Objective: To investigate the changes of phenotypes, proliferation activity and cytotoxicity of cytokine-induced killer (CIK) cells after co-cultured with autologous dendritic cells sensitized by CD 40-pulsed apoptotic tumor cells. Methods: DCs and CIK cells were induced from peripheral blood mononuclear cells (PBMC) of healthy subjects by the regular method. The immature DCs were loaded with apoptotic tumor cells pulsed with or without CD 40 mAb. The mature DCs were co-cultured with CIK cells for 5 d to obtain DC40Ag-CIK cells and DCAg-CIK cells. The proliferative activity of the effector cells was observed. Cell phenotypes were analyzed by flow cytometry. The level of interferon IFN-γ in the supernatant of cultured cells was measured by enzyme-linked immunosorbent assays (ELISA). The cytotoxicity was detected by [3H]TdR incorporation method. Results: The expression rates of CD 1a, CD 80, CD 83, CD 86, and HLR-DR were up-regulated in DCs after loaded with apoptotic tumor cells. CD 40 mAb-pulsed apoptotic tumor cells further induced maturation of DCs. On the 14th day the DC40Ag -CIK cells, DCAg-CIK cells, and CIK cells proliferated and expanded (18.2 ± 1.7) times, (15.0 ± 1.2) times, (9.3 ± 1.8) times, respectively. The proportion of CD3+ CD56+ cells was markedly up-regulated in DC40Ag-CIK cells compared with DCAg-CIK cells and CIK cells (P < 0.05). The cytotoxicity of DC40Ag-CIK cells and DCAg-CIK cells on A 549 cells was enhanced compared with CIK cells (P < 0.05). DC40Ag-CIK cells had much stronger cytotoxicity than DCAg-CIK cells (P < 0.05). The level of IFN-γ was (1 494.7 ± 246.3), (2 706.3 ± 197.0), and (3 676.3 ± 335.0) pg/mL in the supernatant of CIK, DCAg-CIK, and DC40Ag-CIK cell cultures, respectively. Conclusion: DCs loaded with apoptotic tumor cells pulsed by CD 40 could further enhanced the proliferative activity and cytotoxicity of CIK cell compared with those without CD 40 pulsation.

ObjectiveTo investigate the value of CEUS in differential diagnosis of benign and malignant thyroid solid lesions.MethodsTotally 45 patients with thyroid solid lesions underwent CEUS examination.The enhancement mode and blood perfusion characteristics of malignant and benign lesions were analyzed,and the results were compared with pathology.ResultsCEUS diagnosed 31 benign lesions and 14 malignant masses.The diagnostic accordance rate of CEUS was 93.75％ (30/32) and 92.31％ (12/13) for benign and malignant lesions respectively.In 31 benign lesions,27 (27/31,87.10 ％) showed entire homogeneous enhancement,4 (4/31,12.90％) presented inhomogeneous enhancement.In 14 malignant masses,1 (1/14,7.14 ％) showed homogeneous hypoechoic enhancement,12 (12/14,85.71％) presented inhomogeneous hyperechoic enhancement and 1 (1/14,7.14％) presented non-enhancement.ConclusionCombined with two-dimensional grey scale ultrasound and CDFI,CEUS enables dynamic observation of the microvascular perfusion of thyroid lesions,therefore helps to differentiate benign and malignant thyroid lesions.

Objective To discuss the ultrasound imaging of acardia twin before and after spontaneously blood blocked in twin reversed arterial perfusion sequence (TRAP), and to analyze the inlfuence factor for the prognosis of pump twin. Methods Seven TRAP with pump twins and acardia′s blood lfow blocked were diagnosed by US and autopsy in Hubei Women and Children′s Hospital between 2001 January to 2012 September. The ultrasound images, clinical data and pump twin’ outcome were analyzed. Results Ultrasound images showed skin edema, acardia, spine and lower limbs in seven acardia cases before blood blocked, among which 4 were acardius acephalus, 3 were acardius anceps. Single umbilical artery were detected in 7 cases with reversed umbilical artery perfusion toward fetus. Four cases had rare blood lfow (UA-PI ratio<0.7. Five acardia cases had slower growing rate than the pump twin. Ultrasound images showed no growing, no blood lfow in the acardia, the acardia twin became vagued in the second and third trimester, and ifnally developed into a paper fetus. A linear umbilical cord extend from umbilical region to placenta were found in 7 cases whose blood lfow were spontaneously blocked. Pump twin′s outcome:3 pump twins survived, 3 died in uterus, and 1 was induced labor due to hydrocephalus and cardiac failure. The most important factors that affected the prognosis of pump twin included:faster growing in acardia twin with less blood supply, abnormal brain and heart function in pump twin, chromosome abnormalities, abnormal amniotic fluid and cord entanglement. Conclusions Less blood flow and slow growth speed prompt in acardia twin suggested spontaneously acardia blood block. It is mandatory to monitor the pump twin after the spontaneous block of acardiac’s blood lfow.

