Objective To investigate the expression of nestin in fibroblasts of adult human dermis.Methods A total of 6 samples of normal human skin were collected.Immunohistochemistry and immunocytochemistry staining were used to detect the nestin expression in adult human dermis and in cultured fibroblasts of different passages(3rd,5th,7th,10th,and 12th passages,respectively) in vitro.Nestin positive cells were counted to evaluate the expression quantity and intensity.Results There were 103.3?67.4 fibroblasts per square millimeter(mm~2) of adult human dermis,and the nestin positive fibroblasts accounted for(9.5?3.0)% of total amount.The amount of nestin positive fibroblasts in vitro was obviously higher than that in vivo.Significant difference was observed in the amount of nestin expression among different passages(P

OBJECTIVE:To optimize the management of drug inventory so as to reduce days of drug turnover. METHODS:Depending on the information management system of the hospital,the method of quality control circle was used to analyze the rea-sons of long days of drug turnover,corresponding measures for continuous improvement were developed,and the effects of the ac-tivities in the quality control circle were evaluated on the basis of the rate of achieving the goal and the growth rate of circle mem-bers. RESULTS:In the activities of the quality control circle,based on the factors such as personnel,drugs and the method,corre-sponding measures were developed in respect of permanent applicants for drugs,the upper and lower limits of drugs to be gotten by the applicant,the increase in the frequency of purchase,“zero inventory”management for part of drugs,and the optimization of the generation program of purchase orders,where the percentage of the drugs with the turnover days within 15 d was increased from 72% to over 85%,the rate of achieving the goal was 107.9%. All the circle members significantly grew as to the application of the method of quality control circle,sense of responsibility,initiative,team spirit,communication and coordination,with growth rate of 12%-28%. CONCLUSIONS:The activities of the quality control circle have achieved a good effect in optimizing the drug inventory management of our hospital and increased the percentage of the drugs with the turnover days within 15 d.

Objective To determine the relative and independent risk factors of survival in patients with non-hepatitis B and non-hepatitis C hepatocellular carcinoma (NBNC-HCC).Methods The clinical records of 109 patients who underwent surgical resection for NBNC-HCC at Tianjin Medical University Cancer Institute & Hospital between January 2010 and January 2013 were retrospectively analyzed.The risk factors influencing disease-free survival (DFS) and overall survival (OS) were used as primary outcome measures.Univariate analysis was conducted to determine the relative risk factor predicting prognosis of NBNC-HCC,and the Cox proportional hazards model was used to determine independent risk factors of DFS and OS.Results For the 109 NBNC-HCC patients,the 1-,2-,3-year overall survival rates were 90.8％,78.0％ and 65.1％,respectively.The compounding disease-free survival rates were 74.0％,63.3％ and 55.8％,respectively.Univariate analysis showed the AFP level,ascites,and TNM staging were the risk factors of OS (all P ＜ O.05).The AFP level,ascites,BCLC stage,TNM staging were related with DFS (all P ＜ 0.05).Multivariate analysis demonstrated AFP and ascites to be the independent risk factors of OS and DFS.Conclusions AFP and ascites were independent risk factors of OS and DFS.For the NBNC-HCC patients,a strong positive AFP with ascites indicated poor prognosis.

Objective To investigate the safety and efficacy of reducing pulmonary arterial pressure in patients with congeni‐tal heart disease(CHD) complicated with pulmonary hypertension(PAH) .Methods From September 2014 to January 2015 in our hospital ,34 patients with CHD complicated with PAH were selected ,all of them were treated with endothelin receptor antagonist , bosentan ,on the basis of conventional therapy .The hemodynamics observation ,cardiac function detection and six‐minute walking distance test(6 MWD)were performed after pulmonary artery pressure reducing therapy .Results After treatment ,the pulmonary vascular resistance (PVR) ,arterial oxygen saturation(SaO2 ) ,Qp/Qs and right cardiac output(CO) in these patients was (218 .30 ± 91 .25)dyn · s-1 · cm -5 ,(95 .16 ± 7 .84)% ,(1 .10 ± 0 .27) and (5 .20 ± 1 .36) L/min ,respectively ,which were better than those be‐fore treatment(P<0 .05) .There was no statistically significant difference in the pulmonary artery systolic pressure(sPAP) ,pulmo‐nary artery diastolic pressure pulse AI(dPAP) ,mean pulmonary arterial pressure(MPAP) ,heart rate(HR) and central venous pres‐sure(CVP) before and after the treatment(P>0 .05) .There was no statistically significant difference in the right ventricular diame‐ter(RVD) ,left ventricular ejection fraction(LVEF) ,three tricuspid regurgitation velocity(VP) ,three tricuspid valve transvalvular pressure difference(PGTV) ,left ventricular diastolic volume (LVEDV) and left ventricular diastolic diameter(LVEDD) before and after the treatment(P>0 .05) .After 3 months and 6 months of treatment ,6 MWD was (378 .09 ± 40 .12) and (423 .07 ± 35 .32) m respectively ,both of which were higher than those before treatment ,the differences were statistically significant (P<0 .05) .Conclu‐sion The application of bosentan therapy is safe and effective for patients with CHD complicated with PAH ,which could improve pulmonary hemodynamics and 6 MWD .

