SCNP( single cell network profiling) assay can depict the characters of signal pathway network without isolating the dif-ferent cells in advance in complex tissues. It will promote the disease mechanism elucidating, disease classification, diagnosis, and therapeutic regimen at cell level. Drug screening and ration-al personalized treatment will also be improved.

Objective To retrospectively investigate diagnostic and therapeutic value of intradiscal steroid injection in patients with discogenic low back pain combined with radial fissure of annulus fibrosis.Methods Totally 120 patients who had undergone CT guided intervertebral discography and steroid injections,including 72 males and 48 females,aged from 25 to 60 years (average,48 years),were recruited to this study.According to Dallas discography description system,7 cases were rated as grade 0,36 grade 1,48grade 2,and 29 grade 3.The Visual Analogue Scale (VAS) and Roland Morris Disability Questionnaire (RMDQ) were used to evaluate clinical effect at 2 weeks,2 months,6 months,12 months and 24 months postoperatively.Results Most of patients who underwent steroid injection in single highly suspect diseased disc claimed significant symptom improvement.There were statistically significant differences between pre- and post-operative VAS and RMDQ.The clinical effect in grade 3 group was better than those in grade 1 and grade 2 groups,and the differences were significant.Patients with severe disc disruption (grade 3) had a lower recurrence rate of low back pain compared with other patients.Conclusion Intradiseal steroid injection not only can significantly relieve discogenic low back pain,but also can benefit diagnosis of discogenic low back pain,especially in patients who fail to reproduce concordant pain on discography.For patients with severe rupture of the annulus fibrosus,the relief of discogenic low back pain is more significant.

Objective To explore the change and value of interleukin (IL)-2,IL-6 and tumor necrosis factor (TNF)-α in the serum samples of patients with brucellosis.Methods The levels of serum IL-2,IL-6 and TNF-α were measured using the enzyme linked immunosorbent assay (ELISA) method in 155 patients with brucellosis in different clinical stages (including 69 cases in acute,34 cases in subacute and 52 cases in chronic periods) and 50 healthy controls.IL-2 was used to represent the helper T cell (Th)-type 1 cytokines,IL-6 represent Th2 type cytokines,and the Th1/Th2 ratio in different clinical stages was compared.Results The expression level of serum IL-2 in patients with brucellosis was different (ng/L:acute:10.15 ± 2.01;subacute:9.53 ± 1.68;chronic:6.76± 1.31;control:47.25 ± 5.68),the differences were statistically significant (F =74.921,P ＜ 0.05).The expression levels of serum IL-2 in acute,subacute and chronic periods of brucellosis patients were significantly lower than that of healthy controls (all P ＜ 0.05).The expression levels of serum IL-2 in acute and subacute periods of brucellosis patients were higher than that of chronic period patients (all P ＜ 0.05).The expression of IL-6 and TNF-α in serum of patients in different clinical stages were different (ng/L:acute:615.22± 341.07,802.55 ± 479.53;subacute:478.45 ± 105.33,680.21 ± 366.95;chronic:306.37 ± 96.12,455.36 ± 176.27;control:121.45 ± 30.16,87.51 ± 24.03),the differences were statistically significant (F =57.692,63.210,all P ＜ 0.05).The levels of serum IL-6 and TNF-o were significantly higher in patients with brucellosis in acute,subacute and chronic clinical stages than that of healthy controls (all P ＜ 0.05).Serum IL-6 and TNF-α levels in acute period of brucellosis patients were higher than those of subacute and chronic periods patients (all P ＜ 0.05);the levels of serum IL-6 and TNF-α in subacute period of brucellosis patients were also significantly higher than that of chronic period patients (all P ＜ 0.05).The Th1/Th2 ratio was different (acute:0.02 ± 0.00;subacute:0.02 ± 0.00;chronic:0.23 ± 0.02;control:0.41 ± 0.06) in clinical patients with brucellosis,the differences were statistically significant (F =17.843,P ＜ 0.05),the value of Th1/Th2 in acute and subacute period patients were lower than that of chronic period (all P ＜ 0.05).Conclusion IL-2,IL-6 and TNF-α may play an important role in the pathogenesis of brucellosis,and their dynamic changes can reflect the progression and outcome of brucellosis.

