Objective To treat the spontaneous bacterial peritonitis (SBP) of liver cirrhosis and to indicate the factors of early diagnosis and progrosis . Methods There were 107 patients, we observed age,sex,causes of liver cirrhosis,incidental rate of SBP and infection rate in thethe hospital,bacteria examination and drug allergy test. By setting control group, we compared liver function,blood routine,ascites routine,B supersonic examination,Child-pough Grading and complications. Results Cirrhosis mainly resulted from HBV infection(83.2%);Most of patients were male;Cirrhosis patients associated with SBP accounted for 21.6%,in which infection rate in the hospital accounted for 16.8%;becteria positive rate of ascites cultivation was 14%,most bacteria were monobacteria,G -bacillus(66.7%);Drug allergy test indicated drug resistance rate exceeds 50%,in the followorder penicillin,amino-group,oxygen-fluonine killer.Comparing with control group,cases of Child-pough grade C were abviously more( p

With the emerging of aging society and advances of information sciences, telemedicine has gradually become a new medical model.Telemedicine can be used in health monitoring, disease diagnosis, counseling, education, chronic disease management and long-term care in elderly population;particularly in management of chronic heart failure, diabetes and other chronic diseases, as well as in referral and continuous medical care.To promote telemedicine in the elderly population can break the physical limitations of different health care settings, so that geriatrician and the allied team members are enable to maximize their values in providing corresponding health services.This article reviews the progress of telemedicine in foreign countries, which would be of reference value for development of telemedicine for elderly people in China.

Objective:To prepare the immunoglobulin Y(IgY) against Avain Influenza Virus (H5N1) and to investgate its inhibitory activity to Influenza virus A (FM1).Methods:Iimmunized by Avain Influenza vaccine,IgY against Avain Influenza Virus was purified from the yolk and then the antibody was enriched by the means:caprylate acid-two-step salt precipitation-gel chromatograph.TD0 of IgY and the inhibory effectiveness were showed by nhibiting cytopathic effect (CPE) thst in MDCK infected with Influenza virus A(FM1).Results:IgY against Avain Influenza Virus was obtained.The TD0 value of IgY against Avain Influenza to MDCK cell line was 1.764 mg/ml,while at the dosage as low as 0.082 8 mg/ml the lnfluenza virus A(FM1) was still inhibited in vitro.Connchusion:Caprylate acid-two-step salt precipitation-gel chromatograph can prepare IgY successfully and the inhibitory effectiveness of IgY is good for inhibition of Influenza virus A(FM1).

Recent studies have found that peptide therapies tar-geting specific epitopes can avoid nonspecific immune suppres-sion induced by traditional medicines for the treatment of autoim-mune diseases, and have shown great therapeutic effect in ani-mal models of autoimmune diseases and clinical trials. The pa-per summaries the research progress and trends of peptide drugs for the treatment of autoimmune diseases from candidate peptide sources and their suppression mechanisms, which can provide a theoretical basis for the in-depth understanding of immune toler-ance and allow for discovery of new treatment for autoimmune diseases.

Objective To study the ralationship of arrhythmias and heart electrical parameters changes after transcatheter closure of ventricular septal defect (VSD) .Method 50 patients had been successfully finnished the transcatheter closure of ventricular septal defect,and then we observed ralationship of arrhythmias and heart electrical parameters changes. Results (1) Compared with the situation of VSD occluder preoperative and postoperative, during follow-up there were 20 arrhythmia cases, including bundle branch block 16 cases, including the complete left bundle branch block 2 cases,complete right bundle branch block 4 cases,a transient third-degree trioventricular conduction block 1 case, most return to normal in the follow-up. 2 Intracavitary electrogram showed before and after transcatheter closure:A-V conduction parameters A-H,H-V value of (75.10 ± 14.34) ms vs (80.67±23.03) ms and (47.9±12.61) ms vs (50.07±15.23) ms,the difference was not statistically significant ( >0.05) . Conclusions (1) Some patients with new ECG changes after transcatheter closure of VSD, manifested as an increase in bundle branch block in a week, but most return to normal,the prognosis is good. (2) Intraoperative A-H,H-V extension is not related with with postoperative slow arrhythmia;(3) Arrhythmia is a common complication after VSD transcatheler closure, to strictly selecte indications,and to avoid too large diameter are the effective measures to reduce the arrhythmias after transcatheter closure of ventricular septal defect (VSD) .

