Objective To investigate the early variations and clinical value of serum delta bilirubin after orthotopic liver transplantation. Methods Orthotopic liver transplantation was performed in 27 cases.Of them,10 cases were uneventful;8 patients suffered from acute rejection.According to the outcome,18 patients (including 10 uneventful cases and 8 cases with acute rejection) survived while other 9 died.Daily determination of serum delta bilirubin was examined in all patients. Results The changing patterns of serum delta bilirubin were different between uneventful patients and those with acute rejection.For those uneventful patients,?B% tended to increase after operation.On the 21st day after transplantation,it reached(37.5?11.2)%.To the contrary,after acute rejection occurred,?B% decreased from basal level(26.4?9.8)% to(20.2?12.7)%(n=8,t=2.12,P=0.07).Serum concentration of total bilirubin (TB) and conjugated bilirubin (CB) significantly increased after acute rejection arose.The difference between peak and basal level of TB and CB was (150.3?113.2)?mol/L(n=8)and(118.5?93.4)?mol/L(n=8)respectively(t=3.75,P=0.007;t=3.59,P=0.009).On the 14th day after operation,?B% in patients with good outcome(n=18) significantly higher than that in patients who died(n=9)(33.4%?12.2% vs 22.0%?10.0%,t=2.42,P=0.02).Conclusions Two weeks after operations,?B% is correlative to the outcome of the patients.But as for the diagnosis of the acute rejection,?B% shows no advantages over serum TB or CB.

BACKGROUND:Percutaneous kyphoplasty with bone cement injection for repair of multi-segmental thoracolumbar vertebral osteoporotic fractures can restore the compressed vertebral height, correct deformity and reduce complications. OBJECTIVE: To explore the therapeutic effects of percutaneous kyphoplasty with bone cement in patients with multi-segmental thoracolumbar vertebral osteoporotic fractures. METHODS:Eighty patients with multi-segmental thoracolumbar vertebral osteoporotic fractures were enroled, 29 males and 51 females, aged 61-78 year, including 52 case of two-segmental vertebral fractures, 22 cases of three-segmental vertebral fractures, 6 cases of four-segmental vertebral fractures. Al the patients were divided into experimental group and control group randomly. Patients in the control group were given active basic treatment and anti-osteoporosis treatment and stayed in bed. Patients in the experimental group were given percutaneous kyphoplasty with bone cement injection on the above basis. Al the patients were folowed-up 12 months after treatment. Then the Oswesty dysfunction index, Barthel index, visual analog scale score, and theanterior vertebral height and midline height, Cobb angle were compared between the two groups. RESULTS AND CONCLUSION: In the experimental group, the Oswesty dysfunction index, Barthel index, visual analog scale score, and the anterior vertebral height and midline height, Cobb angle were al significantly improved at 3 days, 3 months and 12 months after treatment than before (P < 0.05). In the control group, the Oswesty dysfunction index, Barthel index and visual analog scale score were improved significantly at 3 and 12 months after treatment (P < 0.05), while the anterior vertebral height and midline height were improve dramaticaly at 12 months after treatment (P < 0.05). Compared with the control group, the experimental group showed better the Oswesty dysfunction index and Cobb angle than the control group at 12 months after treatment (P < 0.05), but there were no difference in the other indicators between the two groups. No adverse reactions associated with bone cement material occurred in the experimental group. Taken together, the percutaneous kyphoplasty with bone cement injection can rapidly relieve pain in patients with multi-segmental thoracolumbar vertebral osteoporotic fractures, which can correct kyphosis and improve patient's quality of life.

With the change of medical model and the transfer of health to communities and rural towns,the expanding enrollment of colleges and universities makes collegiate internship progrms more and more difficult Clinical College of Guilin Medical University explores the new methodology of teaching practice,constructs and practises the new molde of internal madichine teaching,Combines the coummunity internship programs with hospital internship programs.and was improved the quality of practice teaching

Objective To analyze the incidence of the disease, clinical features, diagnostic criteria, therapy and prognosis of Penicilliosis marneffei found in Guangdong province. Methods To analyze patients data, clinical features, laboratory findings, response to therapy, and prognosis of 15 cases Penicilliosis marneffei found in Guangdong province of China. Results The male was predominant compared with the female (ratio 2 to 1) and without occupational preference, but the patients with AIDS as underlying disease were mostly drivers and the unemployed. Thirteen patients were immunocompromised such as AIDS, connective tissue disease, and kidney transplant. Clinical features showed different manifestations, such as high fever, loss of weight, skin lesion, and respiratory system symptoms. Biopsy of the skin lesion showed PAS stain positive yeast-like, or sausage-form spores. Four patients were localized infection of the skin, eleven patients were systemic infection. Nine patients died, five recovered, 1 patient refused to be treated. Fifteen isolates from different anatomic sites of the patients were identified to be Penicillium marneffei by morphology and dimorphism in the culture, and eleven isolates among these 15 isolates were also confirmed by DNA sequence analysis. Conclusion The incidence rate of Penicilliosis marneffei become higher in the recent years and many patients were accompanied with AIDS in Guangdong province. Attention should be paid to the disease.

