Objective To investigate the clinical biomarkers of acute lung injury(ALI) after the Stanford A aortic dissection.Methods Thirty patients underwent Stanford A aoatic dissection were selected as subjects,who hospitalized from January 2006 to March 2013.Of which,21 patients underwent total arch replacement with stented elephant trunk procedure and 9 patients underwent triple-branched stent graft placement.The general information of patients,preoperation echocardiogram data,and arterial partial pressure of oxygen (PaO2),partial pressure of carbon dioxide (PaCO2) and fraction of inspired oxygen(FiO2) were recorded before,after the operation and entering ICU.Alveolar-arterial oxygen difference (A-aDO2),oxygenation index (OI) were calculated.Results A-aDO2 and OI at preoperation,postoperative and entering ICU point were (112.47 ±41.06) mmHg,(136.13 ± 29.51) mmHg and (141.37 ± 25.94) mmHg; (535.23 ± 70.15) mmHg; (491.50 ± 73.12) mmHg and (387.33 ± 91.32) mmHg respectively,and the differences were significant (F=35.926,323.742;P =0.000).The levels of A-aDO2 and OI at entering ICU were significant different from that of pre-operation and post-operation (P ＜ 0.01,P ＜ 0.05).Conclusion Early postoperative oxygenation and switching functions of patients with Stanford A aortic dissection are subject to damage to some degree.The A-aDO2 and OI might be sensitive biomarkers of the diagnosis for early acute lung injury of aortic dissection patients.

Acquired syphilis uveitis,due to lack of the characteristic features,presents with various types.The most common type is posterior uveitis and panuveitis,including chorioretinitis,retinal vasculitis,optic nerve retinitis.The diagnosis and assessment of response to treatment depends mainly on the serological diagnostic tests,including nontreponemal and treponemal test.Acquired syphilis uveitis often presents with manifestations similar to various types of uveitis,especially to autoimmune uveitis and other infectious uveitis,so differential diagnosis is important.The gold standard treatment for active syphilitic uveitis is penicillin G,or doxycycline if patient is allergy to penicillin.Clinically misdiagnosis and delayed treatment may result in irreversible visual impairment and severe systemic and eye complications.However such timely treatment always has a good prognosis.

Objective To study the effect of combined transplantation of pancreatic islets and hepatocytes on the treatment of diabetic rats and the possibility on hepatocytes inducing islet allograft tolerance. Methods Forty diabetic SD rats were randomly divided into 4 groups: normal control group,diabetic control group, pancreatic islet grafted group,and hepatocyte and pancreatic islet transplanted group. The pancreatic islets of fetal SD rats were implanted into the gastric subserosa of recipients. The alteration of diabetes and immune status were observed. Results There were 58.8% (20/34) diabetic rats cured after pancreatic islets transplantation. The survival time in the combined grafted group was longer than that in the pancreatic islet grafted group ( P

Objective To observe the protective effect of Xiaohuangdecotion against liver damage inα-naphthylisothiocyanate (ANIT)- induced cholestasis in rats and probe the potential mechanisms.Methods Male Wistar rats (40) were randomly divided into a normal group, a model group, aXiaohuangdecotion treatment group, and a UDCA control group (10 for each). Except for rats in the normal group, ANIT solution (6 ml/kg) was administered in other rats by gavages for cholestasis model. After ANIT treated 48 h, rats inXiaohuangdecotion group and UDCA group were treated withXiaohuangdecotion (1.73 g/kg) and UDCA (10 mg/kg) respectively for 1 week. And, rats in the normal group and the model group were given an equal volume of saline. At the end of the experiment, liver function rats were examined. Liver histology was examined by HE staining, and CD68 factor was tested by immunohistochemistry and Western blot.Results Compared with the model group, the content of ALT (164.6 ± 53.4 U/Lvs. 208.4 ± 28.5 U/L), AST (247.6 ± 76.1 U/Lvs. 341.8 ± 32.8 U/L), ALP (601.0 ± 101.1 U/Lvs. 720.6 ± 123.3 U/L), TBiL (96.5 ± 18.1μmol/Lvs. 149.6 ± 30.2μmol/L), DBiL (73.7 ± 16.6μmol/Lvs. 140.3 ± 28.6μmol/L) and TBA (93.4 ± 13.0μmol/Lvs. 146.5 ± 38.9μmol/L) were significantly reduced in the treatment group (P<0.01 orP<0.05). Compared with the model group, CD68 level (7.08 ± 0.19 vs. 17.42 ± 0.48)were significantly reduced by intervention ofXiaohuangdecotion (P<0.01).ConclusionsXiaohuangdecotion could improve liver functions and reduce CD68 expression, leading to a good hepatoprotective and jaundice-relieving effects.

