Objective To describe the clinicopathological features of histiocytic necrotizing lymphadenitis ( HNL). Methods Routine lymph node biopsies of 10 HNL cases were reviewed and their immunophenotyping were performed using S-P immunohistochemical staining. Results Histologically, HNL had discrete or integrated nodules variable in size in the paracortex,expecially in the interfollicular area,which were full of proliferating pleomorphic histocytes,transformed lymphocytes,and karyorrhectic debris without infiltration of the neutrophils, plasma cells and/or eosinophils. Immunohistochemistry revealed CD45RO + for transformed lymphocytes,CD68 +for histiocytes.and CD20 +for lymphocytes in the residual germinal centers. Conclusion The presence of pleomorphic histiocytes, transformed T-cells, and karyor-rhectic debris in the biopsy of lymph nodes, together with the absence of neutrophils support the diagnosis of HNL.

Objective To investigate the difference of differentiation from rat bone marrow mesenchymal stem cells(MSCs) from normal group and hepatic fibrosis model group into hepatocyte-like cells.Methods Wistar rats were randomly divided into two groups: normal group and hepatic fibrosis model group.The liver fibrosis was induced by CCL4.MSCs were isolated by combining gradient density centrifugation with plastic adherence.Pure MSCs were obtained by cultivation and passage.The cells then treated with HGF and FGF-4.Levels of AFP and albumin from supernatant were determined on day 15,21 and 27.On day 27,cells of induced and non-induced were collected,glycogen store of hepatocytes and the expressions of CK-18 and CK-19 were detected.Results The level of AFP in induced MSCs was higher on day 15,21,27,and reached the peak on day 21;there was no significant difference between induced and non-induced MSCs in albumin levels on day 15,but on day 21,27,compared with the non-induced MSCs,the albumin level in the induced MSCs was higher and reaches its peak on day 27;glycogen storage of induced MSCs was measured on day 27 as compared with non-induced MSCs;the induced MSCs expressed CK-18 and CK-19 while the non-induced MSCs did not.Compared by the levels of AFP and albumin,there was no significant difference in differentiation effect of MSCs between the normal group and hepatic fibrosis model group.Conclusion Rat MSCs of hepatic fibrosis model group could differentiate into hepatocyte-like cells with hepatic phenotype and biological function in the presence HGF and FGF-4.

We built rats model of endometriosis applying autologus endometrial transplants to compare the graft vol-ume of the modeling rats before and after dosing,serum tumor necrosis factor alpha(TNF-α)levels in rats,and the expressions of vascular endothelial cell growth factor(VEGF)in ectopic endometrium.To compare with the control group,the graft volume of DingKunDan group was reduced and the serum TNF-αlevel declined ,and also the ex-pression of VEGF in ectopic endometrium was reduced.Their differences were statistically significant (P <0.05). DingKunDan can inhibit the growth of ectopic endometrium in endometrosis model rats.The mechanism may be re-lated to the decrease of the serum TNF-αlevel and the VEGF expression.

Objective To study the effects of collaborative care model on the negative mood and the quality of life of lung cancer patients. Methods Sixty patients were randomized into the observation group and the control group with 30 cases in each.The control group only received usual care,the observation group Was treated with collaborative care,encouraging patients and their families to participate in health care.Using SDS、SAS、activities of daily living(ADL)scale and St.George's Respiratory Question-naire(SGRQ)to evaluate the effects ofthe patients in both groups on admission and one months after the discharge.Results One months after the discharge,the scores of anxiety and depression among the observation group were lower than those of the control group;ADL grade and quality of life score in the observation group compared with the control group were significantly improved,the difference was statistically significant. Conclusions Application of collaborative care management can improve the state of anxiety and depression,reduce hospitalization time and medical costs as well as improve quality of life.

Objective To investigate the alteration of peripheral tissue`s temperature of the coagulation zone of microwave ablation in brain tissue, and to provide experimental evidence for clinical application. Methods Twelve canines were treated by microwave ablation in brain tissue. Each was ablated for 180 s with microwave output power of 20 W, 30 W, and 40 W. During the operation the peripheral temperature at the distance of 0.5 cm, 1.0 cm, 1.5 cm and 2.0 cm from the ablation center was recorded respectively. The ultrasound was performed 1 hour after the operation, and then the animals were executed and the microscopic changes of the ablation lesion were observed. Results Eleven canines suffered well for the ablation, while 1 presented abnormal respiration during the operation and died 2 hours later. During the operation, the temperature of the area 0.5 cm from the center rose signiifcantly, with the maximum temperature was (96.40±1.46)℃at the power of 20 W, and 100℃at the power of 30 W and 40 W. The temperature of the area 1.0 cm from the center rose faster, with the maximum temperatures at different powers all above the 46℃. The temperature of the area 1.5 cm from the center rose slower, with the maximum temperature below 46℃at the power of 20 W and 30 W and above 46℃at the power of 40 W. The maximum temperatures of the area 2.0 cm from the center at different powers were all below 46℃. The difference of the maximum temperature at different distances (1.0 cm, 1.5 cm, and 2.0 cm from the center) was signiifcant (F=776.78, 2640.64 and 3025.53, all P<0.05). The length and width of the ablation lesion as well as the area of edema increased with the power. At the power of 20 W, 30 W, and 40 W, the length of the ablation lesion was (29.3±1.8) mm, (32.7±2.1) mm and (34.2±2.4) mm, the width was (22.5±1.5) mm, (23.7±1.7) mm and (27.1±2.0) mm, and the width of the edema zone was (2.3±0.4) mm, (2.6±0.4) mm and (2.7±0.5) mm. The differences of the length and width of the ablation lesion at different powers were signiifcant (F=11.46, 14.49, both P<0.01). The difference of the edema area at different powers was insigniifcant (F=1.94, P=0.169). Conclusions Microwave ablation is a safe therapeutic modality. However, the shorter distance from the ablation center and greater ablation power give rise to larger ablation lesion, higher maximum temperature, and faster temperature increase. Therefore, 2.0 cm from the ablation center is a safe area.

