Objective To investigate the expression levels of regulator of G-protein signaling 4 (RGS4) in pediatric nephroblastoma and pericancerous tissues, and explore the relationship between RGS4 and the occurrence and development of pediatric nephroblastoma. Methods Thirty-seven samples of pediatric nephroblastoma tissues and 8 samples of pericancerous tissues were collected after surgery to detect the expression of RGS4 protein by immunohistochemistry. Another 8 samples of fresh cancer tissues and corresponding pericancerous tissues were collected to detect the mRNA and protein levels of RGS4 by qRT-PCR and Western blot assay, respectively. Results Immunohistochemistry results showed that RGS4 protein was positively expressed both in pediatric nephroblastoma and pericancerous tissues, and its high expression rate was lower in pediatric nephroblastoma than that in pericancerous tissues [(37.83%(14/37) vs. 87.5%(7/8),χ2=4.675, P<0.05]. The expression level of RGS4 mRNA was significantly lower in pediatric nephroblastoma than that in pericancerous tissues (1.064 ± 0.549 vs. 5.374 ± 0.735, t=13.290, n=8, P < 0.01). Western blot results showed that the expression level of RGS4 protein was lower in pediatric nephroblastoma than that of pericancerous tissues (0.301±0.092 vs. 0.779 ± 0.041, t=13.424, n=8, P < 0.01). Conclusion The expression level of RGS4 is down-regulated in pediatric nephroblastoma, which may be related to the occurrence and development of pediatric nephroblastoma.

Objective To compare blood flow perfusion conditions of renal allograft of different renal function with conventional ultrasound and contrast enhanced ultrasonography (CEUS). Methods Sixty patients underwent kidney transplatation were divided into normal group (SCr≤110 μmol/L) and abnormal group (SCr＞110 μmol/L). Renal structure and inner diameter of renal artery were messured with two-dimensional ultrasound. The hemodynamic parameters (PSV, EDV and RI) were messured with CDFI. Data of renal blood flow perfusion (AT, TTP, △I and Increase), data of renal blood flow perfusion (AT, TTP, △I and Increase) were quantitatively analyzed with CEUS combined with time intensity curve. All the data were compared between two groups.Results There was no significantly difference of above indexes for B-mode ultrasound and CDFI between two groups, except EDV of arcuate arteries. CEUS parameters of patients with normal renal function were better than those with abnormal function.Conclusion Microcirculation perfusion changes of transplanted kidney with abnormal function could be detected with CEUS. The quantitative indexes of transplanted kidney with normal function were better than those with abnormal function.

BACKGROUND:Vascular endothelial growth factor (VEGF) is a crucial factor for regulating bone marrow mesenchymal stem cells in microenvironment, which can promote endothelial differentiation of bone marrow mesenchymal stem cells. But there is no report about VEGF effect on regulating the proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells. OBJECTIVE:To investigate the regulatory role of VEGF in the proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells. METHODS:The bone marrow mesenchymal stem cells were isolated and cultured from mouse long bones. cellCounting Kit-8 was used to test the proliferation of bone marrow mesenchymal stem cells cultured with different concentrations of recombinant VEGF proteins. The appropriate concentration of VEGF recombinant protein was selected to test their effects on the osteogenic differentiation of bone marrow mesenchymal stem cells. The mRNA and protein levels of Osterix, Runx2, alkaline phosphatase, osteocalcin and heme oxygenase-1 in bone marrow mesenchymal stem cells under induction of VEGF were detected by molecular biology methods. RESULTS AND CONCLUSION:(1) VEGF promoted the proliferation of bone marrow mesenchymal stem cells dose-dependently, and 100μg/L was the optimum concentration. (2) VEGF promoted the expression of Osterix, Runx2, alkaline phosphatase and osteocalcin in bone marrow mesenchymal stem cells under osteogenic induction. Similar results were obtained by alizarin red staining and quantification of numbers of calcium nodules. (3) VEGF induced the expression of heme oxygenase-1 in bone marrow mesenchymal stem cells at mRNA and protein levels. These findings indicate that VEGF can induce the expression of heme oxygenase-1 i in bone marrow mesenchymal stem cells, and promote the proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells.

