Objective To examine serum levels of IgG, IgA, IgM, IgE and C3 and explore sensitivity of glucocorticoid (prednisone) in primary nephropathyic children to study pathogenesis of primary nephropathy and direct clinical therapy. Methods Examine serum IgG, IgA, IgM and C3 by scattering turbidimetry and IgE by ELISA. Results Compared with healthy children, children suffering from primary nephropathy had lower IgG and higher IgM and IgE, but the same IgA and C3 Simple and nephritic nephropathy had very significant difference in sensitivity of glucocorticoid(x2=18.48 P

Objective To evaluate the risk factors for early rebleeding (ERB) after elective endoscopic variceal ligation (EVL) in cirrhotic patients and the influence of ERB on the long-term survival.Methods A total of 198 cirrhotic patients who received elective EVL were retrospectively evaluated.Twenty-six patients rebleeded within 6 weeks after initial EVL and were assigned to the ERB group.One hundred and seventy-two other cirrhotic patients were assigned to the control group.Multivariate analysis was used to define the high risk factors of ERB.A Kaplan-Meier analysis was performed to evaluate the cumulative survival rates between two groups.Results The Child-Pugh classification (P =0.016),Child-Pugh scores (P=0.012),and the total bilirubin (P =0.001) were significantly different between ERB and control group.Multivariate analysis showed total bilirubin was the only independent risk factor of ERB (OR =2.02,95％CI:1.04-4.04,P =0.008).The proportional mortality indicator of bleeding-related deaths was 66.7％ (10/15) in ERB group and 13.6％ (6/44) in control group (P ＜0.01).The five-year curmulative survival rate of the control-group was significantly higher than that of the rebleeding group (67.8％ vs.25.3％,P ＜ 0.01).Conclusion Cirrhotic patients with ERB after elective EVL have a poor prognosis.High level of total bilirubin may predict ERB.

Teacher's career development in British medical school has experienced a very long process from establish to gradually mature.So far,it has already set up its system and its own characters in strategy and teacher's self-development.By analyzing characters of teacher's career development in British medical school including teacher development center,teacher's self-development and assessment for medical educators,we aimed to raise enlightenments on teacher's career development in China.

Background and purpose: Primary study showed that clusterin was associated with tumorigenicity. The goal of the study is to investigate the role of secretory clusterin in non-small cell lung cancer cell A549/H460. Methods: The lung cancer cell A549/H460 was treated with purified secretory clusterin, the Boyden Chamber migration assay was used to detected the migration of the lung cancer cell;the CCK8 assay was used to detected the growth of the cells;microRNA expression spectrum in H460 treated with secretory clusterin was analyzed, after that, we used the real-time florescence quantification detected the expression of microRNA in H460, and the biological function of microRNA molecular mechanisms of secretory clusterin was analyzed. Results: Secretory clusterin promoted the migration in A549/H460 (P<0.000 1);Secretory clusterin inhibited the growth in H460/A549 (P<0.000 1);MicroRNA-302b-3p, microRNA-23a-5p and microRNA-101-5p was overexpressed in H460 when treated with secretory clusterin. Conclusion:Secretory clusterin could promote the migration and inhibit the growth of lung cancer cell;It could change the microRNA expression spectrum as well. Our studies revealed that secretory clusterin could be used as a tool for further study, and it is a potential target in the treatment of lung cancer.

Objective To establish the quality standard of flavone extracts in licorice residue; To provide the methods and basis for the quality control of total flavonoids extracted from licorice residue.Methods TLC was applied to compare the extracts with liquiritin and licorice; UV-spectrophotometry was used to measure the content of total flavones; EDTA-2Na titration was used to determine the content of calciumion.Results In the chromatogram of the test product, the spots of the same color were displayed on the corresponding position of the control medicinal material, and the fluorescent spots of the same color were displayed on the corresponding position of the control product. UV-spectrophotometry showed glycyrrhizin had a good linear relationship in the range of 3.32–9.96 μg/mL (r=0.9997), the absorbance between 0.3 and 0.7. The average recovery rate was 102.41% (RSD=3.22%), and the average content of total flavonoids in three batches of flavonoids extract was 8.82%. The average content of calciumion was 0.107% (RSD=3.61%).Conclusion This method has good repeatability, high sensitivity and accurate results, and can be used for the quality control of flavonoids in licorice residue.

