To further analyze immunoglobulin (Ig) properties of panel reactive antibodies (PRA) and their potential harmful effects on allogeneic renal transplants. Methods Since dithiothreitol (DTT) is able to crack disulphuric bond of Ig and to depoly-merize IgM with heavy molecular weight, PRA study was performed with treatment of DTT. Thus, a DTT-ERA method was established, which can identify immunoglobulin class in sera of high PRA patients. Results Among 701 recipients, whose sera were positive by the standard PRA, the positive rate of DTT-PRA was 33.2% . Besides, positive PRA patients could be divided into three groups according to their sera's sensitivity to DTT: Group 1 consisted of patients whose sera contained exclusively IgM antibodies; Group 2 consisted of patients whose sera contained of IgG antibodies only; Group 3 consisted of patients whose sera were found to contain both IgM class antibodies and IgG antibodies. Conclusion IgM class antibodies are not associated with posttrans-plant rejection, while IgG antibodies alone and mixture of IgG and IgM antibodies may mediate acute, or even hyperacute rejection.

Objective To make a comparative assessment on both the therapeutic effects and side effects between percutaenous lauromacrogol injection therapy(PLIT) and percutaenous ethanol injection therapy(PEIT) for simple hepatic or renal cyst.Methods In group A,55 patients with simple hepatic or renal cysts underwent ultrasound-guided aspiration and successive PLIT.The intra-operative side effects were investigated and the therapeutic effects assessment by using ultrasonography was conducted 3 months after the treatment.In group B,60 patients with simple hepatic or renal cysts had received ultrasound-guided aspiration and PEIT sometime before.The intra-operative side effects and therapeutic effects on the thirdmonth ultrasonography were independently reviewed according to their case records.Results In group A,3 patients(5.5 ％) expressed slight discomfort but not pain while receiving lauromacrogol injection.Follow-up ultrasound examination at the end of third month demonstrated the cysts in 43 patients completely regressed,while cysts in rest 12 patients shrank over 50 ％ in size,showing the overall response rate(ORR) and completely cure rate(CCR) were 100％ (55/55) and 78.2％ (43/55) for PLIT respectively.In group B,12 patients(20％) suffered from slight to moderate irritating pain or drunk performance.The third-month ultrasound examination disclosed that cysts in 47 patients completely vanished,and cysts in the other 13patients shrank more than a half,indicating the ORR and CCR were 100％ (60/60) and 78.3 ％ (47/60) for PEIT respectively.Conclusions Although their therapeutic efficacy are perfectly similar,PLIT is much more superior to PEIT in term of less and minor side effects.

Objective To investigate the ultrasonic and pathological features of porcine striped muscle injury from thermal and chemical factors respectively, and to analyze the limitation of ultrasound diagnosis given by doctors with different skill levels. Methods An experimental study using fresh porcine striped muscle in vitro was designed, where the injury were caused by microwave ablation (2 450 MHz) and Anhydrous acetic acid (99.8%) injection separately. Blind to pathologic results, the two-dimensiona sonograms taken from each model were analyzed by sonographers with different skill levels independently. Finally, the diagnoses were evaluated and compared among them. Results Two-dimensional sonograms showed distinct changes of the textures in both injury models, which was characterized as the disappearance of regular tissue structure. However, the corresponding histopathology revealed obvious differences between the two interventions on ultrasonograms. There was no statistical difference between chief physician and attending doctor (both of them had over 5-year experiences on skeletal muscle ultrasound ) in identifying the ultrasonic features of boundary, shape and muscle texture (Kappa=0.933, 0.845, 0.789;Kappa=0.790, 0.935, 0.865, all P<0.05). Compared with residents′diagnosis, there were signiifcant differences in identifying the ultrasonic features of echo level and muscle texture in both injury models:Echo level in thermal injury group:chief physician vs residents, Kappa=0.323;attending doctor vs residents, Kappa=0.297. Texture feature in thermal injury group:chief physician vs residents, Kappa=0.259;attending doctor vs residents, Kappa=0.112. Texture feature in chemical injury group:chief physician vsresidents, Kappa=0.253;attending doctor vs residents, Kappa=0.070. Conclusions Microwave ablation and Anhydrous acetic acid can cause different histopathologic changes in correspondence with various features on two-dimensional sonograms. But ultrasonographers with different skill levels leads to signiifcant variations in identiifcation and qualitative diagnosis, which is impossible to be quantitatively analyzed. Chief physician and attending doctor can draw a consistent conclusion and demonstrate the ultrasounic characteristics in porcine striped muscle injury model from thermal or chemical factors.

