Objective To analyze clinical characteristics of crohn's disease in the elderly in order to reduce the rate of misdiagnosis in Crohn's disease in elderly people.Methods Patients with Crohn's disease were divided into elderly group (n=80) and young and middle-aged group (n=100).Clinical manifestations,complications,laboratory test results and misdiagnosis rate were retrospectively analyzed.Results Diarrhea rate was higher in elderly group than in young and middle-aged group (62.5％ vs.28％,x2 =21.54,P＜0.05).The incidence of bloody/pus stools was lower in elderly group than in young and middle-aged group (16.3％ vs.30.0％,x2 =4.621,P＜0.05).Ileus and perianal diseases incidence rates were lower in elderly group than in young and middle-aged group (20.0％ vs.36.0％,1.3％ vs.8.0％,x2=5.538 and 4.263,P＜0.05).Crohn's disease showed more decreased serum albumin,decreased hemoglobin and ESR in elderly group,which accounted for 48.8％,41.3％,and 38.8％ respectively,but there were no differences between the two groups (all P＞0.05).Compared with young and middle-aged group,Crohn's disease was more likely misdiagnosed as colon cancer and ischemic bowel disease in elderly group (x2 =16.05 and 16.07,both P＜ 0.05).Crohn's disease was more likely misdiagnosed as appendicitis,intestinal tuberculosis and ulcerative colitis in young and middle-aged group than in elderly group (x2=4.707,6.210,4.792,respectively,all P＜0.05).Conclusions Crohn's disease in elderly people occurs with more severe diarrheas,less blood and pus stools,less obstruction and perianal lesions as compared with young group,to which we should pay more attention.

Objective] To study the impact of outpatient appointment supposed on the management of outpatient department and whole hospital. [Methods] Survey and research the average outpatient registration volume, patients' registration waiting time and the patients' satisfaction monthly during May 2011 to May 2014 when outpatient appointment was applied, and analyze the impact of outpatient appointment supposed on the management of outpatient department and whole hospital by comparing the results 3 years ago(during April 2008 to April 2011) when outpatient appointment was not applied. [Results] The number of patients with an appointment was on the rise, the total number of outpatients increased with the increase of outpatient appointment, and patients' registration waiting time was significantly shortened with higher satisfaction. The difference had statistical significance( P<0.05). [Conclusion] By outpatient appointment services, outpatient management has been optimized, with the increase of outpatients; the hospital benefits grow, and meanwhile the patients' satisfaction is improved.

Objective To assess the significance of intima‐media thickness(IM T )combined with HCY ,HbA1c and blood lipid in‐dexes in patients with cerebral infarction .Methods 100 cases of patients with cerebral infarction were enrolled in the experiment group ,and were divided into normal blood glucose group ,high blood glucose group and diabetes mellitus(DM)group .60 healthy in‐dividuals were enrolled in the control group .The serum leves of HCY and HbA1c were detected ,and the IMT was determined by u‐sing ultrasonic examination .Results The positive rate of increase of IMT in the exprement group(70% ) were higher than that in the control group(10% ) ,there were significant differences between the two groups (P<0 .05) .The levels of HCY and HbA1c and IMT were higer in the exprement group compared withthose in the control group ,there was significant difference between the two groups(P<0 .05) .The serum levels of HbA1c and IMT were higher in the high blood glucose group and the DM group compared with those in the control group ,there were significant differences between the two groups (P<0 .05) .The sensitivity ,susceptibility and accuracy of IMT combined with HCY ,HbA1c and blood lipid indexes were 97 .1% ,87 .5% and 94 .0% .Conclusion The ultra‐sonic examination combined with biochemical indexes related to cerebral infarction could increase detection rate of cerebral infarc‐tion ,and the ensitivity ,susceptibility and accuracy could also increase .

OBJECTIVE:To observe the efficacy and safety of amitriptyline combined with carbamazepine in the treatment of postherpetic neuralgia(PHN). METHODS:80 patients with PHN were randomly divided into observation group and control group. Control group was orally given Carbamazepine tablets 100 mg,bid,then increased to 100 mg,tid after 3 d. Observation group was additionally given Amitriptyline tablets 12.5 mg every night before bed,d1~3;then increased to 25 mg after 3 d every night be-fore bed,d4~5;and 12.5 mg every morning from 6th d+25 mg every night before bed,and the dose could be adjusted based on the pain and adverse reactions of 2 groups. The treatment course for 2 groups was 4 weeks. Visual analogue scale score(VAS),sleep-ing time,pain disappearing time and clinical efficacy in 2 groups were compared,and the incidence of adverse reactions were re-corded. RESULTS:The total effective rate in observation group was higher than control group,VAS was lower than control group, sleeping time was longer than control group and pain disappearing time was shorter than control group,the differences were statisti-cally significant(P<0.05). There was significant difference in the incidence of adverse reactions between 2 groups(P>0.05). CON-CLUSIONS:Amitriptyline combined with carbamazepine has obvious efficacy in the treatment of PHN,with good safety.

Objective To explore the total anti-oxidation capacity(T-AOC), superoxide dismutase(SOD), nitric oxide synthase(NOS) and nitric oxide(NO) in testis homogenate of the rats’ with chronic fluorosis induced by drinking NaF solutions with different concentration. Methods 24 male Wistar rats were divided into 3 groups (8 rats per group) including control group, low-fluoride(LF) group, high-fluoride(HF) group, which were exposed to fluoride by means of freely drinking tap water containing NaF with 0, 100 and 200 mg/L respectively for 20 weeks. T-AOC, NOS activities and SOD activity of the testis tissue were determined by colorimetry , xanthine oxidase method and nitrate reductase method respectively. Results Compared with the control group, the T-AOC of the testis tissue increased significantly in LF group and decreased significantly in HF group. SOD activity of the testis tissue showed on significant difference among the control group, LF group and HF group . Compared with the control group, the levels of NOS and NO decreased significantly in LF group and increased significantly in HF group. Conclusion The T-AOC of the testis tissue exposed to low level of fluoride presents a compensatory increase induced by the inhibited activity of NOS and synthesis of NO. Higher level of fluoride may increase reactive oxygen species(ROS), and cause abnormal expression of induce nitric oxide synthase(iNOS) and increased synthesis of NO in the testis tissue.

