Objective To study the sensitivity and specificity of oligoclonal bands (OCBs) and intrathecal IgG synthesis rate (IgG Syn) for diagnosis of multiple sclerosis (MS) and the correlation between qualitative and quantitative indices.Methods Albumin and IgG concentrations in the cerebrospinal fluid (CSF) and serum from 30 patients with MS, 40 with other nervous system inflammatory diseases (NID) and 22 with nervous system noninflammatory diseases (NNID) were determined by rate nephelometry method. OCBs in the CSF were detected using isoelectric focusing combined with silver staining, and IgG Syn was calculated. The sensitivity, specificity and positive result likelihood ratio (PRLR) were analyzed.Results There were no significant difference in the abnormal rate of OCBs and IgG Syn between MS group and NID group. When MS and NID groups were compared with NNID group, the difference was extremely significant (all P

Doctor's degree is the highest degree for medical education.Nowadays,medical doctor candidates in more and more medical universities are requested to publish research papers in intemational journals embodied in Science Citation Index(SCI),or they can not graduate with doctor's degree.So,it is significant for medical doctor candidates to learn the related knowledge about SCI and Impact Factor(IF).

Objective To explore a simple and effective way of establishing a 30 % small-forsize liver transplantation in rats. Methods SD rats were selected as the donors and recipients. Smallfor-size orthotopic live transplantation was performed using Kamada's two-cuff method. Donor's liver was flushed via abdominal aorta and hepatectomy in situ was done. Animals were divided into 3 groups (40 pairs of rats in each): group Ⅰ , median lobe was used as graft; group Ⅱ, right of median lobe and right lobe were used as graft; group Ⅲ, median and right lobes were used as graft. The body weight of the donor was the same as the recipient in groups Ⅰ and Ⅱ , but 100～ 120 g less than in group Ⅲ. The operating time, 7-day survival and technical complications were compared among these 3 groups. Results The operating time of hepatectomy was shorter in group Ⅲ than in groups Ⅰ and Ⅱ (8. 8±0.7 vs 11.5± 1.1 vs 10.1 ±1.0 min, P＜0.01). The cold ischemia time of graft, the anhepatic time, the operating time of recipient and the transplanting successful rate showed no significant difference among the 3 groups. Compared with groups Ⅰ and Ⅱ , the incidence of bleeding,bile leakage and IVC stricture was significantly decreased in group Ⅲ (P＜0. 05). Other complications after operation showed no significant difference among the 3 groups (P＞0. 05). Group Ⅲ had more 7-days survivors and longer median survival time, but there was no significant difference among the 3groups. Conclusion Small for donor body weight with median and right lobes as graft was a more effective and simple way of establishing a 30 % small-for-size liver transplantation in rats with shorter hepatectomy time and less complications after operation.

Objective To discuss the relationship between the expression of programmed death-1 (PD-1) in liver with traditional Chinese medicine (TCM) syndromes and pathological diagnosis in chronic hepatitis B.Methods 156 CHB patients treated in our hospital of infectious diseases department were recruited as an observation group. Based on the principle of informed voluntary and approved by the ethics committee, liver biopsy was adopted to make clear liver tissue pathology. According to TCM classification criteria, CHB patients were divided into five groups: a blood stasis group, a damp heat resistance group, a liver and spleen deficiency group, a liver and kidney yin deficiency group, and a spleen and kidney yang deficiency group. In the same period, 12 healthy persons were recruited as a control group. The PD-1 expression was detected with immunohistochemical SP method, and the correlation between expression of PD-1 in liver tissue and TCM syndrome type and liver pathology was analyzed.Results Different degrees of positive cell expression were found in the liver tissue. With the liver inflammation and fibrosis severity, the number of PD-1 positive cells also increased. The PD-1 expression levels varied with mild, moderate, and severe CHB patients (0.24 ± 0.03, 0.36 ± 0.05 vs. 0.43 ± 0.05) , which were statistically significant (P<0.05) . PD-1 expression levels also varied among different TCM type CHB patients, of which, PD-1 expression of blood stasis type was the highest (0.35 ± 0.04), while the liver and spleen deficiency type was the lowest (0.23 ± 0.03).Conclusion The expression levels of PD-1 has a certain correlation with the patients illness, chronic mechanism, and TCM syndromes. CHB patients can be treated by controlling the expression of PD-1.

