Objective To study pathogenesis role of CD28:CTLA4/B7 costimulatory molecules in experimental autoimmune myasthenia gravis(EAMG). Methods Female lewis rats were divided into EAMG group and control group. The rats were immunized thrice with R?97-116 peptide in EAMG group, or only with phosphate buffer saline(PBS) in control group. 5 d after the third immunization, the expressions of CD28,CTLA4,B7-1, B7-2 on the surface of peripheral blood cells, lymphocytes and monocytes were exaimed by flow cytometry. Results In EAMG group,the achievement ratio of EAMG model was 75%; the expressions of CD28,CTLA4,B7-1, B7-2 on the surface of peripheral blood cells were significantly increased than those in control group (P

Objective:To study the expression of 11 cancer-testis (CT) genes and autologous humoral immune response to NY-ESO-1 in gastric carcinoma in China to provide some data for developing a vaccine against this cancer. Methods: Pathology tests were conducted in 101 gastric carcinoma samples,including tumor tissue and paired adjacent normal non-tumor tissue. Reverse transcription-polymerase chain reaction (RT-PCR) was used to test for 11 CT antigen gene expression and ELISA for autologous humoral immune response to NY-ESO-1.The antigen of NY-ESO-1 was also detected in tumor tissues by mAb E978 in IHC.Results: About 74.3% of the samples expressed at least one CT antigen,and the most frequently expressed one was MAGE-3 (41.6%). Twelve out of the 101 samples (11.9%) were found to be NY-ESO-1 mRNA positive. Simultaneously, autologous humoral immune response to NY-ESO-1 was detected in 6 of 12 NY-ESO-1 mRNA positive patients. Conclusion: Multiple CT genes were expressed in gastric cancer samples. MAGE-3,SSX-1,SSX-4, NY-ESO-1/LAGE-1, and MAGE-1 can be chosen as candidate antigens for cancer vaccines due to their higher expression rate. The potential of a multivalent CT antigen vaccine, including NY-ESO-1 and MAGE-3 along with other CT antigens, should be evaluated in patients with gastric cancer.

Breast cancer is one of the most common tumors in the world. HER2 and anti HER2 monoclonal antibody (Herceptin) has been a focus of breast cancer study in recent years. It is believed that HER2 and anti HER2 monoclonal antibody (Herceptin) may be a novel independent prognostic marker and therapeutic target for breast cancer. Herceptin, anti HER2 monoclonal antibody, has been proved to be an effective agent for breast cancer in late stage diseases, recurrent and metastatic lesion.

Objective To summerize the clinical experience of 23 cases of carotid cavernous fistula(CCF) and discuss the treatment strategy. Methods Retrospectively analyzed 23 patients(11 males and 12 females) of CCF,including 14 patients with Barrow type A,1 with type B,1 with type C and 7 with type D. Results Vascular approach for embolization was undertaken in 20 cases by transarterial access and 2 via venous route while 1 case was given up. Among them,9 cases obtained complete occlusion by simple balloon embolization and 5 were treated by direct occlusion of internal carotid artery. Another 5 cases used NBCA glue for the occlusion,1 case was embolized by gelatin-sponge particulates combined with compression of carotid artery,2 cases were treated by coil embolization of cavernous sinus and 1 case was only managed by carotid compression maneuver. We achieved satisfactory clinical results with 21 patients cured and 2 patients improved. Conclusion Complexity and refractory are the characteristic of CCF,and endovascular treatment should be the major choice of treatment. (J Intervent Radiol,2006,15: 323-326)

Objective To study the efficacy of minimally invasive treatment for lower extremities venous ulcers.Methods A total of 48 patients with lower extremities venous ulcers(56 hmbs)wereexamined with venography to identify the primary lesion that resulted ulcer. According to the type and degree of hemedynamie abnormality,high ligation of the great saphenous vein combined with endovenous laser treatment,subfascial endoscopic perforator surgery,and external banding valvuloplasty of the superficial femoral vein were done in 8 eases(8 limbs),high ligafion of the great saphenous vein combined with endovenous laser treatment and subfascial endoscopic perforator surgery were carried out in 24 cases(28 limbs),and high figation of the great saphenous vein combined with endovenous laser treatment was performed on 16 cases(20 linbs).In all cases,the ulcers were eircumferentially ligated at the same time.Results After the operations,superficial varicosis,pigmentations,and eczematous relieved remarkably in the 56 limbs.In 51 limbs,heavy feeling,ache,and edema disappeared 14-18 days after operation.The ulcers of the 56 limbs healed l6-48 days after operation.During 4 to 46 months follow up,ulcers recurred in 4 limbs(7.1%).Conclusions It is effective to correct the incompetence of the superficial,perforating,and deep veins and manage the surface of ulcers for lower extremities venous ulcers.Endovenous Iaser treatment and subfascial endoscopic perforator surgery are easily performing,minimally invasive,and safe operations.The recurrence of leg ulcers can be reduced by external banding valvuloplasty of the superficial femoral vein.

