Adenine ; analogs & derivatives ; therapeutic use ; Adult ; Hepatitis B Surface Antigens ; blood ; Hepatitis B e Antigens ; blood ; Hepatitis B, Chronic ; blood ; drug therapy ; Humans ; Male ; Organophosphonates ; therapeutic use ; Recurrence ; Treatment Outcome

Objective To investigate the diagnostic points of multiple sclerosis and multiple metastatic encephaloma.Methods Choose a case of multiple sclerosis,which had been misdiagnosed as multiple metastatic encephaloma and operated on,to analyse its reasons of misdiagnosis.Results Reasons for the misdiagnosis:The neglect of the importance of the disease history.The scant knowledge of the early represen- tations of the atypical MS(demyelinating pseudotumor).The lack of the knowledge of the non-demyelinating lesions of the MS.The lack of attention to the different representations of the MRI scan between the acute MS and the multiple metastatic encephaloma.The excessive importance is attached to the imageological report. The neglect of the routine examination of cerebrospinal fluid.Conclusion When multiple metastatic en- cephaloma develops,the differential diagnosis of MS should be made.The further examinations should be done to those cases which are hard to tell the difference with metastatic encephaloma by clinical and imageo- logical representations.Try to avoid undergoing surgery or radiotherapy hastily.

0.05 ).But the difference of positive ratio between 1-year-old group was significant in 6 cases of B19 DNA positive (P0.05).Conclusion There are no markedly association between kawasaki disease and human parvovirus B19 infection.

Adult ; Combined Modality Therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Infectious Disease Transmission, Patient-to-Professional ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy ; Severe Acute Respiratory Syndrome ; therapy

Objective To evaluate the effect of dexmedetomidine administered locally on the median effective concentration ( EC50 ) of ropivacaine for paravertebral nerve block ( PVNB) . Methods Forty?eight ASA physical status Ⅰ or Ⅱ female patients, aged 20-64 yr, with body mass index<24 kg∕m2 , scheduled for elective unilateral segmental mastectomy under PVNB, were randomly divided into 2 groups ( n=24 each) using a random number table: ropivacaine group ( group R) and ropivacaine mixed with dexmedetomidine group ( group RD) . PVNB was performed at T4 on the operated side guided by ultrasound and nerve stimulator. Ropivacaine 20 ml and a mixture of ropivacaine and 20 μg dexmedetomidine 20 ml were injected locally in group R and group RD, respectively. The concentration of ropivacaine was determined by up?and?down sequential allocation. The initial ropivacaine concentration was set at 0. 35%, and the ratio between the two successive concentrations was 1. 2. The EC50 and 95%confidence interval of ropivacaine were calculated using Dixon?Massey method. Results The EC50 ( 95%confidence interval) of ropivacaine was 0.27% (0.23%-0.30%) and 0.22% (0.18%-0.25%) in group R and group RD, respectively. Compared with group R, the EC50 of ropivacaine was significantly decreased by 19% in group RD. Conclusion Small dose of dexmedetomidine administered locally can significantly enhance the efficacy of PVNB with ropivacaine.

Objective To explore the feasible approach for establishment of a liver cancer model induced by N-nitrosodiethylamine(DENA)with Sprague-Dawley rat,and to provide ideal animal model for imaging diagnosis and interventional therapy.Methods One-hundred and forty male SD rats were administrated with 0.95 g/L DENA for 10 weeks,and MRI was performed for inspecting pathological changes of rat livers on the following week.When the liver tumor was proved then the rat will be the candidate for sequential procedures,otherwise the animal continued under observation until next MRI examination after 4 weeks.DSA was done in 64 rats'for detecting blood supply of liver tumors.Animals were sacrificed with an overdose of chloral hydrate,The representative tumor tissues were fixed in 10% formalin and 2.5% glutaraldehyde for light and electron microscopy analysis respectively.Alpha fetoprotein(AFP) and hepatocyte were assaied by immunohistochemistry technique in order to identify intrinsic trait of the harvested tumors.Results The earliest induced tumor was detected on 11th week and the latest was on 20th week by MRI,and the median period was 13.9 weeks.Tumor size ranged from 2 mm to 40 mm in diameter. The rate of single and multi-induced tumor was 9.7%(7/72)and 90.3%(65/72),respectively.87.7% (57/65)" of the induced multiple tumors was with hepatocirrhosis and 18.1% of these tumors combined with extrahepatic neoplasm or metastasis.Plenty blood supply was proved by DSA in most of those tumors. Tumors not only derived from hepatocyte but also manifested positive expression of AFP.Histological types of these tumors include hepatocellular carcinoma(HCC)(92.0%,66/72),intrahepatic cholangiocarcinoma (ICC)(4.0%,3/72),and combined HCC and ICC(4.0%,3/72),respectively.Electro-microscope analysis indicated that cytoplasm and organelle of induced tumors were abnormal distinctly compared with those of non-carcinomatous cells.Conclusion DENA can induce ideal rat liver cancer as a feasible animal model,MRI is the best approach for scrutinizing pathological changes of rat livers during induced period.