Objective To explore the surgical approach of reducing the incontinence after radical retropubic prostatectomy with recent anatomic findings. Methods Sixteen patients with stage B prostate carcinoma received continence preserving anatomic radical retropubic prostatectomy. Results All the patients were followed up 3 months to 5 years,mean 13 months.Thirteen patients had normal voiding,two with mild stress incontinence.Only one was complicated with serious incontinence. Conclusions Identifing and preserving the external striated urethral sphincter and its innervation in performing anatomic retropubic prostatectomy will achieve postoperative urinary continence.

Objective To analyze the changes of celluar and humoral immunity in children with juvenile idiopathic arthritis(JIA),as well as the changes in different subtypes,and to investigate the role of cellular and humoral immunity in the pathogenesis of JIA.Methods Ninety-two JIA subjects and 82 controls(healthy children) were included into this study.The levels of T lymphocyte subsets,natural killer (NK)cells,and B cells were analyzed by using flow cytometry.The serum interleukin-1 (IL-1),tumor necrosis factor-α (TNF-α),interleukin-l0 (IL-10),transforming growth factor-β(TGF-β) levels were detected by using enzyme-linked imnmunosorbent assay (ELISA).The serum IgG,IgM,IgA and C3,C4 levels were detected by using velocity scatter turbidimetry.Independent t-test,One-Way ANOVA test and Pearson analysis were adopted for data analysis.Results 1.In the group of JIA,the levels of CD3,CD4,IL-1,TNF-α,IgG,IgM,IgA and C3 were higher than those in the control group(all P ＜ 0.05),while the levels of CD4CD25,CD8,NK cells,IL-10 and TGF-β were lower than those in the control group(all P ＜0.05),and the ratio of CD4/CD8 was higher than that in the control group (P ＜ 0.05).2.In the group of systemic-onset JIA (so-JIA),the levels of CD4,IL-1,TGF-β,IgG,IgM,IgA,C3 and the ratio of CD4/CD8 were higher than those in the oligoarthritis JIA group(all P ＜ 0.05),while the levels of CD4CD25,CD8,IL-10 were lower than those in the oligoarthritis JIA group(all P ＜ 0.05).In the group of polyarthritis JIA,the levels of IL-1,TNF-α,IgG,IgM and IgA were higher than those in the oligoarthritis JIA group(all P ＜0.05),while the levels of CD4CD25,CD8,IL-10 were lower than those in the oligoarthritis JIA group (all P ＜ 0.05) ; In the group of so-JIA,the levels of CD4,TGF-β,C3 and C4 were higher than those in the polyarthritis JIA group (all P ＜ 0.05).3.The value of IL-1,TNF-α were positively correlated with that of C-reactive protein (CRP),erythrocyte sedimentation rate(ESR) in the JIA group(all P ＜ 0.05),while the value of IL-10,TGF-β was negatively correlated with that of CRP,ESR(all P ＜ 0.05).Conclusions There are cellular immunity and humoral immunity disorders in the JIA.Cellular immunity and humoral immunity are all involved in the pathogenesis of JIA.T helper cells are activated and Th1 cytokines increase,suppressive T cells,regulatory T cells impairment and suppressive cytokines decrease but immunoglobin increase,which involve in auto inflammation reaction and articular destruction in JIA.The immunity disturbances are more striking in so-JIA and polyarthritis JIA.IL-1,TNF-α,IL-10 and TGF-β are correlated with the disease activity.

Background and purpose:Physical and psychological trauma has been a challenge for both clinician and patients with breast cancer after modified radical mastectomy,and now more and more patients have begun to accept breast reconstruction,especially Ⅰ stage reconstruction after surgery.The aim of our study was to investigate a breast reconstruction procedure that can not only achieve radical tumor excision but also retain the aesthetic appearance of breast.Methods:15 patients from January 2006 to April 2007 were enrolled with early stage breast cancer have received surgical treatment with conservation of breast skin,breast tissue excision and axillary lymph nodes;latissimus dorsi muscle flap has been used for breast reconstruction.Results:The results of the 15 cases:excellent in 11 cases(83.3%),good in four cases(16.7%).Conclusions:Immediate breast reconstruction after radical mastectomy with conservation of skin has shown good results in terms of aesthetic appearance of breast,this procedure has been proved to be a safe and feasible method of treatment for the patients with early stage breast cancer.

