Cholestasis ; Humans ; Liver Diseases

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.

Liver biopsy plays an important role in the diagnosis of autoimmune liver diseases,particularly in patients without specific clinical manifestations or negative for autoantibodies.The histological features of several autoimmune liver diseases are reviewed.The characteristic features of autoimmune hepatitis in histology include interface hepatitis with lymphoplasmacytic infiltration,hepatic rosette formation,and emperipolesis,while chronic nonsuppurative destructive cholangitis and epithelioid granuloma are frequently found in primary biliary cirrho-sis.Primary sclerosing cholangitis is characterized by onion skin-like periductal fibrosis,while storiform fibrosis with IgG4-positive plas-ma cell infiltration often indicates IgG4 -related sclerosing cholangitis.Enhanced communication between clinicians and pathologists can help improve the diagnosis and treatment of autoimmune liver diseoses.

Objective To observe the clinical effect of recombinant human growth hormone on mechanical ventilation in chronic obstructive pulmonary disease ( COPD) patients complicated with respiratory failure .Methods 31 COPD patients complicated with respiratory failure were randomly divided into rhGH treatment group and control group .All the patients were given antibiotics ,expectorants ,bronchodilators ,glucocorticoid and nutritional support ther-apy.The treatment group was given subcutaneous injection of rhGH ,9u/d,7~14d.The plasma-albumin,prealbumin, ureanitrogen,creatinine,GOT,dailyaveragebloodglucose ,lymphocytecount,C-reactiveprotein,tionofmechanical ventilation,ICU stays were observed pretherapy and post-treatment.Results The plasma total protein,plasma-albu-min,prealbumin,lymphocyte count of the treatment group were significantly higher than those of the control group (P<0.05),(60.3 ±12.8)g/L vs (55.6 ±10.7 )g/L,(38.5 ±5.4)g/L vs (34.6 ±3.6)g/L,(2.3 ±0.2)g/L vs (2.0 ±0.1)g/L,(1.15 ±0.17) ×109/L vs (1.02 ±0.18μ) ×109/L respectively,while C-reactive protein in the treatment group was significantly lower than control group [(8.4 ±3.7)mg/L vs (12.5 ±2.4 )mg/L](P<0.05), blood glucose in the treatment group was slightly higher than control group (6.9 ±1.1) mmol/L vs (6.5 ±0.8 ) mmol/L(P<0.05),the duration of mechanical ventilation and ICU stay time in the treatment group were shorter than those in control group [(13.2 ±3.2)days vs (16.8 ±3.7)days,(17.2 ±2.5)days vs (21.8 ±2.7)days].Conclu-sion Recombinant human growth hormone could help in shortening duration of mechanical ventilation and ICU stays for COPD patients complicated with respiratory failure .

This paper analyses the characteristics of USB bus power.Based on the power demand of the circuits for neuromuscular rehabilitator,power voltage transformation circuits are designed for the realization of USB bus power supply.

Objective We screened autoimmune hepatitis (AIH) from patients who had abnormal liver function without any viral marker in serum, and investigated the clinical and pathological features of AIH type Ⅰ. Methods According to the revised descriptive criteria and scoring system for diagnosis of autoimmune hepatitis proposed by the International Autoimmune Hepatitis Group, we examined the clinical and pathological characteristics of the patients who were diagnosed as AIH type Ⅰ. Results All patients (32 cases) diagnosed as AIH type Ⅰ were female. The age distribution showed a single peak in the decades of the fifties and sixties. Liver function test of these patients showed hepatic profile. Twenty eight patients (87.5%) had hypergammaglobulinemia, 26(81.3%) and elevated serum IgG level. Twenty six cases were positive for antinuclear antibody (ANA). Twelve patients (37.5%) had concurrent autoimmune diseases. Among fifteen patients who underwent liver biopsy, interface hepatitis and lobular hepatitis were observed in 11(73.3%) and 5(33.3%) patients, respectively. Rosetting of liver cells and liver fibrosis or cirrhosis were also detected in 3(20%) and 6(40%) patients respectively. Twenty one patients (65.5%) were considered to have a complete response to immunosuppressive therapy; 9(28.1%) relapsed; and 12(37.5%) sustained remission. Conclusions Autoimmune hepatitis type Ⅰ is mainly diagnosed in middle aged women, characterized by interface hepatitis on histologic examination, the presence of circulating autoantibody, hypergammaglobulinemia and response to immunosupressive treatment.