[ABSTRACT]OBJECTIVETo study the therapeutic efficacy of Montelucast and Cetirizine on allergic rhinitis in children and their effects on the level of serum IFN-γ and IL-4.METHODS Sixty allergic rhinitis children were randomly divided into treatment group (30 children) and control group (30 children). The control group were treated with cetirizine drops (po, ages 2-6, 5 mg, qd, ages >6, 10 mg, qd.). Treatment group were treated with cetirizine drops combined with Montelucast (po, ages 2-5, 4 mg, qn, ages 6-12, 5 mg, qn, ages >12, 10 mg.). Thirty health children were selected as health group.RESULTSBefore treatment, the level of serum IFN-γ in treatment group and control group were significantly lower than that in health group (P<0.01), but the level of serum IL-4 were significantly higher than that in health group (the F was 19.25 and 143.81 respectively;P<0.01). Before treatment, there was no significant difference in the level of serum IFN-γ and IL-4 between treatment and control group (P>0.05). After treatment, the level of serum IFN-γ of both groups increased, and the level of serum IL-4 of both groups decreased. However, the level of serum IL-4 and IFN-γ in treatment group changed significantly (P<0.01). After treatment, VAS scores were lower than that of before treatment, however that of the treatment group was the lowest (P<0.01). After one month follow-up, there was no significant difference between the two groups.CONCLUSIONThe mechanism of Montelucast and cetirizine on treatment of allergic rhinitis may be related to the correction of the disorder of IFN-γ and IL-4.

Objective To investigate the characteristic and the value of renal solid lesions' boundary at contrast-enhanced ultrasonography(CEUS). Methods The study included 225 patients (124 males, 101 females) with renal 239 solid lesions [133 renal cell carcinoma(RCC) and 106 benign lesions]. The enhanced mode of lesion boundary at CEUS was observed. The histopathologic pseudocapsule of RCCs was analysed.Results Enhanced modes of all lesions' boundary at CEUS were classified as: type Ⅰ , iso-enhanced boundry in whole phase, 82.85 % (198 of 239) ;type Ⅱ , a perilesional annular highly-enhanced signal at early phase,4.18% (10 of 239);type Ⅲ ,perilesional annular highly-enhanced signal in whole phase,9.62% (23 of 239) ;type Ⅳ, perilesional annular highly-enhanced signal in midium and late phase, 1.25 % (3 of 239) ;type Ⅴ ,iso-enhanced boundry in the mdium and late phase with no enhancment at early phase, 2. 09% (5 of 239). The distribution of types Ⅰ , Ⅱ , Ⅲ between groups were significant different( P=0.000, 0.046,0. 000), the type Ⅳ and Ⅴ was not ( P = 0.256,0.068). The distribution of perilesional annular highlyenhanced signal between benign and RCC groups was statistically different (x2=29. 681, P=0.000).Regared it as a diagnostic criteria of RCC,the sensitivity was 26.32% (35/133) ,the specificity was 99.06%(105/106) ,the positive predictive value was 97.22% (35/36),the negative predictive value was 51.72%(105/203) ,and the accuracy was 58.58% (140/239). The perilesional annular highly-enhanced signal was not correlated with the pseudocapsule in pathology ( P = 1. 000). Conclusions The boundary enhancement mode of renal solid lesions at CEUS was divided into five types. The perilesional annular highly-enhanced signal was important in diagnosis of RCC,which was not correlated with the pseudocapsule in pathology.

Objective: To study the action of kangfuxin solution on the experimental gastric ulcer.Methods: The rat gastric ulcer models induced by the ligated pylorus and burned acetic acid, the gastric moucosa injury model induced by the absolute ethyl alcohol were used.Results: Kanfuxin solution possessed the protective action on the rat gastric ulcer model induced by the ligated pylorus and rat gastic mucosa injury model induced by the absolute ethyl alcohol, but didn't affect the rat gastric ulcer model induced by burned acetic acid. Conclusion: Kangfuxin Solution also has the actions of inhibiting the output of gastric acid and pepsin.

Objective To evaluate the medium and long-term therapeutic results of percutaneous transhepatic angioplasty for portal vein stenosis (PSV) following pediatric liver transplantation.Methods From Jan.2008 to Dec.2012,5 cases with PVS after pediatric liver transplantation received percutaneous transhepatic angioplasty.There were 3 male and 2 female cases ranging from 7 months to 8 year-old with the median age of 2 years and 10 months.The protopathy included 1 Carolis disease and 4 congenital biliary atresia.The therapeutic results were monitored by clinical follow-up and imaging examination.The clinical data,imaging examination and therapeutic results were analyzed.Results All interventions were performed successfully,and the treatment efficacy was 100％.One patient was diagnosed with earl-onset PVS at 0.5 month after liver transplantation.Four patients were diagnosed with late-onset PVS at 3-30 months after liver transplantation.The prestenotic portal venous average diameter was (2.3 ± 0.6) mm (1.2-3.0 mm),the degrees of stenosis were 70％-95％.The poststenotic portal venous average diameter was (9 ± 1) mm (8-10 mm) (t =32.560,P ＜ 0.05).The prestenotic portal venous average pressure gradient was (11.0 ± 3.2) mmHg (8-16 mmHg),and the poststenotic portal venous pressure gradient was(2.2 ± 1.5) mmHg(0-4.0 mmHg) (t =8.242,P ＜ 0.05).Postoperative follow-up was 10-66 months,the portal veins of all cases were patent,and patency rate was 100％.Conclusions Percutaneous transhepatic stent angioplasty is an effective and safe method for treatment of PVS following liver transplantation.Its medium and long-term patency rates are high.

