Homeobex gene,derived firstly from Drosophila, has the ability of regulating normal embry-onic development and proliferation and differentiation of adult tissue cells. Recent studies demonstrate that HOXA7 can be high and low expressed in adult tumor tissues by means of genetic fusion and genetic silencing to regulate genesis and development of tumor cells. To study its expression and regulation in tumor will be helpful for tumor diagnosis ,treatment and prognosis.

OBJECTIVE To study the differences of quinolones-resistant determining region(QRDR) in DNA gyrase A(gyrA) subunit between drug-resistant Klebsiella pneumoniae induced by fluoroquinolone in vitro and strains isolated from clinical isolates.Furthermore,to reveal the relation between different QRDR gene mutations and drug-resistance. METHODS Ten sensitive K.pneumoniae strains were selected and induced into drug-resistant strains by ciprofloxacin.The QRDR in gyrA by polymerase chain reaction(PCR) was amplified and compared their DNA sequences with clinically isolated quinolone-resistant K.pneumoniae. RESULTS We had found several gene mutations of QRDR in fluoroquinolone-resistant K.pneumoniae induced by ciprofloxacin,including Ser 83(TCC)→Phe(TTC) and Ile(ATC);and Gln106(CAG)→Leu(CTG).And the alteration of Gln106(CAG)→Leu(CTG) was a new discovery. CONCLUSIONS There are gene mutations of QRDR in fluoroquinolone-resistant K.pneumoniae induced by ciprofloxacin.The mutation of Ser 83(TCC) and Gln106(CAG) is probably the molecular basis of inducing drug-resistant strains.

Neurological complications of viral hepatitis mainly include hepatic encephalopathy,hepatic myelopathy,peripheral neuropathy,meningoencephalitis,and epilepsy.Hepatic encephalopathy is a common complication with mature diagnosis and treatment methods,and the other complications are relatively uncommon and lack treatment methods.This article introduces the classification,clinical manifestation,and treatment of each complication,in order to find the optimal therapies for neurological complications of viral hepatitis.

Objective: To observe the clinical effect of tuina for cervical intervertebral disc herniation. Methods: Eighty seven cases were randomized into a treatment and a control group. 39 cases in the treatment group were treated with tuina manipulation, while 48 cases in the control group were treated with combined cervical traction and medium-frequency impulse. Cases in both groups were treated 3 times a week, and 10 times constitute a course of treatment. Results: Of 39 cases in the treatment group, 22 obtained recovery, 13 obtained marked effects and 4 obtained improvement, manifesting a marked effect rate of 89.7% and an effective rate of 100.0%. Of 48 cases in the control group, 23 obtained recoveries, 17obtained marked effects, 7 obtained improvements and 1 saw no improvement, manifesting a marked effect rate of 83.3% and an effective rate of 97.9%. There were no statistical differences in the marked effect rate and total effective rate. Cases in the treatment group were treated 17.8 times on average, while cases in the control group were treated 26.6 times on average. Conclusion: Despite the equivalent effects in the treatment of cervical intervertebral disc herniation, tuina is superior to combined traction and medium-frequency impulse in terms of a faster effect and shorter course of treatment.

