Objective To explore different pathogenesis of chronic hepatitis B(CHB)and asymptomatic H BV carriers(ASCs)by identifying differentially expressed genes.Methods Subtracted library was constructed by suppression subtraetive hybridization(SSH),and α-defensin was identified by dot blot hybridization.Peripheral blood was collected from 46 CHB patients and 11 ASCs.and the expressions of α-defensin mRNA in peripheral blood mononuclear cell and protein in plasma were determined by the real time RT-PCR and enzyme-linked immunosorbent assay(ELISA).Results Real time RT-PCR showed that the expression of α-defensin mRNA in blood samples of CHB was 1.4-fold higher than that of ASCs.As shown by ELISA,the plasma level of α-defensin in CHB was higher than that of ASCs [(216.40±81.25)μg/L vs.(156.00±57.26)μg/L,t=2.23,P<0.05].Conclusion α-defensin may involve in the pathogenesis of CHB,for it iS over-expressed in CHB patients.

A case of 76-years-old male patient with nasal bleeding as the first symptom in our hospital, who was finally diagnosed as tsutsugamushi disease. This old man was bited by insect in farmland 2 days before the symptom occurred. PE: Left thigh and right buttock have eschar, with splenomegaly. Routine blood test: WBC (decrease) 3.9 x 10(9)/L, RBC (decrease) 3.86 x 10(9)/L, PLT (decrease) 41 x 10(9)/L, HGB (decrease) 117 g/L; Chest CT: lung interstitial pneumonia, a small amount of bilateral pleural effusion. Oxk-ag 1:320. The patient was discharged after treatment with chloramphenicol for 8 days.
Aged ; Epistaxis ; diagnosis ; etiology ; Humans ; Male ; Scrub Typhus ; complications ; diagnosis

Objective To study TIMI flow influence of intracoronary injection of GPⅡb/Ⅲa receptor antagonists (tirofiban) in patients with STEMI before primary PCI. Methods Sixty-seven STEMI patients (48 male, mean age 57.4?8.1 years old) admitted during April, 2005 to August, 2007 were included in the study and in all of them, IRA thrombus was found during CAG. The patients were divided into the primary PCI group (n=32) and primary PCI plus introcoronary tirofiban injection group (n=35). Changes in TIMI flow were were obsurved diving the operation. Results The incidence of slow-flow and no-reflow of the intracoronary tirofiban injection+PCI group was lower than that of the primary PCI group (2.86% vs 18.75%,P

Diabetic microangiopathy is one of the most common chronic diabetic complications,which is associated with the genetic predispositions and environmental factors.Well-controlled blood glucose alone can not reduce the morbility or prevent the process of diabetic microangiopathy.The therapy aiming at the pathogenesis is an urgent request.The various proteins related to the development and progression of diabetic microangiopathiy were reviewed,aiming at providing the potential target for early diagnosis and efficient therapy.

Adult ; Antithyroid Agents ; therapeutic use ; Autoantibodies ; blood ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Glycosides ; therapeutic use ; Graves Disease ; drug therapy ; immunology ; Humans ; Immunosuppressive Agents ; therapeutic use ; Male ; Methimazole ; therapeutic use ; Middle Aged ; Phytotherapy ; Tripterygium ; chemistry

Diagnosis, Differential ; Facial Asymmetry ; congenital ; diagnosis ; surgery ; Facial Hemiatrophy ; diagnosis ; Humans ; Hypertrophy ; Orthodontics, Corrective

OBJECTIVETo analyze the clinical effects of short-segment posterior pedicle screw combined with transpedicle vertebral bone grafting in treating thoracolumbar burst fractures.

METHODSFrom March 2008 to March 2013, 62 patients with thoracolumbar burst fractures were treated with short-segment posterior pedicle screw combined with transpedicle vertebral bone grafting. Including 40 males and 22 females, the age from 17 to 65 years old with an average of 38 years. According to AO classification, 34 cases were type A3.1, 7 cases were type A3.2 and 21 cases were type A3.3. Load-sharing scores were from 4 to 6 points with an average of 5.4 points. According to ASIA grade, 2 cases were grade C, 5 cases were grade D and 55 cases were grade E. Preoperative, postoperative at 3 d and final follow-up, the Cobb angle, the relative height of anterior vertebral body and the encroachment rate of spinal canal were measured by X-ray films and computed tomography (CT) scan, meanwhile, the information of bone healing and spinal nerves recovery were observed.

RESULTSAll patients were followed up from 11 to 14 months with an average of 12.2 months. The duration of removing internal fixation were from 9 to 13 months (averaged, 11.5 months). One suffered from infection and was cured by debridement. Two cases had mild pain of back. At 6 months after operation, according to ASIA grade to evaluate never function, 1 case was grade C, 3 cases were grade D and 58 cases were grade E. X-ray and CT showed the fractures obtained good union at final follow-up. The Cobb angle, the relative height of anterior vertebral body and the encroachment rate of spinal canal had obviously improved at 3 days after operation (P<0.05); but there was no significant differences between postoperative at 3 d and final follow-up (P>0.05).

