Objective To evaluate the value of detecting abnormal lymphocyte morphology in peripheral blood and Epstein Barr Virus(EBV)DNA quantity through real-time quantitative PCR (RT-qPCR)in the initial diagnosis for infants patients with infectious mononucleosis (IM).Methods From Jan.2013 to Dec.2014 212 infants patients with IM were analysed ret-rospectively,which were all in-patients in the hospital.The abnormal lymphocyte morphology in peripheral blood and Epstein Barr Virus (EBV)DNA quantity were both detected in the initial fever period and a week later.The latter was detected by real-time quantitative PCR (RT-qPCR),combined with all the symptoms were all analysed comprehensively.The percentage of abnormal lymphocyte more than 10% was positive,and the EBV-DNA quantity more than 1.0×103 copy per ml was posi-tive,too.Results Of all the infants patients,in the initial fever period,82 patients had more than 10% positive abnormal lymphocyte and 100 patients had positive EBV-DNA quantity.But a week later,156 patients had more than 10% positive ab-normal lymphocyte,the maximum abnormal lymphocyte was 56%.And 180 patients had positive EBV-DNA quantity.When both abnormal lymphocyte morphology in peripheral blood and Epstein Barr Virus (EBV)DNA quantity were detected,in the initial fever period,125 patients were positive,it rose significantly more than that of abnormal lymphocyte morphology in peripheral blood (χ2=17.45,P<0.01),and that of Epstein Barr Virus (EBV)DNA quantity,too (χ2=5.92,P<0.05). But a week later,190 patients were positive,it rose significantly more than that of abnormal lymphocyte morphology in pe-ripheral blood (χ2=18.16,P<0.01).There was no significantly rising more than that of Epstein Barr Virus (EBV)DNA quantity (χ2=2.12,P>0.05).Conclusion The detecting of peripheral blood cell morphology combined with EBV-DNA
quantity are very important in the initial diagnosis for infants patients with infectious mononucleosis.Including all the symp-toms,they could improve the diagnosis timely and accurately.

Objective To study the expression of insulin-like growth factor-Ⅱ receptor(IGF-Ⅱ R) and its relationship with the prognosis of human epidermalgrowth factor receptor 2 (HER2) positive breast cancer.Methods The expression of IGF-Ⅱ R in 104 specimens of HER2 positive breast cancer was evaluated by immunohistochemistry.The expression was rated on 2 scales:negative and positive.The age,pathological type,tumor size,lymph node involvement,status of estrogen receptor(ER),and progesterone receptor(PR) of all the cases were reviewed.The relationship between the expression of IGF-Ⅱ R and the above pathological parameters were analyzed by statistical methods.The relationship between the expression of IGF-Ⅱ R and the disease-free survival and overall survival was studied.Results The positive expression rate of IGF-Ⅱ R was 43.3％ (45/104).The positive rate of IGF-Ⅱ R was significantly higher in the lymph node positive group than in the lymph node negative group (61.5 ％ vs 25.0％,P =0.000).No significant correlation was observed between the expression of IGF-Ⅱ R and age,pathological type,tumor size,status of ER,or PR.The disease-free survival and overall survival was significantly lower in IGF-Ⅱ R positive group than in IGF-Ⅱ R negative group.(The 5-year disease-free survival:62.6％ vs 84.7％,P =0.022; The 5-year overall survival:71.5％ vs 89.6％,P =0.024).Cox regressive analysis showed that the lymph node status was an independent risk factor of disease-free survival and overall survival,while the IGF-Ⅱ R was not.Conclusion The positive expression of IGF-Ⅱ R in HER2 positive breast cancer indicates poor prognosis.The expression of IGF-Ⅱ R may be regulated by insulin-like growth factor-Ⅱ (IGF-Ⅱ).

Objective To summary the experience in diagnosis and surgical treatment of differentiated thyroid carcinoma (DTC). Methods The clinical data and follow-up results of 167 cases of DTC were retrospectively analysed. Results (1) The accurate rate of preoperative cytology diagnosis was 76.9%(97/126). (2)121 patients were diagnosed as thyroid carcinoma before or during operation. Histologic examination after primary operation revealed that the carcinoma spread to the isthmus and the opposite lobe in 5 cases. 57 cases were followed up with only 2 cases recurred 2 and 3 years after the operation, and 3 died 6 to 10 months after operation. (3)87.5%(42/48)cases of the reoperation were due to misdiagnosis as benign lesions in primary operation. Histologic examination revealed that residual tumor in the remnant thyroid tissue was found in 45.2%(19/42)cases, and residual tumor in the lymph nodes of the suffered side in 19.0%(8/42)cases. 30 cases were followed up without any recurrence. Conclusions (1) Cytological diagnosis must be paid great attention to preoperatively; (2) Excision of the suffered lobe, isthmus and greater partial of the opposite lobe, along with clearing the enlarged lymphnodes of the isolateral side are generally performed for the DTC; (3) Reoperation due to misdiagnosis as benign lesions in primary operation must remove the remnant tissue of thyroid and the isolateral lymphnodes. The cases should also be followed up even if enough excising is performed in primary operation.

