Latent tuberculosis infection (LTBI) is defined as a patient is infected with Mycobacterium tuberculosis, without signs and symptoms or radiographic evidence of tuberculosis (TB). Until recently, the only test to identify latent tuberculosis infection was the tuberculin skin test (TST). But in BCG-vaceinated or non-mycobacterium tuberculosis infected individuals TST may be false positive and some babies or immunocompromised individuals have negative results on TST even they were proved to be with TB disease. So it is in need of a new method with higher sensitivity and specificity to diagnose LTBi. More recently, a new diagnostic method of interferon gamma release assays (IGRA) was paid close attention, and in some countries it replaced TST and became the final diagnostic method of LTBI. IGRA has high specificity for Mycobacterium tuberculosis without being influenced by BCG vaccinated or non-mycobacterium tuberculosis infection. In people with normal immune systems, the sensitivity of IGRA is same as TST for TB disease, and in immunocompromised individuals the sensitivity of IGRA is higher than TST. IGRA will have important application in diagnosis of LTBI although it cannot absolutely take the place of TST.

Objective To investigate the medication advancement of gastrointestinal polyposis in patients with Peutz-Jeghers syndrome(PJS).Methods Literatures about the medication advancement on gastrointestinal polyposis of PJS were reviewed and analyzed.The recent development of targeting drugs,especially the data of cyclooxygenase-2 selective inhibitors and rapamycin,were emphatically summarized.Results With the deep investigation of PJS and application of selective drugs,the medication of gastrointestinal polyposis in cases of PJS has got more advancement.The extensive use of synthetic cyclooxygenase-2 inhibitors and rapamycin in clinic developed a new way to treat gastrointestinal polyposis of PJS.Conclusion The cyclooxygenase-2 selective inhibitors and rapamycin have the following features: noninvasive,high selectivity and good curative effects.They have splendid prospects in the clinical treatment of gastrointestinal polyposis in patients with PJS and are bring the treatment of gastrointestinal polyposis in cases of PJS into a targeting therapy phase.

Heparanase, an endo- β- D- glucuronidase, that cleaves heparan sulfate chains in heparan sulfate proteoglycans, has recently been found in mammalian. It may play a key role in tumor progression and metastasis. Here we disscuss its molecular structure, biochemical properties, expression in malignant tumor,mechanism in accelerating tumor metastasis and application in heparanase inhibitor.

Objective To review recent studies on Muir Torre syndrome (MTS) and to improve the knowledge about MTS.Methods The literatures in recent years on clinic and gene research of MTS were reviewed.Results MTS was is a rare autosomal dominant disorder characterized by the predisposition to both sebaceous tumors (or multiple keratoacanthomas) and internal malignancies. Gastrointestinal cancers were the most common kind of internal malignancies in MTS patients(61%),followed by genitourinary cancers(22%). In most cases(56%),sebaceous tumors appeared after the emergence of internal maliganancy. Both hereditary nonpolyposis colorectal cancer(HNPCC) and MTS were caused by germline mutations in the DNA mismatch repair genes. MTS patients exhibit significantly more mutations in the hMSH2 than in the hMLH1. In these cases , both internal and skin tumors showed the characteristic of high microsatellite instability(MSI).Conclusion The presence of sebaceous tumors(or multiple keratoacanthomas) necessitates the search for internal malignancies. It is mandatory that patients with MTS, as patients with HNPCC, should be regularly followed up to search new malignancies. Evaluation and monitoring of the family members of patients are also necessary. The patients and their families should be counseled for genetic test. Sequencing the hMSH2 gene should be the prior selection of further examinations when clinical manifestations, history and laboratory tests suggest MTS.

