Objective To study the MTHFR gene (677 gene loci and 1298 gene loci) mutations in Chinese patients with keloid. Methods The tissue DNA was extracted from 20 samples of keloids. and peripheral blood samples from the same patients were employed as the control. Polymerase chain reaction(PCR) was used to amplify the Mthfr 677 gene loci and Mthfr 1298 gene loci from the keloid tissue DNA and peripheral blood DNA. and the PCR products were sequenced directly and then compared with the GenBank data. Results Mutations were detected in 17 out of 20 keloids on Mthfr 677 gene loci, the mutation incidence was 85.0 %. Mutations were detected in 13 out of 20 keloids on Mthfr 1298 gene loci, and the mutation incidence was 65.0 %. The mutation involved point mutation, deletion and insetion as well as multisite and multitype. No MTHFR gene mutation was detected in all peripheral blood samples . Conclusion There is a strong correlation between the MTHFR gene (677 gene loci and 1298 gene loci) mutation and keloid.

Objective Nonsyndromic cleft lip with or without cleft palate(NSCL/P)is a common craniofacial birth defect which results in lifelong medical and social consequences.Although Asians have the highest birth prevalence of oral-facial clefts,the majority of gene mapping studies of cleft lip with or without cleft palate(CL/P)have been in European or Ameriean Caucasians.Therefore,the obiective of this study was to evaluate association between transforming growth factor alpha(TGF-α)gene BamH Ⅰ polymorphism and NSCL/P in Chinese.Methods 107 patients with NSCL/P and 136 healthy controls were examined for TGF-α/BamH Ⅰ genotypes.TGF-α/BamH Ⅰ typing was carried out by digesting the locus specific polymerase chain reaction amplified products with alleles specific BamH Ⅰ restriction enzyme(PCR-RELP).Resuits A1 allele frequency was 0.06 and A2 allele frequency was 0.94 in the controls.A1 allele frequency was 0.14 and A2 allele frequency was 0.86 in patients with NSCL/P(x2=8.27,df=1,P＜0.05).A1 allele frequency was 0.17 and A2 allele frequency was 0.83 in the bilateral cleft lip with or without cleft palate.A1 allele frequency was 0.13 and A2 allele frequency was 0.87 in the unilateral cleft lip with or without cleft palate(x2=0.36,df=1,P＞0.05).There was no statistically significant between the case with family history and the case without family history(x2=0.34,df=1,P＞0.05).Conclusions The above data demonstrate that there is evidence for the association of TGF-α polymorphism with development of NSCL/P in Chinese.

BACKGROUND: Polysaccharide sulfate has bean hot focus in recent research.Regarding anticoagulant property of sulfated polysaccharides, recent studies mainly explored degree Of substitution, and there are rare studies concerning relative molecular mass and spatial structure.OBJECTIVE: To study the anticoagulant activity of the sulfated agarose with different relative molecular masses.METHODS: With formamide as dispersing agent,agarose was sulfated with the method of chlor0sulfonic acid-pyridine.The product was graded and purified with dialysis bag.Two kinds of sulfated agarose with different molecular masses were obtained,and their anticoagulant properties were checked by assays of the activated partial thromboplastin time,thrombin time.RESULTS AND CONCLUSION:.Two kinds of sulfated agarose had similar degree of substitution and sulfation position,whereas their molecular weight was different.The bioassay results of coagulation index demonstrated that the anticoagulant activity of agarose improved with the increasing of molecular mass within a certain range.Relative molecular mass had an important effect on the anticoagulant activity of the sulfated agarose.

Objective To explore the clinical effect and lung CT change of long-term used of low-dose roxithromycin in treatment for bronchial expansion patients in stable phase. Methods 94 cases collected in the Department of Respiration, The Second Hospital Affiliated to Suzhou University from February 2011 to December 2012 were diagnosed as bronchiectasis, 34 cases in control group were given oral treatment for ambroxol 30 mg, three times one day, 60 cases in treatment group were added roxithromycin 75 mg on basis of control group, two times one day. Patients in two groups were both treated for 6 months. The therapeutic effect and the score of life quality and dyspnea scores in two groups were observed, and the changes of CT data were compared before and after treatment. Results After treatment, the life quality score and dyspnea score of two groups were all improved, but the treatment group was signiifcantly higher than the control group (P<0.05). The effective rate in treatment group was 86.67%, which was signiifcantly higher than 70.59%in the control group (P<0.05). After treatment, chest CT imaging score of patients in treatment group were improved, signiifcantly better than that in the control group (P<0.05). Conclusion Long-term low dose administration of roxithromycin can control and stable bronchiectasis symptoms, and improve signs and symptoms .