Objective To investigate the effect and nursing experience of iliacus groin approaches and internal fixation treatment for patients with pelvic fractures. Methods Twenty- six patients with unstable pelvic fracture were obtained iliac groin approaches and internal fixation treatment, the changing symptoms in patients were monitored frequently, and all patients were performed general nursing. Results All patients were followed up for 0.5 to 5.0 years, without obvious complications, the results of surgical treatment included optimal 16 cases, good 7 cases, mean 3 cases. Conclusions Iliacus groin approaches and internal fixation with reconstruction plate treatment on pelvic fractures was proved to be reset accurate, reliable and strong, with better effects. Effective nursing measures can save life of patients with pelvic fractures, speed up rehabilitation of physiological function, improve life quality of the patients.

Objective To discuss the application value of DWI and ADC on predicting therapeutic effect of radiotherapy treatment in NPC. Methods Twenty four local recurrent cases and 38 non-recurrent cases after radiotherapy treatment in NPC were reviewed. MRI and DWI-MRI were performed at pre-radiotherapy and 3, 6, 12 months after treatment, the ADC values of the lesions were analyzed by SPSS 18.0 statistical software. ROC curves based on the ADC values were measured in 3, 6, 12 months after treatment plotted to analyze the threshold ADC value for confirming recurrence. Results The recurrent group and newly diagnosed group showed significantly high signal on DWI, while the non-recurrent group acquired low or mixed signal. The ADC values of the primary tumor in the recurrent group and the non-recurrent group were (0.709 ± 0.078) × 10-3 and (0.693 ± 0.089) × 10-3mm2/s, respectively, t=-0.717,P>0.05, respectively.The ADC values of the primary and recurrent tumor in the recurrent group were (0.730± 0.068) × 10-3mm2/s and (0.709 ± 0.078) × 10-3mm2/s, t=-1.000,P>0.05 , respectively.There were statistical differences between the recurrent group and the non-recurrent group for ADC in 3, 6, 12 months after treatment:(1.128 ± 0.179) × 10-3 and (1.358 ± 0.145) × 10-3mm2/s, t=5.567,P<0.01;(1.164 ± 0.174) and (1.450 ± 0.102) × 10-3mm2/s, t=7.310,P<0.01;(1.107 ± 0.180) × 10-3 and (1.584 ± 0.125) × 10-3mm2/s, t=11.189,P<0.01;respectively. Take 1.29 × 10-3 mm2/s,1.32 × 10-3mm2/s,1.37 × 10-3mm2/s respectively in 3, 6, 12months after treatment as the diagnostic threshold to predict tumor recurrence. The sensitive , specificity, and accuracy were (83.3%, 73.7%, 77.4%), (83.3%, 89.5%, 87.1%), (100.0%, 94.7%, 96.3%).Conclusions Both DWI and ADC value are important for diagnosing and predicting recurrent NPC after radiotherapy treatment, DWI and ADC can be used to regular follow-up after radiotherapy, to further improve the rate of early diagnosis of recurrent NPC.

Objective To observe the effects of berberine on inflammatory factors, adipokines and fatty acid metabo-lism in 3T3-L1 adipocytes, and to investigate the molecular mechanism underlying berberine’s role of improving insulin re-sistance. Methods mRNA level of inflammatory molecules, adipokines, key enzymes and protein in fatty acid metabolism in 3T3-L1 cells were determined by quantitative real time polymerase chain reaction (qRT-PCR) after cells were treated with different concentrations of berberine (0, 5, 10, 20, 40μmol/L) for 24 hours and with 10μmol/L berberine at different du-rations (0,4,8,24,48 h). These factors mainly included interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α), leptin, adipo-nectin, visfatin, fatty acid synthase (FAS), acetyl-CoA carboxylase (ACC), adipose triglyceride lipase (ATGL) and adipocyte fatty acid binding protein (AFABP). Results In 3T3-L1 adipocytes, transcription level of IL-6, TNF-α, leptin, FAS, AT-GL, AFABP reduced with addition of berberine dosage at 10~40μmol/L(P＜0.05)while visfatin mRNA level increased(P＜0.05)compared with the control group. No significant difference was found in expression of adiponectin(P>0.05). Tran-scription level of IL-6, TNF-α, leptin, AFABP, ATGL, FAS decreased with time after 10μmol/L berberine intervention (8-48 h) compared with the control group(P＜0.05). On the other hand, visfatin mRNA level increased(P＜0.05)compared with the control group. Adiponectin mRNA decreased only after cells were treated with berberine for 48 h(P＜0.05). No sig-nificant difference was found transcription of ACC between each groups treated with berberine(P > 0.05). Conclusion mRNA level of inflammatory factors, adipokines, key enzymes and protein in fatty acid metabolism in 3T3-L1 adipocytes can be affected by berberine and this effect depend on its dose and time . This might be the mechanisms underlying berber- ine to improve insulin resistance.

