Objective To investigate the expression and clinical significance of peroxisome proliferator activated receptor γ(PPARγ)in bladder urothelial cancer tissues.Methods Parafflin‐embeded specimen of bladder urothelial cancer tissues from 50 cases and normal tissues near the bladder urothelial cancer from 5 cases were harvested from the Pathology Department of the Renmin Hospital of Wuhan University between 2006 and 2009.Those cases had complete pathological and clinical data.The ex‐pression of PPARγ was detected by immunohistochemical SP method.Quantitative analysis of the PPARγ was measured by high definition pathological graphics context report system (HPIAS‐1000).One‐way analysis of variance and SNK (q)tests were used to analyze the mean density and the positive area rate of the immunohistochemical results.All data were processed by SPSS 13.0.Results The expression of PPARγwas significantly higher in bladder urothelial cancer tissues than in para‐carcinoma tis‐sues(P<0.05).Correlation between expression of PPARγ with TNM stag of bladder urothelial cancer was as follows :Positive rate of PPARγin the tissues with primary tumor size ≥3 cm was 72.4% ,significantly higher than 33.3% in the tissues with tumor size <3 cm(P<0.05);positive rate of PPARγin the cases with lymph node metastasis was 72.7% ,significantly higher than 46.4% in the cases without lymph node metastasis(P<0.05);positive rate of PPARγin patients at stage T3‐4 group was 75.0% ,significantly higher than 41.9% and 45.5% in patients at clinical stage T1 and T2(P<0.05);positive rate of PPARγin patients with poor differentiation was 68.2% ,significantly higher than 42.9% in patients with high or middle differentiation group(P<0.05).Conclusion PPARγ plays an important regulating role in the onset and progress of bladder urothelial cancer ;PPARγexpression level was correlated with primary tumor size ,pathological types and differentiation degree ,lymph node me‐tastasis and clinical stage.This result suggested that PPARγ was closely correlated to metastasis of bladder urothelial cancer.

Objective To analyze the plasty of the tip framework and the nasal tip in insufficient-lining cases with auricular and septal cartilage.Methods The tip framework was formed by using septal extension graft (SEG) and columellar strut (CS) to construct the main framework of nasal tip,and then according to the size of the graft the next processes were chosen for supporting structure.When the graft size met the tip position,the caudal margin of the framework could be beyond the maximum stretch position of the lower lateral cartilage and reached or was close to the expected tip position.When the graft size was insufficient,auricular cartilage was used to hold the caudal margin of the framework to extend or to heighten the framework further.Refined plasty of nasal tip was as follows:when the end of framework was higher than or equal to the dome above 3 mm,auricular cartilage strip was used to reconstruct the dome;when less than 3 mm,multilayer onlay grafts were used to heighten the dome.Results From May 2013 to May 2015,42 cases were followed up from 6 months to 18 months.18 cases belonged to the type 1,including 13 cases using ear cartilage to reconstruct dome,5 cases using onlay graft;24 cases belonged to the type 2,including 14 cases using onlay graft and 10 cases using ear cartilage to reconstruct the dome.They all got good results.Conclusions To the insufficient lining cases,the appropriate method can be chosen to form stable tip framework according to the preoperative design and the graft size.Then onlay grafts or dome reconstruction technique is used to form the tip.Most of the insufficient-lining cases can get satisfactory results.

Objective To analyze the clinical characteristics of Hashimoto's disease(HD) accompanying with thyroid cancer,and to explore the experience of diagnosis and treatment.Methods Clinical data of 41 cases of HD accompanying with thyroid cancer were retrospectively analyzed.The patients were diagnosed by postoperative paraffin pathological examination from Jan.2002 to July 2011.Results 10 cases of HD,37cases of thyroid cancer,and 8 cases HD accompanying with thyroid cancer were diagnosed before operation.The rate of preoperative diagnosis was only 19.51％.All patients underwent surgical treatment,including 22 cases total thyroidectomy,14 cases subtotal thyroidectomy,and 5 cases lesion side lobe resection.24 cases underwent ipsilateral neck dissection,and 4 cases underwent bilateral neck dissection (ipsilateral radical resection,contralateral selective resection).Postoperative paraffin pathological examination proved that there were 39 cases of HD accompanying with thyroid cancer,1 case of focal cancer and 1 case of B-cell lymphoma of mucosa-associated thyroid.All patients were followed up.Conclusions The preoperative diagnosis rate of HD accompanying with thyroid cancer is low and great attention should be paid to its diagnosis.For HD patients,if carcinoma can not be excluded,surgical exploration is recommended.Appropriate surgical method should be chosen according to intraoperative frozen section results.Postoperative thyroid hormone treatment is usually taken.

