To explore the clinical features,diagnosis and treatment of Langerhans cell neoplasms.The data of 6 patients with Langerhans cell neoplasms was analyzed retrospectively.There were Langerhans cell histiocytosis (LCH,n =5) and Langerhans cell sarcoma ( LCS,n =1 ).Among 5 LCH patients,the involved organs included waist,back,scalp,inguinal lymph nodes,parotid gland and left femur.And the symptoms were fever,splenohepatomegalia and destruction of bone.Three patients received surgery,1 had radiotherapy and 1 was discharged without treatment.The follow-up period was 34 - 138 months.Two patients had no relapse,the contra-lateral parotid gland became involved later in another and several organs were involved in other patients.One patient was lost to follow-up.Left occiput of another LCS was involved and both surgery and radiotherapy were administered.Over a follow-up period of 41 months,there was no relapse.Either surgery or radiotherapy is indicated for this rare disease when a single organ is involved.And chemotherapy is administered for the involvement of multiple organs.The patients should be treated individually.

ObjectiveTo research in the essence of the caring experience of caregiver for children with eye enucleation, to find out the caring experience and caregiver's needs, to give them physical and mental nursing in order to make them cooperate with us and implement effective treatment to children.Methods12 caregivers for children with eye enucleation were given semi-structured interviews. The materials were analyzed, putted in order, and themes were got.ResultsThrough deep interview of 12 caregivers, five titles were summarized:overburdened psychology, limited schedule, requirement of health information, overload economic burden, to return and rebuild.ConclusionsThe results could help nurses to give more correct health education and psychological care to caregivers. Then caregivers can cooperate with nurses to give effective treatment to children, thus life quality of children with eye enucleation will be improved a lot.

Objective To study the protective effects of propofol against ischemia-reperfusion injury in rat brains.Methods Modified Longa modle of focal cerebral ischemia-reperfusion injury was used. 200 healthy male SD rats, weighing 200-300g were anesthetized with intraperitoneal(I.P.) ketamine and propofol. When righting reflx was abolished, external carotid artery was exposed. A nylon thread with rounded end was inserted cranially until anterior cerebral artery was reached. After 3h ischemia nylon thread was withdrawn for reperfusion which lasted 3h. Bloos samples were obtained from orbit. Skull was opened and brain removed. In control group carotid artery was exposed but nylon thread was not inserted cranially. The animals were divided into four groups: (1)ischemia-reperfusion model group: normal saline 10 ml was administered I.P.,(2)operation control group: normal saline was given I.P.at the end of operation,(3)nimodipine group: nimodipine 1 mg?kg -1 was administered I.P. 10 min before ischemia,(4) propofol group: propofol 110 mg?kg -1 was given I.P. 10 min before ischemia. Brain infarction area, cerebral water content, serum lactate dehydrogenase(LDH) and creatine kinase(CK) levels,brain SOD activity and MDA and Ca 2+ levels were measured. Ultrastracture of brain tissue was examined by electron microscopy.Results Propofol 110 mg?kg -1 reduced mortality after brain ischemia/reperfusion injury. Infarction area of brain was significantly smaller in propofol and nimodipine groups than that in group 1. Propofol significantly inhibited the increases in serum LDH and CK levels induced by ischemia/reperfusion, increased SOD activity and decreased MDA content and Ca 2+ level in brain tissue. There was less brain tissue damage in propofol group.Conclusions Propofol 110 mg?kg -1 has protective effect against cerebral ischemia-reperfusion injury in rats.

