Objective To study the relevance of peripheral blood mononuclear cell (PBMC) IL- 18 level in patients with chronic HBV infection and the activity of chronic hepatitis B as well as the ex- tent of hepatic tissue inflammation. Methods Flow cytometry was applied to measuring IL-18 level in PBMCs isolated from 147 patients with HBV infection; meanwhile, 22 cases with hepatitis B patients or HBV carriers underwent needling biopsy of liver for liver histopathologic examination. Results IL- 18 level was rising step by step in moderate chronic hepatitis, severe chronic hepatitis, chronic serious hepatitis and acute fatal hepatitis. Elevation of IL-18 level was correlative to the activity of hepatic tis- sue inflammation. Conclusion The expression level of IL-18 is different in various HBV infection states, which is correlative to the activity of chronic hepatitis B as well as the extent of hepatic tissue inflammation. Therefore, IL-18 may be used as an important index of evaluating therapeutic effect and prognosis.

The literature retrieval course is the main form of current domestic medical infor-mation literacy education. But students have no interest in it, so it's difficult to realize the goal of in-formation literacy education. Information literacy education has the same ideas and goals with PBL in developing students' ability to ask questions, analyze and solve problems, as well as in improving students' autonomous learning and life-long learning ability. To study the model of medical information literacy education embedded in PBL from three stages that early course preparation, mid implementa-tion and later evaluation. The research is aimed at the improvement of students' information literacy and their lifelong study ability. It suggests that there are coordinated effects between PBL and informa-tion literacy.

Objective To compare the therapeutic effects with different dosages of sertraline on patients suffering from idiopathic premature ejaculation. Methods IIEF-5 and CIPE questionnaires were completed before the treatment, and 86 patients who met the diagnostic standard of idiopathic premature ejaculation were finally recruited. Subjects were administered sertraline 50 mg/d combined with behavior therapy at stage Ⅰ for 4 weeks. Then, according to the therapeutic effects and the adverse events, all of the patients were divided into 3 groups for stage Ⅱ (another 4 weeks) as ①subjects with good effectiveness but with no or slight adverse events,would continue the treatments ②subjects with no therapeutic effects and with no obvious adverse events were allowed to increase the dosage of sertraline to 100 mg/d;③patients with effectiveness and obvious adverse events were al follows:lowed to reduce the dosage of sertraline to 25 mg/d. Those who had obvious adverse events and no effectiveness quit the study. Results During stage Ⅰ , 63 of 86 patients were effective (73.3%), and 23 patients had no improvement (26. 7%). Thirty-three patients had adverse events (38. 4%), and the remaining 53 patients had no obvious adverse events (61.6%). During stage Ⅱ , of the patients that responded to treatment, 35 patients who had no adverse events and 12 who had slight adverse events continued the treatment. Furthermore, 16 with intolerable adverse events were allowed to reduce the dosage to 25 mg/d. Meanwhile, of those without improvement, 18 subjects without obviousadverse events were allowed to increase the dosage to 100 mg/d, and 5 patients discontinued the treatment. Eight weeks later, among the patients taking 50 mg/d, 47 subjects were effectively with no obvious adverse events. Among the patients taking 25 mg/d, 10 showed improvement, 6 showed no improvement, and 2 had tolerable slight adverse events. Among the patients taking sertraline 100 mg/d,8 witnessed effectiveness, 13 had tolerable adverse events and 2 discontinued the treatment, with 1 having neither effectiveness nor obvious adverse events. The adverse events rate was 21.0% and the total effective rate of 8 weeks of treatment was 80.2 %. Conclusions Sertraline administration is an effective and safe way to treat idiopathic premature ejaculation. Although the effectiveness of the individualized treatment had no obvious improvement comparing routine therapy, there was a notable reduction in the adverse events rate, which increased the patient compliance.

Objective To evaluate magnetic resonance imaging (MRI) for breast-conserving surgery. Methods In this study, 52 cases of breast cancer eligible for breast-conserving surgery judged by traditional screening methods from May 2004 to December 2007 were inspected preoperatively with MRI in order to detect the cases of muhicentric breast cancer. At the same time, tumor size and invasive extent was measured accurately with enhanced magnetic resonance sequence combined with fat-suppression to determine the minimally extent of the surgical excision required. Results In the 52 cases of breast cancer patients, 3 cases of multicentric breast cancer and 49 cases of single breast cancer were diagnosed by MRI ,there were 3 cases with extensive intraductal carcinoma in the cases of single breast cancer. The primary negative margin rate was 93.6% (44/47) in the 47 cases with breast-conserving surgery. Conclusions MRI has thesuperiority to detect the muhicentric disease and the extensive intraductal carcinoma of breast cancer.Therefore MRI is useful in determining the indication and the extent of surgical excision of breast-conservingsurgery.

