Objective To study the CT appearances of primary pulmonary histoplasmosis (PPHP)and evaluate the diagnostic values of CT for PPHP.Methods The clinical materials and multi-slice spiral CT appearances in 8 patients with PPHP proved pathologically were reviewed retrospectively.Results Single or multiple pneumonia-like lesions were seen in 3 esses,single or multiple nodules or masses were in 4 cases,and both pneumonia-like lesions and nodules or mflsses in 1 case.Calcification and halo sign were common,and only slight enhancement was demonstrated after intravenous contrast administration on CT.Conclusion CT is helpful imaging method in the diagnosis and differential diagnosis of PPHP combining with clinical materials although the CT appearances are not specific.

This paper reviews the research progress in relations between indoor air pollution and human health for the last 20 years,and focuses on: the studies on environmental risk assessment methods; the major health effects caused by indoor air pollution; the minor and limited health effects caused by indoor air pollution; other key issues concerned.

Objective To investigate the combined detection of serum cystatin C (Cys‐C ) and homocysteine (Hcy) for the diagnosis of early renal damage in diabetic children. Methods Data of 97 cases of diabetic children were collected in our hospital. According to the levels of 24 hUAER ,diabetic children were divided into <30 mg group (n=34) ,30~299 mg group (n=42) ,and ≥300 mg group (n=21). 40 cases of healthy children were selected as control group (NC). Laboratory indexes were compared among different groups. The critical values of Cys‐C and Hcy in early diagnosis of renal damage were calculated by receiver operating curve (ROC). Results The levels of Cys‐C and Hcy in <30 mg group were significantly higher than in NC group [Cys‐C (1.04 ± 0.26 ) vs(0.79 ± 0.21 ) mg/L ,Hcy (13.09 ± 2.15) vs(8.57 ± 1.24)μmol/L ,respectively ,P< 0.05]. When Cys‐C cutoff point took 1.02 mg/L ,the diagnosis sensitivity for diabetic nephropathy diagnosis was 86.09% and the specificity was 83.28% ,the maximum diagnostic index reached 1.6937 ,ROC area under the curve was 0.841.When Hcy threshold took 13.00 μmol/L ,the sensitivity was 83.98% and the specificity was 79.24% ,with the maximum diagnostic index 1.6322 and ROC area 0.795.Cys‐C combined with Hcy had a sensitivity of 92.38% and a specificity of 89.17% ,with the maximum diagnostic index 1.764 and ROC area 0.928. Conclusion Cys‐C combined with Hcy detection for early diagnosis of renal injury in diabetic children has important clinical value.

Chimeric antigen receptor-transduced-T (CAR-T) cells shows strong cytotoxicity to the tumor with specific antigen by CTL effects and cytokines releasing without MHC-restriction.As multiple clinical trials from cancer centers around the West countries reported recent years,anti-CD19-CAR T cells can not only induce complete remission of B-cell malignancies resistant,but also eliminate the minimal residual disease (MRD) at the molecular level.It is believed that the obstacles from bench to clinic will be cleared and CAR will become one of the main cancer therapies with breakthroughs in comprehensive treatment of tumors.

Objective To realize antimicrobial resistance rate of Pseudomonas aeruginosa (P. aeruginosa)and it’s correlation with antimicrobial use density(AUD),and to provide reference for control of healthcare-associated infec-tion.Methods From July 2011 to December 2013,antimicrobial resistance rate of P. aeruginosa isolated from hospi-talized patients and AUD of patients were monitored,and the correlation between them was analyzed.Results AUD of patients decreased from 73.61 in the third and fourth quarters of 2011 to 41.33 in the same quarters of 2013. Corre-lation coefficient of AUD and antimicrobial resistance rate of P. aeruginosa was -0.32~0.88,correlation coeffi-cient of resistance rate of P. aeruginosa to aztreonam and aztreonam use density was 0.88,there was statistical sig-nificance. Conclusion AUD of hospitalized patients revealed a decreasing tendency,suggesting antimicrobial selec-tive resistance should be considered in clinic.

Objective To study the action of GSK-3βin podocyte transdifferentiation effecundethe high glucose condition . MethodPodocytewere treated in RPMI-1640 medium with differenconcentrationof glucose fo36 h .The expressionof neph-rin ,podocin ,α-Smand Fibronectin were detected by both Western bloand indirecimmunofluorescence analysi.Athe same time ,the change of albumin inflow amounof podocytein differentreatmengroupwadetected by using the Transwell cham-be.The changeof expression amounand activity of GSK-3βin high glucose condition were detected by using the GSK-3 activity assay ki.The phenotypiand functional changeof podocytewere detected aftedisturbing GSK-3βby GSK-3βsiRNin the high glucose group .ResultThe expression levelof nephrin and podocin protein were down-regulated with the increase of the glucose concentration in dose-dependenmanner(P＜0 .05) ,and the expression level of α-Smwaup-regulated with the increase of the glucose concentration in dose-dependenmanner(P＜0 .05);the albumin inflow amounof podocytewaup-regulated with the in-crease of the glucose concentration in dose-dependenmanner(P＜0 .05) .The expression amounof GSK-3βin the high glucose group waincreased(P＜0 .05) .Compared with the control group ,the expression amounof nephrin and podocin aftehigh glucose treatmenin the GSK-3β siRNtreatmengroup waincreased ,while the expression of α-Smwadecreased .Conclusion The high glucose condition could induce the phenotypichange and functional impairmenof mice podocyte;GSK-3βparticipatein the epithelial-mesenchymal transdifferentiation procesof podocyte undethe high glucose condition .

