Objective To investigate the effect of liver transplantation on hepatitis B associated diseases and the efficiency of prevention and treatment on the re-infection of hepatitis B.Methods The data of 17 patients undergoing liver transplantation were analyzed after treatment of lamivudine and hepatitis B immune globulin (HBIg). Results Of the 17 cases of hepatitis B pretransplantation, 2 cases were positive for HBsAg. Liver function was normal in all patients.Conclusions Liver transplantation is an effective therapy for hepatitis B. Lamivudine and HBIg could effectively prevent and treat the re-infection of hepatitis B after liver transplantation.

Objective To explore the role of Kupffer cell-expressed Fas ligand(FasL) on acute pancreatitis(AP),and the protective effect of gadolinium chloride(GdCl3),a Kupffer cell inhibitor,on liver injury during AP.Methods Fifty-four ICR mice were randomly assigned into three groups: healthy control group(n=6);AP group(four time points for observation,6 mice each);Gd+AP group(GdCl3 pretreatment group,four time points for observation,6 mice each).AP was induced in mice using cerulein.Liver parenchymal enzymes(AST,ALT and LDH) and amylase(AMY) were assayed using an automatic analyzer.Serum FasL was assayed with ELISA and FasL protein expression in liver was assayed by Western blotting.Results After induction of AP in mice,the serum levels of AST,ALT,LDH,AMY and liver FasL expression were significantly elevated.Serum FasL levels at 4,8,16 and 24h after AP induction were 505.94?36.21,496.60?33.65,476.64?22.66 and 450.75?38.21,respectively,which were significantly higher than those in healthy control group(83.60?7.75,P

Objective To analyze the prevalence of nosocomial infections among inpatients and its influential factors.Methods The retrospective survey was performed by reviewing and analyzing the clinical data of 7788 inpatients in 2004 in Nankai Hospital of Tianjin.Results Totally 250 nosocomial infection cases were identified,which gave a prevalence of 3.21%.The all-year highest prevalence was found in September.Among all the departments,the highest rate,5.20%,occurred in Department of Gynecology.The inpatients aged more than 60-year-old showed higher prevalence than those under 60 years old.The main infection position was lower respiratory tract(41.60%).Concludes The prevalence of nosocomial infections of Nankai Hospital were within the acceptable standard range defined by Ministry of Health,China.Nevertheless,the prevalence would be reduced if measurements for surveillance and control could be properly applied.

Objective To study whether closed reduction and interlocking intramedullary nailing will worsen the injured radial nerve associated with the fracture of humeral shaft.Methods Of the 353 patients with fracture of humeral shaft who received operation from January 2002 to January 2005,63 ones were complicated with preoperative injury to their radial nerve.A retrospective analysis was done of their physical examination records, operative records,X-ray films and results of the treatment.Eleven cases were treated with closed reduction and interlocking intramedullary nailing,and 52 cases with open reduction and internal fixation of plates and screws fol- lowed by exploration to the radial nerve.Chisquare test of PEMS 3.1 system was adopted to analyze the clinical data. Results The radial nerve was embedded by the fracture ends in nine cases(17.3%)of the 52 cases,and con- tused in the other 43 ones.In the 63 cases,The injured nerves recovered spontaneously 2 to 12 weeks postoperatively except in twn cases.All the eases got bony union 3 to 4 months after operation.Closed reduction and interlocking intramedullary nailing has hardly more harmful effects on the injured radial nerve assoeiated with the fracture of humeral shaft than open reduction and internal fixation of plates and screws followed by neural exploration.Con- clusion Closed reduction and interlocking intramedullary nailing is fit for the freatment of fractures of humeral shaft with radial nerve injury.

0.05). In the xenogeneic fresh nerve graft group, the xenogeneic nerve segment was rejected and absorbed by the recipient. CONCLUSION Xenogeneic acellular nerve could sustain facial nerve regeneration, and may be a substitute to autograft for repairing facial nerve defects.

