Objective To investigate the differences of glycoprotein non-metastatic melanoma b (Gpnmb) expression between M1 and M2 bone marrow-derived macrophages (BMMφs) in mouse.Meth-ods Primary BMMφs were cultured and then identified by immunofluorescence staining for F 4/80 and flow cytometry testing of CD11b.Interferon-γand lipopolysaccharide were used to induce differentiation of BMMφs towards M1 macrophages and interleukin-4 was adopted to induce differentiation of M 2 macropha-ges.Realtime PCR was performed to analyze mRNA expressions of tumor necrosis factor (TNF-α), induc-ible NO synthase (iNOS), macrophage mannose receptor (MMR), arginase-1 (Arg-1) and Gpnmb.Pro-teins of Gpnmb and MMR were detected by double immunofluorescence staining , Western blot and flow cy-tometry.Results (1) Immunofluorescence staining showed high expression of F 4/80 in BMMφs and flow cytometry results showed that CD11b was expressed in 92.7%±6.1% of BMMφs, suggesting that primary BMMφs were successfully cultured.(2) Compared with M0 BMMφs, mRNAs of TNF-αand iNOS were highly up-regulated in M1 BMMφs (both P<0.01), and mRNAs of MMR and Arg-1 were highly up-regula-ted in M2 BMMφs (both P<0.01), indicating that differentiation of BMMφs towards M1 and M2 BMMφs were successfully induced .(3) Expressions of Gpnmb mRNA and Gpnmb protein were predominantly up-regulated in M2 BMMφs in comparison with those in M0 and M1 BMMφs (both P<0.01).Gpnmb and MMR were co-expressed in M2 BMMφs and 83.2%±9.7% of MMR positive BMMφs expressed Gpnmb. Conclusion Gpnmb expression is significantly increased in M 2 macrophages than that in M 1 macrophages in vitro, indicating that Gpnmb which takes part in the differentiation of macrophages might be used as a marker for identification of M 1 and M2 macrophages .

Objective To observe the expression of glycoprotein non-metastatic melanoma protein B (Gpnmb) in the kidney and urine after ischemic-reperfusion injury (IRI),and explore the relationship between Gpnmb and macrophage phenotypes in the IRI kidney.Methods Male C57BL/6J mice were randomly divided into control group (n =4),sham group (n =4) and IRI group (n =12).Both renal pedieles of mice in IRI group were identified and occluded with microvascular clamps for 30 min.Renal pathological injury was observed by PAS staining.The expression of Gpnmb was examined by real-time PCR and immunofluoresence staining.The location of Gpnmb was observed by flow cytometry and double immunofluoresence staining with F4/80.The mRNA expressions of Gpnmb,CD40,CRR7,CD163 and MMR were examined by real-time PCR.The expression of Gpnmb in the urine was examined by Western blotting and ELISA.Results PAS-stained IRI kidney section showed desquamative epithelia,necrosis debris and a large number of inflammatory cell infiltration.Real-time PCR results showed that there was little expression of Gpnmb in the kidney of control group and sham group.However,the Gpnmb mRNA level in IRI kidneys was highly up-regulated at day 1 and day 2 (both P ＜ 0.01) and followed by a decrease that was similar to the control level at day 3.Double immunofluoresence staining of kidney sections from IRI mice revealed that Gpnmb was predominantly detected in F4/80 positive macrophages.The mRNA expression of Gpnmb was not correlated with M1 macrophage phenotypes CD40 and CCR7,but positively correlated with M2 macrophages phenotypes CD163 and MMR.Western blotting and ELISA result showed that there was significant increase of Gpnmb expression in the urine from IRI mice compared to those of the control group and the sham group (P ＜ 0.01).Conclusions Gpnmb expression is up-regulated in IRI kidney and is associated to M2 macrophages.It may play a role in the process of acute kidney injury.Gpnmb expression is also increased in urine after IR injury and it may be a new biomarker to diagnose AKI.

Abstract: Chronic infection of hepatitis B virus (HBV) is the major cause of hepatocellular carcinoma (HCC) in China. The occurrence of HCC through chronic inflammation follows the Darwinian evolutionary law, known as "mutation-selection-adaptation". Inflammatory mutagenic molecules promote the generation of somatic mutations, and the most mutant cells are eliminated by inflammatory microenvironment. However, a minority of mutant cells survive the selective pressure and develop to tumor initial cells by activating oncogenic signaling pathway and acquiring "stemness" characteristics. Alongside this process, HBV also evolves under the pressure of inflammatory microenvironment, which is characterized by the accumulation of cancer-promoting viral mutations, reducing the ability to infect new individuals. The high-risk mutant strains are eliminated with the death of hosts, leading to a phenomenon termed as "dead-end evolution". HBV evolution contributes to cancer evolution by maintaining the inflammatory microenvironment, activating oncogenic pathways, inducing somatic cell mutations, and altering metabolic patterns. The combo mutations of HBV and HBV integrations can be applied to predict the occurrence and prognosis of HCC. Anti-viral treatment reduces the risk of HCC by relieving inflammation. This article reviews the molecular epidemiological evidence and mechanistic advances related to the co-evolution of HBV and HCC. Clarifying the co-evolutionary pattern of virus and cancer and the key molecular events involved, is beneficial for identifying new biomarkers and therapeutic targets, thus improving the prevention and treatment strategies for HCC.

