Objective To analyse the clinical characteristics,follow up their prognsis and evaluate the treatment of patients with Crohn' s disease (CD). Methods The data of patients with CD were collected at Zhongshan Hospital of Fudan University from 2002 to 2007. The diagnosis was made according to the consensus recommended by Chinese Society of Gastroenterology. The disease severity, follow-up and prognsis were evaluated according to the consensus. Results Sixty-six CD patients were enrolled in this study. The ratio of males to females was 2.47 : 1. Age at diagnosis ranged from 12 to 76 years old, and the mean age was (32 ± 17)years old. The main gastroenterological manifestations were abdominal pain (80.3 %), diarrhea (54.6 %), fistula formation (31.8%) ; and the main systemic manifestation was fever (80.3 %) and defective nutrition. A total of 60.6 % of patients with CD had complications and 34. 8% of these patients had more than one complications. Extraintestial manifastation were presented in 7.6% of patients with CD. A total of 86.4% of patients with CD were active state cases and 57. 6% were suffered from inflammation of ileum and colon. Abdominal pain (P = 0. 011), hematochezia (P = 0. 008), fever (P = 0. 001), anemia (P = 0. 020), underweight (P = 0. 010) and heightening of CRP (P = 0. 033) were more common in patients who were in active state than those who were in slient state. During their inducing alleviate treatment, 33.3% of patients with CD were treated with aminosalicylate alone, 36.4% were treated with both aminosalicylate and glucocorticoids, 7. 6% were treated with aminosalicylate, glucocorticoids and immunosuppressant. After medicine treatment, 6.8% of the patients relieved, 62.7% turned better, 28.8% were ineffective, 1.7% died, 55.9% recurd. And 21.2% were treated by surgical operation. A total of 42.4% of patients with CD had histroy of surgical operation and 9.1% were carried on more than one surgical operation.ConclusionsActive state patients with CD had high rate of complications, low extraintestial manifestatons, rare rate of dysplasia and canceration, and high rates of surgical operation and recurring.

OBJECTIVEThis study aims to evaluate the optical data of the different sites of the cobalt-chrome (Co-Cr) alloy abutments covered by four different all-ceramic crowns and the color difference between the crowns and target tab using a digital dental spectrophotometer.

METHODSTen Co-Cr alloy abutments were made and tried in four different groups of all-ceramic crowns, namely, Procera aluminia, Procera zirconia, Lava zirconia (Lava-Zir), and IPS E.max glass-ceramic lithium disilicate-reinforced monolithic. The color data of the cervical, body, and incisal sites of the samples were recorded and analyzed by dental spectrophotometer. The CIE L*, a*, b* values were again measured after veneering. The color difference between the abutments covered by all-ceramic crowns and A2 dentine shade tab was evaluated.

RESULTSThe L* and b* values of the abutments can be increased by all of the four groups of all-ceramic copings, but a* values were decreased in most groups. A statistical difference was observed among four groups. After being veneered, the L* values of all the copings declined slightly, and the values of a*, b* increased significantly. When compared with A2 dentine shade tab, the ΔE of the crowns was below 4.

CONCLUSIONFour ceramic copings were demonstrated to promote the lightness and hue of the alloy abutments effecttively. Though the colorimetric baseline of these copings was uneven, veneer porcelain can efficiently decrease the color difference between the samples and thee target.

Ceramics ; Chromium Alloys ; Cobalt ; Color ; Colorimetry ; Crowns ; Dental Materials ; Dental Porcelain ; Dental Prosthesis Design ; Humans ; Metal Ceramic Alloys ; Titanium ; Zirconium

Single-supervisor system is the widespread practice for graduates of clinical medicine at present. But in terms of education to clinical medical graduate students, students rotate in the departments of various disciplines for a long time, and there are more rotary department, resulting in some students' unbalanced learning development. Combined with the charac-teristics of the department of hematology, multi-supervisors training model was carried out to the rotating masters of other disciplines when they rotated in hematology department. With supervisor equipment and teaching implementation, we applied the principle of integrating theory with practice and trained students' innovation ability and doctor-patient communication ability. Compared with traditional single supervisor training pattern, multi-supervisors system can effec-tively improve the students' theoretical level, practical skills and comprehensive ability when the clinical medical graduate students rotate in the department of hematology.