OBJECTIVE To promote the management of nosocomial infections continuous improvement in the clinical and medical technology department.METHODS According to the regulation of nosocomial infections management,a handbook of nosocomial infections management for clinical and medical technology department was designed,and the monitors of nosocomial infection could perform real time inspection and record according require of the handbook.The department of nosocomial infections management examined the monitoring work of clinical and medical technology department every month and summarized every year,and the results were internalized to the valuation of medical quality management.RESULTS After 3 years of the usage of the handbook,the capability of the monitor groups of nosocomial infection and the quality of the all monitoring items were significantly improved;the qualified rates were all above 96.30%.CONCLUSIONS The handbook of nosocomial infections management is useful to improve the quality of nosocomial infections management in the clinical and medical technology department.

Objective To investigate the effects of p38 mitogen-activated protein kinase (MAPK) short hair RNA (shRNA) delivered by lentiviral vectors (pGLV) on cardiac function after myocardial infarction (MI) in aldosterone overload rats and to explore the mechanism.Methods Aldosterone overload rat myocardial infarction model was obtained by ligating the left anterior descending coronary artery.The pGLV-shRNA was constructed,sequenced and injected into rats via tail vein.Rats were divided into 3 groups:pGLV-shRNA group (n=6),pGLV-shRNA-NC group (n=6,contained a nonsense shRNA) and the sham-operation group (n=6).Cardiac function was measured by cardiac ultrasound.Apoptosis was assessed by transferase (TdT)-mediated biotin-16-dUTP nick-end labelling (TUNEL).The p38 MAPK mRNA expression was analyzed by RT-PCR.The protein expressions of p38 MAPK and caspase-3 were detected by Western blot.Results Compared with the sham-operation group,cardiac systolic function was reduced and myocardial apoptosis index was significantly increased [(31.26 ± 4.45) ％ vs.(15.20 ± 2.18) ％,P ＜ 0.01] in pGLV-shRNA-NC group.The mRNA and protien expressions of p38MAPK and caspase 3 protein expression were significantly increased in pGLV-shRNA-NC group (all P＜0.01).Compared with pGLV-shRNA-NC group,cardiac function was improved,myocardial cell apoptosis index was reduced [(22.35±3.59)％ vs.(31.26±4.45)％,P＜0.05],and the mRNA and protien expressions of p38MAPK and caspase 3 protein expression were decreased in pGLV-shRNA group (all P＜0.05).Conclusions Cardiac dysfunction is associated with p38MAPK-mediated myocardial apoptosis in aldosterone overload MI rats.pGLV-shRNA may inhibit cardiomyocyte apoptosis and improve postMI cardiac function.

Objective To investigate the effects of ligustrazine (TMP) combined with salvia miltiorrhiza on the progression of chronic allograft nephropathy (CAN) in rats and the action mechanism.Methods Fischer 344 rats and Lewis rats were used as renal transplant recipients and donors for ortlotopic kidney transplantation. The CAN model was established.By using random number table,the kidney transplant recipients were divided into five groups:cyclosporine A (CsA) group (A),TMP + CsA group (B),Salvia + CsA group (C),TMP + Salvia + CsA group (D) and blank control group (E,receiving no treatment).At 2nd,4th,6th,8th and 12th week after operation,5 mice in each group were sacrificed,and the transplanted kidney was removed for examination of renal histopathological changes. The immunohistochemistry was used to detect the expression of transforming growth factor β1 (TGF-β1) in the renal allograts,and by using fluorescent quantitative polymerase chain reaction,TGF-β1 mRNA expression in the renal allograts assayed.Results In blank control group,the survival time was no more than two weeks.In group A,the CAN pathological changes occurred at 4th week postoperation,those in group B and group C occurred later than in group A,and latest in group D with mild pathological lesions.In all groups after operation,Banff scores showed an upward trend,and at the same time point,those in group A were significantly higher than groups B,C and D ( P＜0.05 and P＜0.01 ).and those in group D was significantly lower than in group B and group C (P＜0.05),but no significant difference was found between group B and group C (P＞0.05).With time over,the TGF-β1 expression intensity showed an increasing trend.At the same time point,TGF-β1 expression intensity in group A was strongest among groups A,B,C and D (P＜0.05 and P＜0.01 ),and that in group D was significantly lower than in group B and group C (P＜0.05),but no significant difference was found between group B and group C (P＞00.05).The changes of TGF-β1mRNA expression pattem in each group showed the same trends as TGF-β1 protein expression.Conclusion TMP or salvia miltiorrhiza can delay the progression of CAN in kidney transplant rats by down-regulating the TGF-β1 expression,and the combined use of them exerts synergic effects.

