patitis C.Conclusion Autoimmune reaction can be triggered by HCV infection;and autoimmunity is an immporant factor for liver tissue injury in patients with chronic hepatitis C.

Objective To analyze the clinical value of serum and cerebrospinal fluid(CSF) procalcitonin in the diagnosis of adult central nervous system(CNS) infection to provide reference for its clinical diagnosis and treatment .Methods Sixty adult patients with CNS diseases admitted to our hospital from February to December 2015 were selected as the research subjects .All patients were suspected of CNS infection at initial visiting due to suspected CNS symptoms and signs ,and the CSF pathogenic examination and separation were performed to determine the types of infected pathogenic microorganisms .Meanwhile serum and CSF procalcito-nin was detected .The detection results of CSF pathogen and procalcitonin were summarized .The detection results of CSF pathogen served as the gold standard ,serum and CSF procalcitonin> 0 .5 ng/mL as infection positive .The diagnostic test fourfold table was adopted .Then the procalcitonin detection results and CSF pathogenic microorganism detection data were inputted .The consistency of serum and CSF procalcitonin for judging CNS infection was analyzed and calculated .The sensitivity ,specificity and accuracy of serum and CSF procalcitonin detection method for detecting pathogenic microorganisms were analyzed .Results Among 60 cases ,31 cases were bacterial infection ,22 cases were viral infection and no pathogenic bacterium was detected out in 7 cases ,the positive rate was 88 .34% .In the serum procalcitonin detection :49 cases were positive and 11 cases were negative ;in CFS procalcitonin detec-tion:37 cases were positive and 23 cases were negative .The Kappa coefficients of serum procalcitonin and CFS pathogenic detection results was 0 .769 ,indicating that serum procalcitonin and CFS pathogenic detection results had higher consistency ;the Kappa coef-ficients of CSF procalcitonin and CFS pathogenic detection results was 0 .315 ,indicating that CFS procalcitonin and CFS pathogenic detection results had poor consistency .The sensitivity ,accuracy and specificity of serum procalcitonin for diagnosing CNS infection were 96 .08% ,93 .33% and 77 .78% respectively ,which of CSF procalcitonin were 73 .33% ,45 .00% and 38 .46% respectively ;se-rum procalcitonin detection had a higher clinical value in the diagnosis of adult CNS infection ,while CSF procalcitonin detection had little value .Conclusion The serum procalcitonin detection method has higher sensitivity ,accuracy and specificity for the diagnosis of adult CNS infection ,possesses a better guidance role in selecting the treatment scheme and evaluating the curative effect ,and has higher clinical value in adult patients with CNS bacterial infection .

BACKGROUND:Bone morphogenetic protein (BMP) has strong osteoinductibility. At present, it becomes a hot topic to find a proper carrier for BMP. Calcium phosphate cement (CPC) may become a favorable carrier for BMP for its many merits. OBJECTIVE: To evaluate using the CPC/BMP composite as well as only CPC to repair experimental avascular necrosis of femoral head (ANFH).DESIGN: A randomized controlled experimental study SETTING: Experimental Animal Laboratory of the 208 hospital of Chinese PLAMATERIALS: The subjects were 24 healthy adult rabbits of either sex,weighing 2.5-3.0 kg. BMP was provided by Research Institute of Orthopaedics, Xijing Hospital, Fourth Military Medical University of Chinese PLA. CPC was developed together by Department of Orthopaedics, First hospital of Jilin University and Department of Orthopaedics, Aichi Medical University, Japan and Mitsubishi Material Corporation, Japan)METHODS: This experiment was conducted in the Animal Laboratory,the 208 Hospital of Chinese PLA between April 2003 and April 2004.The CPC/BMP composite was constructed by combining calcium phosphate cement (CPC) with bone morphogenetic protein (BMP). The 24 rabbits were randomly divided into two groups: CPC group and CPC/BMP group, 12 rabbits in each group. The models of experimental avascular necrosis of femoral head (ANFH) were made. Then the CPC or CPC/BMP composite were filled into the bone defects. The specimens were harvested separately at the end of 3 and 12 weeks after operation. A series of examinations were carried out including radiograph, histomorphology, and observation under transmission electron microscope (LEM).MAIN OUTCOME MEASURES: Bone formation, degradation of materials and repairing of bone defects in each group.RESULTS:Totally 24 rabbits were examined and analyzed. ① The results of general observation and X-ray examination on the bone defect regions in two groups: at week 12 in CPC group much new bone formed, the volume of CPC decreased. In CPC/BMP group more new bone formed. The phenomena of degradation and absorption were evident and the volume of the material decreased evidently. ② The results of histology observation and transmission electron microscope (TEM) observation in femoral heads in two groups: at week 12 in CPC group CPC decreased and there were some interspaces between CPC and new bone. New bone trabecula enlarged. Juvenile osteocytes could be found with round nucleus, chromatin deviating to one side, rough endoplasmic reticulum (rER) swelling and there were the phenomena of mitochondrion vacuolated and mitochondrial cristaes broken. In CPC/BMP group, CPC was dispersed with new bone intruded into the material and enwrapping each other. Osteoblasts contacted with CPC granules tightly whose rER and mitochondrion in cytoplasm increased and swelled. Many capillaries invaded the material and were encircled by many osteoblasts.CONCLUSION: CPC is an ideal carrier to BMP. The CPC/BMP composite has stronger steoconductibility and osteoinductibility in ANFH repairing than CPC, and is effective in repairing experimental avascular necrosis of femoral head.

