Objective To enhance the recognition of thrombotic thrombocytopenic purpura(TTP) by analyzing the clinical data of acquired TTP .Methods The clinical features ,laboratory detection ,treatment strategy and outcome of 20 patients with ac‐quired TTP were retrospectively analyzed .Results Among 20 patients with acquired TTP ,16 cases had the inducing factors ,inclu‐ding abnormal autoimmune ,systemic lupus erythematosus(SLE) ,antiphospholipid antibody syndrome(APS) ,viral infection ,bacte‐rial infection ,medication ,lymphoma and allogenic hematopoietic stem cell transplantation .When the patients were diagnosed firstly , only 5 cases(25% ) had typical pentalogy of TTP ,18 cases(90% ) were complicated with thrombocytopenia ,14 cases(70% ) were complicated with microangiopathic hemolytic anemia ,17 cases (85% ) with neurologic abnormalities ,15 cases (75% ) fever and 8 ca‐ses(40% ) with renal insufficiency .Sixteen cases(80% ) had high percentage of reticulocytes ,the schistocytes were detected in the peripheral blood smears of 18 cases ,among them microspherocytes were simultaneously detected in 3 cases .Twenty cases had high level of lactate dehydrogenase .All the cases received the therapy of plasmatherapy (plasma exchange and/or plasma infusion) as the principal thing ,among them 9 cases received the glucocorticoid therapy ,2 cases received the cytoxan therapy ,2 cases received the human immune globulin therapy and 4 cases received the low‐dose rituximab therapy (100 mg ,once per week ,for consecutive 4 times) .Eleven cases (55% ) reached complete remission(CR) ,3(15% ) cases got partial remission(PR) and 4(15% ) cases died . The total effective rate was 70% .Three cases(21% ) out of 14 effective cases relapsed .Conclusion The diagnosis of TTP is based on the comprehensive analysis of clinical data .Early diagnosis and early treatment of plasmatherapy as the main means can improve the prognosis of patients with TTP .

Objective To investigate the suppressive effect of bone marrow stromal cells modified by CTLA4Ig-gene on lymphocyte activation. Methods The expressions of CTLA4Ig-gene at transcription level and protein level were assessed by RT-PCR, immunohistochemical techniques and Dot-ELISA. The suppressive effect of CTLA4Ig on lymphocyte activation was investigated in MLR system through MTT and ELISA which quantified IL-2 level. Results The transcription of CTLA4Ig-gene could be detected by RT-PCR in the transfected group and in the passage number two. Immunohistochemistry indicated that CTLA4Ig expression was diffusely located in the cytoplasm of BMSCs. Dot-ELISA could detect the expressed CTA4Ig in the culture medium at 12h and even in culture medium of the passage number l after transfection. MLR system showed that CTLA4Ig had significant inhibition on lymphocyte proliferation and IL-2 secretion. Conclusion Ad-CTLA4Ig could transfect BMSCs efficiently. Morever, CTLA4Ig can suppress lymphocyte activation and IL-2 production.

0.05).Conclusion MSCT perfusion imaging is of significant value in diagnosing and differentiating malignant SPN from benign SPN.

Objective To study 64-slice CT perfusion features of metastatic tumors of liver and its clinical value.Methods 23 cases (40 lesions) with liver metastases underwent CT perfusion scanning.Hepatic arterial perfusion index(HPI) parameters including blood flow perfusion(BF),patlak blood capacity (pBV),vascular permeability (P,permeability),arterial liver perfusion(ALP),portal venous perfusion( PVP ) were analyzed in comparison with that of normal liver .Results (1)BF, pBV , P , ALP , PVP and HPI in normal liver tissue were (47.85?8.11) ml?100ml-1?min-1,41.25?6.32 (1000:1), 64.25?11.10 (0.5 ml?100ml-1?min-1),(24.55?2.96) ml?100ml-1?min-1, (105.24?16.42) ml?100ml-1?min-1,(20.18?3.81),respectively.(2)BF,pBV,P,ALP and PVP between the normal hepatic tissue and the centre of lesions were of statistically significance (P

