Objective To assess atrophy of the multifidus in elderly patients with low back pain using magnetic resonance imaging.Methods Thirty patients with low back pain were recruited,and 15 healthy subjects formed a normal group.The cross sectional area (CSA) and signal strength of the multifidus muscles at the L4-5 and L5-S1 levels were measured along with the signal strength of the hip fat for all of the subjects in both groups using a superconducting magnetic scanner.Results There was no statistically significant CSA difference between the groups at either level.The contrast between multifidus muscle and adipose tissue was significantly different between the groups at both levels.Conclusion In evaluating atrophy of the multifidus muscle in elderly patients with low back pain,the contrast between multifidus muscle and adipose tissue at either level L4-5 or L5-S1 can be used for assessment.It is more reliable,specific and sensitive than the CSA of the muscle.

ObjectiveTo evaluate effects of post-operative analgesia combined with parental presence on emergence agitation after sevoflurane anesthesia in children. Methods60 patients were randomly assigned into three groups with 20 cases each. After sevoflurane inhalation and being given rocuronium, all patients were intubated for mechanical ventilation. Then patients received caudal block. Patiens in group A and B were treated with diclofenac sodium suppositories before operation. To maintain anesthesia patients were adopted sevoflurane inhalation. Patients in group A and C were cared by nurses in post anesthesia care unit, whereas patients in group B added parental presence. Emergence agitation incidence, modified Aldrete scale, PAEDS, CHEOPS were all recorded. ResultsTherewas no difference of modified Aldrete scale among three groups( F =0.652 ,P ＞0. 05) ,but emergence agitation incidence in group C was more than those of group A and B. At each point PAEDS scores of group B were lower than those of group C( x2 =4. 566,7. 234,4. 124,6. 126, P ＜ 0. 05) ,also scores of group B were lower than those of group A at 10 min and 30 min(F=0.654,P＞0.05). PAEDS scores of group A were lower than those of group C at 20min and 30min(t =3.256,3.778,4.556,4.223 ,all P＜0.05). At 20min and 30min CHEOPS scores of group C were higher than those of group A and B ( F =1. 987, P ＞ 0.05 ). ConclusionPost-operative analgesia combined with parental presence could decrease the incidence of emergence agitation after sevoflurane anesthesia in children.

Objective To determine the expressions of transcription factor activator protein-2α (AP-2α), estrogen receptor-β (ER-β) and matrixmetalloproteinase-9 (MMP-9) in lichen planus (LP) lesions and their significance. Methods Tissue samples were resected from the lesions of 30 patients with LP and normal skin of 30 human controls. An immunohistochemical method using streptavidin-peroxidase (SP) was performed to detect the expression of ER-β and MMP-9, reverse transcription-PCR and Western blot to measure the mRNA and protein expressions of AP-2α, ER-β and MMP-9 in these specimens. Results There was a significant decrease in the mRNA expressions of AP-2α (0.488 ± 0.039 vs. 1.008 ± 0.023, P < 0.01 ) and ER-β (0.365 ± 0.032 vs. 0.998 ± 0.036, P < 0.01), together with an increase in the expression of MMP-9 (1.237 ± 0.027 vs. 0.567 ± 0.015, P< 0.01) in the LP lesions compared with the control specimens; similar results were observed for the protein expressions of AP-2α, ER-β and MMP-9. In LP lesions, the expression of AP-2α was positively correlated with that of ER-β (R = 0.89, P < 0.01), but negatively correlated with that of MMP-9 (r = -0.91, P < 0.01). Conclusions The down-regulation of ER-β expression and up-regulation of MMP-9 expression may be ascribed to the abnormal regulation of upstream target genes mediated by the decreased expression of AP-2α, which may be involved in the pathogenesis of LP.