Objective To investigate the ultrastructural characteristics of amelanotic melanocytes (AMMCs). Methods Individual hair follicles from normal human scalp were digested with collagenase type V, then washed in phosphate buffer saline. Hair-follicle cell suspensions were prepared by trypsin and cultured in a medium suitable for melanocyte growth. The keratinocytes were removed by differential trypsinization. Geneticin (100?g/mL) was used to eliminate contaminating fibroblasts. After 3 passages the cells were trypsinized, washed in phosphate buffer saline, and finally processed for transmission electron microscopy. Results Under transmission electron microscope, the cultured cells were round or oval-shaped with a single large nucleus and double-layered karyotheca. Abundant euchromosome but sparse heterochromosome was observed within the nucleus. There were various organelles in the cytoplasm, including mitochondria, rough endoplasmic reticulum (RER), ribosomes and abundant melanosomes of nearly uniform size. The electronic density granules distributed in a concentric pattern in most of the melanosomes. Colgi complexes were inconspicuous in the cells. Conclusions Compared to epidermal melanocytes, AMMCs from human hair follicles have different ultrastructural characteristics which implies their functional immaturity. AMMCs may serve as the depot for mature melanocytes.

Objective To explore the correlation between epicardial adipose tissue(EAT) thickness and cardiovascular risk factors in patients with coronary artery disease.Methods According to the results of coronary angiography,84 cases of patients undergone coronary angiography were divided into the normal control group(28 patients),coronary artery disease group with single-vessel lesion (28 patients),coronary artery disease group with multi-vessels lesion(28 patients),respectively,then measured the EAT thickness and carotid intima-media thickness(IMT) by high-frequency ultrasound.A correlation analysis was carried out between the EAT and IMT and cardiovascular risk factors.Results In either coronary artery disease group with single-vessel lesion or multi-vessels lesion,the thicknesses of EAT and IMT were significantly higher than those in the normal control group(P ＜0.01),and the difference between group of single-vessel lesion and multi-vessels lesion was also statistically significant (P ＜0.01).A correlation analysis between the EAT and IMT and cardiovascular risk factors showed that there were significantly positive correlations between EAT and the IMT,age,weight,waist circumference,body mass index,low-density lipoprotein,Creactive protein (r = 0.124～0.790,P ＜0.05 or P ＜0.01),and the significantly negative correlation between EAT and high-density lipoprotein (r = - 0.203,P ＜ 0.05).Correlation between EAT and the IMT was 0.678,0.713,0.737 in the normal control group,group with single-vessel lesion,group with multivessels lesion,respectively.Conclusions There were favorable correlation between EAT and carotid IMT in cardiovascular risk factors.The more severity of coronary heart disease,the more high correlations of EAT and IMT.EAT can be a valuable index in evaluating coronary artery disease.

Objective To investigate the relationship between acute biliary pancreatitis and pancreaticobiliary maljunction and the role of magnetic resonance cholangiopancreatography(MRCP) in evaluation of pancreatico biliary maljunction.Methods To compare the liver function indicators of different groups of acute biliary pancreatitis patients(153 cases) associated with pancreatico biliary maljunction and without pancreatico biliary maljunction before and after the conservative treatment.Results The 32 acute biliary pancreatitis patients with pancreatico biliary maljunction detected by MRCP were compared with the 121 cases without pancreatico biliary maljunction.The ALT,AST,GGT after conservative treatment in both group of pancreatico biliary maljunction and Npancreatico biliary maljunction were significantly decreased (P ＜ 0.05).ALT,AST and GGT of pancreatico biliary maljunction group were higher than that of Npancreatico biliary maljunction group with statistical significance (P ＜ 0.05).Conclusions MRCP as a noninvasive cholangiopancreatography study of pancreatico biliary maljunction is a safe and reliable examination method,pancreatico biliary maljunction is one of the important causes of acute biliary pancreatitis.