Objective To investigate the clinicopathological features and the pathogenesis of rhabdomyolysis caused by exertional heat stroke.Methods Eight patients including 6 military soldiers and 2 physical exercisers trained under high temperature environment were enrolled into this study.Their clinical manifestations were compatible with the diagnostic standard of exertional heat stroke.Consecutive blood biochemistry tests were performed in all patients,and electromyography and muscle biopsy in 3 cases.Results Eight patients were all male,with average age of 27.4 years old.The main clinical characteristics included myalgia in 4 patients,muscle weakness in 2 patients,fever in 5 patients,and tea-colored urine in 3 patients.One patient had acute renal failure,and 2 patients developed multiple organ failure syndromes and disseminated intravascular coagulation.One muscle biopsy done in the third day after the onset showed obvious muscle necrosis without inflammatory infiltrates,while the other 2 muscle biopsy done 2 weeks after the onset showed muscle necrosis companied by inflammatory phagocytic response.Six patients full recovered,1 patient partially recovered and one patient died.Conclusions Rhabdomyolysis caused by exertional heat stroke predominantly occurred in males.The main clinical features include muscle pain,weakness,significantly elevated serum creatine kinase and myoglobin level and myoglobinuria.Muscle pathology indicated muscle necrosis in the early stage and accompanied inflammatory infiltrates in the late stage.Most patients will get recovered with prompt diagnosis and treatment while the severe cases can be life-threatening.

In order to acquire the information on the changes and improvement after the implementation of National Schistosomiasis Control and Prevention Regulation, a survey was performed. The awareness of schistosomiasis and the regulation, stool management and other related contents were carried out in the rural areas of Jiangsu, Anhui, Jiangxi, Hubei, Hunan, Sichuan and Yunan provinces. The results showed 98.9% of the residents knew about schistosomiasis, 89. 8% knew the regulation, 95. 1% supported the management of drinking water and lavatory, 45.3% used tap water as their ordinary drinking water supply, but there were 47.6% still drank well water, 51.1% used water closet and 40.0% used simple toilet. The work on improving water and sanitary conditions in mountain areas was left behind that in lake areas. It is indicated that there is still a lot we must do to promote the propaganda of the regulation.

Child ; Humans ; Lymphoma, Follicular ; diagnosis

Objective:To compare the histological differences between magnetic anastomosis and traditional suture in canine portal vein (PV) .Methods:Eighteen healthy Chinese garden dogs, either gender, 8-12 months and weighing 13.5-18.9 kg, were randomly divided into magnetic compressive anastomats (MCA) group ( n=9) and hand-sewing (HS) group ( n=9) for PV reconstruction. The time of PV anastomosis was compared between the two groups. HE and Masson staining were performed immediately and at 4, 8, 12 and 24 weeks after operation. The ultrastructure of the anastomosis was observed using scanning and transmission electron microscopy. Results:All dogs survived. The PV anastomosis time was significantly shorter in MCA group (3.58±2.75) min than that HS group (12.89±3.12) min, P<0.01. In MCA group, the vascular wall of anastomotic stoma was well aligned immediately after operation, and the shrinkage was obvious in HS group by gross eyes. At 24 weeks, electron microscope scanning showed the re-endothelialization was smooth and endothelial cells arranged regularly at the anastomotic site of the MCA group, whereas different-sized and irregularly aligned endothelial cells and large collagenous fibers arranged in disorder were present at the HS anastomotic stoma. Representative HE and Masson staining confirmed that the magnetic device was associated with decreased infiltration of inflammatory cells and deposition of fibrotic collagen at 24 weeks explanted anastomotic stomas compared with the HS group. Conclusions:Compared with the HS, MCA produced shorter anastomosis time, smooth anastomotic intima, light fibrous tissue hyperplasia, no foreign body residue, mild inflammatory reaction and reliable technique for canines PV anastomosis.

