After 12 months,X ray and CT scan showed that skulls were healed.Conclusions Implanting operation with autoskull stored at ultra-hypothermia is one of the most effective technique for repairing skull defects.

AIM: To investigate the effects of irbesartan on acute myocardial ischemia-reperfusion injury and on expression of ICAM-1 and VCAM-1 in myocardial ischemia-reperfusion areas in rabbits. METHODS: Anterior descending branch of left coronary artery (LAD) was ligated in ischemia-reperfusion (IR) group but not in the sham group. Rabbits of IR group were subjected to 60 min of LAD occlusion, and 360 min of reperfusion. In the treated group, the rabbits were given irbesartan until the trial ended. Then, all rabbits were killed and tissue samples were removed from IR areas. After disposed with routine histological methods and stained with hematoxylin and eosin (HE), these samples were examined by light microscopy. The expression of ICAM-1 and VCAM-1 were also investigated by employing immunohistochemical SP method in the tissue samples. RESULTS: Degree of damage in cardiocytes and of neutrophil infiltration were more serious in IR group than those in sham group (P

Objective To investigate the effect of using massage by finger pressing to prevent the enteroparalysis which caused by continue atropine injection. Methods Divided 60 patients with severe organophosphorus poisoning into experimental group and control group randomly, there were 30 cases in each group.Routine nursing cares were used in the control group, the massage by finger pressing was added in the experimental group.Compared the correlative indexes such as the time of first defecation, the times of defecation, the number of patients with enteroparalysis, the time of cholinesterase reactivation between the two groups. Results By the statistic test, all the indexes which have mentioned above had significant differences between 2 groups,P

Objective To compare the therapeutic effects of closed reduction and transverse fixation with Kirschner wires and open reduction and fixation with mini-plates or Kirschner wires for the fifth metacarpal base fracture.Methods Data of 50 patients,who had been treated in our hospital for the fifth metacarpal base fracture from August 2005 to May 2012,were enrolled in this study.Twenty-six patients underwent closed closed reduction and transverse fixation with Kirschner wires,including 22 males and 4 females,aged from 17 to 41 years; according to the OTA classification,there were 8 of type A1,11 of type B1,and 7 of type C1.Twenty-four patients underwent open reduction and fixation with mini-plates or Kirschner wires,including 21 males and 3 females,aged from 19 to 46 years (average,26 years); according to the OTA classification,there were 11 of type A1,8 of type B1 and 5 of type C1.The total active motion (TAM) score of Chinese Medical Associaition was used to evaluate the range of motion of the joint.Results In closed reduction group,the operation time ranged from 14 to 33 min; the treatment costs ranged from 2018 to 2995 yuan; 23 patients were followed up for 6 to 26 months; X-rays showed the anatomic reduction was achieved in all patients,and the fracture healing time ranged from 4 to 7 weeks; according to the TAM score,the result was excellent in 15,good in 6 and fair in 2,and the excellent and good rate was 91.3％.In open reduction group,the operation time ranged from 45 to 105 min; the treatment costs ranged from 3874 to 4793 yuan; 22 patients were followed up for 6 to 21 months; X-rays showed the anatomic reduction was achieved in all patients,and the fracture healing time ranged from 4 to 8 weeks; according to the TAM score,the result was excellent in 13,good in 7 and fair in 2,and the excellent and good rate was 90.9％.Conclusion Closed reduction and transverse fixation with Kirschner wires is an effective method for the fifth metacarpal base fracture,which has several advantages,such as simple operation,stable fixation,satisfactory results,short operation time and low treatment costs.

Objective To investigate the effects of solution-focused brief therapy on self-perceived burden and quality of life in patients with stroke.methods 60 patients with stroke recruited at the department of rehabilitation of a hospital in Chengde city from January to June 2016 were divided into control group (n=30) and experimental group (n=30).Both groups received conventional nursing care and rehabilitation treatment.In addition,the experimental group received psychological intervention of solution-focused brief therapy,2-3 times a week,30-45 minutes for each time.The self-perceived burden scale(SPBS),memorial university of Newfoundland scale of happiness(MUNSH) and short from 36 health survey questionaire(SF-36) were used to assess the patients before and after intervention.Result s(1)The differences of the scores of SPBS ((39.27±5.83) vs (22.40±4.03),t=16.248,P<0.01) and MUNSH ((4.20±4.50) vs (31.10±3.66),t=-24.136,P<0.01) for the experimental group before and after the intervention were statistically significant.There were statistically significant differences in scores of SPBS ((22.40±4.03) vs (35.30±2.63),t=-14.683,P<0.01) and MUNSH ((31.10±3.66) vs (19.67±3.64),t=12.127,P<0.01) between the experimental group and control group after the intervention.(2)The scores of physiologic functioning,general health,vitality,social functioning,role-emotional and mental health for the experiment group were higher than before(t=-23.427--6.624,all P<0.01).After the intervention,the scores of physiologic functioning,general health,vitality,social functioning,role-emotional and mental health in the experiment group were higher than those in control group(t=5.705-12.806,all P<0.01).Conclusion Solution-focused brief therapy can effectively reduce the self-perceived burden of stroke patients and improve their quality of life.

