Introduction: Anti-IL18 antibody was applied to inhibit IL-18, regulate the cytokine network, inhibit liver immune injury, and exert a protective effect against immune liver injury. The present study aimed to explore the immunological mechanism of the effect of anti-IL18 antibody on immune liver injury in mice, and appropriate dose of antibody intervention, in order to provide theoretical and animal experimental evidence for the treatment of immune liver injury. Materials and methods: Bacillus Calmette-Guerin (BCG) and lipopolysaccharide (LPS) were used to establish an animal model of immune liver injury. For the intervention group, the high and low doses of anti-IL18 antibody were intraperitoneally injected on day 2, 7 and 12. The control and model groups were intraperitoneally administered with normal saline. From the following day, the positive control group was intragastrically administered with bifendate pills, daily. Serum levels of alanine transaminase (ALT), aspartate transaminase (AST), IL-18, interleukin-1 (IL-1), and tumor necrosis factor alpha (TNF-alpha) were measured after 12 days. The liver, spleen and thymus gland were removed, and the weight coefficients were calculated. Liver tissue was collected and sectioned for hematoxylinesosin staining (H&E) and Van Gieson's staining. Results: The results revealed that the coefficients of the injured liver, spleen and thymus in the high-dose antibody intervention group were significantly decreased compared with those in the model group (P< 0.05). Furthermore, ALT and AST levels were all significantly lower in the high-dose, low-dose and positive control groups, compared with the model group (P< 0.01). The high-dose intervention group exhibited a significantly inhibited increase in IL-18, IL-1 and TNF-alpha (P< 0.05). Furthermore, in the high-and low-dose antibody intervention groups, and positive control group, the pathological liver damage was reduced to varying degrees, while the cytological grades of liver cell injury were significantly different among these groups (X2 = 14.667, P< 0.01). Discussion and conclusions: These results indicate that immune liver injury in antibody intervention mice could be alleviated, and this was most significant in the high-dose group. High-and low-dose antibody intervention inhibited the immune injury of the liver, thereby playing a protective role in mouse immune liver injury.

This study aims to investigate the gastrointestinal functions of patients with liver failure (LF) based on gastrointestinal dysfunction (GD) scores and serum gastrointestinal hormone levels. The GD in LF patients was scored using the gastrointestinal dysfunction scoring criteria. Serum gastrin (GAS), cholecystokinin (CCK), and motilin (MTL) levels were determined in LF patients. In addition, liver function and prothrombin activity were detected, and ultrasonography was performed. The GD score was significantly higher in the LF groups than in the control group. Compared with the control group, serum GAS, CCK, and MTL levels significantly increased in the LF groups, and was positively correlated with the severity of LF. Furthermore, in the LF groups, GD was positively correlated with the severity of LF. However, the GD score and serum GAS, CCK, and MTL levels in the acute LF group were not statistically different, when compared with those in the subacute LF group, acute-on-chronic LF group and chronic LF group. LF plays a key role in the development of GD, and may be the main cause of obvious gastrointestinal symptoms, such as abdominal distension, nausea, vomiting and anorexia, in LF patients. The severity of GD is not associated with LF type, but is positively correlated with the severity of LF, suggesting that GD in LF patients may have complicated mechanisms.

This study aims to investigate the relationship between gastrointestinal dysfunction (GD) and cirrhosis severity in cirrhotic patients, to provide evidences for the prevention and treatment of GD in cirrhotic patients. A total of 95 cirrhotic inpatients and outpatients, who were treated in the Department of Gastroenterology of Xinqu Hospital of the First Affiliated Hospital of Henan University of Science and Technology, were enrolled in the present study, and assigned as the experimental group (cirrhosis group). According to Child-Pugh classification, these patients were divided into 3 groups: group A (n=45), group B (n=23), and group C (n=27). Forty healthy adults who received health check-ups during the same period served as the control group. The gastrointestinal (GI) symptoms of cirrhotic patients were scored, and the fasting serum gastrin (GAS), motilin (MTL), and vasoactive intestinal peptide (VIP) levels were measured in all subjects. The potential correlations of GI symptom scores of patients in these cirrhosis groups with GI hormone levels and cirrhosis severity were analyzed. In cirrhotic patients, the GI symptom scores significantly increased. Furthermore, the symptom scores gradually increased along with the aggravation of liver damage. Moreover, serum GAS and VIP levels were significantly higher in the cirrhosis groups than in the control group, whereas MTL levels were significantly lower. These changes were significantly correlated with cirrhosis severity. The linear correlation analysis revealed that the GI symptom score was positively correlated with GAS and VIP levels, and negatively correlated with MTL level. In addition, the linear correlation analysis revealed that GI symptom score and GAS and VIP levels were positively correlated with cirrhosis severity, whereas MTL level was negatively correlated with cirrhosis severity. Cirrhotic patients have more obvious GI symptoms and higher GI hormone levels, which are closely correlated with the progression of liver cirrhosis and the degree of liver function damage.

