Stromal cell-derived factor-1(SDF-1)is an early cell growth factor which belongs to a subfamily of chemokines.The CXCR4 is SDF-1 receptor.The SDF-1 interacting with CXCR4 plays important roles in physiological and pathological processes such as hematopiesis, stem cell homing,angiogenesis and leukemic cells infiltrating.To study the expression of CXCR4 in leukemia and the relationship between CXCR4 and leukemic cells infiltration can add indicators for leukemic MIC diagnosis of immunology indexes and have great significance to take molecule targeted therapy for preventing leukemia from infiltration or relapse as well.

Objective To evaluate the determination of glomerular filtration rate (GFR) by non-ionic contrast medium iohexol plasma clearance. Methods GFR of 93 patients, 45 male and 48 female, age ranged from 12 to 80, with different renal functions was determined. The patient underwent an overnight fast and 5 ml of iohexol was injected into peripheral vein in the morning. 2 ml plasma sample was collected 4 hours after injection, and plasma concentration of iohexol was measured by high performance liquid chromatography(HPLC) . The iohexol plasma clearance was calculated by two one-compartment model; Jacobsson's and Bubeck's model. 99mTc clearance was used as the reference method. Results Iohexol-GFR obtained by Jacobsson's model vs 99mTc-GFR yielded a correlation of r = 0. 85, standard error of the estimate (SE) = 16. 06 ml/min. There was also a high correlation between iohexol-GFR obtained by Bubeck's model and 99mTc-GFR, r = 0. 82, SE = 17. 75 ml/min. In the patients in early stage of renal failure, iohexol-GFR was the most sensitive indication as compared to Scr and Ccr. Conclusion Iohexol plasma clearance calculated by Jacobsson's and Bubeck's models is a simple and accurate method of determining GFR.

The evaluation of glomerular filtration rate is important in the diagnosis,treatment, and prognosis for patients. Although there are different equations widely used and convenient,the accuracy of them on the specific populations, including diabetic patients and the elderlys, still needs further discussion. We recommend using the Chronic Kidney Disease Epidemiology Collaboration ( CKD-EPI) from creatinine and cystatin C in the elderlys. For diabetic patients, however, this equation should be recommended with cautions.

Objective To evaluate the applicability of the simplified equation of MDRD to predict glomerular filtration rate(GFR)from serum creatinine in Chinese patients with chronic kidney disease(CKD),and refit the MDRD equation parameter estimates with Chinese patients data.Methods A total of 760 hospitalized CKD patients were investigated from 2002 to 2005.Patients'sex,age,height and body weight were recorded;plasma creatinine and ~ 99m Tc-GFR(standardized by body surface area)were measured in all patients;GFR was estimated with simplified equation of MDRD and Cockcroft-Gault;the accurancy of estimated GFR with MDRD and CG were compared with~ 99m Tc-GFR in different stage of CKD.Totally 670 patients were randomly selected as the training sample,the remaining 90 patients constituted the validation sample.We used stepwise multiple regression to refit the equation of MDRD and the regression models were developed by using the training sample.The refitting equation was then tested and compared with the other equation in the validation sample.Results (1)Both the MDRD and CG-GFR prediction equations seemd to systematically underestimate GFR,but the accurancy of MDRD equation was better than CG-GFR in stage Ⅰ~Ⅲ of CKD.(2)The bias of estimated GFR(MDRD or CG-GFR equation)with ~ 99m Tc-GFR was lower in stage Ⅰ~Ⅲ than in stage Ⅳ~Ⅴ of CKD.(3)Refitting of the MDRD equation parameter estimates to Chinese patients data set resulted in the following prediction equations:GFR=234.96?(Scr)~ -0.926 ?(Age)~ -0.280 ?0.828(Female).(4)Comparing with~ 99m Tc-GFR,the bias of estimated GFR calculated by the refitting MDRD equation was lower than that of estimated with MDRD or CG especially in the stage Ⅳ~Ⅴ of CKD in Chinese patients.Conclusion the simplified equation of MDRD can estimate GRF accurately,but the equation must be refitted in Chinese patients.

