Hemophagocytic lymphohistiocytosis (HLH) is characterized by hemophagocytosis and a reactive process resulting from prolonged and excessive activation of antigen presenting cells (macrophages,histiocytes) and CD8+ T cells.The majority of genetic causes identified to date affect the cytotoxic function of NK and T cells,crippling immunologic mechanisms that mediate natural immune contraction.The predominant clinical findings of HLH are fevers (often hectic and persistent),cytopenias,hepatitis and splenomegaly.Due to the life-threatening implications of the diagnosis of genetically determined HLH,antiinflammatory therapy,often consisting of steroids,etoposide or antithymocyte globulin,should be instituted promptly,followed by curative hematopoietic cell transplantation.Secondary HLH,associated with autoimmune disorders or viral infections in teens and adults,should control the primary inflammatory.

Objectives To study the impact of initial age of treatment on testicular morphology and function in male pa-tients with multiple pituitary hormone deficiency using human chorionic gonadotropin (hCG) and human menopausal gonadotro-pin (hMG). Methods Patients with multiple pituitary hormone deficiency were treated with hCG and hMG while keeping other hormone levels normal. Correlations among their testicular volume, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and height, bone age were analyzed. Results After 6-month hCG and hMG treatment, the penis length of 54 male patients was significantly increased from (2.58 ± 0.69) cm to (4.19 ± 0.77) cm , and penis circumference was also increased from (3.71 ± 1.36) cm to (5.95 ± 1.26) cm;the testicular volume was increased from (1.76 ± 1.49) ml to (5.20±2.30) ml;height was increased from (147.01 ± 12.29) cm to (151.98 ± 11.52) cm and bone age was increased from (11.22 ± 2.71) years to (11.64 ± 2.72) years;the differences before and after treatment were statistically significant (all P<0.01). As the patients' age increased, their testicular volume and testosterone level increased slowly, and significant differences amongst each age group were found (P<0.05). The in-creased value of testicular volume, serum FSH and LH levels, and height growth tended to be negatively correlated to the initial age of therapy (r=-0.517~-0.334, P<0.05). Conclusions Early and proper treatment in male patients with multiple pituitary hormone deficiency using hCG and hMG improves testicular function and secondary sex characteristics.

BACKGROUND:A variety of cel growth factors are involved in skeletal muscle regeneration; moreover, these factors cooperate with each other to promote muscle repair and regeneration. OBJECTIVE:To explore the synergy mechanism of a variety of cel growth factors in promoting damage repair. METHODS:By using literature survey, Wanfang, CNKI and PubMed databases were searched for articles related to exercise-induced muscle damage and repair using the keywords of “cel growth factor; skeletal muscle damage;repair; fibroblast growth factor” in Chinese and English, respectively. Research achievements related to exercise-induced muscle damage, molecular biological characteristics of cel growth factors and skeletal muscle injury repair are discussed. RESULTS AND CONCLUSION: Basic fibroblast growth factor plays a basic biological role to promote cel proliferation and angiogenesis, which is the strongest cytokine known to promote cel growth and reflects a very important role in skeletal muscle repair. Epidermal growth factor is synthesized by monocytes and ectodermal cels, which is prominent to stimulate the division and proliferation of a variety of tissues and cels, enhance cel movement, division and synthesis of interstitial protein. Insulin-like growth factors are a family of insulin-like growth factor 1-related and insulin-like growth factor 2-related peptides, which can promote muscle protein synthesis, promote muscle cel proliferation and differentiation, and participate in skeletal muscle regeneration and repair, thereby accelerating wound healing of the muscles. Neurotrophic factor is a kind of trace soluble substances around sensory neurons and produced by neuron-targeted cels, which can specificaly promote neuronal growth and maintenance, and promote skeletal muscle repair. But studies on the synergy mechanism of a variety of cel growth factors in the repair of exercise-induced muscle damage are just at the initial stage, and further research is necessary.

Objective To find out whether NOTCH receptors can serve as direct downstream targets of transforming growth factor β(TGF-β)/Smad4 signaling in endothelial cells.Methods Real-time PCR and Western blotting were performed to verify whether the expression of notch1 and notch4 was regulated by TGF-β pathway.Luciferase reporter assay was employed to investigate how the promoter of notch1 and notch4 was regulated by TGF-β.Then, ChIP assay was used confirm whether the promoter of notch1 and notch4 physically interacted with SMAD protein.Results TGF-β1 and bone morphogenetic protein 4 (BMP4) treatment increased the expression of both notch1 and notch4 at the transcriptional level.In addition, SMAD4 was physically associated with the SMAD binding sites on the notch4 promoter, which was largely enhanced under the treatment of TGF-β1 and BMP4.Importantly, TGF-β1 and BMP4 failed to transactivate notch4 in the absence of endogenous SMAD4 or the SMAD binding regions on the notch4 promoter.Conclusion The expression of NOTCH receptor can be directly up-regulated by SMAD4-mediated TGF-β/BMP signaling in cerebrovascular endothelial cells.

