CD40 Ligand ; pharmacology ; HL-60 Cells ; drug effects ; Humans ; fas Receptor ; metabolism

Objective To design a kind of special support mattress for the endoscopic retrograde cholangiopancreatography (ERCP), and to improve the comfort of the patients during the procedure, and evaluate the efficacy and safety during clinical application. Methods By 3D modeling, we designed a special memory foam mattress for ERCP. From January 2014 to September 2014, 424 patients who underwent ERCP treatment without general anesthesia and could take semi-prone position, were divided into special mattress group (210 cases) and ordinary mattress group (214 cases) according to the random number table method. The satisfaction of the patients and the operators of the two groups were evaluated and compared. Results The operation times of the two groups were (32.9±18.5) min and (33.2±20.1) min, respectively, and there was no significant difference between the two groups (P>0.05). The overall satisfaction ratings of the patients in the two groups were (7.9±1.6) points and (6.3±1.3) points, respectively (P<0.01), and the discomfort ratings of the patients in the two groups were (1.3± 0.9) points and (3.8 ±1.2) points (t=116.45, 246.91, P<0.01). The operator satisfaction scores of two groups were (8.5±1.3) points and (8.5±1.8) points, respectively, and there was no significant difference (P>0.05). No mattress related complications were found. Conclusions The special memory foam mattress for ERCP can alleviate the discomfort and improve the tolerance during the procedure. Therefore, it is worth promoting the application.

Objective To investigate the peripheral blood Th17 and CD4 + CD25 + regulatory T cell levels and their correlations in patients with primary hepatocellular carcinoma (PHC).Methods Peripheral blood samples were collected from 30 PHC patients and 25 healthy controls in the First Affiliated Hospital of Zhejiang University from June 2008 to May 2009.Mononuclear cells were isolated and the Th17 and CD4 + CD25 + regulatory T cells were detected by flow cytometry and compared between patients and controls by t test.Spearman test was performed to analyze the correlation of Th17 with CD4 + CD25 +regulatory T cell concentrations.Results The levels of Th17 and CD4 + CD25 + regulatory T cells in peripheral blood in healthy controls were (2.10 ± 0.87) ％ and (7.10 ± 2.32) ％ ; while those in PHC patients were (3.38±1.68)％ and (11.78±5.62)％ (t=3.640 and 4.162,P＜0.01).The level of Th17 cells was positively associated with that of CD4 + CD25 + regulatory T cells in PHC patients (r =0.821,P ＜0.01).Conclusion The levels of Th17 and CD4 + CD25 + regulatory T cells in peripheral blood are high in PHC patients and positively correlated with each other,which indicates that CD4 + CD25 + regulatory T cells may contribute to the disease progression and pathogenesis of carcinoma through inducing Th17 cells differentiation.

Objective To evaluate the value of CT in diagnosis of cervical intervertebral disk herniation. Methods The observation of CT appearances of 146 cases and the size, type, position of cervical intervertebral disk herniation were analyzed. Results ①Cervical intervertebral disk herniation was always multi-segments,often lolated at C4,5and C5,6. ②C5,6was mostly seen (142 cases,97.3%). ③Among centric and lateral type,centic type was mostly seen { 135 cases,92.5%). ④Of 135 cases of centric type,54 cases were mild type (< 2 mm) ,66 cases were moderate type (2 ～ 4 mm) , 15 cases were severe type (> 4 mm). Conclusion CT scan is convenient, efficient,accuracte and the first choice method in diagnosing cervical intervertebral disk herniation.

Retinopathy of prematurity (ROP) is a proliferative vascular retinal disease. Cryotherapy, laser photocoagulation, intravitreal injection of anti-vascular endothelial growth factor, scleral buckling surgery and vitrectomy are the main treatments. Treated with cryotherapy or laser photocoagulation or intravitreal injection of anti-vascular endothelial growth factor, patients with a history of ROP have thicker foveas, and the morphology of the fovea and the development of the retinal vessels in the macular area are affected, resulting in abnormal vision development. However, the specific mechanisms by which different treatments of ROP affecting the development of the macula are not yet clear. It still need further study with large samples to verify and explore, whether changes in the levels of intraocular vascular endothelial growth factor changing the process of normal macular development and how the abnormal development of the macula affects visual function.

Objective To investigate the role of intra-operative and percutaneous three-dimensional contrast-enhanced ultrasonic cholangiography (3D-CEUSC) in the diagnosis of biliary anomalies. Methods Diluted SonoVue, an ultrasonic contrast agent, was injected into the cystic duct of 13 living liver donors via a cannula for intra-operative 3D-CEUSC, while injection via a T tube or a PTCD tube were done in 14 patients for percutaneous 3D-CEUSC. The maximum branching order of the intra-hepatic bile ducts, the percentages of display of the first-, second-, and third-order intra-hepatic bile ducts, and the rates of detection of biliary anatomical anomalies were evaluated. Results The median of the maximum branching order of the intra-hepatic bile ducts shown was fourth-order on intraoperative 3D-CEUSC and third-order on percutaneous 3D-CEUSC, respectively. The difference was significant (P=0.01). From the first- to the third-order of intra-hepatic bile ducts, the percentages of display for intra-operative 3D-CEUSC were 100% (23/23), 96.2% (50/52) and 82.7% (86/104),respectively, while they were 100% (24/24), 94.6% (54/56) and 60. 7% (68/112) for percutaneous 3D-CEUSC. The differences were not significant when comparing the first- and the second-order branches of intra-hepatic bile ducts as shown either on intra-operative or percutaneous 3D-CEUSC (P=1).The percentages of display of the third-order branches using intra-operative 3D-CEUSC was higher than that of percutaneous 3D-CEUSC (P＜0. 0001). Three biliary anatomical anomalies were detected by intra-operative 3D-CEUSC and 4 anomalies were detected by percutaneous 3D-CEUSC. All of these anomalies were confirmed by X-ray cholangiography. Conclusion Both intra-operative and percutaneous 3D-CEUSC could diagnose biliary anatomical anomalies accurately. These procedures may become important techniques to evaluate the biliary anatomy in hepatobiliary surgery pre-operatively or intraoperatively.