Objective To evaluate the relationship between long non-coding RNAs (LncRNA) in tumor tissues and clinico-pathological features of hepatocllular carcinoma (HCC).Methods Using hepatocellular carcinoma gene database GSE36376,we conducted a study on eight LncRNAs which are associated with liver diseases and analyzed the correlation between these LncRNAs and HCC clinico-pathological characteristics.We also evaluated the potential effect of LncRNAs on HCC development.Results H19 was overexpressed in non-tumorous tissues of HCC (P ＜ 0.05),while MEG3,HOXA13,KCNQ1OT1 were all upregulated in tumorous tissues (all P ＜ 0.05).HULC level in HCC tumorous tissues was negatively correlated with AJCC staging,BCLC staging and tumor size (all P ＜ 0.05).UCA1 was positively correlated with BCLC staging (r =0.135,P ＜ 0.05).Univariate analysis and multivariate logistic analyses showed that UCA1 was a risk factor of intrahepatic metastasis of HCC (OR =6.054,95％ CI =1.429 ～ 25.642,P ＜ 0.05); in contrast,HULC overexpression in tumorous tissues played a positive role in HCC tumor size (OR=0.805,95％CI=0.678 ～0.956,P＜0.05).Conclusion HULC in tumorous tissues suppressed HCC proliferation,while UCA1 was a risk factor of HCC aggressiveness.

We retrospectively reviewed the tongue images and related clinical data of 118 AIDS patients treated in Shanghai Public Health Clinical Center Affiliated to Fudan University. The tongue images included: cyanotic and purplish tongue ( 33, 28.0% ), light-reddish tongue ( 32, 27.1% ), light-whitish tongue (21, 17.8% ) , bulgy tongue(19, 16.1% ), dark-red tongue (7, 5.9% ) and fissured tongue (6,5.1% ). There were significant differences in counts of CD4+T lymphocytes, white blood cells and red blood cells among different tongue imagine groups. The tongue image can indicate the pathogenic factors of disease as well as the functions of viscera in AIDS patients.

Objective To summarize and describe clinical features and treatment outcome of syphilitic scleritis.Methods A retrospective study was conducted in patients diagnosed as syphilitic scleritis from 2011 to 2016 in our hospital.Clinical characteristics and prognosis were evaluated.Results Seven patients (7 eyes) were diagnosed as syphilitic scleritis by clinical and serological examinations.All patients were unaware that they had syphilis infection before visit.The ocular manifestation was the only clinical fmdings in three patients.Both treponema pallidum particle agglutination and rapid plasma regain were positive.Meanwhile,the scleritis infection was excluded,tests for human immunodeficiency virus (HIV) were negative.Syphilitic scleritis was unilateral in all patients,and the duration was from one week to two years.Initial symptoms were varied in degree of ocular redness,pain and visual impairment.Two patients presented with anterior episcleritis,nodular anterior scleritis was found in three patients,one patient showed diffuse anterior scleritis,and one patient presented with diffuse episcleritis combined with acute syphilitic posterior placoid chorioretinitis.All patients were treated with penicillin G,and inflammation resolved quickly after treatment.Conelusion Syphilitic scleritis is rare and ease to be misdiagnosed,various types of anterior scleritis is the main manifestation.Syphilitic serologic test should be performed for the suspected cases.The prognosis is well with anti-syphilis therapy.

