Primary biliary cirrhosis (PBC) is a slowly progressive autoimmune disease of the liver.Studies on the pathphysiology of this disease have demonstrated the immune-mediated destruction of the intrahepatic bile ducts and portal infammation seem to be the result of an intense autoimmune response directed against the autoantigens located in the biliary epithelium.Immunologically,PBC is characterized by the presense of antimitochodrial antibodies,elevated serum IgM and lymphoid infiltration in the portal tract.Indeed,the relationships between IgM and PBC have been a major focus of research on its pathphysiology,which lead to an increased understanding of the abnormal immune responses involved in PBC.This review summarizes data on the biological and clinical significance of Hyper-IgM in PBC,and highlights the potential role of IgM for the diagnosis and treatment of PBC.

OBJECTIVE: To explore the regularity and characteristics of ADR induced by levofloxacin. METHODS: Retrieved from, CHKD of CNKI and Wanfang database, a total of 205 literatures about levofloxacin-induced ADR were collected and analyzed statistically in respect of patients’ gender, age, case history, administration route, clinical manifestation and result of treatment. RESULTS: 483 cases(92.9%) were given levofloxacin intravenously in total of 520 ADR cases. 156 cases were characterized with lesion of skin and its appendants (30.0%), followed by lesion of nervous system (n=133, 25.6%), lesion of cardiovascular system (n=65, 12.5%) and anaphylactic shock (n=45, 8.7%). The earliest ADR occurred within 2 min after administration while the latest occurred in 34 d after administration. 514 cases recovered when drug withdrawal or treatment were taken. However, there were 2 cases of sequelae, 4 cases of death and 62 cases of unexpected serious ADRs. CONCLUSION:ADRs induced by levofloxacin present complicated and various symptoms caused by several factors in which the most serious result in death. Clinical doctors should pay more attention to levofloxacin-induced ADRs.

Objective To observe the incidence of acute radiation pneumonitis (RP)after intensity modulated radiation therapy,and to explore the relationship between the incidence of RP and the parameters from dose-volume histogram (DVH)in the patients with non-small cell lung cancer (NSCLC).Methods By Pinnacle 7.6c TPS, 46 patients with NSCLC were treated by IMRT.The values of the percentages of the lung volumes receieved 5, 10,20,and 30 Gy radition to the total lung volumes (V5 ,V10 ,V20 ,V30 )and mean lung dose (MLD)were observed,and its correlation with acute RP was analyzed.Results The incidence of acute RP of the patients with NSCLC was 37.0% (17/46),among then there were 29 cases (63.0%)of Grade 0 (non-pneumonitis group), 12 cases (26.1%)of Grade 1,5 cases (10.9%)of Grade 2,and there were no Grade 4 and 5 RP.The values of V5,V10,V20,V30,and MLD of lung were 53.34 %,43.12%,24.15%,15.36 %,and 16.02 Gy.The values of V5,V10,V20,V30,and MLD in pneumonitis group were 57.81%,48.91%,31.34%,17.83%, 21.71 Gy,and they were 49. 81%,39.78%,21.82%,13.12%,and 13.71 Gy in non-pneumonitis group, there were significant differences between two groups (P<0.05).Conclusion The intensity modulated radiation therapy in treatment of NSCLC can protect the lung tissue,and the parameters of DVH such as V5 ,V10 ,V20 , V30 and MLD can predict the occurrence of RP.

Objective To observe the therapeutic effect of Tanreqing Injection in treatment of acute irradiation oropharyngeal mucositis in the patients with head and neck cancer, and to provide reference for its clinical application.Methods Fifty patients with head and neck cancer were randomly divided into treatment group and control group(n=25).The patients in treatment group received concurrently intravenous infusion of Tanreqing Inj ection during irradiation course.The patients in control group received daily regular oral nursing;oropharyngeal mucositis was evaluated according to the protocol proposed by RTOG.Results The patients in treatment group with Ⅰ and Ⅱ oropharyngeal mucosal injury accounted for 76%,and the patients in control group with Ⅲ,Ⅳoropharyngeal mucosal injury accounted for 60%,there was statistically significant difference between two groups (P<0.05).The scores of the patients with oropharyngeal pain in treatment group were 0-3 (mild),in control group they were 4- 6 (moderate).The patients with mild,moderate,and severe oropharyngeal pain in treatment group and control group after radiotherapy accounted for 72%,24%,4% and 12%,64%,24%;there were statistically significant differences between two groups (P<0.05).Conclusion Tanreqing Injection has a good therapeutic effect on acute radiation stomatitis and layngopharyngitis, and it has the effects of relieving oral and pharyngeal mucosa inj ury,anti-inflammatory and analgesic and accelerating wound healing.

Objective To investigate the occurrence of intraoperative occupational exposure to blood among sur-geons in a hospital,so as to make effective precaution measures.Methods Combined with questionnaires,the mo-nitoring data of occupational exposure to blood among surgeons from June 2011 to June 2013 were analyzed statisti-cally.Results A total of 49 surgeons sustained 115 times of occupational exposure to blood,including 42 times (36.52%)in general surgery surgeons,36 (31 .30%)in orthopedic surgeons,31 (26.96%)in obstetrics and gyne-cology surgeons,and 6(5.22%)in urinary surgery surgeons.The main occupational exposure were sharp injuries (n=71 ,61 .74%),blood and body fluid splashing were 44 times (38.26%);the top two exposed sites were hands (49.57%)and faces (17.39%).88.70% of exposed cases were given emergent treatment,and 55.65% of exposed cases were reported.The follow-up found no surgeons were infected after the prompt and correct treatment. Conclusion Surgeons are at high risk of occupational exposure.Occupational precaution should be strengthened, occupational awareness and ability of HCWs should be enhanced,and post-exposure treatment should be improved.