Objective To investigate the clinical efficiency of Isophane Protamine Biosynthetic Human Insulin Injection (pre‐mixed 30R)(Novolin 30R) combined with insulin pump therapy in patients with diabetes mellitus complicated with pulmonary in‐fection ,and to analyze the detection indexes .Methods From Jan .2010 to Feb .2013 ,90 cases of patients with diabetes mellitus com‐plicated with pulmonary infection were selected and divided into the observation group and control group .The control group re‐ceived Novolin 30R treatment and conventional treatment ,the observation group were given insulin pump therapy based on the treatment of control group .The clinical efficiency and detection indexes were compared and analyzed .Results The cure rate and to‐tal effective rate were 51 .11% and 82 .22% respectively in the control group ,and were 84 .44% and 100 .00% in the observation group respectively .There were significant differences of both cure rate and total effective rate between the two groups (P<0 .05) . There were statistically significant differences of hospitalization time ,the time for reaching target of glucose ,insulin dose ,recovery time of body temperature ,hospital costs ,incidence rate of complications ,serum levels of sodium ,potassium and urea nitrogen ,os‐molality and PH value between the two groups(P<0 .05) .Conclusion The combination of Novolin 30R and insulin pump therapy could provide satisfactory clinical efficiency in patients with diabetes mellitus complicated with pulmonary infection .

Objective To evaluate the application effect of modular management in technique and nursing of department of radiology. Methods 7 modules were divided: administrative management, quality management, equipment management, environment and emergency management, material cost management, education management and scientific research management. Each module was responsible for specially-assigned person reporting daily circumstance. Results After more than a year, 16 technical professionals, 8 educational professionals, 10 research professionals and 7 technicians were cultivated, 12 key performance indicators (KPI value) increased steadily were set up. Conclusions Modular management provided a novel concept for technique and medical care management of radiology department. Our practice suggests that modular management is alternative for development of technique and medical care in radiology department. Further research and application are needed.

Objective To investigate the outcome of the finger reconstruction using one toe transfer to repair the tissue defects of two fingers at the same time. Methods Two fingers joint tissue missing and finger defect of 8 fingers in 4 cases were reconstructed with dissociative transplants harvested from two parts of the same toe at the same time.Using the paratelum of the second toes reconstructed the indicis paratelum or finger tip,and using the proximal interphalangeal joint of the second toes repaired the proximal interphalangeal joint's tissue defects of the middle finger at the same time in 2 cases.Using the distal interphalangeal joint and the proximal interphalangeal joint of one second toe reconstructed the proximal interpha langeal joints of the index finger and the middle finger in 1 case.Using the proximal interphalangeal joint and the metatarsophalangeal joint of one second toe reconstructed the metacarpophalangeal joints of the index finger and the middle finger in 1 case. Results All the transplants survived.The patients were followed-up from 2 months to 46 months postoperatively.The function and shape of 2 resconstruction fingers were excellent as assessed with Criterion on Functional Evaluation on Finger Reconstruction issued by Chinese Society of Hand Surgery.Five resconstruction fingers were good.One resconstruction finger was fire. Conclusion For some appropriate cases with the tissue defects of 2 fingers such as the finger's paratelum,the interphalangeal joint or the metacarpophalangeal joint,this operated technique was a good method.

