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

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).

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.

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 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 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 establish a LC-MS/MS method for the determination of MMA in serum,and provide a assay for the diagnosis and screening of methylmalonic academia in the clinic. Methods MMA was extracted from 205 serum samples from healthy controls and 146 serum samples from patients with liquidliquid extraction method with MTBE as the extraction solvent. The supernatant was transferred to a tube and dried with nitrogen gas. Then the residual was derived with HCI-BuOH mixed agent to give a product, which was analyzed directly by LC-MS-MS system with a gradient elution, selective reaction monitor, a Discovery C18 column (50 mm × 2. 1 mm ,5 μm) as the isolation column and a mobile phase consisting of methanol and water (0. 1% formic acid, V/V), respectively. The concentration of MMA was detected with the isotope internal standard method. The stand curve was employed with a series of calibrators. The recovery was estimated with the 3 serum samples with the concentrations of 2, 25, 80 μg/L respectively. The accuracy,precision and stability were also tested with quality control samples. Moreover, the range of concentrations in healthy people were detected to investigate the influence of hemolysis on the detection results. Thirteen samples were randomly tested according to the digital chart. The testing results were compared with the results provided by Medical Diagnositic institution (MDI) in Germany. The paired t-test was applied to statistical analysis. Results The linear range of this method was 2-100 μg/L, and the correlation coefficient (R2 ) was more than 0. 995. The retention time of MMA derivative was 10. 5 min. Succinic acid and MMA were not found to interfere with each other. The within-run RSD was less than 6. 4%, and the between-run RSD was less than 5.0%. The recovery rates were from 96. 42% to 103. 33%. The limit of quantification was 1 μg/L.The accuracies of the method were form 94. 2% to 108. 2%. The samples were stable for 6 h at room temperature and stable for 70 d even keep at - 20 ℃. The samples were stable after 10 freeze-thaw cycles. The derivatives of MMA were found to be stable at least for 5 d at 4 ℃. The medians of the hemolysis group and the normal group were 102.53 (13.84-302.33) μg/L and 39.52 (11.94-203.08) μg/L,respectively. There was significant difference between the 2 groups ( T = 8, P ＜ 0. 05 ). The medians of comparison test in our laboratory and the MDI were 32. 82(24. 50-100. 42) μg/L and 32. 20(26. 65-93. 30)μg/L There was no significant difference between the 2 groups( T=7 ,P ＞0. 05 ). The mean value (-x± s)of 158 healthy adults( 18-58 years old) and 47 healthy teenages( 1-17 years old)were ( 18.46 ± 10.49 )μg/L and (22. 38 ± 11.45) μg/L, respectively. Conclusions A LC-MS/MS method for analysis of MMA in serum is established successfully. The quantitative method is simple and accurate with good sensitivity,specificity and repeatability. The method can be applied for diagnosis, screening and monitoring of methylmalonic acidemia.

Objective To assess sperm chromatin structure assay (SCSA) and sperm chromatin dispersion test (SCD) for DNA fragmentation evaluation in human infertility, and the correlation between these two methods. Methods We used SCSA and SCD assays to detect DNA fragmentation in sperm from 134 infertile men. The correlation of SCSA and SCD assays was analyzed. The sperm DNA fragmentation index (DFI) was divided into 3 groups (≤15%DFI, >15~≤30%DFI and>30%DFI), and the difference between SCSA and SCD assays was assessed. Results The SCSA assay was strongly correlated with the SCD assay for sperm DNA fragmentation (r=0.915, P<0.001). There was no significant difference between>15~ ≤30%DFI and>30%DFI groups. However, SCD showed higher levels of DNA fragmentation than that measured by SCSA for≤15%DFI group (13.50 4.82 vs 9.79 2.60, P<0.001). Conclusion There is a strong positive correlation between SCSA and SCD assays in detection of DNA fragmentation. SCD assay showed higher levels of DNA fragmentation than that measured by SCSA for≤15%DFI group.

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.

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.