Objective To compare the value of pacemaker implantation using the subclavian vein (SCV) puncture and thecephalic vein(CV) cutdown approach.Methods One hundred and forty-six patients were randomized into SCV group (98 patients) and CV group (48 patients).We observed the success rate,surgery duration,fluoroscopy time and complications of the two groups.Results The SCV group had significantly higher success rate,shorter duration of surgery and fluoroscopy than the CV group (success rate:100％ (98/98) vs.89％ (43/48),x2 =10.5,P ＜ 0.05 ; duration of surgery:(118 ± 35) min vs.(256 ± 75)min,t =12.12,P ＜0.01 ; duration of fluoroscopy:(15 ±5) min vs.(35 ± 10) min,t =13.08,P ＜0.01).Both groups had one case who developed compilations which were pocket hematoma and wire electrode dislocation respectively.The rate of complications was not significantly different between the two groups (P ＞ 0.05).Conclusion The SCV approach should be considered a preferable access in pacemaker implantation.

Objective To evaluate surgical therapies for chronic pancreatitis.Method The clinical data of 229 patients admitted for chronic pancreatitis during March 2009 to November 2013 in our hospital was retrospectively analyzed,different operation method and their clinical outcome were compared.Results Drainage operations or resection operations were made to all these 229 patients according to different types.57 patients underwent longitudinal pancreaticojejunostomy (LPJ procedure).118 patients received local resection of the head of pancreas combined with longitudinal pancreaticojejunostomy (Frey procedure in 105 cases,Berne procedure in 6 cases,Beger procedure in 7 cases).7 patients received pancreaticoduodenectomy,21 patients received distal pancreas resection,26 patients received other procedures.Post-operative pain relief rate was 89.3％,overall morbidity was 19.6％.Conclusions In cases of chronic pancreatitis,different surgical types are adopted according to their individual indications.Operation in accordance with pathological types guarantees clinical outcome.

Objective To compare biliary tract intraductal papillary mucinous neoplasm (BT-IPMN) with intraductal papillary mucinous neoplasm of the pancreas (P-IPMN).Methods From January 2008 to December 2013,eleven (6.0％) cases of BT-IPMNs were retrospectively identified from a total of 182 biliary tract tumors resected in our institution,while 50 cases underwent surgery for P-IPMN.The mean age of the 11 BT-IPMN cases was 57.3 years (range 40 to 74 years).There were 8 men (73.0％).The mean age of the 50 P-IPMN cases was 57.4 years (range 33 to 85 years).There were 34 men (68.0％).The clinical features,radiologic findings,pathology,surgical strategies,and long-term follow up outcomes between the 2 groups of patients were analyzed.Results There was no significant difference between BT-IPMN and P-IPMN in the following aspects:mean age,sex ratios and clinical presentation [including the most common presenting symptom abdominal pain (73.0％ vs.68.0％),and elevated tumor markers (CEA and CA19-9)].The mean tumor size of BT-IPMN was significantly smaller than P-IPMN (1.7 vs.4.1 cm,P ＜ 0.05).Macroscopically visible mucin was detected in all the 11 patients basing on the original surgical reports.The most common abnormal preoperative imaging findings for BT-IPMN were bile duct dilatation (100％) and intraluminal masses (55.0％).Most cases (82.0％) involved the intrahepatic bile duct and hilum.For tumor clearance,we conducted left hepatectomy in most cases (64.0％).Only one patient underwent biopsy and choledochojejunostomy for multiple tumors involving the extrahepatic,right and left bile ducts.BT-IPMN was likely to have a higher risk of malignancy (55.0％ vs.44.0％) and poorer prognosis (median survival,57 vs.63 months),although there was no significant difference (P ＞ 0.05).The patient without tumor resection died of liver failure 22 months after palliative surgery.Conclusions BT-IPMNs are very rare and they had some similarity with P-IPMN.Complete resection of BT-IPMN is associated with good survival.