Background and purpose:Ethanol has been reported to stimulate progression of breast cancer, yet the underlying mechanism is not fully understood. This study aimed to investigate effects of ethyl alcohol (EtOH) on the calcium-activated neutral protease (CANP)-cyclin E/focal adhesion kinase (FAK) signaling and cell migration in breast cancer cells, as well as the role of epidermal growth factor receptor (EGFR) in the EtOH-stimulated effects, in order to assess the signaling mechanism(s) underlying how EtOH enhances cancer progression.Methods:Human breast cancer cell line MCF-7 was employed as a model system, with MCF-10A mammary epithelial cells as control. In vitro wound healing assay was carried out to evaluate EtOH-induced cell migration. The effects of EtOH or epidermal growth factor on the proteolysis of cyclin E/FAK were detected by Western blot. EGFR inhibitor (EGFR-I) and a speciifc inhibitor for CANP, Calpeptin, were applied to pretreat cultured cells to explore their inlfuences on the cell migration and cyclin E/FAK proteolysis triggered by EtOH.Results:Treatment of model cells with EtOH (0.3%) stimulated significant proteolysis of cyclin E/FAK in a dose-/time-dependent manner and increased migration (+47.30%,P<0.05) in MCF-7 breast cancer cells, but had no signiifcant effect on migration in MCF-10A cells. Pretreatment with Calpeptin (10 μmol/L) signiifcantly reduced EtOH (0.3%)- or EGFR (10 ng/mL)-induced cyclin E/FAK truncation. EGFR-I (3 μmol/L) pro-foundly reduced EtOH-indcued CANP dependent proteolysis of CANP1 and cyclin E/FAK as well as cell migration (-53.00%,P<0.01).Conclusion:EtOH signiifcantly stimulates activation of CANP via EGFR pathway, resulting in proteolysis of cyclin E/FAK and migration in MCF-7 breast cancer cells, suggesting EGFR-CANP signaling to be a potential target for suppression of metastasis in breast cancer.

Objective To investigate influences of co-culture with the bone marrow stromal cells (BMSCs) on imatinib sensitivity,and the role of stromal cell-derived factor-1 (SDF-1)/chemokine receptor 4 (CXCR4) axis in imatinib resistance of K562 cells in the co-culture model.Methods The model was constructed by co-culturing K562 cells with BMSCs isolated and cultured from the patients with chronic myeloid leukemia.The apoptosis rate and the CXCR4 expressing rate of the K562 cells exposed to 0.5 μmol/L imatinib for 72 hours were detected by fluorescent-activated cell scanning (FACS) machine.The K562 cells were exposed to 0.5 μmol/L imatinib for 4 hours,and labelled by calckin-AM fluorescent labeling sytem.The adhesion rate of the K562 cells co-cultured with BMSCs for 24 hours was calculated with fluorescence intensity.The IC50 value of K562 cells exposed to imatinib was detected by methyl thiazolyl tetrazolium (MTT) assay while the SDF-1/CXCR4 axis was blocked by 10 μg/ml monoclonal antibody of CXCR4.Results The apoptosis rate of K562 cells exposed to 0.5 μmol/L imatinib for 72 hours in co-culture group and suspension culture group was (15.48 ±4.17) ％ and (32.01 ±6.83) ％,respectively.The apoptosis rates of K562 cells in the two groups were significantly different (t =5.587,P =0.001).For the co-culture group,the CXCR4 expressing rates of K562 cells unexposed and exposed to 0.5 μmol/L imatinib for 72 hours were (20.31 ± 3.76) ％ (suspension cultured:11.28％ ± 3.44％) and (53.64 ± 5.35) ％ (suspension cultured:25.34％ ± 3.21％),respectively.Those results showed that co-culture with BMSCs and exposure to imatinib induced the K562 cells to express CXCR4.The adhesion rates of the K562 cells to the BMSCs were elevated from (42.18 ± 6.17) ％ to (68.97 ± 11.08) ％ when the K562 cells were exposed to 0.5 μmol/L imatinib for 4 hours.The IC50 values of block group (the SDF-1/CXCR4 axis was blocked by 10 μg/ml monoclonal antibody of CXCR4) and unblock group were (0.68 ± 0.04) μmol/L and (1.27 ± 0.05) μmol/L,respectively.The IC50 values of two groups were significantly different(t =4.869,P =0.001).Conclusions The K562 cells co-cultured with the BMSCs from the patients with chronic myeloid leukemia can obtain resistance to imatinib,which was related with that co-culture with the BMSCs and exposure to imatinib can induce the K562 cells to express CXCR4.To a certain extent,the imatinib resistance mediated by co-culture with BMSCs can be reversed by monoclonal antibody of CXCR4.