Objective To discuss the relationship between C-reactive protein and prognosis of acute coronary syndrome. Methods C-reactive protein of 60 acute coronary syndrome patients was evaluated. The individuals were divided into two groups:One group with higher CRP level and another group with normal CRP level. The following-up duration was 6 months. After correct therapy, the morbidity of re-angina, arrhythmia, heart failure, re-infarction and cardiac death was compared. Results The morbidity of re-angina, arrhythmia, heart failure, re-infarction, cardiac death was 46.3%(19/41), 43.9%(18/41),9.76%(4/41),22.0%(9/41),7.32%(3/41)respectively in higher CRP level group; The morbidity of re-angina, arrhythmia, heart failure, re-infarction was 15.8%(3/19),10.5%(2/19), 5.3%(1/19),5.3%(1/19)respectively in normal CRP group and there was no cardiac death accident. There was significant different between the two groups. Conclusions CRP plays an important role in the onset of acute coronary syndrome, and its level is related with the higher morbidity of re-angina, arrhythmia, heart failure, re-infarction and cardiac death.

BACKGROUND: In recent years, there are some effects on using pancreatic islet cell or pancreas transplantation in the treatment of diabetes. But there are still two major problems: lack of donor and immune rejection. Mesenchymal stem cells can be induced to islet-like cells in vitro. OBJECTIVE: To study the progress in the differentiation of insulin secretion cells induced by mesenchymal stem cells. RETRIEVAL STRATEGY: A computer-based online search of Pubmed was undertaken for the related English articles dated from August 1997 to August 2007 with the of "mesenchymal stem cells,insulin secreting cell". At the same time, we searched China Journal Full-Text Database for the related Chinese articles published between August 1997 and August 2007 with the same key words. Total retrieved 108 literatures which are firstly selected into the inclusive criteria: ①The articles focusing on the mesenchymal stem cells induced differentiation into insulin secreting cells. ②choose articles at the same field or published in authoritative magazine published in the recent time. Exclusive criteria: ①Repeated experiments or ②Meta analysis articles. LITERATURE EVALUATION: All the literatures are about the differentiation of insulin secretion cells induced by bone marrow mesenchymal stem cells. Of the 30 selected literatures, 2 are reviews and the others are clinical or basic experiment study. DATA SYNTHESIS: ①Because the pancreas is similar to the nervous system in the mechanism of development and control, now people think that nerve growth factor may be the key signal to the pancreas development. Mesenchymal stem cells have an ability of multi-differentiation; it can be induced into nestin positive cells by using epidermal growth factor and basic fibroblast growth factor. Mesenchymal stem cells will be further induced to pancreatic cells if we add conditioned medium as the appropriate micro-environment for islet cells. ②Now identification and functional study of insulin-like cells are for the following areas: observe whether there is islet-like cells group gathered by cell morphology; test insulin, glucagons and somatostatin expression after induction; test insulin and glucagons gene expression using RT-PCR method after induction; to study the function of induced pancreatic cells by using glucose-stimulated insulin release test. CONCLUSION: As the research about mesenchymal stem cells can be induced islet-like cell in vitro becoming ever-changing technology, it becomes a new program of cell therapy to diabetes in face of all problems. According to all the present experimental results, the insulin secretion of induced pancreatic islet cells is much smaller than the normal amount of insulin secretion. Therefore, how to induce efficiently with human physiology of islet cell in vitro and then transplant safely into the human body will bring a new leap of diabetes treatment.

BACKGROUND: Cells grew slowly in a low number after conventional induction. Growth factor can accelerate induction speed, but growth factor is expensive. OBJECTIVE: To verify the efficiency of differentiation of human bone marrow mesenchymal stem cells (BMSCs) into osteoblasts in vitro in a inductor without growth factor. DESIGN, TIME AND SETTING: The control cytology observation experiment was conducted from July 2007 to February 2008 at the Center Laboratory of Hospital Affiliated to Medical College of Qingdao University. MATERIALS: Bone marrow was collected from diabetic patients undergoing autologous stem cell transplantation. Informed consent was obtained from patients. METHODS: Using density gradient method, BMSCs were separate and primary cultured. At the third passage, BMSCs were incubated in 0.1 ?mol/L dexamethasone, 10 mmol/L ?-glycerine sodium, and 50 ?mol/L vitamin C. BMSCs in the control group were left intact. MAIN OUTCOME MEASURES: Morphology of BMSCs was observed under a phase contrast microscope. Morphological changes were measured by alkaline phosphatase staining and calcified nodules staining after induction. RESULTS: Under the phase contrast microscope, the third passage of BMSCs was uniform, spindle. At 7 days, cells were confluence. Some cells were overlapped over time. Mesenchymal tissues gradually piled up, with mineralization, multiple nodes. At 14 days, brown mineralized nodes were found under an inverted microscope. At 21 days, mineralization in fragmentis were formed. Von Kossa method demonstrated black calcified nodules and positive alkaline phosphatase. CONCLUSION: BMSCs can be induced into osteoblasts easily, with high and rapid proliferation.

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