Objective To study dIe ESBLs and plasmid-mediated AmpC enzymes in E.Coli and Klebsiella spp. with CLSI ESBL-screening test positive,confirmation test negative but cefepime susceptible.Methods Antimierobial susceptibility testing were performed by Kirby-Bauer(K-B)method.The genes encoding ESBLs and plasmid-mediated AmpC enzymes were detected by PCR Transfer of ESBLs or plagmid-mediated AmpC resistance was studied by conjugation experiments.The homology of donor (E.coli),recipient(E.coli J53)and their transconjugants were analyzed by ERIC-PCR DNA fingerprints of E.coli and Klebsiella pneumoniae were analyzed by PFGE as recommended bv PulseNet protocoL Results Of 18 isolates from Huashan Hospital,11 were E.coli.6 were Klebsiella pneumoniae and 1 was Klebsiella oxytoca.Antimicrobial susceptibility testing indicated all of 18 isolates were positive on the CLSI ESBL screening test but negative on the confirmation test.and all of isolates were susceptible to cefepime(a zoneof-inhibition diameter of≥18 mm wag considered to indicate susceptible).PCR results indicated that 9 of the 11 E.coli isolates predued CMY-2 AmpC enzyme.TEM,SHV,CTX-M,PER,VEB or SFO type β-lactamages were not identified.Of 6 Klebsiella pneumoniae isolates.5 were DHA-1 AmpC-producing strains.4 of the 5 DHA-1 AmpC-producing strains were coexistence of broad-speetrumβ-lactamaae or extended-spectrumβ-lactamase.including two producing SHV-11 and two producing CTX-M-14 and SHV-62 type ESBL respectively.One Klebsiella oxytoca wag also DHA-1 AmpC producing strain.Conjugation experiments indicated that both ESBLs and AmpC enzymes could be transfefred from donor to recipient.PFGE indicated that the DNA fingerprints of K.pneumoniae were difierent but seven CMY-2 AmpC-producing E.coli isolates from general surgieal ward were similar.Concluslons The main mechanism of antibiotic resistance in CLSI ESBLs-screening test-positive but eefepime.susceptible E.coli and KIebsiellaspp.is production of plagmid-mediated AmpC enzymes.Some strains produce both AmpC enzyme and ESBLs.Such strains should be reported as resistant to cefepime.The results suggest that laboratories should routinely conduct research on the ESBLs and plnsmid.mediated AmpC enzymes in Enterobacteriaceae in order to report antimicrobial susceptibility testing results more correcdy.

Objective To evaluate the therapeutic effect,as well as the safety,of on-demand sildenafil on men with idiopathic ED.Methods One hundred and four men who met the diagnosis criteria of idiopathic ED were recruited into 2 groups.Among them,46 men who refused or were reluctant to take pharmacotherapy were recruited into the clinical control group with instruction of sexual knowledge and skills.Fifty-eight men who were involved in the on-demand group,were administrated sildenafil 50 mg just 1h before the coitus at thebeginning,then,if needed adjusted the dosage according to the effect and tolerance of the first four administration.The questionnaire of IIEF-5 was completed at the baseline and the end point,and the clinic total effective rate,the fully recovery rate of ED and the adverse events were also evaluated at the end of administration.Both groups were treated for 3 months.The therapeutic effect was reevaluated 1 month and 3 months later,respectively.Results After 3 months treatment,scores of IIEF-5 at the baseline and the end point for control group and on-demand group were as follow:5.2 and 12.6,4.2 and 19.8 ;and the fully recovery rate of ED for each group were as follow:12 (26.1％),56 (96.6％) ; the total effective rate for each group were 27.7％,97.2％ ; 1 month and 3 months after the end point,the fully recovery rate of ED and the total effective rate were evaluated separately,for 1 month:8 (17.4％),56(96.6％) and 19.4％,97.1％; for 3 months:7 (15.2％),55 (94.8％) and 16.4％,96.4％.The side effects in on-demand group (16,27.6％) was little higher than the control group (5,10.9％) (P ＞0.05).Most of the side effects were not only subtle and transient but also would vanish with the time.Accordingly,no one discontinued because of side effects.Conclusions Treatment of idiopathic ED with sildenafil was effective and safe.In terms of the fully recovery rate,total effective rate and effect maintenance,the on-demand group at the end point,even 1 month and 3 months after the end point,showed a great advantage over the control group.

OBJECTIVE To compare the difference of testing cleaning effectiveness in the operation instrument between the eye measurement and hemoglobin enzyme test.METHODS Five batches of instrument after cleaning were tested by two methods.RESULTS By eye inspection,all tested samples were qualified.However there were only 76 percent of samples qualified according to enzyme test.CONCLUSIONS Compared with eye inspection,enzyme test is a more sensitive method.Enzyme test can better assess the cleaning effectiveness than others.

