In order to improve the quality of epilepsy teaching,the appropriate version of the international classification of epilepsy and epileptic syndrome were selected to teach in the different level students by the way of PBL and clinical case analysis.The clinical thoughts and enthusiasm were improved.The classification of epilepsy could be grasped and easily used in their clinical work.

Objective To explore changes of the immune function of red blood cells in gastric disease.Methods RBC C3b receptor rosette(RBCC3bRR)and RBC immune complex rosette(RBCICR)were tested in chronic gastritis group(n =103),duodenal ball ulcer group(n =75)and control group(n =30)to evaluate the immune function of RBC.Results RBCC3bRR were(20.83 ± 5.16)％ in the control group,(16.26 ±5.17)％ in the chronic gastritis group and(13.65 ± 5.19)％ in the duodenal ball ulcer group.RBCICR were respectively(7.63 ± 4.09)％,(10.59 + 4.45)％ and(10.04 ± 4.13)％ in these three groups.RBCC3bRR of chronic gastritis and duodenal ball ulcer were lower than control group(P ＜0.0l),while RBCICR were higher than normal control group(P ＜0.05 and P ＜0.01 respectively).There was no significant difference on RBCC3bRR and RBCICR between HP negative chronic gastritis and HP negative duodenal ball ulcer and between HP positive chronic gastritis and HP positive duodenal ball ulcer(P ＞ 0.05).RBCC3bRR of HP positive chronic gastritis and duodenal ball ulcer was significantly lower than that of HP negative(P ＜ 0.05and P ＜ 0.01 respectively),RBCICR significantly higher than that of HP negative(P ＜ 0.01).After HP eradication,RBCC3bRR of patients with chronic gastritis and duodenal ball ulcer was increased significantly (P＜0.05 and P ＜ 0.01 respectively).RBCICR was significantly lower than before treatment(P ＜ 0.01).Conclusion HP infection,chronic gastritis and duodenal ulcer can decrease the immune function of red blood cells.

BACKGROUND: Critical closing pressure (CCP) is recently thought to play a key role in cerebral blood flow autoregulation as an effective downstream pressure of cerebral circulation and can objectively reflect the cerebrovascular tone, namely the vascular smooth muscle contraction and diastole, which is subjected to dynamic modulation.OBJECTIVE: To dynamically assess the hypertension-induced damage of the contraction function of cerebral microvascular smooth muscles and its correlation with morphological changes based on CCP evaluation.DESIGN: Randomized controlled experiment.SETTING: Institute of Neural Science of Second Hospital Affiliated to Guangzhou Medical College and Department of Neurology, First Hospital Affiliated to Sun Yet-san University.MATERIALS: The experiment was carried out at the Laboratory of Physiological Science of Sun Yet-san University between July 2002 and August 2003. Totally 160 health male SD rats were randomized into control group and hypertension group with 80 rats in each group. METHODS: Stroke-prone renovas cular hyp ortonsive rats were established in rats of the hypertension group by bilateral renal artery occlusion with two clips. The rats in the control group were not subjected to the occlusion with other treatments identical to those of the hypertension group. At the time points of 2, 4, 6, 8, 10, 12, 14 and 16 weeks after operation, respectively, 10 rats were randomly selected from each of the two groups for determination of arterial pressure and CCP. After the measurements the frontal-parietal lobe was obtained from the anaesthetized rats and cut into slices for quantitative analysis of the morphological changes in cerebral microvessels.different postoperative time points.mean arterial pressure in hypertension group obviously increased from the 6th postoperative week with significant difference from that of the control after operation to a level significantly higher than that of the control group at postoperative 14 and 16 weeks [(63.75±7.43) vs (37.28±3.68) mm Hg and (67.37±15.57) vs (38.39t7.41) mm Hg, respectively, P ＜ 0.05].significance from that of the control group at the 8th postoperative week (Paverage arterial pressure and cerebral arteriole tunica media (r=0.906 93,0.811 36, respectively, P ＜ 0.05). The changes in CCP was more obvious in the early and advanced stages of blood pressure elevation, but not so manifest during obvious blood pressure increment, displaying an inverted S-shaped curve of changes (R2=0.996 2, P ＜ 0.05).CONCLUSION: Contraction of the cerebrovascular smooth muscles is enhanced with the dynamic increment of arterial pressure after the development of hypertension. Vascular tone increase is more manifest during the early and advanced stages of hypertension.

