Objective To observe the change of homocysteine(Hcy)and lipoprotein-a[Lp(a)]of cerebral infarction patients and perform the correlation analysis on them.Methods The serum Hcy and Lp(a)levels were detected in 230 patients with cerebral in-farction and 90 healthy controls.The detection results were performed the comparison between the groups and the correlation analy-sis.Results The serum Hcy and Lp(a)levels in the overall cerebral infarction group and the cerebral infarction group with in-creased Hcy were significantly higher than those in the healthy controls(P <0.01).The serum Hcy and Lp(a)levels in the cerebral infarction group without increased serum Hcy had no statistical difference compared with the healthy control group(P >0.05).The serum Hcy and Lp(a)levels in the overall cerebral infarction group had no statistical difference compared with the cerebral infarc-tion group with increased Hcy(P >0.05).The serum Hcy and Lp(a)levels in the overall cerebral infarction group and the cerebral infarction group with increased Hcy had statistical difference compared with the cerebral infarction group without increased Hcy (P <0.01).The serum Hcy in the overall cerebral infarction group is positively correlated with Lp(a)(r =0.859,P <0.01).Con-clusion The increase of serum Hcy and Lp(a)levels is closely related with the occurrence of cerebral infarction and has certain val-ue in the diagnosis of cerebral infarction,moreover serum Hcy is positively correlated with Lp(a).

Objective To detect serum leucine aminopeptidase (LAP) level in the patients with hyperthyroidism for investiga‐ting the changes of LAP in the patients with thyroid dysfunction and its clinical significance .Methods 117 patients with hyperthy‐roidism were taken as the test group and 109 healthy people as the control group .The differences of various laboratory indexes were comparatively analyzed and the correlation between LAP with FT 3 ,FT4 and TSH was analyzed .117 patients with hyperthyroidism were divided into the liver damage group(52 cases) and non‐liver damage group(65 cases) and performed the LAP determination . Results The serum LAP ,FT3 ,FT4 and TSH levels in the hyperthyroidism whole group ,hyperthyroidism liver damage group and hyperthyroidism non‐liver damage group had statistically significant differences compared with those in the control group (P<0 .01) ,serum LAP was positively correlated with FT 3 and FT4 ,and negatively correlated with TSH ;LAP ,FT3 ,FT4 and TSH had no statistical differences between the hyperthyroidism live damage group and the hyperthyroidism non‐liver damage group (P>0 .05) .Conclusion The serum LAP content is closely related with the thyroid hormones and has certain clinical reference value for the diagnosis ,disease condition evaluation and medication .Lap can serve as an independent diagnostic indicator .

Background Long-term administration of glucocorticoid drugs induces ocular hypertension in susceptible individuals probably.It has been verified that 1 1β-hydroxysteroid dehydrogenase type 1 (11β-HSD1),glucocorticoid receptor (GR) and mineralocorticoid receptor (MR) can affect the generating of aqueous humor,but how they play the role in glucocorticoid-induced ocular hypertension is unclear.Objective This study was to investigate the relationship of expressions of 11β-HSD1 and steroids receptors in ciliary body and steroid-induced ocular hypertension.Methods Thirteen 12-16 week-old New Zealand albino rabbits were randomized to control group (5 rabbits) and experimental group (8 rabbits).Steroid-induced glaucoma models were induced by administration of subconjunctival injection of 5 mg dexamethasone solution(1 ml) and 0.5％ dexamethasone eye drops on alternate days in the left eyes for consecutive two months in the experimental group,and the equal volume of sterile normal saline solution was used in the same way in the control group.The successful criteria of model eyes was defined as rising of intraocular pressure (IOP) to ≥ 18 mmHg for over one week.Then,the animals were sacrificed by excessive anesthesia and the ciliary tissues were isolated for the assay of expressions of 1 1β-HSD1 protein by immunochemistry,and the expressions of 11β-HSD1 mRNA,GR mRNA and MR mRNA in ciliary body were semi-quantitatively detected by reverse transcription-PCR (RT-PCR).The experimental results were compared between the two groups.Results The IOP was normal in the first two weeks after administration of drugs,and no significant difference was found in IOP between the first week and the second week in the experimental group (q =0.469,P ＞0.05).From 3 through 5 weeks after injection,the IOP was gradually elevated,with the highest value of (18.87±0.77) mmHg in the fifth week.Significant differences were seen between the two groups at mentioned-above time points (q =10.535,20.353,28.681,all at P ＜ 0.01).11β-HSD1 protein was positively expressed in nonpigmented epithelial cells of ciliary tissue of rabbits in both groups,however,the expression intensity was weaker in the experimental group compared with the control group.The relative expressional values of MR mRNA,GR mRNA and 11β-HSD1 mRNA in the ciliary tissue were 2.22±0.78,0.64±0.11 and 0.47±0.16 in the experimental group,and those in the control group were 0.94±0.27,1.88±0.74 and 2.68±1.28,with significant differences between the two groups (t =6.070,P =0.004 ; t =5.170,P =0.007 ; t =5.540,P =0.005).Conclusions Corticosteroidinduced glaucoma probably is associated with the up-regulation of MR level and down-regulations of GR and 11β-HSD1 in ciliary body.

