We collected the clinical information of 21 in-patients diagnosed as Lyme disease in Peking Union College Univemity Hospital from Apr. 1994 to Jan. 2008. The clinical manifestations, laboratory tests, therapy and prognosis were analyzed retrospectively. 16 of 21 (76%) patients had fever, 14 of 21 (67%) eases had skin lesion, 17 patients had nervous symptoms, 10 cases showed arthrosis and only 2 of 21 eases involved in heart. The antibiotics of penieilin,ceftriaxone and doxyeycline were used for therapy. All of the 21 patients improved clinically and discharged. 12 cases were followed up for 1 month to 12 years and 2 of them relapsed, both of whom were in Stage Ⅲ. 8 cases remained persistent symptoms. As the manifestations of Lyme disease are complicated, for clinical borderline cases the prompt detection of etiological agent may be useful for early diagnosis. The antibiotic therapy should begin as early as possible to avoid developing chronic Lyme disease.

Objective To determine the immunophenotypic features of peripheral lymphocytes in adult patients with Epstein-Barr virus (EBV)-associated infectious mononucleosis (IM) and chronic active EBV infection (CAEBV).Methods Eighteen IM patients,12 CAEBV patients and 18 healthy donors were included.Lymphocyte subsets including CD3-CD+19 B cells,CD3-CD+16/56 NK cells,CD4+ and CD8+T cells in peripheral blood were measured by flow cytometry.The expression of activation markers (HLA-DR and CD38) on CD8+T cells and CD28 expression on T cells were also determined.Kruskal-Wallis H and MannWhitney U tests were used to compare variables among groups.Results IM patients had dramatically increased CD8+T cell counts than healthy donors (5.22 × 109/L vs 0.54 × 109/L,P ＜ 0.001).B cell counts moderately reduced in patients with IM than in healthy donors.No difference was found in absolute CD4+T cell and NK cell counts between IM and healthy donors.The levels of HLA-DR and CD38 on CD8+T cells significantly increased in IM patients compared with those in healthy controls.The intensity of CD28 on CD8+T cells significantly decreased,which was not seen on CD4+T cells.The median cell counts of B,NK,CD4+T and CD8+T subsets in CAEBV patients were 0.02 × 109/L,0.06 × 109/L,0.26 × 109/L and 0.21 ×109/L respectively,which were significantly lower than those in healthy donors (0.22 × 109/L,0.38 ×109/L,0.78 × 109/L,0.54 × 109/L) and IM patients (0.12 × 109/L,0.40 × 109/L,0.91 × 109/L,5.22 ×109/L).The positive rates of HLA-DR and CD38 on CD8+T cells in CAEBV patients were higher than those in healthy controls,but lower than those in IM patients.Conclusions The immunophenotypic pattern in adult patients with IM is characterized by a dramatic increase of extensively activated CD8+ T cells,a moderate reduction of CD+19B cells and no significant change of CD4+T cells and CD+16/56NK cells.CAEBV is featured by an immunosuppression status as demonstrated by significantly decreased B,NK,CD4+T and CD8+T subsets.

Objective To evaluate the relationship between fatty liver disease and liver metastases from colorectal cancer.Methods Eight hundred and ninety patients with colorectal cancer,who were submitted to hospital from 1993 to 2002 and had complete clinical data,were retrospectively analyzed.Of 890 patients,127 were diagnosed as fatty liver(FL)by ultrasonography,and the other 763 who were without fatty liver were served as controls(NFL).The clinical data including pathology,liver matastasis or mortality after surgery were analyzed.The survival rate and liver matastasis after surgery were followed up and statistically analyzed.Results The liver metastases was lower in FL group than that in NFL group(7 cases vs 102 cases,P=0.012).The tumor size was smaller in FL group than that in NFL group[(4.15±1.80)crn vs(4.77±2.25)cm,P=0.0016].The Dukes B(247/732,33.74%)and C(232/732,31.83%)patients were more common in NFL group,whereas Dukes A(41/121,33.61 %)and B(40/121,32.77%)were more common in FL group with significant difference(P＜0.05).No significant difference was found in 7-year survival rate between two groups who had been followed up(P=0.3024).Conclusion The lower incidence of liver metastases is found in FL group,which indicate that fatty liver disease may inhibit liver metastases from colorectal cancer by underlying mechanisms.

