Objective To investigate the computed tomography (CT) and magnetic resonance imaging (MRI) characteristics of immunoglobulin G4 associated cholangitis (IAC) and the key points for identification and diagnosis.Methods The clinical data of 11 patients with IAC who were admitted to the Peking University People's Hospital from January 2013 to January 2015 were retrospectively analyzed.Patients received plain and enhanced scan of CT,plain and enhanced scan of MRI and magnetic resonance cholangiopancreatography (MRCP) examination before hormone therapy.Patients were followed up by telephone interview and outpatient examination till January 2015,and their imaging data were evaluated.Results Of the 11 patients,7 patients received plain and enhanced scan of CT,6 patients received plain and enhanced scan of MRI and 7 patients received MRCP examination.The results of CT and MRI examinations showed bile duct segmental stricture and non-obliteration of cavity were detected in the 11 patients.Diffused thickening of intrahepatic and extrahepatic bile duct and no correlation between the thickening and the stricture of the bile duct was detected in the 8 patients.The bile duct wall of 3 patients was locally thickened,including 2 thickened common bile duct wall at the region of the head of the pancreas and 1 thickened hilar bile duct.The results of MRI showed low T2WI signal of the bile duct wall in 7 patients and equal signal in 4 patients.Enhanced signal in the bile duct wall was detected in the delayed phase in 11 patients by enhanced scan of CT and MRI,and 8 of the 11 patients had enhanced signal in the arterial,venal and delayed phase.Nine patients were complicated with autoimmune pancreatitis (3 of them were with concomitant renal disease),and 1 patient was only complicated with immune-related renal disease.Enlargement of lymph nodes was detected around the pancreas in 3 patients,while no enlargement of lymph nodes was detected in 8 patients.Among all the 11 patients undergoing hormone therapy,8 patients were followed up for a median time of 13 months (range,6-18 months),including 7 patients with good recovery and 1 patient with recurrence of IAC.Conclusion Diffused and irregular thickening and stenosis but not occlusion of biliary duct,the thickening and stenosis which are detected by CT and MRI examinations is relatively independent,and associated with autoimmune pancreatitis and other organs involved may be helpful to make a diagnosis of IAC.

Objective In order to provide the reasons for local injecting Xiaozhiling to treat malignant tumors. Methods 10 mice were subcutaneosly injected with S 180 Tumor cell to create tumor models and then Xiaozhiling 10ml/kg were intratumorly injected for 3 times.Finally,observation and comparison were made for the pathologic changes under optic and electronic microscopies. Results The results showed that Xiaozhiling had strong antitumor effect on S 180 tumor(adquate rate was 37.3%).Pathalogical exemination revealed that the tumor tissue necrosed obviously,some wesslincataneous cells breaked up, red blood cells extravasation,micro blood clots formed.No changes occurred in the control group. Conclusions Xiaozhiling could be a new drug for clinical treatment of malignant tumor.

Objective To study the change of Insulin-like growth factor 1(IGF-1)and Epidermal growth factor(EGF)level in blood of newborns with asphyxiated.Investigation the effect of stomach-intestine hormone to newborns asphyxiated.Methods plasma IGF-1,EGF level of 48 neonatal asphyxia and 36 normal newborns(1d,3d,7d)were tested by radioimmunoassay.Result In comparision with normal neonatal,IGF-1,EGF level of neonatal asphyxia reduced significantly(P

The purified 3C8 was obtained by two step column purification,including Protein G affinity purification and DEAE anion exchange purification.The purity of purified 3C8 was about 93％ when analyzed by reverse column.SDS-PAGE showed that the purity of 3C8 was increased greatly by two step purification.By flowcytometry we found that 3C8 specifically binded with B7-H4/293T cells and did not bind with Mock/293T cells,moreover 3C8 did not bind with other B7 family members transgene cells.In confocal experiment 3C8 could specifically stained B7-H4/293T cells.In Western blot only B7-H4/293T cells showed positive band while Mock/293T cells showed negative result.The result of immunohistochemistry showed that B7-H4 was highly expressed in prostate cancer and renal cell carcinoma,while para-cancer tissues did not express B7-H4.The T cell proliferation experiment showed that B7-H4-Ig could bind to activate T cells and inhibit T cell proliferation,while 3C8 could block the binding of B7-H4-Ig and reverse the T cell proliferation inhibition effect of B7-H4-Ig by CFSE and CCK8 assay.The cytokine IFN-γ and IL-2 secreted by activating T cells was decreased by B7-H4-Ig and 3C8 could reverse the effect of B7-H4-Ig.

