Objective To observe the subarachnoid space the epidural space joint block labor analgesia (CSEA) changes of T lymphocyte subsets.Methods 100 cases of full-term mothers were randomly divided into two groups,analgesia group and the control group.The analgesic group row CSEA childbirth analgesia.Two groups of maternal cervix large 2 to 3cm (T1),when the baby was delivered (T2),24h (T3),blood was colleoted after childbirth,detected by radioimmunoassay of cortisol.Flow cytometry assay was wsed to test T lymphocyte subsets CD3+,CD4+,CD8+,CD4+/CD8+,And the birth process,Apgar score,Labor pain visual analogue score (VAS) were recoroded.Results (1) Active phase of the first stage of childbirth analgesia group was significantly shorter than the control group (t =2.182,P ＜ 0.05).The second and third stage of Childbirth and neonatal Apgar score difference between the two groups was not statistically significant.(2)Serum cortisol concentration at T2 analgesia group was significantly lower that of than the control group (P ＜ 0.05).(3) The two groups in maternal blood of CD3+,CD4+,CD4+ / CD8+ were reduced to varying degrees,T3 was reduced significantly (P ＜ 0.05),Analgesia group was significantly lower than that of the control group (all P ＜ 0.05).Conclusion CSEA analgesia in Childbirth can shorten the first stage of Childbirth active period,has no significant effect on the Apgar score,can alleviate the pain and stress reactions such as the suppression of the maternal immune function.

Objective To explore whether childhood abuse experiences predict higher levels of depression and lower levels of self-esteem for graduate students and examine the mediating role of social support between childhood abuse and mental health.Methods A sample of 907 graduate students were investigated with the Childhood Trauma Questionnaire (CTQ-SF),Perceived Social Support Scale (PSSS),Self-esteem Scale (SES) and Center for Epidemiological Survey Scale (CESD).Results The scores of childhood abuse,social support,self-esteem,and depression of graduate students were (33.88±9.35),(68.31±12.01),(36.62±4.80) and (35.85± 9.20).Childhood abuse was negatively correlated with self-esteem (r=-0.32,P＜0.01),but positively correlated with depression (r=0.28,P＜0.01),and negatively correlated with social support (r=-0.44,P＜0.01).Social support was positively correlated with self-esteem (r=0.39,P＜0.01),and negatively correlated with depression (r=-0.41,P ＜0.01).Examining the mediation model indicated that social support had a partial mediation effects(42％) on the relationship between childhood abuse and self-esteem,and social support had a partial mediation effects(54％) on the relationship between childhood abuse and depression.Conclusions The childhood abuse not only affects the graduate student's self-esteem and depression directly,but also can take the same effect by social support indirectly.

Objective To observe the clinical efficacy of distant collateral needling in treating cervical spondylotic radiculopathy. Method Eighty patients with cervical spondylotic radiculopathy were randomized into a treatment group and a control group, 40 cases in each group. The treatment group was intervened by distant collateral needling, while the control group was by ordinary acupuncture treatment. The symptom and sign scores were observed before and after intervention, and the clinical efficacies were compared between the two groups. Result The symptom and sign scores were changed significantly after intervention in both groups (P<0.01). The symptom and sign scores of the treatment group were significantly different from that of the control group after intervention (P<0.05). The total effective rate and the recovery plus markedly-effective rate were respectively 94.9% and 84.6% in the treatment group versus 89.2% and 64.9% in the control group. The between-group difference in the total effective rate was statistically insignificant (P>0.05); there was a significant difference in comparing the recovery plus markedly-effective rate between the two groups (P<0.05).Conclusion Distant collateral needling is an effective method in treating cervical spondylotic radiculopathy.

