Objectives To study the difference in the expression of monocyte chemoattractant protein-1 (MCP-1) and soluble intercellular adhesion molecule-1 (sICAM-1) between vitiliginous and non-vitiliginous patches in patients with stable vitiligo, and to compare the number of peripheral regulatory T cells between vitiligo patients in stable stage and normal controls. Methods Suction blister fluid was collected at 1 to 3 h after the suction. The expression of MCP-1 and sICAM-1 in skin tissue fluid was detected with ELISA. The number of regulatory T cells in the blood of vitiligo patients and controls was detected by flow cytometry. Results There was no significant difference in the number of regulatory T cells between vitiligo patients and normal controls. The expression of MCP-1 and sICAM-1 in skin tissue fluid was significantly higher in vitiliginous skin than that in non-vitiliginous patches in patients with common type vitiligo, while there was no significant difference between the two kinds of patches in patients with segmental type vitiligo. Conclusions The immune function is abnormal in vitiliginous skin of the common type vitiligo patients in stable stage, which might explain the lack of success in transplantation for this disease.

Objective:To investigate the relationship between telomerase activity and the biological behavior of prostate cancer.Methods:The telomerase activity in prostate cancer tissues was detected by TRAP (telomeric repeat amplification protocol) ELISA which is based upon amplification of the initial telomerase product and detected by ELISA.Results:None of the 10 samples from normal prostates expressed telomerase activity.The thirteen of fifteen cases (86.0%) with prostate cancer presented telomerase activity.The activity of telomerase was associated with the pathological differentiation of prostate cancer.The two of twelve cases (17.0%) with benign prostatic hyperplasia (BPH) expressed telomerase activity,and the activity of telomerase was lower than prostate cancer.Conclusion:The telomerase acitivity may be related to the biological behavior of prostate cancer and can evaluate the malignant potential of prostate cancer.The presence of telomerase acitivity in some cases of BPH may indicate the presence of a minority of malignant cells,as yet clinically undetected,within the population of BPH cells.

ObjectiveTo assess the relationship of interleukin-17(IL-17) and transforming growth factor-β(TGF-β) with the development of vitiligo.MethodsEnzyme-linked immunosorbent assay (ELISA) was carried out to measure the levels of IL-17 and TGF-β in sera from 120 patients with vitiligo and 60 healthy controls.The correlations of serum IL-17 and TGF-β levels with patients' gender,stage and duration of disease,involved body area and presence of family history were assessed.ResultsThe level of serum IL-17 was significantly higher in patients with active vitiligo than in the controls and patients with stable vitiligo (both P ＜0.05).With the rise in involved body area,the level of serum IL-17 gradually increased (x2 =12.656,P ＜0.05).The level of TGF-β in patients with active vitiligo was a little higher than that in the controls and patients with stable vitiligo,with no significant difference between these groups(both P ＞ 0.05).Conclusions The levels of serum IL-17 and TGF-β are somewhat correlated with the activity of vitiligo,and both of them may play a certain role in the pathogenesis of vitiligo.

ObjectiveTo investigate the influence of internal sphincter deletions on postoperative fecal incontinence in rectal cancer patients after intersphincteric resection (ISR). MethodsSeventy one cases of rectal tumour were respectively treated by low anterior resection (group A, intact internal sphincter),partial ISR (group B,1/3 internal sphincter deletion),subtotal ISR (group C,2/3 internal sphincter deletion) and total ISR (group D,total internal sphincter deletion).Anorectal manometry and Vaizey scoring system were used to trace dynamic changes of fecal incontinence in the four groups in one year follow up. Data were analyzed with repeated-measures analysis of variance and multivariate analysis of variance. ResultsIn all cases the length of postoperative anal high-pressure zone shortened by groups.With time the length of high-pressure zone increased slightly.By the end of postoperative 12 months,there were still significant differences between groups( F =41.873,P =0.000).The maximum resting pressure of anal canal significantly reduced in all groups.By the end of postoperative 12 months,it almost restored to preoperative level in group A,while in group B and C it was about 2/3 of the preoperative level; and 1/3 of the preoperative level in group D.Vaizey score at postoperative 10 days,increased in all groups.In group B and C the score was on continuous decrease until the end of postoperative 12 months(P =0.158) it was close to that in group A.While in group D it was only 13.7 ±3.2 by the end of postoperative 12 months.Multiple regression analysis showed that by the end of postoperative 12 month,the maximum resting pressure of anal canal and postoperative anal high-pressure zone length were significantly and negatively related with the subjective Vaizey score of fecal incontinence ( t =- 4.802,P =0.000 ; t =- 2.011,P =0.048 ).ConclusionsIn patients of ultra-low rectal cancer undergoing intersphincteric resection,fecal incontinence severity indicator vaizey score as evaluated by the end of postoperative 12 months was associated with the maximum resting pressure of anal canal and anal high-pressure zone length.In addition,postoperative fecal incontinence severity carries reversible dynamic changes, and with time, most patients could restore satisfactory stool control function.

