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 investigate the effect of galectin-3 (Gal-3) on the pathogenesis of primary biliary cirrhosis (PBC).Methods The clinic data of 72 PBC patients at different stages were analyzed and the serum levels of Gal-3 were detected in 72 PBC patients and 20 controls by enzyme linked immunosorbent assay (ELISA).Independent t-test,variance analysis,LSD-t and Pearson correlation analysis were adopted for data analysis.Results The serum Gal-3 levels were significantly higher in PBC patients than those of healthy controls [(855±634) pg/ml,(463±446) pg/ml,P＜0.05].With the progression of disease,the levels of Gal-3,platelets,hemoglobin,albumin,IgM and complement C3 gradually declined,but the level of total bilirubin gradually elevated(P＜0.05).There was positive correlation between Gal-3 and immunoglobin IgM,complement C3 levels (r=0.330,P=0.005; r=0.357,P=0.002).There was negative correlation between Gal-3 and total bilirubin levels (r=0.350,P=0.003).Conclusion The Gal-3 can participate in the immune-mediated inflammation of PBC and the formation of liver fibrosis.The levels of Gal-3,platelet count,hemoglobin,albumin,IgM,complement C3 and total bilirubin could be regarded as laboratory parameters for the evaluation of the disease severity and prognosis.

Objective To investigate the effect of pregnancy-induced hypertension (PIH) syndrome on the blood lipid level of neonate. Methods Eighty neonates, whose mother had PIH, were enrolled and divided into three groups according to the 6th version of diagnostic standard from published Obstetrics and Gynecology:gestational hypertension group (PIH group 1 ,n = 30) ,mild pre-eclampsia group (PIH group 2,n =30),serious pre-eclampsia group (PIH group 3,n =20) ,and 40 infants with healthy mother were enrolled as normal control group. The blood lipid was measured by automatic biochemical analyzer. Results (1) The TG levels of the cord blood were (0.28±0. 10)mmol/L in PIH group 1,(0.33 ±0.09)mmol/L in PIH group 2,(0.39 ±0.06) mmol/L in PIH group 3,and (0. 23 ±0. 07)mmol/L in normal control respectively. TG levels were significantly higher in PIH groups compared to normal control,and the TG concentration increased gradually with the mothers' gestational hypertension (F = 2. 765, Ps <0. 05). (2)The HDL-C levels of the cord blood were (0. 61 ±0. 23) mmol/L in PIH group 1, (0. 54 ± 0. 25) mmol/L in PIH group 2, (0.47 ± 0. 15) mmol/L in PIH group 3, (0. 65 ±0. 14) mmol/L in the normal contral respectively;and the ApoA levels of the cord blood were (0. 63 ±0.24)g/L in PIH group 1 ,(0. 59 ±0. 16)g/L in PIH group 2, (0.53 ±0.21)g/L in PIH group 3,(0.69 ±0. 12)g/L in the normal contral respectively. Both index were significantly higher in PIH groups compared to normal control, and the concentrations decreased gradually with the mothers' gestational hypertension (F=2.783,P<0.05;F=2.831,P<0.05). (3)The TC levels of the cord blood were (1.41 ± 0. 37) mmol/L in PIH group 1, (1. 51 ±0.45) mmol/L in PIH group 2, (1. 56 ±0. 56) mmol/L in PIH group3, (1. 36 ±0.41) mmol/L in the normal contral respectively;and the LDL-C levels of the cord blood were (0. 79 ±0. 26)mmol/L in PIH group 1,(0. 80 ±0. 18)mmol/L in PIH group 2,(0. 82 ±0. 30)mmol/L in PIH group 3,(0.74 ±0. 18) mmol/L in the normal contral respectively. The data showed that the cord blood TC and LDL-C levels of PIH were higher than normal control and increased gradually with the mothers'gestational hypertension, but they didn' treach the significant level (F = 0. 695,P>0. 05;F = 0. 483,P>0. 05). (4)The LPA levels of the cord blood were (24. 50 ± 12. 01) g/L in PIH group 2, (22. 68 ± 9. 50) g/L PIH group 3,which were lower than normal control (25.70 ±11.90) g/L, and the LPA levels of the cord blood were higher in PIH group 1(33.46 ± 20. 10)g/L,while the differences didn't reach significant level compared among four groups (F = 1.480,P> 0.05). Conclusion The unhealthy intrauterus condition of PIH lead abmoral fat metabolism in fetus, and itmight get worse along with the severity of the mother's gestational hypertension. We presumed that the neonates of PIH mothers would be more prone to have coronary heart disease,atherosclerosis and abnormal fat metabolism related disease compared with newboms from normal control group.

Because of its specificity , significant effect , low side effect , molecular targeted therapy has been applied in the treatment of breast cancer .Recently, various molecular targeted drugs have been exploited including targeted HER family, VEGF, multi-targeted therapeutic drugs , and drugs combination .

After the present situation and characteristics of literature novelty assessment of traditional Chinese medicine were described, the importance of characteristic traditional Chinese medicine literacy of literature novelty assessors of traditional Chinese medicine was elaborated, the effect of literature novelty assessors on the literature novelty assessment of traditional Chinese medicine and the training of literature novelty assessors were studied in order to provide reference for other colleges and universities or scientific research institutions.

