The immune mechanism of Graves' diseases (GD) and the roles of regulator T cells were investigated. In 32 patients with GD (GD group) and 20 healthy volunteers (control group), flow cytometry was used to detect the proportion of CD4+CD25+ cells, MACS to isolate CD4+ CD25+ cells, RT-PCR to assay the expression of FOXP3, and ELISA to test the level of IL-10, respectively. It was found that there was no significant change in the proportion of CD4+CD25+ T cells between GD group and control group (P>0.05), while secretion of IL-10 and expression of FOXP3 in GD group were lower than control group (P<0.01 and P<0.05, respectively). In conclusion, though the proportion of regulatory T cells of peripheral blood lymphocytes in the patients with GD, the functions of them were significantly weakened, which might be a pathogenic factor in GD.

Objective To explore the relationship between metabolic syndrome and ApoA5 gene polymorphism and serum concentration. Methods 100 patients with metabolic syndrome(MS group) and 100 healthy people(control group) were enrolled in this study. The ApoA5 serum concentration of two groups were measured by using enzyme-linked immunosorbent assay(ELISA), the genotypes of ApoA5-1131T＞C polymorphism were analyzed by polymerase chain reaction-restriction fragment length polymorphism, and fasting blood glucose (FBG), total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HDL) and white blood cell, hemoglobin,platelet, liver and kidney function were measured. Results MS group was compared with control group. In MS group, the ApoA5 serum concentration was significantly lower[(96.68±18.09)ng/ml vs (128.32±23.78)ng/ml,P＜0.01], while the triglycerides levels were obviously higher[(2.35±1.07)mmol/L vs (1.62±1.13)mmol/L,P＜0.01], and ApoA5-1131C allele frequency was higher than that in control group (30% vs 16.5%,P＜0.05). Conclusions The ApoA5 serum concentration in metabolic syndrome was decreased, and ApoA5-1131C was associated with metabolic syndrome.

Objective To study early diagnosis and treatment of Wernicke's encephalopathy(WE) in allogeneic peripheral blood stem cell transplantation recipients.Method A 17 years old patient with acute B-lymphocytic leukemia received HLA-matched nonrelative allogeneic peripheral blood stem cell transplantation after conditioning with total-body irradiation/idamycin/cyclophosphamide (TBI/IDA/Cy) regimen.CD25 monoclonal antibody and cyclosporine A+mycophenolate mofetil + methotrexate were administrated for graft versus host disease prophylaxis.Result On the day 8,the platelet was over 20 × 109/L; On the day 10,the neutrophile granulocyte was over 0.5 × 109/L; On the day 28,full engraftment was confirmed by a bone marrow medicolegal identification.The continued nausea and vomiting after HSCT resulted in deficiency of intake and malabsorption.On the day 54,illusion and tremor occurred,and the follow-up brain MRI suggested WE,but the patient died before thiamine replacing therapy.Conclusion WE is also a rare neurologic complication of HSCT,however,it can easily be overlooked.So early radiologic surveillance and treatment for patients with WE is very important to minimize central nervous system complications and unwanted mortality.

Objective To investigate methods and experience of autologous granular fat transplantation by correction of aging face. Methods 178 cases of aging face subjects were treated by liposuction. Then autologous granular fat was harvested by liposuction,centrifuged and purified, and injected into marked areas of aging face. The injection process should be controled by multilevel and multiple tennel, in order to supplement the loss of facial soft tissue volume and improve the aging face. Results The follow-up period ranged from 3 months to 3 years. All the subjects had a satisfactory results with no obvious complications such as fat liquefaction, infection and ulceration. The effect of autologous granular fat transplantation was obvious and permanent. Conclusions Autologous granular fat transplantation is a safe and effective surgical technique for facial soft tissue augmentation that can effectively improve aging face and worthy of clinical application.