ObjectiveTo explore the diagnostic value of 16-slices CT in urinary calculus. Methods25 cases of suspected urinary calculus were examined by 16-slices CT and some of these images were reconstructed with MPR. ResultsIn the 25 casces CT found 21cases of urinary calculus,among them kidney calculus 22 cases,urinary tract calculus 13 cases.In 5 of 21 cases,urinary calculus were not found with US.In all 6 cases urinary calculus were not detected by KUB and/or IVP. Conclusion16-slices CT was a valuable method in diagnosing urinary calculus.

Objective To develop a molecular method to type coagulase-negative staphylococci(CNS) using 16S～23S internal transcribed spacer-PCR(ITS-PCR)Methods ITS-PCR was performed to identify six control strains and a collection of 171 clinical strains, identified as CNS by AutoScan-4 System The API Staph system also tested the discrepant strainsResults A total of 11 CNS species from control strains and clinical ones confirmed by the API Staph system were resolved by their unique ITS-PCR patterns These results constructed the primary database of CNS in the laboratory They were obtained with Staphylococcusepidermidis, Shaemolyticus, Shominis, Ssaprophyticus, Sxylosus, Swarneri, Scapitis, Scohhni subspurealyticum,S sciuri, Sauricular, Ssimulans Only S sciuri showed intraspecific polymorphism on its ITS-PCR pattern 9357%(160/171) clinical isolates can be identified by this ITS-PCR data base and the accuracy is 9375%(150/160) The coincidence of the API Staph system and ITS-PCR was better than that of AutoScan-4 system results There is at lest 936%(16/171) CNS results from AutoScan-4 system are falseConclusion ITS-PCR is verified as a valuable, easy to perform, rapid, high reliable and low cost molecular typing method for coagulase negative staphylococci

Objective To analyze the distribution of HLA-C alleles in Shandong Han population of China.Methods One hundred and fifty unrelated potential donors,self-claimed as Han population from Shandong province,were selected from China Marrow Donor Program.Genotypes of HLA-C with the donors were identified by PCR-SBT.The frequencies of allele were calculated with direct counting method and the differences with other populations were analyzed with SPSS16.0 x2 software.Results A total of 25 alleles of HLA-C were observed and the most common alleles were C * 06:02 and C * 07:02 with the frequency of more than 10.00％.Moreover,there were 16 kinds of alleles with the frequency of more than 1.00％ accounting for 95.33％ of the total alleles.The distribution of HLA-C alleles in Shandong Han population was similar to that in northern Han population,but had some differences with that in southern Han population.In addition,the distribution of HLA-C alleles in Shandong Han population significantly differed from that of German/African American.Conclusion This study on the distribution of HLA-C alleles in Shandong Han population provides valuable references for further studies on the genetics of HLA,cross-match for organ transplantation and other genetic-associated diseases in this population.