Gallibacterium anatis,a member of the Pasteurellaceae family,constitutes a part of the normal micro-flora of the upper respiratory tract and the lower genital tract in chickens.However,increasing evidence indicate that G.anatis is also associated with a wide range of pathological changes,particularly in the reproductive organs,which leads to decreased egg production,lowered animal welfare and increased mortality.As a recently defined opportunistic pathogen limited focus has been placed on the pathogenesis and putative virulence factors permitting G.anatis to cause disease.One of the most studied virulence determinants is a large RTX-like toxin (GtxA),which has been demonstrated to induce a strong leukotoxic effect on avian macrophages.A number of fimbria of different sizes and shapes,particularly the F17-1ike fimbriaes,appear to be common in a diverse selection of G.anatis strains.The capsular material expressed possibly involved in serum resistance,metalloproteases capable of degrading immunoglobulins,hemagglutinins,and all factors which may promote biofilm formation are likely linked to the virulence of G.anatis.This review summarized the putative virulence factors described for this bacterium to date.

BACKGROUND:Finite element method is widely used in the femoral neck fracture, but the study concerning different fixation methods of femoral neck fracture is not much. OBJECTIVE:To analyze biomechanical properties of different fixation methods for femoral neck fracture using finite element analysis. METHODS:The femur of voluntters was scanned with CT, at thickness 0.6 mm, from the site above the greater trochanter of the femur. Scanning data were saved in .DICOM format. Data of right proximal femur were imported into Mimics software. Osteotomy was performed according to Pauwels I type fracture. Models of two tensile force screws, ful y threaded hol ow screw and proximal femoral locking plate were established. Three-dimensional finite element method was used to analyze stress distribution, stress concentration position, displacement distribution and maximum displacement in different models of femoral neck fracture with different internal fixation methods. RESULTS AND CONCLUSION:(1) The maximum stress value of two lag screws model was biggest. The maximum stress value of ful y threaded hol ow screw model was minimized. The maximum stresses of two lag screws model, ful y threaded hol ow screw model and proximal femoral locking plate model al were concentrated in the fixed end of fractures. (2) The femoral maximum stress of two lag screws model was biggest. The femoral maximum stress value of proximal femoral locking plate model was minimized. The femoral maximum stresses of two lag screws model, ful y threaded hol ow screw model and proximal femoral locking plate model al were concentrated in the medial femoral smal rotor near and medial femoral and fixation contact points. (3) The maximum displacement of two lag screws model was biggest. The maximum displacement of ful y threaded hol ow screw model was minimized. The maximum displacement of two lag screws model, ful y threaded hol ow screw model and proximal femoral locking plate model al was in the femoral head. (4) The maximum displacement value of two lag screws model fixed place was biggest. The maximum displacement value of ful y threaded hol ow screw model fixed place was minimized. The maximum displacement value of two lag screws model was biggest at femoral head. The maximum displacement value of ful y threaded hol ow screw model was minimized at femoral head. (5) Results showed that the treatment effect of ful y threaded hol ow screw on Pauwels I fractures was better than other two fixation methods.