Objectives To investigate the T cell subsets changes in hemorrhagic fever with renal syndrome (HFRS) patients. Methods 22 HFRS patients who were diagnosed in Qin Huang Dao Third Hospital from April 2005 to July 2005 were enrolled in this study and divided into two groups according to clinical manifestations. T cell subsets of the 22 patients were monitored at week 1, 4 and 12. Another 56 subjects were enrolled as healthy controls. Results B cell count was normal during the 12 weeks in all the subjects. NK cell decreased significantly at week 1, and recovered at week 4 rapidly. CD4+ T cell count was normal throughout the course of the disease, but the percentage of memory phenotypy increased at week 1and4, reaching(64.1±17.5)% and (59.9±10.1)%, but recovered at week 12. CD4+CD28+T cells were normal throughout the entire study. CD8+ T cell count increased dramatically at week 1 and 4, but finally recovered at week 12. The count of CD8+ CD28-T cells increased significantly at week 1 in low-grade goup, but in median-grade group, this increase lagged to week 4 and was not as significant as in low-grade group. The percentage of CD38+ or HLA-DR+ subsets of CD8+ T cell increased at week 1, 4. Conclusion The results confirmed the relationship between HFRS progression and cellular immunity. It revealed that, at the early stage of HFRS, rapid and effective cytotoxicity T lymphocyte response my contribute to clear Hantavirus away and improve HFRS symptom.

Objective To investigate the significance and characteristics of T lymphocyte subsets and co-stimulatory CD28 in peripheral blood of patients with primary biliary cirrhosis. Methods Tri-colour flow-cytometry was used to detect the levels of T lymphocyte subsets in peripheral blood in 98 patients with primary biliary cirrhosis and 30 age and gender matched healthy controls. Results Compared to control group the percentage of CD4+ T increased and CD8+ T lymphocyte decreased in the PBC group. The CD4+/CD8+ ratio in the PBC group was higher than that in the control group (P<0.05). And the percentage of CD4+CD28- T cells and CD8+CD28- T cells increased, too (P<0.05). Conclusion There are immunological abnormalities in PBC and the expression of co-stimulator CD28 is significantly decreased. CD8+CD28-T lymphocytes may have immune regulatory effect in PBC.

This paper analysed the rhinoscope's clinical value in microsurgical treatment of intracranial aneurysms. Application of the rhinoscope in 87 patients, only 2 patients had ruptured during operation. However, 11 cases had ruptured in 94 cases without using rhinoscope, P < 0.05, they had a significant difference. By DSA follow-up review, 82 cases of used rhinoscope only 2 cases had remained the aneurysm neck, but 9 cases had the aneurysm neck in 77 cases which had not used the rhinoscope in the microsurgical treatment, P < 0.05, they also had significant difference. The application of rhinoscope in microsurgical treatment of intracranial aneurysms intraoperative, can reduce the risk of the intraoperative aneurysm rupture. It can achieve better clinical effect.
Adult ; Aged ; Endoscopy ; Female ; Humans ; Intracranial Aneurysm ; surgery ; Male ; Microsurgery ; Middle Aged ; Nose ; surgery ; Treatment Outcome

Objective To evaluate the influence of long-term nucleotide reverse transcriptase inhibitors (NRTIs) on lipids metabolism in HIV/AIDS patients and correlating clinical factors.Methods A total of 118 HIV/AIDS patients were divided into 3 groups:untreated group (40 patients),highly active antiretroviral therapy(HAART) for 1-2 years group (37 patients) and HAART over 5 years group (41 patients),with 20 healthy individuals as the control group.Clinical lipodystrophy (LD) was defined as concordance between patient's report of change and physical examination.Fat mass (FM) was measured by dual-energy X-ray absorptiometry (DXA).Results There was no significant difference in the incidence of LD between HAART for 1-2 years group and HAART over 5 years group (51.2％ vs 40.5％,P =0.345).The prevalence of LD was 2.4 folds with strvudine (d4T) treatment compared with zidovudine (AZT)-containing regimens (61.6％ vs 23.5％,P =0.001).Based on DXA measurements,FM of total body and limbs were significantly lower in the HAART over 5 years group than that in the control group,the untreated group and the HAART for 1-2 years group (P ＜ 0.05).Trunk FM was significantly lower in the HAART over 5 years group than the untreated group and the HAART for 1-2 years group (P ＜ 0.05).FM of total body and trunk were significantly lower in patients without LD in the HAART over 5 years group than patients without LD in the HAART for 1-2 years group (P ＜ 0.05).FM was correlated positively with body weight and BMI.Limbs FM was correlated negatively with peripheral blood triglyceride concentration.Conclusions HIV/AIDS patients with NRTIs therapy have high prevalence of LD,which mainly occurs 1-2 years after therapy,and increases with d4T treatment compared with AZT-containing regimens.There was no significant difference in the incidence of LD between the HAART for 1-2 years group and the HAART over 5 years group.FM was significantly decreased after long-term HAART in the patients with or without LD.DXA can evaluate LD objectively and guide further clinical treatment.

