The variable heavy chain region (VH) genes of 3 untreated patients with B-cell chronic lymphocytic leukemia (B-CLL) were cloned and analyzed. The VH family used was VH3-11, VH3-72 and VH3-33. More than 2% difference from the corresponding germline gene was detected in all the 3 obtained potential functional genes (average 16.7). Mutation pattern analysis indicated evidence of antigen selective pressure observed in 1 of 3 cases. Our findings suggested that the tumor cells originate from post-GC cells.
Amino Acid Sequence ; Gene Rearrangement ; Immunoglobulin Variable Region/*genetics ; Leukemia, B-Cell, Chronic/*genetics ; Molecular Sequence Data ; *Mutation

Objective:To investigate the use of proton pump inhibitors ( PPIs) in the patients with cirrhosis or hepatitis in one hospital and evaluate the use rationality .Methods:A retrospective study was carried out on 211 patients with the diagnosis of hepatitis or cirrhosis in the infectious disease ward between 2013 and 2014 , and the use rationality of PPIs was evaluated .Results: A total of 211 cases were inspected, and among them, 192 ones were treated with PPIs (91%) with 62 ones treated with PPIs irrationally, which accounted for 29.3%of the total cases.The main irrational use of PPIs was long treatment course (24.5%), inadequate prophylaxis indications (5.7%) and purposeless use (2.6%).Conclusion: Irrational use of PPI is common in hepatitis or cirrhosis patients . Clinical pharmacists should strengthen pharmaceutical care to improve the rational drug use .

Objective To review the clinical and laboratory features of tuberculous meningitis (TBM). Methods The clinical and laboratory data from 246 cases of TBM in Tuberculosis Treatment Center of Integrated Chinese and Western Medicine Hospital of Zhejiang Province from January 1,1999 to December 31,2005 were collected and analyzed with SPSS 15.0 software. Results In 246 TBM patients,203(82.5%)was of basilar meningitis, 170(69. 1%)complicated with pulmonary tuberculosis. Fever,nausea, vomiting and headache were common symptoms in TBM patients. PPD skin tests were positive in 155(63.0%)patients, but only 12(4.9%)were acid-fast bacillus smear-positive in cerebrospinal fluid (CSF). CSF test showed that the white blood cells[(320 - 880)× 106/L], protein(0. 95 - 13.8 g/L)were increased, while glucose(1.53 - 3.2 mmol/L)and chloride content(90 - 111 mmol/L)were decreased. Adenosine deaminase ≥8 U/L was observed in 230(93.5%)patients, and 185(75.2%)patients were tuberculosis antibody positive. Eighty-one(32. 9%)patients showed nodular or annular shadows in cranial CT. After comprehensive therapy, 242(98.4%)patients recovered or improved and no sequela was observed, while 4(1.6%)patients died. Conclusion Early diagnosis of TBM should be based on clinical manifestations, changes of cerebrospinal fluid, imaging examination and PPD test.

Objective To investigate the clinical, histopathological and immunopathological charac teristics of erythema annulare centrifugum (EAC). Methods A retrospective study was performed on 54 cases of EAC collected from 2001 to 2005. Information was gathered about patients' sex, age, disease course, distribution and morphology of eruptions, symptoms, complications. Also, the findings of histopathology and direct immunofluorescence examination in some patients were evaluated. Remits EAC most commonly occurred on the lower limb, and was usually complicated by various diseases among which mycosis predominated. Histological examination revealed compact lymphocyte infiltration in dermal vessels in 32 of these 54 patients. Direct immunofluorescence showed the deposition of IgG, lgM, or C3 on the walls of small vessels in 6 of 12 tissue samples tested. Conclusions EAC is a multifactorial disease, and it seems that the infiltration of lymphocytes and deposition of circulatory immune complex on small blood vessels in dermis may play important roles in its pathogenesis.

A total of 120 medical students were surveyed to investigate the current status of communication between medical students and old patients and the awareness of medical laws. The questionnaire shows many students don't have enough knowledge of communication skills and medical laws. Furthermore, the most important reason of the medical disputes is the lack of communication between doctors and patients so the cultivation of communication skills and legal knowledge should be strengthened.