BACKGROUND:Different methods and biomaterials have been applied in animal experiments and clinical practice to prevent the formation of epidural scars,Biodegradable and sticky semi-fluid gels are the most often used material.Salvia miltforrhiza radix (SMR) and carbomer have been clinically confirmed to be the safe and effective drugs and gel agents. OBJECTIVE:To observe the effect of SMR-gel on preventing epidural adhesion after laminectomy.DESIGN:A complete randomized grouping design, a controlled experiment. SETTING:Department of Orthopaedics,Shenzhen People's Hospital (Second Clinical College of Jinan University). MATERIALS:Thirty-six healthy pure New Zealand rabbits were used,either male of female,clean degree,2-3 years of age. They were randomly divided into four groups with 9 rabbits in each group:blank control group,gel contro group, HA group and SMR-gel group. Carbomer934 powder (Shanghai People's Pharmaceutical Factory, batch number: 20000510) , hyaluronic acid (HA) [Shandong Bausch & Lomb Freda Pharaceutical, Co., Ltd.,No.H10960136,2 mL (20 mg)].METHODS:The experiments were carried out in the animal laboratory of Shenzhen People's Hospital from April 2002 to August 2003.①Preparing SMR-gel:SMR was prepared into extract powder.Carbomer934 powder was added by water for dissolving and swelling and stayed overnight,then SMR-gel was prepared by dipping with triethanolamine,adding with SMR extract powder (2 g),then adding with purified water till 100.0 g and stirring uniformly.②The rabbits were anesthetized. and the lamina of vertebra was totally resected at L3 and L6 (reserving superior and Inferior articular processes).then defects of 10 mm×5 mm were made to expose the dura mater.The vertebral defects were added with 1 mL carbomer gel, 1 mL HA (20 g/L) and 1 mL SMR-gel in the gel control group,HA group and SMR-gel group respectively.whereas nothing was added in the blank control group.③Gross samples:Three rabbits were killed 4,6 and 8 weeks postoperatively in each group.vertebraI ventral fascia were stripped to remove the spinal segments (L3,L6) for operation completely,and totally 24 samples for each time.One sample was selected in each group 4 weeks postoperatively. and the samples were observed under H-600 transmission electron microscope (Hitachi). ④The adhesion compactness of scar tissue with dura mater was evaluated in the 24 samples of the 4 groups at 8 weeks postoperatively:There were 4 grades:No obvious adhesion between dural sac and scar tissue for grade O:Extensive and compact adhesion between dural sac and scar tissue. impossible blunt dissection between dural sac and scar tissue.incomplete dural sac after sharp dissection for grade Ⅲ.Each spinal segment was cut into 4 parts equally,and all were prepared into sections and stained,then the thickness of epidural scar was determined with Tiger2000 image analyzer. ⑤The rank sum test was used in the scar adhesion compactness grading evaluated with naked eyes,whereas analysis of variance.and two-two comparison were used in analyzing the thickness of epidural scar.P＜0.05 was considered as significant difference.MAIN OUTCOME MEASURES:①Results of gross scar adhesion compactness grading at 8 weeks and comparison of the thickness of epidural scar at 4.6 and 8 weeks;②Results of gross observation,histological examination and ultrastructure.RESULTS: All the 36 rabbits were involved in the analysis of results. ①Results of gross observation and pathohistological examination:There was compact adhesion at each time point in the blank control group,part adhesion in the gel control group and HA group, and no obvious adhesion in the SMR-gel group.②Results of quantitative analysis:The rabbits with lower scores of scar adhesion compactness grading In the blank control group,gel control group and HA group were obviously fewer than those in the SMR-gel group (W=45-52,P＜0.05-0.01).The scar thickness at 4 and 8 weeks in the SMR-gel group was obviously less than that in the other 3 groups(F=128.657,152.246,80.891,P＜0.01).③Results of observation under transmission electron microscope:The proliferation of fibroblasts at 4 week was active in the blank control group,gel control group and HA group,but inactive in the SMR-gel group.CONCLUSION:①SMR can inhibit the fibroblasts to proliferate,differentiate and synthetize into secretory collagens,and then inhibit the formation of epidural scar adhesion.②HA can be absorbed by organs very early,which reduces its role in preventing adhesion.Whereas carbomer gel can stay longer, and it plays a role in inhibiting and blocking adhesion in the whole process of wound repairing.