Pathology is a subject that studies the etiology,pathogenesis,pathological changes,progression and outcome of diseases.Pathology links the basic research and clinical practice and is an important part of translational medicine.In order to cultivate qualified pathological graduates with solid pathological theories and the abilities of proposing and addressing scientific hypotheses from pathological morphology changes,we employ modularized special training to divide the pathology training courses into morphology learning module,article searching and reading module,project design module,experiment operation module and scientific presentation module.The training contents among these modules are relatively independent but closely connected,and compose a strategy that aims to improve the scientific innovation ability of pathological graduates.

Objective To analyze the results of the Objective Structured Clinical Examination(OSCE) of medical interns in Department of Gynecology and Obstetrics,and to assess the role of OSCE in clinical teaching and practice. MethodsAtolal of 104 medical interns of five-year education program in 2002 and seven-year education program in 2003 in School of Medicine had taken part in OSCE of gynecology and obstetrics.The OSCE consisted of six stations: gynecologic examination,obstetric examination,oral test,interrogation of standardized-patients(SP),drawing partogram,and non-stress test(NST) explanation.After gathering the data of each station,the software of SPSS 11.0 was used to make statistical analysis. Results The median scores were as follows: 92.0 for gynecologic examination,91.0 for obstetric examination,83.5 for oral test,80.0 for interrogation of SP,80.0 for drawing partogram,and 70.0 for NST explanation.There was no significant impact of familiarity to OSCE on the results of the test.The results showed that medical interns did good job in basic performance,but lack of clinical practice skills in some complicated practice of gynecology and obstetrics.Conclusion The grading system and stations setup of OSCE in Department of Gynecology and Obstetrics in Shanghai Sixth People's Hospital show objectivity and equity.The OSCE can be widely applied in the after-department examination and even graduation examination.

OBJECTIVETo investigate the clinical significance of myocardial enzymes in patients with acute tetramine (TEM) poisoning.

METHODSThe dynamic changes of the activity of myocardial enzymes and ECG were observed in 67 patients with acute TEM poisoning as well as in 67 healthy people for medical checkup at outpatient department as the control group.

RESULTSMyocardial enzymes of the patients with acute TEM poisoning were increased to different extents on the first day. There was significant difference in the activity of aspartate aminotransferase (AST), creatine phosphokinase (CPK), lactic dehydrogenase (LDH), alpha-hydroxybutyrate dehydrogenase (alpha-HBDH) and CPK isoenzyme MB (CK-MB) between the patients and the healthy people in the control group (P < 0.01). There was significant difference in the myocardial enzymes at different time points among the patients with mild, middle and severe poisoning (P < 0.01). The severer the TEM poisoning was, the higher the activity of myocardial enzymes and the abnormal rate of ECG were. The activity of CPK was the earliest to rise with the highest aptitude of fluctuation and the longest time of elevation. The change of the myocardial enzymes was earlier than that of ECG. The abnormal rate of AST, CPK, CK-MB, LDH, alpha-HBDH was 86.57%, 98.51%, 94.03%, 89.55% and 79.10% respectively. The abnormal rate of ECG was 49.3% on the third day of poisoning. Measurement of myocardial enzymes was better than ECG in sensitivity.

CONCLUSIONAcute tetramine poisoning can damage myocardium, which is reversible. CPK is a typical marker for the damage and can serve as one of the important clinical monitoring indices.

Acute Disease ; Adolescent ; Adult ; Aspartate Aminotransferases ; metabolism ; Bridged-Ring Compounds ; poisoning ; Child ; Child, Preschool ; Creatine Kinase ; metabolism ; Creatine Kinase, MB Form ; metabolism ; Electrocardiography ; Female ; Humans ; Hydroxybutyrate Dehydrogenase ; metabolism ; L-Lactate Dehydrogenase ; metabolism ; Male ; Middle Aged ; Myocardium ; enzymology