Objective To study the application of standardized patients practice and agent physician system in digestion medical clinical practice. Methods One hundred and fifty five-year-clinical medical students who began digestion medical clinical practice from 2008 to 2009 were selected and randomly divided into teaching reform group and control group, each group containing 75 people. According to teaching reform group students' willingness and through the selection, 69 were identified as agent physician. Standardized patients and agent physician simulation clinical training were applied in the teaching reform group while conventional teaching methods were used in the control group. Sta-tistical analysis of the experimental data was conducted using SPSS 11.0 statistical package. Measure-ment data use independent-samples t test and rank sum test was used for heterogeneity of variance. Results Teaching reform group students' inquiry contents and skills scores for each project were higher than those of control group and the score difference was statistically significant (P<0.05) in chronological order, the transition language, interrogation schedule, repeated questions, summary records, citing verification, instrumentation courtesy, friendly behavior, praise and encouragement, eliciting the patient's views, concerns about the effects of disease, care and support and assistance aspects. After the end of the third internship, two groups were compared in operation results, reform history collection, physical examination skills group score and the excellent and good rate being higher (P=0.002, 0.001). After three times' practice, teaching group students' scoring pass rate in medical ethics demeanor, interrogation techniques and physical examination skills, case analysis is higher than that of the control group students, and the difference was statistically significant(P<0.05). Conclusion Application of standardized patients and implementing agency resident simulation clinical training in the guide teaching of digestion department of internal medicine has achieved good effect.

目的：探讨标准化培训与代理医生在消化内科实习带教中的应用。方法选取2008、2009级进入消化内科实习的5年制临床专业学生150名为研究对象，随机分为标准化培训组（教改组）和对照组各75名。教改组应用标准化培训和代理医师的方法，对照组应用常规方法，通过评分表分别评价两组学生在问诊技能、体检技能和病例分析等方面的优劣。结果教改组学生在第3次实习后，病历作业成绩、医德风范、问诊技能、体检技能及病例分析等方面的及格率明显优于对照组，差异有统计学意义（P<0.05）。结论标准化培训和代理医生方法在一定程度上解决了病例少、病种局限性的问题，既提高了带教教师的实际经验，又增强了实习生的实习能力。

目的 评价在洛阳市中学生中开展学校和家庭性与生殖健康知识教育的干预效果,为进一步研究和实施提供依据.方法 采用以学校为单位的干预性研究,干预模式采取单纯学校教育与家庭和学校同步教育.干预活动主要由学校教师组织家长、学生以班级为单位进行健康知识教育,每2周1次,每次不少于1h,共不少于20次,干预时间为2 a.通过基线和终末两次问卷调查及学生和家长的小组访谈,比较干预组和对照组干预前后以及2个干预组间学生性与生殖健康知识水平和对性相关问题的态度,评价干预效果并探讨不同干预措施的影响.结果 初中生干预对生殖生理知识的增加差值作用最大(两个干预组分别为22.58±10.21和28.82±13.42);与单纯学校性与生殖健康教育相比,家庭和学校同步教育使高中生对婚前性行为的态度更趋于保守;未发现两种干预方式对初中生的婚前性行为态度产生影响(P值均＞0.05).家庭和学校教育有效提高了父母的生殖健康知识水平,干预后干预组和对照组知识得分增加值均数之差为4.69分.结论 中学生中开展学校和家庭性与生殖健康教育的效果明显,但干预方式有待进一步研究.