Objective To investigate the effects of fasudil on expressions of Bcl-2 and Bax in cerebral cortex of model rats with subarachnoid hemorrhage (SAH). Methods Thirty rats were divided into sham operation group, SAH group and SAH+fasudil group, 10 rats in each group. Double injection of blood into occipital cistern method was used for SAH model in SAH group and SAH+fasudil group. In the sham operation group, the blood injection was instead by normal saline. In the SAH+fasudil group, at 30 min after the second injection of blood, rats were administrated with intraperitoneal injection of fasudil at a dose of 3 mg/kg. The general situation, neurological score, TUNEL staining for cortex cell apoptosis, immune histochemical staining and Western blotting assay for Bcl-2 and Bax protein expression were compared 24 h after the operation between the three groups. Results Compared with the sham operation group, rats in SAH group and SAH +fasudil group appeared obvious neurological deficits. The neurological score was significantly lower in SAH group ( 2.68 ± 0.31) than that of sham operation group (5.00±0.00). The neurological score was significantly higher in SAH+fasudil group (3.27 ± 0.35) compared with that of SAH group (2.68 ± 0.31, P<0.05). There was obvious cell apoptosis in SAH group and SAH+fasudil group, and the apoptosis was less in SAH+fasudil group than that of SAH group (P<0.05). The level of Bcl-2 expression was significantly lower in SAH group than that of sham operation group, and Bax expression was significantly higher in SAH group than that of sham operation group (P<0.05). The level of Bcl-2 expression was significantly higher in SAH+fasudil group than that of SAH group, but Bax expression was significantly lower in SAH+fasudil group than that of SAH group (P<0.05). Conclusion Fasudil can improve the neurological damage in rats with SAH, which may be related with the regulation of apoptosis related proteins Bcl-2 and Bax.

Objective To investigate the variations of intestinal flora of common carp in patients with hyperuricemia in Qingdao District.Methods The fecal flora was analyzed by gradient dilution method.The levels of uric acid in blood and feces were detected by enzyme colorimetry method and phosphortungstic acid method,respectively.Results E.coli (7.58 ± 0.34,P ＜ 0.05),the total count of aerobian (7.76 ± 0.67,P ＜ 0.05),and bacteroides (2.75 ± 0.31,P ＜ 0.05) were significantly increased in hyperuricemia patients compared to controls.Bifidobacterium (5.38 ± 0.34,P ＜ 0.05) and lactobacillus (2.69 ± 1.48,P ＜ 0.05) were sig-nificantly decreased compared to controls.Concentrations of uric acid in blood and feces were both significantly higher in the patients relative to healthy controls.Decomposition capability was similar to healthy controls.Decomposition capability of uric acid revealed a close correlation with bifidobacterium and lactobacillus,respectively (r =0.565,0.328,P ＜ 0.05).Conclusions Intestinal dysbacteriosis was found by the analysis of fecal flora in patient with hyperuricemia in Qingdao district.Dysbacteriosis might participate in the process of hyperuricemia onset.

Objective To investigate clinical feature,therapy and prognosis of 63 (rhabdomyolysis,RM) patients.Methods Retrospective analysis was used for the 63 patients who were from Nanjing from Janurary 2010 to August of 2016.Results Clinical history:the pathogenic factors mainly contained eating lobster,excessive exercise,lipid-lowering drugs,and minority patients were induced by infection,cardiac defibrillation,alcohol,and unexplained factors.Clinical features:most patients presented different degree of muscle soreness and weakness,and urine color of soy sauce;and few patients manifested a fever,respiratory distress and sound hoarse.Of which 11 RM patients concurrent acute kidney injury (AKI),there was no obvious bias of pathogenic factors among 11 patients.Clinical examination:the data was described by median,including creatine kinase 6 400 U/L,aspartate aminotransferase 399 U/L,lactate dehydrogenase 816 U/L,α-hydroxybutyric acid 445 U/L,and myoglobin 1 200 ng/ml.Creatine kinase and myoglobin were selected to measure muscle injure,there was no significant difference among the groups (P ＞ 0.05).Renal tubular injury index such as urincosmotic pressure,urine retinol-binding protein and N-acetyl-beta-D-glucosaminidase (NAG) enzyme,the abnormal percentage were 62.5％,50％,and 47.6％.Treatment:patients without complications through resting,water infusion,urine alkalization,were cured;and 11 cases of patients with AKI,1 case gave up,5 cases underwent hemodialysis,and 5 cases underwent conservative treatment,creatinine decreased to the basic level.Conclusions Among different pathogenic factors of RM,there were no obvious differences in clinlcal symptom,muscle damage degree,and whether the coexistence of AKI and prognosis.The understanding of RM,early diagnosis and treatment would prevent AKI and improve the prognosis.