Objective To observe the incidence,clinical types,and prognosis of pulmonary involvement in children with systemic lupus erythematosus(SLE),and to probe the relationship between the relative factors.Methods The clinical data of 61 children with SLE,who treated in Children's Hospital of Shanghai from Jan.2006 to Dec.2011 were analyzed retrospectively.The lung manifestations of the patients were classified according to their clinical symptoms and signs,and lung imaging examination (chest X-ray and CT).Other data of the SLE patients with lung injury or without lung injury were collected,including the course of the disease,activity index [SLE disease activity index (SLEDAI) scoring 0-4 was divided into no activity,5-9 was divided into low activity,10-14 was divided into moderate activity,and more than 15 as severe activity],blood sedimentation,the values of serum complement and the positive rate of dsDNA in autoantibody,and a comparison was made and statistical analysis was performed.Results Pulmonary injury occurred in 17 cases with an incidence rate of 27.9％ (17/61 cases),and the average course of the disease was (8.76 ± 6.96) months.The clinical manifestations of 17 cases included fever,cough,dyspnea,hypoxemia,chest pain,lower breath sound,and lung rale,which were not non-specificity.According to imageological examination,in 17 cases there were 2 cases with pulmonary hypertension (the incidence rate was 11.8％),4 cases with acute lupus pneumonitis (the incidence rate was 23.5％),6 cases with interstitial pneumonia (the incidence rate was 35.3％),7 cases with lesion of pleura (the incidence rate was 41.2％),10 cases with pulmonary infection (the incidence rate was 58.8％).There were no statistical differences between patients with and without lung injury(infectious and non-infectious)in the course,the values of serumn complement,the positive rate of dsDNA and activity index.Lung lesions of the 17 patients recovered quickly after early diagnosis and active treatment.Conclusions Pulmonary manifestation in children with SLE is not uncommon,and it can happen at any stage of the disease,not just on the stage of lupus activity,but it usually indicates disease was not controlled.Pulmonary manifestation of SLE in children involve many parts of lung,including pulmonary parenchyma,interstitial,blood vessels,pleura,etc.Early diagnosis and active treatment can improve the short-term prognosis of lung injury with lupus,and long-term outcome remains to be observed.

Objective To investigate an appropriate megavoltage computed tomography ( MVCT ) protocol to guide helical tomotherapy ( HT) for multiple metastases. Methods According to the location of target volume, 48 patients with multiple metastases undergoing HT were divided into head/chest group ( n=15), head/pelvis group (n=15), and chest/pelvis group (n=18). Each target volume received MVCT scans during the treatment. The obtained MVCT images were registered to CT images and the setup errors were recorded. The CTV?PTV margins were calculated. Comparison was made by paired t test. Results In the head/chest group, there was no significant difference in the setup error in x?axis between the head and chest (-0.15±1?25 vs. -0.21±2?34, P=0?71), while the head had significantly smaller setup errors in y?and z?axis than the chest (0.73±1?22 vs. 1.56±2?54, P=0?00;0.93±1?44 vs. 2.65±1?88, P=0?00). In the head/pelvis group, the head had significantly smaller setup errors in x?, y?, and z?axis than the pelvis (-0.16±1?31 vs. -1.29±3?72, P=0?00;0.81±1?34 vs. 3.20±3?90, P=0?00;1.24±1?75 vs. 5.49±2?80, P=0?00) . In the chest/pelvis group, there were no significant differences in setup errors in x?or y?axis between the chest and pelvis (-0.25± 2?90 vs. -0.22± 3?65, P=0?06;0.35± 3?60 vs. 0.38± 3?78, P=0?87), while the chest had a significantly smaller setup error in z?axis than the pelvis (1.95±2?81 vs. 3.35± 3?05, P=0?00) . In the three groups, the CTV?PTV margins of lower target volume were reduced in three dimensions after the correction of upper target volume, in which y?axis showed the largest reduction of CTV?PTV margins (5?13 vs. 4?01;9?17 vs. 8?30;8?52 vs. 7?13). Conclusions The setup error of individual target volume should not be used for correction of the overall setup error in HT for multiple metastases with isolated target volume. An MVCT protocol that provides image?based guidance for multiple target volumes is recommended.