This article reviews the recent achievements in parasitology including new diagnostic techniques,molecular mechanism of parasitic pathogenesis,drug resistance,antigenic variation,parasite genomics and proteomics. The perspective development in the area is also discussed.

Objective To search the surgical methods of esophageal carcinoma complicated with cicatricial pyloric obstruction .Methods 18 cases were treated with resection. Among the resections,16 cases underwent resection of esophageal carcinoma esophago-gastrostomy above aortic arch in chest plus gastro-jejunum anastomosis ;2 cases treatment with resection of esophageal carcinoma plus esophago-gastretomy above aortic arch in chest combined with pyloroplasty.Results Of 18 cases ,cure rate was 100%.No severe complications were occurred in the procedure. Conclusion Surgical operation is safe , applicable and effective in treatment of esophageal carcinoma complicated with cicatricial pyloric obstruction.

Objective:To explore the relationship between arrival time and the retention in emergency room and the prognosis in patients with severe trauma.Methods:The clinical data of 1 738 emergency trauma patients in emergency intensive care from trauma center information system of the First Affiliated Hospital of Soochow University were extracted. The emergency retention was the time in the emergency room ≥ 4 h. The 24 h of the day was divided into three shifts at 8:00, 15:00 and 22:00. Logistic regression model was used to calculate the crude OR and adjusted OR after adjustment by age, sex and RTS of emergency shifts, and COX regression analysis was performed with emergency death as the endpoint. Results:Among the total of 1 738 patients with severe trauma, there were 852 (49.02%) cases of emergency retention. Taking the morning shift as the reference baseline, the risks of emergency retention in middle shift and night shift were increased gradually. The OR value of night shift was statistically significant ( P<0.01), and the crude OR and adjusted OR were 2.21 (95% CI: 1.71-2.86) and 2.36 (95% CI: 1.76-3.18), respectively. The univariate COX regression model indicated that the crude HR of night shift was statistically significant ( HR=0.26, 95% CI: 0.08-0.90, P=0.033). However, the multivariate COX regression model showed no statistically significant differences in the adjusted HR of middle shift ( HR=0.96, 95% CI: 0.43-2.14, P=0.914) and night shift ( HR=0.40, 95% CI: 0.08-1.85, P=0.238), respectively. Conclusions:The arrival time of emergency trauma patients might be a contributor to the emergency retention, and night shift patients are more likely to encounter retention, but there is no significant effect on patient death.

Aim To investigate the effects of endogenous and exogenous hydrogen sulfide(H_2S)on the proliferation and apoptosis of human fetal lung fibroblasts.Methods Human fetal lung fibroblasts were cultured under 2% O2～93% N_2～5% CO_2 for 24 h to produce hypoxia.Cells were divided into 6 groups:(1)Hypoxia group(N_2);(2)N_2+600 μmol·L~(-1) NaHS group;(3)N_2+1 200 μmol·L~(-1) NaHS group;(4)N_2+6 400 μmol·L~(-1) NaHS group;(5)N_2+400 μmol·L~(-1) cysteine(Cys)group;(6)N_2+200 μmol·L~(-1) S-adenosyl-L-methionine(SAM)group.After they were cultured for 24 h, MTT assay was used to evaluate the cell proliferation, and flow cytometry was used to detect cell apoptosis.Results Compared with N_2 group, 600 and 1 200 μmol·L ~(-1) NaHS(H_2S donor)significantly reduced proliferation induced by hypoxia of human fetal lung fibroblasts(P <0.01)without effects on apoptotic rates of cells(P >0.05)and 6 400 μmol·L~(-1) NaHS increased apoptosis of human fetal lung fibroblasts during hypoxia significantly(P <0.05), although no effects were found on proliferation of cells(P >0.05).In addition, Cys, substrate of cystathionine β-synthetase(H2S synthase, CBS) or SAM(activator of CBS)did not affect proliferation of human fetal lung fibroblasts induced by hypoxia(P >0.05), whereas apoptotic rates were increased significantly compared with that of N_2 group(P <0.05).Conclusions Endogenous and exogenous hydrogen sulfide can inhibit proliferation induced by hypoxia and promote apoptosis of human fetal lung fibroblasts, suggesting endogenous hydrogen sulfide may play a protective role through lung fibroblasts by inhibiting the pulmonary vascular structural remodeling caused by hypoxia.

