Hepatic eosinophilic granuloma is a rare benign liver lesion,which results from granuloma formation due to chronic inflammation.Two patients were admitted to the Yantaishan Hospital and Yuhuangding Hospital from July 2008 to April 2012,respectively.The results of laboratory examination showed the elevation of peripheral blood eosinophils,and ultrasound examinations revealed low-echo masses in the liver and no blood flow was detected.The results of computed tomography showed hypoattenuation lesions with well-demarcated boundary.After intravenous administration of contrast angent,the lesions demostrated delayed heterogeneous enhancement with internal grid.The results of magnetic resonance imaging of 1 patient showed the lesion had slight hyper-intensity to the surrounding liver parenchyma on T1-weighted images,and slight high signal with low signal separation strip inside on fat-suppressed T2-weighted images.An obvious high signal was detected in diffusion weighted imaging.Familiarity with the imaging characteristics and combination of the elevation of peripheral eosinophil can help surgeons to make a suggestive diagnosis.

Objective To evaluate the effects of morphine preconditioning on the expression of microRNAs (miRNAs) during hypoxia-reoxygenation (H/R) in isolated cardiomyocytes in rats with heart failure.Methods Healthy adult male Sprague Dawley rats,w eighing 200-220 g,were used in this study.Adriamycin 2.0 mg/kg was injected once a week for 6 weeks via the tail vein to induce heart failure.The cardiomyocytes were isolated from the failing hearts of rats and seeded in 24-well plates or in 60 mm diameter dishes.The cells were then randomly divided into 3 groups (n =16 each) using a random number table:control group (group C); group H/R;morphine preconditioning group (group MP).The cells were cultured in normal culture atmosphere in group C.After being exposed to hypoxic air (5％ CO2-95％ N2) for 90 min,the cells were returned to the high-glucose DMEM supplemented with 10％ newborn bovine serum and were then cultured for 120 min in H/R and MP groups.In group M,the cells were cultured in morphine culture medium (final concentration of morphine 0.3 μmol/L) for 10 min and then were returned to the culture medium without morphine and cultured for 30 min immediately before hypoxia.At 120 min of reoxygenation,the cells of 8 wells in each group were chosen to detect the cell viability and lactate dehydrogenase (LDH) activity (by Typan blue staining).All the RNAs were extracted from the cardiomyocytes of the left 8 wells in each group and subjected to miRNA microarray to screen differentially expressed miRNAs.Results The cell viability was significantly lower,the activity of LDH was higher,the expression of miR-6216 and let7e-5p was higher,and the expression of miR-133b-5p was lower in H/R and MP groups than in group C (P ＜ 0.05).Compared with H/R group,the cell viability was significantly increased,the activity of LDH was decreased,the expression of miR-133b-5p was up-regulated,and the expression of miR-6216 and let-7e-5p was down-regulated in MP group (P ＜ 0.05).Conclusion Morphine preconditioning reduces H/R injury to isolated cardiomyocytes in rats with heart failure through regulating the expression of miRNAs such as miR133b-5p,miR-6216 and let-7e-5p.

Objective To evaluate the role of c-Jun N-terminal kinase (JNK) and p38 mitogen-activated protein kinase (p38MAPK) signaling pathways in reduction of ischemia-reperfusion (I/R) injury by morphine preconditioning in the rats with heart failure.Methods Adult male Sprague-Dawley rats,weighing 200-230 g,in which doxorubicin 2 mg/kg was injected via the tail vein once a week for 6 consecutive weeks to induce chronic heart failure,were studied.At the end of 8th week,45 rats with chronic heart failure were randomly divided into 5 groups (n =9 each) using a random number table:sham operation group (group S),group I/R,morphine preconditioning group (group MPC),SP600125 (JNK inhibitor) + morphine preconditioning group (group MSP) and SB203580 (p38MAPK inhibitor) + morphine preconditioning group (group MSB).Myocardial I/R was induced by 30 min occlusion of the anterior descending branch of the coronary artery followed by 120 min reperfusion in each group except group S.In group MPC,the rats were subjected to 3 cycles of 5-min infusion of 0.1 mg/kg morphine via the femoral vein at 5 min interval before ischemia.In MSP and MSB groups,SP600125 0.5 mg/kg and SB203580 0.2 mg/kg were injected via the femoral vein,respectively,at 10 min before morphine preconditioning.The animals were sacrificed at 120 min of reperfusion,and the myocardial specimens were obtained for determination of the total areas of right and left ventricles (LV+RV),area at risk (AAR),infarct size (IS),and expression of PKC δ in myocardial tissues (by immunohistochemistry),and IS/AAR ratio was calculated.Results There was no significant difference in LV+RV and AAR between the five groups (P＞0.05).Compared with group S,IS and IS/AAR were significantly increased,and the expression of PKC δ was upregulated in I/R and MSB groups (P＜0.05).Compared with group I/R,IS and IS/AAR were significantly decreased,and the expression of PKC δ was down-regulated in MPC and MSP groups (P＜0.05).Compared with group MPC,IS and IS/AAR were significantly increased,and the expression of PKC δ was upregulated in group MSB (P＜0.05),and no significant change was found in the parameters mentioned above in group MSP (P＞0.05).Conclusion Activation of p38MAPK signaling pathway is involved in reduction of myocardial I/R injury by morphine preconditioning,and the mechanism is related to down-regulation of PKC δ expression in rats with heart failure;JNK signaling pathway is not involved in this process.

