Objective To investigate the differential diagnosis of pleural effusions with CT density.Methods to meas- ure the CT density of 67 cases of tuberculo-pleural effsions and malignant pleural effusions.Results tuberculo-pleu- rai effsions and malignant pleural effusions are difference.Conclusion CT density of pleural effusions is helpful to dif- ferentiate tuberculo-pleural effsions between malignant pleural effsions.

Objective To investigate the effectiveness and technical points of anatomical liver resection by trans-Glisson Sheath methylene blue staining in treatment of hepatolithiasis of right posterior lobe.Methods The clinical data of 12 cases of hepatolithiasis of right posterior lobe treated with anatomical liver resection by Glisson sheath methylene blue staining were retrospectively analyzed.Result 6 of 12 patients had undergone more than 2 previous biliary surgeries.All patients underwent contrast-enhanced CT scan and portography,hepatolithiasis of segment Ⅵ in 4 cases,right posterior lobe in 8 cases,accompanied by left lateral lobe bile duct stones in 2 cases,the right caudate lobe bile duct stones in 1 case.Methylene blue was injected into the portal vein,the methylene blue interface of segment Ⅵ or right posterior lobe displays well.Methylene blue interface was larger than the ischemia interface,which is in accordance with the anatomy.Along the methylene blue interface,hepatic resection was performed including right posterior lobe resection (n =9),segment Ⅵ resection (n =3),and combined with left lateral lobe resection (n =2) and the right caudate lobe resection (n =1).There was no postoperative mortality.Incision infection occurred in 5 cases,4 had right pleural effusion and 2 had a biliary fistula that were treated conservatively.With a mean follow-up period of 3.2 years,all patients are symptoms free and stone free.Conclusions Anatomical liver resection by methylene blue staining is a safe and effective treatment for hepatolithiasis of right posterior lobe.

Objective To evaluate the imaging feature of microcarcinoma of thyroid with CT.Methods CT findings of 50 lesions in 47 patients with microcarcinoma of thyroid ( dimeter,0.5 to 1.0 cm) were retrospectively analyzed.All of the patients had pathological diagnosis.Results Of the 50 lesions,38 lesions showed homogeneous low density on non-enhanced CT and various degree of enhancement on postcontrast CT. Thirty-three lesions showed discontinuous edge of the thyroids on non-enhanced CT. The boundary of 30 lesions became unclear on post-contrast CT relative to non-enhanced CT and the extension of low density of lesions decreased. Theshape of 31 lesions were irregular. Fifteen lesions showed calcifications,with granular calcifications in 13 lesions.Ten lesions were complicated with thyroiditis.Conclusions Irregular shape,discontinuous edge of the thyroids,the shrinkage of low density of lesions on post-contrast CT relative to non-enhanced CT,granular calcifications and multiple small lymph node around lesions indicate the diagnosis of microcarcinoma of the thyroid.It should be noted that thyroiditis can cover up microcarcinoma of thyroid.

Objective To construct lentiviral vector carrying rat′s calcitonin gene-related peptide(CGRP) gene for the following-up study on the function of CGRP .Methods CGRP gene segment was subcloned into shuttle plasmid ,become Puc57-CGRP .The pLenO-DCE-CGRP expression vector was be constructed by double digests .The pLenO-DCE-CGRP and 4 auxiliary packaging plas-mids were co-transfected into 293T cells .Cells were cultured for 48 hours .The supernant was collected and concentrated ,and then the viral titers were tested by multiple proportions dilution method and flow cytometer .The expression levels of CGRP were detec-ted in CGRP-modified 293T cells by Real-time PCR .Results The results of digestion and sequencing show that the pLenO-DCE-CGRP vector was constructed successfully .The titer of the lentiviral particles was 5 .1 × 108 TU /mL .Conclusion The high-titer lentvirus vector containing CGRP gene is constructed successfully ,which lay a foundation for transfecting mesenchymal stem cell (MSC) and studying the function of CGRP .

BACKGROUND:At present,most general hospitals in China treat patients with neurosis and mental diseases merely by means of clinical psychological consultation,which cannot meet the requirements of social service for metal disorders. Is it feasible to establish open psychology wards?OBJECTIVE:To investigate the feasibility of establishing open psychology ward in general hospitals for patients with neurosis and mental diseases.DESIGN:Case analysis based on patients.SETTING:Department of Psychology of Guangdong Medical College Affiliated Hospital.PARTICIPANTS:Totally 900 patients with various types of neurosis were admitted to the Department of Psychology of Guangdong Medical College Affiliated Hospital between July 2000 and March 2003.There were 688 patients with different kinds of psychoneurosis and112 cases of mental diseases. Of them,there were 523 men and 377women aged from 11 to 80 years.with the mean age of (42±8) years and hospitalization duration of(17.0±6.5) days.METHODS:Open management consisting of open ward,supporting system,humanized restriction,collective physical exercise and psychological support was adopted.Symptom checklist (SCL-90) was used by trained psychological doctors to assess the therapeutic effects in the 900 patients with neurosis and mental diseases after two-month rehabilitation.Meanwhile,169 patients with depression were examined with Hamilton rating scale for depression(HAMD) at 2,4,8 weeks of treatment.patients.RESULTS:Open psychology ward could provide an environment for patients to live and make free contact with the outside world. Of the 900patients with various neurosis and metal diseases,531 (59.0%) had recovery to normal,264(29.4%) had obvious improvement,81(9.0%) had improvement,and 24 (2.6%) had no therapeutic effect,with the total effective rate of 97.4% .None of the patients had any accident. HAMD score of the 169 patients with depression was (32.3±3.6) before treatment,was obviously lower at 2,4 and 8 weeks of treatment [(17.4±4.2),(11.5±4.8) and(5.8±3.6),respectively](P ＜ 0.01).CONCLUSION:The therapeutic effect of the open psychology ward in the general hospital on various neuropathies and mental diseases was 97.4% in the 900 cases,with no accident occurring during hospitalization.Depression of the 169 patients was obviously improved,indicating that it isfeasible to establish open psychology ward in general hospitals.