Background:The clinical presentation of eosinophilic gastroenteritis( EG)is nonspecific and has not received much concern by physicians and pathologists. The diagnosis of EG was delayed in many cases. Aims:To explore the clinical features of EG. Methods:The clinical,laboratory,endoscopic and radiologic features and treatment in patients who were diagnosed as EG from October 2011 to September 2013 in Zhongshan Hospital, Fudan University were analyzed retrospectively. Results:Median age of 10 EG patients was 41. 9 years. Four patients had a history of allergy or asthma. The time from onset to diagnose was 25 days on average. The most common symptoms were abdominal pain with bloating, diarrhea or vomiting. Eight patients had hypereosinophilia. Abdominal CT revealed uniform edema or stratified thickness of intestinal wall or ascites in 7 patients. Endoscopy revealed erythema,edema and erosion in antrum,duodenum or jejunum in 6 patients. All cases were confirmed as having eosinophilic infiltration by mucosal biopsy or examination of ascites. Seven patients were successfully treated with corticosteroid. One patients experienced relapse after discontinuing corticosteroids during following up. Conclusions:EG may be more common than previously recognized and should be considered in the differential diagnosis of unexplained abdominal pain with peripheral eosinophilia or uniform edema or stratified thickness of intestinal wall. Multiple biopsies in multiple sites including descending duodenum and pathological examination for finding eosinophil infiltration are the keys to confirm the diagnosis. Corticosteroids are effective in relieving symptoms and improving eosinophilia.

Professor CHAO En-xiang thinks that several rules should be obeyed when we treat gangrenous appendicitis complication with paralytic ileus and ARDS.Firstly,we should adhere to the TCM characteristics of the holistic concept and treatment based on syndrome of differentiation.Secondly,we should formulate therapeutic method according to major pathogenesis.Thirdly,we should use drugs flexibly according to the patient's specific situation.Professor CHAO En-xiang considered it was the syndrome of dysfunctional activity of qi,fu qi being obstructed,dysfunction of middle-jiao in transportation.The therapeutical principle was regulating qi activity,dredging intestines and relieving distention.Nasal feeding with Dachengqi decoction adding Agastache rugosa,Tatarian Aster,paste umbilicus with mud of shallot stalk,fresh ginger,fennel and enema with Radix Aucklandiae.

Objective This study investigates the relationship of serum irfflammatory cytokine levels with intracranial pressure (ICP) in patients with severe traumatic brain injury (TBI) after surgery.Methods A total of 32 cases with severe TBI and placement of ICP monitor were prospectively enrolled.Serum was collected before surgery and every 12 h after surgery.Cytokines levels of interleukin (IL)-1β,IL-8,and tumor necrosis factor (TNF)-α were analyzed and compared with outcome of patients.Hourly values of ICP were recorded.The degree of ICP above treatment threshold (20 mm Hg) were calculated every 12 h as pressure times time dose(PTD-ICP20),which was compared with serum cytokine levels before (Pre) and after (Post) the 12-hour time period using linear regression method.Results Serum IL-1β (P＜0.05),IL-8 (P＜0.01) and TNF-a (P＜0.01) levels elevated dramatically after severe TBI and were significantly associated with outcome of patients.Mean PTD-ICP20 was (42.9 ± 60.2)mm Hg/h and was correlated with increased Pre-IL-8 (r=0.554,P＜0.001),Pre-TNF-α (r=0.597,P＜0.001),Post-IL-8 (r=0.629,P＜0.001) and Post-TNF-α (r=0.538,P＜0.001) levels.Conclusion Serum IL-8 and TNF-α demonstrated the most promising candidate bio.rnarkers of impending ICP elevation in this study.These findings indicate a feasible way of monitoring patients with severe TBI.

Objective To investigate the changes of osteopontin (OPN) expression in murine colitis induced by dextran sodium sulfate (DSS) and its role in inflammatory bowel disease (IBD).MethodsThirty-two male BALB/C mice were randomly assigned into 4 groups: control group (group A), DSS-induced murine colitis model group (group B), salazosulfapyridine treatment group (group C) and infliximab treatment group (group D). Plasma OPN concentration was measured by enzyme linked immunosorbent assay (ELISA). OPN mRNA level was detect by using reverse transcriptase polymerase chain reaction (RT-PCR) and protein expression in colonic tissues was analyzed by using Western blotting. The location expression of OPN in colonic tissues was determined by immunohistochemical staining. ResultsIn group A, B,C and D, the plasma concentrations of OPN were (5.26±1.93) ng/ml, (10.21±2.37) ng/ml, (4.58±1.83) ng/ml and (4.82±1.83) ng/ml,respectively: the mRNA levels of OPN in colonic tissues were (0.36±0.16), (0.71±0.17),(0.32±0.07) and (0. 34±0. 08), respectively; the protein levels of OPN in colonic tissues were (0.44±0.10), (0.85±0.04), (0.61±0.11) and (0.58±0.17), respectively. The OPN-positive cell numbers in lamina propria mononuclear were (46.6±10.9), (155.5±43.8), (73.1±6.8) and (70.6±8.3), respectively. The expression of OPN in group B was significantly higher than that in group A (P<0.05). Compared with group B, the expressions of OPN in group C and D were significantly decreased (all P valus <0. 05). No significant difference was detected between group C and D. Conclusions The study shows that the expression of OPN significantly increased in DSS-induced murine colitis and decreased after treated with drugs. OPN-mediated immune response contributes to DSS-induced murine colitis.