OBJECTIVETo observe effects of treatment from the lung and treatment from the intestine on the level of vasoactive intestinal peptide (VIP) in the lung and intestine of ulcerative colitis (UC) rats.

METHODSThe UC rat model was established in 52 rats by using rabbit intestine mucosa tissue allergen combined TNBS-ethanol model (with the model successful rate of 78.0%). Eight rats randomly selected from 40 successfully modeled rats and 8 of 16 rats from the normal group were recruited as the model group and the normal control group before intervention (at week 0). The rest 32 successfully modeled rats were randomly divided into the model group, the Western medicine treatment group (salazosulfapyridine), the treatment from lung group (Huangqi Jiegeng Decoction), and the treatment from intestine group (Huangqi Huanglian Decoction), 8 in each group. Rats in each treatment group were administered with corresponding medication 8 times the dose of a 60 kg adult human. Another 8 normal rats were recruited as the normal group. Equal volume of pure water was given to rats in the model group and the normal group by gastrog avage, once per day. Contents of VIP in the lung tissue and the intestinal tissue were detected at week 0 and 4 after 4-week consecutive intervention. Pathomorphological changes of the lung tissue and the colon tissue were observed under light microscope.

RESULTSCompared with the normal control group at week 0, evenly distributed diffuse inflammation could be seen in the pulmonary interstitial tissue; the bronchial wall was thickened; a huge amount of infiltration surrounded bronchi and blood vessels; a large area of necrosis of intestinal mucosa and inflammatory cell infiltration could also be seen in the model group. Pathological injuries of the lung and the colon were more alleviated in each treatment group than in the model group at the same time point. Compared with the normal control group at the same time point, VIP contents in the lung tissue significantly decreased in the model group at the end of week 4 (P<0.05); VIP contents in the colon tissue significantly increased in the model group at the end of week 0 and 4 (P <0.05). Compared with the model group, VIP contents in the lung tissue significantly increased in the Western medicine treatment group and the treatment from lung group at the end of week 4 (P<0.01); VIP contents in the colon tissue significantly decreased in the treatment from lung group and the treatment from intestine group (P<0.05, P<0.01).

CONCLUSIONTreatment from the lung and treatment from the intestine showed predominant advantage in improving local inflammation of the lung and the intestinal tract, alleviating pathological injuries, promoting repair of injuries through regulating VIP contents in the lung tissue and the colon tissue.

Animals ; Colitis, Ulcerative ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Intestinal Mucosa ; metabolism ; Intestines ; Lung ; Male ; Rabbits ; Rats ; Vasoactive Intestinal Peptide

Objective To study clinical efficacy of porcine-derived small intestinal submucosa (Surgisis) in treatment of pelvic organ prolapse (POP).Methods From Mar.2012 to Mar.2013,15 patients with POP at more than Ⅲ of POP quantitation (POP-Q) staging system undergoing pelvic reconstructive surgery with Surgisis in Peking University People's Hospital.The mean age was 59 years old (39-82).The variable site of POP-Q staging systemn was compared between preoperative and postoperative status among those patients.Quality of life questionnaire of pelvic floor impact questionnaire (PFIQ-7),pelvic floor distress inventory short form (PFDI-20) and PISQ-31 were studied to evaluate subjective satisfaction,recurrence and the quality of life's improvement.Results All patients were followed up at mean of 9.9 months (3-15 months),the mean time of surgery was 96 mins (65-120 mins),the mean blood loss was 159 ml (50-500 ml).No infection and erosion was observed on those patients.The rate of subjective satisfaction was 14/15,the recurrence rate of prolapse was 2/15.Scoring system of PFDI-20 was from 87 (56-124) at operative status to 30 (22-48) at postoperative status.PFIQ-20 was from 129 (85-158) at preoperative status to 24 (18-48) at postoperative status.PISQ-31 was from 48 (32-55) at preoperative status to 79 (66-89) at postoperative status,which all reached statistical difference (all P ＜0.05).Total 9 patients obtained satisfactory sexual life.Conclusions The short-term clinical effect of pelvic reconstructive surgery with Surgisis was satisfied,quality of life and sexual life was improved,and less complication were observed.However,long-term clinical effect on patients should be warranted to follow up.

Objective To understand postoperative experience for patients with relapsed bladder tumor and analyze its influence factors in order to supply references of postoperative nursing for nurses. Methods Patients with relapsed bladder tumot(10 cases) were interviewed and the obtained results underwent analysis and finishing thematically. Results Factors influencing postoperative experience included education haekground,whether having faith and hobbies or not,the disease,medical charge and pressure of future life.The supporting system came from family,group and society. Conclusions Nurses should strengthen mental care and health education based on patients' specific circumstances in order to improve postoperative quality of life.