Objective To explore the content change of Alpha Fetal Protein(AFP) and Alpha Fetal Protein Variants(AFP-L3) pre-and post-liver transplantation operation for liver cancer patients.Methods AFP-L3 was de-termined by micro centrifugal column from twelve cases of successive sera(For each case,one original shale pre-oper-ation,and mole shares post-operation successively),and preserved from patients who were diagnosed as fiver cancer and completed fiver transplantation operation.simultaneously the content of AFP and AFP-L3 in the original serum were also determined.and the ratio of AFP-L3 in AFP was calculated in order to compare the content change of AFP and the ratio of AFP-L3 pre-and post-liver transplantation operation.Results Compared with twelve cases of pre-and post-operation,the AFP in only five cases turned tO negative;The AFP in other cases keeped positive though AFP-L3%tumde to negative.and the content of AFP in some specific cases still keeped in a high level.Regarding AFP-L3,besides two casses turning to negative immediately after operation,the content of AFP-L3 in other patients de-creased gradually after operation,and it approached to negative(AFP-L3%<10%).Through statistical analysis,be-tween the half lives of AFP and AFP-L3%,there waa no statistic significance.Therefore,AFP-L3% could be considered as an independent reference item.Conclusion After a radical cure of liver resection or liver transplantation operation,AFP-L3%usually turned to negative in a rather short period (about 1 to 20 days).The ratio of AFP-L3 in AFP became be-low 10%,and it indicated that the operation would be quite complete,remaining liver would have hepatitis or hepatocirrho-sis.Otherwise,the ratio was not decrease during a long period,and it indicated the operation had not eliminated focuses completdy.

Background and purpose:Cytotoxic T lymphocyte (CTL) plays a vital role in the process of anti-tumor immunology. The aim of this study was to investigate whether changes in concentration of IL-2 (50, 200 and 1 000 U/mL) would affect the sub-population and cytotoxic function of cells cultivated by peptide-specific CTL induction systemin vitro and also observe whether using the concentration of IL-2 at a range of 50-1 000 U/mL isbeneifcial to regulatory cells (Tregs) enrichment.Methods:Peripheral blood from 10 healthy donors and 10 cancer patients that were HLA-A2 positive, were collected in the study. HLA-A2 restricted CTL epitope P321 (ILIGETIKI) derived from COX-2 pulsed with different concentrations of IL-2 were used to induce peptides-speciifc CTLin vitro. Flow cytometry was performed to analyze the proliferative capability, the proportion of different T-cell subsets, and secretion of perforin, granzyme B and IFN-γ. IFN-γ secretion was assessed by ELISpot assay.Results:High concentration of IL-2 increased the proliferative activity. The percentage of CD4+ T cells of cancer patient group was signiifcantly higher than that of healthy donor group, while the percentage of CD8+ T cells of cancer patient group was signiifcantly lower than that of healthy donor group. And there was no signiifcant difference in the percentages of CD4+ T cells, CD8+ T cells and Tregs among groups with different IL-2 concentrations. No difference was seen in cytokine (perforin, granzyme B, IFN-γ) secretion capacity of CD8+ T cells. ELISpot study revealed that high-dose IL-2 resulted in the increasing of IFN-γ secretion.Conclusion:The sub-population and the function of cells cultured by peptide-speciifc CTL induction systemin vitro are not affected by different concentrations of IL-2. Furthermore, high concentrations of IL-2 (50-1 000 U/mL) do not provide the enrichment for Tregs. Higher concentration of IL-2 is likely to cause high secretion of IFN-γ in ELISpot assay. In order to exclude the distraction of NK cells or NKT cells, the concentration of 50 U/mL is better choice.