Objective To study the function of 4 different haplotypes cDNA which are constructed by two non-homonymy single nueleotide polymorphism (SNP) sites C19170G (Leu45Val) and C30799G (Ala500Gly) in the coding region of human CⅡTA gene. Methods HeLa cells were transfeeted with eu-karyotic expression vectors containing four different haplotypes cDNA. C Ⅱ TA mRNA and HLA classⅡanti-gen (HLA-DR, DP, DQ) were respectively detected by RT-PCR and indirect cell immunofluoreseence tech-nique in the untransfected and transfeeted with four eukaryotic expression vectors and empty vectors HeLa cells. The quantity of HLA classⅡ antigen were analyzed by flow eytometry. Results No expression of CⅡTA mRNA and HLA class Ⅱ antigen were observed on original HeLa cells and empty vector transfected cells. CⅡTA mRNA expression was emerged, and the expression of HLA class Ⅱ antigen were observed in the HeLa cells transfected with eukaryotic expression vectors containing four different haplotypes cDNA. And there were not significantly different with the levels of HLA class Ⅱ antigen expression among HeLa cells transfected with eukaryotic expression vectors containing four different haplotypes cDNA ( P > 0.05 ). Con-dusion The SNP of Chinese at the sites C19170G(Leu45Val) and C30799G(Ala500Gly) in the coding site of C Ⅱ TA gene did not influence capability of CⅡTA trans-aetivating HLA class Ⅱgene expression.

The attempt of vitrectomy is to remove the lesion of vitreous body and relieve vitreous traction to retina.Whether the vitrectomy is successful or not depend on if exist a close adhesion between vitreous body and retina or a posterior vitreous detachment (PVD).The drug assisted vitrectomy is a new technique.These drugs can help surgeon to form PVD during surgery safely and effectively.The drug is utilized prior to vitreoretinal operation to promote the colliquate of vitreous body or dissolve of fibroplasia membrane of the vitreous body in order to release the traction between the posterior cortex of vitreous body and the inner limiting membrane of retina.The research advance in relevant drugs is reviewed in this article.

BACKGROUND:Cytomegalovirus is one of the opportunistic infection viruses for organ transplant patients, and it can lead to functional loss of organ grafts and even endanger lives. Therefore, accurate diagnosis of cytomegalovirus infection at early phase is the key to clinical treatment. OBJECTIVE:To analyze the detection method, accuracy, detection time and clinical significance of cytomegalovirus infection after organ transplantation. METHODS: A computer-based search of VIP, PubMed and CNKI as wel as manual search of books were performed for literatures concerning organ transplantation and cytomegalovirus infection published from January 2007 to December 2014. The keywords were transplantation, cytomegalovirus in English and Chinese, respectively. Total 1 894 papers in English and 31 articles in Chinese were found. Among them, only 35 papers which were highly representative and published in related authoritative journals were chosen for further analysis. RESULTS AND CONCLUSION:The main non-invasive detection of cytomegalovirus infection is stil the test of CMV-pp65 antigen with good sensitivity and specificity which can accurately reflect the status of cytomegalovirus infection. This method is also the most important clinical diagnostic method. Molecular biological detection of cytomegalovirus can detect potentialy infected people, and this method can detect the infection earlier than CMV-pp65 antigen method, which is suitable for the early diagnosis of cytomegalovirus infection and early drug treatment. Quantitative nucleic acid test can be used to analyze cytomegalovirus-DNA copies so as to determine the concentrations of the virus in patients, which may provide a more sensitive monitoring way for inapparently infected patients. Cytomegalovirus-IgG and cytomegalovirus-IgM in serum can be used to determine whether organ transplant recipients have been infected by cytomegalovirus. Virus culture and histological examination have been used for several years, both of which are the gold standard for detecting cytomegalovirus. However, these methods cannot be used in early diagnosis and active infection. Immunological detection method provides a new ideal for the diagnosis of cytomegalovirus infection. This method can monitor cytomegalovirus infection from early phase accurately and assess the risk of cytomegalovirus, providing a new way for the development of the diagnosis of cytomegalovirus infection.

