Objective To explore clinical effect of sufentanil combined with ropivacaine in interscalene brachial plexus block by ultrasound-mediated.Methods 66 patients received the treatment of interscalene brachial plexus block were divided into group A,B and C randomly.Group A received traditional blind puncture interscalene brachial plexus block with ropivacaine;Group B received interscalene brachial plexus block with ropivacaine by ultrasound-mediated;Group C received interscalene brachial plexus block with combination of sufentanil and ropivacaine by ultrasound-mediated.The operation time,VAS score,pain and movement block onset time,anesthesia fine ratio and incidence of complications were observed and compared.Results The operation times of group B and C were significantly shortened compared with group A(all P ＜0.05) ;The pain and movement block onset time was shortened significantly in group B (all P ＜ 0.05),and more significantly in group C than those in group A (all P ＜ 0.05) ;The VAS score at 30min,60min and 120min after operation of brachial plexus block were significantly decreased in group C than those in group A and B (all P ＜ 0.05) ; Anesthesia fine ratio in group B and C significantly improved than that in group A (all P ＜ 0.05) ; Incidence of complications of group B and C was significantly lower than that in group A after operation of brachial plexus block (all P ＜ 0.05).Conclusion Sufentanil combined with ropivacaine in interscalene brachial plexus block by ultrasound-mediated has good effect and safety,and it can improve the onset time and effect of pain and movement block.

Objective:To summarize the clinicopathologia and imaging features of Hemiballism-hemichorea induced by hyperglycemia and increase the understanding of the disease and improve the accuracy of diagnosis. Methods:The imaging images and clinical manifestation of 5 cases Hemiballism-hemichorea induced by hyperglycemia were analyzed retrospectively. The disease pathogenesis and mechanism relating to the Characteristic neuroradiological findings was obtained by literature review. Results:The common clinical manifestation of Hemiballism-hemichorea induced by hyperglycemia is unilateral limb involuntary movements. CT scans typically show an area of hyperdensity in the basal ganglia and The characteristic finding on the T1-weighted MRI is high signal intensity in the contralateral putamen. Conclusion: Hemiballism-hemichorea induced by hyperglycemia is an unusual but important differential diagnosis in patients with particular neuroradiological findings as prompt diagnosis and treatment of hyperglycemia has an excellent prognosis. The correct diagnosis could be received through integrated the patient's past medical history, presentation, laboratory and imaging inspection into account.

Objective To explore the main affecting factors on sanitary quality of public places and to assess the sanitary quality scientifically. Methods The sanitary qualities of 6 kinds of public places of entertainment in Taiyuan during 1998～2000 were assessed using the method of compreheusive fuzzy assessmeat. Results All of 6 kinds of public places revealed similar sanitary qualities. All of the sanitary indexes accorded with the related National Sanitary Standards. The sanitary qualities were better for ballrooms, theaters, bar and billiard rooms in hotels with Grade Ⅰ quality, and were worse for tennis and bowling halls with Grade Ⅱ quality. The assessments on single index showed that the affecting factors of sanitary quality of public places of entertainment were the levels of CO2, noise and CO. Conclusion The sanitary quality of entertainment public places was better during 1998～2000.

Objective To study the exposure-response relationship between particulate pollution level and hospital outpatient visits. Method From 2001 to 2005,daily outpatient visits data were from a municipal hospital in Taiyuan,meteorological data and air pollution data were from Taiyuan Meteorological Bureau and Taiyuan Environmental Monitoring Station respectively. Poisson Generalized Additive Model(GAM)) extended Poisson regression was used to examine the relationship between particulate pollution level and hospital outpatient visits,controlling with time trends,weather and the day of week. According to the shape of exposure-response relationship curve,piecewise linear regression was used for risk analysis. Results From 2001 to 2005,the average concentration of PM10 was 190.41 ?g/m3,the average number of daily hospital outpatient visits was 18.31 to the respiratory department,and 23.99 to the cardiovascular department. Exposure-response relationship analysis suggested a nonlinear positive correlation between PM10 and daily hospital outpatient visits. A larger increase in daily hospital outpatient visits was observed at lower concentration of PM10 than that at higher concentration. When PM10 increased 10 ?g/m3,respiratory outpatient visits increased 0.260 1%-0.917 8% and respiratory outpatient visits increased 0.208 3%-0.402 7%. The estimated effects of 2 or 3 days moving average of PM10 concentration were greater than that of concurrent day. The stronger effect of PM10 was found on respiratory outpatient visits,which was statistically significant. Conclusion PM10 may produce effect on respiratory outpatient visits.

