Objective To investigate the clinical and pathological features of Wegener granulomatosis to improve the management of it. Methods Twenty-three patients with Wegener granulomatosis were analyzed retrospectively. Results The average age at onset was 37.2 years (range from 20~57 years). The average interval from clinical symptoms presentation to diagnosis was 5.8 months. The initial symptom of 23 cases was the upper respiratory tract involvement (48%). The patients had multiple system and organ involvement. 87% patients with WG had lung involvement and 78% patients had glucocorticoids. Seventeen out of 23 were cANCA (74%) positive. The pathological manifestations included necrotizing granulomatosis and vasculitis. Conclusion Clinical manifestation of WG is complicate, including multiple system and organ involvement. The upper and lower respiratory tract and kidney are the most commonly involved organs. Necrotizing granulomatosis and vasculitis are the pathological features of WG.

Objective To study the effect of clopidogrel on different CYP2C19 genotypes and platelet reactivity in acute cerebral infarction patients with antiplatelet aggregation.Methods Four hundred and seventy-four cases of cerebral infarction patients in Beijing Tiantan Hospital Affiliated to Capital Medical University from April 2015 to April 2016 were collected.CYP2C19 genotype was determined,and the genotype was divided into the wild type group,the heterozygous type group and the mutant homozygous group.Platelet aggregation inhibition rate(ADP%) and platelet reactivity index induced by ADP were detected.Patients were divided into clopidogrel resistance group(group CR) and non resistant group according to whether ADP% was less than 30.SPSS 16.0 statistical software was used for statistical analysis,the comparison between groups using independent samples t test,chi square test and multivariate analysis using Logistic regression analysis,when P<0.05 difference was statistically significant.Results Among the 474 patients,204 cases(43.04%) were divided into wild-type group,and 204(43.04%) and 66(13.92%) were divided into the mutant heterozygous group and mutant homozygous group.In Chi square test analysis,clopidogrel resistance group and non resistance group CYP2C19 genotype distribution was significantly different(χ2=6.658,P=0.036).CR group angle(α) values((68.87±5.47)°) and MA((66.77±6.25) mm) were higher than that of CS group ((66.55±6.05)° and (63.30±5.66) mm,t=2.199,3.387,P=0.029,0.001).The multivariate logistic regression analysis showed that OR of angle level was 1.028,95%CI was 0.929-1.137 (P=0.595);OR of Ma level was 1.561,95%CI was 0.785-0.970 (P=0.012).Conclusion The effect of clopidogrel on platelet aggregation in patients with acute cerebral infarction is decreased by CYP2C19 gene mutation.CYP2C19 mutant allele is a risk factor for clopidogrel resistance.Angle (α) value and MA value are the risk factors for the diagnosis of CR in the patients with acute cerebral infarction,and the risk of clopidogrel resistance increased when the patients′ Angle (α) value and the value of MA increased.MA value as a predictor of CR and the screening tool has a certain value.

AIM: To detect the effects of Xinmailing Solution and MK-801 on injury of neuronal cell induced by glutamate. METHODS: Cultured neuronal cell injuried by glutamate was prepared and the content of malondialdehyde and nitrite in cell supernatant was measured. Morphology changes were also observed with discrepancy microscope at the same time. RESULTS: Xinmailing Solution and MK-801 attenuated cell injury induced by glutamate,and inhibited increase in malondialdehyde and nitrite in cell supernatant. CONCLUSION: Xinmailing Solution had a protective effect on neuronal cell at cell level.

Objective To analyze the prevalence of human papilloma virus(HPV) and the relationship between HPV and vaginal environment in puerperium women.Methods One thousand and twenty-nine cases puerperium women were detected for HPV subtype by using nucleic acid flow-through hybridization.Patients with HPV positive had been considered as observe group and the rest as control.The prenatal infection of HPV of HPV-DNA positive and negative postpartum puerperium women, and the vaginal cleanliness of prenatal and postpartum were analyzed.Results In 1 029 cases puerperium women, the total HPV-DNA positive rate was 10.30％(106/1029) ,and high risk infection rate was 95.65％ (110/115).The rate of HPV positive before pregnant in HPV positive group (46.51％, 40/86) was higher than that in HPV negative group (9.09％, 10/110).There was significant difference of vaginal environment in the two groups (x2 =36.567, P＜0.05).In HPV-DNA positive and negative women during the puerperium vaginal cleaning degree of Ⅰ , Ⅱ ratio prenatal respectively were 56.98％ (49/86) and 76.36％ (84/110), and the difference was significant (x2 =8.317, P ＜0.05).Postpartum to 45.35％ (39/86) and 60.00 (66/110), and the difference was significant (x2 =3.941, P＜0.05).Conclusion The HPV infection of pregnant women are easy to getagain.There is relevance between HPV infection and vaginal environment.

