ObjectiveTo observe the influence of lipopolysaccharide (LPS) on collagen metabolism of normal human skin fibroblasts and its biological role in the formation of hypertrophic scar.Methods Fibroblasts were isolated and cultured in vitro,and then exposed to different doses of LPS (0.005,0.01,0.05,0.1,0.5,1.0 μg/ml) from E.coli.055:B5 respectively.The expression of proccllagen type Ⅰ,Ⅲand collagenase mRNAs was tested by RT -PCR.Fibroblasts from hypertrophic scar tissue obtained from the same patients in the same culture passage were used as control.ResultsCompared with control group,the expression of procollagen typeⅠ,Ⅲ mRNAs in normal skin fibroblasts increased (0.323 ± 0.041,0.303 ± 0.063,0.391 ± 0.071,0.344 ± 0.086,0.488 ± 0.059,0.401 ± 0.087,0.616 ± 0.107,0.434 ±0.084,0.823 ±0.092,0.542 ± 0.082),while the expression of collagenase mRNAs of normal skin fibroblasts depressed(0.598 ± 0.068,0.556 ± 0.049,0.441 ± 0.043,0.372 ± 0.083,0.260 ± 0.027 ).When LPS was set to the concentration of 0.005 μg/ml,it showed a concentration dependent manner.However,when the concentration of LPS was set to 0.5 μg/ml,the expression of procollagen type Ⅰ,Ⅲ and collagenase mRNAs of normal skin fibroblasts began to decrease (0.451 ± 0.063,0.374 ± 0.072,0.360 ± 0.062).When the concentration of LPS was set to 1.0 μg/ml,the expression of procollagen type Ⅰ,Ⅲ mRNAs (0.162 ± 0.025,0.171 ± 0.061 )were inhibited and the expression of collagenase mRNAs began to increase (0.444 ±0.114).When the concentration of LPS was set to 0.1 μg/ml,the expression of procollagen type Ⅰ,Ⅲ and collagenase mRNAs of normal skin fibroblasts(0.823 ±0.092,0.542 ±0.082,0.260 ±0.027)was similar to that of hypertrophic scar tissue fibroblasts(0.829 ±0.049,0.569 ±0.038,0.277 ±0.059).ConclusionsThis result supported that LPS may be an important factor in collagen metabolism of normal skin fibroblasts and it plays an important role in hypertrophic scar formation.

Objective To analyse CT and DSA appearances of intrahepatic cholangiocarcinoma,and to improve understanding of intrahepatic cholangiocarcinoma.Methods Plain and enhanced CT scanning were performed in 17 patients with intrahepatic cholangiocarcinoma pathollogically proved,6 patients(6/17) performed dynamic CT scanning,5 performed DSA examinations.Results Pre-contrast CT scanning was a single low density lesions in all patients,post-contrast CT scanning showed slightly inhomogeneous enhancement in 17 patients,3 patients(3/17) showed low density unenhancement area with margin enhancement,2 patients delayed enhancement;Intrahepatic billary delatation was found in 15 patients and was within the lesion in 10 patients(10/15);On DSA,5 patients showed enlaragement increasment and rigidity of supplying arteries and tumour stain.Conclusion CT scanning and DSA were important,investigative methods for intrahepatic cholangiocarcinoma,the billary dilatations with slightly inhomogeneous enhancement lesions is important sign in diagnosising intrahepatic cholangiocarcinoma.

Objective To analyze MSCT characteristics of septic pulmonary embolism (SPE) caused by intravenous drug and to improve diagnosis. Methods The MSCT findings of 16 patients of SPE induced by intravenous drug were analyzed retrospectively from March, 2001 to September, 2008. Results Peripheral or sub-pleural zones were commonly affected mainly within upper lung. Patchy, nodular and cavity shadows were detected respectively in 9 (56.25%), 12 (75.00%) and 8 patients (50.00%), while pulmonary cysts in 14 patients (87.50%). Six patients underwent CTPA, and pulmonary arteries filling defect was found in 2 patients. Pleural effusion and pneumothorax were also found in 10 and 3 patients, respectively, whereas miscellaneously shaped lesions were deteced in all 16 patients. Conclusion MSCT is an important method for diagnosing SPE caused by intravenous drug abuse. Pulmonary arteries filling defect is the direct sign and the cysts and nodular shadow with or without cavity in peripheral or sub-pleural pulmonary zones are characteristic findings.