Objective To explore the effects of comprehensive restraint reduction program on preventing un-planned extubation among ICU patients with tracheal intubation. Methods Totally 266 cases of ICU patients with tracheal intubation in our hospital were selected as the research objects using the convenient sampling method.They were divided into two groups by time: the experimental group of 130 cases implementing a comprehensive reduction constraint program and the control group of 136 cases using conventional physical restraint in nursing process.The constraint rate, constraint length, UEX incidence, skin and satisfaction of the two groups were compared. Results In the experimental group, the rate of physical restraint and UEX decreased, the average restraint length of each patient was shortened, skin integrity at the site of restraint improved, and the satisfaction of patients increased. Compared with the control group, the differences were statistically significant(P<0.01 or P<0.05). Conclusion The com-prehensive restraint reduction program can reduce the rate of physical restraint and the incidence of unplanned ex-tubation among ICU patients with tracheal intubation.

Objective To study the value of magnetic resonance vessel wall imaging in assessing the atherosclerotic plaque burden of rabbit model.Methods We built up abdominal atherosclerotic animal model in 30 New Zealand rabbits by high lipid diet combined with abdominal artery denudation.The animals were divided into 3 groups randomly,which were the 1-week group,1-month group and 2-months group.The MRI and histology examination were carried out at relative time points.The correlations of area or thickness of vessel wall by MRI with histology examination were analyzed.Results Among the 30 rabbits,3 died due to anesthesia or surgery,one rabbit model failed because of the thin vessel,and another 3 died of diarrhea or inflammation during the high lipid diet feeding.Eventually,totally 23 rabbits fulfilled the examinations (7 in 1-week group,7 in 1-month group and 9 in 2-months group).The vessel wall area of histology examination grew larger along with the post-surgery duration,from 1.7663 mm2of 1-week group to 2.4371 mm2 of the 1-month group till 3.5978 mm2 of 2-months group,with statistic significant difference among 3 groups (F=5.052,P=0.017).There were strong correlations of area or thickness vessel wall resulted from MRI with histology examination(r=0.688,0.642;P=0.001,0.002).Conclusions High resolution MR vessel wall imaging technique may evaluate and follow up the plaque burden in the early stage of atherosclerosis.

Objective We evaluate if supplementary grading system can refine patient selection and accurately predict neurological outcome in BAVM. Methods We retrospectively study 221 BAVM patients who were treated micro?surgically by our hospital. The score of pre and post operation mRS and relative clinical, radiology data were collected. Two different logistic models (Spetzler-Martin, Supplementary Spetzler-Martin grading model) were constructed to com?pare the area under ROC. Results Some factors are significant different between worse outcome patients and good out?come patients:Non-hemorrhagic presentations prior surgery, AVM bigger than 3cm, diffuse shape of AVM and the elder patients. Predictive accuracy was higher for the supplementary model (ROC area, 0.91), than the Spetzler-Martin model (ROC area, 0.774). So the predictive accuracy of supplementary model was significantly better than that of the Spet?zler-Martin model (P=0.0362). Conclusions Supplementary Spetzler-Martin model can improve preoperative risk pre?diction and subgroup the patients more efficiently. When the score less than 5(including 5) in supplementary Spet?zler-Martin patients seem to have lower risk relative to surgery.

ObjectiveTo evaluate the value of microsurgery for acoustic neuromas.MethodsThe author performed a retrospective study of 63 consecutive patients after vestibular schwannomas (VSs) microsurgery with the retrosigoid approaches. The tumor was debulked firstly and dissected from surrounding neural and vascular structures by gripping the tumor capsule,and then drilled of the IAC.Intraoperative electrophysiological monitoring of facial nerve function during operation.Results Total tumor resection was achieved in 52 cases, subtotal resection was achieved in 11 cases. The anatomic preservation of facial nerve was achieved in 58 cases,the acoustic nerve was preserved anatomically in 29 cases.Fifty-eight cases received a follow-up, the mean follow-up time was 7.2 years. Two recurrent patients were found and there were no operative deaths. A long term facial nerve status:twenty-three cases were in grade Ⅰ, twenty-nine cases in grade Ⅱ ,five cases in grade Ⅲ , one cases in grade Ⅳ.Hearing level had an improvement in 9 cases and remained unchanged in 8 cases.ConclusionMicrosurgery treatment is the main choice of the treatment of VSs, could achieve better result in control of tumor and facial and acoustic nerve function restoration.