BACKGROUND: The standardized treatment for patients who require total hip replacement is the implantation of an intramedullary diaphyseal anchored hip prosthesis. A bone-sparing non-stemmed hip prosthesis (NSHP) can be used as an alternative device for young patients. The NSHP relies on proximal femoral metaphyseal and neck fixation. The theoretic advantage of leaving diaphyseal bone intact is easier conversion to a stemmed prosthesis. On the other hand,clinical investigations published reported THR had high loosening rate of the prosthesis, which greatly limits its long-term clinical results; the aim of NSHP is to give the femoral prothesis a kind of biological fixation to decrease the loosening rate of the prosthesis. This retrospective study evaluated the medium- and short-term results after total joint replacement using NSHP.OBJECTIVE: To evaluate the outcome of NSHP for the treatment of young patients with hip disorders.DESIGN: Case analysis.SETTING: Department of Orthopaedics, the First Affiliated Hospital of Guangxi Medical University.PARTICIPANTS: Fifteen patients (17 hips) with hip disorders, who were treated at the Department of Orthopaedics,First Affiliated Hospital of Guangxi Medical University between 2001 and 2005, were retrieved. The involved patients included 8 males and 7 females. They were aged (37.8±9.8) years ranging from 21 to 49 years when they underwent operation. Indications for implantation included avascular necrosis (7 hips), posttraumatic osteoarthritis(4 hips), primary osteoarthritis(3 hips), osteoarthritis secondary to dysplasia(3 hips). Informed consents were obtained from all the patients before operation. The neotype of non-stemmed hip prosthesis (NSHP) was made of Co-Cr-Mo casting alloy with good biocompatibility by Shanghai Fusheng Medical Equipment Co., Ltd (Guoyao guanxie (shi) No. 2002-3040397; Guoshi Yaojianxie(zhun) No. 2005-3460799).METHODS: Fifteen patients (17 hips) with hip diseases subjected to the replacement of total hip with NSHP. Patients were followed-up once every other 6 months in the postoperative first year, then once every year, 5 years in total. The follow-up visit included functional evaluation and X-ray evaluation. ① Functional evaluation: Evaluative criteria of Harris joint function scale were adopted: full marks (point) =100, ≥ 80 excellent, ≥ 60 good, 40 fair and ＜ 40 poor; The following clinical data were documented: relief of pain, ability to lie on the operated side, additional procedures, use of pain medication, postoperative hip dislocations and so on. Pain was evaluated by using visual analogue scale (VAS),which ranged from 0 (no pain) to 10 (worst possible pain). ② X-ray evaluation: A standardized radiographic assessment was performed using an anteroposterior view of the pelvis. The following radiological data were recorded: preoperative grade of osteoarthritis as classified according to the method from Busse et al, preoperative grade of femoral head necrosis as classified according to the method from Ficat et al, inclination angle of the operated and the untreated side,radiolucencies according to the method of Buergi et al, heterotopic ossifications, as classified according to the method of Brooker et al. Postoperative adverse events and complications were observed and revision operation was needed if necessary.MAIN OUTCOME MEASURES: Correlative conditions of patients who were followed up for 5 years: ① Inserting angle of prothesis and the collodiaphyseal angle in the opposite side. ②Radiolucency and heterotopic ossification classification.