Objective To evaluate the effects of nucleoside/nucleotide analogue treatment on immunoglobulin and complement in patients with chronic hepatitis B (CHB).MethodsA total of 157 CHB patients were recruited and divided into CHB group,liver cirrhosis (LC) group and severe hepatitis B (SHB) group.There were 50 patients who received oral antiviral treatment (lamivudine 100 mg/d,or entecavir 0.5 mg/d,or telbivudine 600 mg/d).Serum levels of complement 3 and 4 (C3,C4),C-reaction protein (CRP),hemolytic complement (CH50),immunoglobulin G,M,A (IgG,IgM,IgA),hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) were detected by enzyme-linked immunosorbent assay (ELISA) or immunoturbidimetry.Hepatitis B virus (HBV) DNA was quantified by real-time polymerase chain reaction (RT-PCR) before and 1,2,3 and 4 weeks after nucleoside antiviral therapy.Comparison of means was done by t test and Mann-Whitney test.The correlation was analyzed by Pearson correlation coefficient test.ResultsSerum IgA and IgM levels of SHB and LC patients were significantly higher than those of CHB patients (P＜0.01).Levels of C3,C4,CH50 and CRP were significantly different among three groups.Levels of C3,IgM,IgG and HBV DNA in HBeAg positive patients were significantly different from those in HBeAg negative patients.There was a statistically significant difference of IgA,IgM,C3 and CH50 levels between patients with high HBV DNA level and low HBV DNA level in HBeAg-positive patients.While in the HBeAg-negative patients,only the IgA level was significantly different with HBV DNA levels.After anti-viral treatment,immunoglobulin and HBV DNA levels were all decreased in three groups,while the serum complement level was increased compared to baseline,and the differences became significant at week 4 of treatment. HBV DNA level was negatively correlated with C3 (r=-0.78,P=0.021) and HBeAg titer was positively correlated with C3 (r=0.87,P=0.015).ConclusionsThe immunoglobulin,CRP,C3,C4,and C H50 could reflect the inflammatory activity in liver.The changes of C3 level can predict the efficacy of antiviral therapy.

Objective To investigate the survival of advanced stage periampullary carcinoma and its prognostic factors.Methods The clinical data and follow up of 134 patients with advanced stage periampullary carcinoma admitted to our hospital between January 2007 and December 2010 were retrospectively collected and analyzed.Results Of 134 patients,there were 83 males and 51 females.The mean age±S.D.was 62.49±11.41 (28-83).For the 86 patients who underwent surgery,32 had extensive peritoneal metastases on surgical exploration,27 had metastases/involvement of the liver or stomach,and 27 had major vessel infiltration.For these 86 patients,55 received surgical exploration,whereas 31 had surgical exploration plus bypass anastomosis. 45 patients received chemotherapy,while 67 received chemotherapy plus radiotherapy.The improvements in quality of life and in clinical response rate after concurrent chemoradiotherapy or chemotherapy alone were 73.1％ and 57.8％,respectively.The overall survival was 14.27±1.06 months.The median survival time was 11 (8.95±13.05) months.The 1- and 3-year survival rates were 43％ and 10％,respectively.Karnofsky performance status,and the presence or absence of jaundice co-related with poor prognosis on single factor analysis.The Karnofsky performance status was an independent survival predictor on multifactor analysis.Conclusions The prognosis of patients with advanced stage periampullary carcinoma was poor.Chemotherapy with or without radiotherapy had similar impact on overall survival,Karnofsky performance status was an independent survival predictor.