Objective To evaluate the roles of 1-phosphatidylinositol 3-kinase (PI3K) and extracellular signal-regulated kinase (ERK) signaling pathways in reduction of ischemia-reperfusion (I/R) injury to the isolated hearts by morphine preconditioning in the rats with chronic heart failure.Methods Adult male Sprague-Dawley rats,weighing 200-230 g,in which doxorubicin 2.0 mg/kg was injected via the tail vein once a week for 6 weeks to induce chronic heart failure,were studied.At the end of 8th week,42 rats with chronic heart failure were randomly divided into 7 groups (n =6 each) using a random number table:sham operation group (group S),I/R group,morphine preconditioning group (group MP),PD98059 (ERK inhibitor) + morphine preconditioning group (group PD + MP),wortmannin (PI3K inhibitor) + morphine preconditioning group (group WT + MP),PD98059 group (group PD) and wortmannin group (group WT).The hearts were quickly excised and passively perfused in a Langendorff apparatus and subjected to 30 min of occlusion of the left coronary artery followed by 2 h of reperfusion to establish the model of I/R injury.In group S,the hearts were only sutured,but not ligated and were continuously perfused with K-H solution for 195 min.In group I/R,the hearts were perfused with K-H solution for 45 min before ischemia.In group MP,the hearts were perfused with K-H solution for 15 min,with K-H solution containing morphine 1 μmol/L for 5 min and then with K-H solution for 5 min (3 cycles in total) before ischemia.In PD + MP and WT + MP groups,the hearts were perfused with K-H solution containing PD98059 (10 μmol/L) and wortmannin (100 nmol/L),respectively,starting from 10 min before morphine preconditioning until 5 min of ischemia.In PD and WT groups,the hearts were perfused with K-H solution containing PD98059 (10 μmol/L) and wortmannin (100 nmol/L),respectively,starting from 40 min before ischemia until 5 rin of ischemia.At 15 min of equilibration (baseline) and 5 and 10 min of reperfusion,the coronary flow was collected to detect the activity of lactate dehydrogenase (LDH).Infarct size (IS) and area at risk (AAR) were measured at the end of reperfusion and IS/AAR ratio was calculated.Results Compared with group S,LDH activity was significantly increased at 5 and 10 min of reperfusion,IS and IS/AAR ratio were also increased (P ＜ 0.05),and no significant change was found in AAR in group I/R (P ＞ 0.05).Compared with group I/R,LDH activity was significantly decreased at 5 min of reperfusion,IS and IS/AAR ratio were also decreased (P ＜ 0.05),and no significant change was found in AAR in group MP,and no significant change was found in LDH activity,IS,AAR and IS/AAR ratio in WT and PD groups (P ＞ 0.05).Compared with group MP,LDH activity was significantly increased at 5 and 10 min of reperfusion (P ＜ 0.05),and IS and IS/AAR ratio were decreased in group PD + MP,and no significant change was found in LDH activity,IS,AAR and IS/AAR ratio in group WT + MP (P ＞ 0.05).Conclusion Activation of ERK signaling pathway is involved in reduction of I/R injury to isolated hearts by morphine preconditioning in rats with chronic heart failure,however,PI3K signaling pathway has no such effect.