Objeetive To investigate the effect of alteration of blood flow in the hepatic artery on the therapeutic effect of cryoablation in VX2 hepatic tumor rabbit model.Methods Thirty rabbits with VX2 hepatic tumor were divided into three groups according to hepatic artery blood flow:complete occlusion of the hepatic artery(group A),paaial occlusion of the hepatic artery(group B),and no occlusion of the hepatic artery(group C).With conventional CT scau and perfusion scan,the values of blood flow(BF)and blood volume(BV)of VX2 tumor were computed and the differences among the three groups were analyzed.After cryoablation,the animals were euthanized and the livers were removed.The hepatic tissue from the cryoablation area and surrounding area underwent both methyl thiazolyl tetrazolium(MTT)diaphorase staining and triphenyl tetrazolium chloride(TTC)staining.The gross pathology and histopathological 3.14)ml/100 g in group C,respectively.There were significant differences among the three groups in the BF and BV(F value was 452.16 and 421.33 in the BF and BV,respectively,P＜0.01);(2)The maximum diameter of cryoablation-induced necrosis was(2.3±0.3)cm in group A,(1.5±0.2)cm in group B,and(0.8±0.1)cm in group C,respectively.The difference was significant among the groups (F value was 315.32,P＜0.01).(3)There were well-defined frozen areas.bordering areas and normal surrounding areas in MTT staining.In group C,positive staining around some blood vessels could be seen.Conclusion Alteration of the blood flow in the hepetatic artery can affect the cryoablation efficacy.With the decrease of hepatic artery blood flow,the efficacy of cryoablation on liver tumor increased.

Objective: To explore the application of18F-lfuorodeoxyglucose (FDG) micro- positron emission tomography (PET) myocardial metabolism imaging for evaluating dilated cardiomyopathy model (DCM) in experimental rats. Methods: A total of 12 male SD rats were randomly divided into 2 groups: DCM group, the rats received intraperitoneal injection of adriamycin at 1.0 mg/kg twice per week and Control group, the rats received intraperitoneal injection of normal saline, all animals were treated for 6 weeks followed by 2 weeks observation.n=6 in each group. Echocardiography was performed at pre- and post-modeling,18F-FDG micro-PET myocardial metabolism imaging was conducted after modeling and plasma level of BNP was examined as well. Finally, the rats were scariifed to observe the pathological changes of myocardial tissue. Results: 1 rat died in DCM group and the rest were with successful modeling conifrmed by echocardiography and pathology. Compared with Control group, DCM group showed decreased standard uptake value of18F-FDG (1.23 ± 0.55) vs (6.65 ± 0.41),P<0.01; the standard uptake value of18F-FDG was negatively related to left ventricular end diastolic diameter (LVEDD) (R=-0.709,P=0.015), LVESD (R=-0.924, P=0.000) and plasma level of BNP (R=-0.948,P=0.000), while positively related to LVEF (R=0.968,P=0.000) and fractional shortening (R=0.863,P=0.001). Conclusion:18F-FDG micro-PET myocardial metabolism imaging combining echocardiography, biochemical and pathological examinations may evaluate DCM modeling in rats, which provide a non-invasive and intravital tool for small animal experiment.