Objective To investigate 13 high-risk types of HPV (HR HPV) infection rates in women with different grades of cervical lesions.Methods A total of 350 women, who were hospitalized in the department of gynecology in Bao′an Maternity & Child health hospital, were enrolled for the study.TCT technology was used to evaluate the cervical epithelium.The group were divided according to the cytology results.Multiplex real time PCR (mRT PCR) was used to detect the viral loads.HR HPV infection rate of different groups were analyzed using χ2 test or Fisher exact test.HR HPV viral loads of patients in different grades of cervical lesion groups were compared using Kruskal-Wallis or Wilcoxon test, and the age distribution of HR HPV positive group and negative group was analyzed by using Wilcoxon test.Results The HR HPV infection rates of NILM, ASCUS, LSIL, HSIL were 3.4% (10/295), 20.0% (7/35), 78.6% (11/14) and 100.0% (6/6), respectively.HR HPV positivity in NILM was lower than ASCUS (χ2=14.43,P<0.01) and LSIL (χ2=107.69,P<0.01), HR HPV positivity in ASCUS was lower than LSIL (χ2=14.76,P<0.01). The median of HR HPV viral loads in NILM, ASCUS, LSIL and HSIL were 4.10 (3.38-6.27), 5.33 (3.63-6.66), 5.77 (4.01-7.01) and 5.58 (4.19-5.85) respectively (copies/ml,lg).Combined ASCUS, LSIL and HSIL groups into cervical lesion group, HR HPV viral load of which was higher than that of NILM (U=43.0, P<0.05).The median Ages of HR HPV positive group and negative group were 36 and 33, respectively.No statistical significance was found between them (U=4 544, P>0.05).Conclusions The present study revealed that HR HPV infection was related to cervical lesion, but there was no correlation between viral load and cervical lesion grade. In additional, no difference in age distribution was found between HR HPV positive group and negative group.

OBJECTIVEThe automatic generation of planning targets and auxiliary contours have achieved in Eclipse TPS 11.0.

METHODSThe scripting language autohotkey was used to develop a software for automatically generated contours in Eclipse TPS. This software is named Contour Auto Margin (CAM), which is composed of operational functions of contours, script generated visualization and script file operations. RESULTS Ten cases in different cancers have separately selected, in Eclipse TPS 11.0 scripts generated by the software could not only automatically generate contours but also do contour post-processing. For different cancers, there was no difference between automatically generated contours and manually created contours.

CONCLUSIONThe CAM is a user-friendly and powerful software, and can automatically generated contours fast in Eclipse TPS 11.0. With the help of CAM, it greatly save plan preparation time and improve working efficiency of radiation therapy physicists.

Objective To construct a large animal model of ischemic heart disease induced by acute myocardial infarction (AMI) . Methods Male Diannan Mini-pigs were selected (n=8), weight 20 ± 4 Kg. After general anesthesia and endotracheal intubation, blood pressure and electrocardiograph were monitored. Parasternal incision was taken and thoracotomyv was performed at 4th-to-5th intercostalgap. Pericardium was opened and left anterior descending artery was ligated. Echocardiography was performed at baseline, postoperative 28 and 60 day. Euthanasia and heart explanted was conducted at 60 day of experimental pig. After gross examination of the heart, the histological examination was used to assess myocardial infarction by using H&E staining. Results All of the pigs were presented with ventricular arrhythmias in varying degrees after ligation of the left anterior descending artery, of whom 2 died of refractory ventricular fibrillation, the mortality was 25%. Echocardiography assessment showed the loss left ventricular function, the thinning of left ventricular apical and the enlargement of left ventricule. Histological examination revealed that myocardial fibrosis and fibrous scar were formed in myocardial infarction area. Conclusion The ligation of left anterior descending artery through thoracotomy under direct vision is a reliable strategy for construction of AMI porcine model and the experimental porcine can develop ischemic cardiac dysfunction progressively.

