Sepsis constitutes a serious threat to human health and represents a major burden to the health care system.Recent years have witnessed a deeper insight into the mechanism of the onset of sepsis,together with some new therapeutic strategies,including early aggressive volume therapy,activated protein C,potentiated insulin therapy,adrenal function replacement therapy,and some new therapeutic targets,which have offered some hope for the management of sepsis.

Objective To analyze the clinical features of tsutsugamushi disease.Methods 113 cases of tsutsugamushi disease from 1991-2005 were reviewed.Results The symptoms of fever,eschar or ulcer,tetter and lymph node tu- mescence accounted for 100%,80.5% (91/113),6.2% (7/113) and 75.2% (85/113) respectively.Liver damage and pulmonary damage were observed in 75.2% (85/113) and 47.8% (54/113) cases.78.8% (89/113) cases were masculine in OX_K check.Conclusion Tsutsugamushi diseases showed complicated and multiple clinical manifestations and more attention should be paid to for avoiding misdiagnosis.

AIM To investigate the poteintation of adriamycin induced apoptosis by neferine in resistant human breast cancer cell line MCF 7/Adr. METHODS Apoptosis was detected by PI stain flow cytometry and Tunel assay. The intracellular adriamycin (ADR) accumulation was assayed by HPLC and the expression of P gp was determined by flow cytometry. RESULTS (1)MCF 7/Adr cells resisted the apoptosis induced by ADR while Nef augmented ADR medidated apoptosis; (2) Nef (10 ?mol?L -1 ) increased the accumulation of ADR up to 2 88 fold in MCF 7/Adr cells but not in sensitive cells MCF 7/S; (3) Nef(10 ?mol?L -1 ) reduced the expression of P gp in MCF 7/Adr cells. CONCLUSIONS Nef can overcome apoptosis resistance in MCF 7/Adr cells and its mechanisms are involved in the augment of ADR accumulation and the down-modulation of P gp expression in MCF 7/Adr cells.

Purpose:To study the expression of CK19 and CK2 0mRNA in peripheral blood patients with FRGO Stage ⅠA to ⅡA cervical carcinoma and to investigate its clinical significance. Methods:Using the reverse transcription polymerase chain reacti on(RT-PCR),CK19 and CK20mRNA expression was examined in peripheral blood fro m 250 patients with early cervical carcinoma before operation,50 Patients with benign gynecological tumors and 18 healthy volunteers. In 250 patients,possible correlations between clinical pathological factors were analyzed. Results:The positive expression rates of CK19 and CK20mRNA were 36% and 24% in 250 cervical carcinomas respectively,in comparison with 3.0% an d 0% with benign gynecological tumors and all subjects in healthy volunteers wer e negative; The expression of CK19 and CK20 mRNA were significantly correlated w ith lymph vascular space involvement,but was not associated with prognostic fac tors including stage,differentiation,pathological types ,lymph node metastasis ,bully tumor size . In patients with CK19 mRNA(+)/CK20 mRNA(+),the rate of lymp h node metastasis and vascular space involvement and recurrence outside the pelv is was significantly higher than that of patients with CK1R mNA9(-)/CK20 mRNA(- )(P

Objective To investigate the genotype and gene mutation of hepatitis E virus isolated from the serum and stool samples of the patients with epidemic outbreak hepatitis E in certain recruit barracks of Guangzhou. Methods The reverse transcription polymerase chain reaction (RT-PCR) was performed to amplify the partial ORF2 nucleotide acid sequences of hepatitis E virus isolated from 34 and 46 inpatients with epidemic outbreak and sporadic hepatitis E respectively. The PCR products of the positive samples were cloned and sequenced. Results The 14 strains, including 12 epidemic strains and 2 sporadic strains, were isolated from the total 80 inpatients. The homology of nucleotide acid and amino acid sequences of 12 epidemic outbreak strains is 95.3%～100% and 94.0% ～100% . The homology between epidemic outbreak strains and sporadic strains is 95.3%～99.3% and 94.0%～100%. Compared with the standard different genotypes of HEV, these strains have the highest homology to the Jap1 strain which belongs to genotype Ⅳ, with homology of 96.0%～100%, respectively. Phylogenetic analysis indicated that these the nucleotide acid sequence homology of 92.0%～95.3% and amino acid sequence stains and Jap1 strain share the same cluster. Conclusion[KG1]Epidemic outbreak strains isolated from the patients in recruit barracks of Guangzhou belong to the genotype Ⅳ of HEV and the nucleotide acid sequences had partial mutation.

Objective To evaluate the value and limitation of MRI in the diagnosis of meningovascular neurosyphilis. Methods Five cases of neurosyphilis confirmed by clinical history/laboratory were examined with MRI (3 plain MRI, 2 enhanced MRI). The results of blood and CSF TPPA/RPR were positive and HIV was negative. Results Abnormal signals were demonstrated in the temporal lobe in 3 cases, and infarction was revealed in the basal ganglion and periventricular white matter in another 2 cases. There was no marked contrast enhancement in the 2 cases. Conclusion Meningovascular neurosyphilis has no characteristic features on MRI, but MRI is an effective method in delineating the size, range, and characters of neurosyphilis, and it is also an useful modality to follow-up after antibiotic therapy.