Objective To explore the feasibihty of TRAIL to be used to remove the leukemia cells from the autologous hemopoietic stem cell transplants. Methods The expression of decoy receptor 1 and decoy receptor 2 on the bone marrow mononuclear cell were routine-ly isolated and observed by fluorescence microscope after PE-DcR1 or PE-DcR2 stain. The apeptosis rates of mononuclearcell and Jurkat cells interfered by 200ng/ml TRAIL for 18h were determined by flow cytometry after AnnexinV/Pl stain. The interfered mononuclear cells were cultured to count the number to form colony-forming unit-fibroblast(CFU-F). The Jurkat cells labeled by green fluorescent protein were in-corporated into the mononuclear ceils and affected by 200ng/ml TRAIL for 24h. The incorporated cells were cultured in the system with GM-CSF and EPO and the numbers of the CFU-GM, BFU-E and fluorescence colony were counted on the seventh day. Results Both decoy re-ceptor land decoy receptor 2 of TRAIL can be detected on membrane or in cytoplasm of the bone marrow mononuclear cell. The apoptosis rate of mononuclear cell interfered by 200ng/ml TRAIL for 18h was (5.95±1.23)%, which was markedly lower than that of Jurkat cells (33.42±2.28) %. The number of CFU-F of TRAIL group and control group were 235.67 ~ 33.56 and 249.33±42.72, respectively. No marked difference can be found between the mentioned two groups. Moreover, TRAIL decreased the number of fluorescence colony formed by Jurkat cells without significant decreasing the number of CFU-GM and BFU-E formed by bone marrow mononuclear cells. Conclusion TRAIL can selectively induce apoptosis in Jurkat cells without marked toxic effect on the bone marrow mononuclear cells, which means that TRAIL can be used to remove the leukemia cells from the autologous hemopeietic stem cell transplants in vitro.

Objective To explore the diagnosis and treatment of upper limb trauma fracture complicated with deep vein thrombosis ( DVT) during preoperative period. Methods The data of 16 patients with upper limb trauma fractures complicated with DVT was analyzed retrospectively. The methods of diagnosis included color Doppler ultrasonography,multi slice CT angiography ( CTA) ,artery and vein visual-ization of upper limbs,and D-dimer detection. The treatment was majored in thrombolysis by urokinase and anticoagulation by low molecular heparin. Results There were 14 patients with increased levels of D-dimer,8 patients diagnosed by color Doppler ultrasonography,3 patients diagnosed by CTA and 5 by artery and vein visualization. The DVT of 5 patients before operation were disappeared after treatment and cured. Among the 10 patients received operation,8 cases were succeeded and 2 cases complicated with pulmonary embolism,and 1 case was died. Conclusion The color Doppler ultrasonography is the first priority for diagnosis of upper limb trauma fracture complicated with DVT. The patients should be discovered in time and arranged thrombolysis and anticoagulation in early time.

Objective To observe the effects of endoplasmic reticulum stress (ERS) on the activation of monocytes induced by high glucose and explore the underlying mechanism.Methods The monocyte cell line THP-1 was stimulated with high glucose,and then treated with molecular chaperone betaine.The levels of glucose regulation protein 78 (GRP78) and p-JNK,which were associated with ERS were detected by real-time PCR and Western blotting.The proliferation of the cell line was detected by MTT method.Transwell and immunofluorescence were applied to observe the chemotaxis and phenotype of cells respectively.Results The levels of GRP78 and p-JNK of THP-1 cells stimulated by high glucose were significantly increased compared with the normal control group (all P ＜ 0.05).The proliferation and chemotactic were also enhanced (all P ＜ 0.05).The number of cells in M1 phenotype was increased remarkably (P ＜ 0.05).All the indexes above could be rescued by betaine.Conclusion The activation of THP-1 cells can be induced by high glucose through ERS,while molecular chaperone betaine can reverse the activation.

Objective To investigate the chemotherapeaties sensitivity and expression of bcl-2, bcl-xL and bax of Jurkat cells co-cultured with bone marrow stromal cells (BMSC) isolated and cultured from leukemia patients. Methods BMSC were isolated and cultured from leukemia patients routinely. To construct the co-cultured model, Jurkat cells were co-cultured with of the irradiated layer BMSC by 60Co and observed the model with scanning electron microscope. The Jurkat cells suspension-cultured were used as control. The apoptosis and IC50 were detected by the FACS can machine and MTT, respectively. The expression of bcl-2,bcl-xL and bax in Jurkat cells was detected by Western blotting. Results We found that the Jurkat cells in the model showed a decreased sensitivity to DNR, IC50 values for leukemic BMSC and nonadhered contol were of 2.30 μmol/L and 0.45 μmol/L, respectively. Moreover, Jurkat cells adhered to BMSC have a survival advantage over suspended cells following DNR exposure for 24 h, apoptosis percentages for leukemic BMSC group and nonadhered controls were of (6.05±0.54)% and (25.74±6.15)%, respectively. As compared with controls, leukemic BMSC group had significant difference in apoptosis percentages (P <0.01). The expression of bcl-2 in Jurkat cells was up-regnlated when adhered to BMSC for 4 h and the higher expression emerged after adhering for 24 h and 48 h. No marked change of bcl-xL and bax expressions were observed in the adhered Jurkat cells. Conclusion The adhered-culture with bone marrow stromal cells isolated from leukemia patients could make the leukemia cells acquire drug resistance, which was associated with the up-regulated expression of bcl-2 in the leukemia cells.

