Objective To summary 9 cases of histiocytic necrotizing lymphadenitis(HNL) of children and discuss the diagnosis and therapy.Methods Reviewed clinical data and histological findings.Nine cases of HNL from 1999 to 2003 years.Results All patients had fever and swelling of lymph node on neck.They were diagnosed by lymph node excisional biopsy.Six cases were administrated of glucocorticoid and benefited significantly.Conclusions The etiological factor and pathogenesis is unknown,yet.The clinical situation is not characterful.The diagnosis is always established by histopathology. The effect of management using glucocorticoid is remarkable.A long course can probably decrease recurrence.

Objective To analyze causes for postoperative fixation-related complications of femoral in- tertrochanteric fractures treated with dynamic hip screws(DHS)and dynamic condylar screws(DCS).Methods From January 1995 to December 2004,215 cases of intertrochanteric fracture were treated with DHS/DCS.Their postoperative fixation-related complications were analyzed to find out the causes.Results All cases were followed up for 13 to 72 months(mean,32 months).The rate of excellent and good functional recovery of hip was 94.0%. Postoperative internal-fixation-related complications occurred in 31 cases,including hip varus in 14 cases who had posterior intertrochanteric fragments,delayed union of fracture in 12 cases who had fractured calcar and lesser trochanter and massive dissection of soft tissues,and cutting-out of lag screws in five cases,three of whom had to receive prosthetic replacement.Conclusions Unsuitable implant selection is an important factor leading to postoperative fixation-related complications.Unstable fracture,serious osteoporosis and unsatisfactory reduction will increase the incidence of complications.

Objective To study the localization of Smad 2 and Smad 4 proteins, which are intracellular signaling molecules of transforming growth factor ? family in adult rat testis. Method Immunohistochemical ABC method with glucose oxidase DAB nickel enhancement technique was used in the present study. Results Smad 2 immunoreactivity was mainly located in the spermatogonia, spermatocytes, spermatids, Sertoli cells in the seminiferous tubule and Leydig cells in the interstitial tissue. The reactive substance distributes in cytoplasm with negative nuclei. While Smad 4 is mainly expressed in cytoplasm of Leydig cells, and Sertoli cells is weak stained. Conclusion Our findings of Smad 2 expression in spermatogenic cells and Smad 4 expression in Leydig cells provide direct evidence for the molecular mechanism of TGF ? action during spermatogenesis.

Background Research demonstrated that alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid GluR2 (AMPA-GluR2) is associated with amblyopia.It has been shown that levodopa and cytidine diphosphate choline can improve visual function of amblyopic children,but the mechanism is unclear.Objective This study was to explore the possible effects of levodopa and cytidine diphosphate choline on amblyopia.Methods Monocular deprivation (MD) animal models were created in 60 2-week-old SD rats by monolateral eyelid suturing and observed for 31 days and reared in natural light together with 15 other matched normal healthy SD rats.The models were randomly divided into the MD group,levodopa group,cytidine diphosphate choline group and normal saline control group,with 15 rats for each group.40 mg/kg of levodopa,80 mg/kg of cytidine diphosphate choline,I ml normal saline were given to the rats,respectively,for 28 consecutive days.Expressions of the AMPA-CluR2 protein and AMPA-CluR2 mRNA in the rat visual cortex were detected by immunohistochemistry,Western blot and real-time fluorescence quantitative PCR.Use of the animals followed the Regulations for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission.Results The expression values of the AMPA-GluR2 protein (AMPA-GluR2/β-actin) and AMPA-GluR2 mRNA (2-△△Ct) were significantly lower in the MD group than those of the normal control group (protein:0.32 ± 0.02 vs.0.64 ± 0.05,t =13.287,P＜0.05 ;mRNA:0.30±0.01 vs.0.84±0.03,t=38.184,P＜0.05).Those in the levodopa group were significantly increased in comparison with the normal saline solution group (protein:0.59 ±0.04 vs.0.33 ±0.03,t =11.628,P＜0.05 ; mRNA:0.71±0.06 vs.0.33 ±0.02,t =13.435,P＜0.05).The expression values of the AMPA-GluR2 protein and AMPA-GluR2 mRNA were significantly increased in the cytidine diphosphate choline group compared with the normal saline solution group (protein:0.52 ± 0.04 vs.0.33 ± 0.03,t =8.497,P ＜ 0.05 ; mRNA:0.48± 0.04 vs.0.33 ± 0.02,t =7.500,P＜0.05).Conclusions AMPA-GluR2 is associated with the plasticity of visual development.Levodopa and cytidine diphosphate choline may improve visual function by down-regulating the expression of AMPA-GluR2 in the visual cortex.

