Objective:To investigate the role of FASL and TRAIL in the AICD (activation induced cell death) of PBLs in patients with chronic hepatitis B.Methods:The PBLs of 20 nonnal control,24 patients with chronic hepatitis B and 24 patients with chronic severe hepatitis B were isolated and cultured with or without phytohemagglutinin( 10 pig/ml) for 48 hours in vitro. After incubation,the cells were harvested by centrifugation and the expression of FASL.,TRAIL in PBLs was assayed by reverse transcriptase-polymerase chain reaction (RT-PCR) and im-munohistochemical staining (SABC Method) .Results-.The expression of FASL mRNANTRAIL mRNA was undetectable in the resting PBLs of three investigated groups, but it was obviously increased after PHA stimulation in vitro. In comparison with the group of normal controls, the expression of FASL mRNA,TRAIL mRNA in PBLs was significantly higher in the group of patients with chronic hepatitis B( P

Objective To detect the important parameters of three dimensional structure of the aortic annulus by using real time three dimensional transesophageal echocardiograhy (RT 3D TEE) and analyse morphological and physiological characteristics , in order to establish simplified model of aortic valve and provide references for designing aortic annulus .Methods A total of 95 ca‐ses of healthy individuals carrying out RT 3D TEE were selected ,and the images of total volume of aortic root were collected .The important parameters of three dimensional aortic valve in four cardiac cycles ,including sinus tube junction(S) ,distance between ad‐jacent valve junction(L ,R and N) ,diameter of the circumcircle of triangle(J) ,aortic annulus height(H) ,long diameter(A) ,short di‐ameter(B) and eccentricity ratio (B/A) of the aortic valve ,were measured by using the QLAB7 .0 software .In the 3D imaging ,the extending relationship between the bottom of aortic valve and aortic annulus was analysed ,the structural characteristics of the aortic valve were simplified ,and the model was established .Results The values of the parameters measured at the end‐diastole were as follows :sinus tube junction (26 .3 ± 3 .3)mm ,three‐dimensional aortic annulus height(12 .4 ± 1 .9)mm ,aortic valve long diameter and short diameter (25 .9 ± 2 .7)mm and (19 .8 ± 2 .0)mm ,adjacent valve junction distance(L ,R and N) all was(21 .6 ± 2 .5)mm . These three structures approximately formed an equilateral triangle .The values of the adjacent cycle time ,the change of sinus tube junction ,distance between adjacent valve junction ,aortic annulus height and long diameter were compared ,and there was no statisti‐cal significant differences(P>0 .05) ,while statistically significant differences were found in the aortic valve short diameter and long short diameter between those at the end‐diastole and those at the medium‐systole(P<0 .01) .Conclusion RT 3D TEE can accu‐rately measure the size of each part of the aortic valve and display its shape and change ,which contribute to simplifying and recon‐structing the aortic annlus .

OBJECTIVE To investigate the drug resistance and the prevalence of inducible clindamycin resistance in clinical isolates of Staphylococcus aureus and evaluate the clinical value of cefoxitin disk diffusion method and oxacillin disk diffusion for detection of meticillin-resistant S.aureus(MRSA).METHODS Bacteria identification and susceptibility test were performed by VITEK-2 system and K-B disk method.The PBP2a was detected by latex agglutination and MRSA was identified by cefoxitin disk diffusion method and oxacillin disk diffusion.The inducible resistance of erythromycin to clindamycin was checked by D-test according to the standards of CLSI(NCCLS).The statistical analysis was performed by WHONET 5.4 and SPSS 13.0 software.RESULTS Resistant rate to penicillin and ampicillin was 98.9% and 100.0%,respectively.Vancomycin-resistant(VRE) or intermediate strains were not found.Of the 93 S.aureus isolates,MRSA and meticillin-sensitive S.aureus(MSSA) were 58(62.4%) and 35(37.6%),respectively.The resistant rate of MRSA to 11 antibiotics was higher than MSSA.The sensitivity and specificity of cefoxitin disk diffusion method were 98.3% and 97.1%,respectively,those of oxacillin disk diffusion were 75.9% and 94.3%.Of the 9 isolates resitant to erythromycin but susceptible to clindamycin,5(55.6%) showed inducible resistance to clindamycin.CONCLUSIONS Resistance of S.aureus is quite serious.Cefoxitin disc diffusion method is a simple and reliable method for the detection of MRSA.The inducible resistance of erythromycin to clindamycin in S aureus should be checked by D-test in clinical microbiology laboratory routinely.

