Objective: To detect P53 and Ki-67 protein,human papill om a virus (HPV),cytomegalovirus(CMV) and Epstein-Barr virus(EBV)in the warts of o ral mucosa from HIV-positive patients.Methods: The expression P53 and Ki-67 protein,HPV,EBV and CMV were detected by immunohistochemistry and PCR in 34 cases of oral mucosa warts from HIV-positve patients,33 cases of oral epithelia dysplasia and 45 cases of oral squamous cell carcinoma. Results:(1)The expression of P53 and Ki-67 protein in the cases of oral mucosa warts from HIV-positive patients were 23%and 76% re spectively,lower than those in oral suquamous cell carcinoma lesions from non- HIV individuals(62.8% and 97.8% respectively,P0.05).(2)The HPV infection in the warts of oral mucosa from HIV -positive patients was 88.2%,much higher than in oral suquamous cell carcinoma lesions (35.6%) and in dysplastic lesions (9.1%) from non-HIV individuals(P

Objective:To compare the difference of microalbuminuria (MAU) and von Willebrand factor (vWF) between essential hypertensives and hypertensive patients with metabolic syndrome (MS), and to explore the association of these factors with MS. Methods: According to the new definition of MS by International Diabetes Federation (IDF) for 2005, 133 consecutive essential hypertensives were divi-ded into two groups: hypertensive patients with metabolic syndrome (EH-MS group, n=97), and essential hypertensives (EH group, n=36). Biochemistry assay, plasma vWF, 24 hours urine albumin excretion (UAE) and morning urine albumin/creatinine ratio (ACR) were measured. The association of MAU and vWF with MS was analysed. Results: Waist circumference, body mass index, triglyceride (TG), low density lipoprotein cholesterol (LDL-C), plasma vWF and UAE were increased(P0.05, respectively). Logistic regression showed HDL-C, TG, LDL-C,vWF and UAE were associated with the deve-lopment of MS in hypertensive patients (standardized coefficients: -0.825, 0.63, 0.339, 0.331, 0.371,P

Objective To establish the rat overlap syndrome (OS) model of intermittent hypoxia (IH) combined with pulmonary emphysema and to explore its connection with hepatic oxidative stress, inflammatory status in the live and coagu?lation profile. Methods Male Wistar rats (n=60) were randomly divided into four groups:control group (A), IH group (B), pulmonary emphysema group (C) and OS group (D). The rat model of pulmonary emphysema was established by exposing rats in smoke for 16 weeks. From the 13th week, pre-programmed intermittent hypoxia/re-oxygenation (IH/ROX) exposure was given in the meantime of smoke exposure in OS group. Liver tissues were sectioned or triturated for pathological scoring or for detecting expression levels of superoxide dismutase (SOD), catalase (CAT) and malondialdehyde (MDA) respectively. Se?rum levels of coagulant/anticoagulant factors such as antithrombin (AT), fibrinogen (FIB), von Willebrand factor(vWF) and FactorⅧ(FⅧ) were also evaluated using biochemistry analysis. Results The levels of pathological scores and coagulant factors(FIB, FⅧ:C and vWF:Ag)were significantly higher in group D than those in group A, B and C. The values of SOD, CAT and AT were significantly lower in group D than those in other three groups. Serum levels of FIB, vWF:Ag, FⅧ:C and AT:A correlated with SOD(r equal to-0.905、-0.941、-0.946 and 0.817 respective,P<0.01). Conclusion In rat overlap syndrome when IH combined with pulmonary emphysema, hepatic inflammation and coagulability present mutual promotion effect and produce a more significant liver-derivative inflammatory and prothrombotic status.

Objective To compare the QTc and QTcd between type 2 diabetic and non-diabetic patients with post-myocardial infarction (post-MI) ,and to compare the QTcd in type 2 diabetic patients with post-MI treated with insulin,sulfonylurea,mefformin,or diet alone. Methods We measured the QTc and QTcd through simultaneous 12-lead Electrocardiogram in 138 post-MI patients,including 70 type 2 diabetic (of which,23 were assigned to re-ceive insulin,20 glipizide,16 mefformin,11 diet control) and 68 non-diabetic patients. Result Compared with post-MI patients without diabetes,those with type 2 diabetes had significantly higher QTc [(377.2±24.3) ms vs (342.9±27.5)ms,t=7.79,P<0.01] and QTcd [(48.8±19.7)ms vs (40.3±26.6)ms,t=2.14,P<0.05]. There were no significant difference between the mefformin group and the diet control group (P>0.05). The QTc and QTcd in the insulin group were significantly higher than those in the other three group s(P<0.05),and the QTc and QTcd in the glipizide group were higher than those in the mefformin group or diet control group(P<0.05,and P<0.01,respectively). Conclusion Type 2 diabetes is associated with an additional increase in the QTcd in post-MI patients,suggesting higher mortality risk in post-MI patients with type 2 diabetes. Insulin and glipizide may in-crease the QTc and QTcd in post-MI patients with diabetes. These effects were more significant in the insulin therapy group.