Objectives To investigate the expression of hTERT, p16 and Topo-Ⅱ? in astrocytoma as well as their relationship during histogenesis and development of astrocytoma. Methods The expression of hTERT, p16 and Topo-Ⅱa in 64 astrocytoma specimens with different malignant grades and 10 normal brain tissues were studied using tissue microarray and immunohistochemistory. Results The expression rate of hTERT and Topo-Ⅱa were 50 % and 59.4 % respectively, they increased along with the increase of the malignant grade(P

Objective To study the expression of PTEN et al and their significance in T lymphoblastic lymphoma/leukaemia (T-LBL/ALL). Methods Seventy-six cases of T-LBL/ALL were studied by using immunohistochemistry (EnVision method) for CD3, CD7, CD10, CD20, CD23, CD43, CD45RO, CD99, TdT, MPO and PTEN. Follow-up was included. Results In the Seventy-six cases of T-LBL/ALL, the percentages of tumor cells expressing TdT, CD99, CD3, CD7, CD45RO and CD43 were 93.42%, 94.74%, 67.12%, 92.11%, 36.85%,and 51.33%, respectivly while MPO, CD20 and CD23 were all negative. The index of Ki-67 expression higher than 80 % was found in 27 and ≤80% in 49 cases. The expression of PTEN (64.47 %) in T-LBL/ALL was lower than that of in reactivated lymphoid tissue (100%, P<0.05). PTEN was reversely correlated with stage,Ki-67 expression and LDH level (P<0.05). CD3-positive cases were more than CD3-negative cases in abnormal LDH level (P<0.05). Follow-up data was obtained in 50 cases, ranging from 1 to 108 months. The overall survival rate was 35.8 %, with median survival time 330 days. No prognostic significance was found in the expression of PTEN, CD3, CD7, CD10, CD43, Ki-67 and CD45RO (P >0.05). Conclusion The antibodies of CD3,CD7, CD10, CD20, CD43, CD45RO, CD99, TdT, MPO and Ki-67 were very helpful for the diagnosis of T-LBL/ALL.Down-regulation of PTEN may play an important role on the development of T-LBL/ALL.

Objective To investigate the protein and gene expression of bcl-2, bcl-6 in diffuse large B-cell lymphoma (DLBCL). Methods 73 cases of DLBCL were selected for study using the Envision immunohistochemistry method with a panel of antibodies CD3, CD10, CD20, bcl-6, bcl-2, MUM-1. The bcl-2gene expression in 57 of 73 cases with chromosome translocation t (14; 18), breakage and amplification of 3q27 chromosome in 54 of 73 cases were detected by fluorescence in situ hybridization (FISH) method. Results The percentages of tumor cells expressing CD10, bcl-6, MUM-1, bcl-2 were separately 15.1%, 38.4 %, 71.2 %, 79.2 %. t (14;18) chromosomes were detected in 16 of 57 cases (28.1%). The expression of bcl-2 protein have significantly correlated with immunophenotype subtype (P=0.035), and t (14;18) was significantly correlated with the prognosis (P=0.045). There were no association between the expression of bcl-2 protein and t (14;18)(P=0.710). 11 of 54 cases were presented with 3q27 chromosomal breakage (20.4 %), and 14 cases were chromosomal amplification (25.9 %). The prognosis of cases with positive bcl-6 protein was better than that with negative protein obviously. There was no relationship between bcl-6 and 3q27 chromosomal breakage or amplification (P=1.000). Conclusion The expression of bcl-2, bcl-6 protein and gene were different events and had the different significance on DLBCL. The expression of bcl-2 protein was a prognostic marker correlated with immunophenotype subtype, and GCB type with the positive expression of bcl-2 protein had the poor prognosis. Conversely, t(14;18) was an independent event for the prognosis, and the positive expression have the poor prognosis. Patients who require the target therapy should be detected for the t(14;18). The expression of bcl-6 protein was beneficial to the judgment of DLBCL prognosis, it could be an independent factor of the prognosis. 3q27 chromosomal breakage may be a hint to the poor prognosis.