Objective To investigate the sensitivity of BIOMED-2 primer system in adult acute lymphoblastic leukemia (AIJ,) patients Ig gene rearrangement, and to analyze their frequency, corearrangement pattern, utilization of V, D and J genes and composition of junctional regions. Methods Amplification of rearranged IgH (complete and incomplete), IgK, IgK-Kde and IgL was performed in standard PCR in 29 adult ALL patients. Monoclonal PCR products were subjected directly to DNA sequencing. Sequences were identified by comparison with all known human Ig germline sequences to analyze the recombination patterns, somatic mutations and germline gene segments usage. Results IgH, incomplete IgH, IgK, igK-Kde and Igl, rearrangements were found with positive rate of 70.8%, 12.5% , 29.2% , 25.0% and 0 of B-ALL patients, respectively. All B-ALL patients displayed at least one pattern of Ig gene rearrangements. In TALL, one of five patients was found with incomplete IgH rearrangement, two patients were found with IgK rearrangements and two patients were PCR-negative. The sequence analysis showed that the most frequently used V, D, J segments in adult B-ALL patients were from VH3/VH4 families, DH3 family and JH6 family, respectively. Four of five IgK rearrangement used VκI family. 23.5% B-ALL IgH contained scattered replacement mutations with replacement to silent substitution ratio < 1 in complementarity determining regions. Conclusion BIOMED-2 multiplex PCR analysis strategy is a reliable and useful technique in the adult BALL patients.

Objective To investigate the efficiency of transjugular intrahepatic portosystemic shunt (TIPS) with Fluency stent in improving the hepatic and renal function and survival rate in patients with decompensated cirrhosis.Methods The decompensated cirrhosis patients who were treated in our hospital from May 2008 to September 2011 were retrospectively analyzed.One group of patients (n =48) undergoing TIPS was randomly selected as treatment group,while another group of patients (n =48) treated by medicine and therapeutic endoscope was randomly chosen as control group.Clinical data and fellow-up data were retrospectively reviewed.There was no significant deviation in baseline characteristics (age,gender composition,etiology,renal function,hepatic function et al) among all the patients before the operations; The laboratory results of hepatic and renal function in 2 groups before and after operation (1 week,20 days,3 months,6 months,1 year,2 years,3 years) were recorded and compared with independent samples t-test or Wilcoxon rank sum test.The survival rates of two groups in 3 years were analyzed using Kaplan-Meier survival curve and compared with Chi-square test.Results Three years after the operation,there were significant differences between the treatment group and the control group in AST(70.8 vs.108.7 U/L,Z =-2.958,P ＜ 0.05) and TBIL (51.2 vs.76.2 μmol/L,Z =-2.004,P ＜ 0.05).The Cr value of the 3rd year after the treatment were (9928.2 ± 2363.8) in the the control group and (7742.1 ± 2845.6) μmol/L in the treatment group(t =-2.074,P ＜ 0.05).BUN of the 1st,2nd and 3rd years after the treatment were (2.0 ± 1.1),(2.3 ± 1.5),(2.5 ± 1.3) mmol/L in the treatment group,while it was (2.6 ± 1.1),(3.8 ±1.2),(5.4 ± 1.1)mmol/L in the control group.There was significant difference between the 2 groups (t =-2.222,-3.940 and-6.110,P ＜ 0.05).Comparing the survival rate in the 2 groups with Kaplan-Meier survival curve,the 3 year survival rate in the treatment group was 46.2％,while in the control group it was only 30.0％ (x2 =6.341,P ＜ 0.05).Conclusions Compared with medicine therapy and therapeutic endoscopy,TIPS with Fluency stent may improve the hepatic function,renal function and survival rate in liver cirrhosis patients.It is a safe and effective therapy choice for patients with decompensated cirrhosis.