Objective To observe the effect of levocarnitine and trimetazidine on left ventricular mass index in patients with maintenance hemodialysis (MHD),and to explore the safety and efficacy of the two drugs when used in combination.Methods 48 cases of MHD were randomly divided into control group and treatment group,24 cases in each group.On the basis of routine treatment,treatment group was treated with L -carnitine 1.0g by intravenous, 3 times per week,and trimetazidine tablets 20mg,3 times daily at the end of each dialysis.The control group was only treated with L -carnitine.The course of treatment was 12 months.The left atrial diameter (LAD),left ventricular end diastolic diameter (LVDD),left ventricular end diameter (LVDS),interventricular septal thickness (IvST),left ventricular posterior wall thickness (LVPWt),left ventricular ejection fraction (LVEF),stroke volume (SV),left ventricular mass index calculation were detected and compared before and after treatment in the two groups.Results After treatment,the LAD,LVDd,LVDs,IvST,LVPWt in the control group were (40.25 ±1.73)mm,(51.16 ± 3.17)mm,(32.52 ±2.86)mm,(11.16 ±1.23)mm,(10.23 ±1.19)mm,which were decreased compared with before treatment [(42.63 ±1.82)mm,(53.71 ±3.26)mm,(35.83 ±3.12)mm,(12.51 ±1.39)mm,(11.76 ± 1.37)mm],and the LAD,LVDd,LVDs,IvST,LVPWt in the treatment group were (37.61 ±1.86)mm,(47.53 ± 3.18)mm,(29.71 ±2.93)mm,(10.46 ±1.32)mm,(9.14 ±1.32)mm,which were decreased compared with beforetreatment [(42.89 ±1.91 )mm,(54.18 ±3.29)mm,(35.76 ±3.27)mm,(12.49 ±1.35 )mm,(11.73 ± 1.41)mm](t control group =4.643,2.747,3.831,3.563,4.130,t treatment group =9.702,7.120,6.750,5.209, 6.569,all P <0.05 ),and each index of the treatment group was significantly lower than the control group (t =5.091,3.961,3.362,2.901,3.005,all P <0.05 ).The LVMI of the control group and treatment group was (121.63 ±7.16)g/m2 ,(115.49 ±7.91)g/m2 after treatment,which were decreased compared with before treatment [(127.32 ±7.51)g/m2,(126.87 ±7.28)g/m2 ](t =2.686,5.186,all P <0.05).The EF and SV of the control group were (58.16 ±4.35)%,(43.61 ±4.72)mL after treatment,which were increased compared with before treat-ment[(55.32 ±4.17)%,(40.52 ±4.13)mL](t =2.686,5.186,all P <0.05).The EF and SV of the treatment group were (61.26 ±4.13)%,(46.25 ±4.17)mL after treatment,which were increased compared with before treat-ment[(55.28 ±4.51)%,(40.81 ±4.96)mL](t =4.791,4.113,all P <0.05).After treatment,LVMI in the treat-ment group was lower than that in the control group,SV and EF were higher than those in the control group (t =2.819,2.532,2.053,all P <0.05).Conclusion Compared with single levocarnitine,the therapy of levocarnitine and trimetazidine can better reduce left ventricular mass index in MHD patients and improve the cardiac structure and function,which is safe and effective.

BACKGROUND:About 10%-49%of maintenance hemodialysis patients are accompanied by refractory hypertension and common drug therapy is ineffective. Continuous renal replacement therapy could clear the middle and giant molecule toxins in the blood plasma of patients, it is theoretical y treat refractory hypertension through reducing the toxin levels.
OBJECTIVE:To observe the effect of continuous renal replacement therapy on maintenance hemodialysis patients with refractory hypertension.
METHODS:A total of 45 maintenance hemodialysis patients with refractory hypertension were randomly divided into two groups, hemodialysis group (n=22) and continuous blood purification group (n=23). Hemodialysis group underwent conventional hemodialysis treatment. Continuous blood purification group underwent conventional hemodialysis therapy, and treatment of continuous blood purification weekly.
RESULTS AND CONCLUSION:After 3 months of treatment, the renin activity, endothelin, angiotensin II, C-reactive protein, interleukin-6, and tumor necrosis factor-αlevels in continuous blood purification group were significantly lower than the levels before the experiment, while 24-hour mean blood pressure levels were significantly decreased (P<0.05). In hemodialysis group, renin activity, endothelin, angiotensin II, C-reactive
protein, interleukin-6, and tumor necrosis factor-αlevels and 24-hour mean blood pressure did not change (P>0.05). After the test, continuous blood purification group showed significantly lower levels of the above index than the hemodialysis group (P<0.05). Continuous renal replacement therapy plus hemodialysis significantly reduce the blood pressure in maintenance hemodialysis patients with refractory hypertension, the potential mechanisms are mediated by lowering the middle and giant molecule toxin as wel as inflammatory factor in plasma.

Objective To explore the effectiveness and safety of deep brain magnetic stimulation technique (dTMS) for treatment of Alzheimer's disease (AD).Methods Totally 116 patients with AD were randomly divided into 4 groups:(1) dTMS:given dTMS really stimulation therapy,(2)medication group:treatment with donepezil 5 mg/d,(3) combination treatment group:given dTMS and donepezil therapy,(4) blank control group:given pseudorandom stimulation treatment.33 healthy control cases were given dTMS's stimulation treatment.The treatment course was 6 months.Application of mini mental state examination scale (MMSE),the Montreal cognitive assessment scale (MoCA),Hamilton Depression Scale (HAMD),ischemic scale (HIS),Boston naming test,activity of daily living(ADL) and neuropsychological questionnaire (NPI) were used to evaluate the cognitive function.All the participants received blood tests and ECG in order to evaluate the safety of dTMS.Results After 6 months treatment,compair with the blank control group,all scale scoresof dTMS group,medication group and combined treatment group were improved significantly in MMSE (t=2.49,2.46,2.20),MoCA(t=2.59,2.39,2.87),ADL(t=2.35,2.17,2.83),NPI(t=3.05,2.40,2.65) and sub-cognitive scale score (all P＜0.05).All scale scores of combination treatment group were better than dTMS group and medication group (P＜0.05).There's no significant difference between drug treatment groups and dTMS group (P＞0.05).After 6 months treatment,compared with healthy control group,the scale scores were aggravated in 4 groups of AD (P＜0.05)Conclusions dTMS can be effective and safe in the treatment of AD patients with cognitive and noncognitive symptoms.

