Objective To investigate the clinical significance and indications of non operative management for liver trauma(LT). Methods The clinical date of 66 cases of LT treated by non operation from November 1987 to November 2000 were retrospectively analyzed. Results There were 38 cases (57.6%) in class I of LT, 18(27.3%) in class II, 10(15.2%) in class III in this series. 64 cases were cured (97.0%), including 2 cases combined with active bleeding were converted to operation and curred; 2 cases (3.0%) died of combining with severe brain damag. 4 cases(6.1%) complicated with liver abscess were cured by non operative treatment. Conclusions The non operative management is suitable for all cases of class I, II and partial cases of class III of LT. The observation of blood dynamics is most important, and B-type ultrasonography is also imporant, The operation would be done if the case is combined with massive active bleeding.

Objective:To investigate the role of CD46 and Nectin-4 on Measles virus (MV) infecting human pulmonary alveolar epithelial cells (HPAEpiC),and the interaction between CD46 and Nectin-4.Methods: Measles virus was divided into pre-infection group and 2 h-infection group,HPAEpiCs treatment with anti-CD46 antibody and/or anti-Nectin-4 antibody as experimental groups,and untreated HPAEpiCs as a control.The variation of viral replication level was detected.A Co-immunoprecipitation assay (Co-IP) was used to explore whether CD46 and Nectin-4 had interactive relationship in MV infection.Results: Compared with the control group,MV titers were reduced in HPAEpiCs of the pre-infection group treated with anti-CD46 and anti-Nectin-4 respectively (48.03% and 49.53%).Furthermore,virus titers showed a more reduction in which treated with anti-CD46 and anti-Nectin-4 antibodies (27.15%,P<0.01).Western blot and Real-time PCR showed that anti-CD46 antibody and anti-Nectin-4 antibodies decreased the rate of MV infection.In the 2 h-infection group,however,the treatment with anti-CD46 and anti-Nectin-4 could significantly reduce the MV titer and NP protein in HPAEpiCs.The Co-IP assay showed that there were interaction between CD46 and Nectin-4.Conclusion: CD46 and Nectin-4 mediated MV infecting HPAEpiCs.Moreover,CD46 and Nectin-4 may play a synergetic role in MV infection,which could enhance the infection effect.

ObjectivesTo investigate the changes of hepatocellular carcinoma cell line SMMC-7721 in cell ultrastructure and skeleton during apoptosis induced by Survivin ASODN.MethodsSurvivin ASODN was transfected into SMMC-7721 cells mediated by DOTAP liposomal reagent. The changes of Survivin protein and mRNA expression after transfection were assessed by Western blot and in situ hybridization. The apoptotic rate was detected by flow cytometer. Cell ultrastructure and skeleton were observed by electron microscope and confocal microscope. Caspase-3 was assessed by kinase activity assess method. Results The expression of Survivin protein and mRNA decreased from 69.59 and 75.6 to 10.71 and 22.9 respectively. The cell ultrastructure showed apoptotic changes. Cell skeleton microfilament system changed after Survivin ASODN transfection. The average intensity of microfilament system fluorescent decreased from 190 to 64. The activity of Caspase-3 increased from 0.015 3 to 0.099 2.ConclusionsTransfection of ASODN targeted to Survivin mRNA by DOTAP liposomal transfection reagent down-regulated the expression of Survivin protein and mRNA in SMMC 7721 cell line and activate Caspase-3, which in turns induced cell apoptosis.

Objective To investigate the genotype distribution of hepatitis C virus (HCV) in Guangdong Province by linear probe assay (LiPA) and core,non-structural protein 5B (NS5B) sequence analysis,and to evaluate the accuracy of LiPA for genotyping.MethodsOne hundred and ten HCV specimens from chronic hepatitis C (CHC) patients in Guangdong Province were genotyped by both core,NS5B sequence analysis and INNO-LiPA 2.0.The data were then analyzed with SPSS 10.0 software.ResultsAmong the 110 specimens,core and NS5B fragment could be amplified from 97 and 62 specimens,respectively,while both fragments were obtained from 57 specimens. The results of genotyping by core sequence analysis were completely consistent with the results of NS5B sequencing.One hundred and two specimens were classified into five subtypes,i.e.genotype 1a,2a,3a,3b,6a,with frequencies of 61.8％ (64),9.8％ (10),3.9％ (4),3.9％ (4),20.6％ (21),respectively.All but genotype 6 strains can be genotyped correctly by using INNO-LiPA 2.0.However,only subtype 1b and 3b could be genotyped accurately.81.5％ genotype 6a strains were genotyped as 1b by mistake. Conclusions Genotype 6a has become the second most prevalent genotype in Guangdong Province.The LiPA cannot distinguish genotype 6a from 1b strains accurately which needs further investigation.