Objective To establish the theoretical basis of the probiotic application among very low birth weight(VLBW) infants,the efficacy of probiotics on the gut microbiota of VLBW infants on the 14th postnatal day was studied.Method The VLBW infants admitted to BaoAn Maternal and Child Care Hospital from January 2015 to December 2015 were randomly assigned into probiotics group and placebo group.From the first feeding to corrected gestational age of 36 weeks,probiotics group was treated with a combination of Bifidobacterium and Lactobacillus while placebo group with placebo.Fecal samples were collected on the 1st and 14th postnatal day.Total bacterial DNA was extracted and sequenced using high-throughput 16S rRNA gene sequencing on MiSeq sequencing platform.Result A total of 21 VLBW infants were enrolled,9 in probiotics group and other 12 placebo group.No significant differences of clinical data existed between the two group (P ＞ 0.05),The abundance and diversity of microflora (P ＞ 0.05) on the first day between the two group were similar.Compared with placebo group,the relative abundance of Bifidobacterium and Lactobacillales in stool samples on the 14th day was significantly increased,while the Halomonas was significantly decreased.The relative abundance of the Shannon-index was increased,but without significant difference (P =0.16).Conclusion Enteral supplementation of probiotics in VLBW infants may increase probiotic bacterium and microflora diversity.

Objective To investigate the immune cell population change during the anesthesia process in patients undergoing craniotomy surgery. Methods A total of 18 patients undergoing craniotomy who had an inhalational general anesthetic were selected as our subjects. Blood samples were collected before anesthesia (T0)and 30 min(T1),45 min(T2),60 min(craniotomy operated,T3),120 min(tumor resected,T4)and 240 min(T5)after anesthesia. Blood cell counts including neutrophils,monocytes and lymphocytes were determined along with lymphocyte subpopulations( T cells,inducer and helper T cells,suppressor and cytotoxic T cells,NK cells,B cells ). Data were analyzed by SPSS 13. 0 software. Results In terms of the immune cell during neuroanesthesia,induction neutrophils,monocytes and lymphocytes decreased significantly from( 4. 50 ± 2. 00 ) × 109/L(,0. 51 ± 0. 22)× 109/L,(1. 90 ± 0. 70)× 109/L to(3. 10 ± 1. 50)× 109/L,(0. 32 ± 0. 17)× 109/L, (1. 10 ± 0. 50)× 109/L at the 30 min after anesthesia,and the differences were significant( P﹤0. 05). It also showed that Ts and NK cells decreased significantly from( 0. 55 ± 0. 29 )× 109/L,( 0. 32 ± 0. 14 )× 109/L to (0. 33 ± 0. 22 )× 109/L,( 0. 10 ± 0. 08 )× 109/L at the 30 min after anesthesia,and the differences were significant( P﹤0. 05 ). Conclusion Special and non special immune system are inhibited during craniotomy, especially at the early anesthesia. Among the inhibited immune cells,neutrophils recover early and followed Ts and NK cells.

Objective To investigate the relationship between serum homocysteine ( Hcy ) and cognitive impairment in patients with cerebral infarction combined chronic obstructive pulmonary disease (COPD) after stroke, and observe the plasma Hcy levels and cognitive function improvement when treated with folic acid and vitamin B12 .Methods 87 acute cerebral infarction combined with COPD patients as the research object, then the general clinical data were recorded, hematology indexes ( Hcy, folic acid, vitamin B12 ) were determined, and their cognitive function with a simple mental state scale (MMSE) was assayed.According to the plasma Hcy levels, the subjects were divided into Hcy-normal group (n =21) and Hcy-increased group (n=66), then compare the cognitive function between the two groups.Hcy-increased subjects were randomly divided into intervention group (conventional treatment +folic acid 2.5 mg +VitB12 0.5 mg) and control group (conventional treatment).After six months follow-up, we retested plasma Hcy levels and MMSE assessment, comparison of plasma Hcy concentration change and cognitive function improvement between two groups.Results Compared with Hcy-normal group, plasma folic acid, VitB12 levels significantly decreased in Hcy-increased group (P<0.05).And Hcy concentration was negatively correlated with folic acid(r=-0.351,P =0.000)and VitB12(r=-0.242,P=0.015)levels.In addition, the MMSE, directional force and delayed recall score decreased in Hcy-increased group compared with the Hcy-normal group ( P<0.05 ).Hcy levels were significantly lower than the baseline level (P<0.05), MMSE and the sub-project of cognitive function score increased after treated with folic acid and VitB12 for six months, although there was no statistically significant difference.Conclusion Plasma Hcy level is associated with cognitive impairment in patients with cerebral infarction combined chronic obstructive pulmonary disease (COPD), patients treated with folic acid and VitB12 may help slow the recent cognitive dysfunction after stroke in the near future.