BACKGROUNDRecently,mutations in the epidermal growth factor receptor(EGFR) gene were reported to correlate with EGFR tyrosine kinase inhibitor(TKI) response.In this study,relationship between mutations of EGFR in plasma and pleural effusion and responses to gefitinib was investigated in pretreated patients with advanced non-small cell lung cancer(NSCLC).

METHODSThe circulating free DNA was isolated from the plasma of 53 cases and pleural effusion of another 10 cases and analysed for EGFR mutations by LightCycle PCR method.Relationship between EGFR mutations and response to gefitinib was analysed with Chi-square test.

RESULTSEGFR mutations were found in 17 of 63 cases(27.0%).EGFR mutations were frequently present in females(P=0.024) and non-smokers(P=0.021).Patients with EGFR mutations had a significantly better response rate compared to that of the wild-type patients(P=0.000).

CONCLUSIONSThe EGFR mutations exist in the plasma and the pleural effusion from patients with advanced NSCLC.These mutations can be detected with LightCycle PCR method which is highly specific and sensitive and easy to perform compared with the direct sequencing.It will enable us to get a potential implication in the diagnosis and targeted therapy of NSCLC at late stage.

Objective To evaluate the efficacy and safety of photodynamic therapy(PDT)combined with intravitreaIinjection of bevacizumab for choroidal neovascularization(CNV)caused by agerelated macular degeneration(AMD). Methods A total of 21 eyes of 21 patients with AMD,which was diagnosed by examination of visual acuity,intraocular pressure,ocular fundus,fundus color photography,fundus fluoreseein angiography(FFA),indocyanine green angiography(ICGA)and optic coherence tomography(OCT),were underwent PDT combined with intravitreal injection of Bevacizumab.The patients,15 males(15 eyes)and 6 females(6 eyes),aged from 56 to 78 years,with the average of 68.6years.The best corrected visual acuity:counting fingers/10cm-0.9,logMAR was 1.04±0.41.CNV located in below or side central fovea of macula.There was obvious leakage of fluorescein which examined by FFA and ICGA.The average of retinal thickness of macular foveal was(258.91±78.66)μm.The treatment method of PDT has to according to the way of PDT for TAP and Verteporfin PDT for VIP.Intravitreal infeetion with 1.5mg bevacizumab was performed after three days under surface anesthesia.Follow-up time was 1,3,6,12 months after the treatment. Resuits At last visit,the best corrected visual acuity:counting fingers/10 cm-1.5,logMAR was 1.04±0.41,and the differences are statistically significant compared with before.The BCVA improved four or more lines in 6 eyes(28.57%),improved two to four lines in 9 eyes(42.86%),stabilized(±1 line or no change)in 6 eyes(28.57%)and decreased in none.The average intraocular pressure was(15.20±2.41)mmHg after surgery,and the differences was not statistically significant compared with before(P＞0.05).FFA and lCGA showed CNV complete closure in 13 eyes(61.90%).partial closure in 8 eyes(38.10%).The average of retinal thickness of macular foveal was(127.38±20.14)μm(P＜0.01). Conclusion Combining treatment with PDT and intravitreal injection of Bevacizumab is safe and effective for CNV which caused by AMD.It has significant improvement in BCVA.1eakage of CNV and retinal edema.

Objective:To investigate and summarize the procedures of direct-covedng pancreaticojejunostomy with remaining jejunal mucosa in pancreaticoduodenectomy and to analyze the incidence of pancreatic fistula and other postoperative complications.Methods:A total of 21 patients were treated with pancreaticoduodenectomy between May 2005 and June 2009.During the surgery,we dissected 3cm long remnant of the pancreas out of ambient tissues.Near the 2.0-3.0cm of the pancreatic remnant.we fixed partial posterior wall with the full-thickness jejunum without mucosa destroyed by interrupted suture,and then pushed the remnant into the jejunum and fixed the anterior wall.Finally,at the 1.0cm of the panceratic remnant,we binded the iejunum to surround the pancreas through 7-silk sutures.Results:One case was treated with secondary surgery due to bleeding of the pancreatic remnant.The other patients recovered smoothly without pancreatic fistula or other complications.Conclusion:Postoperative pancreatic fistula is related to the texture of pancreas,method of pancreaticojejunostomy,surgical skills and perioperative treatment.Compared with other types of pancreaticojejunostomy,direct-covering pancreaticojejunostomy with remaining jejunal mucosa is simpler.