OBJECTIVE:To compare the total flavonoids content and antioxidant activity in the barks,leaves,male flowers and seeds of Eucommiae ulmoides. METHODS:UV spectrophotometry was used to determine the total flavonoids content in differ-ent parts;tests was conducted to clear 2,2′-nitrilobis(3-ethylbenzothiazoline-6-sulfonic acid)(ABTS+),1,1-diphenyl-2-trinitro-phenylhydrazine(DPPH)radicals and the reducing ability of Cu2+,using half clear/reduction concentration value(IC50)as evalua-tion indexes,and vitamin C was regarded as positive control. RESULTS:The total flavonoids content of the E. ulmoides from hight to low was as follows as leaves>male flowers>barks>seeds,except there was no significant difference in barks and seeds (P>0.05),the other parts had significant differences (P<0.05);the ability of different parts eliminating DPPH and ABTS+ free radical was as follows as leaves>male flowers>seeds>barks,except there was no significant difference in the indicators of leaves and male flowers(P>0.05),the other parts had significant differences(P<0.05);the ability of reducing Cu2+ free radical was as follows as leaves>male flowers>barks>seeds,there was significant difference in leaves and males flowers with barks and seeds (P<0.05). CONCLUSIONS:The content of total flavonoids in leaves and male flowers is high,and the antioxidant activity is strong,which has a great prospect of exploitation and utilization to make up for deficiencies in barks of E. ulmoides.

Objective To explore the four criteria,including bedside index for severity in acute pancreatitis(BISAP),Ranson score,modified CT severity index(MCTSI) and acute physiology and chronic health evaluation scoring system Ⅱ (APACHE Ⅱ) in assessment of severity and prognosis of hyperlipidemic acute pancreatitis.Methods A total of 326 patients with hyperlipidemic acute pancreatitis were studied retrospectively from August 2006 to July 2015.The discrepancy of the four criteria in assessment of severity and prognosis of hyperlipidemic acute pancreatitis was compared with chi-square test and receiver operating characteristic curve.Results The incidences of moderately severe acute pancreatitis and severe acute pancreatitis,local complications and mortality of patients with BISAP score ≥3,Ranson score ≥3,APACHE Ⅱ score≥8 and MCTSI score≥4 were significantly higher than BISAP score ＜ 3,Ranson score ＜ 3,APACHE Ⅱ score ＜ 8 and MCTSI ＜ 4 respectively (all P ＜ 0.05).As far as severity was concerned,the sensitivity and AUC of APACHE Ⅱ were 57％ and 0.814,which were higher than the other systems.The second most sensitive criterion was BISAP.In assessment of local complications,the sensitivity and AUC of MCTSI were 68％ and 0.791,which were higher than the other three.The most sensitive criterion to predict mortality was BISAP with sensitivity 89％ and AUC 0.867,which was followed by APACHE Ⅱ.Conclusions All four criteria can be used to determine the severity,local complications and mortality.Generally,BISAP is simple and easy to practice,and better than the other three.

Objective To prospectively investigate the characteristics and correlative influential factors for the changes in pulmonary artery hypertension (PAH)in chronic kidney disease (CKD) patients without end-stage renal disease.Methods Complete clinical and laboratory data of 133 outpatients without ESRD (CKD stage 2,3 and 4)in Beijing Hospital between January 2012 and January 2013 were retrospectively analyzed.Pulmonary artery systolic pressure(PASP)was assessed by echocardiography according to the guideline from the American Society of Echocardiography in 2010,and PASP more than 35 mmHg(1 mmHg=0.133 kPa)was diagnosed as PAH.Results PAH was found in twelve(9.0 ％) patients,including 7 females and 5 males,with mean age(82.9 ± 5.4 years).The prevalence of PAH was 2.3％,10.9％ and 17.6％ in the patients of CKD stage 2,3 and 4(P＜ 0.05) respectively.PASP could be calculated in 67 patients in whom tricuspid regurgitation was present.The mean PASP was (27.1 ± 5.4) mmHg,(31.0 ± 8.3) mmHg and (37.3 ± 13.8) mmHg in patients with CKD stage 2,3 and 4,respectively(P ＜ 0.05).Body mass index(BMI),eGFR and BUN showed significant differences between PAH group and non-PAH group with statistical significance (P＜0.05).Multivariate logistic regression analysis revealed that the lower BMI and the higher stage of CKD were independent risk factors for PAH (P ＜ 0.05).Conclusions PAH is not a rare complication in the CKD patients without end-stage renal disease.The incidence of PAH is significantly associated with lower BMI and the higher stage of CKD.Doppler echocardiography should be performed periodically to detect PAH in CKD patients in order to improve the prognosis of these patients.

Objective To explore the diagnosis,treatment and prognosis of primary gastric malignant (lymphoma)(PGML).Methods The diagnosis and treatment data of 21 cases of PGML admitted in our(hospital) during 8 years was retrospectively analyzed.The diagnostic methods included barium meal(examination),gastroscopy,B type ultrasonography,and CT scan.All patients underwent operative treatment and most of the patients received adjuvant chemotherapy.Results Upper abdominal pain,digestive tract bleeding,emaciation and abdominal mass were common clinical manifestations of PGML.The resectabilty rate of PGML was 90.5% while the 5-year survival rate was 57.1%.Conclusions The key to a satisfactory prognosis was early diagnosis,radical curative operation and combined treatment.