Objective:To find the rate of anxiety and depression in peritoneal dialysis (PD) patients,and the relationship between these emotion disorder and PD processes.Method:88 PD patients were studied, their mood state was evaluated with Hamilton Anxiety Scale and Hamilton Depression Scale. Nutritional indexes, residual renal function and dialysis adequacy, and inflammation status were also recorded as well as history of cardiac-cerebral vascular disease. These patients were followed for 2 years.Result:44.3% patients were detected as anxiety, and 56.8% depression. Higher SGA was associated with higher Hamilton anxiety/depression scale. Patients with higher anxiety and higher depression had lower serum albumin, lower protein intake, lower body index, and lower mid-arm muscle area and fat area. Anxiety and depression is related to cardiac-cerebral vascular diseases and diabetes.There was no significant relationship between Hamilton anxiety/depression score and patient's survival.Conclusion:There is a high rates of anxiety and depression in PD patients and it may be a potential risk factor of malnutrition.

Objective To study the relationship between the levels of serum IL-6, TNF-? and L-carnitine and atherosclerosis in hemodialysis patients. Methods 43 cases of hemodialysis patients and 33 cases of healthy subjects were enrolled in this study. The serum levels of IL-6, TNF-? and free L-carnitine were measured. Carotid artery atherosclerosis plague was detected by type B echocardiogaphy. Results Serum IL-6 and TNF-? levels significantly increased in hemodialysis patients than those in healthy subjects. Frequency of serum free L-carnitine deficiency(

Objective To investigate the change of dendritic cells (DCs) in rats with hepatic carcinoma treated by radiofrequency ablation (RFA),and to explore the mechanisms of anti-tumor immune response to RFA. Methods Forty healthy SD rats with established animal model of hepatic carcinoma were randomly divided into control group (n = 10) ,RFA 7 d group (n = 16) and RFA 14 d group (n = 14). The rats of control group were killed without treatment. The other rats were killed in 7 d and 14 d after RFA treatment respectively. Peripheral blood, liver tissue around the ablation area and spleen were taken out. The OX62,OX6,CD86 of DCs were analyzed with flowcytometry. Results ①OX62 cells accounted for (0.45 ± 0.19)% of mononuelear cells in peripheral blood in control group. The account of OX62 cells increased to (0.78 ± 0.30)% and (1.53 % 0.80)% in RFA 7 d and 14 d groups respectively. There were significant differences between control and RFA 7 d group, control and RFA 14 d group (P<0.05). ②OX62 cells accounted for (18.91 ± 4.58)% of mononuclear cells in liver tissue around the tumor in control group. The account of OX62 cells increased to (24.49 ± 4.59)% in RFA 7 d group (P<0.05). The expression of OX6 on DCs in liver tissue was (15.29 ± 4.59)% and increased to (34.2 ± 11.62)% and (39.18 ± 9.14)% in RFA 7 d and RFA 14 d group respectively (P<0.05). ③OX62 cells accounted for (11.69 ± 4.39)% of mononuclear cells in spleen in control group which increased to (15.10±2.37)% in RFA 14 d group (P<0.05). Conclusions The precursor DCs in peripheral blood and DCs in liver and spleen increased significantly after RFA. The expressions of OX6 on DCs in liver and spleen increased after RFA. RFA can promote the differentiation and maturation of DC. The increased function of antigen presenting may contribute to the anti-tumor responses after RFA.

Objective To investigate the relationship of B-type natriuretic peptide(BNP),Creactive protein(CRP)and left ventricular diastolic function with cardio-and cerebrovascular disease (CVD)in the elderly patients with hemodialysis.Methods 96 elderly patients with hemodialysis were divided into CVD group(n =35)and non CVD control group(n =61).The patients were followed up once a month for 24 to 30 months.The baseline anthropometric and laboratory parameters were measured.The ratio of mitral peak flow velocity(E)and peak velocities at mitral annuluses (Em)during early diastole of left ventricular was recorded by doppler echocardiography.The time and cause of hospitalization and mortality by CVD were documented.Results The levels of CRP and BNP were significantly higher in CVD group than in control group[(3.1 ± 6.7)mg/L vs.(1.8 ± 1.2)mg/L,(1345.2±1427.8)pmol/L vs.(719.8±1073.8)pmol/L](t=2.14 and-2.82,P＜0.05 or P＜0.01).The ratio of E/ Em was increased in CVD group as compared with control group(t=5.23,P＜0.01).Kaplan-Meier survival curves showed that the morbidity of CVD events was enhanced(P＜0.05 or P＜0.01)at BNP≥500 pmol/L,CRP≥1.5 mg/L and E/Em≥17 which were the independent risk factors of CVD events for the elderly patients with hemodialysis by COX regression model.There was positive correlation between LogBNP and E /Em(r =0.23,P ＜ 0.05).Conclusions Higher levels of BNP,CRP and E/Em may predict the increasing risks of CVD in the elderly patients with hemodialysis.

