DQA1*0501.TSHR peptides of 183～198、195～210、248～263、301～320、343～362 and 357～376 could bind with high affinity to both HLA-DR3 and HLA-DQA1*0501,all of their IC50 values less than(1 ?mol/L),but they could bind to neither HLA-DR7 nor HLA-DQA1*0201 with high affinity.Conclusion Epitopes of TSHR 183～198,195～210,248～263,301～320,343～362 and 357～376 on the TSHR extracellular domain might be the auto-antigens to cause GD.

Objective To investigate effects of the mental self-help education intervention on the quality of life (QOL) after breast cancer surgery.Methods One hundred and forty-seven patients planed to be modified radical mastectomy for breast cancer were divided into 76 cases of the experimental group and 71 cases of the control group using a random number table.The QOL of those patients were evaluated with Chinese version of the European organization for research and treatment for patients of cancer (EORTC QLQ-C30) when one week and three month after surgery.The patients in control group received conventional care and health education while the patients in experimental group received mental self-help education by the trained psychological specialist nurses.The changes of QOL before and after interventions were compared between two groups.Results After the mental self-education, the scores of QOL in the experimental group were significantly higher than before the intervention and higher than the control group (P < 0.05 ).Conclusions Mental self-education can improve the quality of life of patients after breast cancer surgery.

Adolescent ; Asthma ; blood ; CD40 Ligand ; blood ; Child ; Child, Preschool ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Humans ; Immunoglobulin E ; blood ; Interleukin-4 ; blood ; T-Lymphocytes ; metabolism

OBJECTIVETo explore the essence of Spleen-Kidney Deficiency in middle-aged patients.

METHODSInvestigation was carried out in 773 cases of 50-69 years old to assay 34 parameters in them, including blood lipid, oxidation and anti-oxidation related substance, sex hormone, liver and renal function, immune function, blood routine, blood pressure and lung vital capacity, etc.

RESULTSSpleen Deficiency Syndrome is closely related with lipid metabolism disorder; Kidney-Qi Deficiency Syndrome is closely related with hypoimmune function; Kidney-Yin Deficiency Syndrome is closely related with lipid metabolism disorder and hypertension, and Kidney Yang Deficiency is closely related with weakness of anti-oxidation capacity, hypoimmunity, the internal environment disorder of sex hormone and aging, manifested as multiple functions abating.

CONCLUSIONSpleen Deficiency, Kidney-Qi Deficiency and Kidney Yang Deficiency are different layers of a gradually developed and aggravated pathological process, but Kidney-Yin Deficiency could not be listed into this layer.

Aged ; Aging ; CD4-CD8 Ratio ; Cholesterol ; blood ; Diagnosis, Differential ; Female ; Humans ; Kidney Diseases ; blood ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Splenic Diseases ; blood ; Superoxide Dismutase ; blood ; Yang Deficiency ; blood ; Yin Deficiency ; blood

Objective To investigate the small-world property of default mode network in relapsingremitting multiple sclerosis (RRMS) compared with the (matched) healthy control subjects,using a graph theory for resting-state functional network analysis.Methods Twenty four patients with RRMS and 24 age-,and sexmatched healthy controls were exanined with resting-state functional MRI (R-fMRI) and 3D-T1WI on Trio 3.0 Tesla.The R-fMRI data were preprocessed,then 20 regions of interest (ROIs) was defined and extracted from the default mode network.The functional connectivity between a pair of regions was defined as the Pearson's correlation coefficient in the time courses.Graph theoretical analysis was implemented and compared with the property of binary functional network.Further,the relationships were examined between the topological property of functional networks and the clinical parameters.Results In this study,functional network in the default mode network was conducted,and the small-world characteristics were observed in both RRMS and healthy control group.In the range of densities (Dmin:0.01∶0.48 ;Dmin =0.42),compared with healthy control group,RRMS groups had a slightly smaller normalized clustering coefficient (P＞0.05),a slightly larger normalized path length (P＞0.05),and a slightly decrease small-world index (P＞0.05).The left posterior cingulated cortex showed a significantly larger clustering coefficient in RRMS group (P=0.031) on the network threshold at Dmin.The area under a curve (AUC) for clustering coefficient measure curves of the left posterior cingulated cortex (density range of 0.42:0.01:0.48) between two groups were compared.The AUC result was similar to the Dmin result (P=0.031).Negative correlation was observed between the clustering coefficient of left posterior cingulated cortex and the Paced Auditory Serial Addition Test (PASAT) in both the Dmin(P=0.023) and the AUC (P=0.020).Conclusion The default mode network has small-world property in RRMS group.The significantly increased clustering coefficience is observed in the left posterior cingulated cortex,which may be a side effect.