Over one half the patients with rheumatoid arthritis (RA) are being treated with methotrexate (MTX). Although well proven, the efficacy of MTX varies in individual patients. This study examined the metabolic biomarkers that can be used to predict the therapeutic effect of MTX by using metabolomic analysis. Rats were immunized with collagen to rapidly cause collagen-induced arthritis (CIA) and then treated with 0.1 mg/kg MTX for 4 weeks. The clinical signs and the histopathological features of CIA were observed to evaluate the therapeutic effects. Urine samples of CIA rats were collected, and analyzed by using 600 M (1)H-nuclear magnetic resonance ((1)H-NMR) for spectral binning after the therapy. The urine spectra were divided into spectral bins, and 20 endogenous metabolites were assigned by Chenomx Suite. Multivariate analyses were performed to identify the spectral pattern of endogenous metabolites related to MTX therapy. The results showed that the clustering of the spectra of the urine samples from the responsive rats (n=20) was different from that from the non-responsive rats (n=11). Multivariate analysis showed difference in metabolic profiles between the responsive and non-responsive rats by using partial least squares-discrimination analysis (PLS-DA) (R(2)=0.812, Q(2)=0.604). In targeted profiling, 13 endogenous metabolites (uric acid, taurine, histidine, methionine, glycine, etc.) were selected as putative biomarkers for predicting therapeutic response to MTX. It was suggested that (1)H-NMR-based metabolomic analysis can be used to predict the therapeutic effect of MTX, and several metabolites were found to be related to the therapeutic effects of MTX.

Objective To compare the efficacy and side effects between systemic chemotherapy and hepatic arterial infusion by combination of oxaliplatin and 5-fluorouracil (FOLFOX-6) with 5-fluorouracil in the patients who have developed hepatic metastasis after colorectal cancer operation. The factors that would affect the prognosis without operational treatment were also analyzed. Methods 46patients who had signed the informed consents were allocated into two groups: the group with general chemotherapy (Trial Group includes 26 cases) and the one with hepatic arterial infusion chemotherapy (Control Group includes 20 cases). The total effective rate, the prognosis, the cytoxicitic side effects,quality of life, the total survival rate and the responses were the main parameters determined. Kaplan-Meier was used to analyze Mono-factor to the prognostic responses and the Cox mode was used to analyze poly-factor to the prognostic responses. Results The overall survival rate was significantly higher by using systemic treatment versus HAI(median, 15. 0 v 11.2 months;P＜0.05). The difference in overall responsive rate (CR+PR) between the two groups was statistically significant (50% v 10%;P=0. 011). No significant difference was found in PS scale during the treatment. (P=0. 126). Except for myelosuppression and abdominal pain, no significant difference was found in the other side effects. Univariate analysis revealed that the invasive lesions to serosa, the distribution of liver metastases, the size and number of liver metastases, primary carcinoma involving lymph nodes and the treatment were correlated with prognoses. Cox regression analysis showed that the larger diameter of liver metastases, the number of liver lesions, primary carcinomas involved in serosal layer and the treatment modules were independent prognostic factors. Conclusions The oxaliplatin-based FOLFOX-6 chemotherapy regiment has a better responsive rate and survival rate than the traditional infusion with 5-fluorouracil to the main hepatic artery for interventional therapy. The diameter of the hepatic metastasis larger than 5em, multiple hepatic metastasis and the primary lesions penetrating serosal layer suggest the poor prognosis. The oxaliplatin-based systematic chemotherapy has a better prognosis. Therefore,it is worth carrying on further study on modification of traditional hepatic arterial infusion and on evaluation of therapy by combination of the hepatic arterial infusion with the systematic chemotherapy.

Objective To investigate the role of tissue-resident memory T lymphocytes in the pathogenesis of psoriasis.Methods Clinical information was collected from 32 patients with progressive plaque psoriasis.Tissue specimens were obtained from both lesional and nonlesional psoriatic skin of all the patients,as well as from faded lesions in 9 of these patients.Tissue specimens from the normal skin of 10 healthy individuals served as the controls.Immunohistochemical staining was performed to detect the two characteristic surface markers CD69 and CDI03 on tissue-resident memory T lymphocytes and to analyze the status of these T lymphocytes at different stages of psoriasis.The results of immunohistochemical staining were compared by t test.Results The mean number of CD69+CD103+ T lymphocytes per high-power field was significantly higher in lesional skin than in nonlesional skin of the 32 patients (11.34 ± 7.60 vs.2.72 ± 4.20,t =8.46,P ＜ 0.01),but similar between psoriatic lesions in the 9 patients before and after subsidence (14.33 ± 2.21 vs.12.00 ± 4.58,t =1.98,P =0.08).There was no significant difference in the mean number of CD69+CD103+ T lymphocytes between nonlesional psoriatic skin and normal control skin (2.72 ± 4.20 vs.1.70 ± 2.98,t =0.71,P ＞ 0.05).Conclusion Tissue-resident memory T lymphocytes may play a role in the formation and recurrence of psoriatic lesions in patients.