Peking University Health Science Center has various characteristics of educational manage-ment practice such as clear three level management, diversified management training and strict quality control, and at the same time there exist many deficiencies, such as lack of the implementation of management regulations and the requirements caused by multi-level management and management quality having ups and downs be-cause of human factors and etc.. By introducing life cycle management into national continuing medical educa-tion project management, we make management run through the whole life cycle of national continuing medical education project, namely five aspects of management from reporting and publishing, planning and publicity, holding and supervision, graduation and certificates, as well as summary and feedback, which plays an impor-tant role in standardizing the national continuing medical education project and improving the quality of the project.

Objective:To investigate the frequency and severity of systemic adverse reactions in children with allergic rhinitis (AR) undergoing subcutaneous immunotherapy (SCIT).Methods:The clinical data of 321 children with allergic rhinitis receiving SCIT at Department of Otorhinolaryngology, Changzhou Third People′s Hospital from January 2016 to January 2020 were retrospectively analyzed. There were 180 boys and 141 girls aged 5 to 14 years. Patients were injected subcutaneously with standardized dust mites allergen extract. The onset time, symptoms and signs and treatment of adverse reactions were documented. The relationship of adverse reactions with gender, age, treatment course and dosage of allergen injection were analyzed.Results:Patients received total 13 053 injections, and 115 adverse reactions (0.88%) occurred in 56 cases (17.45%). The incidence of adverse reactions in children aged 5-9 years was higher than in those aged 10-14 years, for both the number of cases and injections (χ2=4.41, P=0.04; χ2=9.13, P<0.01), but no significant differences were observed in gender of patients. The incidence of adverse reactions in the age group 2-3 years was lower than that in age groups<1 year and 1-<2 years in both of cases and injections (χ2=22.86, P<0.01; χ2=6.43, P=0.01; χ2=12.14, P<0.01; χ2=13.74, P<0.01). The incidence of adverse reactions in the high-dosage phase (100 000 SQ-U) was higher than that in the low-dosage phase (<100 000 SQ-U) (χ2=4.35, P=0.04). Conclusions:The study shows that the incidence of adverse reactions in children with allergic rhinitis receiving subcutaneous immunotherapy is less than 1% in the number of injections and most of them are grade Ⅰ adverse reactions. The study also shows that younger age, the early course of treatment and the high dosage of allergens are risk factors for adverse reactions.

Objective In order to improve the outcome of surgical treatment for atherosclerotic heart disease,we summarize our clinical experience of surgical treatment during the last four years and propose our therapeutic strategy.Methods A retrospective study was performed including consecutive 1052 patients receiving isolated or combined CABG surgery which was performed by a single surgical team from January 2006 through March 2010 at Fu Wai Hospital.Patients'characters were quantified by European score System for cardiac operative risk evaluation (EuroSCORE).Operative strategies were classified as candioplegic arrest,on-pump beating,isolated off-pump,and the hybrid procedures to treat the concomitnnt diseases,such as peripheral vascular disease,atrial fibrillation,congenital heart diseases,et al.Clinical data including the surgical indications,preoperative patient co-morbidity,postoperative clinical course,and perioperative outcomes were analyzed of.Results Patients showed a mean EuroSCORE of 3.4 ±2.6.There were 127 patients ( 12％ ) with a EuroSCORE ＞6.The mean age of the patients was(61.2 ± 9.5 ) years,ranging from 26 to 84 years.The overall in-hospital postoperative mortality rate was 0％,and all patients had an uneventful recovery course and discharged.The transfusion rate was 31.9％.950 patients (90.3％)were OPCAB and 102 (9.7％) were on-pump CABG.There were 87 patients underwent concomitant CABG and heart valvereplacement or repair.21 patients underwent hybrid procedure by simultaneous peripheral artery stenting and OPCAB,and 14patients underwent redo CABG.The Average number of distal anastomoses was 3.2 ±0.9,and the mean postoperative hospital stay was (7.7 ± 2.5 ) days.Fourteen patients had re-exploration for bleeding,8 with pneumonia,5 with acute renal insufficiency and 6 had intra-aortic balloon pump (IABP) for cardiac dysfunction.All these patients recovered after proper treatment.Conulusion Surgical treatment for the coronary heart disease could achieve satisfactory curative effects by the individualized treatment,technological innovation and strengthen perioperative management.Excellent results and low major complications in the perioperative coupe could be expected through this strategy.