Objective:The purpose of this study is to evaluate the frequency of MDSCs in peripheral blood of hepatocellular carcinoma patients and to investigate the clinical significance of change of MDSCs in the peripheral blood and provide new ways for e-valuating immune state and prognosis of hepatocellular carcinoma patients.Methods: Blood samples were obtained from 62 patients with HCC and 20 healthy donors.The phenotype of CD3,CD4,CD33,HLA-DR and Th1,Th2 immune subsets in peripheral blood of each group were observed by FCM methods.Results:There were statically different frequencies in the peripheral blood between hepato-cellular carcinoma and healthy control group,which the proportion of total CD3+T lymphocytes and CD3+CD4+T cells were lower and the proportion of CD33+HLA-DR-MDSCs was higher in hepatocellular carcinoma patients.( P<0.05 ).The increase of percentage of MDSCs was greater in patients at Stage C and D than in patients at stage A and B.Conclusion:The Th1/Th2 ratio in the PBMC were of imbalance and MDSCs was significantly increased in peripheral blood of hepatocellular carcinoma patients.The increase of MDSCs was significantly correlated with clinical stage.CD33+HLA-DR-MDSCs may play an important role in prediction in prognosis and tumor immune status of hepatocellular carcinoma.

Objective To explore the effects of estrogen on oxidative stress of the lung tissue induced by acute paraquat (PQ) poisoning. Methods Thirty-two male adult New Zealand rabbits were randomly divided into model group and estrogen intervention group, 16 rabbits in each group. The model of lung injury induced by PQ poisoning was reproduced by feeding 16 mg/kg of 20% PQ through gastric tube. The rabbits in estrogen intervention group received intravenous infusion of 5 mg/kg estrogen after PQ challenge for 7 days, and the rabbits in model group received an equal volume of normal saline. Three rabbits in each group were sacrificed at 1, 2 and 3 days respectively after exposure. The lung tissue was harvested, the levels of reactive oxygen species (ROS) was determined by 2',7'-dichlorofluorescin diacetate (DCFH-DA), malondialdehyde (MDA) was determined by thiobarbituric acid (TBA), the mRNA expression of manganese-containing superoxide dismutase (MnSOD) was determined by reverse transcription-polymerase chain reaction (RT-PCR), and adenosine triphosphatase (ATP) content in mitochondrion was determined by enzyme linked immunosorbent assay (ELISA). The pathological changes in lung were observed under light microscopy using hematoxylin and eosin (HE) staining, and the lung injury was evaluated with lung injury score. Results The contents of ROS and MDA in lung within 3 days after PQ poisoning were gradually increased, and MnSOD mRNA expression and ATP content were gradually decreased. Estrogen intervention could significantly reduce the production of ROS and MDA after PQ poisoning [3-day ROS (fluorescence intensity): 161.05±30.04 vs. 188.30±31.80, 3-day MDA (mmol/L): 98.71±0.92 vs. 122.12±1.24], up-regulate MnSOD mRNA expression (integral A value: 3.05±0.90 vs. 1.22±0.24), and increase ATP content in mitochondrion (ng/L: 3.75±0.92 vs. 2.28±0.29) with statistically significant differences (all P < 0.01). In lung tissue after PQ poisoning, congestion, edema, focal pulmonary consolidation, pulmonary interstitial and alveolar space were infiltrated by a large number of neutrophil, alveolar interval were thickened obviously and the above phenomenon were most serious at 3 days after poisoning as shown under optical microscope. Estrogen intervention could significantly improve lung injury as compared with that of model group, and the lung injury score at 3 days was significantly lower than that of model group (11.8±0.7 vs. 13.5±1.0, P < 0.01). Conclusions The oxidative stress indicators in the lung tissue after PQ poisoning were obviously abnormal, the pathological damage was serious with time dependence. The administration of estrogen can reduce acute lung injury after PQ poisoning by reducing the oxidative stress.

Objective To design and testify a novel strategy for acquiring mimetic epitope mapping by screening for a phage random peptide library using polyclonal anti keratin autoantibodies (AK auto Ab). Methods AK auto Ab were isolated and purified from pooled human sera by keratin affinity column in which keratin had been linked with CNBr Sepharose 4B,then biotinylated by the biotin ester. A 15 mer phage random peptide library was biopanned for 3 cycles and positive clones were identified by ELISA,competition assay and DNA sequencing. ResultsBy sequence comparison 23 positive clones were selected randomly and three epitopes were confirmed. Among the three epitopes SLSPMPTTNRR was the dominant epitope. The phages carrying positive clones reacted with AK auto Ab specifically and keratin could prevent interaction between AK auto Ab and positive phages. Conclusion The designed strategy is successfully applied in acquiring epitopes of polyclonal autoantibodies to keratin, which could provide a new approach for the discovery of epitope mapping which binds to natural autoantibodies.