BACKGROUND: Shape memory polyurethane (SMPU) may be employed for bone repair capable of resisting stress shielding and bone non-union due to the shape memory effect responding to changed external temperature. Evaluating the cytocompatibility of SMPU is important for its further in vivo experiments and applications. However, few have been done to investigate the cytocompatibility of SMPU after encounted from deforming and shape recovering.OBJECTIVE: To evaluate the osteoblast compatibility of SMPU before and after stretching-shape recovering process. METHODS: Solvent casting method was used to fabricate SMPU films; the obtained SMPU films were stretched to 200%, and then fixed and finally recovered to its odginal shape at T_g+15 ℃, T_g-15 ℃ and T_g+15 ℃, respectively. Atomic force microscope (AFM) with tapping mode was employed to probe the surface morphology and phase separation of SMPU. Primary osteoblasts at 3-5 passages were seeded on SMPU films in vitro to evaluate the adhesion, proliferation and spreading of osteoblasts. RESULTS AND CONCLUSION: There were obvious and regular phase separation resulted from soft segments and hard segments in SMPU, and some groove-ddge architectures within a scale of micrometers were produced by the stretching-shape recovering process. These special micropatterned structures promoted osteoblast adhesion and proliferation, and also resulted in partially oriented cell growth along the grooves. Shape memory process, i.e. stretching-shape recovering process may obviously change the surface morphology of SMPU films, and suggesting better biocompatibility with osteoblasts.

BACKGROUND: In clinical, propofol can contract cerebral vessels, decrease cerebral blood flow, decrease brain metabolic oxygen consumption,which can decrease pressure in brain. Studies prove that propofol can protect endothelial cell that may be injuried by active oxygen injury and also decrease nerves injury of experimental rats with cerebral ischemia.OBJECTIVE: To investigate the protective effects of propofol on cerebral ischemia-reperfusion injury in rat and its mechanism.DESIGN: Randomized and controlled study.SETTING:Anesthesiological Department of the Second Affiliated Hospital of Xi'an Jiaotong University.PARTICIPANTS: The experiment was conducted at Pharmacological Laboratory of Medical College of Xi' an Jiaotong University in 2004. Totally 40 healthy male SD rats, aged 3-4 months, weighting 200-300 g, were divided randomly into four groups: Model group, control group, nimodipine group and propofol group, with 10 in each group.METHODS: The rats were anesthetized by intraperitoneal methods with ketamine and propofol separately. When righting reflex was abolished, external carotid artery was separated and ligated. A nylon thread was put at the stump site of external carotid artery without ligation. Model group: 10 mL normal saline was injected into intraperitone in 10 minutes before ischemia.Control group: 10 mL normal saline was injected into intraperitone at the end of operation. Nimodipine group: 10 g/L nimodipine (1 mg/kg) was injected into intraperitone in10 minutes before ischemia. Propofol group: 10 g/L propofol (110 mg/Kg) was injected into intraperitone in 10 minutes before ischemia. When ischemia was lasted for 3 hours, nylon thread was with drawed for reperfusion. When reperfusion was lasted for 3 hours, blood samples were obtained from orbit. Skulls were opened and brains were removed.Effect of propofol on cerebral ischemia-reperfusion injury was observed.MAIN OUTCOME MEASURES: Infarction area, cerebral water content,serum lactate dehydrogenase (LDH) and creatine kinase (CK) levels, brain superoxide dismutase (SOD) activity, malondialdehyde (MDA) and Ca2+levels were measured. Ultrastructure of brain tissue was examined under electron microscope.RESULTS: ①Infarct area in propofol group was significantly smaller than that in model group [(10.45±3.65, 19.68±4.03)%, (t=3.493,P ＜ 0.01)]. ② CK level was lower in propofol group than that in model group [(471±200,1 930±917) IU/L, (t=3.493, P ＜ 0.01)]; and LDH level in propofol group [(8 240±2 580) U/L] was significantly different from that in model group [(15 470±2 680) U/L, (t=3.441, P ＜ 0.01)]; And water content in brain tissue was lower in propofol group than that in model group [(78.2±2.4,82.9±2.9)%, (t=3.321, P ＜ 0.01)]. ③ The death rate of rats was 13.6%in propofol group, and 47.6% in model group, the former was decreased obviously as compared with the latter, and the difference was significant (t=6.21,P ＜ 0.05). ④ SOD activity was (1 690±780) U/g in propofol group and (830±110) U/g in model group, the difference was significant (t=3.420, P ＜ 0.01); but MDA content was obviously lower in propofol group than that in model group [(0.058±0.014, 0.115±0.047) μmol/g, (t=3.336, P ＜ 0.01)].CONCLUSION: Propofol has protective effect on cerebral ischemia-reper fusion injury in rats, and the mechanism is related with inhibition of Ca2+overloading and lipid peroxidation.

