By using the method of clonal analysis the evidence to prove that Hemophagocytic syndrome (HPS) is reactive or malignant was investigated to probe into the pathogenesis of HPS and its relations with clinical prognosis. The macrophages abnormally proliferated in bone marrow were isolated. Electrophoresis analysis was made after DNA extraction, enzyme restriction of human ardrogen receptor (HUMARA) genetic locus, and PCR amplification. In the 9 specimens, clonal proliferation was found in 2 cases and nonclonal proliferation in 7. Among the 7 cases of nonclonal proliferation, 3 were voluntarily discharged without clinical outcome, 2 cases fully recovered after 2-3 week treatment of large dose gamma globulin intravenous drip and hormone therapy, 1 case died at the 43th day after the hormone and anti-infection therapy, and one case was found to have granular leukoblast in peripheral blood after 3 weeks and diagnosed as having M2a after bone puncture. For the two patients with clonal proliferation, one obtained remission after chemotherapy and the other was died after 32 days without chemotherapy. It was concluded that there do exist clonal or malignant proliferation in HPS, so not every case is reactive.
Clone Cells ; Histiocytosis, Non-Langerhans-Cell/*blood ; Histiocytosis, Non-Langerhans-Cell/therapy ; Macrophages/*pathology ; gamma-Globulins/therapeutic use

Blood Cell Count ; Bone Marrow Cells ; pathology ; Child ; Cytokines ; analysis ; Fever ; Histiocytosis, Non-Langerhans-Cell ; metabolism ; pathology ; therapy ; Humans ; Interleukin-2 ; analysis ; Interleukin-6 ; analysis ; Receptors, Interleukin-1 ; analysis

0.05).Conclusions Serum DAO can be used as a sensitive marker to early diagnose gastrointestinal dysfunction in critical neonates.Serum D-lactate will be of high specific clinical significance in diagnosis,the change of D-lactate may have relations to the features of intestinal microflora in early neonates.

Simultaneous concurrence of subacute thyroiditis and Graves' disease is rare.We present one case of subacute thyroiditis with Graves' disease and combine with other reports to explore the clinical characteristics and therapeutic considerations.If subacute thyroiditis is considered coexisting simultaneously with Graves' disease,radioactive iodine uptake,thyroid autoantibody,fine-needle aspiration of thyroid gland,thyroid nuclide imaging examination,etc,should be done to make correct diagnosis and to adjust the therapeutic plan.

Objective To study the effect of hand-assisted laparoscopic anterior resection for rectal cancer(RC).Methods The clinical data of 28 cases of RC operated with hand-assisted laparoscopy were analyzed retrospectively. Results The operations in all the 28 cases were successfully performed, and no intra-or post-operative complications were observed.The number of resected lymph nodes and the resected margins from the tumor were sufficient.After operation,the patients felt less pain, recovered quicker and bowel movement recovered early;first postoperative flatus was appeared at 32 hours after operation;average postoperative hospital stay was 7 days.All the patients were followed-up for 8 to 19 months,and no trocar port tumor implantation or local recurrence occurred.Conclusions The results demonstrate that hand-assisted laparoscopic anterior resection in the treatment of RC have many advantages,such as safe,less trauma,the patients recover quicker,resection of the tumor more complete etc,so it can be used extensively.