Objective To investigate the efficacy of pegylated interferon (PEG-IFN)+ ribavirin (RBV) treatment in patients with chronic hepatitis C (CHC),and to evaluate the predictors of treatment response.Methods One hundred and thirty CHC patients treated with PEG-IFN a-2a 180 μg weekly or PegIFNα-2b 80 μg weekly plus RBV 900-1200 mg/d for 48 weeks in Guangdong Province were enrolled.The clinical data including age,gender,body mass index (BMI),spleen index (SPI),the diameter of portal vein (PV),hepatitis C virus (HCV) genotype,HCV RNA level were collected at baseline,week 4,12,24,48 of treatment and week 24 of follow-up.Patients obtained sustained virological response (SVR) were compared to those with non-sustained virological response (NSVR).The related factors of SVR were analyzed.The data were compared by t test,chi square test or Logistic regression.Results The total SVR rate was 84％ (109/130),among which rapid virological response ( RVR ),early virological response ( EVR ),and end-of-treatment virological response (ETVR) were 21％ (27/130),72％ (94/130) and 93％ (121/130),respectively.HCV genotype was determined in 70 patients and the SVR rate was 82 ％ (45/55) in the genotype 1 patients and 87％ (13/15) in the genotype non-1 patients.Age,baseline HCV RNA,BMI and SPI were all negatively associated with SVR rate (regression coefficient＜0,all OR＜1,all P＜0.05),while EVR and total cumulative treatment dose of RBV were positively associated with SVR rate (regression coefficient＞0,both OR＞ 1,both P＜0.05).However,RVR,PV and total cumulative treatment doses of PEG-IFN were not associated with SVR rate (P＞0.05).Conclusions The SVR rate of PEG-IFN plus RBV combined treatment is high in CHC patients and more than 80％ of patients can be cured.However,the SVR rates are lower in patients elder than 35 years,with previous treatment failure history,baseline HCV RNA＞6 × 105 IU/mL,BMI＞26 kg/m2,SPI＞40 cm2,or the total cumulative treatment doses of RBV less than 80 ％ of standard dose.

Objective To study the relationship between chromosomal abnormality and Y chromosome microdeletions and male infertility. Methods Lymphocytes were cultured from peripheral blood of 1975 male infertility patients and stained with Giemsa. The chromosomes were analyzed under microscope. Y chromosome specific sequence tags (STS) were selected, then the Y chromosome microdeletions in AZF regions were screened by polymerase chain reaction (PCR) in azoospermia and oligozoospermia patients. Results There were 305 cases of detected chromosomal abnormalities (15.44%) in the 1975 cases. There were 101 cases (5.11 %) with autosome abnormalities which clinically manifested as oligozoospermia and teratospermia. There were 204 cases (10. 33%) of sexual chromosome abnormalities and the patients were mainly characterized with Klinefelter's syndrome. Y chromosome microdeletions were detected in 109 (14.97 %) of the 728 cases of azoospermia or oligozoospermia. The most common microdeletion of Y chromosome was AZFc (62.39%) and these patients were characterized with azoospermia and oligozoospermia. Five patients (4. 59%) who suffered Y chromosome microdeletion in AZFa region and AZFb region were characterized with azoospermia. Fifteen cases (13.76%) with microdeletion in AZFb region and AZFc region were mainly characterized with azoospermia. There were 6 cases (5. 50 % ) of microdeletion in AZFa, AZFb and AZFc regions,these patients were all characterized with azoospermia. Conclusions Both Chromosome abnormalities and Y chromosome microdeletions are important causes for male infertility.