Objective To discuss the change of serum TGF-β1 and IL-10 in peripheral blood of rats with liver tumor treated by RFA.Methods Thirty experimental liver tumor model of SD rats were prepared by implantation of tumor particles.These rats were randomly divided equally into three groups including 1 week after RFA,2 week after RFA and control group.Peripheral blood of control group,group 1 week after RFA and group 2 week after RFA was taken out respectively without RFA,1 week and 2 week after RFA.The mononuclear cells of peripheral blood were separated by Ficoll density gradient centrifugation.The expression level of IL-10 in peripheral blood was analyzed with flowcytometry.Serum TGF-β1 were dectected by ELISA.Results The serum expression level of TGF-β1 of control group was(6.61±0.12)μg/L,and that of group 1 week and 2 week after RFA were respectively(5.63±0.46)μg/L and(5.53±0.56)μg/L.There was statistical significance for the difference between control group and group 1 week or group 2 week after RFA.The serum expression level of IL-10 of control gorup was 95.92±2.31,and that of group 1 week and 2 week after RFA were respectively 89.71±5.44 and 87.67±11.11.There was statistical significance for the difference between control group and group 1 week after RFA.Conclusions RFA can destroy the tumor tissues in situ and relief immune suppression by IL-10,TGF-β1 secreted by tumor tissue.RFA can improve differentiation and maturation of dendritic cell in local area of tumor and promate ability of antigen-presentation of body.

Objective To investigate the changes of chemokines related to dendritic cells in liver and spleen in rats with hepatic carcinoma treated by radiofrequency ablation (RFA),and to explore the mechanism of anti-tumor responses to RFA.Methods Forty healthy SD rats with established animal model of hepatic carcinoma were randomly divided into control group (n=10),RFA 7d group (n=16) and RFA 14d group (n=14).The rats of control group were killed without treatment.The other rats were killed in 7d and 14d after RFA treatment respectively.Spleen and liver tissue around the ablation area or around the tumor were taken out.The expressions of macrophage inflammatory protein (MIP)-1a in liver tissue and MIP-3β in spleen were analyzed by ELISA.Results The expression of MIP-1a in liver tissue was (232.92±54.5B)ng/L in control group,which enhanced to (499.38±15.14)ng/L and (495.90±9.94)ng/L in RFA 7d and 14d groups respectively.There were significant differences between control and RFA 7d group,control and RFA 14d group(P＜0.05).The expression of MIP-3βin spleen was (70.08±2.67) ng/L in control group,which enhanced to (151.57±48.48)ng/L and (154.57±18.25)ng/L in RFA 7 d and 14 d groups respectively.There were significant differences between control and RFA 7 d group,control and RFA 14 d group (P＜0.05).Conclusions The expressions of MIP-1a in liver tissue and MIP-3β in spleen increase significantly after RFA.These changes will promote recruitment and migration of dendritic cells and may contribute to the anti-tumor responses after RFA.

Objective To study the change of spleen Dendritic cells in normal rats treated by radio-frequency ablation(RFA). Methods Eighteen healthy SD rats were separated into group 1 week after RFA with 6 rats,group 2 week after RFA with 6 rats and control group with 6 rats. Spleen tissue were taken out respectively before RFA, 1 week after RFA and 2 weeks after RFA. The number and the phenotype of Dendritic cells in spleen were analyzed with flowcytometry. Results Pathologyical examination after RFA showed the characteristic that coagulation necrosis and cellular degeneration and granulation tissue forming appeared from target center to peripheral of the target. (10. 36±3. 21) % of normal rat mononuclear cells in spleen express OX-62, the ratio became (18. 03±5. 7) % 1 week after RFA and (12. 63±8. 0) % 2 weeks after RFA, the difference between group 1 week after RFA and control group was marked. (76. 33±7. 86) % of normal rat mononuclear cells in spleen express OX-6,the ratio became (78.33±7.25)% 1 week after RFA and (86. 04±7. 25) % 2 weeks after RFA, the difference between group 2 weeks after RFA and control group was marked. (63. 06±8. 77) % of normal rat mononuclear cells in spleen express CD86,the ratio was (55. 74±14. 49)% 1 week after RFA and (63.49±11.81)% 2 weeks after RFA,the difference between groups 1 week or 2 weeks after RFA and control group was not marked. Conclusions RFA can increasing the number of precursor Dendritic cells migrating from peripheral blood to spleen, and those cells may furtherly differentiate or maturate, which may be contributed to improve the ability delivery of body to antigen to a certain extent.