Objective To study the imaging characteristics of osteosarcoma.Methods 35 patients with osteosarcoma proved pathologically were examined by radiography,of them 25 cases were examined with CT scan or MRI,and 8 cases undergone contrast-enhanced MRI.The imaging features of osteosarcoma were analysed comparatively with that of pathology.Results The lesions localized at distal part of femur in 17 cases and proximal part of tibia in 8 cases,that were most location of this tumor.The imaging characteristics of osteosarcoma included bone destruction,neoplastic bone,periosteal reaction and soft-tissue mass,in some cases,epiphyseal plate and epiphysis were involved,even the joint face and the opposite osseous of joint(skip lesions).On enhanced MR scanning,the margin of tumor was enhanced in early and the center of tumor was delayed enhancement.CT could showed "sieve sign"and small neoplastic bone.Conclusion Osteosarcoma has certain imaging characteristics;X-ray examination is the first choice in diagnosing osteosarcoma,CT and MR could provide much more comprehensive imaging information for clinic.

Objective To investigate the relation between brain natriuretic peptide (BNP) rs198388 polymorphism and the susceptibility of essential hypertension in Han population of Hunan. Methods A total of 567 patients with hypertension (the hypertension group) and 555 healthy volunteers (the control group) were enrolled. Gender, age, smoking and drinking history of the 2 groups were not significantly different. Blood pressure was measured in the 2 groups. After fasting for 12 h or more, blood glucose, total cholesterol, triglycerides, high density lipoprotein cholesterol and low density lipoprotein cholesterol were measured. DNA polymorphism analysis was done by polymerase chain reaction-restriction fragment length polymorphism method, and genotype was determined by agarose gel electrophoresis. Results The GG, GA, and AA genotypeswere detected.The frequencies of GA and AA genotypes and A allele were significantly lower in the hypertension group (GA and AA:12.3%;A:6.9%) than those in the control group (GA and AA:18.4%; A:9.7%; P=0.009, and P=0.014, respectively). Conclusion BNP rs198388 polymorphism may be associated with essential hypertension in Han people in Hunan. Carrying rs198388 GA and AA genotypes and A allele may be the reason for low risk of hypertension.

Objective To evaluate the soft tissue profile in adults with unoperated isolated cleft palate. Methods Twenty patients older than 16 years(median age,18.4) with unoperated isolated cleft palate were enrolled.Soft tissue lateral cephalograms were traced and compared with those of cleft operated patients and class-Ⅰocclusion individuals.The results of various measurements were analyzed with ANOVA by SPSS11.5. Results In adults with unoperated isolated cleft palate,there was restriction at the top of the upper lip,and the antelabrum of upper lip and the lower lip were found normal. Conclusion The soft tissue profile in adults with unoperated isolated cleft palate exhibits almost the same characteristics as the corresponding hard tissue,and there is covering over effect of the soft tissue to some extent.

Objective To establish classification and regression tree (CART) for differentiating benign from malignant solitary pulmonary nudules (SPN).Methods One hundred and sixteen consecutive cases with 116 solitary pulmonary nodules,which finally were pathologically proven 54 malignant nodules and 62 benign nodules,were prospectively registered in this research.Twelve clinical presentations and 22 CT findings were collected as predictors.A classification tree was established to distinguish benign SPNs from malignant ones.In the observer test,two groups (one made of junior radiologists and one of senior radiologists) were independently presented with clinical information and CT images without knowing the pathologic and machine-learning results.Performance of observers and CART were compared by receiver operating characteristic analysis.Results Receiver operating characteristic analysis showed areas under the curve of CART,senior radiologists and junior radiologists respectively were 0.910±0.029,0.827±0.038,0.612±0.052. Difference between areas (DBF) between CART and junior radiologists was 0.297 (P＜0.01).DBF between CART and senior radiologists was 0.083(P＜0.05).DBF between senior and junior radiologists was 0.214(P＜0.01).CART showed a best diagnostic efficiency,followed by junior radiologists,and then senior radiologists.Conclusion Our data mining techniques using CART prove a high accuracy in differentiating benign from malignant pulmonary nodules based on clinical variables and CT findings.It will be a potentially useful tool in further application of artificial intelligence in the imaging diagnosis.

