Mononuclear cells separated from heparinized fresh venous blood of healthy male bloodclonors by means of Ficoll- Hypaque density gradient centrifugation were subjected to petri dish adhesion and nylon wool-column separation to obtain monocytes and T lymphocytes of high purity, respectively. Antigen- presenting capability of the monocytes, as reflected by T lymphocyte proliferation, was assayed after the monocytes had been preincubated with PPD (purified protein derivative, end concentration12.5 ?g /ml ) and methione enkephalin (M-Enk) in defferent concentrations for 24 hours at 37 ℃ in a humidified incubator containing 5% CO_2. It was shown that the antigen-presenting capability of the monocytes was markedly enhanced by M-Enk when its concentration was from 10 ~(-10) M to 10~(-14) M(close to the normal serum concentration of M-Enk), and this effect of M-Enk could be cancelled if the monocytes had been pretreated with 10~(-6) M naloxone for 30 min before addition of PPD and M-Enk, suggesting that the effect of M-Enk in these concentrations was mediated through the opioid receptors on the monocytes. M-Enk in high concentrations (10~(-4) M-10~(-6)), however, was found to inhibit th'e antigen- presenting capability significantly and this inhibition could not be cancelled by pretreatment of the monocytes with naloxone.

Objective: To evaluate the effects of fixed inclined bite plate on jaw bone and dentition in juveniles with Class Ⅱ division 1 malocclusion.Methods: Eighteen patients(10 male and 8 female aged 11.5～13.8 years old) were treated with fixed inclined bite plate for bite-opening, twelve patients(6 male and 6 female) were involved as the control. Cephalograms were taken before and after the treatment.Results: After treatment ANB was significantly reduced and mandibular development was improved; AFH and PFH were significantly increased; the first molar in mandible was siginificantly elongated.Conclusion: Fixed inclined bite plate is effective in the improvement of sagittal skeletal relationship and in the orthodontic treatment in the juveniles with Class Ⅱ division 1 malocclusion.

Objective To investigate the clinical features of the amyotrophic lateral sclerosis(ALS) which initial located in anterior horn of thoraci spinal cord.Methods The clinical data of 3 patients with ALS which initial located in anterior horn of thoraci spinal cord were analysed retrospectively.Results All of the 3 cases were male.The age of onset was 52,66 and 62 years old,respectively.They all presented as dyspnoea,with obvious atrophy in intercostal muscle and rectus abdominis.However,the muscle weakness and atrophy in the limbs were occurred slight degree and late comparativly.EMG showed the neurogenic damage in upper limbs and vertebra muslce.Conclusions The ALS which initial located in anterior horn in thoraci spinal cord is male dominant,the average age of onset is delay than that in ALS.The dyspnoea obvious.The respiratory muscle atrophy is earlier than the muscle weakness and atrophy in the limb.Definite diagnosis depende on the EMG.

Objective To develop a method for the separation and preparation panaxynol. Methods Panax Notoginseng was extracted by SEF-CO_2, and absorbed by silica gel to remove most of the polar impurities. Panaxynol was preparated with RP-HPLC. Result Panaxynol was identified by UV、IR、MS、NMR,and the purity of panaxynol reached 98%. Conclusion The developed method is simple, reproducible and easy to operate. The solvent is cheap,with low boiling point and easy to recovery property.

Objective To review the clinical features of lung nodule and the common misdiagnosed reasons and diseases. Methods A total of 44 literature on misdiagnosed lung nodule in the latest ten years were reviewed and their clinical characters, diagnosis methods were analyzed. Results Forty-four relative literatures were found, in which there were 319 misdiagnosed cases. The median of onset age was 43 years. Female patients were more than male. Cough, chest distress and fever were primary symptoms. 46. 39% of the patients were characterized with hilus of lung lymphadenectasis symmetrically. The most common misdiagnosis were tuberculosis, lung cancer and lymphadenoma ( 53.61%, 25. 71% and 10. 34% ). Majority of patients were correctly diagnosed by biopsy, especially through transbronchial lung or mucosa biopsy or lymphaden biopsy. Conclusion Clinicians should improve the understanding on lung nodule and comprehensively analyze and differentiate it with other diseases to reduce the misdiagnosis.