ObjectiveTo evaluate the performance of a three-gene typing system in the determination of Treponema pallidum (Tp) genotypes.MethodsTo determine the genotypes of Tp,three targets were assessed,including the number of 60 base-pair repeats,restriction fragment length polymorphism(RFLP) pattem of tprEGJ gene after MseI digestion and the sequence of tp0548 gene.The DNA extracted from the Nichols strain of Tp served as the positive control,and that from the moist ulcer of patients with genital herpes and negative RPR or TPPA test results served as the negative control.To validate the typing method,clinical specimens were collected from the moist skin lesions of patients with primary or secondary syphilis,and subjected to the amplification of polA gene by PCR.The enhanced molecular typing system was used to determine the genotypes of Tp in Tp DNA-positive specimens.ResultsThe Nichols strain harbored a genotype of 14a/a.No amplification of any of the three target genes was found in the negative control.The arp gene,tprEGJ gene and tp0548 gene were amplified from 94.1％,91.2％ and 94.1％ of the 40 clinical specimens,and the genotype was successfully determined by the three-gene typing system for 91.2％ of the clinical Tp strains.The predominant type of arp,tprEGJ and tp0548 genes was 14 repeats,d and f,respectively in these clinical Tp isolates.ConclusionThe enhanced molecular tying method for Tp exhibits high sensitivity,specificity and discrimination potential.

ObjectiveTo investigate the prevalence of syphilis among outpatients in sexually transmitted disease (STD) clinics in Guangxi Zhnang Autonomous Region,and to assess the socioeconomic and behavioral factors associated with the infection.MethodsThe outpatients to 14 STD clinics in 8 cities of Guangxi Zhnang Autonomous Region were investigated with questionnaires by their doctors at the first visit.Venous blood samples were obtained from these outpatients and subjected to toludine red unheated serum test (TRUST) to screen for syphilis.Treponema pollidum particle agglutination (TPPA) was performed for TRUSTpositive samples.The epidemiological data were collected by using EpiData software,statistically analyzed by using SPSS13.0 software package.ResultsA total of 10 930 STD outpatients were recruited in the study,and 1297 samples were confirmed to be both TRUST and TPPA positive.The prevalence of syphilis was 11.9％ in all of the outpatients,14.3％ in female outpatients and 10.3％ in male outpatients,13.3％ in the outpatients of Zhuang nationality,and 11.4％ in those of Han nationalily.Multivariate analysis showed that syphilis was independently related to female sex[odds ratio(OR) 2.23,95％ confidence interval(CI) 1.69 - 3.00,P＜0.01 ],low educaiion level (middle school:OR 1.70,95％ CI 1.11 - 2.62,P ＜ 0.05; primary school or illiteracy,OR 1.98,95％ CI 1.13 - 3.46,P＜0.05),annual income of more than 30000 Yuan (OR 1.91,95％ CI 1.18 -3.10,P ＜ 0.01 ),commercial sex workers or having multiple sexual partners(OR 1.54,95％ CI 1.16 - 2.06,P ＜0.01 ).ConclusionsSyphilis serology should be the routine test in STD clinical settings in Guangxi region,and the intervention should be enhanced to control the prevalence of syphilis in high-risk populations.

Objective To investigate the effect and the significance of soft tissue repairing and functional reconstruction in limb salvage operation on extremity malignant bone tumors by individulized prosthesis replacement after malignant tumor resection with the help of Neo-adjuvant chemo-therapy. Methods A total of 78 patients with malignant bone tumor were recruited, including 42 males and 36 females. Aged 19～61, with an average of (29.12±9.47).Tumor in 14 patients was in the proximal humerus, 11 in the proximal femur, 27 in the distal femur, 3 in femoral middle part, and 23 in the proximal tibial. There were 29 cases of osteogenic sarcoma, 18 chondroma sarcomatosum, 7 maligant enchondroma with pathological fracture, 20 maligant giant cell tumor,and 4 maligant inflammatory myofibroblastoma of the bone. Soft tissue repairing and functional reconstruction were carried out together with individualized prosthesis replacement. The type of the prostheses was as follows: 14 patients had long stem humerus head prosthesis, 50 made hinged knee prostheses with femoral or tibial component, 3 whole femur replacements, 7 long stem femoral head prostheses, 4 long stem hip prostheses.Results All patients were followed up for an average of (26.80±8.06) months (4～37 months) and postoperative functions were estimated according to Enneking system. Among the 78 patients, results in 48 (61.5%) were excellent, 17(21.8%) were good,10 (12.8%) were fair,and 3(4.9%) were poor. The satisfactory rate was 83.3%. Conclusion Soft tissue repairing and functional reconstruction in limb salvage operation on extremity bone malignant tumors by individualized prosthesis replacement not only spare the limbs, but also keep their function.It can remove the psychologic obstacles caused by extremity absence, and is effective for bone malignant tumor.