Aim To investigate the roles of mitogen-ac-tivated protein kinases ( MAPK ) pathways in the pro-tective effects of remifentanil preconditioning against is-chemia/reperfusion injury of isolated heart in rats with heart failure. Methods Adult male SD rats were injected with adriamycin via tail vein for 6 weeks to induce heart failure. The rats were confirmed chronic heart failure through echocardiography and randomly divided into 9 groups(n=6)as follows: sham group, ischemia/reperfusion group ( IR) , remifentanil precon-ditioning group( RPC) , ERK inhibitor PD98059+RPC group ( RPD ) , p38 inhibitor SB203580 +RPC group ( RSB ) , JNK inhibitor SP600125 + RPC group ( RSP ) , and the inhibitor control groups ( PD , SB and SP) . All hearts were linked to the Langendorff ap-paratus. The coronary effluent was collected to detect the activity of lactate dehydrogenase ( LDH ) at base-line, 5 min and 10 min after reperfusion, respectively. Infarct size ( IS) and area at risk ( AAR) were deter-mined by 2, 3, 5-triphenyl-tetrazolium (TTC) staining at the end of reperfusion. Left ventricular developed pressure ( LVDP), ± dp/dtmax and heart rate ( HR) were recorded to evaluate cardiac function in each group. Results When compared with IR group, RPC significantly reduced IS / AAR and decreased the ac-tivity of LDH at 5 min and 10 min after reperfusion. However, SP600125 almost thoroughly abolished the protective effects of RPC, as evidenced by the in-creased value of IS / AAR and the high activity of LDH. In addition, PD98059 also partly blocked the effects of RPC, while SB203580 showed no influence on RPC. Meanwhile, the hemodynamic parameters such as LVDP, HR and ± dp/dtmax were not signifi-cantly different in any group except sham group. Con-clusion JNK and ERK pathways may play an impor-tant role in cardioprotective effects of remifentanil pre-conditioning against ischemia/reperfusion injury in rats with heart failure.

Objective To investigate the relative factors of the neonates that were abandoned in hospital less than 24 hours,then the level of the local neonates medical service and the neonatal remedy skills and the life quality could be improved.Methods The clinical data of 379 cases of hospitalized neonates less than 24 hours from 2007 to 2011 were analyzed retrospectively.The correlation factors of the neonates abandoned in hospital less than 24 hours(122 cases) and hospitalized more than 24 hours (244 cases) were analyzed by single and multiple factor regression analysis.Results (1) There were 379 neonates who were in hospital less than 24 hours,among them,122 neonates were gave up the treatments.The differences of the gestational age and weight among abandon group,hospital referral group,improve group and uncured group were significant(P ＜0.01).(2) The numbers of neonates abandoned in hospital less than 24 hours were different significantly from 2007 to 2011 (P ＜0.05) and tendency was decreased year by year(chi-square trend test x2 =6.115,P =0.013).The uncured group was increased year by year (P ＜ 0.05).The hospital referral group,improved group were fluctuation,but no descend or rise tendency(P ＞0.05).(3) The differences of the gestational age,birth weight,uterine-incision delivery,intrapartum asphyxia,intrauterine distress,birth hospital,family income less than twenty thousand yuan every year,father's culture level,diagnosed premature,very low birth weight infant,low birth weight infant,respiratory distress syndrome and brain injuries were significant between neonates in hospital less than 24 hours and more than 24 hours(P ＜ 0.05).The differences of the male,intrapartum high risk factors,mother's morbid state and miscarriage were not significant(P ＞0.05).(4) The uterine-incision delivery,intrapartum asphyxia,birth in the county and below county hospital,family income less than twenty thousand yuan every year and diagnosed respiratory distress syndrome were correlation to the abandon treatment in 24 hours.There were no correlation to the gave up treatment in 24 hours to the rest of the factors.Conclusion We should set up the systemic gravid detection system,avoid premature birth and respiratory distress syndrome,add the hardware configuration and medical personnel to the neonate department,improve the professional technology level,perfect social security system mechanism,decrease the hospital discharge rate of the hospitalization less than 24 hours,improve the level of the local neonatal treatment technology and the quality of population.

Objective:To evaluate the changes of neurocognitive function in early stage in patients with first-episode schizophrenia.Methods:In this study,73 cases of patients with first-episode schizophrenia (research group) and 75 cases of health person (control group) were selected from January 2015 to January 2016 in our hospital.The neurocognitive function was evaluated by neuro-psychological testing tool and the data between two group were compared.Results:Scores of delayed recall,total recall,3 trial,2 trial and 1 trial of research group were lower than those of control group in BVMT-R test,and the difference was statistically significant (P＜0.05).In HVLT-R test,the scores of total delay,3 trial and 2 trial of research group were significantly lower than those of control group (P＜0.05).The consuming time of dominant hands and subdominant hands in pegboard tasks were significantly higher in research group than in control group (P＜0.05).Conpletion time of connection test A,color connection 1 and 2 in connection test of research group were significantly higher than those of control group (P＜0.05).Attempt number and correct number in research group in PASAT test were significantly lower than in control group (P＜0.05).Number of search errors in research group was higher than in control group,while number of search correct,search total score and digital sign score were significantly lower than in control group (P＜0.05).Total number of words,color and color / word count in research group were lower than in control group in Stroop color word test,and the difference was statistically significant (P＜0.05).WMS-Ⅲ test results between two group had no significant difference (P＞0.05).Conclusion:The neurocognitive function in early stage in patients with first-episode schizophrenia has been extensively damaged.