A sensitive and selective liquid chromatography mass spectrometry (LC-MS) method for determination of clozapine in rat plasma was developed. After addition of metoprolol as internal standard (IS), protein precipitation by acetonitrile was used as sample preparation. Chromatographic separation was achieved on a Zorbax SB-C18 (2.1 mm x 150 mm, 5 mu m) column with acetonitrile-0.1% formic acid as mobile phase with gradient elution. Electrospray ionization (ESI) source was applied and operated in positive ion mode; selective ion monitoring (SIM) mode was used to quantification using target fragment ions m/z 327 for clozapine and m/z 268 for the IS. Calibration plots were linear over the range of 5-1000 ng/mL for clozapine in plasma. Lower limit of quantification (LLOQ) for clozapine was 5 ng/mL. Mean recovery of clozapine from plasma was in the range 78.9-90.5%. CV of intra-day and inter-day precision were both less than 7%. This method is sensitive and selective enough to be used in pharmacokinetic research for determination of clozapine in rat plasma.

Objective To evaluate the clinical treatment of ectopic pregnancy.Methods The methods and characteristics of clinical treatment of 342 cases of ectopic pregnancy in our hospital nearly five years were retrospectively analyzed.Results 38 cases of ectopic pregnancy were treated by conservative drugMTX,the success rate was 92.11%;the defeated factors had the medicine side effect to cause the treatment termination and acute abdomen,the failure rate was 7.89%.Surgical treatment had open operation and laparoscopic operation,laparoscopic operation had a small scar,shorter operative time,less bleeding,rapid postoperative recovery,shorter hospital stay,and the difference was statistically significant(P 0.05) compared with open operation.Tubal pregnancy surgery treatment had Salpingectomy and retain tubal conservative surgery,blood β-HCG returned to normal after 14 days using Salpingectomy,but the conservative surgery returned to normal after 21 days,both compared to postoperative day 1 was no significant difference(P 0.05);After 4,7 and 14 days the difference was statistically significant(P 0.05);the mesosalpinx of pregnancy site was injected with MTX 20 mg after conservative surgery to prevent persistent ectopic pregnancy,and the difference was statistically significant(P 0.05) compared with no injection of MTX.Conclusion The success rate of MTX treated conservatively ectopic pregnancy is high,which become the first choice to patients who retain uterine tube and fear the surgery.The laparoscopic operation can be taken as the priority method of treatment to patients and doctors.Injecting MTX into mesosalpinx of pregnancy site after conservative surgery can effectively prevent the occurrence of persistent ectopic pregnancy.

Objective To develop a HPLC method for the determination of saikosaponin b2 in rat plasma.Methods The analytical column was packed with Agilent TC-C18.A mixture of acetonitrile-0.2% trifluoroacetic acid-water(40∶20∶40)was used as the mobile phase with the flow rate at 1.0 mL·min-1.The detection wavelength was set at 254 nm.The Saikosaponin-b2 was extracted by ethyl acetate from plasma at the alkaline condition.Results Excellent liner relationship was obtained from the range of 0.05 mg·L-1 to 6.00 mg·L-1(r=0.999 7).The lower limit of quantitation is 0.05 mg·L-1.The intra-day RSD were 5.20%,4.80%and 2.84% and inter-day RSD were 6.39%,5.13% and 2.47% respectively at three concentrations(0.1,1.0,4.0 mg·L-1),and the relative recoveries were(97.17±7.22)%,(103.87±4.28)% and(101.75±1.54)% respectively.Conclusion The method was simple,rapid,accurate for determining the saikosaponin b2 concentration in rat plasma and for pharmacokinetics study.

Objective To estimate the average infectious power of hepatitis A in natural population in different regions of China,and provide basic parameters for the quantitative research of hepatitis A immunization strategies. Methods According to the data of the prevalence of hepatitis A antibodies in National Epidemiological survey of hepatitis in 1992,different regions were divided into a high,medium high,medium,medium low and low prevalence areas.Simple catalytic model was used to fit different prevalence rates of hepatitis A,and estimate the average infectious power of hepatitis A. Results The average infectious power of hepatitis A from high areas to low were: 44.02%,23.09%,17.50%,10.24% and 5.26% respectively.The test of fitting goodness showed P values were greater than 0.05. Conclusion In natural populations of hepatitis A,using simple catalytic model fitting prevalence data can gain good effect.Data on average infectious power of hepatitis A provide basic parameters for the quantitative research of hepatitis A immunization strategies.