Objective To explore the expressions of histamine receptor subtypes (H1, H2, H3, H4 receptor) in children's mid-urethral striated muscles and during mouse C2C12 striated myogenesis.Methods Children's mid-urethral striated muscle samples were paraffin embedded and tissue sections were made, then immunohistochemical staining was used to check H1, H2, H3, H4 receptors.C2C12 myogenesis was induced, the early differentiation early markers of desmin, middle marker of myogenin, late marker of myosin heavy chain and histamine 4 receptor subtype mRNA were checked by quantitative real-time polymerase chain reaction.Immunofluorescence staining was done to check 3 differentiation markers and histamine H3 receptor protein.Results During myogenesis, the expression of desmin mRNA in the differentiation of 2,4,6 days were 12,68,60 times as many as that of the undifferentiated myoblasts;the expression of myogenin mRNA in the differentiation of 2,4,6 days were 631,1 408,914 times as many as that of the undifferentiated myoblasts;the expression of myosin heavy chain mRNA in the differentiation of 2,4,6 days were 7 718,9 448,286 288 times as many as that of the undifferentiated myoblasts.The expression level of H1 receptor mRNA in the differentiation of 6 days was about 25％ to undifferentiated cells;the expression of H2 receptor mRNA in undifferentiated cells and differentiated cells groups had no significant difference (F =1.47, P ＞ 0.05);the expression of H3 receptor mRNA in the differentiation of 2,4,6 days was 28,103,198 times to undifferentiated cells;H4 receptor mRNA was not detected.In immunofluorescence staining, H3 receptor protein staining intensity increased with the differentiation.Immunohistochemistry of pediatric urethral striated staining indicated that H1, H2, H3 receptor staining was positive,H1 receptor showed strong positive staining, H3 receptor moderate positive staining,and H2 receptor showed weak positive staining.Conclusions Histamine receptor subtypes of H1 receptor, H2 receptor and H3 receptor were found during mouse striated myogenesis and in the children's mid-urethral striated muscles.The increasing expression of H3R with myogenesis might indicate it plays a role in mature striated muscle cells.

Objective To make a comparative assessment on both the therapeutic effects and side effects between percutaenous lauromacrogol injection therapy(PLIT) and percutaenous ethanol injection therapy(PEIT) for simple hepatic or renal cyst.Methods In group A,55 patients with simple hepatic or renal cysts underwent ultrasound-guided aspiration and successive PLIT.The intra-operative side effects were investigated and the therapeutic effects assessment by using ultrasonography was conducted 3 months after the treatment.In group B,60 patients with simple hepatic or renal cysts had received ultrasound-guided aspiration and PEIT sometime before.The intra-operative side effects and therapeutic effects on the thirdmonth ultrasonography were independently reviewed according to their case records.Results In group A,3 patients(5.5 ％) expressed slight discomfort but not pain while receiving lauromacrogol injection.Follow-up ultrasound examination at the end of third month demonstrated the cysts in 43 patients completely regressed,while cysts in rest 12 patients shrank over 50 ％ in size,showing the overall response rate(ORR) and completely cure rate(CCR) were 100％ (55/55) and 78.2％ (43/55) for PLIT respectively.In group B,12 patients(20％) suffered from slight to moderate irritating pain or drunk performance.The third-month ultrasound examination disclosed that cysts in 47 patients completely vanished,and cysts in the other 13patients shrank more than a half,indicating the ORR and CCR were 100％ (60/60) and 78.3 ％ (47/60) for PEIT respectively.Conclusions Although their therapeutic efficacy are perfectly similar,PLIT is much more superior to PEIT in term of less and minor side effects.

Objective To analyze diagnostic evaluation of urethral sphincter electromyography (US-EMGs) for patients with multiple system atrophy (MSA).Methods Totally 15 patients who were diagnosed as MSA were examined as treatment group while 17 non-MSA patients were examined as controls.US-EMGs were performed in the both groups.Spontaneous activities when relax,parameters of motor unit potentials(MUPs) mean duration and amplitude,percentage of polyphasic ware,satellite potential,recruitment potentials and amplitude when strong contraction were recorded and analyzed.Results USEMGs changes of various abnormalities were found in 13 cases (86.7％) in MSA group.There were significant differences of electromyographic findings between the MSA group and control group including MUPs mean duration[(12.79 ±3.18)ms vs (9.49 ± 1.51)ms] and amplitude[(828.53 ±459.89) μV vs (378.76 ± 152.26) μV] as well as recruitment potentials [(11.47 ± 21.55) ％ vs (8.23 ± 10.74) ％] and amplitude [(2.19 ± 1.24) mV vs (0.75 ± 0.42) mV] when strong contraction (all P values ＜ 0.05).Conclusions There is certain value of US-EMGs for the diagnosis of MSA.It could be used as a routine electrophysiological method for the patients who are suspected of MSA.It could be a supplement of externalanal sphincter electromyography.

Objective To evaluate the clinical,neuroimaging and electrophysiology features of 62 patients with multiple system atrophy(MSA).Methods Sixty-two cases with diagnosis of probable MSA were recruited in a retrospective studied.Clinical,neuroimage and external anal sphincter electromyography (EAS-EMG)data was retrospectively analyzed.Results In 62 cases(44 male and 18 female),the onset age was between 37 and 76.Among them,29 cases(46.8 % )were MSA-A,with orthostatie hypotension as the main clinical manifestation;24 cases(38.7 % )were MSA-C,with cerebellar ataxia ag the main chnical manifestation;9 cases(14.5 % )were MSA-P,with extrapyramidal symptoms as the main clinical manifestation.MRI showed that main lesion of MSA-A was in the cerebellum:that of MSA-C was in the cerebellum,pons and medulla;and that of MSA-P was in the putamen.Fifty-one cases did EAS-EMG and 46 cases showed neurogenie impairments.Nineteen cases were initially misdiagnosed with other diseases.Conclusions MSA is easy to be omitted or misdiagnosed at early stage.The diagnostie rate of MSA can be increased by the combination of clinical expressions,neuroimage,EAS-EMG and other necessary examinations.