Objective To explore the risk factors of hyperbilirubinemia in late preterm infants. Methods Clinical data of 211 cases of late preterm infants with hyperbilirubinemia and 246 cases of late preterm infants without hyperbilirubinemia were retro-spectively analyzed between 2011 and 2012. The risk factors of hyperbilirubinemia were filtered. Results Twenty-seven cases of late premature infants with hyperbilirubinemia were severe. Hospital stay less than 3 days, birth asphyxia history, small for gestatio-nal age, head hematoma, delivery injury, hypoalbuminemia, polycythemia, infection, hemolytic disease, feeding intolerance, and fe-tal excretion delay were associated with hyperbilirubinemia (P<0.05). Rural origin, pregnancy-induced hypertension syndrome and premature rupture of membrane were also associated with hyperbilirubinemia (P<0.05). Multivariate logistic regression analysis showed the history of birth asphyxia , fetal excretion delay, hypoalbuminemia, pregnancy-induced hypertension syndrome were risk factors of hyperbilirubinemia in late preterm infants (OR=2.35-4.05). Pregnancy-induced hypertension syndrome and hemolytic dis-ease were risk factors of severe hyperbilirubinemia in late preterm infants (OR=5.74, 73.64). Conclusions Neonatal asphyxia, fetal excretion delay, hypoalbuminemia and pregnancy-induced hypertension syndrome are risk factors of hyperbilirubinemia in late pre-term infants. Strengthening the management of pregnancy-induced hypertension syndrome and the treatment of newborn hemolytic disease can reduce the occurrence of severe hyperbilirubinemia in late preterm infants.

BACKGROUND:MicroRNA plays an important role in the process of growth and aging of living body. To know the role of let-7d in inducing bone marrow mesenchymal stem celldifferentiation into neurons can promote the stem celltransplantation. OBJECTIVE:To investigate the role of let-7d in inducing bone marrow mesenchymal stem celldifferentiation into neurons. METHODS:(1) The lentiviral vector of let-7d was constructed and transfected into rat bone marrow mesenchymal stem cells. The cells were divided into non-transfected group, negative control group (transfected with FU-RNAi-NC-LV), transfected enhancement group (transfected with let-7d-LV), transfected inhibition group ( transfected with let-7d-inhibition-LV). (2) Rat bone marrow mesenchymal stem cells were treated with fasudil as an inducer for triggering the cells to differentiate into neurons. The expression of neuron-specific markers, neuron-specific enolase and microtubule-associated protein 2, were measured by immunocytochemical method. The mRNA expression of microtubule-associated protein 2 was detected by RT-PCR. The viability of bone marrow mesenchymal stem cells was determined by MTT method. RESULTS AND CONCLUSION:Under inverted fluorescence microscope, the cells were successful y transfected with let-7d. Fasudil induced bone marrow mesenchymal stem cells to differentiate into neurons. The transfection efficiency and expression levels of neuron-specific enolase and microtubule-associated protein 2 in transfected enhancement group were higher than those in the negative control group (P<0.05);while in the inhibition group, they were lower than those in the negative control group (P<0.05). These findings indicate that let-7d can promote the differentiation of bone marrow mesenchymal stem cells into neurons induced by fasudil, and by control ing the expression of let-7d we can influence the differentiation efficiency from bone marrow mesenchymal stem cells to neurons.

Objective:To explore the technique of two-flap in ear reconstruction.Method:Quantitative tissue expansions were used in the mastoid area in the first stage.After the final injection,there was 1 month of sustaining time.Expanded skin flap and unexpanded fascia flap were designed in the second stage,so thetwo-flaptechnique was used in the ear reconstruction.From January 2004 to December 2008,1 427 patients of microtia were treated using two-flap technque.Result:The expanded skin flap could show the fine structures of the reconstructed ears.The reconstructed ears had vivid cranioauricular angle after using the unexpanded fascia flap.Conclusion: Two-flap method was easily manipulated and the complications were rare.The reconstructed ears had lucid and three-dimensional contour.