Objective To explore the value of somatostatin receptor scintigraphy(SRS) in evaluating the immune activity of orbital inflammatory pseudotumor associated with systemic vasculitis.Methods Twenty-five patients with orbital inflammatory pseudotumor associated with systemic vasculitis (10 males,15 females,average age:(51.2± 14.2) years) underwent SRS.The uptake ratio (UR) of orbital inflammatory pseudotumor was obtained.(1) Patients were divided into group A (with immune activity) and group B (without immune activity) according to Birmingham vasculitis activity score (BVAS).The difference of UR between the 2 groups was compared by two-sample t test.The difference of UR before and after treatment in 12 patients was also compared.(2) Based on the results by BVAS,ROC curve was used to obtain the cut-off value of UR,as well as the diagnostic efficiency and Youden index.The consistency between SRS and BVAS was calculated.(3)Patients were divided into two groups according to the cut-off value of UR and the prognosis difference between them was compared by Fisher exact test.(4)The expression of SSTR2 and SSTR5 was observed by immunohistochemistry.Results (1) UR in group A was significantly higher than that in group B (2.09±0.44 vs 1.32±0.46,t =5.94,P＜0.01).After glucocorticoids treatment,the UR in group A reduced significantly (t=4.07,P＜0.01),but not in group B (t=1.76,P＞0.05).(2)ROC curve analysis identified UR cut-off value as 1.66,with the sensitivity of 87.5％,specificity of 95.7％,positive predictive value of 95.2％,negative predictive value of 88.0％,accuracy of 91.3％ and Youden index of 83.2％.The consistency between SRS and BVAS was strong (Kappa =0.840).(3) The prognosis was significantly different between patients with UR≥ 1.66 and UR＜1.66 (P＜0.05).(4) The immunohistochemical results revealed high expression of SSTR2 and SSTR5 in inflammatory cells in patients with immune activity.Conclusion SRS has potential value in evaluating the immune activity of orbital inflammatory pseudotumor associated with systemic vasculitis.

Objective To explore the relationship between methylenetetrahydrofolate reductase (MTHFR) 677C ＞ T and unexplained recurrent pregnancy loss (URPL).Methods All patients were recruited from the outpatient department of Obstetrics/Gynaecology & Genetics of Hangzhou First People's Hospital from January 2013 to May 2014.A case-control study was performed.According to the stochastic indicator method,there were 125 subjects with a history of ≥2 times URPL as the case group,and 905 healthy parous women with no history of URPL as the control group.Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to detect the distributions of the polymorphisms of MTHFR 677C ＞ T,and the results were validated using oligo-chip and direct sequencing.Results The allele and genotype frequencies of MTHFR were 60.0％ for C,40.0％ for T,32.0％ for CC,56.0％ for CT,and 12.0％ for TT in the case group and 67.4％ for C,32.6％ for T,41.4％ for CC,52.0％ for CT,and 6.6％ for TT in the control group,respectively.The prevalence of allele T was significantly higher in the case group than in the control group (OR =1.379,95％ CI =1.051-1.808,P =0.020),the frequency of genotype TT was also significantly higher in the case group than in the control group (OR =2.344,95％ CI =1.220-4.503,P =0.009).Conclusion The fertile women with MTHFR 677T allele and 677TT genotype may be susceptibility to URPL in a Chinese Han population from the Hangzhou area.

Objective: This paper investigates Shenmai Injection’s effect on the cellular immunity of patients with acute exacerbated chronic obstructive pulmonary disease (AECOPD). Methods: 92 cases of AECOPD patients are randomly divided into two groups----control group and treatment group, each with 46 patients. Patients in the two groups are given the same treatment such as anti-inflammatory, astiasthmatic, eliminating phlegm, inhale oxygen. Based on conventional treatment, the treatment group dissolves 40mL of Shenmai Injection in 250mL of injection glucose (5%). Such solution is dripped in vein continuously for two courses of treatment, with ten drops for a course of treatment and once a drop. Indexes of CD+3, CD+4, CD+8of peripheral blood T lymphocyte subsets and ratio of CD+4/CD+8 are tested before two weeks and after two weeks of the treatment, in order to discuss the effect of Shenmai Injection on the cellular immunity of patients with acute exacerbation of chronic obstructive pulmonary disease. Results: After two weeks' treatment, the indexes of CD+3, CD+4 raise up, the indexes of CD+8 go down, and the ratio of CD4+/CD8+ increases. In contrast, there is a significant difference for the patients before the treatment; So is the same with Indexes of CD+3, CD4+, CD8+ and ratio of CD+4/CD+8 to the patients in the treatment group and those in the control group after two weeks. Conclusion: Shenmai Injection can improve the AECOPD patient’s cellular immunity.

