Objective Rats with nonalcoholic fatty liver disease (NAFLD) were used to investigate the secretory state of pancreas and the expression of insulin receptor (IR). Methods NAFLD rat model was reproduced, and then the structure of pancreatic tissue, secretory states of ? and ? cells (serum, tissue) and the expression of IR were examined and determined by means of HE staining, ELISA, and immunohistochemistry. Results In all experimental groups, the structure of pancreatic tissue showed no obvious change; the blood sugar level tended to rise. The insulin level in serum began to elevate obviously at 4th week (P≤0.01), while the insulin content in tissue began to increase at 6th week (P≤0.01), and distributed mainly in the middle part of the pancreas with a tendency of elevation along with the time. The content of glucagon in pancreatic tissue began to increase at 8th week (P≤0.01), and reached the peak at 12th week. The expression of IR in tissue began to decrease at 6th week (P≤0.01), and then tended to be stable after 8th week. Conclusions In NAFLD, there was changes in secretory state of pancreas with the accompaniment of insulin resistance. There was a tendency of elevation of levels of insulin both in serum and pancreatic tissue, but the time of expression was different. The expression of glucagen shows an increase tendency, while the decrease of IR might be the crucial cause of insulin resistance in NAFLD.

Objective To study the changes in serum endotoxin level of the patients with primary biliary cirrhosis (PBC) and the relationship between endotoxin and serum biochemical parameters. Methods Clinical data of 63 cases PBC patients confirmed by liver puncture biopsy were retrospectively studied. The clinical features, results of laboratory tests, pathological findings of all the 63 patients were analyzed. Endotoxin level was determined by limulus amebocyte lysate test in the serum obtained from the 63 cases of patients with primary biliary cirrhosis, and then compared with that of 30 healthy individuals. Results The sex ratio (male to female) of PBC patients was 1 to 8, and the mean age was 43.8 years. The prevalent complaints were jaundice and fatigue. 70.3% patients showed AMA positive. The levels of ?-glutamyltransferase (r-GGT), alkaline phosphatase (ALP) and bilirubin in the serum were markedly elevated in the majority of the patients. Compared with the early stage, the levels of ALT and AST declined slightly during the advanced stage (P

Objective The key points in the epithelial-mesenchymal transition ( EMT) procedure include the downregula-tion of epithelial protein (E cadherin) and the upregulation of cell activity and cell matrix generation .The aim of this study was to es-tablish a method for primary culture and identification of mouse renal tubular epithelial cells and to explore whether the activation of C3aR can induce epithelial-to-mesenchymal transition in mouse primary renal epithelial cells . Methods Murine renal tubular seg-ments were used for primary cell culture .Immunocytochemistry and immunofluorescence staining were used to identify the renal tubular epithelial cells.The experiment groups included control group , five different concentrations of C3aR agonist groups (0.1, 1, 100, 500, and 2000 ng/mL), and three different time-point groups.The mRNA levels of E-cadherin,α-smooth muscle actin (SMA) and colla-gen I in renal tubular epithelial cells were detected by Real-time PCR; the protein of E-cadherin, α-SMA were detected by Western blot.The cytoskeleton of epithelial cells was observed by phalloidin staining . Results Compared with the control group , the protein expression of E-cadherin deceased (0.950±0.901 vs 0.650±0.221) and the expression of α-SMA (1.380±0.062 vs 1.600±0.103) and collagen I increased in C3aR agonist group (500 ng/mL, after 48 hours) (P<0.05).In addition, the association between these changes and C3aR agonists was presented in a dose-and time-dependent man-ner, respectively.The cytoskeleton staining showed that treatment of renal tubular epithelial cells with C 3aR agonists induced the formation of actin stress fibers in a time-dependent manner . Conclusion The method for primary culture and identification of mouse renal tubular epithelial cells were successfully established .The activation of C3aR could induce epithelial-to-mesenchymal transition in mouse primary renal epithelial cells , which plays an essential role in the de-velopment of renal fibrosis .Moreover , this study indicated that C 3aR may become a new therapeutic target in kidney diseases .