Objective To investigate the relationship of CD4+ and CD8+ T cells with melanocytes in skin of patients with psoriasis,and to study their clinical significance.Methods Tissue specimens were obtained from both lesional and nonlesional skin of 29 patients with progressive psoriasis and 5 patients with regressive psoriasis,as well as from normal skin of 6 healthy individuals.Immunohistochemical staining was performed to determine the quantity and distribution of CD4+ T and CD8+ T cells,as well as the quantity of melanocytes and proportion of cells containing pigment granules in the basal layer of these specimens.Statistical analysis was carried out with the software SPSS 18.0 by one-way analysis of variance (ANOVA),least significant difference (LSD) test and Pearson correlation analysis.Results In patients with psoriasis,the mean number of CD4+ T cells per high-power (× 200) field was significantly larger in lesional skin than in nonlesional skin (epidermis:5.29 ± 4.66 vs.0,P＜ 0.05;dermis:77.50 ± 43.66 vs.9.67 ± 7.73,P＜ 0.05),so was the mean number of CD8+ T cells per high-power (× 200) field (epidermis:7.83 ± 6.27 vs.0.71 ± 1.20,P＜ 0.05;dermis:46.08 ± 34.26 vs.5.54 ± 4.43,P ＜ 0.05).A significant increase was also observed in the number of CD4+ and CD8+ T cells in lesional skin of patients with psoriasis compared with the normal control skin (both P ＜ 0.05).The lesional skin of patients with psoriasis also showed significandy increased number of melanocytes (103.45 ± 16.96),but decreased proportion of pigment granule-containing cells (7.45％ ± 3.86％) in the basal layer compared with nonlesional skin (43.62 ± 14.20,P＜ 0.05;43.10％ ± 14.91％,P＜ 0.05) and normal control skin (43.33 ± 14.02,P＜ 0.05;54.17％ ± 29.40％,P ＜ 0.05).There were no significant differences in either the mean number of CD4+ T cells,CD8+ T cells and melanocytes or the proportion of pigment granule-containing cells between nonlesional psoriatic skin and normal control skin (all P ＞ 0.05).The mean number of melanocytes was significantly higher in regressive psoriatic lesions than in white patches arising in subsided psoriatic lesions (P ＜ 0.05) and normal control skin (P ＜ 0.05),but similar between white patches and normal control skin (P ＞ 0.05),while the proportion of pigment granule-containing cells was insignificantly lower in regressive psoriatic lesions than in white patches (P ＞ 0.05),and significantly lower in regressive psoriatic lesions and white patches than in normal control skin (both P ＜ 0.05).Neither the number of CD4+ T cells nor that of CD8 + T cells was correlated with the number of melanocytes or the proportion of pigment granule-containing cells in progressive psoriatic lesions (both P ＞ 0.05),while the number of both CD4 + T cells and CD8 + T cells was positively correlated with that of melanocytes (r =0.46 and 0.56,respectively,both P ＜ 0.05),but uncorrelated with the proportion of pigment granule-containing cells in nonlesional psoriatic skin (both P ＞ 0.05).Conclusions In progressive psoriatic lesions,there is a significant increase in the number of CD4+ and CD8 + T cells as well as melanocytes in the basal layer,but a significant decrease in the proportion of pigment granule-containing cells.After subsidence of psoriatic lesions,both the number of melanocytes and proportion of pigment granule-containing cells gradually reach the levels in normal skin of healthy individuals.