Objective To investigate the effect and significance of regulating endoplasmic reticulum stress on the expression of histone methyltransferases SET7/9 in the kidneys of db/db mice.Methods Db/db mice were randomly divided into two groups according to random number table method:diabetic nephropathy model group (DN group,n=18) and betaine treatment group (DN+B group,n =18),db/m mice were defined as normal control group (NC group,n =18).At the end of 4,8 and 12 weeks,the expression of GRP78,SET7/9,H3K4me2,and monocyte chemoattractant protein 1 (MCP-1) was determined by real-time fluorescence PCR and Western blotting.24-hour urinary protein excretion rate (UPER) and urine MCP-1 were measured by enzyme linked immunosorbent assay (ELISA).The dynamic changes of blood glucose(BG),serum creatinine (Scr),blood urea nitrogen (BUN) were tested by completely automatic biochemistry analyzer.The morphology of kidney was estimated by special staining of periodic acid-schiff (PAS).Results The levels of BG,BUN,UAER and MCP-1 were significantly higher in DN group than those in NC group (P ＜ 0.05),and were in time-dependent manner.Glomerular basement membrane thickening and mesangial cells proliferation began to emerge in DN group at the end of week 4 and mesangial matrix expansion was more obvious at the end of week 12.The mRNA and protein expression of GRP78 and SET7/9 were elevated significantly in DN group as compared to NC group.The H3K4me2 protein expression level was also increased in time-dependent manner.Compared with the DN group,in DN+B group glomerular lesions attenuated and the GRP78 and SET7/9 expression levels obviously decreased (P ＜ 0.05).Furthermore,the levels of BG,BUN,UPER,MCP-1,H3K4me2 in DN+B group were also reduced (P ＜ 0.05).Conclusion Endoplasmic reticulum stress may be the upstream mechanism of mediating the expression of SET7/9 in the kidneys of DN mice.

Objectives To study the value of CT and MRI in diagnosing focal nodular hyperplasia (FNH).Methods The CT and MRI findings of 16 patients with FNH confirmed histopathologically were analyzed retrospectively.Both plain and dynamic enhanced CT scannings were performed in all the patients.Plain and dynamic enhanced MRI were carried out in 9 patients.Results (1) There were 16 patients with 19 lesions,and 8 lesions were in the left lobe,5 lesions in the right lobe,4 lesions between the left/right lobes and 2 lesions in the caudate lobe.The morphology of the lesions showed 15 lesions to have clear boundaries and 4 lesions to have fuzzy boundaries.The tumor diameters varied from 2.2 to 9.6 cm,(average 4.3 cm).(2) Sixteen patients underwent CT examination.On plain CT,the lesions were isotonic (n＝ 5),or slightly low-density (n=11).In 7 lesions,there was a slit-like,stellate-shaped low density central scar.Nine patients underwent MRI examination.On T2WI,6 lesions showed slightly higher signal while the remaining 3 lesions showed iso-signal.On T1WI,4 lesions showed slightly lower signal,3 lesions showed iso-signal and 2 lesions showed slightly higher signal while in 1 lesion the local signal showed reduction in anti-phase 1.A central scar was seen in 6 lesions which showed high signal on T2WI,and low signal on T1WI.(3) Enhanced CT: 15 lesions were significantly enhanced and 1 lesion showed mild enhancement at the arterial phase.For the patients with mild enhancement,the scar in the center of the lesion showed no enhancement.In all lesions,the central scar did not enhance.In 5 lesions,enhancements of thickened and torturous arteries were seen.In all the lesions with enhancement,the enhancement was reduced at the portal venous phase,with 12 lesions showing slightly higher density,3 lesions isodensity and 1 lesion low-density.Three lesions showed mild enhancement of the central scar.All the substantial parts of the lesions with enhancement declined at the delay phase,with 3 lesions showing slightly higher density,9 lesions of isodensity and 4 lesions slightly low density.In 7 lesions with central scar delayed enhancement,they showed slightly higher density.Nine patients underwent MRI enhancement and the enhancement characteristics were similar to CT,but the arterial phase magnitude was higher than that of CT.In 4 lesions,the central scar began to enhance at the portal venous phase,while 6 lesions continued to enhance,thus showing slightly higher signal at the delay phase.In a large lesion,there was persistent delayed enhancement in the capsule.(4) On DWI,6 lesions showed inhomogeneous,slightly hyperintensity with the center showing a slit-like low signal area.Three lesions showed iso-signal.The ADC values of the lesions were (1.31±0.08)× 10-3 mm2/s,and the normal liver parenchyma were (1.22± 0.14)× 10-3 mm2/s,(difference not statistically significant).Conclusions CT and MRI using plain and dynamic enhanced scans could show fully and accurately the pathological features and the characteristics of blood supply of FNH.The characteristic signs on both CT and MRI make an accurate diagnosis of FNH.MRI when compared with CT was slightly better.A combined use of both CT and MRI has an important value in the diagnosis of FNH.