Objective: To study the correlation of blood stasis syndrome or its accompanied syndromes with Gensini score in patients with coronary heart disease (CHD) in stable condition. Methods: The syndrome types of traditional Chinese medicine (TCM) and blood stasis score in 131 CHD patients confirmed by coronary angiography were recorded. Gensini score was calculated according to the coronary pathological characteristics showed by angiography. The correlations of blood stasis syndrome and its accompanied syndromes with coronary lesion and Gensini score were analyzed. Results: Among the TCM syndrome types, blood stasis, turbid phlegm and qi deficiency were the most common syndromes, revealed in 85 patients (64.9%), 83 patients (63.4%) and 85 patients (64.9%), respectively. The coronary lesion length and Gensini score in the patients with blood stasis syndrome were much higher than those in the patients with non-blood stasis syndrome (P<0.05 or P<0.01). In the subtypes of blood stasis, the coronary lesion length and Gensini score in the patients with blood stasis accompanied by turbid phlegm syndrome were higher than those in the patients with non-blood stasis syndrome (P<0.05). And in the patients whose blood stasis syndrome score was more than 9 points, the coronary lesion length was higher than that in the patients whose blood stasis syndrome score was less than 9 points (P<0.05). Besides, with bivariate analysis, the blood stasis syndrome score showed no correlation with Gensini score (Pearson correlation coefficient was 0.104, P=0.241). Conclusion: Blood stasis syndrome is the most common TCM syndrome in CHD patients in stable condition. The blood stasis syndrome score is proportional to coronary lesion length, and reflects the severity of coronary lesion.

Small intestinal neuroendocrine carcinoma is poorly differentiated,highly malignant,and originated from the diffuse neuroendocrine system.It diffusely expresses the general neuroendocrine differentiation markers.The disease can be manifested as carcinoid syndrome,but most of the patients were with occult onset and absence of specific clinical symptoms,which led to difficult diagnosis before operation.On June 18,2012,a patient with manifestation of recurrent vague abdominal pain received capsule endoscopy at the Northern Jiangsu People's Hospital.The capsule endoscope was retained in the distal small intestine,and malignant ileum lesion was revealed during the surgical exploration.Finally,poorly differentiated neuroendocrine carcinoma with abdominal wall metastases was identified by pathological examination.

Objective To investigate the effect of JNK signal pathway in acute necrotizing pancreatitis (ANP) associated lung injury.Methods A total of 24 SD rats were randomly divided into sham group and ANP group,ANP rats were induced by retrograde injection of 5％ sodium taurocholate into common bile duct.The rats were sacrificed 12 and 24h later,and the pancreas and lung tissue were resected and underwent routine pathologic examination,ELISA method was used to detect the level of TNF-α and IL-1β in lung tissue.Expression of JNK mRNA was detected by real time PCR,and the expression of JNK protein were evaluated by Western blotting.Results There was bleeding,necrosis,large amount of inflammatory cells infiltration in pancreatic tissue; and there was edema,pulmonary consolidation,interstitial edema,inflammatory cells infihration in lung tissue in ANP group.The levels of TNF-α and IL-1β,JNK mRNA,JNK protein,phosphorylation JNK were ( 374.3 ± 124.0) pg/ml,(649.0 ± 114.9) pg/ml,2.57 ± 0.76,1.40 ± 0.81,0.81 ± 0.20 in ANP group,which were significantly higher than those in with sham group[( 218.2 ± 68.4)pg/ml,(524.3±58.4)pg/ml,1.03±0.11,0.32±0.11,0.32±0.11,P＜0.05].Conclusions JNK signal pathway plays an important role in experimental ANP associated lung injury in rats.