Objective To explore the effect of elbow release and debridment with arthroscopy for elbow malfunction. Methods The study was carried out on 15 patients (male 11, female 4; age 21-63 years old, average 40.1 years old) with the use of arthroscopy to brisement accretion and articular capsule from August 2001 to December 2003. The mean course was 55.2 months (range, 8-24 months). The flexion angle of joint preopration was 15?-60?, average 30.4?, the extension angle was -80?--20?, average -51.2?. The diagnosis was osteophyma and liberum in 4. The old fracture of radius capitulum was in 2; the old fracture of ulnar olecranon in 2; the old fracture of condyle of humerus in 3; degeneration in 4. The brachial plexus anesthesia,the elbow hung to traction, interna and extra-pathway, to cut synovium and accretion fibers with shver, removal liberum and milling osteophyma, meanwhile brisement articular capsule. Pathology manifestation in arthroscopy: there were a lot hyperemia synovium and fiber accretion. There was cartilage exfoliation in 8, hyperplasy and liberum in 5, ossification of cicatricle in 2. The motion range of elbow was reexamined, if the extension function was restricted, release was performed on anterior soft tissue and capsule. If the flexion function was restricted, release was carried out on posterior capsule via posterior straight approach(3 cm supra point of olecranon). Results All patients recovered daily life and occupation postoperative 7 to 14 days. Transient ulnar nerve paralysis occurred postoperatively in one case, which recovered three months later. There were no blood vessel and nerve injury. The mean follow-up period was 14.1 months (range, 7-20 months). At the final follow-up, the flexion of joint post operation was 70?-120?, to improve average 60.5?; the extension of joint post operation was -20?--5?, to improve average 37.6?. In accordance with HSS scoring system, excellent 7, good 5, fail 3. Conclusion Using of arthroscopy to release elbow joint have many advantages such as less trauma, quick recovery and less sequela. The application in release with arthroscopy is a good way for elbow malfunction.

Objective MRI was a powerful technique for evaluation of the meniscus injury.However,meniscal injuries were the most common reason for arthroscopy of the knee.The research was to reveal the relationship between the classification on MRI and the morphological changes of the meniscus injury under the arthroscopy in order to indicate the surgical procedures according to the MRI degree of meniscus in-juries.Methods From October2000to December2001,157knees of152cases with meniscus tears were analyzed retrospectively,who were classified into the osteoarthritis group and sport injury group depending on the causes of injury.There were107knees in osteoarthritis group,50knees in sport injury group.All cases were made MRI examination with T 1 and T 2 sequences,and152of them underwent arthroscopic oper-ation.According to the different signal intensity,changes of contour and edge of meniscus,juried meniscus were divided into four degrees,referring to the standard described by Stoller.The conditions of torn menis-cus were observe and recorded while performing arthroscopy in order to compare with that on MRI.Results The MRI classification in osteoarthritis group,there were gradeⅠin21knees,gradeⅡin34knees,gradeⅢin40knees,and gradeⅣin12knees;Depending on the exploration in arthroscopy,the accurate rate of diagnosis of MRI for meniscus injury was100%(21/21)for gradeⅠ,91.2%(31/34)for gradeⅡ,92.5%(37/40)for gradeⅢand100%(12/12)for gradeⅣ.The patients with gradeⅢand gradeⅣinjury of the meniscus all underwent the operation of arthroscopy.The MRI classification in sport injury group,there were gradeⅠin5knees,gradeⅡin4knees,gradeⅢin26knees,and gradeⅣin15knees.The accurate rate of diagnosis of MRI was75%(3/4)for gradeⅡ,92.3%(24/26)for gradeⅢand93.3%(14/15)for gradeⅣ.Conclusion In the meniscus tears,gradeⅠinjury on MRI is not indicated to surgical treatment,gradeⅡcan be explored in arthroscopy or observed when it is in need based on clinical symptoms.GradeⅢand gradeⅣof meniscus injury necessitate partial meniscectomy or meniscoplasty.

