Objective To explore interleukin 4 and immunoglobulin E levels indicators monitoring value in diagnosis of drug allergy reaction . Methods The way of intravenous injection and conventional intraperitoneal injection was used, with the corresponding drugs such as saline, horse serum sensitized, and in different time interleukin -4 and total immunoglobulin E index were recorded in guinea pig serum.Results Injection of saline and Chuankezhi injection, interleukin-4 and total immunoglobulin E protein content , the difference was not statistically significant, but in other drug induced sensitive D8, D14 and D21, interleukin-4 and total immunoglobulin E protein content increased significantly.Conclusion Interleukin 4 and immunoglobulin E levels index detection is the diagnosis of drug allergy is an effective and fast way .

Objective To assess the reliability of the modified lateral transgluteal approach (modified Bauer approach) to the hip for the joint prosthesis.Method The Bauer approach modification was used for 43 hip endoprosthetic replacement.Results The modified approach provided good exposure of the hip for arthroplasty, and early chance of function recovery.Excellent and good rate was 96.97% according to Harris result evaluation. No evidence of weakness of abductors of the hip and damage to superior glouteal nerve was found at six months.Conclusion The modified Bauer approach is reliable and recommendable for primary hip replacement because of its good exposure of the hip and the least disturbance to the abductor function.

Background The loss of perspiration after a massive deep burn hampers the survivor to lead a life of high quality, as they are deprived the function of regulating body temperature through perspiration during sultry months. With maturation of science of burn care, the number of survivors is increased, therefore, it is imperative that this problem should be tackled in order to improve their quality of life. Objective To explore the possibility of transdifferentiating bone marrow mesenchymal stem cells (MSCs) into sweat gland cells (SGCs), and implanting the latter into fresh skin wound to generate functional sweat glands. Methods Human bone marrow MSCs and SGCs were isolated from the same patients. They were identified with specific markers, and then co-cultured. The stem cells which subsequently exhibited the phenotype of sweat gland cells were implanted into scald injured paws of nude mice, and regeneration of functioning sweat glands was confirmed by perspiration test (iodine and starch) and histological examination. A male patient bearing almost iden- tical burn scars on the posterior aspect of both arms was enrolled for clinical trial. The scars were first proved to be anhydrotic with iodine and starch test. With patient's written consent, the clinical trial was carried out. Bone marrow MSCs and sweat gland cells were obtained from the patient. After being heat shocked, the SGCs were co-cultured with MSCs. Three days later, the scars of both arms were excised. MSCs having acquired the phenotype of sweat gland cells after co-culture were evenly spread onto the excision wound on the right arm. They were covered with a piece of acellular allogeneic dermis, which was perforated with numerous micropores. On top of the latter, micrografts of autologous origin were transplanted, and the wound was finally covered with a piece of allogeneic skin graft. The wound on the left side was similarly covered, but without transdifferentiated MSCs. After complete healing of the wounds, perspiration test with iodine and starch was performed, and biopsy was taken from the MSCs transplanted area. The components of the sweat collected from the implantation area were analyzed and compared with that from normal skin elsewhere on the body. The same procedure was performed in a girl patient with a chin-neck contracture. The scar was totally excised, and into one third of the excision wound in vitro transdifferentiated MSCs were implanted similar to the above patient. The examinations were repeated after wound healed. Results In the animal experiment, it was shown that there was regeneration of functional sweat glands in the burned paws of the nude mice. In human patients, all wounds healed nicely. The areas where transdifferented MSCs were implanted showed positive iodine-starch perspiration test. Histological and immunohistochemical examination confirmed that the transformed MSCs bore the specific marker carcinoembryonic antigen (CEA) of sweat gland cells. Biochemical analysis of the excreted sweat contained similar components as that of sweat collected from normal skin. Conclusions MSCs can be transdifferentiated into SGCs in vitro, and they can be implanted into a fresh wound to form functional sweat glands. However, enormous amount of work should be done before the same result would be realized in patients with massive deep burn within a short duration after the injury, so that the patients could regain the function of perspiration after surviving the massive loss of normal skin.