Objective To observe the change of intima/media thickness ratio and expression of inflammatory factors in renal small artery of diabetic rats, and to explore the correlations of intim/media ratio with inflammatory factors and vascular lesions of diabetic nephropathy (DN) rats. Methods Seventy healthy SD rats were randomly divided into diabetic nephropathy group (DN, n=40) and normal control group (N, n=30). DN rat model was induced by intraperitoneal injection of streptozotocin (STZ). Thirty-five DN rats were successfully established. N group received same dose of citrate buffer. Rats were sacrificed after 4, 12, 24 weeks respectively.The intima/media thickness ratio in renal small artery was detected by immunofluorescence. The monocyte chemoattractant protein-1 (MCP-1) protein and mRNA expression of renal small artery were detected by immunohistochemistry and in-situ hybridization at each time point. Results Blood glucose and urine protein excretion (24 h) at different time points in DN group were significantly higher than those of N group (P＜0.05). From the 12th week, Scr, BUN, serum phosphorus were significantly higher than those of N group (P＜0.05). At the 4th week, renal small artery had the expression of MCP-1 protein and mRNA. The expression increased gradually with time, reached the highest at the 24th week, and was significantly higher than that of N group at each time point (P＜0.05). Immunofluorescence results showed that as compared to N group, in the first 4 weeks, intima/media thickness ratio in DN group was not different, at the 12th week the ratio was higher but without significant difference, at the 24th week the ratio was significantly higher (P＜0.05). Small artery intima/media thickness ratio of DN group was positively correlated with MCP-1, cholesterol, triglyceride, serum phosphate (r=0.742, P＜0.01; r=0.740, P＜0.01; r=0.829, P＜0.01; r=0.580, P＜0.01). Conclusions The arterioles intima/media thickness ratio of early DN is significantly correlated with MCP-1, lipids and phosphorus. MCP-1 may be involved in the DN vascular disease.

Objective To observe the expression of bone matrix proteins and the change of intima-tunica media thickness ratio in diabetic rat small renal artery and to explore their correlation and effects on diabetic nephropathy. Methods Seventy healthy SD rats were randomly divided into diabetic group(DN,n=40)and normal control group(N,n=30).DN rat model was induced by streptozotocin(STZ)intraperitoneal injection and the N group rats were given the same dose of citrate buffer.Thirty-five rats were successfully induced in DN group.The rats were sacrificed at week 4,12 and 24,respectively.The protein and mRNA expression of core-bind factor alpha 1(Cbfcd).bone morphogenetic protein 2(BMP-2)and matrix Gla protein(MGP)in smallrenal artery were detected by immunohistochemistry,in-situ hybridization and real-time PCR at each time point. Results Cbfctl and BMP-2 were expressed obviously in small renal artery of DN group by immunohistochemistry stain and in-situ hybridization from 4 to 24 weeks compared with N group at each time point,reaching the peak at week 24.Real-time PCR showed that the MGP mRNA was evidently increased at week 4,slightly decreased at week 12,lowest at week 24in DN group.The BMP-2 mRNA began to increase from week 4 onward,being peak at week 24in DN group.The ratio of intima to tunica media thickness had no significant difference in DN group compared with N group at week 4,but at week 12 and 24 there were significant difference between them.There was a positive correlation between Cbfα1 and BMP-2 expression,but they were negatively correlated with the expression of MGP.The ratio of intima to tunica media thickness was significantly-correlated with the expression of Cbfα1 and BMP-2. Conclusions The ratio of intima to tunica media thickness is positively correlated with Cbfα1 and BMP-2 in small renal artery of early DN.Cbfα1,BMP-2 and MGP may be involved in the progression of vascular lesions in DN.