Objective To measure the longitudinal elastic modulus in patients with acute ischemic stroke by shear wave elasotography(SWE),and to study its feasibility and related factors.Methods There were 1 79 cases with acute ischemic stroke (AIS)including 103 cases with large artery atherosclerosis and 76 cases with lacunar infarction classified according to the TOAST classification.There were 168 age and sex-matched cases as control group.Pulse wave velocity (PWV ) of bilateral carotid was measured by radiofrequency ultrasound.The 20 areas of superficial walls of bilateral carotid artery were analyzed by SWE,and the average values of longitudinal average elastic modulus (MEmean ),the maximum elastic modulus (MEmax )and minimum elastic modulus (MEmin )were calculated.The independent factors of MEmean were analyzed using multiple linear regression analysis.Results ①Compared with control group, PWV in patients with AIS was increased (P <0.05).②The MEmax and MEmean of carotid artery in patients with AIS were more than those in the control group (P <0.05).③Age,systolic blood pressure,PWV and low-density lipoprotein cholesterol(LDL-C)were positively related to MEmean (r =0.221 ,0.1 74,0.776 and 0.1 73,respectively,P <0.05 ),and were independent factors for MEmean .Conclusions SWE can evaluated the arterial stiffness using longitudinal elastic modulus of carotid.Age,systolic blood pressure,PWV and LDL were independent factors for longitudinal elastic modulus.

Objective To evaluate the therapeutic effectiveness of percutaneous endovascular treatment of hepatic venous outflow obstruction (HVOO)after pediatric liver transplantation(LT).Methods From January 2008 to January 2013,10 children with obstruction of hepatic vein (HV) or inferior vena cava (IVC) anastomosis underwent percutaneous transluminal angioplasty (PTA) with balloon dilation or stent placement.The hepatic venous outflow obstruction occurred 10-455 days (median,125 days) after pediatric liver transplantation.According to the time of obstruction,the obstruction was divide into early onset (＜1 month) and late onset(＞1 month).The effectiveness of PTA was analyzed.Results Twenty-one procedures were performed.One treatment was ineffective,and technical and initial clinical success ratio was 95.2％ (20/21) and 70.0％ (7/10),respectively.In 3 cases with early onset after LT,operation was performed after unsuccessful PTA in 1 case.One patient who developed recurrent stenosis was treated with PTAS.The other patient died of acute rejection.Late onset after LT was found in 7 cases,who were treated with PTA or stent successfully.Conclusions In cases of venous outflow obstruction resulting from HV and/or IVC lesions after pediatric liver transplantation,percutaneous endovascular treatment with balloon dilation or stent placement is a safe and effective alternative treatment that results in midterm and long-term patency.Early-onset or hepatic veins combined with superior vena cava obstruction should be implanted with stents as early as possible.Late-onset or hepatic veins obstruction alone can be get better results with Balloon Dilatation.

Objective To evaluate the clinical value of ultrasonography guided percutaneous core needle biopsy in pancreatic lesions. Methods Thirty-four patients with 36 pancreatic lesions in Shanghai First People′s Hospital Afifliated to Shanghai Jiao Tong University from February 2012 to November 2013 underwent conventional ultrasound-guided percutaneous core needle biopsy using automatic gun and 18-gauge biopsy needles. The site, size, internal and surrounding vascularity, the sampling number of the lesions, and whether the specimens′ quality was satisfied were recorded. Then specimens were sent for pathological examination, and all above observations were compared with the ifnal diagnosis. Results The number of lesions with 2, 3 and 4 samplings was 32, 2 and 2, respectively. The average number of sampling was 2.2 (mean, 2.17;standard deviation, 0.51) and the acquisition rate of satisifed specimens was 89%(32/36). The pathological results of biopsy were malignant in 31 of 36 lesions including 27 cases of ductal adenocarcinoma, 2 cases of lymphoma, 1 case of small cell neuroendocrine carcinoma and 1 case of uterine leiomyosarcoma metastasis. The other 5 lesions were non-malignant including 3 cases of benign lesion, 1 cases of atypical hyperplasia and 1 cases of granulation tissue. The 36 lesions were ifnally diagnosed as 34 cases of pancreatic malignancy, 2 cases of non-malignant neoplasm. The sensitivity, speciifcity, accuracy, positive predictive value and negative predictive value of ultrasonography guided percutaneous core needle biopsy in pancreatic lesions were 91%(31/34), 100%(2/2), 92%(33/36), 100%(31/31) and 40%(2/5), respectively. Youden index was 0.91. Two patients had mild upper abdominal pain and 1 patient had transient elevated serum amylase. No pancreatitis, pancreatic fistula, peritonitis, bleeding or dispersion of malignant cells along the penetrating channel or other serious complications occurred. Conclusion Ultrasonography guided percutaneous core needle biopsy is a simple, rapid, safe and effective diagnostic method in pancreatic lesions with high clinical value.