Objective To study the factors affecting the prognosis of intracranial aneurysm operation for elderly patients. Methods Thirty elderly patients (≥60 years old) with intracranial aneurysm who were treated surgically were evaluated retrospectively. The factors that might affect the result of operation were analyzed by slng]e-factor and multi-factor. Result The factors that had significant correlation with the prognosis were Hunt-Hess grade,location of aneurysm,surgical timing (P =0.007,0.019,0.007).Conclusion The prognosis of intracranial aneurysm operation for elderly patients is affected by many factors,age is not a contraindication to aneurysm operation,early aneurysm operation treatment is suggested for elderly patients.

BACKGROUND: The dynamic changes of pneumocyte apoptosis and aspartate-specific cysteine proteases-3 (caspase-3) expression in lung tissue of rats during the process of lung ischemia/reperfusion (I/R) injury and the possible action mechanisms remain unclear.OBJECTIVE: This study was to observe the dynamic changes of pneumocyte apoptosis and caspase-3 expression in the rat lung tissue during the process of lung I/R injury, and to analyze the role of pneumocyte apoptosis and the possible action mechanism.DESIGN: A randomized controlled animal experiment.SETTING: Emergency Center, First Hospital, Nanjing Medical University.MATERIALS: This study was carried out in the Animal Laboratory of the First Hospital of Nanjing Medcial University and Nanjing Center for Radioimmunity between April 2006 and September 2006. Twenty-eight male healthy SD rats of clean grade, with body weight of 250 to 350 g, aged 49 to 76 days, were provided by the Experimental Animal Center of Nanjing Medical University. The involved rats were randomized into experimental group and control group, with 14 rats in each.METHODS: ①Experimental intervention: Rats in the experimental group were created into models of lung I/R injury according to the method of Eppinger et al. They were occluded for 45 minutes at the porta of lung (no systolic and diastolic reactions in lung tissue being considered as successful occlusion), and then they were reperfused (recovery of systolic and diastolic function being considered as successful reperfusion); After that, lung tissues were harvested at 3 and 6 hours after lung I/R injury, 7 rats at each time point. Each rat in the control group was subjected to a thoracotony only, but lung tissues were isolated at the same time point by the same method. ②Experimental evaluation: Apoptotic cells in the lung tissue were detected with a flow cytometer by Annexin-V-PI staining, and apoptosis rate was calculated. Caspase-3 expression in the lung tissue was observed by immunohistochemical method and image analysis. Wet to dry weight ratio(W/D) of lung tissue of rats in the two groups was calculated; the number of injured pulmonary alveoli at I/R 3 hours/that at I/R 6 hours was calculated for quantitative evaluation of injured lung tissue; Patho-morphological changes of lung tissue were observed by haematoxylin & eosin staining under an optical microscope.MAIN OUTCOME MEASURES: ①Pneumocyte apoptosis rate and caspase-3 expression in the lung tissue. ②W/D of lung tissue and quantitative evaluation of injured lung tissue. ③Patho-morphological changes of lung tissue.RESULTS: Twenty-eight rats were involved in the final analysis, without deletion. ①Pneumocyte apoptosis rates in the experimental group at I/R 3 and 6 hours were significantly increased as compared with control group (P＜0.01). In the experimental group, pneumocyte apoptosis rate was decreased a little at I/R 6 hours than at I/R 3 hours (P＜0.05). ②Caspase-3 expression in the lung tissue of rats of experimental group reached its top at I/R 3 hours, and was decreased a little at I/R 6 hours. At each time point, caspase-3 expression in the experimental group was increased as compared with control group (P＜0.01). ③In the experimental group, the number of injured pulmonary alveoli at I/R 3 hours/that at I/R 6 hours and W/D ratios of lung tissues were significantly increased as compared with control group (P＜0.01). In the experimental group, two ratios at I/R 6 hours were higher than those at I/R 3 hours (P＜0.05).④In the experimental group, the structure of pulmonary alveoli was destructed, collapsed and disappeared; lots of inflammatory cell infiltration was found; Patho-morphological changes of injured lung tissue at I/R 6 hours were severer than those at I/R 3 hours. No obvious changes were found in the control group.CONCLUSION: At the early stage of lung I/R injury, the alteration of caspase-3 maybe activate pneumocyte apoptosis and induce the apoptosis of lung tissue, and thereby leads to lung injury.

