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.

BACKGROUND: The method of culture purified sinoatrial node cell is important in investigating its ultrastructural characteristics and autorhythmic mechanisms.However,the corresponding method has not been standardized.OBJECTIVE: To summarize the localization,cultivation and purification of sinoatrial nodes isolated from newborn rabbits,and to study the morphological characters of primary cultured pacemaker cells.METHODS: Hearts of the newborn rabbits(within 24 hours)were embedded in paraffin for hematoxylin-eosin staining,The location of sinoatrial nodes was observed under an optical microscope,the morphology of sinoatrial nodes cells were observed by light microscope and electron microscope.RESULTS AND CONCLUSION: Sinoatrial nodes localized in the anterior wall of the superior vena cava and the posterior laterial wall of right atrium.There was about 0.32 mm between its lowest point and sulcus terminalis.Three distinct types of cells were observed among the cultured cells of sinoatrial nodes: spindle,spider and polygon.The spindle cells occupied the greatest proportion of the cultured cells(59.6±7.3)%.The spontaneous contraction frequency of spindle cells was the highest among the constracting cells(145±9)times per minute.The ultrastructure observation showed that myofibrils and other organelles in spindle cells were sparse and significantly decreased in number compared with triangle cells.There was no significant difference between triangle cells isolated from sinoatrial nodes and from atrial muscle.Sinoatrial nodes could be harvested along the anterior root of the superior vena cava down to the posterolateral sulcus.Among the cultured cells from neonatal rabbit sinoatrial nodes,the spindle cells with small body and fast pulse frequency are pacemaker cells.

Objective To investigate the clinical and pathological features,diagnosis and differential diagnosis of isolated granulocytic sarcoma of the ovary. Methods The clinical manifestations,pathological features,immunohistochemistry,treatment and prognosis were analyzed in 1 case of isolated granulocytic sarcoma of the bilateral ovary with the review of literatures. Results Granulocytic sarcoma of the ovary was rare. Only 14 cases had been reported so far. This case presented a greenish masse arising from the right ovary measuring 10.0 cm × 8.5 cm × 6.0 cm and 4.8 cm × 3.0 cm × 2.2 cm mass in the left ovary. The neoplastic cells grew in a diffuse pattern or India file, composed of myeloid cells at various stages of maturation, being predominantly primitive myelocytes with a few immature eosinophils. Immunohistochemistry,tumor cells were strongly positive for MPO,CD117,CD43,but negative for CD79α,CD3 Conclusions In routine morpholog,granulocytic sarcoma may be misinterpreted as lymphoma,granular cell tumor,et al. Neoplastic cells at various stages of maturation,India file pattern and immature eosinophils are important diagnostic clues. Immunohistochemical stains are essential in order to obtain correct diagnosis. Despite the localized nature of tumor, intensive antileukemia chemotherapy is necessary.

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 analyze laboratory turnaround time (TAT) and find effective ways to shorten TAT.Methods Data associated with cardiac panel (CK,cTnI and Mb) were collected in 2011 including 19 906 outpatient data and 22 973 inpatient data.The medians and the average medians of the quality indicators on TAT were calculated and the results were transformed to the Six Sigma scale to estimate the degree of control over related process.Processes were considered well controlled when σ ≥4.Based on the results of data analysis,an improvement plan was decided by laboratory quality management meeting and clinical communication meeting.The effect of the improvement plan was evaluated through 2011-2012 satisfaction surveys of outpatients and clinicians.Results The average median of overtime reports for outpatient from specimen collection to reception was 2.78％ (3.5σ),and 17.82％ (2.5σ) for inpatients.The average median of overtime reports for outpatient from specimen reception to result reporting was 3.39％ (3.4σ),and 2.96％ (3.4σ) for inpatients.The average median of overtime reports for outpatient from specimen collection to result reporting was 3.93％ (3.3σ),and 12.18％ (2.7σ) for inpatient.The results of TAT satisfaction surveys for outpatients from 2011 to 2012 were similar,which were 78％ in 2011 and 79％ in 2012; the results for clinicians showed an increase from 80％ in 2011 to 90％ in 2012,including an increase from 75％ to 79％ for very satisfaction choice.Conclusions Outside the laboratory TAT is a key step in sickroom patients delay TAT.The implementation for ten improvement suggestions enabled to shorten TAT effectively.