Objective To study the association between the CTLA-4 gene polymorphism and Graves disease.Methods A total of 120 unrelated patients with Graves disease southern Han nationality of China were recruited from clinics in the Department of Endocrinology and Metabolism,the First Affiliated Hospital of Sun Yat-sen University from 2001 to 2003.Ethnically matched 123 control subjects with no history of autoimmune disease were from Guangdong.We investigated the polymorphism of the cytotoxic T lymphocyte antigen 4 gene on chromosome 2q33.1 microsatellite markers of CTLA4 were chosen,this was done by PCR amplification of marker sequences using fluorescently labeled primers and subsequent analysis of the PCR products on ABI prism 377.Results Twenty alleles were observed in the population,with sizes ranging from 84 to 144 bp.There was no significant difference when compared with controls in the distribution of the genotypes(?2=21.428,P=0.208).This investigation indicated that the gene of CTLA4 was not susceptible gene for Graves disease.Conclusion This study suggests that CTLA4 gene may not be susceptible gene to Graves disease for the Chinese southern Han population.

Objective To probe into the optometry students' acceptability of interactive teaching mode by the questionnaire survey.Methods Totally 207 optometry students including 42 five-year undergraduate students,17 seven-year program students,95 three-year postgraduate students and 53 three-year junior college students were investigated for their acceptability of interactive teaching mode by the questionnaire survey.Results The results showed that 63.3％ of the students preferred traditional teaching mode; 70％ of the students would like to accept interactive teaching mode,the others didn't accept it or hesitated to accept it.Lack of self-confidence was the major reason.Conclusions Most medical college students are willing to accept the interactive teaching mode.Interactive teaching mode should be combined with traditional teaching mode.

Background Phakic posterior chamber implantable contact lens (PPC-ICL) or phakic posterior chamber Toric implantable contact lens (PPC-TICL) implantation is an effective way for the correction of high myopia or high myopia with astigmia,but it often has residual myopic power.Excimer laser-assisted subepithelial keratectomy (LASEK) can correct the residual myopia following PPC-ICL or PPC-TICL,but its effectiveness and safety deserve attention.Objective This study was to analyze the clinical effectiveness and safety of LASEK for residual myopia after PPC-ICL implantation for extreme high myopia.Methods A prospective cases-observational study was performed,and written informed consent was obtained from each patient before any surgery.Fourteen eyes of 9 patients with residual myopia following PPC-ICL or PPC-TICL for the eyes with spherical equivalent refraction of ≥-20.00 D were collected in the Affiliated Hospital of Guizhou Medical University from July 2010 to March 2015,including PPCICL implantation in 8 eyes and PPC-TICL implantation in 6 eyes.LASEK were performed on the eyes to correct the residual myopic power.Uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),haze,the distance of intraocular lens to lens,corneal thickness,corneal topography,corneal endothelial cell counting,intraocular pressure (IOP) and fundus were examined and compared before and after surgery.The effectiveness and safety of the surgery were evaluated.Results The operation was smooth and no complication was found after surgery in all of the eyes.The UCVA and BCVA were significantly different in the eyes among before surgery,6 months after PPC-ICL implantation and 12 months after LASEK (F =31.360,1.778;both at P＜0.05),and the UCVA after LASEK was higher than BCVA before LASEK.The refractive powers were (-22.27-±4.29),(-3.75±2.25) and (-0.42±0.63) D before surgery,6 months after PPC-ICL implantation and 12 months after LASEK,showing a significant difference among them (F=46.370,P＜0.05),and the refractive power was considerably lower after LASEK than that before surgery and after PPC-ICL implantation (both at P＜0.05).No significant difference was found in IOP or corneal endothelial cell counting in operated eyes among before surgery,6 months after PPC-ICL implantation and 12 months after LASEK (F=1.663,1.055;both at P＞0.05).The distance of intraocular lens to lens was (0.69±0.26)mm in the eyes after LASEK and (0.71 ±0.29)mm in the eyes after PPC-ICL implantation,with no significant difference between them (t =0.192,P＞0.05).Conclusions PPC-ICL or PPC-TICL implantation for the correction extreme high myopia often remains a certain degree of myopia,and LASEK for the correction of residual refractive power is safe and effective.

Objective To explore the reliability of the modified Penn spasm frequency scale (MPSFS),the spinal cord assessment tool for spasticity (SCATS),the spinal cord injury spasticity evaluation tool (SCI-SET) and visual analogue scales (VASs) and their inter-correlation so as the provide evidence for clinical application.Methods The spasticity of thirty-five patients with spinal cord injury was assessed by 2 raters using the 4 scales with an interval of half an hour between assessments.Three days later,all of the subjects were again evaluated by one of the 2 raters in the same environment.The intra-class correlation coefficient (ICC),standard error of measurement (SEM) and minimal detectable difference (MDD95) were calculated,and the correlations among the 4 scales were analyzed.Results The test-retest ICC for the MPSFS was 0.94 and the inter-rater reliability ICC was 0.90.For the SCATS they were 0.948 and 0.939 respectively.,For the VAS they were 0.962 and 0.974,and for the SCI-SET they were 0.969 and 0.989.There was significant inter-correlation among all four scales,with negative correlation between the SCI-SET and the others.The observed correlations were all of medium strength (r=-0.421 to-0.5),except for a high correlation between the SCI-SET and VAS results (r=0.55 to 0.94).Conclusion The MPSFS,SCATS,VAS and SCI-SET are all reliable tools for evaluating spasticity among people with spinal cord injury.All can be applied in clinical practice.