Objective To explore the characteristics and clinical significance of lung function in children with mycoplasma pneumoniae pneumonia. Methods The pulmonary ventilation function of 60 cases of mycoplasma pneumoniae pneumonia was tested in the acute stage and 2 weeks after treatment by the pneumatometer made by JAEGER company in Germany. FVC, FEV1, PEF, FEF25,FEF50、FEF75 and MMEF75/25 was detected. Results In acute phase, lung function indexs (FVC, FEV1, PEF, FEF25, FEF50, FEF75, MMEF75/25) of 60 children with MPP were less than expected:(1.56 ± 0.53) L vs.(1.99 ± 0.69) L, (1.37 ± 0.47) L vs. (1.68 ± 0.57) L, (2.90 ± 0.86) L/s vs. (3.95 ± 1.08) L/s, (2.48 ± 0.67) L/s vs. (3.56 ± 0.89) L/s, (1.42 ± 0.41) L/s vs. (2.51 ± 0.64) L/s, (0.65 ± 0.20) L/s vs. (1.28 ± 0.33) L/s, (1.22 ± 0.77) L/s vs.(2.18 ± 0.61) L/s], and there were significant difference (P<0.01). In recovery period, the level of FVC, FEV1, PEF, FEF25, FEF50, FEF75, MMEF75/25 was significantly better than that in acute phase: (98.80 ± 9.34)% vs.(79.14 ± 6.28)%, (98.67 ± 8.28)% vs. (81.63 ± 6.56)%, (86.23 ± 6.86)% vs.(73.17 ± 6.21)%, (85.17 ± 7.86)% vs. (69.79 ± 8.16)%, (79.08 ± 7.99)% vs. (56.57 ± 8.77)%, (70.85 ± 7.48)% vs. (50.66 ± 9.86)%, (77.35 ± 6.81)% vs. (56.19 ± 9.61)%, P<0.01. Conclusions In the acute stage, the pulmonary function of children with MPP shows hybrid ventilation dysfunction. In the recovery period, pulmonary function index improves significantly, but there are still abnormal small airway indicators.

Aim To explore the role of endoplasmic reticulum stress(ERS) in Astragaloside Ⅳ-induced cardioprotection in H9c2 cardiac cells, and to explore the potential mitochondrial mechanism.Methods Conventional culture was performed of rat heart tissue-derived H9c2 cells.Experiment was randomly divided into the control group, the ERS inducer 2-Deoxy-D-Glucose(2-DG) group, Astragaloside Ⅳ and 2-DG combination group, Astragaloside Ⅳ group.Confocal microscopy was used to observe the changes of TMRE fluorescence intensity so as to confirm the influence of ERS on the mitochondrial potential, and further speculate on the opening of the mitochondrial permeability transition pore(mPTP).Western blot analysis was applied to detect the expressions of ERS proteins GRP 78, GRP 94 and IRE1.Transmission electron microscopy was used to observe the ultrastructure of the cells.Results Different doses of 2-DG could mimic the mPTP opener atractyloside to induce the mPTP opening with the peak at 100 μmol·L-1;Astragaloside Ⅳ significantly reduced 2-DG-induced mPTP opening, the expression of GPR 78, GRP 94 and IRE1 and reduced injury of mitochondria and endoplasmic reticulum.Conclusions Endoplasmic reticulum stress could be induced by 2-DG.Astragaloside ⅳ-induced mitochondrial cardioprotection involves inhibition of the ERS through GRP 78, GRP 94 and IRE1 by prevention of the mPTP opening.