Objective To summarize the MSCT signs and the key points of differential diagnosis of sclerosing mesenteritises (SM) which were misdiagnosed by clinical and CT,to reduce the misdiagnosis rate.Methods Clinical and MSCT data of 23 misdiagnosed SM patients were analyzed retrospectively.The misdiagnosed diseases,misdiagnosed causes,and differential diagnosis were analyzed.Results SM were mainly misdiagnosed as tumor and infective inflammation.The main causes of misdiagnosis and differential diagnostic features were listed as follows.(1)SM didn't have specific clinical manifestations.(2)The density of the adipose tissue in mesentery increasedmisty mesentery.A clear demarcation between the lesion and the surrounding normal fatty tissue could be differentiated from infective inflammation.(3)The mass-like false capsule had space-occupying effect of displacement of the surrounding structures.However, the blood vessels were encapsulated by the mass-like false capsule with fat ring around, which could be differentiated from fat-containing tumors.(4)The soft mass was formed at the root of the mesentery.The fat halo sign and mild enhancement of the mass can be differentiated from lymphoma and carcinoid.Conclusion SM is easily misdiagnosed both in clinical practice and medical imaging.Recognition of differential diagnostic features of MSCT can reduce the misdiagnosis rate.

Objective To investigate the relationship between the expression of KAI1 mRNA and the clinicopathological parameters and prognostic outcome of patients with gastric Callcer. Methods The expressions of KAI1 mRNA in 70 samples of gastric cancer tissue and 18 samples of benign gastric lesion were detected by in situ hybridization.Results The positive rates of KAI1 mRNA expression in benign gastric lesion and gastric cancer tissue were 94%(17/18)and 31%(22/70),respectively.The expression of KAI1 mRNA was influenced by tumor difierentiation degree and the state of lymph node metastasis.The positive rate of KAI1 mRNA expression was gradually decreased as the increase of invasion depth and the tumor clinical stages.The 5-year survival rate of patients with positive expression of KAI1 mRNA WaS higher than these with negative expression of KAI1 mRNA.Conclmions The less and down-regulation of KAI1 gene expression may be involved in the occurrence and development of gastric cancer.KAI1 gene might be a valuable indicator for early diagnosis and predicting the malignancy and metastasis potential of gastric cancer and the prognosis of patients with gastric cancer.

Objective To observe the application of the mini-mental status examination (MMSE)cognitive assessment in the patients with brain glioma before and after surgery. Methods Using MMSE,36 pastients with primary brain glioma were subjected to the cognitive assessment before surgery, after surgery,and 3 monthsr after surgery. Results The quantitative cognitive assessments with MMSE before surgery revealed the hidden cognitive dysfunction patients.The quantitative cognitive assessments after surgery showed that surgeons might need to protect the non-function area and to form the idea of cognitive function in patients with glioma.Conclusion MMSE assessment is a simple,understandably,and convenient method having good compliance of patient. It may be effectively used to assess cognitive impairment for patients with glioma and worth being studied continuously and used widely in the clinic practice.

This paper is to introduce our experiences in treating 2 batches of 13 burn victims transferred from remote areas on postburn days 3 and 4. Methods Thirteen burn victims of 2 mass casualties were transferred to our burns institute from remote areas on postburn days 3 and 4 on June 27, 2001 and June 2, 2002, respectively. There were 4 males and 9 females, age ranged from 20 to 43 years, with a mean age of 31.1±6.2 years. The mean total burn area was 74.3%±24.7% TBSA (range, 25% to 97%). Among them, 10 patients suffered from serious burn with mean total burn area involving 86.0%±11.5% TBSA (range, 60% to 97%), and mean full-thickness burn of 63.9%±26.3% TBSA. Four patients also manifested signs of severe inhalation injury, and 6 patients with moderate inhalation injury. In three patients with mean total burn area covering 35.5%±10.0% TBSA (range, 25% to 45%), with mean full-thickness burn of 15.3%±5.0%, were al having moderate inhalation injuries. Among these 13 patients, 3 were having high body temperature (39℃), while 3 manifested hypothermia. The heart rate was 140-160/min, and respiratory rate 26 to 32/min in 6 patients. Abdominal distension or loss of bowel sound were found in 4 patients. Low white cell and platelet count were found in some patients. In 13 cases, liver function, renal function, myocardiac enzyme, and coagulation function were abnormal. Results Among 13 burn victims, one patient died of myocarditis on postburn day 29, and another one died of hepatic failure (history of chronic hepatitis B) on postburn day 45 with only 2% TBSA of burn wound remained open. Conclusion Burns victims occurred in mass casualties who were transferred from remote areas to our Burns Institute were all in critical condition, usually with multiple complications, demanding most meticulous care. Our strategies in this regard consisted of dispatch of experienced surgeons and nurses to the referring hospitals and the airport to receive the patients to offer appropriate care to them during the journey,organization of the medical staff so that each of them was ordained specific function, thus conditions of the patients were evaluated immediately and appropriate treatment started expeditiously for those lethal complications on arrival. Timely and exact comprehensive treatments were prerequisite to save the patients’ life. Adequate metabolic support should be emphasized, and coagulant of anticoagulant treatment should be carried out when indicated.