Objective To compare the doses of shrsine with the basal insulin of continuous subcutaneous insulin infusion(CSII) and the fluctuation of blood glucose (BG)in patients with diabetes mellitus from CSII to glargine-based multiple dally insulin injections therapy.Methods One hundred and two type 2 diabetic patients achieved ideal glycemia control with CSII,then transferred to slarsine-based multiple daily insulin injections therapy.The doses of glargine with the basal insulin of insulin pump and the flucmarion of BG were compared in type 2 diabetic patients from CSII to shrgine-based multiple daily insulin injecfions therapy.Results When the fasting BG achieved an ideal level,the basal insulin doses of CSII were(0.30±0.11)U/(kg·d),and the doses of ghrgine insulin were(0.28±0.09)U/(kg·d).However,the difference between the two methods was no statistically significant.The mean level of BG of CSII and multipie daily insulin injections was(7.94±1.32)mmol/L and(7.49±1.34)mmol/L respectively,the mean BG levels of two methods were more than their three times sample standard deviation.Conclusion Glargine insulin Callphya similax role in the basal insulin of CSII.

Objective To investigate the expression of 4-hydroxynonenal (4-HNE) in the kidney of diabetic rats and the effect of probucol.Methods The rats were being intraperitoneal injected with STZ (60 mg/kg) to establish diabetic models.Then diabetic rats were randomly divided into diabetic group (group D,n =24),probucol treated group (group P,n =24).Normal rats were taken as control group (group C,n =24).Rats in group P were treated by probucol (110 mg·kg-1·d-1); rats in group D and group C were given equal volume water instead.Scr,BUN,triglyceride (TG),total cholesterol (TC) and 24-hour urinary proteinin were measured at the 4th,8th and 12th week.PAS staining and HE staining were used to evaluate the pathological changes of the kidney.The immunohistochemistry and Western blotting were used to detect the expression of 4-HNE in renal tissue.Results Levels of Scr,BUN,TG,TC and 24-hour urinary protein in group D were higher than those in group C at the 4th,8th and 12th week(all P ＜ 0.05); Levels of Scr,BUN,TG,TC and 24-huor urinary protein in group P were lower than those in group D at 4th,8th and 12th week (all P ＜ 0.05).The pathological changes of the kidney in group D were more serious than that in group P.The expression of 4-HNE in group D were higher than group C at the 4th,8th and 12th week (all P ＜ 0.05);The expression of 4-HNE in the kidneys of group P decreased significantly compared to that of group D at the same time (P ＜ 0.05).Conclusions As an indicator of lipid peroxidation,the expression of 4-HNE significantly increases in the kidney of diabetic rat.Probucol may protect the diabetic kidney through decreasing the expression of 4-HNE and the level of lipid peroxidation.

Objective To further study the value of MR T2WI fat saturation sequence in acute Spinal Trauma. Methods 109 cases of acute Spinal Trauma underwent MR imaging were analysed retrospectively. The detection rate of lesions with bone marrow edema, Vertebral fracture and spinal cord injury was compared in T2WI and FS T2WI. Results FS T2WI could detect more lesions of obscure fracture and bone marrow edema than that in T2WI,and it could accurately show the extent and the feature of anatomic structure in acute injury of bone. Conclusion FS T2WI can improve the diagnostic sensition and accuracy in Spinal Trauma, and it should be used as a routine MR sequence for detecting Spinal Trauma.

Objective To study the imaging features of Scheuermann disease and compare the value of MRI, X-Ray and CT images in diagnosis of this disease. Methods The images of 14 Scheuermann disease patients were analyzed retrospectively. Results The pathological changed vertebraes have wedge-shaped changes in different degree. The edges of the vertebraes manifest roughness and have become step-shaped, or Schmorl′s nodes were demonstrated. Conclusion The multi-vertebraes wedge-shaped changes and the Schmorl′s nodes are the main imaging features of Scheuermann disease. The pathological change occurs in the different spine segments, and the imaging features are not completely same. X-Ray and MRI images are more important in diagnosis of this disease. MRI Multi-direction imaging displays clearly the Schmorl′s nodes, marrow dropsy, the fat accumulation and the intervertebral disc denaturation. What′s more important is that MRI has its own superiority in the differential diagnosis of this disease.

Objective:To investigate the expression of protein arginine methyltransferase 5 (PRMT5)in the gastric cancer tissue,and to explore the relationship between the PRMT5 expression and the occurrence and the clinicopathologic characteristics of gastric cancer, and to find a new treatment target for gastric cancer.Methods:Forty-three cases of gastric cancer tissue and 15 cases of adjacent normal gastric tissue were used as gastric cancer group and control group,respectively.The immunohistochemical staining was used to detect the expression of PRMT5 in the specimens.Results:Compared with control group (13.3%),the expression rate of PRMT5 in gastric cancer group (72.1%)was significantly increased (P < 0.05).In control group,there was some weak positive expression of PRMT5,the expressions were weak or moderate,the tan particles mainly located in the cytoplasm,less in the nuclei.In high differentiation gastric cancer specimens,the tan particles mainly located in the cytoplasm and more in nuclei, characterized by medium or strong expressions. In poorly differentiated and undifferentiated gastric cancer specimens,the tan particles mainly located in the cytoplasm and nucleus,and strongly expressed in nucleus.The higher expression of PRMT5 was associated with the size of tumor diameter,degree of differentition,depth of invasion,degree of lymph node metastasis,and TNM stage (P <0.05 or P <0.01),but had no correlation with the gender and age of patients (P >0.05).Conclusion:High expression of PRMT5 may play an important role in the occurrence and development of gastric cancer.

Objective To study the prevalence of toenail onychomycosis in the patients with diabetes mel-litus. Methods The incidence and predisposing factors of onychomycosis were studied in the in- and out-patients with diabetes mellitus(n = 456). The data were also compared with non-diabetic patients (control group, n = 350). Results The prevalence rates of toenail onychomycosis were 20.8% and 9.4% in the diabetics and control group, respectively, with statistical difference (P