A 54-year-old man diagnosed with chronic lymphocytic leukemia (CLL) was admitted in our department in June 2014. After one cycle of FC chemotherapy, a bone marrow examination revealed normalized lymphocyte count and another acute myeloid leuke-mia (AML)-M5 clone. The patient refused sequential treatment and only received follow-up examination. He had continuous hemato-logically stable disease and died of pulmonary infection on July 2015. After a multidisciplinary team discussion, we confirmed the si-multaneous diagnosis of CLL and AML-M5. Through this discussion,tumor second hit model,tumor evolution model,andtumor heterogeneitywere further defined.

Objective To compare the efficacy and complications of percutaneous nephroscope decortication of cystic renal disease with transureteroscopic decompression of cystic renal disease.Methods Retrospectively analyze the clinical data of 42 simple renal cyst cases,who under treatment of surgical in Zhongnan Hospital of Wuhan University from Sep.2010 to Sep.2014 via percutaneous nephrolithotomy as well as ureteroscope.There were 21 patients in each group.Comparisons were made between the two groups on operation time,peripheral tissue injury,blood loss,postoperative infection,hospitalzation time.Postoperative recurrence were followed up.Results For the percutaneous nephroscope decortication of cystic renal disease group and transureteroscopic decompression of cystic renal disease group,the operation time were (38.43 ± 9.76) minutes,(28.95 ± 8.67) minutes,the number of tissue injury were 8,6;the blood loss were (28.62 ± 9.82) mL,(23.48 ± 7.65) mL;the number of postoperative infection was 4,10;the postoperative recurrence were 2,5;the hospitalzation time were 2 days and 8 days.Compared with the transureteroscopic decompression group,the percutaneous nephroscope decortication group had a less postoperative infection and fewer postoperative recurrence (P ＜ 0.05).But the operation time was longer in the percutaneous nephroscope decortication group (P ＜ 0.05).Conclusions The therapeutic effect of percutaneous nephroscope decortication is much better than that of transureteroscopic decompression,but also has a little disadvantage.

Objective:To find the possible mechanisms of endovascular radiation in the prevention of restenosis in rabbits following carotid endarterectomy and to observe the dose effect relationship.Methods:Twenty four rabbits were randomly divided into three groups following carotid endarterectomy (each n=8) and were allocated to receive a radiation dose of 0,10,20Gy( 32 P)respectively.Changes in the levels of plasma nitric oxide(NO) and endothelin 1(ET 1)were measured 3 day before operation and 3,7,14,28 day after operation.Results:The plasma NO was markedly increased and ET 1 was markedly decreased in endovascular radiation groups compared to control groups.The results were similar in the two groups(10Gy versus 20Gy).Conclusion:The endovascular radiation may inhibit smooth muscle cell proliferation and migration,and thus prevent restenosis by increasing NO and decreasing the level of ET 1.Changes of the levels of plasma NO and ET 1 is a practicable methods to detect the effect of therapy.

Objective To evaluate the value of lung ultrasound score (LUS) in the quantitative assessment of the severity of neonatal respiratory distress syndrome (NRDS) and the value of clinical diagnosis and treatment.Methods Totally 74 NRDS cases and 30 normal neonates were studied.LUS was compared with X-ray examination,clinical data,ventilator assisted ventilation and ventilator parameters.ROC curve was used to calculate sensitivity and specificity of LUS to predict the severity of NRDS and application of invasive ventilator treatment.Results The main findings of the lung ultrasound in NRDS included diffuse distribution of dense B line,disappeared A line,pleural line abnormalities,decreased pulmonary slip sign and pulmonary consolidation.LUS in patients with NRDS was significantly correlated with X ray grades,clinical grades,assisted ventilation mode grades,number of days on ventilator and ventilator parameters (all P＜0.05).LUS value to predict mild,moderate and severe NRDS were 13.0,22.5,and 29.5,respectively.The best cutoff point for LUS to predict the adoptation of invasive assisted ventilation was 22.5,which had sensitivity of 86.0 ％ and specificity of 64.5 ％.Conclusion LUS can be used to diagnose and evaluate the severity of the desease,and to guide the clinical diagnosis and treatment.