BACKGROUND: Clinical diagnosis criteria for rotary subluxation of atlanto-axial joint have not been identified. Many clinical diagnoses are suspicious. Therefore, investigating a new diagnostic method and diagnostic evidence is beneficial to enhancing diagnosis accuracy, and is a study hotspot in the current field.OBJECTIVE: This study aimed to observe the relationship between anatomy of normal human atlanto-axial joint and functional positions, and to provide anatomical basis for the diagnosis of atlanto-axial rotary subluxation.DESIGN: Single sample self-control study.SETTING: Department of Imageology, Zhongshan Hospital Affiliated to Xiamen University.PARTICIPANTS: This study was carried out in the CT Room, Department of Imageology, Zhongshan Hospital Affiliated to Xiamen University between June 2003 and November 2004. Fifty-three volunteers, 27 males and 26 females, with an average age of 31.2 years (range 4.5-75 years), without cervical trauma or history of cervical diseases, were randomly recruited in to this study. Written informed consents were obtained from each subject or their guardians.METHODS:CT helical scanning and three-dimensional reconstruction imaging of atlanto-axial joint in the neutral position were performed in all the volunteers and were supplemented in the right and left rotary position in 21 subjects on a helical CT scanner (somatom plus 4, Siemens, Germany), SUN magic view 1000 workstation and three-dimensional reconstruction software.MAIN OUTCOME MEASURES: ① Lateral atlanto-axial articular facet contraposition. ② Lateral atlanto dental space③ Atlanto dental interval. ④ The largest extent of articular facets dislocation in the right and left rotary positions. ⑤ Head's rotary maximal angle in the right and left rotary positions.RESULTS: ① Three-dimensional images with atlanto-axial joint in the functional position of 53 patients showed that the articular surfaces of lateral atlanto-axial joint had basic contraposition, the width of atlanto-dental interval ranged from 1.0 to 3.3 mm, and the lateral atlanto-dental distance devirated in 24 patients (45.28%).②Three-dimensional images with atlanto-axial joint in the rotary position of 21 patients showed that the width of atlanto dental interval had no change, the articular facets of lateral atlanto-axial joint had rotary displacement with the width ranging from 5.76 to 8.18 mm, and anastomotic area of articular facet was decreased by 1/2 to 2/3. The condyles had deflected to the rotary direction in the patients with symmetrical lateral atlanto dental space, and for 15 patients with asymmetrical lateral atlanto dental space, the condyle deflected slightly or had no changes.CONCLUSION: CT-three dimensional imaging can clearly show the anatomical structure of atlanto-axial joint in functional position and the changing rule of atlanto-axial joint movement, providing theoretical evidence for the clinical diagnosis and the treatment of atlanto-axial subluxation.

Objective To investigate the factors that may affect the prognosis of patients with moderate-advanced hepatocellular carcinoma (HCC) who are receiving sorafonib therapy.Methods The clinical data of 38 HCC patients,whose diagnoses were confirmed by pathology or clinical imaging and were in accord with the Barcelona Clinic Liver Cancer (BCLC) staging criteria,were retrospectively analyzed.Sorafenib 400 mg was orally given twice everyday,and according to modified RECIST criteria the tumor response was evaluated once every 4-6 weeks,the adverse events were recorded,and the drug toxicity was evaluated by grading standard 3.0 edition for common adverse reactions formulated by American National Cancer Institute.Results Among the 38 patients,one patient developed hepatic encephalopathy after took sorafenib for two weeks,and medication had to be stopped.Of other 37 patients,14 patients developed pancreatic atrophy in different degrees (positive group),the median progression free survival (mPFS) was 9.0 months,and the median overall survival (mOS) was 25.8 months;pancreatic atrophy didn't occurred in the remaining 23 patients (negative group),the mPFS was 3.3 months,and the mOS was 8.4 months.The differences in mPFS and in mOS between the two groups were statistically significant (P＜0.01 and P=0.025respectively).The main adverse events included hand-foot skin reaction,diarrhea,fatigue and weight loss,which were relieved after symptomatic treatment,and no severe untoward effect occurred.Conclusion Certain correlation exists between pancreatic atrophy and the curative effect of sorafenib.For patients who develop severe diarrhea associated with pancreatic atrophy,a longer survival time as well as a longer stable state of disease can be expected.(J Intervent Radiol,2017,26:258-262)