ObjectiveTo evaluate the efficacy and safety of simultaneous hybrid carotid artery stenting and off-pump coronary artery bypass in the treatment of coronary artery disease associated with serious carotid artery stenosis.Methods From January 2008 to December 2010,30 consecutive patients of CAD associated with serious carotid artery stenosis underwent off-pump coronary artery bypass.Fifteen patients received the hybrid revascularization by carotid artery stenting,immediately followed by off-pump coronary artery bypass and 15 consecutive patients underwent staged carotid artery stenting and off-pump coronary artery bypass.ResultsRevascularization was successful in all 30 patients ( 100％ ).There were no procedure-related complications and no in-hospital death for both procedures.Although the postoperative courses were uneventful with the exception of 2 patients who suffered from strokes,no vital organ dysfunction occurred.In the staged group,atrial fibrillation,acute renal inefficiency and reoperation for bleeding occurred each in 1 patient,respectively.There was no significant difference in the ventilation time [(31.7 ± 27.8 ) h vs ( 17.9 ± 7.06 ) h,P =0.073],intensive care unit stay [( 87.7 ± 61.6 ) vs (52.3 ± 80.8) h,P=0.189],and the volume of chest drainage [(945 ±260) ml vs (764 ±334) ml,P =0.109] between the hybrid revascularization and staged procedure groups.There was a shorter hospital stay after CAS of patients undergoing hybrid CAS-OPCAB compared with staged CAS-OPCAB [(9.7 ± 3.3 ) vs ( 17.1 ± 6.9 ) days,P =0.001].Conclusion For patients with both carotid artery stenosis and coronary artery disease,simultaneous hybrid or staged revascularization by carotid artery stenting,followed with off-pump coronary artery bypass,are feasible,safe,and less invasive therapeutic strategies.Both procedures do not influence the liver and renal function.Besides,no significant difference exists in the volume of chest drainage,ICU stay,respirator time,and between the staged and hybrid procedures.Compared with staged CAS-OPCAB the patients undergoing hybrid CAS-OPCAB strategy needs a shorter postoperative hospital stay time and decreases the total hospitalization cost at hospital.Further investigation are warranted to study its long-term efficacy.

Objective To discuss the importance of balloon occlusion test before interventional treatment of the intracranial giant intemal carotid artery aneurysms and to sum up the nursing experience in assisting the procedure. Methods Proper perioperative nursing measures were carried out for 12 patients, who suffered from intracranial giant internal carotid artery aneurysm and underwent spring coil occlusion treatment. Nursing measures included mental care, observation of the vital signs, prevention of the complications, etc. Results Neither death nor exacerbation of the condition occurred in all the 12 patients. The patients were discharged from the hospital with a mean hospitalization of nine days. During a follow-up period ranged from 4 months to one year, seven patients had no disagreeable feeling, one patient complained of discomfort but no abnormality was found on follow-up DSA, and disappearance of the aneurysm was observed in 4 patients. Conclusion The monitoring of the vital signs, the prevention of the complications and the standard nursing care are the key points for ensuring a successful operation in treating intracranial giant intemal carotid artery aneurysms with spring coil occlusion.

Objective To evaluate the early change of left ventricular (LV) systolic function in patients with type 2 diabetes mellitus(T2DM) by ultrasound speckle tracking imaging. Methods Ninety-five subjects were included:40 T2DM with normal LV ejection fraction (LVEF≥50% ,group A),20 T2DM with abnormal LVEF (LVEF<550 %) (group B), and 35 normal controls. Two-dimensional strain images were acquired from LV short-axis view. LV peak systolic global and segmental radial strain and circumferential strain at the levels of mitral annulus, papillary muscle and apex, and LV systolic global and segmental rotation at the levels of mitral annulus and apex and LV peak systolic global twist were assessed. Results In group A, compared with control group, LV peak systolic radial strain parameters were not significant difference (P >0.05), peak systolic circumferential strain of part segments, average peak strain of each plane and global strain were reduced (P <50.05～0.001) ,and LV peak systolic rotation of all apical segments, peak systolic global rotation at the levels of mitral annulus and apex,and peak systolic global twist were significantly increased (P <0.05～0.001). Compared with control group and group A,all LV systolic radial strain and circumferential strain parameters, LV systolic global and segmental rotation and peak systolic global twist in group B were significantly reduced (P <0.05 ～ 0.001). Conclusions Speckle tracking imaging could be used to evaluate the early change of LV torsional deformation and LV systolic function in T2DM.