Objective To establish lung adenocarcinoma drug resistance cell strain induced by cis-diaminodichloroplatin and investigate the biologic characteristics and chromosome karyotype of cell strain.Methods Large dosage impact and step by step inducing method were used to establish A549 and SPC-A-1 drug resistance cells: A549/CDDP and SPC-A-1/CDDP.MTT was used to detect the cell drug resistance index. Bioluminescence was used to detect the energy metabolism.Cell cycle was analysed by flow cytometer.The differential staining technique and SKY were used to analyze the chromatosome of A549/CDDP and SPC-A-1/CDDP.Results The drug resistance index of A549/CDDP and SPC-A-1/CDDP were 14.0 and 12.0. The content of ATP,ADP and AMP decreased significantly.The cell cycle of A549/CDDP and SPC-A-1/CDDP were of no notable changes.The results of the differential staining technique and SKY showed that the chromatosome of A549/CDDP and SPC-A-1/CDDP had several derivative chromosomes.Both cells had the same derivative chromosome: der(21)t(21;22).Conclusion CDDP can induce lung adenocarcinoma cell strain drug resistance.The derivative chromosome,including der(21)t(21;22) may have relationship with the drug resistance of cell strains.

Objective To analyze the unbalanced state of hereditary material of squamous carcinoma, adenocarcinoma and other lung cancers. Methods Fifty-five patients suffered from lung cancer were included in this study, including 24 of squamous carcinoma, 13 of adenocarcinoma, 5 of adenosquanous carcinoma, 8 of bronchioalveolar carcinoma, 4 of small cell lung cancer and 1 of atypical carcinoma. The technology of comparative genomic hybridization (CGH) was used. The normal DNA was obtained from 20 healthy male volunteers. Results The common extension region of squamous carcinoma was 2q, 5p, 11q and 22q, and the common deletion region was 1p, 4q, 5q, 6q, 8p, 9p, 10q, 11p, 13q, 18q and 21q. The common extension region of adenocarcinoma was 5p, 8q and 11q, and the common deletion region was 10p and 19. Conclusion The hereditary material of squamous carcinoma, adenocarcinoma and other lung cancers was unbalanced. The extension and deletion of chromatosome were the base of the occurrence of different lung cancer.

Objective To evaluate the anesthesia and perioperative treatment for simultaneous liver-kidney-pancreas transplantation. Methods The preoperative preparation included improvement of the hepatic function, alleviation of uremia and control of blood glucose level. General anesthesia was employed and maintained with isoflurane combined with intermittent intravenous administration of midazolam, fentanyl and vecuronium. Dopamine and low dose of epinephrine were used to maintain arterial blood pressure if necessary. The parameters of blood coagulation, the indexes of hepatic and renal function, blood glucose and amylase levels in blood and urine were surveyed regularly. The treatment was adjusted according to the results of tests mentioned above. Results The circulation was stable and blood gas was normal in the course of surgery. The concentration of blood glucose was higher at the end of the operation than that of pre-operation. Normal hepatic and pancreatic function was achieved about a week after operation, while the renal function showed no satisfactory improvement. The patient was given hemodialysis until the second transplantation of kidney. Three days later, the renal function recovered to normal. Up to the present, all the grafted organs showed good function. Conclusion Appropriate preoperative preparation, optimal anesthetic procedure and management, perfect protection of function of multiple organs, and maintenance of stable hemodynamics and homeostasis were the key points of successful anesthesia and management for simultaneous liver-kidney-pancreas transplantation.

Objective To reproduce a simple and practicable animal model of rheumatoid arthritis(RA)for evaluating the therapeutic effects of recombinant human interleukin-1 receptor antagonist(rhIL-1Ra).Methods The animal model of RA was reproduced in Wistar rats by intradermic injection of an admixture of bovine type Ⅱcollagen and Freund's complete adjuvant on the foot pad,tail,and back of the rats and the injections were repeated 7 days later.Results Two weeks after the second injection,all the extremities were markedly swollen.The diameter of ankle joints,the level of TNF-? in serum,and the size of the paws were increased obviously.There was destruction and absorption of the bone trabeculae of distal end of the tibia.There was also necrosis and fibrosis of cartilage of the joints.The articular space was narrowed.Thus RA model was successfully reproduced in rat.Conclusion Bovine type Ⅱcollagen and Freund's complete adjuvant were a favorable agent for the reproduction of RA model in rats.

The subjects examined were 398athletes. The method used included both questions and clinical examination. The differences of the data obtained all underwent Chi Square (X~2) test. Result of the investigation showed: the site of the highest incidence of injury was the ankle, 38.4%; the nextwas the knee, 26. 1%; the foot, 15. 3%; low back, 10. 3%; the thigh, 6. 8%; Tendo Achilles, 6. 5%; tibia, 4. 5%and fibula, 2. 3%. The incidence was relatively higher wbenever the injury had any relation with the shape ofthe knee (genu valgum, genu recurvatum), hallux Yalgus, c avus and callus and tarsal navicular. The differencesamong incidences of injury related with the shape of the lower limbs are of important statistical significance.As for the incidence of abnormal shape of limbs, genu valgum and recurvatum are outstanding in female wbilegenu varum occurs much more in male. This article is emphasized on the analysis of the mechanism of the influence of limb shape on injury;and it is thought that it is mainly due to changes in the line of force. In the authors' opinion, in the choiceof high level athletes, those who have such abnormal anatomy of their limbs should not be selected.