Human cytomegalovirus (HCMV) late mRNA expression in megakaryoblast and in turn the pathogenesis of idiopathic thrombocytopenic purpura (ITP) patients with HCMV infection, and effectiveness of ganciclovir were investigated. Colony forming unit-megakaryocytes (CFU-MK) of 46 ITP patients with HCMV infection were incubated from patients' bone marrow mononuclear cells (MNC). Reverse transcriptase-polymerase chain reaction (RT-PCR) was subsequently used for CFU-MK for HCMV-late mRNA detection. Ganciclovir therapy was given to both HCMV-late mRNA positive and negative groups for comparison of therapeutic effectiveness. The results in 19 of 46 CFU-MK culture cells specimens with positive HCMV-DNA by PCR or positive CMV-IgM by enzyme linked immunosorbent assay (ELISA) in the correspondent serum of peripheral blood were positive for HCMV-late mRNA. Sixteen out of 19, patients with positive HCMV-late mRNA CFU-MK had a positive response to ganciclovir. Amongst 27 patients with negative HCMV-late mRNA CFU-MK, only 4 positive responders to ganciclovir therapy were observed. Curative effectiveness of ganciclovir in HCMV-late mRNA positive group was significantly higher than that in HCMV-late mRNA negative group (P<0.01). It was suggested that HCMV could directly infect CFU-MK, which might be one of the mechanisms responsible for HCMV related ITP. The ganciclovir is an effective therapy in resulting in the increases in thrombocyte in the ITP patients whose HCMV- late mRNA was positive in their CFU-MK.

AlM: To investigate and evaluate the prevalence of xerophthalmia among aerospace science and technology staff and its influencing factors for the eye health guidance.
METHODS: The staff underwent physical examination in our examination center from September 2013 to June 2014 were preliminary screened, and those patients with symptoms of dry eye were investigated with questionnaires and diagnosed by basic lacrimal secretion test ( Schirmer l ) , breakup time of tear film ( BUT ) test and fluorescein ( FL) staining test .
RESULTS: There were 606 complaints of dry eye symptoms of the 1 000 premiers, distributed in random (60. 6%), and 432 employees were diagnosed (43. 2%). The positive rate of dry eye was 71. 3%. The causes of xerophthalmia, besides of gender, age, also include a variety of factors such as air-conditioner, heating, video terminals, sleep time, etc.
CONCLUSlON: Dry eye, an epidemic disease, has a variety of symptoms and complex etiology, the main causes of aerospace science and technology staff with dry eye is working environment and some local factors. We can give appropriate health guidance according to the different factors. Meanwhile the relevant series of dry eye screening should also be taken as a routine examination in ophthalmic examination.

? AIM: To investigate the influence of phacoemulsification on corneal endothelial cells and its injury risk factors in diabetic cataract patients.?METHODS: From January 2013 to October 2015, 186 diabetic cataract patients ( 224 eyes ) as diabetes group and 190 patients with simple cataract ( 227 eyes ) as control group in our hospital were enrolled. All patients received phacoemulsification combined with intraocular lens implantation. Observation of corneal endothelial cell density, coefficient of variation and percentage of hexagonal cells preoperatively, 1d, 1wk, 1 and 3mo postoperatively were carried out, and multiple Logistic regression analysis for risk factors of corneal endothelial cell injury was taken.?RESULTS: There were no significant difference in the density of corneal endothelial cells, the coefficient of variation and the percentage of hexagonal cells between the two groups before surgery (P>0. 05). Each time point after operation corneal endothelial cell density and the percentage of hexagonal endothelial cells of diabetes group were significantly lower than the preoperative and those of control group ( P < 0. 05 ). Each time after operation endothelial cell coefficient of variation of diabetes group were significantly higher than the preoperative(P<0. 05). The endothelial cell coefficient of variation in diabetes group of the 1wk, 1 and 3mo after operation were significantly higher than those of the control group ( P<0. 05 ) . Corneal endothelial cell density and percentage of hexagonal cells of the control group at 1wk, 1 and 3mo after operation were significantly lower than the preoperative ( P<0. 05 ). The endothelial cell coefficient of variation of control group at 1wk, 1 and 3mo after operation were significantly higher than the preoperative(P<0. 05). Single factor analysis showed that age, shallow anterior chamber, long ultrasonic time, short eye axis, high energy ultrasonic, high cumulative released energy, a lot of perfusate and nuclear hardness ≥ grade Ⅲ associated with corneal endothelial cell injury ( P< 0. 05 ) . Multivariate Logistic regression analysis showed that age, long ultrasonic time, high ultrasonic energy, high cumulative released energy and nuclear hardness ≥ grade Ⅲ were the risk factors of corneal endothelial cell injury, the OR value and 95%CI were 1. 742 (1. 056-2. 682), 1. 958 (1. 227-3. 135), 2. 064(1. 274-3. 256), 2. 585(1. 493-3. 682), 2. 193 (1. 348-3. 316).?CONCLUSION: The injury of corneal endothelial cells after phacoemulsification in diabetic cataract patients is more serious than in patients with simple cataract. Age, long ultrasonic time, high ultrasonic energy, high cumulative released energy and nuclear hardness ≥grade Ⅲ are the risk factors of corneal endothelial cell injury.