Objective To establish a HPLC-ELSD method for determining the content of astragaloside Ⅳ in Qingshen Jianfei Tablets. Methods Stationary phase was C_(18) column (4.6 mm?250 mm, 5 ?m), mobile phase was acetonitrice-water (35 : 65). The evaporation temperature was 120 ℃, the pulverization temperatire was 80 ℃, the flow rate was 1.6 mL/min and column temperature was 35 ℃. Results The standard curve was linear within the range of 1.03～8.24 ?g, r=0.9999. The average recovery was 99.35% with RSD = 1.36% (n = 6). Conclusion The established method is simple and accurate, with good reproducibility and high precision, and suitable for the determination of astragaloside Ⅳ in Qingshen Jianfei Tablets.

To compare the clinical effect of phacoemulsification and middle incision extracapsular cataract extraction ( Ml-ECCE) . METHODS: One hundred and eighty - five eyes of phacoemulsification (137 cases) and 185 eyes of 139 cases for Ml-ECCE from January 2011 to May 2013 were involved in this study. And the ratio posterior capsular rupture during surgery, visual acuity, corneal edema, corneal astigmatism and intraocular pressure post operation were followed up.RESULTS: On 1d after surgery, uncorrected visual acuity in the group of Ml-ECCE was better than that of phacoemulsification group, while from 3d; 1 and 3mo after surgery, no significant difference was found from the above two groups. On 1d postoperation, corneal edema ratio in phacoemulsification group ( 45 eyes ) was higher than that in Ml-ECCE group(20 eyes) ( X2=11. 665, P=0. 0006 ) . No significant difference was found for the ratio of posterior capsule rupture during surgery in these two surgical technique groups(X2=0. 094,P=0. 759). On 1wk;1 and 3mo after surgery, significant difference was found for the average of surgical induced corneal astigmatism between two groups (u=6. 661, 6. 880, 4. 187, P = 0. 00, respectively ). During following up, no significant difference was found for the intraocular pressure between two groups ( u=1. 858, 0. 963, 0. 471, 1. 349, 1. 388; P= 0. 063, 0. 335, 0. 638, 0. 177, 0. 165). lntraocular pressure on 1d postoperation in phacoemulsification and Ml-ECCE groups was higher than before operation ( u = 19. 86, 19. 39, P = 0. 00, respectively). And on 1wk; 1 and 3mo postoperation, intraocular pressure in the operated eyes in both groups was lower than before operation for 2~3mmHg.CONCLUSlON: Although phacoemulsification and Ml-ECCE could both get good visual rehabilitation, with similar visual outcome, no significant effect for intraocular pressure, and no severe complications, the latter one owns the advantage that easier maneuver, quicker recovery, and cheaper instruments needed, which is suitable for the hard nuclei cataract in local hospitals. Ml-ECCE is a safe, effective and easy manipulation for local hospital for large batch of cataract surgeries.

Objective To studythe efficacy of levosimendan in treating refractory heart failure complicating severe renal in sufficiency.Methods Sixty-seven cases of refractory heart failure complicating severe renal insufficiency in the internal medicine department of our hospital were randomly divided into the levosimendan treatment group(L group,n=33)and dopamine treatment group(D group,n=34).The changes of N-terminal pro-B-type natriuretic peptide(NT-pro-BNP),left ventricular ejection fraction (LVEF)and glomerular filtration rate(GFR)before treatment and on 1,3,7,30 d after treatment were compared between the two groups and analyzed.Results Before the treatment,there were no statistically significant differences in the baseline indicators between the two groups(P＞0.05).The group L:the NT-pro-BNP level on 1,3,7 d after treatment was decreased significantly(P＜ 0.05),LVEF on 3,7 d was significantly increased compared with th baseline(P＜0.05)and GFR on 1,3,7,30 d was significantly increased compared with the baseline(P＜0.05).The group D:the NT-pro-BNP level on 7 d of treatment was significantly decreased(P＜0.05),LVEF on 7 d of treatment was significantly increased compared with the baseline(P＜0.05),and no statistically significant changes were observed in GFR on 1,3,7,30 d(P＞0.05).After treatment,NT-pro-BNP,LVEF and GFR significant level values in the group L were better than those in the group D.Conclusion Levosimendan is superior to dopamine in improving heart and renal function for the patients with refractory heart failure complicating severe renal insufficiency.