Objective To observe the therapeutic efficacy of Ganshuang granules in the treatment of hepatic fibrosis.Methods Sixty-eight patients with cirrhosis due to chronic hepatitis B (CHB)were divided into experimental group (n=34)and control group (n=34).Both groups received adefovir dipivoxil for 6 months,and the experimental group received Ganshuang granules additionally for 24 weeks.After treat-ment,the changes in hepatic fibrosis indices including hyaluronic acid (HA),laminin (LN),collagenⅣ(CⅣ),and precollagenⅢ(PCⅢ),as well as liver stiffness value were evaluated by paired t test.Results In the experimental group,the serum levels of HA,LN,CⅣ, and PCⅢwere significantly decreased by 37.5%,34.2%,35.4%,and 39.9%,respectively (t=2.238,2.151,2.148,and 2.198,P<0.05 for all),and the liver stiffness value was significantly cut by 40.6%(t=2.189,P<0.05).However,the control group showed no sig-nificant changes in these indices.Conclusion For patients with cirrhosis due to CHB,Ganshuang granules can effectively reduce serum mark-ers of hepatic fibrosis and liver stiffness value and have a good therapeutic efficacy in the treatment of hepatic fibrosis.

Objective To investigate the correlation between mental status of patients with stroke and their quality of life. Method One hundred and three stroke patients were measured by HRSD,HMAM and SS-QOL to explore the correlation between mental status and quality of life.Results Among the 103 patients,68 developed depression, taking up 66.02%,with a total score of 31.62±12.58;52 anxiety,taking up 50.49%,with a total score of 22.17±5.38.The level of depression and anxiety were negatively correlated with the life quality(P<0.01).Conclusions The occurence rate of depression and anxiety in stroke patients is higher. The higher the scores on depression and anxiety,the worse the quality of life.

Objective To investigate the role of MHC class Ⅱ transactivator(CⅡTA) in upregulating the expression of HLA class Ⅱ antigen in HepG2 cells.Methods Eukaryotic expression vector EBS-NPL-CⅡTA containing CⅡTA cDNA or the empty vector EBS-NPL was transfected into HepG2 cells respectively.CⅡTA mRNA and HLA class Ⅱ antigen(HLA-DR,DP,DQ) were respectively detecued by RT-PCR,indirect cell immunofluorescence technique and flow cytometry in original HepG2 cells,HepG2 cells transfected with EBS-NPL-CⅡTA or the empty vector EBS-NPL.Results The expression of CⅡTA mRNA and HLA class Ⅱ antigen(HLA-DR,DP,DQ) were not observed in original HepG2 cells and HepG2 cells transfected with empty vector,but in the HepG2 cells transfected with EBS-NPL-CⅡTA.Conclusion CⅡTA is a switching factor of mastering the expression of HLA class Ⅱ antigen in HepG2 cells.The lack of CⅡTA expression in HepG2 cells contributes to no expression of HLAⅡ antigen.

Objective To optimize the formulation of sinomenine hydrochloride pulsatile drug delivery tablets by central composite design-response surface method.Methods The tablets containing sinomenine hydrochloride were prepared by dry-compression coating technique.The influence factors included the amount of sodium carboxymethyl starch in core tablets, the ratio of HPMC/carrrageenan,and the amount of matrix materials in coating film.The evaluation parameter was lag time.Experiments were done on the central composite design,and the data were simulated using multi-linear equation and second-order polynomial equation.The possibly optimal formulation was predicted by response surface method.The lag time of the tablets prepared under the optimum condition was compared with the predicted.Results The lag time was simulated using second-order polynomial equation and the regression coefficient was 0.993 7.The lag time in vitro of the tablets prepared under the optimum conditions was about 6 h,then drug released in pulsatilerelease character.Bias between the observed and predicted values of the lag time was within ?4.43%.Conclusion The sinomenine hydrochloride pulsatile tablets could release drug quickly in vitro at the predetermined time.Central composite design-response surface method can be used to optimize the formulation and the model developed in this study proves to be highly predictable.