Objective To explore the effects of Fractalkine (FKN) on the biological functions of human pancreatic cancer cell lines SW-1990 and PNAC-1.Methods Adenovirus mediated FKN-small interfering RNA (siRNA) was transfected into human pancreatic cancer cell lines SW 1990 and PNAC-1.The differences in proliferation and invasion ability between before and after FKN-siRNA transfection were determined by clone formation assay,MTT assay and cells invasion assay.After FKN-siRNA transfection,the expression of FKN,tumor necrosis factor (TNF)-α and interleukin (IL)-6 at protein and mRNA level in human pancreatic cancer cell were detected by Western blot and reverse transcription-polymerase chain reaction (RT-PCR).The data were analyzed by one way analysis of variance.Results After human pancreatic cancer cell lines SW-1990 and PNAC-1 transfected with FKN-siRNA,the clone numbers (5.27 ％ ± 0.35 ％ and 4.60 ％ ± 0.30％ ) increased compared with those of control group ( 1.97％ ±0.25％ and 1.77％ ± 0.25％ ) and negative FKN-siRNA group (2.10％±0.30％ and 1.97％±0.25％),and the difference was statistically significant (F=113.51,103.86; both P＜0.05).The clone size was also enlarged.After human pancreatic cancer cell lines SW-1990 and PNAC-1 transfected with FKN-siRNA for 48 hours and 72 hours,the MTT test results showed the absorbance value (48 h:1.28±0.07 and 1.19±0.14; 72 h:1.49±0.11 and 1.52±0.16) was higher than that of control group (48 h:0.80±0.03 and 0.74±0.11;72 h:0.89±0.03 and 0.93±0.04) and negative FKN-siRNA group (48 h:0.85±0.02 and 0.76±0.05; 72 h:0.89±0.02 and 1.07±0.09),and the difference was statistically significant (F=83.80,71.99,17.19,23.51; all P＜0.05).The invasion ability assay showed that the invasion ability of FKN-siRNA transfected cells was stronger than that of control group and negative FKN-siRNA group,and the difference was statistically significant (F=37.37,9.08; both P＜0.05).After FKN-siRNA transfection,the expression of FKN at protein and mRNA level in SW-1990 and PNAC-1 cell line decreased (protein:F=118.93 and 88.62,mRNA:F=47.91 and 72.59),at the same time the expression of TNF-α and IL-6 at protein and mRNA level increased (protein:FTNF-α =112.90 and 77.88,FIL-6 =165.27 and 286.49,mRNA:FTNF-α ==47.93 and 45.19,FIL-6 =36.41 and 23.67),and the differences were statistically significant (all P values＜0.05).Conclusion With siRNA technology to silent FKN function,the proliferation and invasion ability of pancreatic cancer cell lines increased,which indicated FKN might inhibit certain biological functions of pancreatic cancer cells.

Objective To investigate the relationship between the dynamic changes of interleukin-1β (IL-1β) levels and severity and complications of patients with multiple trauma at the early stage.Methods Among 97 patients with multiple trauma in Emergency Department of Shanghai Jiao Tong University Affiliated Sixth People's Hospital between August 2015 and May 2016,12 patients were excluded as follows,(1) with burns or chemical injuries;(2) pregnancy or menopausal women;(3) had bacterial infection a week ago;(4) with chronic diseases.The other 85 patients with multiple traumas were classified into three categories according to the injury severity score (ISS).That is,the slight group (22 cases,9≤ ISS ＜ 15),moderate group (35 cases,15 ≤ ISS ＜ 25) and severe group (28 cases,ISS ≥ 25).Their venous blood samples were collected at 6,12,24,48 and 72 hours after trauma respectively,and the serum IL-1 β levels were measured using a specific immunoluminometric assays.The basal conditions including age,the hospitalization days and so on among these three groups were compared via ANOVA.The mean IL-1 β levels at above time intervals among three groups were compared.Finally,the relationship between the peak concentration of IL-1β and injury severity and complications was analyzed by multiple Logistic regression.Results (1) As the increasing severity of trauma,the patients with longer days of hospitalization and higher rate of multiple organ dysfunction syndrome (MODS) (P ＜ 0.05).(2) The levels of IL-1 β in the moderate and severe groups were remarkably higher than those in the slight group (P ＜ 0.02).(3) The IL-1β levels in each group peaked at 6 hours after trauma and began to decline.(4) Multivariate logistic analysis showed that peak concentration of IL-1 β was still an independent predictor for injury severity (moderate group:odds ratio,1.21;95％ confidence interval:1.05-1.39,P =0.007;severe group:odds ratio,1.20;95％ confidence interval:1.03-1.40,P =0.019) and sepsis (odds ratio,1.28;95％ confidence interval:1.10-1.50,P =0.001),but had no significant association with MODS and trauma mortality even after controlling other risk factors.Conclusions The serum IL-1β at 6 hours after injury could be used as an early effective indicator to evaluate the injury severity and infectionrelated complications in patients with multiple trauma.

