Objective To research the clinical curative effect of pegylated interferon α-2a (Peg-IFNα-2a) combined with ribavirin in treating chronic hepatitis C with positive autoantibodies.Methods The autoantibodies were screened in 93 cases of chronic hepatitis C patients and then the patients were divided into positive group and negative group.Both of the two groups were given therapy with Peg-IFN α-2a combined with ribavirin.The capacity of hepatitis C virus (HCV) RNA,virological response rate,and blood concentration of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were quantified before and in the process of treatment.Results Twenty-eight patients had autoantibodies,with 17 patients of antimitochondrial antibody,8 patients of anti smooth muscle antibody and 3 patients of anti-liver-kidney microsomal antibody-1.The quantity of HCV RNA and the virological response rate had no significant difference before and after treatment (P ＞ 0.05).The concentration of ALT and AST in positive group were higher than those in negative group before and in the process of treatment,while there were obvious differences only after 36 weeks of treatment (P ＜ 0.05).Conclusion Peg-IFN α-2a combined with ribavirin is effective for chronic hepatitis C for all the patients,but liver function of autoantibody negative patients have a better recovery.

High - risk corneal transplantation immunological rejection is a primary factor affecting the success or failure of the corneal transplantation. As a result, application of immunosuppressive agent in high - risk corneal transplantation rejection reaction occupies an irreplaceable position. However, many local and systemic adverse reactions appeared in the process of application. In order to improve the achievement ratio of the corneal transplantation, experts and scholars at home and abroad have obtained remarkable achievements in dosage form, route of administration and drug combination;meanwhile, a considerable progress was also made in genetic engineering. This paper is a review of prevention and treatment on high - risk corneal graft rejection reaction.

Objective To investigate the feasibility of autogenous vein graft as a connector to repair recurrent laryngeal nerve(RLN) defect. Methods 20 healthy dogs were randomly devided into 4 groups: group 1(n=6), 2(n=6), 3(n=5) and control group(n=3). Left RLN of dogs in group 1,2,3 were resected for 1,2,3 centimetres respectively and followed by repairment with autogenous vein graft, while RLNS of dogs in control group were resected but not conducted by autogenous vein graft. Six months after operation, the vocal fold movement, phonation and induced action potensial as well as morphologic observation of the aryngeal muslces were studied. Results In group 1, phonation of dogs was all restored to normal. The vocal fold of RLN resected side showed no atrophy symmetrical to the normal side and adducted apparently when phonating. Furthermore thyroarythenoid muscle and posterior cricoarytenoid muscle both could generate induced action potentially. Regenerated nerves in verin graft and distal nerve were observed by light microscope and electron microscope. In group 2,3 and control group hoarseness improved six months after op eration, the vocal fold of RLN resected side was atrophied apparently and fixed paramedianly. Fissure existed in glottis when vocal fold closed, and compensative movement of opposite vocal fold across over the median line was found. Thyoarthenoid muscle and posterior cricoarytenoid muscle unable to generate an action was found. Regenerated nerves were not observed in vein graft or distal nerve by light microscope and electron microscope. Conclusions It is feasible to repair RLN defect in certain length by autogenous vein graft.

Objective To evaluate the prognostic value of white blood cell and hemoglobin in patients with acute aortic dissection(AAD).Methods White blood cell.hemoglobin and fibrinogen were measured in 42 AAD patients.The mortality during hospitalization was observed and the short-term prognosis in AAD patients was as-seased.Results There was 13 death during hospitalization.with the mortality of 30.95%.The value of white blood cell was higher in death group than in survival group[(13.73±6.91)×109>/L vs.(9.43±4.97)×109>/L.P< 0.05).The value of hemoglobin was lower in death group of than in survival group[(118.54±22.38)g/L vs. (131.72±18.17) g/L,P<0.05].There were no differences in the value of fibrinogen between the groups [(3.15±1.15)g/L vs.(3.48±1.24)g/L,P>0.05).The mortality in the group of elevated white blood cell(≥10.0×109>/L)was higher than that in the group of normal white blood cell(10.0×109/L)(41.18%vs.24%.P<0.05).The mortality in the group of decreased hemoglobin(≤110g/L)was higher than that in the group of nor-mal hemoglobin(>110 g/L)(50.00%vs.27.78%,P<0.05).Conclusion The value of white blood cell and he-moglobin could help to assess the short-term prognosis of patients with AAD.

The psychiatric problem has become a global public health issue. The model of mental health service advocate that“Treatment of disease occurred in the hospital, but rehabilitation and management in the community”. This brings great challenge to the community health service center. By comparing the domestic and foreign mental health service system, this paper discusses the necessity of carrying out the standardized training of general practitioners in psychiatry and psychology.