Objective To investigate the effects of endogenous estrogen on blood glucose level,serum insulin level,and plasma total antioxidant capacity in streptozotocin-induced diabetic female mice,and to explore possible protective effects of estrogen on pancreatic islet cells.Methods Female mice were randomly according to body weight divided into four groups:( 1 ) Sham( Sham operation and vehicle administration) ; ( 2 ) Ovx( ovariectomy and vebicle administration ) ; ( 3 ) Sham + STZ ( Sham operation and STZ administration ) ; and ( 4 ) Ovx + STZ ( ovariectomy and STZ administration).The diabetic mice were induced by intraperitoneal injection of streptozotocin (STZ,50 mg/kg ).Blood glucose levels were measured once a week.Results The blood glucose level and malondialdehyde of Ovx group were higher than that in Sham group,while total anti-oxidant capacity ( T-AOC ) was lower than those in Sham group.the blood glucose level and MDA of Ovx+ STZ group were higher than those in Sham +STZ group,while T-AOC and serum insulin level were lower than those in Sham + STZ group.Conclusions Endogenous estrogen may have some protective effects on pancreatic islet function from streptozotocin-induced diabetes mellitus in female mice.

Objective To understand the changes of cardiac systolic and diastolic function in human immunodeficiency virus (HIV)-infected patients without evidence of cardiac disease in China.Methods Forty-two HIV-infected patients who were followed up in the Department of Infectious Diseases at Peking Union Medical College Hospital without cardiac involvement were recruited.All the HIV-infected patients had received highly active antiroviral therapy (HAART) for more than 12 months with viral suppression.And 30 age and sex matched healthy subjects without cardiac disease manifestations were enrolled as controls.Every group members underwent transthoracic echocardiography evaluation.The indexes of cardiac systolic and diastolic function between HIV-infected patients and healthy controls were compared.Results Diastolic abnormality occurred in 20 cases in HIV-infected group and 6 cases in control group, with statistically significant difference (χ2=5.79, P=0.007).The E wave deceleration time (EDT) in HIV-infected patients were significantly decreased than healthy controls ([161.87±21.64] ms vs.[190.34±37.22], t=-3.20, P=0.002).There were no significant differences of E/A ratio ([1.16±0.35] vs.[1.19±0.26]), E/Ea ratio ([5.43±1.99] vs.[5.78±0.91]), isovolumic relaxation time (IVRT), ([93.18±20.34] ms vs.[93.57±18.55]ms), Ea ([10.18±2.80] cm/s vs.[11.45±2.75] cm/s) between HIV-infected patients and controls (t=1.13,1.53,0.67 and 0.29, respectively, all P>0.05).Among cardiac systolic function markers, left ventricular ejection fractions in HIV-infected patients and control group were (66.7±6.4)% and (68.7±4.2)%, respectively.And left ventricular shortening rates were (37.08±4.79)% and (38.17±3.96)%, respectively.Both showed no significant difference between the two groups (t=-1.51 and-1.00, respectively, both P>0.05).Conclusions Compared with control group, subclinical cardiac diastolic dysfunction is more frequently observed in HIV-infected patients.However, there are no significant differences of cardiac systolic function markers between HIV-infected patients and controls.

STGC3, a novel tumor related gene, was cloned recently. The previous studies indicated that STGC3 can inhibit the proliferation of CNE2 cell line in vitro. To examine the effect of STGC3 on the tumorigenicity of CNE2 cell line and explore its mechanism in nude mice. The Tet/pTRE/CNE2-STGC3 cell line was planted under the front leg skin of nude mice and induced by doxycycline (Dox). The mRNA and protein level of STGC3 in transplanted tumor tissues were detected with RT-PCR and Western Blotting. The apoptosis ratio of the tumor cell was analyzed with flow cytometry. STGC3, Bcl-2 and Bax proteins were examined by immunohistochemistry method. The results indicated that high level of STGC3 expression can inhibit tumorigenicity of CNE2 cell line in nude mice. Tumor grew slowly, later and smaller. Cell apoptotic percentage increased. Bcl-2 protein expression was down-regulated and Bax protein expression was up-regulated in Tet/pTRE/CNE2-STGC3 cell line (P