Objective To analyze the mammographic features and pathological characteristics among different molecular subtypes of breast cancer.Methods The results of 210 cases breast cancer identified by postoperative pathology were collected and classified to three groups;Luminal,HER-2(+)and TNBC(triple negative breast cancer)by molecular subtypes.Three groups'mammograph-ic features and pathological characteristics were compared.Results 210 cases included 147 Luminal cases,30 HER-2 (+)cases and 33 TNBC cases.There were statistically significant difference between tumor grading and lymph node metastasis (P <0.05).Three groups had statistically significant difference among mass number,mass margin and calcification incidence(P <0.05),and had no sta-tistically significant difference between mass size and shape(P >0.05).The mammographic features of Luminal molecules subtypes showed more mass with burr,HER-2(+)molecules subtypes showed no fixed features but more calcification incidence than other groups,TNBC molecules subtypes showed merely mass with clear margin and less calcification.Conclusion The mammographic fea-tures and pathological characteristics of different molecular subtypes of breast cancer are significant differences.

Objective To investigate the clinical features and treatments of pituitary abscess.Method The clinical data of 6 patients with pituitary abscess were examed along with a review of the literature.Results Of 6 patients,headache was presented in 5 patients,hypopituitarism in 4 patients,visual disturbance and/or bitemporal hemianopsia in 4 patients and fever in 1 patient.MRI and CT images showed a cystic sellar lesion with ring enhancement in 5 patients.Preoperative diagnosis of pituitary abscess was made in 2 patients,pituitary adenomas in 3 patients and craniopharyngiomas in 1 patient.All cases were treated surgically by transsphenoidal approach in 5 patients and transscranial in 1 patient.Followed with postoperative antibiotics therapy for 3 weeks,the symptoms were improved postoperatively in all cases.Followed up 8 months to 10 years,1 patient who underwent craniotomy recurred and wag cured by via transsphenoidal surgery.Conclusions The pituitary abscess is easily misdiagnosed.The cystic pituitary lesion should be considered the possibility of pituitary abscess.Transsphenoidal surgery and proper perioperative antibiotics therapy are the keys to the treatment of pituitary abscess.

To evaluate changes in quality- of- life of adults with concomitant exotropia before and after surgery.
●METHODS:A retrospective cohort method was used in this research. Sixty - five patients with concomitant exotropia ( ranged from 18 - 30 years) were enrolled. Quality of life was studied with 2 different questionnaires [the Adult Strabismus - 20 ( AS - 20) and the MOS 36 -item Short - Form health survey ( SF - 36 )], which patients completed preoperatively and at 3mo postoperatively.
●RESULTS: With the AS - 20, 3mo after surgery, the mean psychosocial and visual function scores of AS- 20 improved significantly (P<0. 01). Similarly, with the SF-36, the mean score in 7 of 8 areas improved significantly ( P < 0. 01 ), including physiological function, role limitations due to physiological health, general health, vitality, social function, role limitations due to emotional problems, mental health and the overall mean score. However, with respect to bodily pain, no significant improvement was found after surgery(P>0. 05).
● CONCLUSlON: Surgical treatment of concomitant exotropia in adults gives a highly significant improvement in quality - of - life scores. We should pay more attention to the impact of strabismus on quality of life clinically to improve the outcome of the surgery.