目的分析手足口病(HFMD)危重型的临床特点,为诊断提供线索。方法对本院2010年收治的HFMD危重型78例患儿的发病特点、临床表现、辅助检查结果进行分析。结果病例分布在5-11月,呈2个高峰。59例居住在农村,26/31例为EV71感染,70例为3岁以下,男女比例为1.791.0,61例于病程3 d内出现危重表现。三凹征阳性59例,休克42例,肺部啰音36例,血性泡沫痰23例,昏迷16例,频繁抽搐11例,脑疝4例。尿糖、血糖、血WBC和PLT、心肌酶、ALT、二氧化碳分压、脑压、脑脊液白细胞数和蛋白升高,血氧分压、pH值、二氧化碳结合力降低,胸片、ECG、EEG、MRI等部分患儿出现异常。结论 HFMD危重型以呼吸系统危重表现多见,应动态监测血气、胸片等。

目的了解医学院校大学生逃课的原因,探讨预防逃课行为的对策。方法采用整群随机抽样的方法,选择不同专业、不同年级的大学生,进行问卷调查。结果共调查292名学生,逃课率为81.5%,女生高于男生,逃课现象随年级增高而更严重,逃课后主要去向是去自习、图书馆或者上网。结论医学院校大学生逃课情况比较严重,应该采取针对性措施来减少大学生的逃课现象。

目的评价在中学生中开展学校和家庭生殖健康教育的效果,为进一步研究和实施提供依据。方法采用以学校为单位的干预性研究,干预模式采取单纯学校教育(干预1组)与家庭和学校同步教育(干预2组)。通过基线和终末两次问卷调查及学生和家长的小组访谈,比较干预前后、干预组和对照组以及两个干预组间学生生殖健康知识水平,来评价干预的效果。结果基线调查发现,中学生的生殖健康知识均较低,而初中生更低(均数仅为30.75分)。干预后发现,初中生中,干预对生殖生理知识的增加作用最大(两个干预组相对于对照组的增加差值分别为22.58和28.82),增加作用最小的是避孕知识(两个干预组相对于对照组的增加差值为0.65和6.84);两种干预方式比较,干预方式1对艾滋病、性病知识的增值作用较大,而干预方式2对生殖生理知识的增加作用较大,两种干预方式对避孕知识的增加作用无显著差别。结论干预提高了中学生的生殖健康知识水平,其中家庭和学校同步教育的效果更显著。

Objective To establish a method of chemiluminescent immunoassay for determination of carcinoembrynic antigen(CEA) in human serum. Methods The two-site enzyme immunoassay was based on the direct sandwich technique.A monoclonal antibody was bonded to the microplate for coating and the conjugation of alkaline phosphatase to another polyclonal antibody was performed by NaIO4 method.Chemiluminescent immunoassay was established by optimizing CSPD and SapphireII luminescent system.The reference range was defined by testing 800 serum samples from healthy subjects.The comparison for 100 serum samples from patients was assayed by the bayer Acs:180 Automated Immunoassay System. Results The detectable minimum was 0.5 ng/mL.The linear scope was from 0.5 to 640.0 ng/mL.Average inter and intra-assays were 8.6% and 7.5%,respectively.The recoveries ranged from 97.4% to 101.8%.The cross-reacting rate for AFP(3 μg/mL),Ferritin(10 μg/mL),HAS(200 g/L),IgG(100 g/L) were≤0.015%,0.034%,4.5×10-8 and 5.0×10-8,respectively.Compared with bayer Acs:180 Automated Immunoassay System,the relative coefficient was 0.968(P0.001). Conclusion A successful establishment of chemiluminescent immunoassay provides a way for clinical determination of CEA.

Objective To study the characteristics of athletic injuries among college students and to provide evidence for the prevention of athletic injuries. Methods A self designed questionnaire was used to investigate injuries among college students randomly cluster sampled from Luoyang colleges.Multivariate logistic regression analysis was performed. Results Multivariate logistic analysis indicated that the time of warming-up,basketball sport safety education,hard floor and different grade,were the risk factors to injuries. Conclusion The related health education and management should be reinforced among them.