Objective To investigate the current situation of thyroid disease by analyzing retrospectively the color poppler ultrasonography data of neck discomfort in Heilongjiang Province.Methods A total of 13 020 cases (18-93 years old) of thyroid ultrasound examination data collected from September 2009 to October 2012 at the Department of Ultrasound,Fourth Affiliated Hospital of Harbin Medical University,were retrospectively analyzed.According to the sonographic features of thyroid (thyroid morphology,size,echo characteristics,blood flow,nodular location,number,calcification,etc),combined with ultrasound diagnosis,the relationships between gender and disease,age and disease,ultrasound diagnosis and disease classification,gender,number of nodules and benign and malignant were analyzed.Results Among the 13 020 cases,524 cases was excluded.There were 2 291 male cases; abnormalities were detected in 1 679 cases,and the abnormal ratio was 73.29％; there were 10 205 female cases; 7 946 cases were abnormal,and the abnormal ratio was 77.86％.The proportion of abnormal thyroid cases of the total number of female was higher than that of male,and the ratio of male and female was 1.00 ∶ 4.73 (1 679∶7 946); gender differences were statistically significant(x2 =18.476,P ＜ 0.01).There were nodular type 5 018 cases,diffuse type 2 012 cases and mixed type 2 603 cases in sonographic findings.The nodular type on ultrasound images showed mainly nodular goiter(79.21％,3 975/5 018).The diffuse type on ultrasonic images showed mainly Hashimoto Thyroiditis(59.24％,1 192/2 012).The mixed cases on ultrasound images showed mainly nodular goiter (89.83％,2 331/2 595).Ultrasound diagnostic results showed that nodular goiter accounted for 65.52％ (6 306/9 625) and Hashimoto Thyroiditis accounted for 17.97％ (1 730/9 625).Proportion of thyroid disease increased gradually with age,reached a peak [29.93％(2 557/8 544) and 28.84％ (2 464/8 544)] between the ages of 41-50 and 51-60 years old.The proportion gradually decreased into[14.17％(1 211/8 544),7.26％(620/8 544)] between the age of 61-71 and ＞ 71 years old.The incidence differences of malignant nodules between different age groups were statistically significant (x2 =407.796,P ＜ 0.01).Among malignant nodules,solitary nodule accounted for 95.76％ (113/118) ; multiple nodules accounted for 4.24％ (5/118),and there were more solitary nodule than multiple nodules(x2 =15.286,P ＜ 0.01).About malignant solitary nodules,women accounted for 87.61％(99/113); men accounted for 12.39％ (14/113),and women's were significantly higher than man's(x2 =360.960,P ＜ 0.01).Correlation analysis showed that the results of ultrasounddiagnosisofvarious thyroid diseases were highly correlated with the ultrasonic types of diseases(r =0.139 99,P ＜ 0.01).Conclusions Nodular goiter and Hashimoto Thyroiditis are the most common adult neck discomfort diagnosed by ultrasound in Heilongjiang Province.The high-risk age of thyroid disease is between 41-60 years old.Thyroid malignant is more common in single nodular,and the number of female patients is significantly higher than that of men.

10.3969/j.issn.2095-4344.2013.24.007

The results of RT-PCR and immunohistochemistry showed that the expressions of vascular endothelial growth factor (VEGF) and its receptor ( flk-1 ) in the renal cortex of insulin-resistant rats during the phase of normal blood glucose were significantly increased, which were decreased by telmisartan. The result suggests that telmisartan may ease kidney damage via decreasing VEGF and flk-1 expressions.

