Objective To study the consistency and complementarity of endoscopic ultrasonography (EUS),white light endoscopy (WLE) and magnifying endoscopy (ME) in diagnosis of ulcerative colitis (UC).Methods We collected 125 cases of UC patients diagnosed by WLE and EUS (including 51 cases of WLE + ME + EUS).According to UC mucosal morphology under WLE and crypt openings under ME,we divided all the cases into several groups and analyzed intestinal wall thickness (TWT) under EUS in each group.Results According to the results of UC inflammation degree under WLE,all patients were divided into four groups: 16 severe cases,46 moderate cases,44 mild,and 19 remission stage.TWT results were (5.903 ± 1.551 ) mm,(4.673 ± 1.235 ) mm,(3.756 ± 1.322 )mm and ( 3.464 ± 0.970) mm,respectively.Differences were significant between any two groups ( P ＜ 0.05 ),except for that between mild and remission groups.According to the results of UC inflammation degree under ME,all patients were divided into six groups: 9 cases of villous-like structure,9 cases of typical coral reef-like structure,8 severe coral reef-like structure,13 regular crypt opening,6 epithelial minimal defect and 6 small yellow spot (SYS).TWT results were (5.701 ±0.941 )mm,(5.518 ±0.581 )mm,(5.181 ±0.751 )mm,(3.763 ±0.659) mm,(3.587 ±0.461 )mm and (2.505 ± 0.330 )mm,respectively.Differences were significant between any two groups ( P ＜ 0.05 ) except for those between epithelial minimal defect and regular crypt opening,typical coral reeflike structure,villous-like and severe coral reef-like structure.EUS results showed SYS (6/6) and regular crypt opening ( 10/13 ) were mostly located in mucosa,while lesions of severe coral reef-like structure (8/8) invaded the muscularis propria.Conclusion EUS shows high consistency with WLE and ME in diagnosis of UC inflammation degree and invasive depth.It could assist and even substitute ME for evaluation.

Objectives:To investigate the nutritional status of the maintenance hemodialysis(MHD) patients. Methods:The dietary investigation, anthropometry and biochemical tests were conducted in 46 MHD patients,including weight,triceps skinfold(TSF), arm muscle circumference(AMC), serum total protein(TP), albumin(Alb), prealbumin(PA), transferrin(TF) and ideal weight rate(IBW%).Then nutritional status was evaluated. Results:①The energy intake of most MHD patients was lower than 125.4 kJ/(kg?d) and the mean protein intake was nearly 1.0 g/(kg?d).②According to each single index,the incidence of malnutrition was:39.13% by IBW%, 71.74% by TSF, 58.70% by AMC, 30.43 % by Alb and 82.61% by TF respectively.Only 6.52% patients had all normal paremeters. Conclusions:Malnutrition incidence of MHD patients was as high as 93.48% in our study. The regular nutritional assessment and the nutritional advice are very important for the better clinical outcome in the MHD patients.

OBJECTIVETo investigate the mid-term outcome of operation for thoracolumbar tuberculosis. METHODS : Twenty-eight patiens with thoracolumbar tuberculosis underwent one stage anterior debridement,interbody fusion with bone graft and posterior pedicle screw internal fixation treatment from July 2006 to July 2011. There were 17 males and 11 females. Total 17 patients had nerve injuries ,including 6 cases of grade B, 5 cases of grade C, 6 cases of grade D according to Frankel classification. The poisoning symptoms of tuberculosis and recovery of spinal function were observed. The bone fusion and recovery of [umbar function were evaluated.

RESULTSAll the patients were followed up ,and the duration ranged from 39 to 85 months (mean 57 months). The clinical symptoms were controlled gradually, and the thoracolumbar back pain was alleviated after operation. Among the 17 patients with complications of nerve injuries, 3 patients were improved from preoperative grade B to postoperative grade D, 3 patients were improved from preoperative grade B to postopertive E, 5 patients with preoperative grade C and 6 patients with preoperative D were almostly recovered to normal after operation. According to JOA scoring system for curative effect evaluation, the excellent and good rate at the 3rd month, the 1st year, the 3rd year and the 5th year after operation were 67.86% ,82.14% ,85.71% ,89.29% and 91.30% respectively. The results at the 6th month and the 1st year had no statistical differences compared to the results at the 3rd month (P > 0.05); but the results at the 3rd year and the 5th year were better than that at 3 months after operation (P < 0.05); and the results between 3 yesrs and 5 years after operation had no statistical differences (P < O.05). The degeneration of adjacent segments were evaluated according to the California University (Universith of California at Los Angeles , UCLA) score. The degeneration rate was 53.57% (15/28) at the 3rd year after surgery, which was better than that before surgery. Twenty-three patients were followed up for 5 years ,and the degeneration rate was 86.96% (20/23) ,which was better than those of before surgery and 3 years after surgery.