TA method for the content determination of methionine sulfoxide and methionine sulfone in compound amino acid injection (18AA-II) was established in order to investigate their level in 155 batches of this product, and to explore the reason for the generation of these two impurities.The determination was performed on an Agilent Poroshell 120 EC-C18 column with mobile phases of sodium acetate/tetrahydrofuran solution (A) and sodium acetate solution -acetonitrile-methanol (B, 200∶400∶400) (gradient elution) at the flow rate of 0.5 mL/min.The excitation wavelength and the emission wavelength of the fluorescence detector were 233 nm and 441 nm, respectively.The column temperature was 40 °C, and the injection volume was 8 μL.The contents of methionine sulfoxide and methionine sulfone from 155 batches of compound amino acid injection (18AA-II) was determined using this method, and the residual oxygen content was detected by headspace gas analyzer.The results showed that the linear range of methionine sulfoxide and methionine sulfone were 0.128 1-10.250 0 μg/mL (r = 0.999 9) and 0.261 0-10.440 0 μg/mL (r = 0.999 8), respectively.The limits of quantitation were 0.13 μg/mL and 0.26 μg/mL, respectively; the limits of detection were 0.04 μg/mL and 0.09 μg/mL, respectively.RSDs of precision, stability and repetitive test were all lower than 1.3%.The recoveries ranged 98.00%-100.79% (RSD = 1.15%, n = 9) and 98.19%-102.31% (RSD = 1.33%, n = 9).The content level of oxidized related substances from different manufacturers showed significant difference, showing relevance with the residual oxygen content to some extent, yet no significant correlation with the added amount of antioxygen (sodium pyrosulfite).The method is validated to be useful for the content control of methionine sulfoxide and methionine sulfone in compound amino acid injection (18AA-II).It is quite necessary to include the determination of oxidized related substance into the quality specification.Manufacturers should strengthen the control of remaining oxygen in their products.

ObjectiveTo investigate the treatment strategies and factors influencing the prognosis of patients with primary gallbladder carcinoma.MethodsThe clinical data of 135 patients with primary gallbladder cancer who were admitted to the Cancer Hospital of Tianjin Medical University from January 2000 to December 2009 were retrospectively analyzed.The survival curve was drawn by the Kaplan-Meier method,and the survival rates were analyzed by using the Log-rank test.Factors which may have influences on the prognosis were analyzed by univariate analysis and COX multivariate analysis.ResultsThe overall 1-,3-,5-year survival rates of the 135 patients were 46.7％,10.4％ and 5.2％,respectively.The 1-,3-,5-year survival rates of 74 patients who received radical resection of gallbladder cancer were 68.9％,18.9％ and 9.5％,respectively.The 1-,3-,5-year survival rates of 50 patients who received palliative treatment were 24.0％,0 and 0,respectively.The 1-,3-,5-year survival rates of 11 patients who received conservative treatment were 0,0 and 0,respectively.There was no significant difference in the survival rates among patients who received different treatment methods (x2 =5.642,P ＜ 0.05 ). Of the 9 patients with gallbladder cancer who received reoperation after laparoscopic choledochotomy,the survival time of 1 patient in stage Ⅰ and 1 of the 3 patients in stage Ⅱ who received radical surgery exceeded 5 years,while the survival time of 5 patients in stage Ⅱ who received palliative treatment was shorter than 5 years.There was a significant difference in the survival time among the 3 groups of patients ( x2 =5.642,P＜0.05).Under the condition of same TNM stages ( Ⅱ,ⅢA,ⅢB,ⅣA,ⅣB),the survival rates of patients who received radical resection of gallbladder cancer were significantly higher than those who received palliative or conservative treatment ( x2 =8.971,21.250,44.153,6.696,21.722,P ＜ 0.05 ).The results of univariate analysis showed that age,CA19-9,TNM stages and treatment methods were risk factors influencing the median survival time ( x2 =8.466,3.977,9.837,5.642,P ＜ 0.05 ).The results of multivariate analysis showed that age,TNM stages and treatment methods were the independent risk factors influencing the median survival time ( Wald=5.779,14.724,11.640,P＜0.05).ConclusionThe prognosis of primary gallbladder cancer is poor.Age,TNM stages and treatment methods are the independent factors influencing the prognosis of patients with gallbladder cancer,and patients who receive radical resection have relatively good prognosis.