For the reform and development of clinical laboratory education, based on the previous course reform, Laboratory Medicine College of Chongqing Medical University has put the leading teachers'responsibility system of laboratory medicine course into practice. In the recent 3 years, the course is better organized.The students are more interested in the course and they communicate more with teachers than ever before. The effect of the course is obvious. The leading teachers' responsibility system in laboratory medicine course should be promoted.

Objective: To observe the effect of Yi Jin Jing (Sinew-transforming Qigong Exercises) plus tuina on the neck for stiff neck. Methods: A total of 60 patients with stiff neck who met the screening criteria were selected and randomly divided into two groups, with 30 cases in each group. Patients in the control group received tuina on the neck, 30 min every time, once a day, while patients in the observation group practiced Yi Jin Jing (Sinew-transforming Qigong Exercises) plus the same tuina therapy as the control group, and Yi Jin Jing (Sinew-transforming Qigong Exercises) was conducted for more than 30 min every time, once a day. Visual analog scale (VAS) scores were observed before treatment, and after 1 time, 3 times and 5 times of treatment to evaluate the degree of neck pain. Results: During the treatment, each group had 2 dropouts. After treatment, the total effective rate was 92.9％ in the observation group versus 82.1％ in the control group, showing a statistical significance (P<0.05). The VAS scores in the observation group at the three time points were significantly lower than those in the control group (all P<0.05). Conclusion: Yi Jin Jing (Sinew-transforming Qigong Exercises) plus tuina on the neck can effectively relieve neck pain and improve cervical range of motion in patients with stiff neck, and can achieve a better effect than tuina alone.

This paper summarizes that to strengthen the construction of national key disciplines Clinical Laboratory Diagnostic and build professional post-graduate education platform for innovation,the exploration and practice of reform have been done in Chongqing Medical University,in the teaching ranks and exercise disciplinary research direction to enhance the level of scientific research and laboratory construction.

Objective To investigate the risk factors and treatment for infections after spinal internal fixation surgery. Methods The clinical data of 472 patients who underwent spinal internal fixation surgery from January 2012 to December 2012 was analyzed retrospectively, an average age of 50. 6 years (38~78 years). All cases were underwent posterior procedures. All infected patients received emergency opera-tion of wound debridement, drainage and sensitive antibiotic treatment. The mean follow-up time was 11 months (8~19 months). Risk fac-tors and treatment for infections were summarized and discussed. Results Of 472 patients,postoperative infections occurred in 9 cases with the infection rate of 1. 91%. The operation time,intraoperative blood and postoperative drainage was 100~325 min,200~1500 mL and 65~1350 mL,respectively,which were greater than the similar surgeries of same period. The initial signs of wound infection was observed at 10 d (6~16 d) after surgery. CRP,ESR and WBC were significantly increased in 4~7 d after surgery,and maintained at high level at least for 14 d. Bacterial culture results showed infection bacteria were mainly common skin flora. One infection recurred during followed-up and subse-quent treatment was successful. Conclusion Wound infection after internal fixation mainly occurred in the posterior procedure of spine, which were deep infection. The main clinical manifestation was the wound exudate and local deep tenderness,fever and wound surface swelling were relatively rare. Increased intraoperative bleeding,postoperative drainage volume,operation time were the risk factors,which lead to perio-perative malnutrition and subsequent infections. Debridement,drainage,and intravenously sensitive antibiotics could obtain an ideal outcome for most cases. It was not necessary to remove the internal fixation instrument and bone grafting.

Adolescent ; Adult ; Alprostadil ; pharmacology ; Anticoagulants ; pharmacology ; Child ; Child, Preschool ; Dextrans ; pharmacology ; Female ; Fibrinolytic Agents ; pharmacology ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Heparin ; pharmacology ; Hepatic Veno-Occlusive Disease ; etiology ; prevention & control ; therapy ; Humans ; Infant ; Male ; Middle Aged ; Platelet Aggregation Inhibitors ; pharmacology ; Treatment Outcome