Objective:To study immunological stimulation of synthetic oligodeoxynucleotides(ODN) containing unmethylated CpG dinucleotides(CpG-ODN) on human immune cells.Methods:CpG-ODN was co-cultured with peripheral blood mononuclear cells(PBMC) .The IFN-? and IFN-? in the supernatant were measured by ELISA;the reverse transcription PCR was used to analyze the expression levels of TLR9 mR NA in PBMC;MTT method was used to detect NK-mediated lytic activity of K562 cells.Results:CpG-ODN induced high amounts of IFN-? as well as IFN-? production;the lysis of K562 mediated by CpG-ODN 2216 stimulating NK cells was increased;the CpG-ODN could up-regulate the expression of TLR9 mRNA in PBMC. Conclusion: CpG-ODN 2216 can activate human immune reaction by increasing the production of IFN-? and IFN-?,the expression of TLR9 and NK cell lytic activity.

Objective To evaluate the role of polymorphonuclear (PMN) in patients with acute myocardial infarction (AMI).The preventive effects of Vitamin C-a potent free radical scavenger,on parameters of PMN oxygen free radicals (OFR) production in patients with AMI were also studied.Methods 60 patients with AMI were randomized to receive either conventional treatment only (group Ⅰ,n=30) or conventional treatment supplemented with vitamin C infusion,3.0 g/d,for 7 days (group Ⅱ,n=30).Parameters of PMN OFR production were assayed by a method named as polymorphonuclear chemiluminescence (PMN-CL) on the 1st,3rd,7th and 10th day after been hospitalized.62 healthy controls of similar age,sex were also studied.Results Parameters of PMN-CL increased significantly in patients with AMI compared with that in the healthy controls.Parameters of PMN-CL decreased significantly in group Ⅱ on the 3rd,7th and 10th day compared with that in group Ⅰ(P<0.05,0.01,0.001,respectively).ST segment score was significantly higher in group Ⅱ than that in group Ⅰ on the 3rd,7th and 10th day.Conclusion These results indicate that the PMN act as a potential contributor to extension of tissue injury induced by OFR.Supplementation with vitamin C may suppress PMN OFR production and could be beneficial in preventing myocardial necrosis.

Objective To determine the clinical features and the factors affecting the recurrence of ovarian borderline epithelial tumors. Methods A retrospective data of 112 cases with ovarian borderline epithelial tumors admitted in General Hospital of Tianjin Medical University from 2000 to 2015 were analyzed. Results The average age was (50.59±16.90) years in 112 patients with FIGO stageⅠof 102 (91.07%) patients, stageⅡof 4 (3.57%) and stageⅢof 6 (5.36%). The serum tumor marker (CA125) was examined in 102 patients, and 27 cases with the elevated indicator (26.47%). Surgical treatment was performed in 112 patients. Younger patients were more likely to choose conservative surgery. Ninety-seven patients were followed up, and 5 of them relapsed. Non fertility preserving surgery was performed in patients with recurrence. The recurrence rates of patients with different clinical pathological factors were compared. The recurrence rate was higher in patients with micro infiltration than that of patients without micro infiltration [37.50%(3/8) vs. 2.25%(2/89), P=0.004]. And the recurrence rate was higher in patients with microemulsion type borderline serous tumor than that of patients with non-papillary tumors [40.00%(2/5)vs. 0(0/41),P=0.019]. Seven patients underwent conservative surgery had normal spontaneous pregnancy. Conclusion The fertility-sparing surgery can be used as the treatment procedures for young patients, which is safe and effective. It is necessary to be on alert of recurrence for the cases with micropapillary pattern, and microinvasive tumor.