AIM:Todetecttheeffectofspironolactoneonhyperthyroxine-inducedatrialremodeling.METH-ODS:New Zealand rabbits were divided into control group ( C ) , hyperthyroxine group ( H ) and spironolactone group ( S) .Thyroxin was given to the rabbits in group H and group S by intraperitoneal injection for 4 weeks , and then spirono-lactone was given in group S by gavage for 2 weeks.Atrial fibrillation (AF) was induced by burststimulation after ad-ministration.The inducing rate of AF and atrial effective refractory period ( AERP) were tested by intra-cardiac electro-physiologic instrument.The expression of AF-related Ca2+channel (Cav1.2), K+channels (Kv1.5 and Kv4.3) and con-nexins (Cx40 and Cx43) at mRNA and protein levels was detected by real-time PCR, immunohistochemistry and Western blot.RESULTS:Spironolactone reduced the inducing rate of AF .No significant difference of AERP between group H and group S was observed (P>0.05).Compared with group H, the protein expression of Cav1.2 was significant increased in group S (P<0.05).The expression of Kv1.5 at mRNA and protein levels in group S was significantly lower than that in group H (P<0.05), while the protein expression of Kv4.3 in group S was significantly decreased compared with group H (P<0.05).The mRNA expression of Cx43 in group S was significantly decreased compared with group H (P<0.01), whereas the protein expression of Cx 40 in group H was significantly higher than that in group S ( P<0.05 ) .CONCLU-SION:Spironolactone attenuates the hyperthyroxine-induced atrial remodeling in rabbits , and reduces the susceptibility of the myocardium to AF .

By analyzing the situation that large general hospitals face at present in their development and the background of reform in the system of overall responsibility by the attending physician in the hospital, the authors offer an account of the guiding ideology for large general hospitals to adopt the system of overall responsibility by the attending physician, the specific steps taken and the initial results attained. They also discuss the impact of the system of overall responsibility by the attending physician on the hospital from the perspectives of human resources, technological innovation, managerial system, and information system. The positive significance of the system of overall responsibility by the attending physician in the management of the hospital reform is also identified.

To observe the incidence of high intraocular pressure ( lOP ) and its risk factors in the early stage (within 7d) after 23 - gauge sutureless microincisional vitrectomy.
●METHODS: Retrospective case series study. Totally 98 patients ( 98 eyes ) who had undergone 23 - gauge sutureless microincisional vitrectomy were enrolled. lOP was measured by non-contact tonometry. High lOP was defined as an lOP > 25mmHg at any time within 7d after surgery. The influence of age, sex, side of operation, course of disease, primary disease pre - operation, reoperation, surgical options, type of tamponade, status of lens, surgical time on postoperative high lOP were analyzed.
● RESULTS: High lOP was found in 33 eyes ( 33. 7%) within 7d after surgery. High lOP was found in 8 eyes on postoperative 1d, the incidence was 24. 2% (8 / 33), and 25 eyes was found on postoperative 3d, the incidence was 75. 8% (25 / 33). The incidence of high lOP of male and female were 32. 8% ( 20 / 61 ) and 35. 1% ( 13 / 37 ) respectively. The incidence of high lOP of right and left eye were 36. 8% (21 / 57) and 29. 3% (12 / 41) respectively. There were no significant differences comparing age (Z =-0. 22), sex( χ2 = 0. 057), side of operation( χ2 = 0. 612), course of disease (Z= -0.079) and surgical time (Z= -0. 553) between patients with high lOP and those without it (P>0. 05). Similarly, no statistical significance was found between eyes with gas tamponade and silicone oil tamponade (χ2 = 1. 04), traumatic eyes and non traumatic eyes(χ2 = 0. 044), and retinal detachment eyes and without retinal detachment eyes ( χ2 = 2. 282, P > 0. 05 ). The incidence of high lOP in eyes with several operations was higher than that in eyes with the first operation ( χ2 =5. 211,P< 0. 05), in eyes with combined operations eyes was significantly higher than that in eyes with pure vitrectomy (χ2 = 4. 57,P< 0. 05), and in eyes with aphakic eye was higher than that in eyes with phakic eyes ( χ2 =4. 224,P<0. 05).
●CONCLUSlON:High lOP occurs commonly in 3d after 23- gauge sutureless microincisional vitrectomy. The risk factors of high lOP are reoperation, combined operations and aphakic eye.