Objective To study the value of D‐dimer for early diagnosing ischemic bowel disease(IBD) and to find more econom‐ic and more effective detection means for its diagnosis and control .Methods Ninety‐five patients with suspected acute IBD in our hospital from October 2014 to October 2015 were selected as the observation group ,and contemporaneous 74 individuals undergoing routine physical examination were selected as the control group .The differences in D‐dimer levels were compared between the con‐trol group and the patients with definitely diagnosed IBD in the observation group on 1 ,7 ,14 d after admission .At the same time the differences in initial WBC level and fecal occult blood were compared between the two groups .The sensitivity and specificity of plas‐ma D‐dimer level for early diagnosing IBD were calculated and their clinical application value was summarized .Results (1) Accord‐ing to plasma D‐dimer results ,the 74 cases of acute IBD were diagnosed and 21 cases were negative ,while 80 positive cases and 15 negative cases were diagnosed by adopting the CT inferior mesenteric arterial angiography and multislice spiral CT ,the sensitivity of plasma D‐dimer detection was 88 .75% and specificity was 80 .0% .(2) The D‐dimer level ,WBC count and fecal occult blood on 1 d after admission in the observation group were (5 480 .12 ± 876 .32)μg/L ,(17 .37 ± 2 .21) × 109/L and 81 .3% respectively ,which were far higher than those in the healthy control group ,the differences were statistically significant (P<0 .05) .(3)The D‐dimer levels on 1 ,7 ,14 d after admission in the observation group were significantly higher than those in the control group (P<0 .05) , while with the treatment duration extension ,the plasma D‐dimer level was gradually decreased .Conclusion The D‐dimer detection has a relatively higher sensitivity and specificity in the early diagnosis of acute IBD and has better clinical application value .

Objective To clarify the diagnostic value of salivary gland ultrasonography in Sj(o)gren's syndrome (SS),and its correlation with the disease activity index and important organs involvement were analyzed.Methods A total of 116 patients with SS were involved,including 71 cases of primary SS and 45cases of secondary SS.Ultrasonography examination of major salivary glands was conducted for these patients,at the same time the clinical data including inflammatory parameters,the immunological parameter and the involved systems were collected.Ultrasonography examination was conducted in 49 cases as the control group.Use t test,x2test and analysis of variance for statistical analysis.Results The positive rate of salivary gland uhrasonography in SS (56/116,48.3％) was significantly higher than that of the normal control groups (1/49,2.0％),(The chi-square value was 32.57,P＜0.05),the sensitivity of salivary gland ultrasonography in primary SS (62.0％) was obviously higher than secondary SS (27％),(The Chi-square value was 13.75,P＜0.01).The specificity of salivary gland ultrasonography was 98％.The scores of salivary gland ultrasonography had shown positive correlation with the erythrocyte sedimentation rate,the levels of Immunoglobulin (Ig)G,and RF(r=0.234,0.353,0.176;P=0.002,0.000,0.013),and negative correlation with the white blood cell count (r=-0.292,P=0.000).Conclusion Salivary gland ultra-sonography provides additional evidence for the diagnosis of SS,particularly in primary SS groups.The scores of ultrasonography are correlated with inflammatory biomarkers,indicating that salivary gland ultrasonography is related to disease activity.

Objective To explore small size toe tissue flap for aesthetic reconstruction of the thumb and / or finger. Methods Six kinds of small size toe tissue transplants had been applied in repairing skin-bone-joint composite tissue defects of the thumb or finger in 74 cases. Results Among 83reconstructed flaps of the 74 patients, 81 flaps survived completely. Follow-up examination made three to forty-eight months postoperatively showed that the outward appearance were excellent in most cases. The function of the thumbs or fingers were good. The donor feet can walk normally with no pain. Conclusion A variable combinations of toe tissues including skin, soft tissue, bone and joint can be harvested to form a lot of small size transplants for refined aesthetic reconstruction of thumb and finger. The functional and aesthetic results are good and the treatment course is shortened.

OBJECTIVE To investigate the clinical feature,diagnosis and treatment of tuberculosis in post-solid organ transplantation patients.METHODS The clinical data of 11 patients with tuberculosis post-solid organ transplantation were analyzed retrospectively,in which eight cases were the patients with post-liver transplantation,two cases were the patients with post-kidney transplantation and one patient with post-liver and kidney transplantation.The diaghosis were based on the case history,pathogenic,image and the consequence of diagnostic therapy against tuberculosis were observed.RESULTS Infection rate of tuberculosis after liver transplantation,kidney transplantation and combined liver and kidney transplantation were 0.92%,1.10% and 7.14%,respectively.The three cases suffered from acute miliary tuberculosis.One case suffered from exudative pulmonary tuberculosis.One case suffered from tuberculosis pleuritis.One case suffered from lymph node tuberculosis.One case suffered from tuberculosis of lumber spine complicating exudative pulmonary tuberculosis.Four cases were not found lesion in their body.Each patient was adopted with individual treatment.The following up were 83 day to 1080 day.One case was died.Ten cases were cured.CONCLUSIONS Tuberculosis patients with post-solid organ transplantation had atypical clinical symptom under immunosuppressive agents.Part of the patients are lacked of evidences from image,bacteriology or immunology.Diagnostic errors are made sometimes.Diagnostic therapy against tuberculosis should be put into practice for the patients with suspicious tuberculosis.