③preoperative osteoarthritis classification, preoperative avascular necrosis of femoral head classification. ④ Revision operation, adverse events and complications. ⑤ Postoperative functional evaluation: Relief of pain (Harris joint function score), ability to lie on the operated side, additional procedures, use of pain medication, postoperative hip dislocations and VAS results.RESULTS: Fifteen patients were involved. One patient was lost after 3-month treatment and the other patients were followed up for 5 years. ① Postoperative functional evaluation results of patients. In the postoperative 5-year follow-up visit, hip joints of 13 patients (15 hips) were still in situ, pain lessened or disappeared in 11 patients (84.6% ,11/13),12 patients(92.3%, 12/13) would undergo the procedure again, 10 patients (76.9%, 10/13) were able to lie on the operated side; The average of Harris hip score was (72±19.6). The average Harris hip score did not vary significantly between the different diagnosis groups (P ＞ 0.05). Postoperative VAS was 2.6±2.2 on average. There was no significant difference in the hip joint pain among different diagnosis groups (P ＞ 0.05); Nine patients required no pain medication (69.2%,9/13).Two patients (15.4% ,2/13) occasionally took nonsteroidal anti-inflammatory drugs and two patients (15.4% ,2/13) took nonsteroidal anti-inflammatory drugs on a regular basis. ② X-ray evaluation results of patients: Preoperative osteoarthristis classification: One hip had grade 1 joint degeneration, 3 hips had grade 2 joint degeneration and 6 hips had grade 3 degeneration. Preoperative avascular necrosis of femoral head classification: Out of 7 patients with avascularnecrosis of femoral head, 4 patients had stage 3 femoral head necrosis, and 3 patients had stage 4 femoral head necrosis. In the postoperative 5-year follow up, 1 patient had radiolucency. Because the range of radiolucency was very small, progression was not quick and clinical symptoms were not severe, so revision operation was not conducted;In the postoperative 6th month, the inclination angle averaged (135.2±6.8)° on the untreated side and (132.2±6.5)° on the treat side. One patient with congenital hip dysplasia and a previous varus derotational osteotomy had a postoperative inclination angle below 120°. Patients with postoperative inclination angles between 125° and 140° had significantly less hip pain than the rest of the series. Heterotopic ossifications classification: Three patients had postoperative heterotopic ossifications, one hip had grade 1 heterotopic ossification, 1 hip had grade 2 heterotopic ossification, and 1 hip had grade 3 heterotopic ossification.③ Revision operation: one patient (5.9%,1/17)required a revision total hip arthroplasty due to pain. Good bone stock of the proximal femur was found in the patient which allowed implantation of a conventional medullary anchored prosthesis. This revision surgery and postoperative rehabilitation were uncomplicated.④ Adverse events and complications: Hip dislocation occurred postoperatively in one patient (5.9%,1/17). Other complications included trochanter bursitis (n=1), fistula (n =1), and seroma (n =1).CONCLUSION: ① NSHP provides biological fixation for femoral prothesis by bone proliferation through the windows with connective tissues surrounding the prothesis and has the characteristics of low stress and deformation, high intensity and rigidity, and anti-loosening, thus, may prolong its live lime. ②Revision surgeries are facilitated by the good bone stock remaining in the proximal femur. ③ The short- and medium-term therapeutic effects of total hip arthroplasty are satisfying in young patients.