Objective To assess the clinical features and associated factors of interstitial lung disease (ILD) in patients with dermatomyositis (DM).Methods Clinical data were retrospectively analyzed on 206 patients with DM collected at the Department of Dermatology,Huashan Hospital,Fudan University in the past 6 years.Chi-square test and t test were performed for statistical analysis.Results The prevalence of ILD was 49.03％ in the 206 patients with DM.Heliotrope rash on the upper eyelids,Gottron's sign (papules),arthralgia,and cough were correlated with the incidence of ILD in DM patients (all P ＜ 0.05),and of these factors,the prevalence of artharalgia and cough were positively correlated with the incidence of ILD,while the presence of Gottron's papules was negatively correlated.The patients with DM and ILD showed a higher prevalence of abnormal serum levels of lactate dehydrogenase (LDH),hydroxybutyrate dehydrogenase (HBDH) and anti-Jo-1 antibodies,as well as with a poorer pulmonary function,compared with those suffering from DM only (all P ＜0.05).Characteristic imaging findings on computed tomography (CT) scan in patients with DM and ILD included linear opacity (57.4％),high-density patchy opacity (31.7％),reticular opacity (16.8％) and even ground glass-like opacity (13.8％),usually at the bottom or apex of the lungs.Conclusions In patients with DM,the prevalence of artharalgia and cough is positively correlated,whereas the presence of Gottron's papules is negatively correlated,with the incidence of ILD.Characteristic imaging findings on CT scan in patients with DM and ILD are linear opacity,high-density patchy opacity,reticular opacity and ground glass-like opacity at the bottom and apex of lungs.

OBJECTIVE: To provide reference of the ideal entry point for antegrade femoral nailing according to analysis correlation between highest point of greater trochanter and the middle line of the medullary cavity in adults by three-dimensional images. METHODS: From January 2016 to January 2017, 107 adults who underwent continuous computed tomography (CT) scans were ultimately enrolled, including 64 males and 43 females with an average age of (51.7±16.4) years old;54 patients on the left side and 53 patients on the right side. Three-dimensional images were built by using image-processing software (Volume Viewer) to reconstruct geometry of cortex and medullary canal. All people weregrouped according to different femoral greater trochanter morphology, such as anterior apex (AA), posterior apex (PA), middle apex (MA) and none apex (NA). Forwards inclination was adjusted to apparent neck shaft angle (ANSA) and true neck shaft angle (TNSA) on the coronal and saggittal view, recorded as C-ANSA, C-TNSA, S-ANSA, S-TNSA respectively, vertical distance from the middle line of femur medullary cavity to the highest point of greater trochanter of femur on the 4 positions were measured and performed statistical analysis, multiple linear regression was applied to analysis relationship between clinical data and VD value. RESULTS: (1)Comparison of VD value among 4 groups on the 4 positions, there were no difference in VD value between AA and MA groups on the S-ANSA position;and no differences in VD value among AA, MA and NA groups on the C-ANSA and C-TNSA position. (2)There were differences in VD value among AA, MA and NA groups on the sagittal plane;while had difference in VD value between PA and NA group on the coronal plane. (3)Prediction equation of VD value on S-ANSA and S-TNSA position by multiple linear regression showed R=0.343, F=3.409, =0.012 on the S-ANSA position;R=0.317, F=2.846, =0.028 on the S-TNSA position; neck shaft angle and sex were risk factors of VD value on the sagittal plane, while no difference in VD value on the coronal position. CONCLUSION (1)When indentify insertion point in adult femoral nail according to the highest point of greater trochanter as anatomic landmark, the morphology of greater trochanter of femur should be distinguished to certain observation position, then evaluate migration before and after on the sagttial plane and lateral offset on the coronal plane. (2)Migration before and after on the sagttial plane is increase with increase of neck shaft angle, and the degree of migration of female before and after is less than that of male.
Adult ; Aged ; Female ; Femur ; Fracture Fixation, Intramedullary ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Tomography, X-Ray Computed

OBJECTIVETo make a study of the effect of Chaihu Shihuang soup on blood serum level TNF, IL-6 and IL-10 of severe acute pancratitis.