Objective To explore the CT findings of pediatric hepatoblastoma and its correlation with pathological subtypes.Methods CT findings and pathological characteristics of 110 patients with hepatoblastoma confirmed by pathology were retrospectively analyzed.Results The locations of the tumor were right lobe (67/110,60.90％),right and left lobe (25/110,22.72％),left lobe (15/110,13.63％) and caudate lobe (3/110,2.72％).The average tumor size was (287.14±272.36) cm3.Most cases were solitary (94/110,85.45％) and round shape (96/110,87.27％).Most cases were well defined (86/110,78.18 ％).Necrosis were irregular in 102 cases,calcification were in 60 cases.Lung metastases were common (23/110,20.90 ％) and vessel involvement were common (56/110,50.90 ％).Lymph node metastasis was in 5 cases.Calcification and homogeneous enhancement in different pathological types had statistically significance (both P ＜0.001).Conclusion CT is helpful for pre-operation and pathological diagnose.

Objective:To clone and express the full length cDNA of human CD38. Methods:The full length cDNA of the human CD38 antigen was amplified from total RNA of Daudi cell by RT-PCR, and it was inserted into pGEM-T. The validity on the sequences was confirmed by automatic DNA sequencing. Inserting the valid CD38 gene into pcDNA3.1(+) plasmid to obtain recombinant mammalian expression vector pcDNA3.1(+)/CD38Z; Using lipofectin gene transfer technique system, recombinant expression vector containing CD38 gene was transfected into COS7 cells. The expression of CD38 molecules on the surface of COS7 cells was detected by FACS and immunohistochemical technique. Results:DNA sequencing showed that the cloned full length cDNA sequence was identical with reported. The result of FACS and immunohistochemical technique indicated that CD38 molecules were expressed on the surface of COS7 cells. Conclusion:The full length cDNA of human CD38 is obtained, recombinant mammalian expression vector pcDNA3.1(+)/CD38Z is successfully constructed, and the CD38 molecules is expressed on the surface of COS7 cells,this may facilitate studies on the biochemistry and function of CD38 antigen.

Objective To analyze the clinical results of mini-incision Schwab grade 4 osteotomy combined with percutaneous pedicle screw fixation for old thoracolumbar compression fractures combined with kyphosis deformity.Methods A retrospective case series study was made on 14 patients with old thoracolumbar compression fractures combined with thoracolumbar kyphosis undergone mini-incision Schwab grade 4 osteotomy plus percutaneous pedicle screw fixation from January 2014 to May 2015.There were 5 males and 9 females,with mean age of 64.5 years (range,58-70 years).The period between injury and surgery ranged between 6 and 14 months (mean,8.6 months).At the time of surgery,the fracture was already healed in 10 patients,while non-healing was found in other 4 patients.Preoperative visual analogue score (VAS) of back pain was (8.5 ± 1.1)points (range,6.5-10 points).Three patients were associated with neurological dysfunction [American Spinal Injury Association (ASIA) grade D].Apex of kyphosis located at T12 in 6 patients and at L1 in 8 patients.Preoperative kyphosis Cobb angle was (42.5 ± 6.0)° (range,39.5°-47.2°).Operation time,blood loss,perioperative complications,postoperative kyphosis Cobb angle,bone fusion,state of implants,neurological function and VAS were determined.Results Operation time was (280 ± 50) min,and blood loss was (110 ±70)ml.No segmental vessels injury,neurological deficit or dural disruption occurred during the surgery and after surgery.Compared to the preoperative detection,kyphosis Cobb angle was improved to (9.3 ±1.7) ° (range,6.2°-12.1 °) after operation (P ＜ 0.05),with the correction rate of 78.1％.Postoperative CT showed 7 screws (6.3％,7/112) were grade 1 screws.The follow-up was lasted for mean 25.2 months (range,14-28.9 months).At the latest follow-up,the kyphosis Cobb angle was (9.6 ±4.1)°(range,6.0°-13.1°),revealing no correction loss.Interbody bone fusion was good,with no instrumentation-related complications observed.Three patients with neurological dysfunction (ASIA grade D) were recovered to ASIA grade E.Compared to the preoperative detection,back pain was improved with the VAS of (2.6 ± 1.0) points at the latest follow-up (P ＜ 0.05).Conclusion Mini-incision Schwab grade 4 osteotomy combined with percutaneous pedicle screw fixation of old thoracolumbar compression fractures with kyphosis deformity can attain satisfactory and reliable efficacy and bone fusion,with low incidence of complications.