Objective To observe the clinical efficacy of XIE’s Wen Du Qu Mai (Warming the Governor Vessel to expel smog) needling method plus heat-sensitive moxibustion in treating chronic simple rhinitis due to yang deficiency. Method Eighty patients with chronic simple rhinitis due to yang deficiency were randomized into a treatment group and a control group, 40 in each group. The treatment group was intervened by acupuncture plus heat-sensitive moxibustion, while the control group was by medication. The symptom and sign score was observed before and after 1-week treatment, and the clinical efficacy was compared. Result The total effective rate was 85.0%in the treatment group versus 55.0% in the control group, and the difference was statistically significant (P<0.05). The symptom and sign scores were changed significantly after treatment in both groups (P<0.01,P<0.05). After treatment, the symptom and sign score in the treatment group was significantly different from that in the control group (P<0.05). Conclusion XIE’s Wen Du Qu Mai needling method is effective in treating chronic simple rhinitis due to yang deficiency.

Objective To study programmed death-1 (PD-1) and T-cell immunoglobulin mucin3 (Tim-3) co-expression on peripheral blood mononuclear cells (PBMC) and hepatitis B virus (HBV)-specific CD8+ T cells in patients with chronic HBV infection and its correlation with liver inflammatory activities.Methods One hundred and sixty subjects with chronic HBV infection who visited the outpatient and inpatient Department of Infectious Diseases in the Third Affiliated Hospital of Sun Yatsen University were enrolled,including 63 cases of mild or moderate CHB (MCHB),31 of severe CHB (SCHB),55 of acute-on-chronic liver failure (ACLF) and 11 inactive HBsAg carriers.Twenty healthy subjects were enrolled as controls.Real-time quantitative polymerase chain reaction (qRT-PCR) was used to detect HBV DNA,enzyme-linked immunosorbent assay (ELISA) to measure HBV serological markers,and flow cytometry to detect human leukocyte antigen (HLA)-A2 and determine the expression of PD-1 and Tim-3 on PBMC and HBV-specific CD8+ T cells.Cell counts of Tim-3+,PD-1+,and Tim-3+/PD1+ PBMC and HBV-specific CD8+ T cells were compared among different groups,and their correlation with commonly used inflammatory activity indicators were studied.Analysis of variance and Kruskal-Wallis test were used for measurement data with gaussian distribution and skewed distribution,respectively.Spearman correlation analysis was used to assess the association between Tim-3/PD-1 expression and inflammatory activity indicators.Results The frequency of Tim-3+/PD-1+ PBMC was 0.25 ％ in ACLF group (P=0.0049),0.24 ％ in SCHB group (P-0.0025) and 0.13％ in MCHB group (P=0.0006),which were significantly higher than that in control group (0.03％),and the frequency of Tim-3 /PD-1-PBMC in the three groups were significantly lower than that in control group (P =0.0000),but the differences between HBsAg carriers (0.10％) and controls (0.03％) were not statistically significant (P=0.28).Among 160 subjects,78 were HLA-A2 positive.The frequency of Tim-3+/PD-1+ HBV-specific CD8+ T cells was 68.72％±17.21％ in ACLF group,and 59.66％± 19.25％ in SCHB group,which were significantly higher than that in HBsAg carrier group (33.93％ ± 10.80％,P=0.0000,P=0.0054).The frequency of Tim-3 /PD-1-HBV-specific CD8+ T cells in ACLF group was 2.80％,which was significantly lower than that in HBsAg carrier group (27.24％,P=0.0004).The frequency of Tim3+/PD-1+ HBV-specific CD8+ T cells was positively correlated with alanine aminotransferase (r=0.26,P=0.022),aspartate aminotransferase (r=0.28,P=0.012) and total bilirubin levels (r=0.36,P=0.001); and inversely correlated with albumin level (r=-0.35,P=0.002) in serum.Furthermore,it was positively correlated with international normalized ratio (INR,r=0.34,P =0.045) and model for end-stage liver disease score (r=0.43,P=0.027) in ACLF group.Conclusions Co-expressions of Tim-3 and PD-1 on PBMC and HBV-specific CD8+ T cells are significantly upregulated in patients with CHB,and correlated with liver inflammatory activities.These findings indicate that Tim-3 and PD-1 co-expression may involve in disease activity and liver failure in CHB.

Objective To investigate CT features of similar Hexheimer's reaction during initial treatment of active pulmonary tuberculosis. Methods The similar Hexheimer's reaction in 44 patients diagnosed by clinic and follow-up CT scans were retrospectively reviewed by three radiologists. Results During initial treatment of active pulmonary tuberculosis, development of radiographic progression were observed in 57 foci, including 28 pulmonary lesions increased at the site of their original lesion or new opacities elsewhere, ipsilateral or contralateral to the original lesion or both, 10 lesions related to the pleura (pleural effusion, pleural tuberculoma), 15 lymphadeneetasis, 3 thymus reactions, and 1 cardiac pericardium thickening, respectively. These reactions appeared from the 20 days to 3. 5 months, then with continuation of the initial chemotherapy for 1.0-3.0 months, the radiographic response was excellent with the areas of progression and the original lesions demonstrating resolution or improvement. Conclusion The CT appearances of similar Hexheimer's reaction during initial treatment of active tuberculosis are specific to a certainty.