Objective To evaluate the value of MR in the diagnosis of primary splenic lymphoma (PSL).Methods The MR imaging features of 3 PSL cases proved by pathology were retrospectively reviewed. Results Three cases were all pathologically diagnosed as B-cell non-Hodgkin's lymphoma(NHL). Two cases were multiple node shape and one was massive shape. Unenhanced MR imaging revealed heterogeneous splenic enlargement, with large nodules showing iso-hyperinternse on T1WI and hypointense on T2WI. Linear hyperintense on T1WI and T2WI was seen on the spleen peripherous. The spleen vascular was infiltrated. CE-MRI showed heterogeneous enhancement of spleen with iso-hypointense. The focus of postperitoneal showed medial enhancement. Immunohistochemistry-showed 2 cases of diffuse B cell. The CD20 and CD19 α of tumor cell showed diffuse( + ) ,CD3 ,CD5 individual( + ) ,CD43 ( + ) ,CD45RO( + ), CD10 ( +/- ), Mum ( + ), MAC387 individual ( + ), 1 case of B lymphocell type, CD79α ( + ) ,CD23( + ) ,CD38( + ) ,λ( + ). Conclusion The MR imaging features of PSL were characteristic and helpful in the diagnosis of PSL, but the correct diagnosis was still dependent on the pathology and immunohistochemical staining.

The effects of hypoxia on the expression of Fos was studied in the distal cerebrospinal fluid contacting neurons (CSF-CNs) in the dorsal raphe nucleus (DR) of the rat. The hypoxic models mimic 8000 m high level were established in a high-altitude decompression chamber. Injecting the tracer of CB ( chorela toxin B subunit) into the rat's lateral ventricles, we investigated the distribution of the distal CSF-CNs in the DR. The single and double immunohistochemistry staining with antibodies to Fos and CB were used to observe the expression of Fos in the distal CSF-CNs in the DR. The results showed that a large number of CB-like immunoreactive (-LI) neurons (31.16 ±3.36/per section) were located in the DR. In hypoxic experimental rats, the number of Fos-LI neurons was increased sharply (40.28 ±2.17/per section, P ＜0.05 compared to control rats), and a few CB/Fos-LI neurons (2.00 ±0.39/per section) could be observed in the DR. In control rats, several Fos-LI neurons (5.55 ±0.81/per section) and no CB/Fos-LI neuron could be observed in the DR. These results suggest that some of the distal CSF-CNs in the DR may play roles in transmitting information between brain and cerebrospinal fluid and modulating the function of brain following hypoxic stimulation.

BACKGROUND:In clinic, monosegmental pedicle screw fixation via the fractured vertebrae is commonly used for the treatment of thoracolumbar fracture. Studies have confirmed that the spinal stability is strengthened through bilateral pedicle screw fixation via fractured vertebrae, but some studies suggest that monosegmental pedicle screw fixation via fractured vertebrae can increase the spinal stability, and the conclusion lacks of the supports of biomechanics.
OBJECTIVE:To evaluate the biomechanical properties of monosegmental pedicle screws fixation via fractured vertebrae for thoracolumbar fracture.
METHODS:Eight cadavers’ thoracolumbar specimens (T11-L3) were provided by the Department of Anatomy, Yangzhou University School of Medicine. Saw was used to transect 2/3 of the vertebrae in order to make complete experimental thoracolumbar specimens. Eight specimens were divided into two group;beyond-fractured vertebrae fixation group and monosegmental fixation via fracture vertebrae group. The specimens in the two groups were treated with adjacent vertebral four screw fixation beyond fractured vertebrae and adjacent vertebral four screw fixation+monosegmental pedicle screw fixation via fractured vertebrae respectively.
RESULTS AND CONCLUSION:After thoracolumbar fracture, the differences between beyond fractured vertebrae fixation and monosegmental pedicle screw fixation via fractured vertebrae were as fol ows:load-strain relationship 12%, load-displacement relationship 11%, strength 18%, axial rigidity 11%, torsional mechanical properties 11%and pul out test 1.8%, and there were no significant differences between two groups (P<0.05). The biomechanics performance of monosegmental pedicle screw fixation via fractured vertebrae was more superior to that of pedicle screw fixation beyond the fracture vertebra for thoracolumbar fracture.