Objective To evaluate the gastroesophageal reflux symptom in patients who underwent continuous ambulatory peritoneal dialysis (CAPD) and the efficacy of proton pump inhibitor (PPI) in treating gastroesophageal reflux. Methods Fifty-eight CAPD patients with good clinical and complete dialyzed eondition,who was admitted to the hospital between Jan. 2008 and July 2008, were inquired about their gastroesophageal reflux symptoms using reflux disease questionnaire (RDQ). The patients who had RDQ≥6 and <12 were received esomeprazole 20 mg daily, while those with RDQ≥12 were received esomeparzole 20 mg twice daily. RDQ score was reevaluated 4 weeks after treatment.Results The common symptom was regurgitation (64.70%), followed by acid reflux (52.9 %), non-cardic chest pain (47.1. %) and heart burn (17. 6%). After 4-week treatment, the RDQ was significantly decreased (P< 0. 05). But there was no difference in outcome of treatment between patients with RDQ≥ 12 and RDQ< 12 (P=0. 059). Conclusion The gastroesophageal reflux symptom in CAPD patients can be relieved by PPI administration, but a larger clinical trial is needed to evaluate the course and efficacy of treatment.

Objective To investigate the influencing factors and prognosis of early and late recurrence after radical resection of primary hepatocellular carcinoma(HCC).Methods The clinical data of 117 patients who received radical resection of HCC at the Tongji Hospital of Huazhong University of Science and Technology from January 2003 to December 2006 were retrospectively analyzed.Tumor recurrence occurred within 2 years after operation was defined as early recurrence,and tumor recurrence occurred latter than 2 years after operation was defined as late recurrence.Relationship between postoperative tumor recurrence and level of alpha-fetoprotein (AFP),AFP/V,tumor diameter,tumor number,blood vessel invasion,tumor differentiation,hepatic cirrhosis,hepatic function,hepatitis B surface antigen,procedure of hepatic resection and blood transfusion was analyzed.The overall survival and disease-free survival rates were determined by Kaplan-Meier method,and the survival rate was analyzed by Log-rank test.Results Eighty-five(72.6％)patients were found with tumor recurrence,including 59(50.4％)with early tumor recurrence and 26(22.2％)with late tumor recurrence.Levels of AFP,AFP/V,tumor diameter,tumor number,blood vessel invasion,tumor differentiation and blood transfusion were the influencing factors of early recurrence(x2 = 12.78,13.40,5.79,9.98,10.26,9.48,8.32,P ＜ 0.05).Level of AFP and hepatic cirrhosis were the influencing factors of late recurrence(x2 =4.46,7.75,P ＜ 0.05).AFP/V,tumor number and blood vessel invasion were the independent risk factors of early recurrence(RR = 0.170,0.172,0.064,P ＜ 0.05).Hepatic cirrhosis was the independent risk factor of late recurrence(RR = 2.809, P ＜ 0.05).The 1-,3-,5-year overall survival rates and tumor-free survival rates were 82.6％,60.8％,54.9％ and 65.0％,38.5％,23.1％.There were significant differences in overall survival and disease-free survival rates among patients with AFP ＜20 μg/L,AFP/V ＜ 14 μg/(L · cm3)or AFP/V ≥ 14 μg/(L · cm3)(P ＜ 0.05).The 1-,3-,5-year overall survival rates of patients with early tumor recurrence were 64.9％,23.0％ and 20.5％,respectively,and the 1-,3-,5-year overall survival rates of patients with late tumor recurrence were 100.0％,88.5％ and 72.5％,respectively.A significant difference in the 1-,3-,5-year overall survival rates between patients with early or late tumor recurrence was observed(x2 = 26.918,P ＜0.05).Conclusions AFP/V,tumor number,blood vessel invasion were independent risk factors of early tumor recurrence,and hepatic cirrhosis was the independent risk factor of late tumor recurrence.There is a significant difference in the survival rate between patients with early or late tumor recurrence.

Objective To study the antitumor activities of extract from Ligia exotica(Roux).Methods The dried powder of total Ligia exotica(Roux) was extracted by 37 ℃ water.The solution was concentrated in vacuum,and then was freeze-dried to afford crude extract.The inhibitory effect of the extract on tumor cells proliferation was assayed by MTT method,and transplant tumor model of sarcoma 180(S180) was used.Results The extract from Ligia exotica displayed obvious proliferation inhibitory effect on HeLa,7901,NCI cells,and no growth inhibitory effect on 929 cells in vitro.After administration at the doses of 0.25,0.50,1.00 g?kg-1,ip,for 7d in tumor-bearing mice with S180,The extract caused 26.9 %,45.3 %,64.6 % inhibition rates,respectively.Conclusion The extract from Ligia exotica showed significant antitumor activity.