Adult ; Cytokines ; metabolism ; Female ; Gene Expression ; Humans ; Interleukin-2 ; blood ; Interleukin-4 ; blood ; Male ; Semaphorins ; genetics ; metabolism ; T-Lymphocytes, Helper-Inducer ; metabolism ; Thrombocytopenia ; genetics ; metabolism

Acupuncture Points ; Acupuncture Therapy ; methods ; Adult ; Female ; Humans ; Male ; Middle Aged ; Xanthomatosis ; therapy

Objective To determine the symptomatological characterictics of isehemie stroke in Chinese people on the basis of Oxfordshire Community Stroke Project (OCSP) criteria. Methods 900 patients with ischemic stroke were reviewed. Ischemic stroke was classified into four subtypes. Results Patients were classified as lacunar infarcts(19.3%) ,total anterior circulation infarcts(17.2%) ,partial anterior circulation infarcts (45.3%), and posterior circulation infarcts(18.2%). The statistical comparison between male and female of each subtype is not significant . Conclusion The difference between the studies is caused by race difference and some other reasons.

Mastoparan(MAS) and α-latrotoxin(α-LTX) are two kinds of insulinotropic peptides obtained from insect toxins which can interact with islet β-cells and induce insulin secretion. The signal mechanism of these insulinotropic peptides regulating insulin-releasing attracts notable attention and has been elucidated more and more details. MAS mainly acts on the molecular components of exocytosis at a late stage. Insulin secretion induced by MAS is obviously dependent on GTP, which subsequently activates G-protein located on insulin secretion granules(ISG), or activates the Rho subfamily of small G proteins to evoke exocytosis and sensitize fusion machinery. The MAS stimulated insulin-releasing activity can be augmented by nutrients. However, its effect is not Ca~(2+) dependent. There are two regulatory pathway triggered by α-LTX: one way is pore formation caused through plasma membrane, another way is the transmembrane signal transduction evoked by cytosolic second messengers. Tetrameri complexs assembled at high concentration of α-LTX toxin or in the presence of extracellular Ca~(2+), can insert α-LTX into plasma membrane to form Ca~(2+) permeable channels and trigger Ca~(2+)-dependent secretion. By binding to transmembrane receptors and activating phospholipase C, α-LTX induces the generation of second messenger DAG and IP3. IP3 triggers Ca~(2+) influx and subsequently activates CaMK pathway, however, DAG also activates PKC pathway to increase insulin release.

Objective To investigate the epidemiology and antibiotic resistance of communityassociated and hospital-associated meticillin-resistant Staphylococcus aureus (CA-MRSA and HA-MRSA) in Jingzhou.Methods A total of 159 MRSA isolates were successively collected from patients in Jingzhou Central Hospital during January 2012 and December 2013.The minimum inhibitory concentrations of 16 antimicrobial agents against 159 MRSA isolates were detected.SCCmec types of the strains were detected by multiplex PCR,and the homology of the strains was analyzed using pulsed field gel electrophoresis (PFGE) and cluster analysis of antibiogram.WHONET 5.6 and SPSS 19.0 were used for data analysis.Results Among 159 MRSA strains,131 were hospital-associated,and 28 were community-associated,which accounted for 82.4％ and 17.6％,respectively.There were significant differences in the age of patients,ward distribution,specimen type,length of stay,length of anti-infection treatment,type of infection and underlying diseases between patients with CA-MRSA or HA-MRSA infections (x2 =19.103,31.372,59.756,71.703,54.153,59.756 and 54.232,all P ＜ 0.01).No vancomycin,linezolid,tigecyeline and nitrofurantoin resistant strains were found,but all strains were resistant to penicillin,cefoxitin and oxacillin.HA-MRSA had higher resistance rates to moxifloxacin,levofloxacin,rifampicin,ciprofloxacin and gentamicin than CA-MRSA (x2 =30.179,27.352,28.523,28.523 and 25.987,all P ＜ 0.01),but its resistance rates to erythromycin and clindamycin were lower (x2 =13.106 and 11.743,both P ＜ 0.01).Among 159 MRSA strains,12 (7.5％) were of SCCmec type Ⅱ,113 (71.1％) were of SCCmec type Ⅲ,26 (16.4％) were of SCCmec type Ⅳ,and 8 were of undifferentiated type.The predominant SCCmec types were type Ⅳ for CA-MRSA (26/28,92.9％) and type Ⅲ for HA-MRSA (113/131,86.3％),respectively.Six PFGE patters were found in 49 HA-MRSA isolates from ICU,and the predominant patters were A1 (24,49.0％),A2 (9,18.4％) and B (9,18.4％).Cluster analysis of antibiogram showed that three groups of HA-MRSA were of high correlations,and they were of PFGE patter A1,A2 and B,respectively.Conclusions HA-MRSA is the predominant MRSA in Jingzhou area,and it is different from CA-MRSA in the age of patients,ward distribution,type of infection and antibiotic resistance.Most HA-MRSA strains are of type SCCmec Ⅲ,and may cause epidemic outbreak in ICU.