[Abstract ] Objective Numerous studies had shown that synaptic-associated proteins (SNAPs) were closely related to the occurrence and development of tumors .The aim of this study was to investigate the expression of synaptosomal-associated protein 47 (SNAP47) and its correlation with the clinicopathological features in non-small cell lung cancer(NSCLC). Methods The expres-sions of SNAP family (SNAP23, SNAP25, SNAP29 and SNAP47) were extracted and analyzed through the gene expression microarray and the cancer genome atlas ( TCGA) data-base.SNAP47 mRNA expression in 52 cases of lung adenocarcinoma and their correspond-ing normal tissues were detected by quantitative real-time PCR ( qRT-PCR) . Results Among 52 cases of lung adenocarcinoma , SNAP47 mRNA expression levels of 41 cases(78.9%) were significantly higher than the adjacent lung tissue (P<0.05).The mRNA level of SNAP47 was associated with lymph node invasion and advanced clinical patho-logical stage .The mRNA levels of SNAP47 of patients in II/III stage were significantly higher than those of I stage patients ( 6.558 ± 4.730 vs 2.718 ±2.370, P<0.05).The mRNA levels of N1+N2 were higher than those of N0 (6.609 ±4.942 vs 3.360 ±2.987,P<0.05). Conclusion The high specificity of SNAP47 expression in lung cancer tissues might be associated with the invasion and lymph node metastasis of NSCLC , which is the potential therapeutic target of lung cancer .

Objective To investigate the role of contrast-enhanced ultrasound(CEUS) for detection of hepatic artery stenosis(HAS) in recipients following orthotopic liver transplantation(OLT). Methods CEUS was performed in 50 OLT recipients (42 men and 8 women) with abnormal liver function test and/or abnormal findings on color Doppler ultrasound(CDUS). Digital subtraction angiography (DSA), computed tomographic angiography(CTA) or follow-up CDUS was used as the reference standard. The degree (mild,narrowing rate＜50 %; moderate, narrowing rate 50 % ～ 75 %; severe, narrowing rate＞ 75 % ), location and type (single or multiple) of HAS were evaluated. Moderate and severe stenosis were defined as substantial stenosis. Results CTA or DSA depicted substantial HAS in 39 patients, 8 patients with mild HAS or normal HA were depicted on CTA,and the remaining 3 patients were diagnosed as non-substantial HAS on clinical and CDUS follow-up. CEUS depicted substantial HAS in 38 cases. Moreover,CEUS corrected falsepositive findings on CDUS in 9 of 50 cases(18.0% ). The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of CEUS in diagnosing HAS were 90.0% ,92.3% ,81.8% ,94. 7% and 75.0%,respectively. Conclusions CEUS is able to provide comprehensive information including presence,degree,location and type of HAS, which may facilitate the further interventional procedure or surgical treatment.

Objective To explore the adverse reactions of contrast-enhanced ultrasound and treatments of the adverse reactions. Methods 6035 patients examined by contrast-enhanced ultrasound were closely observed in the process and 20 minutes after the examination. The occurrence and clinical manifestations of adverse reactions were recorded. The patients were gave symptomatic treatments. Results Two of 6035 patients experienced mild adverse reactions related with contrast-enhanced ultrasound. The incidence rate was 0. 031% (2/6035). No moderate or serious adverse reaction occurred. The two patients recovered well after symptomatic treatments. Conclusions The contrast-enhanced ultrasound has high safety and low incidence rate of adverse reaction. Patients should be under close observation in the process of contrast-enhanced ultrasound. The symptomatic treatments should be gave in time.

BACKGROUNDTo investigate the expression of aquaporins in human pulmonary adenocarcinoma cell line SPC-A-1.

METHODSThe expressions of aquaporin 1, aquaporin 3, aquaporin 4, and aquaporin 5 in mRNA level and their locations were determined in cell line SPC-A-1 respectively by RT-PCR and immunohistochemistry.

RESULTSThe immunohistochemical stain showed aquaporin 3 and aquaporin 5 located on the membrane of SPC-A-1 cell, but no positive stain of aquaporin 1 and aquaporin 4 was observed. Both aquaporin 3 and aquaporin 5 mRNA expressed in SPC-A-1 cell line, and the expression level of aquaporin 5 mRNA was significantly higher than that of aquaporin 3 mRNA ( P < 0.01). Aquaporin 1 and aquaporin 4 mRNA did not express in SPC-A-1 cell line.

CONCLUSIONSAquaporin 3 and aquaporin 5 express in SPC-A-1 cell, and their roles in water transport of SPC-A-1 cell should be further investigated.