Objective Functional mitral regurgitation (FMR) refers to the systolic regurgitation of mitral valve secondary to compromised cardiac function or geometry abnormity with non-organic change of leaflets and ancillary parts of the valve.Severe aortic insufficiency (AI) with left ventricular dilation and dysfunction is clinically a complex heart disease and its postoperative complications and mortality are higher than usual valvular surgery.And such patients are often accompanied by FMR.It is generally acknowledged that FMR may improve after aortic valve replacement (AVR).This study follow up AI patients with left ventricular dilation and dysfunction and preoperative 2 + ＜ FMR ≤3 + to evaluate the outcome of FMR after AVR.Preoperative clinical data is assessed by regression analysis.Methods From January 2000 to April 2011,74 cases of patients were treated,who with severe aortic regurgitation combined with left ventricular dilation (left ventricle,LVEDD ≥ 70 mm) and dysfunction (left ventricle ejection fraction,LVEF ≤ 0.35) accompanied by 2 + ＜ FMR ≤3 +.Postoperative follow-up was performed.Calculation FMR preoperative/FMR postoperative ratio,the age,sex,weight,high blood pressure,ventricular arrhythmia,atrium fibrillation,LVEDD,LVEF,left atrium diameter(LAD),pulmonary artery pressure (PAH),mitral leaflet coaptation point and the mitral annular(CPMA).All factors for logistic multiple faotors regression analysis.Results The perioperative mortality rate was 8.1％.Average follow-up time was (14.9 ± 7.7) months and follow-up rate of 83.6％.5 patients died during follow-up.6 months after surgery,the average of FMR was 2.64 ± 1.17 (+),P ＞0.05 compared with preoperative data.LVEDD,LAD,CPMA,P ＞0.05 compared with the preoperative data.LVEF,PAH,both P ＜0.05 compared with preoperative data.3.Multiple regression analysis:FMR preoperative/FMR postoperative ratio is not correlated with age,gender,weight,LVEDD ≥75 mm,LVEF≤0.30,hypertension,ventricular arrhythmia and FMR postoperative improvement.However,PAH ≥50 mm Hg,LAD ≥50 mm,PAH ≥50 mm Hg,CPMA ≥ 15 mm,preoperative atrial fibrillation was negatively correlated with FMR postoperative improvement.Conclusion Severe AI with left ventricular dilation and dysfunction is a critical clinical heart disease and its postoperative complications and mortality were high.PAH ≥50 mm Hg,LAD ≥50 mm,PAH ≥50 mm Hg,CPMA ≥15 mm,preoperative atrial fibrillation was negatively correlated with FMR postoperative improvement.Since patients with 2 + ＜ FMR≤3 + usually do not improve or even worsen after AVR,those who have these above conditions preoperatively,should be treated on FMR during AVR.

Objective To discuss the correlation between MSCT morphological index of emphysema and pulmonary function test (PFT) indexes. Methods We randomly selected 33 cases with chronic obstructive pulmonary disease (COPD),and conducted CT and PFT in a week. The whole lung was scanned by MSCT at the end of deep aspiration,and the post-processing workstation was used for quantitative determination of a total of 12 morphological indexes,including the density of lung, pulmonary diameter line,lung volume,and etc,then their correlation with lung function index was analyzed.Results FEV1.0%had correlation with upper right lung density ( =0.391, =0.391), lower right lung density ( =0.465, =0.038),the mean lung density ( =0.576,=0.576), and total lung capacity (=0.471, =0.471),upper right lung volume ( =0.413, =0.049) . FEV1.0/FVC had correlation with left lower lung density ( =0.392, =0.024), the mean lung density ( =0.703, = 0.000), total lung transverse diameter ( = 0.521, = 0.521), upper right lung maximum transverse diameter ( =0.627, =0.627), and total lung capacity ( =0.549, =0.549) correlation. FVC had correlation with upper right lung maximum transverse diameter ( = 0.378, = 0.378), characterized by maximum transverse diameter (=0.349, =0.037) . TLC had correlation with mean lung density (=0.523,=0.523), upper right lung maximum transverse diameter ( =0.454, =0.454), and total lung capacity (= 0.001), the right lung volume ( = 0.492, = 0.492) . Conclusion MSCT lung morphology quantitative indicators have good clinical application value in the diagnosis and assessment of emphysema patients.