Objective To investigate the short-term acute rejection incidence of the recipients under the steroid-free immunosuppressive therapy after liver transplantation. Methods This retrospective study included 186 patients who were divided into two groups by random number table.The patients in no steroid group (the study group, n =94) received tacrolimus (Tac) with mycophemolate mofetil (MMF) or cyclosporine with MMF,and those in the steroid group (the control group,n =92) received the aforementioned immunosuppressive therapy combined with steroids.The acute rejection incidence was analyzed during six months post-transplantation.Results There was no significant difference in the gender,age,indication for transplantation,Child-Pugh score,MELD score,operating time,bleeding and transfusion volume during the operation,warm ischemia time and cold ischemia time between the two groups (P＞0.05).Liver biopsy was done on 9 cases of each group.The acute rejection incidence had no significant difference between the study group and the control group (5/94 vs 4/92,5.3％ vs 4.4％,P＞0.05).Conclusion The steroid-free immunosuppressive therapy after liver transplantation did not increase the short term acute rejection incidence.

Objective To investigate the clinical applications of dual-source dual-energy CT and dual-energy virtual unenhanced iodine distribution technology in thoracic tumor scans.Methods CT and clinical data of 58 cases of patients with thorax tumor were analyzed.The quality score,the noise,the average lesion CT values and radiation dose were compared between dual-energy group virtual unenhanced and conventional unenhanced image.The lesion benign and malignant differential diagnosis by strengthen the distribution of iodine value in dual-energy group and strengthen the value of manual measurement in conventional CT group were compared.Results The quality scores in virtual unenhanced and conventional unenhanced image were (4.62±0.52) and (4.71±0.46) points (t =2.319,P ＞ 0.05).The noise in virtual unenhanced images and conventional unenhanced image were (8.10±1.16) and (7.30±1.06) HU (t =5.246,P＜ 0.05).The effective dose in virtual unenhanced and in conventional plain were (5.18±0.96) and (5.55±1.18) mSv (t =4.005,P ＜ 0.05).CT value distribution of iodine was correlated with enhanced CT values.Conclusions The virtual unenhanced images can show well lung disease,which meet the diagnostic requirements and may be instead of the conventional plain chest potential value.Dual-energy iodine distribution of lesions can observe blood supply more directly and more sensitively,can quantityze expression of the extent of the lesions enhanced to provide richer information for clinical diagnosis of tumor lesions.

Objective To evaluate the applied value of functional immunity measured by the ImmunKnow assay in the diagnosis of post-transplant infection in Chinese 1iver recipients.Methods Thirty-eight normal adults and 68 adult liver transplant recipients were under investigation.Whole blood samples from either normal volunteers(each sample for one person)or the liver recipients(one or more samples for one person)were collected freshly and cultured within 6h.The CD4+T cells were selected and their ATP value was assayed the next day.The liver recipients were grouped in stable status(n=52)or infection(n=64)according tO their clinieal manifestation.Results The average ATP value in the recipients with infection after liver transplantation was 165.7±100 μg/L,significantly lower(P＜0.05)than that in stable recipients(309±126 μg/L)or normal volunteers (292±83 μg/L).The low ATP levels in post-transplant recipients had fair good correlation to infection clinically(RR=0.5021,P＜0.01).Infectious risk was high when ATP value was less than 165μg/L(OR=11,95%CI 3.9-32.2,P＜0.01).Specificity and sensitivity of low ATP value in post-transplant infection were 86.53%and 73.81% respectively,Conclusion ImmuKnow assay provides a new tool in monitoring immune status in post-transplant recipients,and call helpfully predict and diagnose clinical infection.