Objective To explore the effect of combination application of preoperative carbohydrate loading and sequential enteral nutrition on the recovery of postoperative patients with stomach neoplasm.Methods Ninety-eight patients with stomach neoplasm were randomly divided into three groups.Those were Group A (preoperative fasting + sequential EN,n =33),group B (preoperative carbohydrate loading + postoperative TPN,n =33) and group C (preoperative carbohydrate loading + sequential EN,n =32).Insulin sensitivity (IS) ; Nutritional indicators including pre-albumin (PA) and transferrin (TRF) ; immunity parameters including IgG,IgM and IgA were measured in blood on the day before the operation,the 1st day,4th day and 8th day after the operation.Meanwhile,anal exhaust time after the operation,incidence of complications and postoperative hospitalizing time were also observed.Results The level of IS in group C at 4th day and 8th day after operation were 35.8 ± 3.2 and 36.1 ± 3.5,higher than those in A group and B group (A group:30.7 ±3.3,33.5 ±2.9;B group:33.7 ±3.1,34.0 ±2.2),and the differences were significant((F =20.88,7.28 ;P ＜0.05).At the 4th day after the operation,the levels of PA in group B and group C were (191 ± 11.6) mg/ and (193 ± 12.7) mg/L,significantly higher than those in group A ((176 ± 14.1) mg/L;F =17.15,P ＜ 0.01).At the 8th day after the operation,the levels of PA and TRF in group C were (221.3 ±30.81) mg/L and (86 ± 0.37) g/L,significantly higher than those in group A and group B (group A:(198.0 ± 30.6) mg/L,(1.60 ± ±0.33) g/L;group B:(202.0 ±28.6) mg/L,(1.61 ±0.34) g/L;F =5.42,5.83 ;P ＜0.01).At the 8th day after the operation,the levels of IgA,IgG and IgM in the group C were (2.74 ±0.69) g/L,(14.55 ±2.57) g/ L,(1.08 ± 0.33) g/L,significantly higher than that in group A and group B (group A:(2.30 ± 0.54) g/L,(12.71 ±2.94) g/L,(0.86 ±0.31) g/L;group B:(2.29 ±0.50) g/L,(12.06 ±3.33) g/L,(0.89 ±0.27)g/L;F =6.12,6.13,4.94;P ＜ 0.05).Conclusion The combination of preoperative carbohydrate loading and sequential enteral nutrition can reduce insulin resistance,improve postoperative nutritional status,improve the recovery of immune function and intestinal function,as well as reduce the incidence of postoperative complications.

Objective To analyze the current situation of TB control in Hefeng County and probe into the role of medical institutions in TB control. Methods In-depth interviews were conducted with health workers of TB prevention, TB patients and their family members; data on registered TB patients were collected; the current situation of TB control was analyzed and countermeasures were put forward. Results The TB epidemic was pretty serious in Hefeng County, with a high morbidity rate and a low cure rate. According to an epidemiological survey in 1990, the TB morbidity rate in the county was 1000/100000. Conclusion Hefeng County failed to give full play to the role of hospitals in TB control and the treatment of TB patients was separated from their management. Hence the deplorable results of TB control. The following countermeasures were presented: ①giving full play to the role of general hospitals in TB control; and ②perfecting the three-level medical networks of prevention and healthcare.

Objective To observe the changes of calcitonin gene related peptide (CGRP) in rat spinal motoneuron after upper motoneuron injury. Methods Thirty six adult male Wistar rats were selected. Spinal cord transection was made at the lower thoracic segment. The lumbar regions of spinal cord were removed immediately, 1, 2, 4, 7 and 14 days after surgery to be divided into dorsal and ventral sections. The content of CGRP in ventral section was detected using radioimmunoassay method.Results The level of CGRP in spinal motoneuron of the lumbar region was decreased significantly after transection of spinal cord, reached the lowest level on the 2nd day after surgery and then maintained at the low level.Conclusions The upper motoneuron injury can result in the decrease of CGRP content in spinal motoneuron.