Diabetic foot infection may hamper wound healing and lead to non-traumatic amputation in diabetes patients and early diagnosis and proper treatment can improve prognosis.In this review,the progress in classification,influencing factors,diagnostic methods and local treatment of diabetic foot infection is introduced.

Objective To evaluate the efficacy of internal fixation with or without fusion in the treatment of thoracolumbar burst fractures.Methods Clinical controlled trails related to the application of pedicle screw instrumentation with or without fusion for thoracolumbar fractures before March,2012were obtained by searching PubMed,Science Direct,Medline and CNKI.Quality evaluation was made on the included literature,from which data were extracted to integrate various rescarch results by using RevMan 5.1.The quantitative data were analyzed based on the effect scale of mean difference (MD) and bilateral 95％ confidence interval (CI).The numeration data were analyzed in the use of effect scale of odds ratio (OR) and bilateral 95％ CI.The merging of some data was manually completed.Results After retrieving,eight English and one Chinese papers of the clinical controlled trials,and two related Meta analysis were obtained.With exclusion of one repetitive research,eight papers were involved in the review.Meta analysis demonstrated that fusion and non-fusion fixation had no significant differences in aspects of correction of kyphotic angle,correction and correction loss of vertebral body height,neurological function improvement,complication rate,and length of hospital stay.While compared with the fusion fixation,non-fusion fixation showed a more serious correction loss of kyphotic angle,a fewer blood loss and a shorter operation time.Conclusions Non-fusion fixation shows the similar efficacy with fusion fixation in the treatment of some thoracolumbar burst fractures pertaining to releasing compression,restoring spinal stability and preventing complications,but it can also significantly decrease operation time and blood loss.Furthermore,non-fusion fixation may markedly improve patients' quality of life since it restores motion of the instrumented segment after removal of implant and decreases the risk of adjacent segmental degeneration.

Objective Based on dual channel melting curve analysis-based assay,we developed a method to rapidly detect the drug-resistant mutations in Mycobacterium tuberculosis through real-time PCR.Methods According to the common first-line drug-resistant mutations of Mycobacterium tuberculosis,we designed six dual-labeled fluorescence probes to rapidly detect the drug-resistant mutations through realtime PCR melting curve after amplifications of drug-resistant related gene region of DNA.The targets include rpoB 81 bp core region,katG315,inhA promoter,ahpC promoter and embB306.To validate the sensitivity and specificity of our method,we performed real-time PCR assays to detect drug-resistant mutations in 76 clinical MDR-TB samples,which were collected by Shanghai CDC in 2008.Results In the validation,this method successfully detected drug-resistant mutations in all 76 clinical MDR-TB samples.The △Tm of mutations were from 1.8 to 14.4 ℃.Comparing with the sequencing data,all mutations covered by the six probes were detected with 100％ sensitivity and 100％ specificity (rpoB,80/80; inhA,7/7 ; katG315,59/ 59;ahpC,8/8;embB306,27/27).This method can successfully detect drug-resistant mutations from 100 copies/μl DNA samples.Conclusions A widely applicable real-time PCR assay to detect first line drug-resistant mutations of Mycobacterium tuberculosis has benn developed.This method has proven to have the advantages of high sensitivity,specificity and low risk of contamination.It can be used in rapid diagnosis of clinical drug-resistant tuberculosis and the evaluation of laboratory drug sensitivity test.

Charcot-Marie-Tooth Disease ; Child, Preschool ; Humans ; Male