OBJECTIVE Toexplorethecredibityoftwoimprovedmodelsofsyntheticvascular dementia(VD)rats.METHODS OneimprovedmodelofVDratswasestablishedbyligatuingthebilat-eral common carotid artery twice at 3 d (improved 2-VO),while the other was established by blocking the middle cerebral artery on the left side by separating pterygopalatine arteria (i mproved MCAO/R). The learning and me mory ability was determined by escape latency in Morris water maze directional navi-gation test and cross-over ti mes in target areas in spatial probe test and the search strategy.The organi-zational structure in CA1 area of the hippocampus was observed and analyzed under a microscope after HEstaining.RESULTS Thelearningandmemoryabilitydecreasedsignificantlyin2modelgroupsat 20 d after the operation.The escape latency was much longer in improved 2-VO group and improved MCAO/R group than that in sham group(P<0.05)especially in improved 2-VO group.41 d after the operation,no difference between MCAO/R and sham group (P <0.05 ).The differences between improved 2-VO group and sham group remained significant(P<0.01 ),and difference between improved 2-VO group and improved MCAO/R group was significant(P<0.01 )at 41 d.The cross-over times in the target area in spatial probe test decreased more significantly in 2 model groups than in sham group. 41 d after the operation,improved MCAO/R group was not different from sham group(P<0.05). Search strategy results showed that swimming trajectory in the improved 2-VO groupwas mostly edge and random type,but was of tendency type and straight type in the improved MCAO/R group.In the organization structure of hippopal CA1 area of rats,the nu mber of cells was reduced,their arrange ment was sparse and chaotic,the morphology of cells was inco mplete,the structure of cells was abnormal, cytoplasmwasscarce,andnucleoliwereinconspicuous.CONCLUSION TwoimprovedVDmodelscan lead to behavior and pathological changes in rats.The i mproved 2-VO model,si mple and stable,is suitable for drug efficacy research.The improved MCAO/R model is the ideal short-term efficacy study.

Aim To investigate the effects of echina-coside ( ECH ) on the learning and memory capacities and brain level of oxygen free radicals of rats with de-mentia induced by amyloid β-peptide. Methods Six-ty Sprague Dawley rats, weighing (300±10) g, were randomly divided with 10 rats pergroup into 6 groups:sham operated group, model, ECH high dose (40 mg ·kg-1·d-1), ECH middle dose (20 mg· kg-1· d-1), ECH low dose (10 mg·kg-1·d-1) and Hup A (Huperzine A, 0. 02 mg·kg-1·d-1) group. Mor-ris maze tests were conducted for evaluating the learn-ing and memory ability. Content of malondialdehyde (MDA), nitric oxide (NO) and activities of superox-ide dismutase ( SOD) and NO synthase ( NOS) in the hippocampus and cortex were detected. ResultsAβ25-35 induced significant learning and memory im-pairment in the rats. Compared with the rats in model group, those treated with ECH at different doses all manifested alleviation of learning and memory impair-ment ( P<0 . 01 , P<0 . 05 ) . Cotents of MDA of ECH treatment group were obviously decreased, while SOD activities were obviously increased, and significantly reduced the release of NO and NOS in the hippocam-pus and cortex brain tissue ( P <0 . 01 , P <0.05 ) . Conclusion ECH can enhance the learning and mem-ory ability in rats with AD, which is presumably relat-ed to accelerating the cleaning of oxygen free radicals and reducing oxidative stress in brain of AD rats.

Aim To investigate the protective effects of echinacoside ( ECH ) on oxidative stress injury in vascular dementia rats. Methods Vascular dementia model was duplicated by means of permanent ligation of bilateral common carotid artery at two times intervals for three days. Biochemical methods was used to detect the GSH, NO, GSH-Px, NOS in each group rat’ s cor-tex and hippocampus. The change of the tissue struc-ture in CA1 area of hippocampus in each group was ob-served and analyzed by microscope after HE staining. Results Compared with sham group, the content of GSH and activity of GSH-Px in the rats of the model group were decreased significantly ( P<0. 01 ) , while the content of NO and activity of NOS were increased obviously (P<0. 05, P <0. 01). Meanwhile, in tis-sue structure of rat’ s hippocampal CA1 area, the num-bers of cells were reduced, cell arrangement was sparse and in disorder, cell form was not intact and cell struc-ture was not normal, cytoplasm, nucleus and cyto-plasm were blurry, nuclei were hyperchromatic and in contraction, and were changed to triangular or irregular shape, lacking nucleoli, and proliferation of glial cells appeared. Compared with the model group, the content of GSH and activity of GSH-Px in the rats of the treat-ment groups were increased significantly ( P<0. 05 , P<0 . 01 ) , while the activity of NOS was decreased ob-viously (P<0. 05, P<0. 01). Meanwhile, in rat tis-sue structure of hippocampal CA1 area, the rat cells in each treatment group were arranged in order, the form of structure was normal, the nuclei were less hyper-chromatic and contracted. Compared with Gal group and sham group, the rats of ECH high dosage group were not different in every part of experiment ( P >0. 05 ) . Conclusion ECH exerts protection on oxida-tive stress injury in vascular dementia rats.