Objective To determine the plasma concentrations and pharmacodynamics of fentanyl and nerphine used in postoperative epidural or intravenous patient-controlled analgesia (PCEA,PCIA) .Methods Sixty ASA Ⅰ - Ⅱ patients (36 male, 24 female), aged 18-25 yr undergoing elective major operation were randomly divided into 3 groups : group Ⅰ received PCEA with 0.13 % bupivacaine + fentanyl 2?g?ml-1 (n = 20) ; groupⅡ received PCEA with 0.13 % bupivacaine + morphine 0.08 mg? ml-1 ( n = 20); group Ⅲ received PCIA with morphine 0.5 mg ? ml-1 ( n = 20). In group Ⅰ and Ⅱ the background infusion rate was 4 ml ? h-1 , PCA bolus dose 2 ml and lock-out interval 20 min, while in group Ⅲ the back ground infusion rate was 1 ml?h-1 , PCA bolus dose 2 ml and lock-out interval 6 min. PCA was maintained for 48 h in all three groups. The vital signs, analgesic effect (VAS, VRS) and side-effects were recorded and venous blood samples were taken for determination of plasma fentanyl and morphine concentrations at 4 h, 24 h and 48 h after PCA was commenced. Results The demographic data were comparable among the three groups. There was no significant difference in MAP, HR and RR during PCA among the three groups. The analgesia was satisfactory in all three groups and no other analgesic was used during PCA. The rate of excellent analgesia ranged between 80%-85 % . The incidences of side-effects were higher in group Ⅱ and Ⅲ as compared with those in group Ⅰ . The volume of epidural PCA solution administered in 48 h was significantly larger in group Ⅰ than that in group Ⅱ( P

Objective To understand the clinical characteristics during clinical diagnose and treatment of young women patients under 35 years with cervical cancer. Methods The clinical data of 95 cervical cancer patients under 35 years was reviewed and analysed retrospectively. Results The percentage of the patients at this age set was 18. 59% ,accounting for almost one fifth of all the same period patients with cervical cancer. The most common primary clinical representation was sexual bleeding of vigina (90.53% ,86/95) ;28 cases (29. 47%, 28/95) were misdiagnosed by naked eye examination and local treated as cervicitis; 13 cases (13. 68%, 13/95) with severe pathological changes were missed diagnosed by biopsy under colposcopy ;53 cases (55. 79% ,53/95) had their ovary preserved by one or two and had no metastasis or recurrence with carcinoma. Conclusions Sexual intercourse bleeding is the most common manifestation of young women with cervical cancer,which demands more attention. The biopsy under colopscopy has certain limitations,and should be performed along with conization while necessary. It is safe and feasible to retain ovary in cervical cancer patients before Ⅱ stage.

Objective To investigate the blood levels of amino acids in children aged 0-15 year, with an attempt to provide evidence for evaluating amino acid status and diagnosing metabolic diseases of amino acid.Methods The blood levels of eleven amino acids in 1900 children aged 0-15 years were determined by tandem mass spectrometry (MS/MS). Results The blood levels of leucine & isoleucine, valine, phenylalanine tyrosine,glycine, proline, ornithine, and alanine gradually decreased after birth, reaching the lowest levels at the ages of 4-6 months, and then gradually increased, reaching the normal range at the ages of 7 months-1 year. The blood levels of alanine and glycine reach the second peaks on the ages of 9 years in girls and on 11 years in boys. The blood levels of methionine and arginine were lowest in the first week of age, became highest in 1-3 months, decreased to the normal ranges after 4-6 months, and kept the level afterwards. The ratios between prosomatic amino acid and productive amino acid, between ornithine and arginine, between citrulline and arginine, and between ornithin and citrulline were highest in the first week of age and decreased to normal values after 3 to 12 months. The concentrations of amino acids in group of 7 months-15 years were significantly different from the group of 1 day-1 month and group of 2-6 months (P ＜0. 05 or P ＜0. 01 ). The concentrations of amino acids were significantly higher in females than in males in the group of 1 day-1 month and in all age groups (P ＜0. 05 or P ＜0. 01 ) . Conclusions The concentrations and profiles of amino acids change remarkably during the first year of age. Age should be carefully considered when evaluating the nutritional status of amino acid and diagnosing metabolic diseases of amino acids.