Objective The purpose of this study was to evaluate the constrast-enhanced CT features and pathologic findings of mediastinal tuberculous lymphadenitis in adults. Methods 39 patients with 180 lymph nodes diagnosed as mediastinal tuberculous lymphadenitis by operation, mediastinoscopy and biopsy were evaluated on enhanced CT scan, including 20 men and 19 women. The median age of the patients was 26 years(range from 16-67 years). Results Five post-contrast patterns of enhancement were found: (1) inhomogeneous enhancement(28.3%,51 nodes); (2) peripheral rim enhancement(26.1%, 47 nodes); (3) homogeneous enhancement(25.0%, 45 nodes); (4)nonenhancement( 14.4%, 26 nodes); (5) separate enhancement(6.11%, 11 nodes); CT-pathologic correlation demonstrated that patterns of enhancement of mediastinal tuberculous lymphadenitis were correlated with distribution of granulation tissue and caseous areas. 28 patients(71.8%) had a combination of enhancement patterns. 11 patients(28.2%) had a single enhancement pattern. Conclusion Constrast-enhanced CT appearance of mediastinal tuberculous lymphadenitis for diameter of 1.0-2.0 cm was homogeneous enhancement, nonenhancement, inhomogeneous enhancement and peripheral rim enhancement; for diameter of ≥2.0 cm was inhomogeneous enhancement, peripheral rim enhancement, homogeneous enhancement and nonenhancement. Peripheral rim enhancement or separate enhancement can suggest a diagnosis of tuberculosis.

Objective:To investigate the effects of early postoperative enteral nutrition on recovery of patients with gastric cancer.Methods:Sixty-five cases of patients with gastric cancer were randomized into early enteral nutrition (EEN) group and enteral nutrition (EN) group.Serum total protein (TB),albumin(ALB),Prealbumin,white blood cell count (WBC),C-reactive protein (CRP),immunoglobulin,peripheral T-lymphocyte subsets,gastrointestinal recovery time,hospital stay and cost were recorded.The nutritional and cellular immunity parameters of the EEN group on 7th day after operation were higher than those of the EN group.Inflammatory response of the EEN group on 3th day after operation was lower than EN group.EEN group showed better immunological response and clinical recovery than the EN group (P ＜ 0.05).Conclusion:Early enteral nutrition in postoperative gastric cancer patients can improve early postoperative nutritional status and immune function,alleviate inflammatory response,promote the recovery of intestinal function and shorten hospital stay.

Objective To describe varied features of pulmonary metastases of lung cancer on CT imaging .Methods 194 patients with pulmonary metastases of lung cancer were evaluated on CT scan , including 106 men and 88 women . The median age of the patients was 45 years ( range from 22 to 78 years ) . The histology of the lung cancer included 56 squamous carcinomas(28.9%),107 adenocarcinomas(55.2%),26 small cell carcinomas(13.4%),and 5 adenosquamous carcinomas(2.1%).Results The usual pattern of pulmonary metastases of lung cancer were parenchyma nodules. The unusual form of metastases that were mainly found in adenocarcinomas were cavitary lesions, ground-glass nodules and lesions with unusual signals including lobulated structure, spiculated margin,pleural indentation and air-bronchogram. The manifestations of lymphangial spread to intrapulmonary were extensive uneven thickening of the interlobular septa and fissures, nodular thickening of brochovascular bundles and many fine nodulars distributed along the brochovascular bundles and interlobular septa.Conclusion The manifestations of intrapulmonary metastases of lung cancer are varied morphologic features.

Objective To investigate the diagnosis and treatment of aggressive fibromatosis after thyroidectomy.Methods One patient who were admitted into our hospital on January 16,2014 were discovered to have left cervical mass at the regular follow-up 8 months after opertaion.The ultrasonic examination showed that there were low echo area of 58 mm ×30 mm in the 3 ~5 muscular layer at the left neck. And it was diagnosed as aggressive fibromatosis through the puncture disease inspection.Whereafter,the patient were readmitted into hospital and recieved radical resection of the tumor on left side of the neck.The clinical,pathological and radiological data of the patient were collect-ed and analyzed so ao to discuss the diagnosis and treatment experience combined with related literatures.Results Postoperative pathologic examination confirmed that it was aggressive fibromatosis.The patient was actively cooperated with perioperative treatment,and the postoperative recovery was good with no local recurrence during the follow-up up to now.Conclusion Early diagnosis and surgical treatment are needed for patients with aggressive fibromatosis after thyroidectomy.