Objective To analysis the effect of conbercept ophthalmic injection on peripheral blood vascular endothelial growth factor,intraocular pressure and visual acuity in patients with age related macular degeneration.Methods 60 patients who were diagnosed with age related macular degeneration were collected.All patients were randomly divided into experimental group and control group,30 cases in each group, lucentis intravitreal injection was given into the vitreous cavity in control group, experimental group give conbercept injection into the vitreous cavity,once a month.All patients were treated for 3 months,after the end of treatment,all patients serum VEGF and CRP,CMT,CNV and fluorescence leakage rate,intraocular pressure and visual acuity were detected.ResuIts After treatment,compared with control group,the content of serum VEGF was significantly lower in the experimental group(P<0.05).The content of serum CRP was significantly lower in experimental group(P<0.05).The CMT,CNV and fluorescence leakage rate were significantly lower in the experimental group (P<0.05).The level of IOP and visual acuity(logMAR)were significantly lower in the experimental group (P<0.05).ConcIusions Conbercept ophthalmic injection can reduce age-related macular degeneration patients week blood VEGF and CRP levels and decrease the CMT, CNV and fluorescence leakage rate, reduce intraocular pressure, visual acuity improvement and have guiding significance for clinic.

Objective To explore the influence of the protection motivation theory (PMT) on the self-nursing ability of high-risk diabetic foot (DF) patients. Methods The outpatients in our hospital were selected with high-risk DF between January 2013 and May 2014, randomly divided into the control group and PMT group, 52 cases in each group. Guided under the protection motivation theory, PMT group received a six-month health education and management; and the control group accepted conventional health education of diabetes. Before and after the intervention, some observation indexes of the two groups respectively were evaluated including the ability of diabetic foot self-nursing, foot condition, fasting blood sugar, 2 h postprandial blood glucose. Result After six months, the scores of the self-care ability of diabetic foot and foot condition from the patients of PMT group were higher than that of PMT group before the intervention and that of control group after intervention (P<0.05). Conclusion PMT can help patients with high-risk DF enhance their foot self-care ability, improve their foot condition, control their blood sugar, and prevent the DF onset.

BACKGROUND:Increasing evidence has shown that lovastatin with less toxicity to normal cels has crucial effects on proliferation, apoptosis and differentiation of various cancer cels. However, its roles in glioma stem cels remain unclear.
OBJECTIVE:To explore the effect of lovastatin on proliferation and apoptosis of glioma stem cels.
METHODS: Flow cytometric sorting was used to separate glioma stem cels from human glioblastoma cel line U87. Effects of lovastatin on the proliferation and apoptosis of glioma stem cels were determined by MTT and flow cytometry, respectively. Furthermore, expression levels of Ki67, Bax and Bcl-2 in glioma stem cels treated with lovastatin were detected using western blot analysis.
RESULTS AND CONCLUSION: The CD133-positive glioma stem cels were sorted from human glioblastoma cel line U87 with a positive percentage of 85%. MTT assay showed that lovastatin inhibited the proliferation of glioma stem cels in dose (5, 10, 20 μmol/L)- and time (24, 48, 72, 96 hours)-dependent manners. Flow cytometry analysis showed that 10 μmol/L lovastatin (48 hours) induced apoptosis in glioma stem cels. In addition, the expression level of Ki67 was decreased by lovastatin treatment in a dose-dependent manner, and the Bcl-2 and Bax expression levels were reduced and increased by 10 μmol/L lovastatin treatment, respectively. In conclusion, lovastatin can inhibit cel proliferation and induce apoptosis of glioma stem cels, and lovastatin may be a potential drug for treatment of brain tumors.

OBJECTIVE:To establish a method for the content determination of carbohydrates in Osseous and cucumis extract injection. METHODS:Ion chromatography was conducted on the column of Dionex CarboPac PA20 with mobile phase of water-1 mol/L Sodium acetate solution-250 mmol/L Sodium hydroxide solution(gradient elution)at flow rate of 0.45 ml/min,column tem-perature was 35 ℃,and injection volume was 10 μl,detector was electrochemical analysis detector. RESULTS:The linear ranges of galactose,glucose,mannose,sucrose and fructose were 0.5-10.0μg/ml(r>0.998 0);RSDs of precision,stability and reproduc-ibility tests were lower than 2%;recovery was 94.8%-99.1%(RSD=0.52%-0.89%,n=9). CONCLUSIONS:The method is sim-ple,fast and accurate,and can be used for the determination of carbohydrates in Osseous and cucumis extract injection.