Professional postgraduates in geriatric medicine are one of the most important re-courses of geriatric specialists. However, training model for geriatric postgraduates is still unclear in China. In general, geriatric medicine has no independent training plan, and is included in internal medicine training. Such model cannot represent the feature of geriatric medicine. The present paper aimed to discuss the ability construction for geriatric postgraduates based on the geriatric medicine specialist training experience both at home and abroad, including diagnosis and treatment of multi-system diseases, ability of geriatric assessment, management of geriatric syndromes, consultation for geriatric rehabilitation and ability for continuity health service in order to cultivate the compound tal-ents suitable for the aging society requirement for geriatric medicine in China.

Objective The study aimed to compare the vector system with the hand instrument in the pain severity during scaling and root planning.Methods 60 periodontal patients were randomly divided into two groups for supportive periodontal therapy (SPT):the experimental group (using vector system) and the control group (using gracey instruments),with 30 cases in each group.And the painfulness after SPT was evaluated by Visual Analogue Scale (VAS).Results 66％ patients felt mild pain during the supportive periodontal therapy with the application of vector system,while 36％ patients felt mild pain in the control group.24 patients in the experimental group accepted vector system for SPT and 23 patients in the experimental group felt less fear of the treatment.Conclusions Patients will feel less discomfort with the application of the vector system,therefore better compliance will be reached.And the cooperation of the doctors and nurses has great impact on the treatment effect.

【Objective】To explore the role of cell cycle regulators in nasopharyngeal carcinoma (NPC) relapse.【Method】To assay p53,MDM2,p21ras and p21WAF1 proteins by LsAB immunohistochemical technique in 69 cases of primary and relapsing NPC tissues.【Results】As compared with primary NPC,the expression rate of p53 or MDM2 protein in relapsing NPC was similar (78% to 80%,84% to 83%),and the expression rate of p21ras or p21WAF1 protein in relapsing NPC was obviously descended (73% to 93%,52% to 84% );the high-expression rate of p53 protein in relapsing NPC was similar (42% to 51%),the high-expression rate of MDM2 protein in relapsing NPC was obviously risen (57% to 32%),and the high-expression rate of p21ras or p21WAF1 protein in relapsing NPC was obviously descended (16% to 65%,17% to 46%).Among of them,the significant rise of MDM2 protein expression level in relapsing NPC mainly occurred in the patients of group 2 which relapsing-interval was shorter than 34 months,P<0.05;the significant descent of p21ras or p21WAF1 protein expression level in relapsing NPC occurred in the patients of group 2 and group 1 which relapsing-interval was equal to or longer than 34 months,P<0.02,respectively.【Conclusions】The overexpression of p53 and MDM2 proteins and the low or negative expression of p21WAF1 protein after clinical cure might still play an important role in NPC relapse,the obvious rise of MDM2 protein level and the obvious descent of p21WAF1 protein level might further accelarate the process of NPC relapse.

Based on the quality of students, we reasonably arranged thetraining course content and enhanced the training of clinical skills; and at the same time focused on teacher training of general practitioners to strengthen the training bases, so as to improve the overall construction of teaching effect, to adapt to the actual medical need of the community and improve community medical service level to achieve the purpose of general practitioners training.