· AIM: To observe the inhibitory effect of triamcinolone acetonide (TA) on the proliferation of monkey choroidretinal endothelial cells (RF/6A) in hypoxia or normal conditions.retinal endothelial cells of rhesus monkey (RF/6A). The effect of TA on the cellular activity was observed by MTT,the effect on cellular proliferation and apoptosis was detected by flow cytometry (FCM).cycle were reduced and the proportion of cells in G2-M phase was increased under the hypoxia condition .TA had a great effect on the cell cycle of choroid-retinal endothelial cells of rhesus monkey and it induced apoptosis of endothelial cells. It relatively increased the S-phase cells and reduced G2-M phase cells under both normal and hypoxia conditions, which indicates its role in blocking cell cycle from s-phase to G2-M phase and reducing mitosis.RF/6A cells while TA has the opposite effect in both normal and hypoxia conditions. TA can also induce apoptosis of endothelial cells.

Background The afferent signals of proprioceptor in extraocular muscles play an important role in controlling eye position and conjugate movement. Palisade ending in the extraocular muscles is the main source of proprioceptive information, and its abnormalities in structure and function may be associated with the occurrence of nystagmus. Objective This study was to observe the changes of palisade ending in the extraocular muscles of patients with congenital nystagmus ( CN) and discuss the probable mechanism. Methods Modified Kestenbaum procedure was performed on 10 patients with CN, and the extraocular muscle samples were collected during the operation. Normal extraocular muscle samples were obtained from the enucleated eyeballs after ocular wound. The ultrathin sections of extraocular muscles were prepared and double-staining by uranyl acetate and lead citrate. The morphological changes of the palisade ending of extraocular muscles were examined under the transmission electron microscopy. Written informed consent was obtained from each subject before surgery. Results The ultrastructure of palisade ending in the extraocular muscle of CN subjects showed the different degrees of alterations. The mild changes included the collapse and disconnection of external capsules and the nonhomogeneous electron-dense substracts. The degeneration and dissociation of myelin in nerve endings, swelling and vacuolation of mitochondria were also exhibited. Myeloid body was found in axon. In the severe patients,the necrosis of Schwann' s cells,dissolve of axon and disappear of capsules were seen. Conclusion The palisade ending of extraocular muscle in the patients with CN are obviously abnormal in comparison with normal one. These alterations are probably associated with the etiology and pathogenesis of CN.

8 ?g/ml were 7 strains in prophylactic treatment group and 3 strains in non-fluconazole prophylactic treatment group respectively.The two groups had significant difference (x~2=8.75,P

Objective To observe the clinical efficacy of acupuncture at the nine acupoints on nape in treating vertebrobasilar ischemia (VBI). Methods Totally 100 VBI patients were randomized into a treatment group and a control group, 50 in each group. The treatment group was intervened by acupuncture at Fengfu (GV 16), Fengchi (GB 20), Wangu (GB 12), Tianzhu (BL 10), and Jiaji (EX-B 2, C3);while the control group was by oral administration of Nimodipine tablets. The parameters in Transcranial Doppler (TCD) and Dizziness Assessment Rating Scale (ADRS) were observed before and after intervention, and the clinical efficacies were compared. Results The TCD parameters were significantly changed in the treatment group after intervention (P<0.05). The TCD parameters [Vs (RVA), Vd (BA, LVA), Vm (BA, RVA), PI (BA)] were significantly changed in the control group after intervention (P<0.05). After intervention, there were significant differences in comparing the TCD parameters [Vs (BA, LVA, RVA), Vd (BA, RVA), Vm (BA, LVA), PI (BA)] between the two groups (P<0.05). The DARS average scores were significantly changed in both groups after 7-day treatment (P<0.01). The DARS average scores after the whole intervention were significantly different from that after 7-day treatment in both groups (P<0.01). There were significant differences in comparing the DARS average scores between the two groups after 7-day intervention and after the whole intervention (P<0.01). The recovery-markedly effective rate and total effective rate were respectively 76.0%and 98.0%in the treatment group versus 44.0%and 96.0%in the control group, and there was a significant difference in comparing the recovery-markedly effective rate (P<0.05). Conclusions Acupuncture at the nine nape acupoints is an effective method in treating VBI.