Objective To evaluate the effect of isoflurane anesthesia on noise-induced hearing loss in guinea pigs.Methods Forty-eight healthy adult male guinea pigs,aged 3 months,weighing 400-500 g,were randomly divided into 4 groups (n =12 each) using a random number table:control group (C group),isoflurane group (I group),noise-induced hearing loss group (N group),and isoflurane + noise-induced hearing loss group (I + N group).Isoflurane was inhaled for 140 min at a concentration of 1％ in I and I + N groups.N and I + N groups were exposed to the noise of 4 kHz center frequency and 118-122 dB sound pressure level for 120 min starting from 20 min after administration.Mean arterial pressure (MAP) was recorded at 10,40,70,100 and 120 min of exposure to noise and cochlear blood flow (CoBF) was recorded before administration and at 10,40,70,100 and 120 min of exposure to noise.Auditory brainstem response (ABR) threshold was recorded before administration and at 1 h,72 h,and 10 days after the end of exposure to noise.Arterial blood samples were obtained and the plasma noradrenaline (NE) concentration was detected by HPLC before exposure to noise and immediately after the end of exposure to noise.Results Compared with group C,MAP and the change rate of CoBF were significantly decreased,and the plasma NE concentration was increased immediately after the end of exposure to noise in I group,and MAP was increased,the change rate of CoBF was decreased,and the plasma NE concentration immediately after the end of exposure,and ABR threshold after the end of exposure were increased in N and I + N groups.Compared with N group,MAP was significantly decreased,the change rate of CoBF was increased,the plasma NE concentration immediately after the end of exposure,and ABR threshold at 1 and 72 h after the end of exposure were increased,and no significant was found in ABR threshold at 10 days after the end of exposure in I + N group.Conclusion Isoflurane anesthesia exerts temporary but not permanent protective effects against noise-induced hearing loss in guinea pigs and partial inhibition of activation of sympathetic nerve and increased CoBF may be involved in the mechanism.

BACKGROUND: Changes of elastic fibers in middle cerebral artery(MCA)is close related withthe aged cerebrovascular disease.OBJECTIVE: To observe the changes of elastic fibers of MCA in different aging rats.DESIGN: A descriptive and controlled study based on experimental animals.SETTING: Department of anatomy and central laboratory in a university.MATERIALS: Totally 36 healthy Wistar rats with either gender, weighing 200 - 280 g, were selected from the Animal Institute of the third medical military university of Chongqing[certification SCXX (army) 2002-007].INTERVENTIONS: Changes of elastic fibers of MCA of different aging rats were observed with light microscope, transmission electron microscope and image analysis system. MAIN OUTCOME MEASURES: ①) Major outcome: changes of elastic lamella in MCA of different aging rats; ②) Secondary outcome: ultramicrostructural changes of internal lamella under the transmission electron microscope. RESULTS: With the increase of age, the folded extent and quantity of internal elastic lamella were decreased, and the content of elastic fibers were also decreased significantly( P ＜ 0.01 ). However, the ratio of collagen fibers to elastic fibers was increased significantly( P ＜ 0.01 ) . In the aging group above 24 months, the internal elastic lamina thinned, delaminated and disrupted, and the lipid deposited in it. Endothelial cells and smooth muscle cells passed through the internal elastic lamina. CONCLUSION: Changes of elastic fibers may be related with the increased susceptibility to the cerebrovascular disease in aged people.