Objective Sirolimus ( SRL) is a potent immunosuppressive drug used to prevent acute allograft rejection after re-nal transplantation.Nevertheless, the occurrence of proteinuria has recently been recognized among patients treated with SRL-based therapy.The aim of this study was to investigate the therapeutic effect of tripterygium wilfordii hook F ( T II) on proteinuria caused by SRL in renal transplant recipients who were treated by trilogy immunosuppressive therapy of sirolimus combined with mycophenolate and hormone. Methods 52 recipients were divided into 2 groups randomly:TⅡgroup (n=27) and valsartan group (n=25).The TⅡgroup was administered 1 mg/kg/d, and the valsartan group 80-160 mg/d for consecutive 12 months.Based on primary trilogy immu-nosuppressive therapy of sirolimus combined with mycophenolate and hormone, the dosage of sirolimus was adjusted according to the target concentration 6-10 ng/ml( ELASA approach) and mycophenolate was administered 750 mg twice per day, adjusting dosage ac-cording to the mycophenolate AUC 0-12 level(35-45 mg· h/L).The evaluation of therapeutic effect includes: complete remission, proteinuria decreased by>50%; partial remission, proteinuria decreased by 20% to 50%; ineffective, proteinuria decreased by<20%. Results During the 12 month follow-up, the total effective rates in the TⅡgroup and the valsartan group were 95.2%and 86.7%respectively, in which the TⅡ group decreased more significantly (P<0.01).The total cholesterol level and triglyceride level in TⅡgroup were obviously lower than those in valsartan group(P<0.01). The total cholesterol level and triglyceride level in valsartan group increased ([6.60±0.2]mmol/L vs [7.11±1.13]mmol/L, [2.47± 1.48]mmol/L vs [2.49±0.32] mmol/L).The serum protein level in TⅡ group was obviously higher than that in valsartan group ([41.1±1.2]g/L vs [37.9±4.2]g/L, P<0.05).At 3 month, 6 month and 12 month follow-up, the average serum creatinine levels in TⅡgroup were obviously lower than those in valsartan group ([1.5±0.4]mg/dl vs [1.6±0.3]mg/dl, P<0.05), ([1.3±0.3]mg/dl vs [1.8±0.5]mg/dl, P<0.05), ([1.1±0.4]mg/dl vs [2.1±0.5]mg/dl, P<0.05).The incidence rate of adverse reaction in valsartan group was obviously greater compared with TⅡgroup( P<0.05) . Conclusion Both tripterygium wilfordii multiglycosides and valsar-tan can reduce proteinuria caused by SRL in renal transplant patients,while the application of TⅡhas more remarkable effect.

Objective BK virus-associated nephropathy ( BKVAN) after kidney transplantation is a key factor that influence the prognosis of transplant kidney .To our knowledge , it is believed to be associated with immune suppression .We observed the cura-tive effect and influencing factorsof anti-rejection scheme that Leflunomide was administered instead of Mycophenolate Mofetil ( MMF) on transplant kidney BKVAN .. Methods This study included 15 kidney transplant recipients with pathologically confirmed BKVAN in Nanjing General Hospital of Nanjing Military Region form March 2007 to March 2013 .Leflunomide was administered instead of Myco-phenolate Mofetil ( MMF) .Serum creatinine level , renal allograft loss rate and side effects of leflunomide were monitored after medica-tion switch.The patients were divided into two groups , which were renal allograft loss group and renal allograft survival group , for fur-ther analyses . The differences between each groups in clinical characteristics as well as histochemical features of the transplanted kidneys were analyzed to determine the cause of renal allograft loss in patients with BKVAN . Results Six patients experienced renal al-lograft loss after switching to leflunomide and needed hemodialysis , and 9 patients had stable renal allograft function , renal allograft loss rate was 40.0%.Hyperuricemia occurred in 8 patients in the period before the medication switch and in 5 patients after the switch;a decrease in blood white cell orplateletcount was found in 2 patients during both periods;an increase in Alanine aminotransferase ( ALT) level occurred in one patient after the medication switch .There were no statistically significant differences in any of the above parame-ters before and after the medication switch.Compared to allograft survival group, serum creatinine level[(1.80 ±0.53)mg/dL vs (2.74 ±0.58)mg/dL, P=0.007], the number of B lymphocytes [(206.44 ±144.96) vs (439.67 ±267.77), P=0.047] and CD68[(588.44 ±271.80) vs (944.67 ±259.32), P=0.025] in renal allograft tissue were significantly higherin the allograft loss group. ConclusionLeflunomide is a safe and effective medication for BKVAN .Patients with significantly increased serum creatinine level might have a poorer prognosis .Significantly increased B lymphocytes and CD 68 cells in renal allograft tissue might indicate a poor prognosis.