Objective:To investigate the expression of Bcl-2 and Bax in renal tissues of patients with hepatitis B virus- associated glomerulonephritis(HBV-GN).Methods:Twenty HBV-GN specimens with complete nephrology data and 10 normal renal specimens were randomly chosen for the present study.Cell apoptosis was detected by means of terminal deoxynucleotidyl transferase mediated d-UTP nick end labeling(TUNEL)and the apoptotic index was calculated;immunohistochemistry was used to detect the protein expression of Bax and Bcl-2.ResuLts:The apoptotic index in HBV-GN group was obviously higher than that of the control group;the apoptotic cells were mainly distributed in the proximal and distal renal tubules and the collecting duct epithelial cells,seldom seen in the glomerular cells.The expression of Bcl-2 in HBV-GN patients was predominately present in the renal tubular epithelia cells(positive in the plasma,membrane and nuclear);the expression of Bax was found in both glomerular cells and renal tubular cells,mainly in tubular epithelial cells,seldom seen in Bowman's capsule or glomerular mesangial region.Conclusion:Apoptosis in the kidney of HBV-GN patients mainly occurs in the renal tubular epithelial cells;expression of Bax and Bcl-2 is mainly in the renal tubular epithelial cells,suggesting that the injury of tubular interstitial damage may be one of the important factors for the development of HBV-GN.

Objective To compare the spine intensity modulated radiation therapy (IMRT) and the conventional radiation therapy on the beagle spinal cord neurons,in order to prove the biological safety of IMRT of the spinal cord.Methods Twelve selected purebred beagles were randomly divided into 2 groups.A beagle clinical model of tumor was mimiced in the ninth and tenth thoracic vertebrae.Then the beagles were irradiated by 2 different models of intensity modulated radiotherapy and conventional radiation therapy,with the total irradiation doses of 50 and 70 Gy.The samples of spinal cord were taken out from the same position of the nine and tenth thoracic vertebrae at the third month after radiation.All the samples were observed by the electron microscope,and the Fas and HSP70 expression in spinal cord neurons were evaluated by immunohistochemistry method.Terminal deoxynucleatidyl transferase mediated dUTP nick and labeling (TUNEL) technique was used to examine the apoptotic cells in the spinal cord.Results The neurons in the spinal cord of IMRT group were mainly reversible injury,and those in the conventional radiation therapy were mainly apoptosis.Compared with the conventional radiation therapy group [50 Gy group,(7.3±1.1)% ;70 Gy group,(11.3 ±.4)%],the apoptosis rate of the spinal cord neurons of the intensity modulated radiotherapy group[50 Gy group,(1.2 ±0.7)%;70 Gy group(2.5 ±0.8)%] was much lower[(50 Gy group,t＝0.022,P＜0.05;70 Gy group,t＝0.017,P＜0.05)].The expression levels of Fas in the IMPT group(50 Gy group,4.6 ±0.8;70 Gy group,7.4 ±1.1)were also much lowerthan those in the other group(50 Gy group,15.1 4-6.4;70 Gy group,19.3 ±7.6.50 Gy group,t＝0.231,P＜0.05;70 Gy group,t:0.457,P＜0.05),while the expression levels of HSP70 in the IMPT group(50 Gy group,9.1 ±0.8;70 Gy group,7.3±1.4)were much higher than those in the conventional radiation therapy group(50 Gy group,2.1 ±0.9;70 Gy group,1.7±0.3;50 Gy group,t＝0.153,P＜0.05;70 Gy group,t＝0.223,P＜0.05).The expression of Fas/HSP70 was positively correlated with the apoptosis rate of the spinal cord neurons(r＝0.996,t＝1.14.P＜0.05).Conclusions The late radiotherapy response of the spinal cord neurons was obviously observed on the third month.Comparison of the morphology and apoptosis rate of the spinal cord neurons after radiotherapy,the expression of Fas and HSP70 indicated that the biological safety in the 1MRT might be much better than that the conventional radiation therapy.