Objective To observe the changes in red cell distribution width (RDW)and plasma N -terminal pro -brain natriuretic peptide(NT -proBNP)in children with chronic heart failure due to congenital heart disease (CHD),and to investigate their correlations with cardiac function.Methods Eighty -four children with chronic heart failure and pneumonia secondary to CHD who were hospitalized in Wuhan Health Care Center for Women and Children from January to December 201 4 were enrolled.According to the modified Ross scoring system,they were divided into 3 subgroups:mild,moderate and severe heart failure subgroups.Forty -five children with pneumonia who were hospitali-zed during the same period were randomly selected as the control group.Then the levels of RDW and plasma NT -proBNP were compared in each group,and the correlation between RDW and NT -proBNP was analyzed.Results The levels of RDW and plasma NT -proBNP in children with heart failure caused by CHD were significantly higher than those of the control group[(1 5.6 ±2.2)% vs (1 3.7 ±1 .5)%,(3 252.9 ±1 061 .5)ng/L vs (67.4 ±1 7.9)ng/L, t =5.51 8,7.838,all P <0.01 ].NT -proBNP levels were gradually increased along with increasing heart failure grade, and there were statistically significant differences[(1 71 8.3 ±456.2)ng/L vs (3 371 .4 ±834.2)ng/L vs (4 681 .2 ± 1 21 4.8)ng/L,F =1 5.961 ,P <0.01 ].RDW levels also increased gradually,while there were no statistically signifi-cant differences[(1 5.2 ±1 .5)% vs (1 5.7 ±2.0)% vs (1 6.0 ±2.8)%,F =2.246,P >0.05].There was no signifi-cant correlation between RDMand NT -proBNP (r =0.1 34,P >0.05).Conclusions For children with CHD,higher RDW and NT -proBNP levels can aid in the diagnosis of chronic heart failure,and NT -proBNP level is associated with the severity of heart failure,yet it is still unclear whether RDW level can reflect the severity of heart failure.

Objective To discuss the mechanism of obesity related glomerularpathology,we detect the expression of Podocin in glomerular podocytes of obesity rats induced by high fat diet.Methods The rats were divided into 2 groups:normal control group(Con group) and obesity group(Ob group).At the 14th week of molding,the body weight,body long,tail long,kidney weight,uria microalbumin,RBP,uria Cre,blood glucose,cholesterol,triglyceride,HDL-C,UA,Cre,BUN,and insulin were measured.The Lee's index,insulin resistance index,insulin sensitive index,Ccr and relative kidney weight were calculated.The tissue structures of the kidney of both groups were studied under light microscope and transmission electro microscope.The expression of Podocin in podocyte of rats' kidney was measured by immunohistochemistry and western blot.Results ①The difference had no statistical significance between the 2 groups in gender,weight,body length,tail length and Lee's index at the beginning (P ＞ 0.05).But after 14 weeks,the weight,body length and Lee's index of Ob group were significantly higher than those of Con group(P ＜0.05).②At the 14th week,the fasting plasma glucose of Ob group was higher than that of Con group (P ＜ 0.05),and the high density lipoproteins (HDL) of Ob group was lower than that of Con group(P ＜ 0.05).However,the difference had no statistical significance in urine acid (UA),serum Cre and blood urea nitrogen (BUN) between the 2 groups (P ＞ 0.05).③The urine protein and endogenous creatinine clearance rate(Ccr) in Ob group were higher than those of Con group (P ＜ 0.05,P ＜0.01).④The relative kidney weight of Ob group was lower than that of Con group(P ＜ 0.05).⑤For rats in Ob group,glomerular hypertrophy,the Bowman' capsule stricture,abnormality in the segmental capillary wall and extraglomerular mesangial cell were observed under light microscope.The glomerular podocytes became broader and foot process of podocyte in Ob group became microvillus-like in Ob group under transmission electro microscope.⑥Immunohistochemistry and western blot showed that the expression of Podocin in podocyte of kidney decreased in Ob group.Conclusions The expression of Podocin decreased in podocyte of kidney in obesity rats.At the same time,the ultrastructure of podocytes was changed.Those may be one of the reasons for protein urine related to obesity.

Objective To investigate the levels of monocyte chemoattractant protein-1(MCP-1)in the bladder tissue and urine of female interstitial cystitis(IC)patients. Methods Thirty-five IC patients according tO the NIDDK IC diagnosis standard,20 urinary infection (UI) patients and 25 asymptomatic controls were collected.All IC patients were accepted 24 hour voiding diaries,O'LearySant IC Questionnaires,potassium sensitivity test (PST) and cystoscopy under anesthetic.RT-PCR and ELISA analyses were used to determine the levels of MCP-1 in the bladder tissue and urine specimens from women with IC、UI and controls.Immunohistochemistry staining was used to observe the distribution of MCP-1 in bladder tissue of IC. Results Urine MCP-1 was (74.1±36.9)pg/ml in IC patients,(280.65±68.9)pg/ml in UI patients and(10.8±6.9)pg/ml in asymptomatic controls(P＜0.01).Tissue MCP-1 was 76.2±24.0 in IC patients,99.5±30.1 in UI patients and 36.1±14.1 in asymptomatic controls(P＜0.01)by RT-PCR analyses.The MCP-1 degree increased in IC patients was between UI patients and asyrnptomatie controls.The severity of IC clinical symptom Was correlated with MCP1 levels. Conclusions The changes in the levels of MCP-1 are associated with IC.After excluding urinary infection,it would be useful for early diagnosis of IC by increased level of MCP-1.