Adult ; Air Pollution, Indoor ; adverse effects ; Benzene ; adverse effects ; Control Groups ; Female ; Humans ; Leukocyte Count ; Male ; Middle Aged ; Occupational Exposure ; adverse effects ; Paint

ObjectiveTo investigate the action mechanism of CD20 lymphocyte infiltration in the renal allograft biopsy with chronic allograft nephropathy (CAN).MethodsCAN cases confirmed by renal biopsy within 2 years after renal transplantation served as study subjects. By using immunohistochemistry,the deposition of C4d and the CD20-positive lymphocytes infiltration in the renal grafts were examined.The clinical follow-up data were analyzed.ResultsForty-four cases of CAN were enrolled in the study, including 13 cases (29.5％ ) of CD20-positive lymphocytes infiltration,and 31cases (70.5％ )of CD20-negative lymphocytes infiltration. CD20-positive lymphocytes in biopsy showed nodular and scattered lymphocytes infiltration.There were 5 (26.3％)cases of CAN Ⅰ,4 cases (25.0％) of CAN Ⅱ,and 4 (44.4％) of CAN Ⅲ in CD20-positive group.There was no statistically significant difference between the only CAN group and CAN with AR group in CD20-positive rate.Immunohistochemical staining showed there were 12 cases (27.3％) with C4d linear deposition in peritubular capillary endothelial cells (PTC).C4d positive rate had no significant difference among the CAN classifications. There was no significant relationship between C4d deposition and CD20-positive lymphocytic infiltration.The average serum creatinine in CD20-negtive group and CD20-posigtive group was 140.8 ± 22.0 and 183.5 ± 25.5μmol/L before biopsy,and 165.6 ± 37.6 and 242.2 ± 59.1 μmol/L one year after biopsy.The average serum creatinine level in CD20-positive group was higher than in CD20-negtive group before and after biopsy.ConclusionProgressive chronic humoral immunity is high risk in the process of CAN. The CD20-positive lymphocyte infiltration has no relevance with CAN grade and C4d deposition in PTC,but is associated with circulating antibody PRA and allograft long-term outcome. Pathogenetic mechanism may not contribute to chronic humoral immune,but B cells presenting donor antigens,are recognized and activated by T cells as antigen-presenting cells.

Objective To investigate the role of HMGB1 in the pathogenesis of organ injury of acute necrotizing pancreatitis (ANP).Methods Male ICR mice were randomly allocated into control group,ANP group and HMGB1 monoclonal antibody group.ANP model was induced by intraperitoneal injection of 20％ L-arginine.Mice in HMGB1 monoclonal antibody group were given intraperitoneal injection of 200 μg of HMGB1 monoclonal antibody immediately after the induction of the ANP model.All the mice were sacrificed at 12,24,and 48 h after ANP induction.Serum level of amylase and liver,renal function were determined,level of serum HMGB1 was measured by using enzyme-linked immunosorbent assay,and then the pathologic changes of pancreas and liver were routinely observed and scored.The HMGB1 mRNA levels in the liver and pancreas were studied by real time fluorescence quantitative PCR.Results The serum levels of HMGB1 at 12 h in control group,ANP group and HMGB 1 monoclonal antibody group were (9.09 ± 1.03),(25.04 ± 4.30),(16.84 ± 4.27) μg/L; and pathological scores of pancreatic tissue were (1.50 ± 0.55),(4.33 ± 0.52),(3.03 ± 0.32) points ; and HMGB1 mRNA expressions in pancreas were 0.48 ± 0.18,7.53 ± 2.71,3.26 ±2.33 ; HMGB1 mRNA expressions in liver were-1.23 ± 0.37,0.15 ± 0.65,－ 1.27 ± 0.72.The corresponding values in ANP group were significantly higher than those in control group (P ＜ 0.05).While the corresponding values in HMGB1 monoclonal antibody group were significantly lower than those in ANP group (P ＜0.05).There was a positive linear relationship between serum HMGB1 level and pancreatic pathological scores 24 h after ANP induction (r =0.768,P ＜ 0.05).In addition,the serum levels of AMY,AST,ALT,LDH,BUN,Cr showed a similar trend as that of serum level of HMGB1,and the serum level of HMGB1 was positively associated with serum levels of Cr,BUN and ALT (r =0.824,0.719,0.590,P＜0.05).Conclusions HMGB1 may be a key factor of inflammatory response and organ dysfunction of ANP in mice,and extrinsic supply of its monoclonal antibody may decrease the injuries of pancreas and other organs during ANP.