Objective　To study the scan technique that can completely demonstrate the structures of middle-inner ear.Methods　Ninety volunteers underwent 30° axial and 105° coronal HRCT scan.The manifestations of the ministructures of middle-inner ear were observed and their demonstration rate was calculated.The demonstration of different structures of middle-inner ear was evaluated and compared on HRCT.Results　(1)The scan planes of 30° axial and 105° coronal were correspondent to some structures of middle-inner ear and could completely demonstrate them.(2)30° axial and 105° coronal HRCT scan had their own advantages respectively in demonstrating the structures of middle-inner ear.Conclusion　The technique of 30° axial and 105° coronal HRCT scan of middle-inner ear is useful in demonstrating the structures,including the nerve,joint,ligament etc and the relationship among them.

Through a third party to investigate the status of hospital services,combined with the hospital plan and vision for the future to determine the strategy of hospital services and establish a service culture system,using of 3T,workshop mode,our hospital carried out long-term,systematic,targeted full quality service training,to cultivate the culture of hospital services,to further enhance the quality of staff and enhance the overall level of service of the hospital,and to build people satisfied with the brand hospital.

Objective To investigate the incidence of left-sided portal hypertension (LSPH) in chronic pancreatitis (CP) and other accompany conditions of CP and explore the diagnostic value of LSPH in chronic pancreatitis.Methods The clinical,pathological and imaging data of 125 CP patients received at least two imaging examination were retrospectively analyzed.The rates of abnormal pathologic findings,abnormal imaging findings and accompanying LSPH in CP were analyzed.The data were analyzed by chi-square test.Results Among 125 CP patients,29.6％ (37/125) received three or more than three kinds of imaging examinations.The pathological detection rates of pancreatic calcification or lithiasis,pancreatic ductal lesion,abnormal pancreatic morphology,pancreatic lesion and LSPH were 58.4％ (73/125),60.8％ (76/125),35.2％ (44/125),48.8％ (61/125) and 24.8％ (31/125),respectively.The sensitivities of imaging examination in those lesions were 68.5 ％(50/73),96.1％ (73/76),95.5％ (42/44),95.1％ (58/61) and 90.3％ (28/31),respectively.The detection rates of pancreatic calcification or lithiasis and pancreatic ductal lesion in pathological examination were significantly higher than those of the others,and differences were statistically significant (x2=33.764 and 37.932,both P＜0.01).The sensitivity of imaging examination in pancreatic calcification or lithiasis was lower than those of the others and the differences were statistically significant (x2 =36.526,P＜0.01).Among 125 CP patients with 223 pancreatic lesions detected by imaging examination,the rates of patients with 0,1,2,3,4 lesions accounted for pancreatic were 5.6％ (7/125),40.0％ (50/125),28.8％ (36/125),21.6％ (27/125) and 4.0％ (5/125),respectively.Of patients with pancreatic calcification or lithiasis,pancreatic ductal lesions,abnormal pancreatic morphology and pancreatic lesions detected by pathological examination,there were 23.7 ％(17/73),20.0％ (15/76),22.6％ (10/44) and 27.9％ (17/61) cases accompanied with LSPH,there was no difference between these groups (x2 =1.262,P=0.738).Conclusion LSPH may be a reference for CP diagnosis by imaging examination.

Objective To explore the effect of biliary obstruction caused acute acalculous cholecystitis (AAC) on ultrastructure of gallbladder interstitial cells of Cajal (ICCs),and the possible mechanism of impaired contraction of gallbladder smooth muscle. Methods Total 60 healthy adult guinea pigs were in this study. The guinea pigs AAC model was induced by common bile duct ligation (BDL). The guinea pigs were divided into five groups equally,including sham control group (Sham),BDL for 12 hours (BDL-12),24 hours (BDL-24),48 hours (BDL-48) and 72 hours (BDL-72)groups. The gallbladder specimens were collected by the end of study. Gallbladder pathological changes were observed with HE staining under light microscope. Three muscle strips were collected of each gallbladder,fixed in constant temperature water bath with different concentration of eight peptide cholecystokinin agonist (CCK-8,1010 mmol/L,10-9 mmol/L,10-8 mmol/L,10-7 mmol/L and 10-6mmol/L),acetylcholine (Ach,10-8 mmol/L,107 mmol/L,10-6 mmol/L,10-5 mmol/L,10-4 mmol/L)and potassium chloride (KC1) (60 mmol/L). The contraction activity of gallbladder muscle strips was recorded by tonotransducer. The ultrastracture changes of gallbladder ICC in sham,BDL-12 and BDL-72 groups was examined by transmission electron microscopy. Results There was no obvious inflammation in Sham and BDL-12 groups. Compared with sham group,there were significant differences of biology score of gallbladder in BDL-48 and BDL-72 groups (P＜0. 05). After adding CCK-8,Ach and KC1,the contraction amplitude of gallbladder muscle increased in each group,and in dose-dependent manner. Compared with sham group,the effect value of each other groups decreased significantly (P＜0. 05). Compared with sham group,the morphology of ICC changed in BDL-12group,and more obvious in BDL-72 group. Conclusion Biliary obstruction can induce AAC. At the earlier stage of ACC,the impaired contraction of gallbladder smooth muscle present even without gallbladder inflammation occurrence. ICC may play an important role in impaired contraction.