Abstract: Objective　To investigate the relationship between the body mass index (BMI) levels and the negative conversion time of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid in adult coronavirus disease 2019 (COVID-19) patients and the asymptomatic persons. Methods　Asymptomatic infected patients and confirmed COVID-19 patients admitted to Chengdu Public Health Clinic Center from February 2021 to November 2021 were dynamically included. The epidemiological and clinical characteristics of the objects were collected, and the SARS-CoV-2 nucleic acid testing of the objects during their hospitalization was continuously monitored, and the negative nucleic acid conversion time was recorded. The t test or Wilcoxon rank sum test, χ2 test or Fisher's exact probability method examine were used to distribute characteristics of each group of variables and the connection between different variables, respectively. Then the variables showed differences in distribution (P<0.05) between different BMI groups were included in the multivariate Cox proportional risk regression model. Results　A total of 253 subjects ranged from 18 to 63 years old, with M(P25, P75) age of 37.0 (30.0, 47.0) years old, were included in this study. The male to female ratio was 4.16 to 1. The BMI was (23.97±3.33) kg/m2. 50.59% (128/253) of the objects were overweight or obese, and 78.13% (100/128) were overweight. The negative time of SARS-CoV-2 nucleic acid conversion of all subjects ranged from 1 to 71 days, with M(P25, P75) of 7.0 (2.0, 18.0) days (P<0.001). The negative time of SARS-CoV-2 nucleic acid conversion of the normal weight or the thin, and the overweight or obese were 5.00 (2.00, 19.00) and 8.00 (2.00, 17.75) days respectively. The results of multivariate Cox's proportional hazards regression model showed that the BMI levels may not be associated with the negative conversion time of SARS-CoV-2 nucleic acid (HR=1.090, 95%CI: 0.843-1.410, P=0.510). Conclusions　Adult asymptomatic persons and confirmed COVID-19 patients are mainly middle-aged and young males, and overweight or obesity is relatively common. Overweight or obesity cannot be considered as an independent factor influencing the negative conversion time of SARS-CoV-2 nucleic acid.

OBJECTIVE: To investigate and analyze the changes of postmortem human biochemical indexes. METHODS: Subclavian venous blood samples were collected from 81 cases of traffic fatalities. Thirteen blood biochemical indexes including liver function (ALT, AST, TBIL and DBIL), renal function (UA and Cr), cardiac function (CK, CK-MB and LDH), electrolytes (K+, Na+ and Cl-), and glucose (GLU) were tested by Roche cobas c311 automatic biochemical analyzer. The descriptive analysis was made by SPSS 17.0 statistical software. RESULTS: The values of ALT, AST, CK, CK-MB, LDH and K+ were higher than normal reference values with more fluctuations. The values of TBIL, DBIL, UA, Cr, Na+, Cl- and GLU were relatively stable with less fluctuations. CONCLUSION The postmortem human blood biochemical indexes of liver function, renal function, cardiac function, electrolytes and glucose could be affected by the factors, especially hemolysis and autolysis. The biochemical indexes, particularly enzymes, increased significantly with higher standard deviation.
Accidents, Traffic/mortality* ; Autopsy ; Blood Chemical Analysis/methods* ; Heart Function Tests ; Humans ; Kidney Function Tests ; Liver Function Tests ; Reference Values

Objective To analyze the clinical features of tuberous sclerosis (TS) patient with infantile spasm and investigate its treatment efficacy with rapamycin. Methods The clinical manifestations of a tuberous sclerosis patient with infantile spasm before and after the treatment with rapamycin were retrospectively analyzed; and the related literature was reviewed. Results Dermatological abnormalities were evidcnt in the child and mainly shown as hypomelanotic macules.His neurological abnormalities included infantile spasm and backward psychomotor development.Head MRI and CT had abnormal changes.Treatment with rapamycin 3 months later disclosed improvement in many ways: the convulsion seizure of the patient decreased apparently, and MRI showed decreased subependymal tuber size; meanwhile,the intellectual development of the patient improved obviously,and there was no adverse reaction. Conclusion Rapamycin,enjoying good effect,would be a new and safety method to treat TS patients with infantile spasm.