CONCLUSIONThe surgical treatment for thoracolumbar spinal tuberculosis can achieve the thorough debridement, reconstruction of spinal stability, recovery of lumbar function and promote the functional recovery of the spinal cord, which is an effective method of treatment. However, the mid term follow-up showed that more severe degenerative changes were found in the postoperative adjacent segment.

Adult ; Aged ; Female ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Spinal Fusion ; methods ; Thoracic Vertebrae ; surgery ; Tuberculosis, Spinal ; physiopathology ; surgery

Animals ; Endoplasmic Reticulum ; metabolism ; Ischemia ; metabolism ; Male ; Molecular Chaperones ; metabolism ; Pressure Ulcer ; metabolism ; Rats ; Rats, Sprague-Dawley ; Subcutaneous Tissue ; blood supply

Objective:This study was to analyze the changes of CD4~+ T lymphocytes and their subtypes,Th1 and Th2 cells,in the peripheral blood of patients with pulmonary tuberculosis disease and to investigate their clinical significance in the pathologic process of pulmonary tuberculosis.Methods:For polarization measurement of T-helper cells,1∶100 diluted Ionomycin and 1∶10 diluted Monensin were added in sequence into the equivalent volume mixture of heparin anti-coagulated whole blood and RPMI-1640 culture liquid.After being well mixed,the mixture was incubated at 5% CO_2,37℃ for 4 hours or overnight.To 100 μl of the mixture and in sequence,the antibodies of CD3-PerCP,CD8-APC,mIgG1-FITC,Rat IgG1-PE,IL-4-PE or IFN-γ-FITC were added.The stained CD4~+ IL-4~+ (Th2) and CD4~+ IFN-γ~+ (Th1) were analyzed by flow cytometry.Results:Compared with those from healthy controls,the peripheral blood of pulmonary tuberculosis patients contained significantly fewer Th1 (P＜0.01) but significantly more Th2 cells (P＜0.05).Th1 cells in the peripheral blood of the patients with miliary pulmonary tuberculosis were obviously fewer (P＜0.05) than in infiltrative pulmonary tuberculosis patients.The amount of Th2 cells in the peripheral blood of the patients with miliary pulmonary tuberculosis was significantly more (P＜0.05) than in either infiltrative pulmonary tuberculosis or tuberculous pleurisy patients.The ratio of CD4~+/CD3~+ tended to decrease in all these patients,and it was much lower (P＜0.05) in the patients of miliary pulmonary tuberculosis than in infiltrative pulmonary tuberculosis patients.Patients suffering from both pulmonary tuberculosis and diabetes had significantly lower levels of Th1 cells and CD4~+/CD3~+ (P＜0.05) and more Th2 cells,compared with those of pulmonary tuberculosis patients without diabetes.Levels of Th1 and Th2 cells restored significantly (P＜0.05) in 15 severe pulmonary tuberculosis patients after receiving tuberculosis chemotherapy and microcalorie theropy for three months.Patients with positive sputum examination tended to have decreased Th1 and CD4~+/CD3~+ (P＞0.05) and significantly increased Th2 (P＜0.05).Conclusion:Immunosuppression existed,in different extents,in patients of infiltrative pulmonary tuberculosis,tuberculous pleurisy,miliary pulmonary tuberculosis as well as patients with both pulmonary tuberculosis and diabetes.Analysis of Th1,Th2 and CD4~+/CD3~+ may be benefit for the judgments of disease conditions and therapeutic effects.

ObjectiveTo assess the satisfaction of general practical students' perception with the two modes of histologic laboratory instruction,and obtain the advantages and disadvantages of each mode.MethodsWeb-based database was established and in the questionnaires were delivered to the general practical students ( n=193 ).Results75％ of students agreed that the case study component of the webbased laboratory instruction was arranged in order.82％ of students identified with the detailed word explanation attached to every image presented.ConclusionStudents support the progression of web-based histologic laboratory instruction,but it is difficult to replace traditional microscope with web-based database in histologic laboratory instruction.