CONCLUSIONShort-segment posterior pedicle screw combined with transpedicle vertebral bone grafting is an effective method to treat thoracolumbar burst fractures. It can reduce the loss of postoperative correction and prevent the internal fixation failure.

Adolescent ; Adult ; Aged ; Bone Transplantation ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Pedicle Screws ; Spinal Fractures ; surgery ; Spinal Fusion ; Thoracic Vertebrae ; injuries ; surgery

BACKGROUND: Tumor spinal metastasis is often complicated with pain,limitations in movement, paralysis and poor prognosis.OBJECTIVE: To investigate the factors affecting the recovery of the spinal functions in patients with spinal metastatic carcinoma and its therapeutic methods so as to improve the living quality of the patients with a terminal cancer.DESIGN: A case-controlled observation.SETTING: The Department of Tumor and Department of Radiotherapy of the Affiliated Hospital of Guangdong Medical College.PARTICIPANTS: We selected 162 patients with spinal metastatic carcinoma with different degrees of paralysis who received treatment at the Department of Oncology and the Department of Radiotherapy of the Affiliated Hospital of Guangdong Medical College between March 1992 and June 2001. They participated in this experiment voluntarily.METHODS:①Radiotherapy and chemotherapy; All the patients were given symptomatic treatment with simple radiotherapy or a combined therapy of simple radiotherapy and chemotherapy, in which the dose of chemotherapy was 2 Gy/time,5 times a week,3 weeks in total. A combined method was used for chemotherapy according to the nature of the different primary tumors. The chemotherapy was conducted for 3 therapeutic courses in average ranging from 2 to 6 courses of treatment with 21 days for each course. ② Physical rehabilitation therapy included exercise therapy, massage (twice/day), functional electrical stimulation (once a day),bladder training and toilet training (once or twice every day), 10 days as a therapeutic course, 3 successive therapeutic courses in total. After the treatment, analgesic pain, muscle power of the limbs and the recovery of defecation function were observed.MAIN OUTCOME MEASURES: Pain-alleviating, muscle power of the limbs and the recovery of defecation function after the operation. RESULTS: Totally 162 patients with spinal metastasis carcinoma were recruited, and all the patients entered the stage of result analysis at the end of therapy with no loss in the midway. ① Pain complete alleviating was in 97 cases (59.88%); no alleveclting in 0 case. ② The condition was remarkably improved in 127 cases(78.40%), and it was not improved in 35 cases (21.60%). The improved rate of muscle power of the patients with one focus and 2 adjacent focuses was 92.98%. The improved rate of the patients with multiple foci was 64.59%. The muscle power of the patients with a disease history of less than 2 weeks was improved remarkably, but there was no change in muscle power in patients with a disease history of more than 2 months. CT or MRI showed that spinal cord at the affected segment of the 21 patients suffered severely compression before the treatment, and only 2 cases were improved in muscle power, with no other changes.③The defecation function of 162 patients all became normal.CONCLUSION: Patients with spinal metastatic carcinoma complicated with paralysis have different degrees of relief and amelioration in pain,muscle power of the limbs and defecation function after radiotherapy,chemotherapy and synthetic rehabilitation therapy. Factors affecting the recovery of spinal function mainly included the length of disease course,compressed degree of the spinal cord, the quantity of metastatic focus, the health status of the patients and therapeutic time and the quality of primary rehabilitation and so on. Mental help to the patients should be paid attention to so as to improve the quality of life at the same time.

Objective To investigate the application of stroke volume variation (SVV) in directing management of elderly septic shock patients. Methods Patients who were diagnosed with elderly septic shock and supported with mechanical ventilation were in?cluded (n=28). They were divided into control group (n=13) and SVV group (n=15). Volume recovery was directed by CVP (central ve?nous pressure ) in control group and by SVV and CO (cardiac output) in SVV guoup respectively. Blood lactate, oxidation index, CVP , MVP, NT-proBNP, time of recovery, the length relying on mechanical ventilation and Vigileo parameters were compared after volume resuscition. During the period of treatment, the incidence of acute left ventricle dysfunction within 24 hours, MODS within 28 days and mortality rates of all causes were compared between these two groups. Changes in SVV, cardiac output (CO) and systemic vascular re?sistance (SVR) in SVV group before and after resustation were recorded. Results Blood lactate acid and NT-proBNP were significant?ly lower in SVV group compared with those in control group whereas oxidation index in SVV group were significantly higher than that of control group. The time of resuscitation and the duration relying on mechanical ventilation were shorter in SVV group than those in control group. On the contrary, the incidence of acute left ventricle dysfunction,MODS and all mortality rates were not significantly different between these two groups. There were significant differences between hemodynamic variables such as SVV, CO in SVV group before and after resuscitation. Conclusion SVV may direct volume resuscitation more effective in elderly septic shock than CVP does.

Many studies show that transforming growth factor-β (TGF-β) can suppress tumor by inhibiting proliferation and dedifferentiation of cells and promoting cell apoptosis at early stage.But during the progression of tumor,its tumor-promoting action will be more and more obvious with the variation of TGF-β itself and its signal path.TGF-β signal path inhibitors have anti-tumor activity,but the clinical effects and side effects still need to be observed.