The ideological education of college students based on human being should pay attention to students’ full development,center on their main position in the ideological and political education,respect and embody students' individual difference and settle their practical problems.

Objective To investigate the distribution of five indicators of hepatitis B(HBV-M)and its relationship with liver function parameters and HBV-DNA load in patients with chronic HBV infection in different stages.Methods The serum samples were collected from 456 patients infected with HBV.The HBV-M,liver functional parameters and HBV-DNA level were quantita-tively detected.According to the stages of disease,the patients were divided into 3 groups including chronic hepatitis B group(inclu-ding mild subgroup,moderate subgroup and severe subgroup),liver cirrhosis group(including compensatory subgroup,decompen-sated subgroup)and hepatocellular carcinoma goup.Results The ratio of HBsAg,HBeAg,HBcAb positive pattern(135 pattern) and HBsAg,HBeAb,HBcAb positive pattern(145 pattern)in the three groups were statistically different(P <0.05).In each chron-ic hepatitis B subgroup,both ALT and AST levels of 135 pattern were significantly higher than the other two patterns(P <0.05). In each liver cirrhosis subgroup and hepatocellular carcinoma group,there were statistically significant differences in ALB and TBIL levels between the three patterns(P <0.05 ).In each group,the HBV-DNA level of 135 positive pattern were significantly higher than the other two patterns(P <0.05).Conclusion With the advancement of chronic hepatitis B,there is a downtrend in the ratio of 135 pattern and increasing trend in the ratio of 145 pattern.If the stage of hepatitis B is discriminated,ALT,AST,ALB TBIL and HBV-DNA level were closely related to HBV-M pattern.

Objective To explore the constraint effect of self - made binding sheets to restless patients. Methods Using soft canvas and thick qualitative cotton for sheets making. 100 cases of Neurusurgery JCAHO into patients of level 2～3 were, randomly divided into 52 cases of obeservation group and 48 cases of control group, then use self - made binding sheets and traditional binding sheets respectively for the purpose of protective constraint. Re-sults The interference treatment and skin damage of the observation group, and the psychological pressure of nursing staff were significantly lower than those in control group (P < 0.01). Conclusions With self - made binding sheets the patients have integrity constraints, and the result is better than the traditional one.

Objective To analyze the changes of drug resistance of Acinetobacter baumannii in our hospital during 2010-2012 to provide reference for clinical rational drug use and the effective control of Acinetobacter baumannii infection .Methods The drug resistance of Acinetobacter baumannii clinically isolated from 2010 to 2012 and its infection situation were retrospectively performed the statistical analysis .Results The clinical isolation rate of Acinetobacter baumannii in our hospital was increased from 218 cases (12 .19% ) to 741 cases (18 .48% ) in 2012 .The resistance rates of 18 kinds of antibiotics were almost more than 70% ,and pan-drug-resistant Acinetobacter baumannii appeared in some clinical departments ,such as ICU and neurology .The selective pressure of antibiotic was one of the main motive causes of drug resistance change ,and age ,underlying diseases ,duration of hospitalization and invasive procedures were the high risk factors in patients infection .Conclusion Hospital should enhance a series of measures including reinforcing the disinfection of the medical environment ,medical equipments and medical staffs ,strengthening the monito-ring of hospital infection and using antibiotics rationally to reduce and control the prevalence of Acinetobacter baumannii .