Objective One of the characteristics of rheumatoid arthritis was multiple joints involved symmetrically. The purpose was to study the method of early diagnosis and treatment for the atypical rheumatoid arthritis involving solitary joint. Methods From April 1997 to December 2002, 5 cases which were 1 male and 4 female patients with an average age of 36.8 years (range, 23 to 47 years), suffered from the swelling and pain of knee joint, and were diagnosed as early rheumatoid arthritis. The interval of the onset to surgical treatment ranged from 2 months to 3 years with a mean of 16.2 months. The patients were evaluated with serum test, joint fluids examination and radiological imaging. They were treated by the synovectomy under the arthroscopy, while the appearances of the joint under arthroscopy were recorded, and the synovial tissue was sent to the pathological examination. The improvements of the joints symptoms and the range of motion were assessed at final follow up. Results During the operation, the light green and little muddy joint fluids were found in all patients. ESR of the patients ranged from 29 to 51 mm/1h with an average of 32.2 mm/1h, all of which were higher than normal value, whereas, 3 cases had positive rheumatoid factor and 4 cases showed significant higher ?2-MG. The radiographic findings were osteoporosis in 3 cases, soft tissue swelling in 4 cases and narrowed joint space in 1 case. The synovium were proliferated and enlarged in dark violet, there were creeping pannus and necrosis fibrin deposition in the cartilage. All of the patients were diagnosed as rheumatoid arthritis confirmed by pathological changes of the synovium. The patients were followed up from 4 months to 5 years (mean, 18.7 months). Pain released in 5 cases, swelling reduced in 3 cases, the range of motion improved by 19 degrees. Unfortunately, all of the patients developed later into typical rheumatoid arthritis after the mean interval of 10.9 months (range, 3 to 25 months), the symptoms were consistent with the criteria of American Rheumatoid Association . Conclusion Solitary joint with rheumatoid arthritis is rare and may be the early status of rheumatoid arthritis. The specific appearance under the arthroscopy prompt the early diagnosis of the knee rheumatoid arthritis, and synovectomy by arthroscopy may be benificial to release the symptoms of rheumatoid arthritis.

Objective To study the apoptotic changes in hepatocytes and the expression of apoptosis-associated proteins Bax and Bcl-2 in the liver tissue of a rat nonalcoholic steato-hepatitis (NASH) model, and explore the relationship between hepatocyte apoptosis and the degree of NASH pathological changes. Methods A rat model of NASH was reproduced with feeding a fat-rich diet for a period of 2, 4, 6, 8 and 12 weeks. Cells apoptosis was evaluated by TdT-mediated dUTP nick end labeling (TUNEL), and the expression of Bax and Bcl-2 proteins was detected by immunohistochemistry in rat liver tissue of control and model groups respectively. Results The number of TUNEL-positive cells was increased in the second week, peaking at the 8th week, and it was significantly correlated with steatosis and hepatic fibrosis (r=0.707 and 0.750, respectively, P0.05). The expressions of Bax and Bcl-2 proteins were mainly located in cytoplasm of hepatocytes, some of which contained lipid droplets. Bax and Bcl-2 positive cells increased gradually with the progression of NASH. In early stage of modeling, the number of Bax positive cells was greater than that of Bcl-2, but the number of the both proteins tended to be about same in the late stage of modeling. Conclusion The cell apoptosis is a main pattern of liver damage in the process of NASH, and it is closely associated with the pathological changes. Proapoptosis protein Bax and antagonisitic protein Bcl-2 might participate in the modulation of hepatocytes apoptosis in the early stage of NASH, and they also have a marked effect in the whole process of NASH.

0.05).For the cases when discharge,the ratio of curing,improve,inefficiency and death were 67.47%,29.01%,2.00% and 1.52%,respectively;for the cases followed up,the ratio of restoration,improve,aggravation and death were 74.31%,23.84%,1.11% and 0.74,respectively.Conclusions It has been revealed that the main liver diseases affecting the Chinese soldier's health in the past three decades include viral liver diseases,fatty liver diseases and liver injuries induced by drug and environmental factors,and the incidence of non-viral liver diseases has gone up in the last decade.Some epidemiological characteristics have emerged in Chinese soldier with liver disease in age,sex,army service branch,rank and original place.The epidemiological data have shown that the main infectious routs of liver diseases in Chinese soldier include inter-soldiers in group live,family members to soldier,and food and beverage.To make a definite diagnosis,the liver biopsy examination should be a very useful choice to the majority of hardly diagnosed liver diseases on clinic.The serological examinations for several main liver diseases have shown some special features,and most of the soldier with liver diseases has well improved after regular treatments.

