In view of the fact that the current concept of asymptomatic period of HIV infection can not express the disease development in this period accurately,and easily lead to ambiguity,the author proposed the concept of‘chronic progress phase’on basis of long-term clinical and scientific research.The author thought that the so-called asymptomatic period of HIV infection had many signs and symptoms of clinical significance,besides the syndrome can be identified,thus it was of great significance for the diagnosis and treatment of AIDS.The concept of‘chronic progress phase’being in accordance with the actual disease evolution,was a more scientific appellation and had been widely accepted by the industry.

Objective To evaluate the diagnostic value of magnetic resonance urography(MRU)in patients with iatrogenic ureteral injuries.Methods MRU in 12 patients with iatrogenic ureteral injuries caused by gynecological and rectal operation were performed.Results MRU examinations were successfully done in all cases at once.The accurate rate in localized and qualitative diagnosis was all 100%.The injures of ureter in 12 cases were all located at lower segment of the ureter,of them,8 patients were purely obstruction,4 cases were obstruction with urinal leakage,all cases were accompanied by dilations of ureter and hydronephrosis.Conclusion MRU is helpful for the diagnosis of iatrogenic ureteral injury.

BACKGROUND:Few cases of acute cerebral embolism were treated by mechanical thrombectomy al over the world. However, there were few cases currently treated by mechanical thrombectomy using Penumbra system. It is an unclear understanding of effects on regional cerebral blood vessels using this kind of surgery.
OBJECTIVE:To describe effects of numerical simulation on regional cerebral blood vessels of an acute cerebral embolism patient by mechanical embolectomy using Penumbra system.
METHODS:A 77-year-old woman suffering from acute cerebral embolism of left middle cerebral artery was selected. Various raw data were col ected in emergency of digital subtraction angiography, then mechanical thrombectomy using Penumbra system was carried out successful y. After these raw data were processed into dimensional numerical models of two kinds of embolectomy methods (“suction bolt method from near to far”and“suction bolt method from far to near”), and then finite element analysis was carried out.
RESULTS AND CONCLUSION:Model establishment and finite element analysis were successful y conducted. Compared with“suction bolt method from near to far”,“suction bolt method from far to near”models had smal er velocity of flow in catheter and smal er wal shear stress of thrombus (P<0.01), and had larger wal shear stress of blood vessel wal , deformation of blood vessel wal (P<0.01) and deformation of thrombus (P<0.05). Results suggested that finite element analysis of mechanical embolectomy using Penumbra system can help physicians to involve in a clear understanding of their impacts on cerebral blood vessels of patients. As a research method, it is worth to continue to explore in the future.

Objective To study the level and difference of cytokine in COPD patients with lung qi deficiency syndrome and lung yin deficiency syndrome. Methods The level of IL-8, IL-1? and TNF-? in COPD patients were detected respectively. There were 30 cases with lung qi deficiency syndrome and 30 cases with lung yin deficiency syndrome, meanwhile, thirty healthy people were selected as the control group. Results The cytokine level of lung qi deficiency syndrome and lung yin deficiency syndrome was significant higher than that of the health people (P

Objective To study the associated gene expression in thymus-dependent lymopholyte of the COPD patients with pulmonary qi deficiency syndrome(PQDS)and pulmonary yin deficiency syndrome (PYDS)by gene chips.Methods Collect peripheral blood of patients with PQDS and PYDS(as experimental samples)and of nomal man(as control samples).By Ficoll method,peripheral blood lymphocyte was collected,then thymus-dependent lymphocyte were extracted and purified by flow cytometry.Total RNA were extracted by one-step technique and purified.Then,synthesis double strand cDNA template from total RNA,transcription of cRNA probe with biotin labeling,subsequently,cRNA sample were fragmented. The gene chip(Human Genome U133 Plus 2.0 Array,38500 genes)was hybridized and scanned.Then fluorescent signal value of gene expressing was obtained,and differential expression genes were sifted. Results There were 45 genes expressed differently among PQDS and normal man,including up-regulated 41 and down-regulated 4;32 genes expressed differently between PYDS and normal man,including up-regulated 19 and down-regulated 13;5 up-regulated genes expressed differently between PQDS and PYDS with normal man.Conclusion Gene chip can be applied to study gene expression profiles effectively and to screen PQDS and PYDS associated genes.

Objective To summarize the experience in diagnosis and treatment for chronic lymphocytic thyroiditis or complicated with other thyroid diseases. Methods Seventy-seven patients were diagnosed as chronic lymphocytic thyroiditis or complicated with other thyroid diseases by operation and histological examination at this department from November 2002 to March 2005. All their clinical records including general information, the results of careful physical examination, thyroid correlated hormone tests, color Doppler, fine needle aspiration cytological examination and some intraoperative examinations have been retrospectively analyzed in this report. Results There were 53 cases of simple chronic lymphocytic thyroiditis, 10 cases complicated by papillary carcinoma, 1 case complicated by follicular carcinoma, 2 cases complicated by non-Hodgkin’s lymphoma, 6 cases complicated by nodular goiter, 4 cases complicated by follicular adenoma, and 1 complicated by parathyroid adenoma. Almost all the operations were successfull and the symptoms of the diseases were alleviated. Seventy-two patients had been followed up ranging from two months to two years differently and none of them relapsed. Sixty-three of these patients have received thyrine inhibition and vicariousness treatment, 2 patients who complicated by non-Hodgkin’s lymphoma had been hospitalized and 7 patients complicated by carcinoma were treated with iodine-131. Conclusion The clinical manifestations of chronic lymphocytic thyroiditis are complex, and it often complicated with other thyroid disease, which make it difficult to diagnose the diseases before operation. However, some ancillary methods such as careful physical examination, thyroid correlated hormone tests, !color Doppler and fine needle aspiration cytological examination may improve the accuracy of preoperative diagnosis. Intraoperative thyroid lamellar section and frozen histological examination are also very important for intraoperative diagnosis and operative modality selection.