BACKGROUND:The repairing of bone defect near joint in long bone resulting from complicated comminuted fracture or excision of bone tumor is very difficult. It is a much studied issue to find a feasible solution to this problem.OBJECTIVE: To explore a feasible treatment to bone defect near joint in long bone through comparative observation of 3 reconstruction methods.DESIGN: A completely randomized experiment with self-control and mutual control.SETTING: Laboratory for Experimental Animals, First Hospital of Jilin University.MATERIALS: Twelve healthy adult hybrid dogs, 5 males and 7 females weighing 12 to 18 kg, were recruited.METHODS: The bone defects near joints were established in upper femoral condyle in the 12 dogs, which were reconstructed by 3 operation styles: only filling with bone cement, filling with bone cement + autogenous ilium bone graft, and filling with bone cement + autogenous ilium bone graft + fixation with L-trapezoid compression plate. There was one dog in each method. The specimens were harvested at the end of weeks 3, 6, 12and 24, respectively, after operation. One week before specimens were harvested the fluorescent labeling was prepared; we conducted vascular perfusion of disulphine blue before the animals were executed.MAIN OUTCOME MEASURES: A series of examinations were carried out, including X-ray film, biomechanical test, intravascular perfusion and tetracycline fluorescent labeling. The bone healing, blood supply recovery and biomechanics were observed in the three groups.RESULTS: The 12 dogs all entered the result analysis. ① Results of Xray examination: Two cases of fracture occurred in experimental side at 6and 12 weeks in group Ⅰ; one case of fracture occurred in experimental side at 6 weeks in group Ⅱ. No fracture happened in group Ⅲ. ② Bone stiffness assayed with biomechanics: It decreased in experimental side as compared to control side by 67% and 70% in group Ⅰ; 66%, 76% and 46% in group Ⅱ; and 8% in group Ⅲ. ③ Specimen observation after operation: Bone formation, callus, and blood supply recovery were significantly better in group Ⅲ than in groups Ⅰ and Ⅱ at all stages.CONCLUSION: The third operation, filling with bone cement + autogenous ilium bone graft + fixation with L-trapezoid compression plate, is an ideal method of bone reconstruction. It can recover bone function, and prevent complications such as refracture and bone nonunion.

Objective To investigate the association between polymorphisms of thyroid-stimulating hormone receptor(TSHR)gene intron 1(rs179247, rs12101261)and Graves′ disease(GD)in the China Han population from Xuzhou city, Jiangsu Province. Methods Total 1 066 GD patients and 1 107 control subjects were recruited for genotyping by Taqman probe technique on Fluidigm EP1 platform. Meanwhile, serum concentrations of thyroid hormone and TSH receptor antibodies(TRAb)were determined. Results The rs179247_A, rs12101261_T were significantly associated with GD risk(OR=1.35, 95%CI 1.19-1.54, P=5.92×10-6; OR=1.32, 95%CI 1.16-1.50, P=2.22×10-5). Logistic regression identified that rs179247 was an independent susceptibility locus of GD. Serum TRAb concentration showed a significant difference(P=0.015)among rs179247_AA, AG, and GG genotypes. Conclusion rs179247 and rs12101261 in TSHR intron 1 are both associated with GD, and rs179247 may contribute risk to GD independently. The polymorphism is associated with TRAb, but not with serum concentration of thyroid hormones, age of onset, diffused thyroid goiter, ophthalmic signs, and relapse.

The study aims to characterize and compare interferon reference standards from 5 manufacturers. By testing molecular mass and trypsin-digested peptide mass mapping, the amino acid sequence was verified and post-translational modifications such as disulfide bond were identified. Results show that the molecular mass and amino acid sequence were consistent with theory; the disulfide bonds of 4 lots of interferon were Cys1-Cys98/Cys29-Cys138, 1 lot was Cys29-Cys139/Cys86-Cys99; N-terminal "+Met", acetyl N-terminal and Met oxidation were identified in part of the sample. UPLC-MS can be used to characterize and compare interferon reference standards from different manufacturers.

Summary Vertical nystagmus is a vertical nystagmus caused by structural abnormalities and/or dysfunction of the central vestibular system and observed in situ in the center of the eyeball. There are two kinds of nystagmus （UBN） and downbeat nystagmus （DBN） according to the direction of nystagmus. The diagnosis of UBN is mainly made by naked eye or electronystagmography/viewer. It is a common neuro-ophthalmologic sign in the field of vestibular medicine. In this paper, the mechanism of vertical nystagmus formation and the location of lesions were briefly introduced, in order to provide help for the diagnosis and treatment of Vertigo.