Objective To evaluate the accuracy, of different threshold segmentation of 18FDG PET for target volume delineation of non-small cell lung cancer(NSCLC) and the potential influence on radiotherapy treatment planning. Methods Eight NSCLC patients who had tumor with clear margin on CT scan and the amplitude of tumor movements not more than 5 mm were enrolled. PET scans were carried out at 1 h after intravenous injection of 18FDG with CT image for attenuation revisement. Gross target volume (GTV) delineated on CT image ( GTVCT ) was used as the standard. Then, GTVs were delineated on PET image with three different threshold segmentation of 42% Imax(total) (42% of maximum voxel intensity within the tumor) ,Iback + 20% Imax-back(max) (mean background intensity + 20% of normalized background-subtracted maximum voxel intensity within the tumor) and Iback -20% Imax-back(slice) (mean background intensity + 20% of normalized background-subtracted maximum voxel intensity of each slice within the tumor) ,the corresponding GTV was named as GTV42%, GTV20%max and GTV20%slice. Both the size of GTV42%, GTV20%max, GTV20%slice and GTVCT,and the coverage over GTVCT for each GTV were compared. A three dimensional margin of 1 cm were added to GTVCT, GTV42%, GTV20%max and GTV20%slice to form corresponding PTVCT, PTV42%, PTV20%max and PTV20%slic e. Three dimensional conformal radiotherapy treatment plans were designed based on PTVCT,PTV42% , PTV20%max and PTV20%slice respectively for each patient. The prescription dose of all PTVs was 66 Gy in 33 fractions in 6.6 weeks. Both the volume accepting dose less than 95% of prescription dose within PTVCT ( VPTV ) and the lung V20 were compared among the four plans based on different PTVs. Tumor control probability(TCP) as well as lung normal tissue complication probability (NTCP) were also compared. Resuits Eight patients were enrolled in this study. Median deviation of volume between GTVPET and GTVCT were -54.1% , -21.5 % and 5.3 % for GTV42% , GTV20%max and GTV20%slice, respectively. Median coverage over GTVCT of GTV42% , GTV20%max and GTV20%slice was 45.9% ,78.0% and 95.3% respectively( F = 57.50,P＜0.01). Median 7.5% of VPTV was observed for radiotherapy treatment plan based on PTV42% ,which meant that it might induce median 1% decrease of TCP comparing with that of radiotherapy treatment plan based on PTVCT. Whereas,there were only 1.3% and 0.0% of VPTV for treatment plans based on PTV20%max and PTV20%slice respectively. As far as TCP was concemed, both PTV20%max group and PTV20%slice group were superior to PTV42% group,there was no significant difference among PTV20%max group, PTV20%slice group and PTVCT group. Lung V20 and lung NTCP showed no significant difference among all groups. Conclusions The threshold segmentation of Iback + 20% Imax-back(slice) , being slice specialized, might be an optimal threshold segmentation for target volume delineation of lung caner. Independent of information of target volume provided by CT scan in advance,it is recommended to use for the target volume delineation of NSCLC with atelectasis.

Objective To investigate the efficacy of pranoprofen drops on dry eye of patients with Sj(o)gren's syndrome (SS).Methods This is a prospective study.Sixty-eight inpatients with dry eye in our hospital were randomly divided into the experimental and control groups.Right eyes were taken for the trial,with 34 cases in each group.The experimental group was given pranoprofen eye drops combined with polyethylene glycol eye drops.Eyes of the control group were given polyethylene glycol drops only.Corneal fluorescein staining (FL),tear film breakup time (BUT) and Schirmer test (SIT) were tested before treatment and 1,2,4 weeks after treatment by the same care giver.The levels of IL-6 and TNF-α in tears were detected by ELISA.Analysis of variance of repeated data and t test were used for statistical analysis.Results The difference of FL,BUT,SIT and content IL-6 and TNF-α in tears in the experimental group patients before treatment and 1,2,4 weeks after treatment were signifcant (F=4.65,7.53,6.43,9.96,10.87; P＜0.05),which were statistically significantly different between the experimental group and the control group patients (F=3.27,5.85,4.36,8.36,7.23; P＜0.05).One week after treatment and before treatment,the difference of BUT and SIT of the two groups was not statistically significant (P＞0.05),those of the 2 weeks after treatment were statistically significantly different [BUT of the experimental group was (11.1±2.5) s,BUT of the control group was (9.7±1.9) s,t=2.594 8,P＜0.05; the SIT of the experimental group was (7.3±1.7) mm,the SIT of the control group was (5.9±1.7) mm,t=3.571 8,P＜0.05].BUT of the two groups at 4 weeks after treatment was statistically significantly different [BUT of the experimental group was (14.4±2.8) s,BUT of the control group was (11.4±2.6) s,t=4.469 4,P＜0.05; the SIT of the experimental group was (9.9±2.1) mm,the SIT of the control group was (8.7±1.9) mm,t=2.568 0,P＜0.05].The difference of FL and IL-6 and TNF-α in tears pretreatment between the two groups was not statistically significant (P＞0.05).At week 1,2,4 after treatment,the differences between the two groups were statistically significant (tFL=4.173 9,3.190 7,4.072 6; tIL-6=2.131 5,2.316 4,5.310 1; tTNF-α=2.216 4,4.871 9,8.175 0; P＜0.05).No significant discomfort and side effects were observed in the two groups.Conclusion Pranoprofen drops can significantly improve symptoms of dry eye in patients with pSS,in particular,the repair of the cornea,may be related to the inhibition of the expression of ocular inflammatory cytokines IL-6 and TNF-α,and thus reduce the ocular surface inflammatory reaction.