Objective To assess the efficacy and safety of 100 mg or 200 mg yimitasvir phosphate combined with sofosbuvir in patients with non-cirrhotic chronic hepatitis C virus ( HCV) genotype 1 infection who were treatment-na?ve or had a virologic failure to prior interferon-based treatment.Methods A multicenter, randomized, open-label, phase 2 clinical trial was conducted.The patients were randomly assigned to yimitasvir phosphate 100 mg+sofosbuvir 400 mg group (Group 100 mg) and yimitasvir phosphate 200 mg+sofosbuvir 400 mg group ( Group 200 mg) in a 1∶1 ratio with the stratified factors of " treatment-naive" or"treatment-experienced" for 12 weeks and followed up for 24 weeks after the end of treatment.During the clinical trial, HCV RNA was tested in all patients.Resistance of virus in patients who didn′t achieved sustained virological response (SVR) was monitored.Safety and tolerability were assessed by monitoring adverse events , physical examination , laboratory examination, electrocardiogram, and vital signs during the study.The primary end point was SVR12 after the end of therapy.Descriptive statistics were used for categorical variables and eight descriptive statistics were used for continuous variables.Descriptive statistics were used and summarized according to HCV genotypes and treatment groups.Safety data were presented using descriptive statistics and summarized according to treatment groups.Results A total of 174 subjects were screened from July 31, 2017 to September 26, 2018.One hundred and twenty-nine patients were successfully enrolled and received treatment , and 127 completed the study.There were 64 patients and 65 patients assigned to Group 100 mg and Group 200 mg, respectively.Among the 129 patients who underwent randomization and were treated , 18.6% were treatment-experienced and: 100%were HCV genotype 1b infection.The total SVR rate was 98.4%(127／129), with 98.4%(63／64, 95%confidence interval [CI]: 91.60%-99.96%) in the Group 100 mg, and 98.50%(64／65, 95%CI: 91.72%-99.96%) in the Group 200 mg.There was no significant difference between the two groups (χ2 ＝0.000 2, P＝0.989 2).The SVR rates in treatment-naive group and treatment-experienced group were 98.10%(95%CI: 93.29%-99.77%) and 100.00%(24／24, 95%CI: 85.75%-100.00%), respectively.Virological failure during treatment ( including breakthrough , rebound and poor efficacy) and relapse after treatment did not occur during the trial.By Sanger sequencing , 11.6%(15／129) patients had baseline NS5A Y93H／Y or Y93H resistance-associated substitutions ( RAS), 1.6%( 2／129) patients had baseline NS5A L31M RAS.No mutation was observed in NS5B S282 at baseline.There was no S282 mutation in HCV NS5B.A total of 100 (77.5%) subjects had adverse events.No adverse events ≥Grade 3 or severe adverse events related to the study treatment.No patient prematurely discontinued study treatment owing to an adverse event.No life-threatening adverse event was reported.Conclusion Twelve weeks of yimitasvir phosphate 100 mg or 200 mg combined with sofosbuvir 400 mg daily is a highly effective and safe regimen for patients without cirrhosis with HCV genotype 1b infection who had not been treated previously or had a virologic failure to prior interferon-based treatment.

Objective:To establish a three-level clinical grade human umbilical cord mesenchymal stem cells (hUC-MSCs) bank, including seed cell bank (SCB), master cell bank (MCB) and working cell bank (WCB), and provide hUC-MSCs with controllable quality for clinical research and application.Methods:247 human umbilical cord tissues were isolated, cultured, amplified, subcultured and frozen in GMP laboratory, and the biological characteristics, safety and stability of hUC-MSCs were tested in accordance with the requirements of relevant quality management control specifications.Results:247 strains of hUC-MSCs were isolated and prepared. The prepared hUC-MSCs have good purity and homogeneity without tumorigenicity, show good differentiation ability in biological efficacy, and have strong immunosuppressive effect in the process of co-culture with immune cells. These cells have passed the quality check of National Institute for Food and Drug Control. In this study, a three-level hUC-MSCs bank was established, and it was included into the National Stem Cell Translational Resource Center.Conclusions:A three-level clinical hUC-MSCs bank was successfully established and preliminarily applied to clinical research, which effectively promoted the standardized development of clinical stem cell resource bank and the clinical transformation and application of stem cells in China.