Objective To study the disease spectrum,the features of clinical pathology,epidemiology and prognosis of liver diseases in Chinese populations from Jan.1980 to Jun.2008.Methods Twenty-five thousand nine hundred and forty-six patients with liver diseases in a wide spectrum of inhabitants(including 1 448 military patients) from 31 provinces or cities of all over mainland China in recent 28 years were involved in the present study for a retrospective study regarding their clinical,pathological and epidemiological features,including laboratory re-examinations and pathological examination.1 322 patients with liver disease(course lasted from 6 months to 18 years) were followed-up by more than 2 liver biopsies to study the outcome of chronic hepatitis B.Results For all the patients involved,the sex ratio of male to female was 3 to 1,with mean age of 32.3?14.4 years ranging from 41 days to 91 years,and the diseases occurred predominantly between the age of 18 to 37 years.Hebei,Henan,Beijing,Shandong and Shanxi provinces(city) ranked at the fore in the endemic distribution of the diseases.The spectrum of liver disease covered more than 100 kinds of liver diseases,of which 73.05% were infectious liver disease.As a whole,the incidence of both infectious and non-infectious,especially the non-infectious liver diseases became more prevalent since 2000.It was shown that the chronic hepatitis B was the most predominant factor which caused liver failure,liver cirrhosis and liver cancer,and chronic hepatitis C was the second factor.Chronic infection pathological changes were found in the liver tissues in 0.26% patients with hepatitis A and 0.51% patients with hepatitis E.For all the 1 322 followed-up patients with chronic hepatitis B,the incidence of liver cirrhosis and hepatocellular carcinoma was respectively 15.36%(203 cases) and 1.06%(14 cases),and the average progressive period for the changes in pathology was 46.37?16.93 months and 60.29?39.15 months,respectively.Meanwhile,the degree of liver fibrosis increased more than one stage in 188 patients(14.22%),decreased more than one stage in 441 patients(33.36%),and no change in 476 patients(30.01%).Conclusions The liver disease spectrum during recent 28 years in Chinese populations has been essentially identified by a retrospective analysis of a large number of clinical pathological data.The clinical features of predominant liver diseases have been illustrated,and the outcome and transition time of chronic hepatitis B has been elucidated in present study.

Objective To explore the clinical and pathological features of the autoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC) overlap syndrome (AIH-PBC overlap syndrome). Methods The clinical data and liver biopsy specimens from 17 cases of the AIH-PBC overlap syndrome were analyzed and compared with 117 cases of AIH and 85 cases of PBC. The pathological features were as analyzed by histological observation and immunohistochemical staining for CK19, CD3, CD4, CD8, CD20, CD25, CD57 and CD68 in the biopsy liver tissues. Results Of the cases of autoimmune liver disease in this study, 8.4% were diagnosed as AIH-PBC overlap syndrome based on clinical, biochemical, serological and pathological examinations. Among the overlap syndrome cases, the females were in predominance (male∶female was 1∶8.5), and the median age of the patients presenting the clinical onset signs was 39.3 years, and the serological double-positive autoantibodies of ANA and AMA-M2 occupied 52.9%(9/17). Serum levels of ALT, ALP, ?-Glo, AST, TBIL, IgG and IgM were higher in patients with overlap syndrome than those in patients with AIH or PBC, respectively. The pathological findings in the biopsy liver tissues from the patients with overlap syndrome included moderate to severe interface hepatitis with plasma cell predominated mixed-inflammatory cells infiltration in hepatic and portal tracts, as well as the damage and obvious reactive proliferation of small bile ducts. Meanwhile, the amounts of CD3, CD4, CD8, CD20, CD25, CD57 and CD68 positive mononuclear cells increased in the overlap syndrome liver tissues compared with those in single PBC or AIH cases. Conclusion AIH-PBC overlap syndrome is not frequent (8.4%) in this study, but exist among autoimmune liver diseases in China. This overlap syndrome presented both clinical and pathological features of AIH and PBC, and cellular immune mediated injuries might be pivotal role in pathogenesis.