ObjectiveTo investigate the relationship of lymphotoxin β receptor (LTβR) and classical nuclear factor-κB (NF-κB) activation pathway in the pathogenesis and progress of cystitis and bladder cancer.MethodsThe LTβR and P65 mRNA expression were detected by Real-time quantitative PCR in 108 cases of fresh bladder tissue specimens (75 cases of bladder cancer,10 cases of inflammation and 23 normal bladder mucosa cases grouped by the tissue classification ),and protein expression were analyzed by immunohistochemistry assay in 118 cases of paraffin-embedded biopsy specimens (73 cases of bladder cancer,30 cases of cysitis and 15 normal bladder mucosa cases).The correlation analysis between the expressions of LTβR and P65 with clinical pathological data was then performed.Differences between LTβR and P65 mRNA and protein expression level were compared in different groups of bladder tissues using Kruskal-Wallis H test and the Chi-square test.Results( 1 )The mRNA expressions of LTβR and NF-κB/P65were higher in bladder cancer than those in normal group ( LTβR:29.4 ( 14.2 - 46.7 ) × 10 - 3/1.2 ( 0.3 -7.0) ×10-3,Z=-5.508; P65:9.7 (2.7 -21.1) ×10-3/1.0(0.8 ～1.8) ×10-3,Z=-5.030,P＜0.05 ).There were significantly differences between bladder cancer with different histological grades ( LTβR:18.2(2.1-31.3) × 10-3/ 28.4(16.6-36.2) × 10-3/47.9(34.3 -70.5) ×10-3,x2K-W=20.378;P65:4.9(1.3 - 12.0) × 10-3/7.4(3.0-21.9) × 10-3/17.0(10.0 ～28.3)× 10-3 ,x2K-W2 =15.219,P all ＜0.05) and lymph node metastasis (LTβR:27.2(9.7-40.1) ×10-3/39.4(26.7 -52.6) ×10-3,Z=-2.552; P65:7.4(2.3-15.6) ×10-3/13.4(6.7-23.3) ×10-3,Z=-2.026,P＜0.05).(2)The positive rates of LTβR and phosphorylated P65 ( p-P65 ) protein in cancer were higber than those of normal group (LTβR:69.8％/13.3％,x2 =16.600 ; p-P65:56.2％/6.7％,x2 =12.220,P ＜ 0.05 ).Upregulation of LTβR and p-P65 were associated with the histological grade (LTβR:56.3％/70.0％/90.4％,x2 =7.055; p-P65:40.6％ /60.0％/76.2％,x2 =6.679,P ＜0.05) and with lymph node metastasis (LTβR:58.3％/92.0％,x2 =8.849; p-P65:52.1％/64.0％,x2 =5.088,P ＜0.05).(3)There was a positive correlation between LTβR and P65 expression ( mRNA:r =0.654,P ＜ 0.05,protein:r =0.399,P ＜ 0.05 )in the bladder cancer and cystitis (r =0.521,P＜0.05).ConclusionsThe activation of LTβR and P65 was associated with progression and metastasis of bladder cancer.The activation of classical NF-κB pathway by LTβR may be achieved by P65.

Objective: To analysis pathogenic conditions and pathogenic characteristics of organic fluorosis caused by applying of anti-fingerprint coating material on touch screen glass of the mobile phone. Methods: To collect clinical data and analyze the causes and pathogenic characteristics of poisoning through surveying occupational health, detecting occupational hazards in the workplace, collecting clinical data and diagnosing of occupational diseases. 6 employees in workshop 1 of packaging were as the organic fluorine exdposed group, and 16 employees in other workshops were as the non-exposed group. Results: Organic fluorine chemicals (perfluoro-1, 3-dimethylcyclohexane, hexadecafluoroheptane, perfluoro-hexane, perfluoromethy lopentane, perfluoro-2-methyl-2-pentene, etc.) can be volatilized by spraying and baking of anti-fingerprint nano-coating material on touch screen. The relative percentage of volatile components in air is 85.65%. Four cases of acute poisoning were caused by organic fluorosis deposited in a dustless air conditioning workshop with poor ventilation.The clinical manifestations of the patients were acute bronchitis, pulmonary edema and/or myocarditis. The average concentration of urine fluorine in the organic fluorine exposed group was 13.7± 4.4 mmol/mol creatinine, which was 4-5 times higher than that of other non-organic fluorine exposed groups. The difference of urine fluorine level between the organic fluorine exposed group and non exposed group was statistically significant (P<0.01) . The main indicators were abnormal for the blood oxygen saturation of finger pulse under suction air, leukocytes, neutrophils, monocytes, hypersensitivec-reactive protein, procalcitonin, l-lactate dehydrogenase, forebrain diuretic natriuretic peptide, hypersensitive troponin T in the four cases. One case was myocardial ischemia, four cases had bilateral lung symmetrically exudative lesions, one case was accompanied by a small amount of pleural pericardial effusion. Conclusion Acute organofluorine poisoning can caused by the applying of the fingerprint nano-coating material on touch screen of the mobile phone. Attention should be paid to occupational poisoning caused by the applying of the small molecular perfluoroalkanes (olefins) in new industries, new processes and new materials.