Objective To explore the neuroprotection of Shuxuetongmai capsule pretreatment, and the effect on the expression of p38 mitogen-activated protein kinase (p38MAPK) in rats with middle cerebral artery occlusion. Methods Ninety-six male SD rats were divided randomly into sham-operated group,ischemia/reperfusion group (I/R),ischemia preconditioning group (IP),and Shuxuetongmai group(n=24). Each group was further randomly divided into 4 subgroups by 3 h, 6 h, 24 h and 72 h after reperfusion, 6 rats in each subgroup. Sham-operated group was only performed artery separation . The middle cerebral artery occlusion (MCAO) model was set up in I/R rats by Longa method. The IP rats were performed for three minutes on the bilateral carotid artery ligation, and formed MCAO model 24 hours later. The rats in the Shuxuetongmai group were pretreated with Shuxuetongmai capsules for 14 days on gavage before the establishment of MCAO model. The neurological deficits were graded in rats by Zea Longa method. Western Blot was used to determine the protein expression of p38MAPK and P-p38MAPK. Tunel method was applied to detect the apoptosis of neurons and the relationship between expression of p38MAPK, P-p38MAPK and apoptosis of neuron. Results No neurological dysfunction appeared in the sham-operated group at each time points, but not for the other groups, which reached the peak at 24 h. Compared with the I/R group, IP group and Shuxuetongmai group presented the mild neurologic function deficiency at different time points in rats (P<0. 05), and no significant differences occurred between ischemia preconditioning group and Shuxuetongmai group (P>0.05). The obvious variation of the value of P-p38MAPK/p38MAPK wasn't detected in sham-operated group at different time points, while obviously presented in I/R group, and the ratios of P-p38MAPK/p38MAPK were increased gradually followed with reperfusion, approaching to the highest level at 24 h. Compared with the I/R group, the P-p38MAPK/p38MAPK declined from 3 h and to the lowest level at 24 h of reperfusion, in both IP and Shuxuetongmai groups(P<0. 05), and with similar phosphorylation. At different time points,very few neurons apoptosis were detected in sham-operated groups, but which increased gradually after reperfusion in other groups, and reached to the peak at 24 h. The neurons apoptosis in both IP group and Shuxuetongmai group were less than that in IR group ( P<0. 05 ) at different time points, and it showed no significant differences on neurons apoptosis between ischemia/preconditioning group and Shuxuetongmai group in rats (P>0. 05). Conclusion Shuxuetongmai capsule pretreatment can induce brain ischemic tolerance, attenuate the apoptosis of neurons in cerebral ischemia reperfusion, and improve neurologic function. The mechanism may be related to the inhibition of p38MAPK phosphorylation.

Objective To summarize the multimodal ultrasonographic characteristics primary thyroid lymphoma (PTLs), and to discuss the diagnosis and differential diagnosis of PTLs. Methods Multimodal ultrasonographic charactericsits of six cases of PTLs were analyzed retrospectively. All of the patients were examined by the conventional two-dimensional ultrasound (2DUS), color Doppler flow imaging (CDFI), contrast-enhanced ultrasound (CEUS), three-dimensional ultrasound (3DUS) reconstruction and elastography imaging (EI) from October 2011 to February 2016 in Changzheng Hospital, affiliated to Secondary Military Medical University. All diagnoses were confirmed by ultrasound-guided percutaneous biopsy.Results (1) 2DUS: six cases of PTLs without capsule were observed as diffusely enlargement type (two cases), unilateral nodular type (one case, on left lobe),and bilateral multiple nodular type (the other three cases). The margin of the multiple nodules were not clear, and some nodules were fused with each other.There were four cases of heterogeneous (extremely) hypoechogenicity and two cases of mixed echogenicity, All of the lesions were characterized by various striped and reticular hyperechogenicity interiorly on ultrasonograms, and only one case showed slightly posterior enhancement. Except one case, multiple cervical lymphnodes hyperplasia were identified on neck regionⅡ-Ⅴin five cases. (2) CDFI and CEUS:CDFI showed abundant blood flow signals in the PTLs nodules peripherally and internally. The striped blood flow was observed in the lesions, and spectrum showed as artery and veins. The plentiful vascular tree was also found in the enlarged lymphnodes. By using high frequency CEUS, six cases of the PTLs demonstrated diffuse and heterogeneous enhancement significantly, including little necrosis area without prominent contrast agent filling in two cases. (3) 3DUS reconstruction: Various striped and reticular hyperechoic features were found on the surface of six cases of PTL nodules. (4) EI: All lesions were soft in six cases. The ratio of elastic strain rate was 1.28-1.96, average (1.82±0.29).Conclusion The ultrasonographic features of PTLs are of certain characteristics, and multiple modes of ultrasound examination can help to grasp the comprehensive imaging informations of PTLs, which should be encouraged positively to facilitate the early detection, early diagnosis and early treatment for PTLs.