Objective To investigate the pathologic changes in the pancreas of rats after intraperitoneal injection of DETC,a kind of superoxide dismutase (SOD) inhibitor,and to compared that with another model of chronic pancreatitis by pancreatic duct injection of TNBS.Methods The rats were randomly divided into DETC group,DETC control group,TNBS group,TNBS control group,normal control group.Rats in DETC group received an intra-peritoneal injection of DETC twice a week,and rats in DETC control group received an intra-peritoneal injection of same amount of normal saline.Rats in TNBS group was injected with 2％ TNBS ethanol phosphate buffer into the pancreatic duct,while rats in TNBS control group was treated with injection of same amount of ethanol phosphate buffer,and rats in normal control group received no treatment.The rats were sacrificed after 2 w,4 w,6 w and 8 w.The serum levels of amylase were determined,and pathological and ultrastructure changes of the pancreas were measured.The levels of SOD,GSH-PX activity and MDA content were detected.The expressions of α-SMA,Desmin,Collagen Ⅰ,Collagen Ⅲ,TGF-β1,FN in tissue were detected by immunohistochemical assay.The TGF-β1 mRNA expression was detected by RTPCR.Results No rat died in DETC group.The mortality rate of TNBS group was 15％.The serum levels of amylase were not statistically different between the 2 groups.The fibrosis scores of rat in DETC group at 4 w was 3.4 ± 1.l,which was significantly higher than that in TNBS group (3.0 ± 1.3,t =3.462,P ＜ 0.05).At 6 w,the damage scores of rat in DETC group was 9.1 ± 1.8,which was significantly higher than that in TNBS group (8.4 ± 1.8,t =2.943,P ＜ 0.05).Scores of vacuolar degeneration and fatty infiltration of rat in DETC group were higher than those in TNBS group,but the difference between the two groups was not statistically significant.Two weeks later,ultrastructure changes of pancreas could be observed,and large amounts of regenerative or mature collagen could be seen at 4 w.The SOD activity of DETC group was significantly decreased when compared with those in TNBS group (t =5.468,P ＜ 0.01).The GSH-PX activity of DETC group at 2 w,6w was significantly decreased when compared with those in TNBS group (t =6.497,10.125,P＜0.01).While the activity of MDA at 6 w,8 w was significantly increased when compared with those in TNBS group (t =3.350,5.407,P ＜0.05).The differences at other time points were not statistically significant.The expressions of (a)-SMA,Desmin,Collagen Ⅰ,Collagen Ⅲ,TGF-β1,FN,and TGF-β1 mRNA were not statistically significant between the 2 groups.Conclusions Sustained suppression of SOD activity can successfully induce chronic pancreatitis.Fatty infiltration and fibrosis in pancreas in DETC group occurs earlier with more severe presentation than that in TNBS group.Intraperitoneal injection of DETC is easy with low mortality rate,which is an ideal method for chronic pancreatitis model induction.

BACKGROUND:Screw loosening and shedding may occur after osteoporosis associated with lumbar degenerative disease treated with pedicle screw fixation. Application of pedicle screw enhanced with cured materials can improve the therapeutic effect.
OBJECTIVE:To compare the clinical effect of pedicle screws enhanced with poly(methyl methacrylate) and injectable calcium sulfate cement in the lumbar internal fixation of osteoporosis.
METHODS:Sixty-one patients diagnosed with osteoporosis combined with lumbar spondylolisthesis, lumbar spinal instability, and severe lumbar spinal stenosis were col ected. Al patients were divided into two groups according to the treatment method:poly(methyl methacrylate) bone cement enhanced pedicle screw group and calcium sulfate bone cement enhanced pedicle screw group.
RESULTS AND CONCLUSION:There were no significant differences in the operation time, blood loss, preoperative and postoperative visual analog scale score, Japanese Orthopedic Association scores and the Japanese Orthopedic Association score improvement rate between two groups (P>0.05). The results showed that two patients had bone cement leakage in poly(methyl methacrylate) group which had no neurological symptoms caused by new symptoms during fol ow-up period. The bone mineral density was not improved gradual y in poly(methyl methacrylate) group with fol ow-up time prolonging;however, in calcium sulfate group, the bone mineral density was increased significantly after treatment, and the change of bone mineral density was linearly related with Japanese Orthopaedic Association score improvement rate in calcium sulfate group. No screw loosening, pul ing out or neurological dysfunction occurred in both groups. The results indicate that like poly(methyl methacrylate), balcium sulfate bone cement can increase the stability of pedicle screws.