ObjectiveTo evaluate whether endometrial blood flow measured by three-dimensional power Doppler ultrasound can predict pregnacy after the treatment of in vitro fertilization and embryo transfer (IVF-ET).MethodsNinty women who received the treatment of IVF-ET examined by threedimensional power Doppler imaging at the day of inject human chorionic gonadotropin(HCG) were enrolled.All patients were divided into pregnancy group (43 cases,include biochemical pregnancy and clinical pregnancy ) and non-pregnancy group(47 cases).The diagnostic value of parameters derived from threedimensional power Doppler imaging was evaluated by using the receiver operating characteristic (ROC)curve.ResultsDifferences of these parameters,including vascularization index (VI),flow index(Fl) and vascularization flow index (VFI)were considered statistically significant between two groups,the parameters of uterine artery and endometrial volume had no significant differences between two groups.The area under ROC curve of VI,FI and VFI were 0.880,0.713 and 0.646,respectively.Among these parameters,VI had the highest diagnostic value for discriminating between benign and malignant endometrium,the cut-off value of which was 0.733 with a sensitivity of 84.2％.Conclusions Threedimensional power Doppler ultrasound was useful for evaluating endometrial blood flow in IVF-ET cycles.Endometrial blood flow parameters may be useful predictors for pregnancy.

Background Excimer laser corneal refractive surgery is one of the major methods to correct refractive error.Centration of the ablation zone is an important factor that affects visual quality after surgery.The pupil center and its shift is a major factor to determine the ablation center.Therefore further study on pupil centroid shift with illumination level alteration is needed.Objective This study aimed to study the characteristics of the pupillary centroid shift along with the change of pupil size under the different illumination conditions and the possible clinical application of the curve of pupillary centroid shift in exeimer laser corneal refractive surgery.MethodsThe variation of pupil size induced by illumination and the changes of pupil center were measured on 114 moderate myopia eyes of 57 subjects with Astra MaxTM Corneal Topographer.Illumination of placido target and image snap model of the topographer was customized to provide 5 illumination levels as follows:0.8,4.4,18.9,82.3,355.0 Lx.Vectorial analysis was used to graph the change of pupil center related to the Coaxially Sighted Corneal Reflex (CSCR).Raw data is converted to relative value to analyze the pupiilary centroid shift.The mean relative change of the pupil size(△P)and the mean of relative pupillary centroid shift(△C)in the form of percentage were used to attenuate the variation among subjects.The original value of illumination(darkest)is defined as 0％ and maximum value(lightest)was as 100％.Results With the increase of illumination,the shift of the pupil center towards nasal side when pupil constrict was found.The mean change of pupil size under the 5 illumination levels were 0,(1.28 +0.40)mm,(2.34 ±0.53)mm,(3.34+0.54)mm,(4.03 ±0.56)mm respectively,and the △P values was 0％,32％,58％,83％,100％ respectively.The mean of pupil centroid shift under the 5 illumination levels were 0,(78±33)μm,(116±60)μm,(143 ±66)μm,(170±71)μm respectively,and the △C was 0％,46％,68％,84％,100％respectively.There was a linear relation between the relative pupil centroid shift and the relative change of pupil size (r=0.980,P=0.025).The amount of pupil centroid shift has a positive correlation with amplitude of the change of pupil size(r=0.480,P＜0.01).Conclusion Pupil center shifts with the change of pupil size.The linear relation between relative pupil centroid shift and the relative change of pupil size can be applied in eximer laser corneal refractive surgery to improve the visual quality with customized ablation center location.

Objective To investigate the influence of gene therapy using survivin as a gene target on biological behavior of pancreatic carcinoma cell line. Methods Chemically synthesized siRNA and shRNA in pGCSi vector were used to silence survivin expression of pancreatic carcinoma cell line PaTu8988. The therapeutical effects of survivin as a gene target were evaluated through determination of the down-regulation of survivin gene expression, cellular shape, cell apoptosis, cell viability and apoptosis signal pathway changes. Results After transfection of different arrays of siRNA and shRNA vectors to silence the survivin expression, survivin mRNA and protein levels were significantly decreased (P < 0.05) ; PI staining revealed the presence of karyopyknosis, the cell apoptosis index was more than 20%; hypodiploid DNA content before G0/G1 detected by flow cytometry ; cell viability measured by MTT assay was significantly decreased (P <0.05) ; the activity of caspase-3 remarkably increased (P < 0. 05). Conclusions The pancreatic carcinoma cell line PaTu8988 be induced to promote spontaneous apoptosis procedure through silencing survivin expression by RNAi, which could accelerate carcinoma cell apoptosis and improve therapeutic effect on pancreatic carcinoma.