Objective To compare the value of (~99m) Tc-octreotide scintigraphy and planar X-ray mammography in the diagnosis of breast cancer. Methods A total of 32 patients with suspected breast cancer were enrolled into this study. All patients underwent (~99m) Tc-octreotide scintigraphy and planar X-ray mammography. The diagnostic efficiency of (~99m) Tc-octreotide scintigraphy and planar X-ray mammography were compared based on the post-surgery pathology. Results The sensitivity of (~99m) Tc-octreotide scintigraphy and planar X-ray mammography in the diagnosis of breast cancer was 91.67% and 66.67%, the specificity was 100% and 37.50%, the accuracy was 93.75% and 59.38%, respectively. Combining (~99m) Tc-octreotide scintigraphy with planar X-ray mammography, the sensitivity, specificity, accuracy, positive predicting values and negative predicting values for breast cancer was 95.83%, 100%, 96.88%, 82.14% and 47.06%, respectively. Conclusion The diagnostic efficiency of (~99m) Tc-octreotide scintigraphy for breast cancer is superior to planar X-ray mammography. (~99m) Tc-octreotide scintigraphy combined with planar X-ray mammography, the diagnostic efficiency for breast cancer will be further improved.

Objective To investigate the effect of modified early warning scores (MEWS)on nosocomial emergency transshipment in primary hospital.Methods From July 2013 to February 2014,192 patients were selected as control group,and from March 2014 to October 2014,192 patients were selected as observation group.The control group conducted assessment and transshipment by experience.The observation group adopted MEWS to evaluate dis-ease and applied targeted treatment.Then,we compared the incidence of unsafe events,accuracy of handover,family member and the related departments 'satisfaction.Results After the implementation of MEWS,the incidence of unsafe events was decreased from 13.0% to 5.2%(χ2 =5.121 ).The accuracy of handover was increased from 85.4% to 94.3% (χ2 =8.248).The family member and related departments 'satisfaction were improved from 89.1%,87.5% to 97.4% and 96.4%,respectively (χ2 =15.561,χ2 =10.141).The differences were statistically significant (P <0.05).Conclusion MEWS can evaluate and classify the safety of patients objectively and effective-ly during nosocomial emergency transshipment.MWES can effectively reduce the incidence of unsafe events,increase the accuracy of handover,improve family member and related departments'satisfaction.

Objective To investigate the present situation of quality of life in the elderly residents aged more than 60 years in Zhanjiang city and to analyze its influence factors .Methods 418 elderly residents over 60 years sampled by the random sampling in Zhanjiang city were performed the questionnaire survey by using the Chinese Scale of World Health Organization QOL (WHOQOL-BREF) .Results The quality of life in the physical ,psychological and environmental fields in male residents was higher than that in the female residents ;which in the psychological and environmental fields in the high cultural level residents was higher than that in the low cultural level residents ;which in the social relations field in the high income residents was higher than that in the low in-come residents ;there were no statistical differences in the quality of life among the elderly residents with different occupations be-fore retirement and marital status ;the Logistic regression analysis showed that gender and occupation were the influence factors of quality of life self evaluation in elderly residents .Conclusion Gender ,occupation ,educational level and income level are the influ-ence factors of quality of life in elderly residents .

Objectives To analyze the diagnosis and management of steroid-resistant nephrotic syndrome (SRNS) accompanied with irreversible leukoencephalopathy in children. Methods The clinical, laboratory and imaging data were retrospectively analyzed in a SRNS child accompanied with irreversible leukoencephalopathy. A literature review was performed. Results After clinical diagnosis of SRNS, glucocorticoid, immunosuppressant, and hemodialysis were administrated for 10 months. During the course of treatment, the seizures, visual problems, and hypertension were repeatedly occured. The cranial MRI showed bilateral occipital parietal lobe hyperintensity and right frontotemporal lobe hyperintensity on T2-weighted imaging and bilateral occipital parietal lobe hypointensity on T2-Flair imaging, which indicated that encephalomalacia was accompanied with gliosis. Conclusions A variety of reasons may induce leukoencephalopathy in children. The accompanied irreversible leu-koencephalopathy should be strongly considered in management of SRNS.

Objective To establish gastric bypass surgery model with SD rat and analyze the influence factors and preventive measures so as to accumulate experience and skills for further developing gastric bypass surgery model on diabetic rat( GK rat) . Methods Gastric by-pass surgery was operated on 30 SD rats. Summarized modeling experience and analyzed various factors affecting modeling success. Results 17 rats weresuccessfully survived after surgery and 13 failed, with the mortality rate 43. 3%. Three rats died during operation, including two for anesthesia and one for heart failure;one died due to anastomotic bleeding two hours after surgery. Eight died in the third day after surgery, including two for infection, two for intestinal necrosis, four for anastomotic stenosis or obstruction. One died because of anastomotic leakage caused by mistaking and satiety the fifth day after surgery. There were no other complications such as wound dehiscence occurred in this group . Conclusion Establishing models of gastric bypass surgery with SD rats which is regarded as pre-experiment of building models of gas-tric bypass surgery with GK rats is economical and feasible. Anesthesia and perioperative management, surgical techniques and infection pre-vention and control are the main factors affecting modeling. The survival rate of rat model could be increased if related factors well controlled.