Background and purpose:The pain is not only the chief symptom of cancer but also the main factor of survival quality for the cancer patient.So it is the most difficult for how to control the pain of moderate to severe late-stage cancer and reduce the rate of side effects.We observed the analgesia effects of micro-dosage ketamine associating morphine patient control skin analgesia(PCSA) for latter cancer pain patients.Methods:52 cases middle, latter cancer pain patients were divided two groups randomly,the first group used the morphine PCSA and the second group used micro-dosage ketamine associating morphine PCSA.The VAS(Visual Analogue Scale) was used to evaluate the pain level,then statistic the side effects rate of two groups.Results:Two groups patients'pain all alleviated fundamentally,the VAS of every period have not statistic difference,but the PCSA pressing times in the first group was more than in the second group.The second group patients'life satisfactory rate was higher obviously than the first group patients';Side effects:the incidence of nausea,vomiting,indulge in sleep and skin titillation in the first group was higher than in the second group;the incidence of respiration depression and hallucination had not difference between two groups.Conclusion:Micro-dosage ketamine associating morphine patient control skin analgesia(PCSA)approach appears to provide patient with safe and effective pain relief and reduce side-effect for moderate to severe late-phase cancer pain,easy to perform and have no process complication to used in clinic.

?AIM: To evaluate the effects on recovering of corneal wound and postoperative discomfort of different methods for primary pterygium.?METHODS: Forty-seven cases ( 60 eyes ) of primary pterygium were excised under microscope with limbal epithelial transplantation, with sharp dissection ( 24 cases, 30 eyes, Group A) and blunt dissection (23 cases, 30 eyes, Group B).All cases were followed up for 1d to 1mo.?RESULTS: The recovering of corneal wound was better in Group B on 1st day and 3rd day after surgery.Pain, photophobia and tears, foreign body sensation were more serious in group A on 1st day after surgery with a statistically significant difference (P=0.005,0.015,0.012). Pain, photophobia and tears, foreign body sensation were more serious in Group A on 3rd day after surgery with a statistically significant difference ( P=0.019,0.018, 0.015).There was no statistically significant difference on 1wk and 1mo after surgery (P>0.05).? CONCLUSION: Compared with sharp dissection, primary pterygium excised with blunt dissection can significantly improve recovering of corneal wound and postoperative discomfort.

NOD mice were treated intraperitoneally with tripterygium wilfordii ployglycosidium (TWP) for 4 weeks to observe the incidence of cyclophosphamide accelerated diabetes.The apoptosis of?-cells was detected by TUNEL,the expression of caspase-3 in islets of the NOD mice was detected by immunohistochemistry and the expression of caspase-8 mRNA in pancreas by RT-PCR.The results revealed that the incidence of diabetes in TWP group was lower than that in control group.The apoptosis index of?-cells was decreased in TWP group. The expression of caspase-3 in islets and the expression of caspase-8 mRNA in pancreas in TWP group were lower than those in control group.

OBJECTIVETo analyze the consistency of evolution condition between HA gene and the whole genome of influenza virus subtype A/H3N2 strains isolated in Zhejiang province from 1998 to 2009, and to study the potential antigenic region on the whole genome.

METHODSThe sequences of whole genome of 19 Zhejiang influenza virus isolates circulated from 1998 to 2009, which conserved by influenza laboratory of Zhejiang Provincial Centre for Disease Prevention and Control, were amplified using RT-PCR assays. The obtained sequences were used to conduct phylogenetic analysis with 10 contemporaneous vaccine strains. Three methods, including comparison of the amino acid substitutions, calculation of the entropy value and the filtering of positive selection sites, were used to confirm the mutable sites on each gene.

RESULTSThe whole genome of influenza virus subtype A/H3N2 was 4466 amino acids in length, with 137 stable mutations. The 144, 158 aa of HA gene mutate four and three times respectively; 93, 143, 307, 370, 372 aa of NA gene and 450 aa of NP gene mutate twice, and there were 29% (12/41) and 77% (24/31) mutations of HA and NA genes occurred on the non-epitope regions respectively. Analysis of the entropy value suggest that many amino acid sites on the non-epitope regions were prone to mutation, including 3, 225, 361 aa of HA gene; 93, 143, 147, 150, 372 aa of NA gene; 113, 576, 586 aa of PB1 gene; 101,256, 382, 421, 437 aa of PA; 377, 450 aa of NP gene; 218 aa of M1 gene and 31 aa of M2 gene.

CONCLUSIONBased on the whole genome of influenza virus subtype A/H3N2 strains isolated in Zhejiang province in 1998 to 2009, there may be several unknown or new antigen sites existing on the non-epitope regions of HA and NA genes and parts of internal genes. The phylogenetic tree constructed based on the complete sequence was more comprehensive than on the HA gene to reflect the genetic relationship and law of evolution among the influenza virus strains.

China ; DNA Mutational Analysis ; DNA, Viral ; genetics ; Evolution, Molecular ; Genetic Variation ; Genome, Viral ; Influenza A Virus, H3N2 Subtype ; classification ; genetics ; isolation & purification ; Molecular Sequence Data ; Phylogeny ; Sequence Analysis