Objective Functional mitral regurgitation (FMR) refers to the systolic regurgitation of mitral valve secondary to compromised cardiac function or geometry abnormity with non-organic change of leaflets and ancillary parts of the valve.Severe aortic insufficiency (AI) with left ventricular dilation and dysfunction is clinically a complex heart disease and its postoperative complications and mortality are higher than usual valvular surgery.And such patients are often accompanied by FMR.It is generally acknowledged that FMR may improve after aortic valve replacement(AVR).This study follow up AI patients with left ventricular dilation and dysfunction and preoperative 2 + ＜ FMR≤3 + to evaluate the outcome of FMR after AVR.Preoperative clinical data is assessed by regression analysis.Methods From January 2000 to April 2011 our hospital treated 74 cases of patients with severe aortic regurgitation combined with left ventricular dilation (LVEDds ≥70 mm) and dysfunction (left ventricle ejection fraction,LVEF≤0.35) accompanied by 2 + ＜ FMR≤3 +.Postoperative follow-up was performed.Results The perioperative mortality rate was 8.1％.Average follow-up time was (14.9 ± 7.7) months and follow-up rate of 83.6％.5 patients died during follow-up.6 months after surgery,the average of FMR was (2.64 ± 1.17) (+),compared with preoperative data.LVEDd,LAD,CPMA,all P ＞ 0.05 compared with the preoperative data.LVEF,PAH,both P ＜ 0.05 compared with preoperative data.3.Multiple regression analysis:FMR pre/FMR post ratio is not correlated with age,gender,weight,LVEDd ≥ 75 mm,LVEF≤0.30,hypertension,ventricular arrhythmia and FMR postoperative improvement.However,PAH ≥ 50 mm Hg(1 mm Hg =0.133 kPa),LAD ≥ 50 mm,PAH≥50 mm Hg,CPMA ≥ 15mm,preoperative atrial fibrillation was negatively correlated with FMR postoperative improvement.Conclusion Severe AI with left ventricular dilation and dysfunction is a critical clinical heart disease and its postoperative complications and mortality are high.PAH ≥ 50 mm Hg,LAD ≥ 50 mm,PAH ≥ 50 nun Hg,CPMA ≥ 15mm,preoperative atrial fibrillation was negatively correlated with FMR postoperative improvement.Since patients with 2 + ＜ FMR ≤3 + usually do not improve or even worsen after AVR,those who have these above conditions preoperatively,should be treated on FMR during AVR.

Objective Stanford type A acute aortic dissection is a life-threatening medical condition with high rates of morbidity and mortality that requires surgical repair, on an emergency basis. The extent of aortic arch repair that should be carried out during emergency surgery of this type is controversial. This study was conducted to report clinical experience on aortic arch repair and determine surgical indication, optimal operative procedures and strategy for Stanford type A acute aortic dissection. Methods 210 consecutive patients with acute Stanford A aortic dissection who underwent aortic arch replacement combined with implantation of stented elephant trunk into the descending aorta between August 2005 and August 2010. Surgical procedures included hemi-aortic arch replacement in 92 patients, subtotal aortic arch replacement in 50 patients and total aortic arch replacement in 68 patients. All operations were performed with the aid of deep hypothermic circulatory arrest and selective antegrade cerebral perfusion (SACP). Enhanced computed tomography scanning was performed to evaluate the postoperative outcomes, particularly the fate of the false lumen remaining in the descending thoracic aorta by aortic arch replacement combined with implantation of stented elephant trunk during follow up. Results Average cardiopulmonary bypass time was (146 ±52) min. The average cross clamp time was(93 ±25)min and average selective cerebral perfusion and circulatory arrest time was(35 ±14)min. The overall in-hospital mortality was 4. 8% (10/210) and morbidity was 8. 6% ( 18/210). Postoperative complications included acute renal failure, stroke, mediastinitis and respiratory insufficiency. During the follow-up period [mean (27 ± 18) months, ranged 2 to 60 months], 1 patient underwent reoperation due to the descending thoracic and abdominal aortic aneurysm. There was no late death. Follow-up enhanced CT scanning showed about 74% false lumens obliterated at the level of the distal border of the stent graft post operation. Conclusion Open aortic arch replacement is an effective approach and provides acceptable outcomes for type A acute aortic dissection. Optimal treatment strategy is the key factor to success in emergency surgical intervention.

Objective To analyze the relationship of the lateral angulation with the incision level after anterior approach operation for thoracolumbar fractures by evaluating the Cobb' s angle at different approach levels.Methods A retrospective study was done on 154 patients with thoracolumbar fractures treated consecutively with anterior operation from May 2004 to January 2008.The preoperative,postoperative and follow-up angle of coronal Cobb and the postoperative angle between screws and endplates on the anteroposterior radiograph were measured.According to the relationship between the injury vertebrae and the incision level,the patients were divided into two groups,ie,incision level ≥2 vertebrae group and incision level ≤ 1 vertebra group.Results All patients were followed up for 6-47 months(mean 37 months),which showed significant postoperative lateral angulation(P ＜ 0.01)especially at follow-up (P ＞ 0.05).The coronal Cobb' s angle showed insignificant difference before operation between two groups but it was increased after operation and during the follow-up(P ＜0.01).The screws A or B were more parallel to the endplate in two groups(P ＜ 0.01),while the parallel of the screws C or D to the endplate showed no statistical difference(P ＞ 0.05).Conclusions Compared with the operation with incision level ≥2 vertebrae,the operation with incision level ≤ 1 vertebra can more easily induce postoperative lateral angulation and exert a significant impact on implantation orientation of the vertebral screws A and B,which may indirectly lead to postoperative lateral angulation.