Objective This study was designed to compare the mRNA expression of Toll-like receptors 2 (TLR2) and Toll-like receptors 4 (TLR4) in monocytes between brucellosis cases and healthy controls,to explore the role and value of TLR2 and TLR4 in the pathogenesis of brucellosis.Methods From March to June in 2015,a total of 155 brucellosis cases at different clinical stages were diagnosed in Ulanqab Center for Endemic Disease Prevention and Control and 50 healthy controls were selected as research subjects.Subjective clinical symptoms of all patients were observed.Serological detection of all cases was done using serum tube agglutination test (SAT).The mRNA expression of TLR2 and TLR4 in peripheral blood cell was detected by real-time PCR technique.Results Fever,hyperhidrosis,weak,bone ache and hepatosplenomegaly were found in patients of acute (69 people),subacute (34 people) and chronic (52 people) periods.The incidences of fever and hyperhidrosis in acute and subacute periods were higher than that in chronic period,and the differences were statistically significant (x2 =58.427,26.190,all P ＜ 0.01).The incidence of bone ache in chronic period was higher than that in acute period,and the difference was statistically significant (x2 =9.264,P ＜ 0.01).In the agglutination titer of 1:800 and higher,the positive rate of chronic period was lower than those in acute and subacute periods,and the differences were statistically significant (x2 =14.302,8.682,all P ＜ 0.01).The mRNA expression levels of TLR2 and TLR4 were different among different clinical periods of brucellosis patients,and the differences were statistically significant (F =17.502,24.931,all P ＜ 0.01).The expression levels of TLR2 mRNA (8.67 ± 2.39) and TLR4 mRNA (12.38 ± 3.87) in acute period of brucellosis patients were higher than those of subacute period (5.21 ± 1.76,7.62 ± 2.21),chronic period (1.25 ± 0.47,1.72 ± 0.55) and healthy control (1.17 ± 0.23,1.43 ± 0.62),and the differences were statistically significant (all P ＜ 0.01).The expression levels of TLR2 and TLR4 mRNA in subacute period of brucellosis patients were higher than those of chronic period and healthy controls,and the differences were statistically significant (all P ＜ 0.01).The expression levels of TLR2 and TLR4 mRNA were not significantly different (all P ＞ 0.05) between chronic period and healthy controls.Conclusion TLR2 and TLR4 may be the specific recognizing receptors participated in the immune response in brucellosis and associated with the occurrence and development of brucellosis.

Objective To investigate the expression and effect of high mobility group box 1(HMGB1) and its signaling pathway(HMGB1 RAGE/TLR4-NF-κB-cytokines)in rats with dilatd cardiomyopathy(DCM).Methods The rats were divided into two groups:normal control group (control,n=20) which treated with physiological saline,and DCM group(n=22) which treated with adriamycin(1 mg/kg twice a week)for 6 weeks,and then observed for 2 weeks.Echocardiography was performed at the end of the study.Plasma IL-1,IL-6,TNF-α level were measured by the flow cytometry.The CRP,BNP concentrations were measured by enzyme linked immunosorbent assay (ELISA).The expression of HMGB1 mRNA,TLR4 mRNA,RAGE mRNA,NF κB mRNA were measured by real time PCR.Results There were four rats dead in the DCM group;two rats were randomly selected from the DCM group to certified modeled successfully by echocardiography and pathological examination.Left ventricular end-diastolic diameter (LVEDD) and left ventricular end systolic diameter (LVESD) in DCM group were significantly higher than those in the normal control group(P＜0.05);left ventricular ejection fraction (LVEF),left ventricular short axis contractility(FS) in DCM group was significantly lower than that in normal control group(P＜0.05).The expression of H MGB1 mRNA,TLR4 mRNA,RAGE mRNA and NF-κB mRNA in myocardial tissue were significantly increased in DCM group than in the normal control saline group (P＜ 0.05),The expression of HMGB1 mRNA were positively correlated with TLR4 mRNA,RAGE mRNA and NF κB mRNA(r=0.873,P=0.005;r=0.949;P=0.000;r=0.898,P=0.002).The serum levels of IL-1,IL 6,TNF α and CRP were significantly higher in DCM group.The expression of HMGB1 mRNA in myocardial tissue was positively correlated with IL 1,IL-6,TNF-α and CRP(r=0.944,P=0.002;r=0.988,P=0.000;r=0.968,P=0.000;r=0.961,P=0.000).Conclusion HMGB1 and it's inflammation signaling pathway (HMGB1-TLR4/RAGE-NF-κB-cytokines) were highly expressed in dilated cardiomyopathy,and have relationship with left ventricular diameter and cardiac function,they may be involved in the development of DCM.