Objective To study the diagnosis and treatment of typhoid intestinal perforation(TIP). Methods The clinical data of 30 cases of TIP treated in our hospital from 1978 to 1998 were retrospectively analysed. Results All 30 cases were performed emergency laparotomy exploration. Of them, 16 cases underwent suture of the perforation, 9 enterectomy and intestinal anastomosis, and 5 exteriorization of intestine. After operation, 2 cases had infection and disruption of incisional wound, 1 pulmonary infection, 1 toxic myocarditis and 4 intestinal fistula. 26 cases curred, 4 cases died including toxic shock in 1 case, intestinal fistula and concomitant asthenia universalis in 3 cases. Conclusions Early diagnosis, early operation and choosing suitable operative procedure are important to reducing the mortality of TIP.

Objective To explore the total anti-oxidation capacity(T-AOC), superoxide dismutase(SOD), nitric oxide synthase(NOS) and nitric oxide(NO) in testis homogenate of the rats’ with chronic fluorosis induced by drinking NaF solutions with different concentration. Methods 24 male Wistar rats were divided into 3 groups (8 rats per group) including control group, low-fluoride(LF) group, high-fluoride(HF) group, which were exposed to fluoride by means of freely drinking tap water containing NaF with 0, 100 and 200 mg/L respectively for 20 weeks. T-AOC, NOS activities and SOD activity of the testis tissue were determined by colorimetry , xanthine oxidase method and nitrate reductase method respectively. Results Compared with the control group, the T-AOC of the testis tissue increased significantly in LF group and decreased significantly in HF group. SOD activity of the testis tissue showed on significant difference among the control group, LF group and HF group . Compared with the control group, the levels of NOS and NO decreased significantly in LF group and increased significantly in HF group. Conclusion The T-AOC of the testis tissue exposed to low level of fluoride presents a compensatory increase induced by the inhibited activity of NOS and synthesis of NO. Higher level of fluoride may increase reactive oxygen species(ROS), and cause abnormal expression of induce nitric oxide synthase(iNOS) and increased synthesis of NO in the testis tissue.

Objective To investigate the application value of real clinical case centered situation simulation examination model in clinical medicine. Methods Two classes were randomly selected from 2008 grade clinical medicine majors, respectively as test group(n=158) and control group(n=156). Final examination of test group includes usual performance, case-oriented situation simulation examination (COSSE) and final written examination. Traditional methods were used in control group. The same paper was used in final written examination of the two groups. Scores of written examination and question-naires were used to evaluate the COSSE model. Data were processed using SPSS 16.0 statistical software;t and chi-square tests were used to analyze the data;P<0.05 signifies that the difference is statistically sig-nificant. Results Scores of final examination in test group were higher than those in control group(P<0.001). Times of independent completion of history taking, physical examinations and medical record writing were more in test group than in control group(P=0.002,0.017,0.048). Conclusions Contents and methods of COSSE is conducive to improving student's professional comprehensive ability.