Objective To develop experimental animal model of the brain stem myoclonus,which more closely replicate clinic features of mechanism, behavior, neuroelectrophysiology and pharmacodynamics.Methods L-5-HTP (the precursor of L-5-HT)was microinjected into the dorsal pons of young guinea pig to induce myoclonus (electromyogram burst of myoclonus≤400 ms by synchronous recording).Some animals were pretreated with anticonvulsant VPA,CZP or CBZ at effective dose 50 (EC_(50)).Myoclonus was induced when the drug level was within their effective anticonvulsion concentration.The neuroelectrophysiological characteristics of myoclonus including latency,time of reaching its peak,duration of seizure peak,the maximum seizure frequency and total duration were detected.EMG and ictal electroencephalogram(EEG)were recorded synchronously.The origin of myoclonus and its correlation with epileptic discharges were further confirmed by jerk-locked back averaging(JLA).Results (1)L-5-HTP induced pure myoclonus from the dorsal pons of guinea pig permanently(8/every site,the rate of producing myoclonus is 100%).(2)The myoclonus presented bilaterally or as general myoclonus,which was sensitive to tactile and sound sensation.(3)The EMG duration of the myoclonus wag longer((208.75 ± 81.42)ms),and ictal EEG showed scattered and irregular spikes and sharp waves without time-locked correlation with EMG activities.(4)The synchronous ictal EEG of the myoclonus showed spike and sharp waves,but there was no time-locked EEG activity in JLA.(5)In the animals treated with anticonvulsant at EC_(50) concentrations:VPA and CZP decreased the maximum seizure frequency(there are 28.13±3.79 per minutes in VPA group and 37.17±4.67 perminutes in CZP group)and shortened the duration of peak time ((55.00±14.14)minutes in VPA group and(50.00±11.73)minutes in CZP group respectively)and total time(VPA group was(124.17±40.04)minutes and CZP group was(156.88±30.71)minutes)of myoclonus(F value were between 23.41 and 35.44,P＜0.01 or P＜0.05).CBZ increased duration of peak time((98.75±13.86)minutes)and total time((257.50±14.79)minutes)of myoclonus(P＜0.05 and 0.01).Conclusions The new model generates pure myoclonus originating from brain stem and also has a shorter duration of muscle construction(≤400 ms)and more sensitivity to tactile and sound sensation.Therefore,the model presents characteristics closer to the brain stem myoclonus in the clinic phenotype in respect of seizure behavior,pharmacodynamics and neuroelectrophysiology.

Flow cytometry analysis of DNA ploidy level and S-phase fraction (SPF) was carried out in 24 snap-forzen tissue specimens of ovarian carcinoma. The relationship of DNA ploidy level and SP-F with age,clinical stage, ascites, histologic type,pathological grade,lymphocyte infiltration and psammoma bodies was analyzed.Results showed that the relationship of DNA ploidy level and SPF with ascites and pathological grade was significant. Aneuploid portion and SPF in patients with ascites or pathological grade Ⅲ or Ⅱ were higher than those in patients with no ascites or pathological grade I. The author considers that DNA ploidy level and SPF of ovarian carcinoma can serve as a relatively independent objective index which reflects tumor's biological behaviours,and will be of great auxiliary value to early diagnosis and therapy of ovarian carcinoma.

Objective To compare the application of three automated microbiology identification and rapid susceptibility assessment systems,Vitek1,Viket2 and BD Phoenix,in detection of extended-spectrum beta-lactamases(ESBLs).Methods The genotypes of 67 clinical isolates of ESBLs-producing E.coli and K.phneumoniae,which were collected from the 1st and 2nd Affiliated Hospital of Zhejiang University,were determined by PCR amplification and sequencing.Meanwhile,these isolates were analyzed by the three automatic microbiology identification system,and the minimum inhibitory concentration(MIC)s for antibiotics were determined.Results Majority of the 67 isolates produced CTXM type of ESBL.Among them,CTX-M-14,CTX-M-22,CTX-M24 and CTX-M-3 were the most frequently detectable types.By using Vitek-AMS,60 isolates(89.6%)were detected to be ESBLs-producing.By using Vitek2,62 isolates(92.5%) were ESBLsproducing.No SHV-12,CTX-M-14 and SHV-28 were detected by the 3 automatic systems.The results of MICs analysis indicated these isolates showed either high resistance for multiple antibiotics or around the boundary areas of MICs test.Conclusions The three automatic analysis systems are able to provide a detectable rate of more than 98% for ESBLs.However,it is needed to further improve the detection for high resistant strain or the strains carrying multiple resistant genes.

Objective To expound the mechanism and the clinical features of Tong-Du-Huo-Luo exercise in treating ankylosing spondylitis.Methods Besides taking SASP per os,the patients in treatment group did Tong-Du-Huo-Luo exercise twice daily. Patients in control group took SASP only.The patients in both groups had accepted the treatments for 6 months.Results Compared with western medicine treatment,the Tong-Du-Huo-Luo exercise can bring better effects on ability of expanding chest,finger-floor distance,pulvinar-wall distance,and improving the results of Schober test and blood sedimentation test.Conclusions Tong-Du-Huo-Luo exercise is an effective method in treating ankylosing spondylitis patients.

The pain is an emerging subject and need developing. The design of the research is the most important. This article emphatically introduced about the issues on quality monitoring and the logical administrative levels during practice.