Objective To study angiography features and clinical significance of "multiple tumor feeding embolization".Methods Twelve patients with pelvic tumor were reviewed retrospectively.The lesions included fibrosarcoma(n=1),chondrosarcoma(n=2),osteosarcoma(n=2) and metastatic tumor(n=7).Results Angiography features were:(1)multiple origin and branch of tumor-feeding vessels.(2)large vascular mass with dense tumor stain.(3)larger size of tumor stain comparing with that of bone destraction.After treatment,symptom relief and tumor shrink were obviously using"the multiple tumor-feeding embolization".Conclusion Angiography features of pelvic tumor are great value in guiding the clinical therapy.

Objective To construct the performance evaluation framework for China′s health system,and provide evidences for enhancement of such evaluation and the health system.Methods Literature review and empirical research were combined with expert consultation to construct such an evaluation index system.Results In view of both international experiences and China′s specifics,an evaluation index system is built based on the generalized concept model of the health system,consisting of 4 class-1 indicators, 1 5 class-2 indicators and 6 9 class-3 indicators.Conclusions The generalized framework of health system performance evaluation fits such evaluation in China,and indicator optimization and understanding of the shortcomings with cautious explanation are of critical importance.This evaluation remains in its infancy in China,and there is a long way to go before a health system performance evaluation system can be built in China.

Objective To observe the anatomical symmetry of the structures and istribution of the Glissonean pedicle of the intrahepatic Glisson system ,integrating with embryology and comparative anatomy .Methods Morphology of the Glissonean pedicle of liver was examined through peeling and dissecting 20 adult corpses without liver pathological changes.The relevant data were collected and analyzed statistically .Meanwhile, we tried to elucidate elaborating the symmetry theory of liver anatomy through the dissection anatomy ,embryonic anatomy and comparative anatomy .Results The angle between main stem of Glisson system/left branch of Glisson system(GM/GL) was (76.7 ±17.36)°.The angle between GM/GR was (81.4 ±13.8)°.The length of the the Glisson pedicle of left hepatic was (3.1 ±0.76) cm.The length of the the Glisson pedicle of middle hepatic was ( 2.61 ±0.72 ) cm.The length of the the Glisson pedicle of right hepatic was (1.5 ±0.50)cm.The shapes of the Glissonean pedicle stem of the left hepatic presenting arch , the number of radial level 3 branches were between 2-8.The shapes of the Glissonean pedicle stem of the middle hepatic continuing the main of Glissonean pedicle , the number of radial level 3 branches were between 2-6.The shapes of 30%of the Glissonean pedicle of the right hepatic presenting Y and V , 70% of the Glissonean pedicle of the right hepatic presenting C , the number of radial level 3 branches were between 3-8.Conclusion In the light of morphology ,embryology and comparative anatomy, it is reasonable to divide the liver into left ,middle,right lobe by Glissonean pedicle of radial level 2 branches and the liver is an axiality and symmetry organ .

Objective To retrospectively design an intensity?modulated radiotherapy ( IMRT) plan with split field and fixed jaw techniques for peripheral lung cancer with mediastinal lymph node metastasis, to compare dosimetric characteristics between the IMRT plans with fixed jaw and dynamic jaw, and to study lung protection by the plan with split field and fixed jaw. Methods Treatment plans were collected from 12 patients with peripheral lung cancer and mediastinal lymph node metastasis who were treated with IMRT in our hospital. All plans used the dynamic jaw technique. The plans with split field and fixed jaw were designed based on the identical computed tomography images and planning target volume ( PTV) . Each jaw position in split field depended on each separate PTV. The prescription dose was 60 Gy in 30 fractions. 95%PTV was planned to receive 100% of the prescription dose. Dosimetric parameters of PTV, conformity index ( CI) , heterogeneity index ( HI) , number of monitor units ( MUs) , and dose?volume values of the lung and heart were obtained from dose?volume histogram. Comparison between the two plans was made by paired t test. Results Both plans met clinical requirements. There were no significant differences in D2 , D98 , CI, or HI of PTV between the two plans ( all P>005) . Compared with the dynamic jaw plan, the fixed jaw plan had MUs increased by 15%?20%( P=0010) . The V5 , V10 , V20 , V30 , and mean dose for the whole lungs were significantly lower in the fixed jaw plan than in the dynamic jaw plan ( P=0000, 0000, 0000, 0002,0000) . The V5 , V20 , and mean dose for the healthy lung were also significantly lower in the fixed jaw plan than in the dynamic jaw plan ( P=0000,0017,0000) . There were no significant differences in dose?volume values for the spinal cord or heart between the two plans ( all P>005) . Conclusions IMRT with split field and fixed jaw is recommended for patients with peripheral lung cancer and mediastinal lymph node metastasis. The therapy to a certain extent reduces low?dose volume for the lung and the incidence of radiation?induced pneumonitis.