Objective To evaluate the value on screening of diabetic retinopathy with digital fundus photography.Design Prospective observational case series.Participant Consecutive 108 patients with typeⅠand typeⅡdiabetes mellitus,without proliferat- ed diabetic retinopathy determined by dilated ophthalmoscopy in Beijing Tongren Hospital.Methods All the patients received six-fields color fundus mydriatic photography after mydriasis and fundus fluorescein angiography.Diagnosis and grading were made based on fun- dus photography of one-field,two-fields,and six-fields.Fundus fluorescein angiography served as the reference standard.Main Out- come Measures Sensitivity,specificity and kappa value of kappa analyses.Results In comparison with fundus fluorescein angiography, if taking mild nonproliferative diabetic retinopathy as referable diabetic retinopathy,one-field fundus photography gave a sensitivity of 73.21%,a specificity of 88.64%,and a kappa statistic of 0.46,while two-fields fundus photography gave a sensitivity of 75.00%,speci- ficity of 86.36%,and a kappa statistic of 0.47,and the six-fields fundus photography gave a sensitivity of 76.05%,specificity of 87.80% and a kappa statistic of 0.48.If taking moderate nonproliferative diabetic retinopathy as referable diabetic retinopathy,one-field fundus photography gave a sensitivity of 72.46%,a specificity of 93.01%,and a kappa statistic of 0.68,while two-fields fundus photography gave a sensitivity of 73.91%,specificity of 93.01%,and a kappa statistic of 0.69,and the six-fields mydriatic digital photography gave a sensitivity of 75.36%,specificity of 92.81% and a kappa statistic of 0.70.In comparison with six-fields fundus photography,one-field fundus photography gave a kappa statistic of 0.97.Conclusion One-field mydriatic digital fundus photography centered at fovea for screening of early diabetic retinopathy especially stage DR2 or more severe is feasible

Objective: To compare the effects of traditional and limited resuscitation on mediators of inflammation and the lung injury in a rat model of hemorrhagic shock. Methods: Seventy-two male Spra-gue-Dawley rats were challenged with hemorrhage followed by unresuscitation or resuscitation with 6 mL/kg blood withdrawl and lactated Ringer's solution of 45 mL/(kg · h) ,30 mL/(kg · h) or 15 mL/ (kg · h). Rats were sacrificed at 24 hrs, 48 hrs and 72 hrs, respectively. Blood was withdrowed for testing plasma levels of lactic acid and TNF-α. Lungs were harvested for observation of the ratio of wet/dry weight and histology. Results: The unresuscitation group were dead within 2 ～ 12 hrs, while the resuscitation groups were survival. The MAP of group 15 mL/(kg · h) increased slowly, but the MAP of 30 and 45 mL/(kg · h) groups increased rapidly. The plasma levels of TNF-α at 24 and 72 hrs and the lactic acid at 24 hrs in group 45 mL/(kg · h) were higher than that of group 15 and 30 mL/(kg · h) (P < 0. 05). The ratio of W/D weight of lungs at 48 and 72 hrs in group 15 mL/(kg · h) was lower than that of group 45 and 30 mL/(kg · h)(P<0.05). The lung injury was alleviated in pace with the time elapsing. The lung injury was more severe in group 45 mL/(kg · h) than the other two groups in 24, 48 and 72 hrs(P <0. 05). Conclusion: Limited fluid resuscitation could decrease the plasma levels of TNF-α and lactic acid,and attenuate the lung injury.

0.05). Conclusions Our study does not support a positive association between Chlamydia pneumoniae infection or reinfection and MS. Chlamydia pneumoniae may be a bystander pathogen.