By observing the arthroscopy cleaning technique with postoperative oral administration with reinforcing kidney and activating blood Chinese herbal medicine in the treatment of knee osteoarthritis (KOA), this article was aimed to evaluate the clinical curative effect and its influence on serum C endⅡ collagen type (CTX-Ⅱ) and cartilage oligomeric matrix protein (COMP). Patients who met the diagnostic criteria were randomly divided into the treatment group and control group, with 30 cases in each group. Joint limited debridement was firstly applied. And the degree of articular cartilage degeneration, synovial hyperplasia and inflammatory degree were observed and recorded. Preoperative venous blood was collected. The contents of CTX-Ⅱ and COMP were detected with ELISA method. After surgery, in the treatment group, surgery plus postoperative oral administration with reinforcing kidney and activating blood Chinese herbal medicine was given. In the control group, surgery plus oral administration with celecoxib capsules was given. Four weeks before and after the treatment, the WOMAC knee function score was used in the evaluation of clinical curative effect. The contents of postoperative serum CTX-Ⅱ and COMP were determined. The results showed that the effectiveness of the treatment group was higher than that of the control group (P < 0.05). In the treatment group, the WOMAC score in pain, rigidity, difficulty of activity and total score had significant differences compared with the control group (P < 0.05). There were statistical significances on serum CTX-Ⅱ and COMP in the treatment group before and after the treatment, as well as the comparison between the treatment and control group both before and after the treatment (P < 0.05). Serum CTX-Ⅱ and COMP had positive correlation with the degeneration of cartilage and synovial hyperplasia with statistical significances (P < 0.05). It was concluded that joint limited debridement under arthroscopy combined with reinforcing kidney and activating blood method had synergistic effect in the treatment of KOA. It can effectively relieve the clinical symptoms and improve the knee joint function. It can also obviously reduce the contents of serum CTX-Ⅱ and COMP. There was internal close relation between the articular cartilage degeneration, synovial hyperplasia under the arthroscopy in KOA and cytokines of CTX-Ⅱ and COMP. The cytokines of CTX-Ⅱ and COMP provided important references for the estimation of articular cartilage degeneration and synovial hyperplasia.

To evaluate the clinical effect of therapeutic soft corneal contact lens in combination with fresh amniotic membrane transplantation in the treatment of pterygium and its clinical value.
●METHODS: This study was a retrospective analysis of 200 pterygium excision patients (200 cases, 220 eyes) in hospital from January 2010-June 2011. The patients were divided into two groups. Group 1 (100 cases, 110 eyes) were patients treated with fresh amniotic membrane transplantation and therapeutic soft corneal contact lens while group 2 ( control group, 100 cases, 110 eyes) did not use corneal contact lens. The clinical outcomes in these two groups were compared in a 6 - 18mo postoperative follow-up observation.
●RESULTS: ln control group using corneal contact lens the epithelium repair time ranged from 2 - 7d with an average time of 3. 8d; in group 1 the epithelial repair time ranged from 1 - 5d with an average time of 2. 5d. The patients were followed up for 6 - 18mo, 9 recurrent eyes were found in control group, the recurrence rate was 8. 2%; 5 recurrent eyes were found in experimental group the recurreat rate was 4. 5%. There were significant differences in the 2 groups comparing treatment outcomes (P< 0. 05). Early stimulative symptoms after surgery can be reduced by wearing contact lenses.
●CONCLUSlON:The therapeutic effect of fresh amniotic membrane transplantation after pterygium excision is enhanced by the therapeutic application of corneal contact lens. The epithelial repair time is shortened, the recurrence rate is reduced after pterygium excision and stimulative symptoms including photophobia, tearing, foreign body sensation and ophthalmodynia caused by corneal epithelial defect can be relieved.

AIM:To investigate the changes of subfoveal choroidal thickness ( SFCT ) in central serous chorioretinopathy ( CSCR) eyes and to compare them with normal control eyes.
METHODS: This was a case-control study and a Meta-analysis. Forty - six CSCR patients diagnosed by the fundus pre - set lens, fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were enrolled in this study. Sixty two age-, sex-, diopter- and axial length-matched 62 normal subjects ( 62 eyes ) were enrolled in this study as the control group. Using enhanced depth imaging optical coherence tomography ( EDI-OCT) , SFCT of CSCR eyes and normal control eyes were measured and compared. Univariate and multivariate linear regression analysis were performed to assess the association between SFCT and clinical factors. The Meta - analysis were conducted using the Stata software package to calculate the summary weighted mean differences ( WMDs) .
RESULTS:The mean SFCT of the CSCR group and the normal control group was 397. 34±83. 91μm and 274. 48±62. 57μm, respectively. The CSCR eyes had a thicker choroid than the control eyes at the SFCT (P<0. 01). Univariate and multivariable linear regression analysis showed that the SFCT was significantly thicker in association with the CSCR diagnosis. The result of our case-control study was consistent with the results of the further Meta-analysis with the pooled WMD of 156. 13μm (95% CI:137. 43, 174. 83) for SFCT.
CONCLUSION:Along with the comprehensive Meta-analysis, SFCT in CSCR eyes was thicker than that of normal control eyes. Increased SFCT might be associated with CSCR.