The emerging technologies change rapidly in the medical field, refresh the medical ethical scenari-os, brought some medical ethical blind spot.Therefore, building the platform of academic research, making use of the new media, MOOC and“flipped classroom”, inheriting the native“The Spirits of A Great Physician” in tradi-tional Chinese medicine and western medicine, life ethics education and sublation of new exploration, the ideolog-ical and moral education for medical students is expected to be improved in China.

Objective:To observe expression of NK cells in peripheral blood in the patients of lung-Qi deficiency and lung-Yin deficiency. Methods:CD_(16)/CD_(56) were determined by flow cytometry in 58 cases of lung-Qi deficiency,12 cases of lung-Yin deficiency and 20 cases of healthy persons.Results:Activities of NK cells in both the patient of lung-Qi deficiency and the patient of lung-Yin deficiency decreased;There were significant differences in activities of NK cells among the various groups of lung-Qi deficiency syndrome.Conclusion:The immunological function in the patient of lung-Qi deficiency syndrome developed gradually to immunodepression of different degrees from active state at early stage,and then developed to lung-Yin deficiency syndrome,and finally leading to maladjustment of hemeostasis of immunological system.

Objective To investigate the efifcacy of interferon alpha (IFNα) followed by nucleotide analogues (NAs) treatment in patients with negative hepatitis B e antigen (HBeAg), undetectable serum HBV-DNA and low hepatitis B surface antigen (HBsAg) levels.Methods The enrolled HBeAg-negative chronic hepatitis B patients had undetectable HBV-DNA level (HBV-DNA<1000 copies/mL for at least 12 months) and low HBsAg level (HBsAg≤2000 U/mL) with long-term NAs treatment. These patients switched their therapy sequentially from NAs regimens to IFNα for 48 weeks. The treatment response was evaluated in terms of serum HBV DNA load, serological HBV markers, liver function tests and routine blood test before treatment and 12, 24 and 48 weeks of treatment. The patients were followed up for 24 weeks after treatment. The primary endpoint was HBsAg loss or seroconversion and HBsAg<10 U/mL. Logistic regression analysis was conducted to examine relevant predictive factors. Receiver operating characteristic curve was used to evaluate the value of prior HBeAg seroconversion and on-treatment HBsAg dynamics in predicting HBeAg seroconversion than in HBsAg persistence group (χ2=9.527,P=0.002). HBsAg loss was more likely in the patients who had HBsAg decline at least 0.5 log U/mL from baseline at week 12 of treatment (χ2=16.576,P<0.001). The area under the ROC curve for prediction of HBsAg loss was 0.810 (95 %CI, 0.686 to 0.935,P<0.001).Conclusions The HBeAg-negative chronic hepatitis B patients with positive virological response and low HBsAg level after NAs treatment are more likely to achieve HBsAg clearance when switched to IFNα treatment. Prior HBeAg seroconversion and on-treatment HBsAg dynamics are useful in predicting and guiding IFNα sequential therapy.

OBJECTIVE:To observe clinical efficacy and safety of Carboxymethylstarch sodium solution in auxiliary treatment of pediatric bronchial asthma. METHODS:Totally 102 children with bronchial asthma selected from our hospital during Mar. 2015-Mar. 2016 were divided into observation group and control group according to admission order,with 51 cases in each group. Control group was given aerosol inhalation of Budesonide suspension for inhalation 0.5-1 mg,tid+ aerosol inhalation of Ipratropi-um bromide solution for inhalation 1-2 mL+Ambroxol hydrochloride and clenbuterol hydrochloride oral solution 2.5-15 mL,po, bid. Observation group was additionally given Carboxymethylstarch sodium solution 7 mL(1-<4 years old),10 mL(4-12 years old),po,tid. Both groups received treatment for 3 months. Clinical efficacy,the time of cough and wheezing relief,the time of lung wheezing disappearance,hospitalization time and the levels of immune indexes (IgG,IgM,IgA) were observed in 2 groups, and the occurrence of ADR was recorded. RESULTS:Total response rate of observation group(90.2%)was significantly higher than that of control group(70.6%),and the time of cough and wheezing relief,the time of lung wheezing disappearance and hospitaliza-tion time of observation group were significantly shorter than those of control group,with statistical significance (P<0.05). There was no statistical significance in the levels of IgG,IgM and IgA between 2 groups before treatment(P>0.05). After treatment,above immune indexes of observation group were significantly higher than before treatment and control group,with statistical significance (P<0.05). No obvious ADR was found in 2 groups during treatment. CONCLUSIONS:Carboxymethylstarch sodium solution in aux-iliary treatment of pediatric bronchial asthma shows good therapeutic efficacy and improves immunity of children with good safety.