Objective To explore the clinicalpathological characteristics of Lynch syndrome associated ovarian cancer.Methods Totally 260 cases ovarian cancer patients were admitted to Tianjin Medical University General Hospital during Jan.2004 and Jan.2011,among which 10 patients( LS group) belonged to Lynch syndrome associated ovarian cancer according to Amsterdam Ⅱ criteria.One hundred ovarian cancer patients without any family cancer history were enrolled randomizely as control group (sporadic group).Results Lynch syndrome associated ovarian cancer accounted for 3.8％ ( 10/260),the incidence rate of ovarian cancer for female family members of Lynch syndrome was 8.7％ ( 10/115 ).Mean age at time of diagnosis in LS group was (46 ±7) years,significantly earlier than that in sporadic group [ (56 ±11 ) years,P ＜ 0.05 ].There was no statistical difference between two groups in histological type or International Federation of Gynecology and Obstetrics ( FIGO ) stage ( P ＞ 0.05 ).Most of the tissue differentiation in LS group were well or moderate differentiated,there was statistical difference between the two groups(9/10 vs.55％,P ＜0.05).The 3-year and 5-year survival rate in LS group were 87.5％ and 52.5％respectively,compared with 55.4％and 22.7％ in sporadic group(all P＜0.05).Conclusion Compared with sporadic ovarian cancer,Lynch syndrome associated ovarian cancer is more likely present as the clinicalpathological characteristics of early age of onset,serous adenocarcinoma,lower grade and better prognosis.

Aorta ; abnormalities ; Child ; Heart Defects, Congenital ; diagnosis ; Heart Ventricles ; abnormalities ; Humans ; Male

OBJECTIVETo investigate the effectiveness and the safety of clinical use of rhGH in the management of severe burn patients.

METHODSTwo hundred burn patients aged 20 - 25 yrs with TBSA from 20% to 50% and admitted within 5 postburn days (PBD) were enrolled in this study. The patients were divided into operation and non-operation groups. Furthermore, each group was randomly divided into control (N), treatment with rhGH in dosage 0.2 IU/Kg/d (A) and treatment with rhGH in dosage 0.4 IU/kg/d (B) groups. The general data, the metabolism of protein and glucose, the immune function, the urine biochemistry, the wound healing rate and hospital stay days recorded and compared among all groups.

RESULTSPlasma protein was increased, the immune function recovered early, the wound healing time was shortened obviously, the wound healing rate was increased evidently and the hospital stay days were decreased significantly in the treatment groups (A and B groups) compared with the N group. The body weight of burn patients remained unchanged in N group. Nevertheless, the plasma levels of glucose and insulin were increased and the urine output of potassium, sodium and chloride decreased in N group compared with those in A and B groups. Moreover, the levels of all these indices in B group were higher than those in A group, whereas side effects were more common in B group than in A group. In addition, the incidence of adverse reaction was higher in operation group than that in non-operation group.

CONCLUSIONrhGH could effectively promote protein synthesis, enhance systemic immune function, accelerate wound healing and shorten hospital stay days in severely burned patients. But attention should be paid to appropriate dosage and duration of use.

Adult ; Burns ; drug therapy ; immunology ; CD4-CD8 Ratio ; Dose-Response Relationship, Drug ; Growth Hormone ; therapeutic use ; Humans ; Middle Aged ; Wound Healing

Objective To evaluate the efficacy of ultrasound-guided great auricular nerve (GAN)block combined with general anesthesia for middle ear microsurgery in adult patients.Methods Sixty-four adult patients of both sexes,aged 18-60 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective middle ear microsurgery,were assigned into 2 groups (n =32 each) using a random number tabte:GAN block combined with general anesthesia group (group GANB+G) and general anesthesia group (group G).Patients received GAN block with 0.25％ ropivacaine 2 ml using ultrasoundguided in-plane technique before anesthesia induction in group GANB+G.Anesthesia induction and maintenance protocols (IV infusion of propofol and target-controlled infusion of remifentanil) were similar in two groups.Analgesia was performed with sufentanil,flurbiprofen axetil or parecoxib sodium after operation to maintain visual analog scale score ＜4 within 48 h after operation.The infusion duration and consumption of propofol and remifentanil,requirement for postoperative analgesia and occurrence of postoperative nausea and vomiting were recorded.Results Compared with group G,the consumption of remifentanil was significantly reduced,and the requirement for postoperative analgesia and incidence of postoperative nausea and vomiting were decreased in group GANB + G (P ＜ 0.05 or 0.01).Conclusion Ultrasound-guided GAN block combined with general anesthesia provides better analgesic efficacy in the the perioperative period in adult patients undergoing middle ear microsurgery.