Objective To investigate the effect of milrinone on the gastric intramucosal pH (pHi), endotoxemia and systemic inflammatory response during cardiopulmonary bypass (CPB) Methods Twenty adult patients undergoing valve replacement were randomly divided into two equal groups of ten patients each: control group (C) and milrinone group (M) In group M milrinone 30?g?kg -1 was given as an intravenous bolus after induction of anesthesia followed by 0 5?g?kg -1 ?min -1 infusion, while in group C normal saline (NS) was given instead of milrinone Patients with ejection fraction (EF)

Objective: To study the antioxidant activity of Clematis chinensis Osbeck polysaccharide(CCP).Methods:① To assay the scavenging activity of CCP on hydroxyl radical and superoxide anion in vitro.② To analyze the effect of CCP on red blood cell autoxidation hemolysis induced by H2O2 by colorimetry.③ To study the effect of CCP on acute hepatic injury of the mice induced by carbon tetrachloride.Results: CCP could eliminate the hydroxyl free radical and the superoxide anion free radical,reduce red blood cell autoxidation hemolysis induced by H2O2,raise the activities of SOD and GSH-Px in hepatic injury mice's serum and liver apparently,reduce the content of MDA and liver index notably.Conclusion: CCP has the significantly action of anti oxidation activity in vitro and in vivo which relates to removing oxygen free radical.

Purpose To explore the relationship between epicardial adipose tissue (EAT) volume and ascending aortic stiffness by CT,so as to early evaluate the lesions of ascending aortic by measuring EAT.Materials and Methods 169 patients with suspected coronary artery disease who underwent coronary CT angiography and coronary angiography in First Affiliated Hospital of Jinzhou Medical University from January 2016 to September 2016 were enrolled.According to the presence of coronary atherosclerosis or not,the patients were divided into research group (109 cases) and control group (60 cases).The research group were further divided into slight,mild,moderate and severe group according to the Gensini score of coronary atherosclerosis.The recorded threshold of EAT volume was 107.2 cm3.The patients with EAT volume higher than 107.2 cm3 belonged to the exposure group,and the rest belonged to the non exposure group.The EAT volume and ascending aortic stiffness were measured,and the relationship between them was assessed.The relationship between EAT volume and coronary atherosclerosis was also analyzed.Results In the control group,there was no correlation between EAT volume and ascending aortic stiffness (r =-0.156,P＞0.05).However,there were negative correlations between EAT volume and ascending aortic stiffness in slight,mild,moderate and severe group (r=-0.378,-0.340,-0.514 and-0.459,P＜0.05).The EAT volumewas an independent risk factor of ascending aortic stiffness (β=-0.009,t=-2.653,P＜0.05).The incidence of CAD in the exposure group was 9.318 times of that in the non exposure group.Conclusion There is obvious correlation between EAT volume and ascending aortic stiffness in patients with CAD.The evaluation of EAT volume can provide an effective reference for the early prediction of ascending aortic lesions in patients with CAD.

Objective To investigate the effect of IVIG on pre-existing anti-HLA-A2 Ab levels and graft skin survival.Methods C57BL/6 wild type mice were sensitized to HLA-A2 by intraperitoneal injec-tion (IP) of HLA-A2 TgN mouse spleen cells (C57BL/6-TgN [HLA-2.1]1Enge SC) expressing human HLA-A2 at day 0, week 3 and 4.Sensitized mice were respectively treated with human IVIG , albumin, gly-cine, or PBS for 5 days during week 7.Skin transplantation from TgN mice to C57BL/6 wild type mice was performed at week 10 .Efficacy of IVIG DES was assessed by measuring anti-HLA Ab levels by ELISA pre-/post-Rx and graft skin survival was monitored daily post-Tx.Results Changes of HLA-A2-IgG levels:IgG HLA-A2 class I Ab levels in all groups predictably increased from baseline following spleen cell IP and peaked at week 4 ( P <0.01 ) , indicating sensitization .IVIG-treated mice showed significantly lower IgG Ab levels vs.albumin, glycine and PBS-treated at week 9 post-desensitization ( P <0.01).IgG quickly increased to extremely high levels in all groups following skin transplantation ( P <0.01 ) .Graft skin sur-vival between Rx-groups were similar with all rejecting at about 7 days post-transplantation ( P >0.05 ) . Conclusion However, IVIG alone does not inhibit anti-HLA class I Ab production after skin transplanta-tion or prolong SG survival , indicating combination of IVIG with other immunosuppressant or more optimal protocol for desensitization might show more efficacy and should be under explored .

AIM:To construct nine novel L-asparaginase mutants and study their enzyme-activity.METHODS:The mutants were constructed using overlap extension PCR according to the principle of alanine-scanning mutagenesis. The enzyme-activity was detected by Nessler's method. RESULTS:The DNA sequencing showed that the mutagenesis was consistent with the theoretical prediction. The enzyme-activity assay demonstrated that each mutant possessed enzyme activity equal to the original enzyme. CONCLUSION:Through gene modification,epitop of L-asparaginase was changed without activity loss.These results provide foundation for further study of the structure-function relationship of L-asparaginase.