METHODSixty SAP cases were divided at random into treatment group and control group (30 cases each). The treatment group were given chai-hu-shi-huang-soup once a day; the control group were given Dachaihu soup once daily, with both treatment period for 7 days. The tumor necrosis factor-alpha (TNF-alpha), interleukin level 6 (IL-6) and 10 (IL-10) of both groups were determined before and after the treatment. We also had 30 healthy cases.

RESULTIL-10 level in both groups was lower than healthy group while TNF-alpha and IL-6 were higher than healthy group (P < 0.01). After treatment, the treatment group's TNF-alpha, IL-6 level were comparatively lower than that in the control group (P < 0.01), and IL-10 level were clearly higher than that of the control group (P < 0.01), comparison of the treatment group before treatment (P < 0.01).

CONCLUSIONChaihu Shihuang soup can significantly regulate cytokine and improve early recovery of SAP.

Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Interleukin-10 ; blood ; Interleukin-6 ; blood ; Male ; Middle Aged ; Pancreatitis, Acute Necrotizing ; blood ; drug therapy ; Tumor Necrosis Factor-alpha ; blood

Background: It is unknown if medication-overuse headache, clinically similar to chronic tension-type headache, has pre-attentive problems which may be related to pain or substance abuse. Methods: Auditory frequency deviance elicited mismatch negativity was recorded from 22 patients with chronic tension-type headache, 26 with medication-overuse headache from underlying chronic tension-type headache and 41 healthy volunteers as controls. Their depression and anxiety scores were noted. Results: There were no signifi cant differences in the N1 latency or amplitude to both standard and deviant stimuli for the different groups. However, the latency and amplitude of mismatch negativity were signifi cantly shortened and reduced at Fz, Cz, and Pz in medication-overuse headache as compared to chronic tension-type headache and normal subjects. Anxiety levels were elevated in chronic tensiontype headache and medication-overuse headache subjects compared to healthy controls but were not correlated with mismatch negativity latency or amplitude in a given group. Conclusions: In medication-overuse headache subjects, the shortened mismatch negativity latency indicates quick involuntary attention switching to auditory change, while its reduced amplitude indicates poor accuracy in discriminating early stimuli, which may be related to medication overuse rather than to the head pain experienced.

Objective To analysis of risk factors for left atrial thrombosis in patients with rheumatic mitral stenosis.Methods From January 2001 to December 2008, 2277 patients with rheumatic mitral stenosis underwent operations in our hospital. There were 737 males and 1540 female, the age ranged from 19 to 84 years [average (50.9 ±10.2) years]. Left atrial thrombosis group (554 cases) and no thrombosis group (1723 cases) were divided, retrospectively collected data were analyzed with univariate and multivariate Logistic regression. Results 12 bvariables, including age, mitral valve orifice area, left atrial diameter, left ventricular diastole diameter, CRP, gender , degree of mitral stenosis, or regurgitation, degree of bicuspid regurgitation, degree of pulmonary hypertension, atrial fibrillation and heart function had statistic difference between two groups. With multivariate Logistic regression for these 12 factors, age, mitral valve orifice area, left atrial diameter, degree of mitral regurgitation and atrial fibrillation were found to be the affecting factors for left atrial thrombosis in patients with rheumatic mitral stenosis. Conclusion For patients with rheumatic mitral stenosis, age, mitral valve orifice area, left atrial diameter and atrial fibrillation are the risk factors for left atrial thrombosis. Mitral regurgitation is a protective factor for left atrial thrombosis.

OBJECTIVETo make a study of the influence of the intervene of traditional Chinese medicine on cytokine level in benign prostatic hyperplasia.

METHODThe patients were divided into treatment group (group A), control group (group B) and healthy group (group C) with the randomly compared researching method. Group A were given Qianliening Tang (QLNT), daily potion, two times a day. Group B were given Qianliekang, three times a day, three pills each time. The course of both treatment lasted for 8 weeks.

RESULTBefore treatment, TNF-alpha, IL-17/IL-10, IL-4 in group A and B are obviously out of order compared with group C (P < 0.01). After the treatment, TNF-alpha, IL-17 in group A decreased dramatically and IL-10, IL-4 increased, which shows great differences compared with those before treatment and with group B (P < 0.01), but still can't reach to group C level.

CONCLUSIONQian liening Tang can efficiently regulate the level of suppressive inflammatory cytokines and proinflammatory cytokines. It provides scientific experimental basis for clinical diagnosis and treatment of the disease.

Adjuvants, Immunologic ; Aged ; Aged, 80 and over ; Cytokines ; blood ; Drugs, Chinese Herbal ; pharmacology ; Humans ; Interferon-gamma ; blood ; Interleukin-10 ; blood ; Interleukin-17 ; blood ; Interleukin-4 ; blood ; Leukocytes, Mononuclear ; drug effects ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Phytotherapy ; Prostatic Hyperplasia ; blood ; drug therapy ; RNA, Messenger ; Synovial Membrane ; drug effects ; Tumor Necrosis Factor-alpha ; blood