Objective To explore a method for establishing the hamster model of Clostridium difficile-associated diarrhea (CDAD)and the indicators for its evaluation.Methods Clindamycin was administered to hamsters subcutaneously (day 1),and 24 h later infected with C.difficile clinical isolates KH1 (ribotype 027,106-108 CFU/mL)or SH9 (ribotype 001 ,108-1010 CFU/mL)by gavage.Animals were observed for CDAD symptoms such as diarrhea,weight loss and death.At the end of ob-servation period (day 7 or death),the cecum was collected from each animal for histological evaluation of inflammation.Results Following a single dose of 100 mg/kg clindamycin subcutaneously,all the animals challenged with KH1 (108 CFU/mL)devel-oped diarrhea and then died within 5 days.All the hamsters challenged with SH9 (1010 CFU/mL)developed diarrhea as well but only 66.7% died at the end of observation period.Among other groups,only one or none developed diarrhea and then died. The symptoms of hamsters with diarrhea included loose stool,wet tail and weight loss.On histological examination,conges-tion,hemorrhage and neutrophil infiltration of the mucosa were observed in the hamsters died of CDAD.Conclusions We have successfully established a hamster CDAD model that allows for future investigations.

Objective To study the use of laparoscopic cholecystectomy (LC) and laparoscopic common bile duct exploration (LCBDE) in patients with cholecystocholedocholithiasis.Methods From July 2006 to June 2010,127 patients with cholecystocholedocholithiasis were treated either by LC+LCBDE (n=78) or LC+endoscopic sphincterotomy (EST,n=49).The treatment success rate,complications,retained bile duct stones rate,recovery of gastrointestinal function and hospital-stay were retrospectively analyzed.Results The LCBDE+ LC group:The operative success rate was 94.87 ％.The incidence of postoperative complications was 5.41 ％.The EST+ LC group:Complete removal of bile duct stones was achieved in 46 of 48 patients (95.92％).The incidence of postoperative complications was 12.77％.There was a significant difference in the incidences of postoperative complications between the EST+ LC group and the LCBDE+ LC group (P＜0.05).The operative time and the cost for hospital stay between the two groups were significantly different (P＜0.05).After a follow-up of 3.2 years (mean,range 1-5 years),there was no significant difference in long-term complications such as bile duct recurrent stones,duodenal papilla stenosis and cholangitis between the two groups (P＜0.05).ConclusionsLCBDE was a safe,efficacious and feasible minimal invasiveness treatment for cholecystocholedocholithiasis.Primary closure of common bile duct in selected cases brought additional benefits to the minimal invasive technique.

Objective To evaluate the application effect of evidence-based nursing in reducing ventilator-associated pneumonia (VAP) of patients with severe head injury. Methods 100 patients with severe head injury using mechanical ventilation were randomly divided into the control group and the observation group with 50 patients in each group.The observation group explored evidence from nursing of ventilator tube,oropharyngeal and sound sects care,airway care,balloon sleeves care to prevent biofilm on the endotracheal tube(ETT-BF) to fall off,enteral nutrition care,decubitus care,ward environment and the hand disinfection of medical staff and was given evidence- based nursing.The control group took routine care.The incidence of VAP,off-line time and mortality rate of the two groups were compared during the same time period. Results The incidence of VAP,off-line time,mortality rate showed significant difference between the two groups.The observation group showed better effect. Conclusions Implementation of evidence-based nursing can significantly reduce the off-line time of patients with severe traumatic brain injury using mechanical ventilation.It can decrease the incidence of VAP and mortality rate,improve the prognosis and reduce medical cost.

Objective To study the effects of mosapride and domperidone on the pulmonary infection of acute stroke patients lying in bed and with nasal feeding. Methods Eighty-nine acute stroke patients lying in bed and with nasal feeding were divided randomly into the treatment group (47 cases) and the control group (42 cases). The control group was treated routinely,and the treatment group was treated with mosapride 5 mg and domporidone 20 mg thrice a day for 4 weeks, besides routine therapy. The incidence rate of pulmonary infection, gastric residual volume (GRV) and the number of cases with gastric contents remaining after 3 hours of nasal feeding were studied. All data were analyzed statistically. Results In the treatment group, 13 cases had pulmonary infection,and the incidence rate was 27.66%(13/47). In the control group,25 cases had pulmonary infection,and the incidence rate was 59.52% (25/42). There was significant difference between the two groups (P < 0.01 ). Three hours after nasal feeding,24 cases with gastric contents remaining were discovered in the treatment group,and GRV was (50.80±15.38) ml. Two hundred and thirty-seven cases with gastric contents remaining were discovered in the control group, and GRV was (112.17±32.54) ml. Significance differences were also detected between the two groups (P<0.01). Conclusion As for the acute stroke patients lying in bed and with nasal feeding,mosapride and domperidone can remarkably cut down the pulmonary infection upon common treatment.