Objective To study changes in the expression levels of OX-62, OX-6 and CD86 of mononuclear cells and the related chemotatic factor macrophage inflammatory protein-1α (MIP-1α) in the livers of rats with Walker-256 tumors treated with radiofrequency ablation (RFA) and to elucidate the influence of RFA on differentiation and migration of liver dendritic cells(DCs).Methods Walker-256 liver tumors were induced in 60 SpragueDawley rats by implanting tumor particles. These rats were randomly divided equally into three groups from which liver tissue around the local area of the tumor was sampled at 7 d and 14 d after RFA. The mononuclear liver cells were separated with Ficoll density gradient centrifugation. The expression levels of OX-62, OX-6 and CD86 in the mononuclear cells were analyzed with flow cytometry. The expression level of MIP-1α in the liver tissue was detected by enzyme-linked immunosorbent assay (ELISA). Results The average expression of OX-6 in the control rats was 15.29 ±4.59% and those 7 d and 14 d after RFA were 34.20±11.62% and 39.18±9.14% respectively. The difference between the two RFA groups and the control group was statistically significant. The average expression rate of OX-62 in the control rats was 18.91±4.58% and those 7 d and 14 d after RFA were 24.49±4.45% and 22.77 ± 3.50% respectively. The difference between the 7 d group and the control group was significant. The average expression rate of CD86 in the control rats was 66.29±17.69% and those 7 d and 14 d after RFA were 55.29±10.69% and 55.93±12.64% respectively. These differences between both RFA groups and the controls group were not significant. The average expression level of MIP-1 α around the tumors was 232.92±54.58 pg/ml in the controls and 499.38±15.14 pg/ml and 495.90±9.94 pg/ml 7d and 14 d after RFA respectively. These differences from the controls were both statistically significant. Conclusion The expression of MIP-1α around the tumors was elevated after RFA, which could promote the migration of DCs. The changes in the expression of OX-62, OX-6 and CD86 also could reflect increased DC differentiation, which could improve local antigen-presenting capacity to a certain extent and recovery of host anti-tumor immune response.

BACKROUND:Previous studies have confirmed that radiofrequency ablation(RFA)has not only efficiently killed tumor cells,but also improved immune suppression of organism.Antigen presenting cells play an important role during anti-tumor immune reaction.Dendritic cells are most powerful antigen presenting cells.OBJECTIVE:To study the influence of RFA on OX-62,OX-6 and CD86 expression of rat peripheral blood mononuclear cells.DESIGN,TIME AND SETTING:The randomized controlled animal observation was performed at the School of Oncology of Peking University from June 2005 to March 2006.MATERIALS:A total of 12 Sprague Dawley rats were equally and randomly assigned into control and 1 -week radiofrequency groups.METHODS:2 mL peripheral blood was extracted from rats of the control group following rats were sacrificed.The left lobe of rat liver was exposed,inserted with acicular electrodes at tilted position.The acicular electrodes were spread out.The action time was 4 minutes.After RFA,the rats were given anti-infective therapy.2 mL peripheral blood was taken out after they were put to death 1 week after RFA.MAIN OUTCOME MEASURES:The following parameters were measured:pathomorphological observation on the liver of normal rats after RFA;OX-62,OX-6 and CD86 expression of peripheral blood mononuclear cells before and after RFA.RESULTS:Pathologyical examination after RFA showed the characteristic that coagulation necrosis and cellular degeneration and granulation tissue forming appeared from target center to peripheral of the target.Positive expression rate of OX-62 in rat peripheral blood in the 1-week radiofrequency group[(0.70±0.16)%]was significantly higher than in the control group [(0.34±0.08)%,P ＜0.05].No significant difference in positive expression rate of OX-6 and CD86 in the peripheral blood mononuclear cells between both groups(P＞0.05).CONCLUSION:RFA can promote the increased number of precursor Dendritic cells in rat peripheral blood,which may be contributed to improve the ability to angtigen presentation during immune response.Dai Wei-de,Doctor,Associate chief physician,Department of Ultrasound,Beijing Hospital of Ministry of Public Health,Beijing 100730,China dai.weide@126.com

Objective To summarize the manifestation of solid pseudopapillary tumor of the pancreas (SPTP) on ultrasound and contrast-enhanced ultrasound (CEUS) and to investigate the diagnostic value of CEUS. Methods The ultrasound and CEUS images of six patients with SPTP confirmed by pathology were reviewed. According to CEUS record,the enhanced and wash-out time,enhanced speed and degree of tumor were analyzed. Results On ultrasound, SPTP presented as solid, well-circumscribed masses, usually heterogeneous in echo texture, and some of them contained macro-calcification. On CEUS, the tumor enhanced simultaneously or slightly late compared with normal pancreatic tissues. The contrast agent washed out quickly in all tumors than in normal pancreatic tissues. The enhanced degrees were equal to or less than that of the normal pancreatic tissues. Some tumors showed capsule and septum enhancement. Conclusions The manifestation of SPTP on CEUS had some features and may be helpful for differentiation diagnosis combine with ultrasound.