Due to the theoretical and technique limitation of traditional surgery,surgical treatment of complex intrahepatic biliary diseases was left for an unresolved difficult problem of the last century.Uncertainties of the anatomical,physiological,pathological changes and surgical techniques in the intrahepatic biliary tract contribute to this complexity.Through integrated application of modern scientific technology and traditional medicine methods and systematic optimization and innovation of biliary surgical theories and techniques,authors have developed a paradigm of precision biliary surgery which is characterized by high quantification,visualization and controllability.The establishment of the precise biliary surgical system solves the difficulty in surgeries for intrahepatic biliary diseases,puts forward the biliary surgery from extrahepatic ducts,hilar ducts to intrahepatic ducts,entering a new segment era of the biliary surgery marked by precision treatment of intrahepatic biliary diseases.

Esophageal gastric variceal bleeding(EGVB)is a serious complication of cirrhotic portal hypertension with high mortality rate. Prevention of EGVB is an important mean to improve the survival of patients. Non-selective beta-blockers(NSBBs)is one of the first-line drugs for primary and secondary prevention of EGVB,however,only about 1 / 3 of cirrhotic patients respond to this treatment when evaluated by hepatic venous pressure gradient( HVPG). This may be related to the genetic polymorphisms of NSBBs’receptors and the metabolic enzymes. This article reviewed the progress in study on therapeutic efficacy of NSBBs and its influencing factors for preventing EGVB in cirrhotic patients.

Objective To investigate the dynamic changes in the serum inflammatory cytokines and their association with neurogenic pulmonary edema (NPE) in the patients with severe hand-foot-mouth disease (HFMD).Methods Eighty-nine patients with severe HFMD from March 2010 to December 2012 were recruited in the study.The patients were divided into NPE group and central nervous system diseases (CNSD) group according whether they had NPE.The cytokines,including interleukin (IL)-4,IL-6,IL-10,IL-17,tumor necrosis factor-α (TNF-α) and interferon-γ(IFN-γ)were evaluated by using enzyme-linked immunosorbent assay on day 1,3 and 5 after admission to hospital.Risk factors for NPE involvement during hospital stay were analyzed with multivariate Logistic regression analysis.Results (1) Compared with the CNSD group,the serum levels of IL-6 (Ftime =1.876,P =0.177,Ftime* group =2.192,P =0.145,Fgroup =7.855,P =0.007),TNF-α(Ftime =13.133,P =0.001,Ftime* group =0.291,P =0.592,Fgroup =3.644,P =0.042),IL-10 (Ftime =14.580,P =0.001,Ftime* group =2.612,P =0.078,Fgroup =16.823,P =0.000),INF-γ (Ftime =3.093,P =0.045,Ftime* group =0.513,P =0.600,Fgroup =20.141,P =0.000) were significantly higher than those in NPE group.(2)The serum levels of TNF-α,IL-10,INF-γ rose to the peak on the third day.(3) By using multivariate Logistic regression analysis,age (OR =3.383,95％ CI:1.173-4.759),days of fever (OR =4.925,95％ CI:1.758-3.794),hyperglycaemia (OR =3.465,95％ CI:1.303-5.220),leucocytosis (OR =7.579,95 ％ CI:2.530-12.704) and elevation of IL-10 (OR =1.228,95 ％ CI:1.007-1.523) were entered into equation.In the risk evaluation model,these variables remained independent predictors for NPE.Conclusions Abnormal cytokine productions appear to be responsible for the pathogenesis of NPE,and might be an effective tool for predicting NPE in infants with severe HFMD.