Objective To investigate the distribution characteristics of the Epstein-Barr virus (EBV)in lymphomas.Methods 438 cases of lymphomas were reclassified according to the WHO classification of lymphoma (2008).ALK1,CD3,CD5,CD7,CD10,CD15,CD20,CD23,CD30,CD43,CD56,CD68,CD79,CD99,CyclinD1,EMA,IgD,TdT,Vs38C and LMP-1 were detected by in situ hybridization of EBER and immunohistochemistry.Results In B cell lymphoma,T and NK cell lymphoma and Hodgkin' s lymphoma (HL),the positive rates of EBER were 5.4 ％ (14/261),16.5 ％ (19/115) and 59.7 ％ (37/62),respectively,and the positive rates of LMP-1 were 5.4 ％ (14/261),5.2 ％ (6/115) and 59.7 ％ (37/62).In DLBCL patients,EBER expression in the older group was significantly higher than that in the younger one [13.2 ％ (7/53) vs 1.2 ％ (1/81),P ＜ 0.05].The expression of EBER and LMP-1 were inconsistent in T and NK cell lymphomas,and the positive rate of EBER was significantly higher than that of LMP-1 (P ＜ 0.05).EBER was all positive in 5 cases of NK/T cell lymphoma-nasal type.The expression of EBER and LMP-1 were consistent in HL.Conclusion The EBV infection was associated with the classification of the lymphoma.The EBV infection was the highest in NK/T cell lymphoma-nasal type,and the next was in HL.Due to the consistency of EBER and LMP-1 expression in the HL,economically,LMP-1 may replace EBER as the indicator of EBV.EBV might play an important role in the occurrence and development of NK/T cell lymphoma-nasal type,HL and so on.

Objective To investigate the significance and expression of PTEN, MLL in T lymphoblastic lymphoma/leukaemia(T-LBL/ALL). Methods Seventy-six cases of T-LBL/ALL were studied by using immunohistochemical EnVision method for PTEN. Fluorescence in-situ hybridization (FISH) for MLL gene (located on chromosome 11q23) was performed to detect its breakage and amplification. Results Among the 76 cases ofT- LBL/ALL, the positive rate of PTEN was 64.47 % (49/76), lower than that in reactivated lymphoid tissue (100 %, 20/20) (λ2= 19.220, P ＜0.05). PTEN expression was reversely correlated to theclinical stage, Ki-67 index and LDH level (P ＜0.05). Among the 76 cases, MLL gene with breakage of 11q23 was detected in 13 cases (17.11%), and amplification in 18 cases (23.68 %). Survival rate ot MLL gene breakage group was lower than that of non-breakage group (25.0 %, 43.6 %). Survival rate of MLL gene amplification group was lower than that of non-amplification group too (17.1%, 42.7 %). Both of breakage and amplification were related to prognosis ( λ 2 = 11.357, λ 2 = 4.533; P ＜0.05). Conclusion Anti-oncogene PTEN down-regulation may play an important role on the development and proceeding of T-LBL/ALL. MLL gene with breakage and amplification of 11q23 are helpful to predict prognosis of T-LBL/ALL. The case with MLL gene breakage and amplification of T-LBL/ALL may have a poor prognosis. It hints this group maybe a subtype of T-LBL/ALL.

Objective To investigate mutations of S protein gene in positive HBsAg and anti-HBs patients with chronic hepatitis B virus (HBV) infection.Methods Fifteen HBsAg(+) and anti-HBs(+) patients and 22 HBsAg(+) and anti-HBs (-) patients (control group) admitted in Renmin Hospital of Wuhan University during January and December 2011 were enrolled in the study.The S protein gene was amplified and sequenced, and the amino acid sequences were translated from the obtained DNA sequences and compared with the reference sequences.Results Compared with the control group, HBsAg (+) and anti-HBs(+) patients showed a higher variability in amino acid within major hydrophilic region (2.95 vs.0.78,x2 =18.059, P＜0.01) and the a determinant (4.44 vs.1.52, x2 =6.985, P＜0.01).The mutations in a determinant at positions P127T, G130E, G130N, M133S, F134I, T140I and G145R were detected only in HBsAg(+) and anti-HBs (+) patients.Conclusion Co-existence of HBsAg and anti-HBs in patients with chronic HBV infection might be associated with the increased amino acid mutations in and around the a determinant of protein S.