Objective:To analyze the association between the expression of ubiquinone oxidoreductase complex assembly factor 4 (NDUFAF4) and clinical prognosis of patients with hepatocellular carcinoma (HCC), evaluate the effect of NDUFAF4 on the radiosensitivity of human HCC cell lines, and unravel the underlying mechanism.Methods:The online database and HCC tissue samples were used to investigate the expression of NDUFAF4, and the correlation between NDUFAF4 expression level and clinical prognosis. The si-NDUFAF4 plasmid which down-regulated the expression level of NDUFAF4 was transferred into HepG2 and Huh7 cells. The radiosensitivity of HCC cell lines was detected by clone formation experiment. Nude mice were prepared for tumor-bearing experiment. The β-catenin level was detected by immunofluorescent staining. The expression levels of E-cadherin and N-cadherin proteins were determined by Western blot.Results:Bioinformatics results confirmed that NDUFAF4 was significantly up-regulated in HCC tissues, and the higher the expression level, the worse the patients' clinical prognosis ( P<0.05). The expression level of NDUFAF4 in HCC tissues was significantly higher than that in the adjacent tissues. Clone formation experiment confirmed that knockdown of NDUFAF4 significantly decreased the survival rate of HCC cells ( P<0.01). In vivo experiment showed that knockdown of NDUFAF4 could prevent the proliferation of HCC cells and down-regualte the expression levels of β-catenin and Ki-67. Knockdown of NDUFAF4 significantly down-regulated the expression level of β-catenin protein in the nucleus of HCC cell lines, suggesting that NDUFAF4 could activate the WNT/β-catenin signaling pathway. Knockdown of NDUFAF4 significantly up-regulated the expression level of E-cadherin and down-regulated that of N-cadherin. Conclusions:Knockdown of NDUFAF4 can significantly enhance the radiosensitivity of HCC cell lines by inhibiting the WNT/β-catenin signaling pathway. The expression level of NDUFAF4 is intimately correlated with clinical prognosis. NDUFAF4 can be considered as a new target for lowering the radiation resistance of HCC.

Objective To assess the CT characteristics of thoracoabdominal localized Castleman disease (LCD) in 55 cases and correlate with histopathologic features. Methods Fifty-five patients with LCD proved histopathologically in thorax ( n = 25 ) and abdomen ( n = 30 ) were collected during past 20 years. The unenhanced and contrast-enhanced CT were performed in all patients. Two radiologists reviewed CT images and the CT findings were analyzed simultaneously. Results In 54 patients with hyaline-vascular type ( n = 50 ) and mixed type ( n = 4 ) localized CD, the lesion typically presented as solitary mass (90. 7% , 49 cases), with irregular or lobular or infiltrative margin ( 83.3% , 45 cases),central calcification (38. 9%, 21 cases), marked enhancement (100% , 54 cases), focal non-necrosis low attenuation areas (72. 2%, 39 cases), lymphadenopathy (70.4%, 38 cases) and dilated feeding vessels adjacent to the mass (96.3%, 52 cases). One lesion with plasma cell type localized CD presented as a mass with irregular margin, mild enhancement and central necrosis. Four morphologic patterns wereclassified on CT, including solitary mass with well-circumscribed margin (n =4), irregular or lobular margin ( n = 30), infiltrative or halo-like margin ( n = 16 ), and multiple coalescent maasses ( n = 5 ). Conclusion CT features of thoracoabdominal localized CD are closely related to the location and pathological type. LCD with hyaline-vascular and mixed type has typical CT characteristics, while LCD with plasma cell type has no typical CT findings.

We report a complete genomic sequence of rare isolates (minor genotype) of the SARS-CoV from SARS patients in Guangdong, China, where the first few cases emerged. The most striking discovery from the isolate is an extra 29-nucleotide sequence located at the nucleotide positions between 27,863 and 27,864 (referred to the complete sequence of BJ01) within an overlapped region composed of BGI-PUP5 (BGI-postulated uncharacterized protein 5) and BGI-PUP6 upstream of the N (nucleocapsid) protein. The discovery of this minor genotype, GD-Ins29, suggests a significant genetic event and differentiates it from the previously reported genotype, the dominant form among all sequenced SARS-CoV isolates. A 17-nt segment of this extra sequence is identical to a segment of the same size in two human mRNA sequences that may interfere with viral replication and transcription in the cytosol of the infected cells. It provides a new avenue for the exploration of the virus-host interaction in viral evolution, host pathogenesis, and vaccine development.
Base Sequence ; China ; Cluster Analysis ; Gene Components ; Genetic Variation ; Genome, Viral ; Genotype ; Molecular Sequence Data ; Phylogeny ; Reverse Transcriptase Polymerase Chain Reaction ; SARS Virus ; genetics ; Sequence Analysis, DNA ; Severe Acute Respiratory Syndrome ; genetics