Objective To learn the death of pneumoconiosis patients in Luoyang and provide basis for improving medical preventive measures against pneumoconiosis. Methods Analysis was carried out on the causes of death,disease categories,industrial distribution,time distribution,spell of sickness and stage distribution. Results The main proportional mortality was pneumocardial and pneumoconiosis.Collier pneumoconiosis occupied 46.99% and silicosis 45.90% among the total death number.86.88% of the pneumoconiosis death cases were from the field of coalmine,mineral,mechanism and glass material.Coalmine that occupied 48.63% was in the first place among all of them.The death number of silicosis increased with time and the collier pneumoconiosis was opposite to it.The average spell of sickness of silicosis was 7.02 years;collier pneumoconiosis was 9.87 years and other pneumoconiosis was 7.43 years.The death number of pneumoconiosis and pulmonary tuberculosis increased with stage and others were opposite to them. Conclusion The main areas to strengthen their prevention measures on pneumoconiosis might be pneumocardial.The main industries to be focused on might be coalmine,mineral,mechanism and glass material.Collier pneumoconiosis and silicosis are key factors among pneumoconiosis death cases.Hygienic supervision should be strengthened.Early diagnosing and controlling syndrome are the critical measure to the restoration.

目的:探讨分娩方式及其它产科因素与尿失禁的关系.方法:对洛阳市某大型企业在职及退休女工采取整层随机抽样进行尿失禁问卷调查.结果:①尿失禁患病率为41.82%,随着年龄的增加而升高(P<0.001);②尿失禁患者体重指数(BMI)和非尿失禁患者比较有显著性差异(P<0.001);③分娩方式与尿失禁明显相关,阴道分娩明显高于剖宫产(P<0.001);④新生儿体重、母乳喂养以及流产次数与尿失禁无关(P>0.05).结论:工厂女工尿失禁患病率较高,年龄及BMI与患病情况密切相关,分娩方式与尿失禁明显相关.应加强孕产期保健,降低尿失禁患病率,提高女性生活质量.

目的了解洛阳市高校知识分子的膳食生糖负荷。方法采用多级抽样的方法在洛阳市高校中抽取具有高级职称的知识分子200人,非营养相关专业140人,医学及营养相关专业60人,用食物频率法对其进行膳食营养状况调查,计算不同人群膳食生糖负荷。结果洛阳市高校知识分子膳食生糖负荷在不同专业人群中有差别(P<0.05)。结论需要对非营养相关专业的高校知识分子进行膳食指导,加强中国传统膳食模式的宣传。

目的 探索一种治疗大面积深度烧伤的方法.方法 2006年3月至2007年10月,本科收治大面积深度烧伤病人15例.实行早期切削焦痂后采用J-1型脱细胞异体真皮基质覆盖手术创面,并在术后分期自体植皮.结果 皮片成活良好,经随访6～18个月,无排斥反应,植皮区光滑平整,色泽及弹性良好,瘢痕增生反应轻.结论 脱细胞异体真皮与自体皮复合移植是治疗深度烧伤的一种比较理想的方法.

目的 调查医院职工及退休职工女性尿失禁患病情况及对该病的认知和求治情况.方法 采用女性尿失禁症状问卷调查,由被调查对象自己填写或调查员代写无记名式问卷.结果 发出问卷550份,回收550份,回收率为100%,获得有效问卷518份.①尿失禁患病率为38.03%,随着年龄增长尿失禁患病呈上升趋势( P ＜0.001).②在被调查对象中,压力性尿失禁患病率最高,其次为混合性尿失禁,急迫性尿失禁所占的比例最低.其患病率分别为28.57%、5.60%、3.86%,其构成比为75.13%、14.72%、10.15%.③尿失禁患者体重指数高于非尿失禁组,且随着年龄的增长逐渐增加( P ＜0.001). ④尿失禁患者认为该病是自然现象者48.65%,对该病不知道怎么办者22.97%,准备去就诊者17.57%,该病对她们造成一定痛苦者9.46%,因经济原因未求治者仅为1.35%.⑤尿失禁患者就诊率为15.70%,求治方向依次为妇产科、泌尿外科、其他等.结论 尿失禁是一种可以预防、延缓发展,甚至可以治愈的一种疾病,我国应加大宣传力度,提高医护人员乃至全社会的重视,以提高人们的健康意识和生活质量.