AIM:To investigate the changes of histone modifications during the activation of primarily cultured rat hepatic stellate cells ( HSCs) and the relationship between histone modification patterns andα-smooth muscle actin (α-SMA) expression, and to explore the roles of histone modifications in the activation of HSCs.METHODS:The rat HSCs were isolated by in situ perfusion of collagenase combined with density gradient centrifugation, cultured in vitro and identi-fied by immunofluorescence staining.The morphological features of the cells were observed under inverted microscope.The changes of desmin and α-SMA during the activation of HSCs were detected by immunofluorescence staining and Western blotting.The levels of histone 3 lysine 4 dimethylation (H3K4me2), histone 3 lysine 9 dimethylation (H3K9me2), his-tone 3 lysine 9 acetylation (acH3K9) and histone 4 lysine 12 acetylation (acH4K12) in quiescent HSCs and activated HSCs were determined by Western blotting.RESULTS: The morphology of HSCs shifted from a quiescent phenotype to highly activated myofibroblast during the culture.Immunofluorescence staining and Western blotting showed that the expres-sion levels of α-SMA and desmin were increased over time and reached maximum at 15 d.According to the results of cell morphology and immunofluorescence staining, the cells cultured for 24 h and 15 d were quiescent and activated HSCs, re-spectively.Compared with quiescent HSCs, there were higher H3K4me2 and lower H3K9me2, acH3K9 and acH4K12 modification levels in activated HSCs ( P<0.01 ) .CONCLUSION: Histone modifications show anomalous expression during the activation of primarily cultured rat HSCs.Histone modifications may contribute to the transdifferentiation of HSCs and the development of hepatic fibrosis.

Objective To study the CT characteristics of coexisting pulmonary tuberculosis and lung cancer.Methods One hundred and four patients of coexisting pulmonary tuberculosis and lung cancer proved by histology,cytology or clinical underwent CT examination.All patients were divided into two groups,group Ⅰ were the patients with the lung cancer after tuberculosis or both found simultaneously (group Ⅰ a with peripheral lung cancer and group Ⅰ b with central lung cancer),group Ⅱ with tuberculosis during lung cancer chemotherapy (group Ⅱ a with peripheral lung cancer and group Ⅱ b with central lung cancer).Imaging characteristics of tuberculosis and lung cancer were compared.x2 test and t test were used for the statistical analysis.Results Of 104 patients,there were 92 patients (88.5％) in group Ⅰ and 12 patients (11.5％)in group Ⅱ.Seventy patients (76.1％) of lung cancer and tuberculosis were located in the same lobe and 22 patients (23.9％) in the different lobes in group Ⅰ.There was no significant difference in distribution of tuberculosis between group Ⅰ and group Ⅱ (x2 =4.302,P =0.507).The fibrous stripes,nodules of calcification and pleural adhesion of tuberculosis were statistically significant between the two groups (x2 =22.737,15.193,27.792,P ＜0.05).There were 33 central lung cancers and 71 peripheral lung cancers.In group Ⅰ a (64 patients of peripheral lung cancers),39 patients (60.9％) had typical manifestations and most of the lesions were ≥ 3 cm(n =49,76.6％),solid lesions showed variable enhancement.Conclusions Secondary tuberculosis during lung cancer chemotherapy has the same CT characteristics with the common active tuberculosis.The morphology,enhancement pattern of lesion and follow-up are helpful for the diagnosis of lung cancer after tuberculosis.

Objective To explore the association between interleukin (IL)-28B variation and spontaneous clearance of hepatitis C virus (HCV) infection.MethodsA total of 280 HCV infected patients including 200 chronic hepatitis C (CHC) patients and 80 spontaneous clearance patients of HCV infection were enrolled in the study.The rs8099917 single nucleotide polymorphyism (SNP) of IL-28B gene was detected and the association between IL-28B variation and spontaneous clearance of HCV infection was analyzed.The data were compared using chi square test.ResultsThe genotype frequencies of TT and non TT (TG and GG) of IL-28B rs8099917 between CHC patients and spontaneous clearance patients were not significantly different ( x2 =15.874,P ＜ 0.01 ). The prevalence of TT genotype in the spontaneous clearance group was 86.2％,which was higher than that in CHC group (62.0％).T and G allele frequencies in CHC group were 78.0％ and 22.0％,respectively,and those in spontaneous clearance group were 92.5％ and 7.5％,respectively,which indicated that T allele was dominant in spontaneous clearance patients. The allele frequency of rs8099917 was statistically different between the two groups (P＜0.01).The spontaneous HCV clear rate in rs8099917 TT patients was 2.84 folds of non-TT patients,while the risk of chronicity of non-TT (TG+GG) patients was 1.36 folds of TT patients.Conclusion The IL-28B (rs8099917) TT genotype is associated with spontaneous clearance of HCV infection,which can be an important factor to predict the spontaneous clearance of HCV.