Objective To explore the common clinical features and mechanism of HenochSchonlein purpura (HSP) in children,and provide evidence and guidance for clinical diagnosis,therapy and prognosis of HSP.Methods Prospective study.Totally 1 232 HSP children blood samples were collected during January 2010 to December 2013 in the Children's Hospital of Zhejiang University School of Medicine,and the levels of immunoglobulin,complement,T lymphocyte subsets and CRP were detected in the acute phase of HSP.The clinical data were analyzed with these indexes to explore the function of cellular and/or humoral immunity in the pathogenesis of HSP.In addition,this study detected serum IgA levels in 200 cases of sepsis rash,200 cases of urticarial and 200 cases of thrombocytopenic purpura patients and 400 cases of healthy children over the same period to our hospital respectively,in order to find out whether IgA is capable of differentiating allergic purpura rash from other similar skin rashes.Results Compared with healthy children,the IgA level was significantly higher [IgA:2.0 (0.6-7.5) g/L vs 1.1(0.6-2.1) g/L,Z =5.928,P =0.03].When IgA ＞ 1.44 g/L,the diagnostic sensitivity and specificity to differentiate allergic purpura patients from sepsis patients were 77.43 ％ (954/1 232) and 80.00％ (160/200),respectively.When IgA ＞ 1.53 g/L,the diagnostic sensitivity and specificity to distinguish from allergic purpura with urticaria patients were 72.57％ (894/1 232) and 74.51％ (149/200).When IgA ＞0.91 g/L,it had a 95.14％ sensitivity (1 172/1 232) and a 79.45％ specificity (159/200) for the differential diagnosis of allergic purpura and thrombocytopenic purpura patients.When IgA ＞ 1.33 g/L,the sensitivity of distinguishing allergic purpura patients from healthy children was 81.25％ (1 001/1 232),while the specificity was 95.00％ (380/400).Conclusions HSP children show cellular immune dysfunction.Th1/Th2 imbalance and over-activation of Th2 cells result in the increased synthesis and release of immune globulin,causing abnormalities in humoral immune.An increase in serum IgA level of HSP patients can differentiate HSP from other similar rashes.

Objective To investigate the relationship between angiotensin converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism and the severe morbidity of neonates. Methods According to the Neonatal Critical Score (draft), neonates were divided into three groups:control group (n=116), non-critical group (n=237) and critical group (n=98). ACE genotype was determined by PCR. Results The DD genotype was significantly higher in critical group compared with the other two. The critical score on first day of hospitalization was significantly lower in DD genotype than ID or II (93.52?6.99 vs 96.43?5.80 and 96.22?6.41, P

Objective To study clinical feature,pathology,treatment and outcome of acute renal failure(ARF) in idiopathic nephrotic syndrome(IDNS).Methods History-taking of 38 cases were carried out all detailly 24-hour urine protein,biochemistry markers,hemorheology,renal histopathology were detected.Results The study fandings that 82 percent of patients were less than 40 years old,76 3 percent were male,74 percent(28 patients) were non-oliguria and 52 6 percent were minimal change glomerulonephritis through the renipuncture,most of the cases had edema of interstitium, by give prednisone of standard dosage,symptomatic treatment or dialysis the satisfying efficacy was got.Conclusions The main features of IDNS complicated with ARF are usual,it is non-oliguria type in clinic minimal glomerulonephritis in pathology,and deficient blood volume leads to occurrence of ARF,but the renal function could be recovered by give prednisone of routine dosage,symptomatic treatment and hemodialysis therapy.