Objective To investigate the correlation between virtual touch tissue quantification (VTQ) and the pathological grading of liver fibrosis in chronic hepatitis B.Methods 64 chronic hepatitis B patients (the chronic hepatitis group) and 40 healthy volunteers (the controlled group) were collected.The patients in the chronic hepatitis group were underwent liver biopsy.According to the hepatic fibrosis degree,the patients in the test group were classified into stage 0,1,2,3 and 4.The liver shear wave velocities (SWV) of all the participant were measured by VTQ.The cut-off values were determined by an analysis of receiver operating characteristic (ROC) curve.Results The mean SWV was (1.04± 0.13)m/s in the controlled group.The SWV in stages 0,1,2,3,and 4 were (1.17 ± 0.08)m/s,(1.33 ± 0.32)m/s,(1.53 ±0.32) m/s,(2.09 ± 0.54) m/s,(2.18 ± 0.70) m/s,respectively.There was a significantly difference in SWV between the controlled group and the chronic hepatitis group (F =34.97,P =0.00).The SWV were significantly different not only between stages 0-2,and 3,but also between 0-2 and 4 (F =8.87,P =0.00).A positive correlation was observed between the liver fibrosis and the SWV in the chronic hepatitis group (r =0.67,P =0.00).When a cut off value was set at 1.43 m/s,area under ROC curve was 0.875.The sensitivity and specificity were 100 ％ and 62.5 ％.Conclusions SWV has a better correlation with liver fibrosis.VTQ can make an accurate assessment for stage 3 and stage 4 of the chronic hepatitis B.Therefore,VTQ can be used as a noninvasive and reliable diagnostic indicator for chronic hepatitis B.

Objective To explore the association between the C46T polymorphism of coagulation factor Ⅻ (FⅫ) gene and the involvement of FⅫ activity (FⅫ:C) in patients with unexplained recurrent spontaneous abortion (URSA), and to elucidate its role in the pathogenesis of URSA. Methods This study included 203 patients with URSA (URSA group) and 171 healthy women with at least one child and no history of infertility or miscarriage (control group) in the southern area of Zhejiang Province. The C 46T polymorphism of the FⅫ gene was analyzed with matrix-assisted laser desorption/ionization time of flight-mass spectrometry (MALDI-TOF-MS) in all subjects. The values of prothrombin time, activated partial thromboplastin time (APTT), fibrinogen, FⅫ:C and other coagulant parameters were determined. The frequency distribution of the wild-type (CC), heterozygote (CT), homozygote (TT) genotypes and C and T alleles were compared between the patients and controls. A comprehensive analysis of association was conducted between C46T genotypes and the FⅫ:C levels in URSA patients. Results The CC, CT, TT genotypes of the FⅫgene were observed in 7 (3.4%, 7/203), 83 (40.9%, 83/203) and 113 (55.7%, 113/203) patients with URSA versus 7 (4.1%, 7/171), 46 (26.9%, 46/171) and 118 (69.0%, 118/171) controls. The frequency of CT in the patients with URSA was significantly higher than that in controls, but the frequency of TT in the patients was lower than that in controls (χ2=7.939, OR=1.884, 95%CI:1.210-2.935, P<0.05). The frequencies of allele C and allele T were observed in 97 (23.9%, 97/406) and 309 (76.1%, 309/406) patients with URSA versus 60 (17.5%, 60/342) and 282 (82.5%, 282/342) controls. The distribution frequency of allele T in URSA group was lower than that in control group (χ2=4.510, OR=1.475, 95%CI:1.029-2.115, P<0.05). The FⅫ:C levels in the patients were (102±13)%in CC genotype, (78±11)%in CT genotype and (59± 9)%in TT genotype, respectively. The differences of the FⅫ:C levels between the CC and CT, CT and TT, CC and TT genotypes in the patients were significant (all P<0.05). Conclusions The low level of FⅫ:C maybe result from the T allele of the FⅫgene in URSA patients. The CT genotype might be relative to the pathogenesis of URSA in a Chinese Han female population from the southern area of Zhejiang province.