Abstract With the amendment of China s family planning, the number of firstborn children has increased gradually, thus resulting in only children transitioning to non only children. The emotional changes and the mental and behavioral problems faced by these firstborn children have begun to receive extensive attention among scholars and society. Childhood emotional and behavioral problems can affect later adult life, such as by increasing the risk of maladjustment and peer rejection in adulthood. Research using innovative study designs is crucial to examine firstborn children s emotional and behavioral problems, and the factors influencing these problems. Empirical research on interventions will be highly important to ensure a healthy transition of firstborn children from only children to non only children.

Objective: This study systematically reviewed the findings of studies on the factors influencing emotional and behavioral problems among firstborn children in transition to siblinghood, to provide a theoretical basis for the study of emotional behavior in firstborn children during role transition. Methods: CBM, VIP, CNKI, WanFang Data, PubMed, Web of Science, OVID and EBSCO were electronically searched to collect studies on the relevant factors influencing the emotional and behavioral characteristics of firstborn children in transition to siblinghood (TTS) from inception to March 3rd, 2021. Literature screening and data extraction were conducted by two independent authors to evaluate the risk of bias in the included studies. The results of the included studies were summarized by qualitative analysis. Results: A total of nine studies were included, comprising four prospective cohort studies and five cross sectional studies. Systematic evaluation results indicated three main types of factor associated with behavioral problems among firstborn children:factors of firstborn children (gender, age and temperament), family factors (parents upbringing, family relationships, family environment, social economy, maternal behavior and whether firstborn children knew that the second children would arrive), and social factors (relationships between teachers and students, peer relationships and life changes). The main factors affecting emotions were their own factors (age and self acceptance). Negative temperament in firstborn children, negative parenting styles, negative family relationships and family environments, prohibited behaviors among mothers, whether the firstborn children were informed of the arrival of the second children during pregnancy, poor relationships between teachers and students, peer relationships and life changes may increase the risk of emotional and behavioral problems among firstborn children. Whether other factors might have affected the results of the study is unclear. Conclusion Important factors influencing firstborn children s emotions and behaviors during TTS, must be confirmed through a high quality prospective cohort study. Intervention studies may be appropriate to verify the results and provide an empirical basis for behavioral interventions in firstborn children with different emotional problems.

Objective:To explore the effect of combining functional electric stimulation (FES) with upper limb cycle training in rehabilitating upper limb motor function and ability in the activities of daily living after a stroke.Methods:Sixty hemiplegic stroke survivors were randomly divided into an experimental group and a control group. In addition to conventional rehabilitation therapy, the experimental group underwent 20 minutes of MOTOmed upper limb cycle training every day while receiving FES. The control group received only the 20 minutes of cycle training. Before and after 4 weeks, Brunnstrom staging was used to quantify hand and upper extremity functioning. The Fulg-Meyer assessment upper extremity scale (FMA-UE) and the modified Barthel index (MBI) were also used before the training and after 1, 2, 3 and 4 weeks of the treatments.Results:After 4 weeks of treatment, significant differences were observed in the average BS scores of both groups compared with before the intervention. The average hand and upper limb stages of the experimental group were significantly better than the control group′s averages. Significant improvement was also observed in the average FMA-UE and MBI scores of both groups after only one week, with significantly greater improvement in the experimental group.Conclusions:Supplementing upper limb cycle training with FES can significantly improve the upper limb motor function and ability in the activities of daily living of stroke survivors. It is more effective than the MOTOmed exercise alone.