Objective To evaluate the efficacy and influence factors of peginterferon combined with ribavirin for the treatment of elderly patients with chronic hepatitis C (CHC).Methods 34 CHC patients aged over 60 years were enrolled in this retrospective study.Virological responses,relapse rate and discontinuation rate were evaluated,and the predictive factors associated with these outcomes were analyzed.Results The proportions of rapid virological response (RVR),early virological response (EVR),end of treatment virological response(ETR),sustained virologic response (SVR) were 26.5％,41.2％,52.9％ and 35.3％,respectively in patients after peginterferon plus ribavirin theraphy,and the relapse rate was 33.3％.The relapse rate was higher in patients with the interferon treatment history than in patients with initial interferon treatment (P＜0.05).The rates of ETR and SVR were lower in CHC patients with diabetes than without diabetes (P＜0.05 or 0.01).The ratio of dose adjustment of peginterferon and ribavirin alone and in combination were 26.5％ (9/ 34),61.8％ (21/34) and 8.8％ (3/34),respectively.The discontinuation rate was 20.6％ (7/34).Multivariate Logistic regression analysis showed that SVR rate was lower in CHC patients with diabetes than in those without diabetes (P＜ 0.05).Conclusions Peginterferon plus ribavirin therapy has a better virological response,but a poor tolerance in CHC patients.Diabetes may be an important risk factor for sustained virologic response in CHC patients.

Objective To observe the prognosis and correlated factors of cystoid macular edema (CME) secondary to uveitis.Methods A retrospective,noncomparative case series study.The clinical data of 31 uveitis patients with CME were collected from Uveitis & Ocular Immunology Service of Tianjin Medical University Eye Hospital from August 2011 to December 2015.Pre-treatment and post-treatment data were collected,including details of best-corrected visual acuity (BCVA),central macular thickness (CMT),other macular complications,and intraocular pressure (IOP).Results Twenty-seven patients (36 eyes) were analyzed.At the 1 st month after treatment,complete resolution of CME was achieved in 14 eyes (38.9％),BCVA increased from (0.66 ±0.36) LogMAR at baseline to (0.40 ±0.31) LogMAR (P ＜0.001),and CMT decreased from (469.0 ± 99.1) μm at baseline to (368.7 ± 85.9) μm (P ＜ 0.001).At the 3rd month after treatment,complete resolution of CME was found in 19 eyes (52.8％),no significant difference was found in CMT(323.9 ±60.0) μm or BCVA(0.37 ±0.32)LogMAR compared with the 1 st month after treatment (P ＞ 0.05),significant difference was found in CMT(P ＜0.001) or BCVA(P ＜0.001) before the start of treatment.At the 6th month or more after treatment,complete resolution of CME occurred in 25 eyes (69.4％),BCVA(0.32 ± 0.28)LogMAR was significant difference compared with that before the start of treatment(P ＜ 0.05),at the 1st month(P ＜ 0.05),at the 3rd month (P ＜ 0.05).CMT (294.2 ± 81.2) μm was significant difference compared with that before the start of treatment(P ＜0.001),at the 1st month(P ＜0.001),however,no significant difference was compared with that at the 3rd month (P ＞ 0.05).At the 6th month or more after treatment,11 eyes (30.6％) had a persistent macular edema,complicated with macular epiretinal membrane,no significant correlation between the reduction of CMT(185.0 ± 114.2) μm and the improvement of BCVA (0.29 ± 0.21) LogMAR was found (r =0.322,P=0.052),while the improvement of BCVA(0.29 ± 0.21)LogMAR was negatively associated with the duration of CME(8.4 ±9.8)months(r =-0.395,P =0.015).Conclusion Current therapies are effective in curing most of the CME secondary to uveitis.The duration of CME,is correlated with poor final visual acuity,the presence of ERM is an important factor associated with regression of CME.

Objective To investigate the value of magnetic resonance (MR) imaging in the assessment of bile duct complications after cholecystectomy. Methods Fifty patients of having bile duct complications after cholecystectomy underwent MR imaging and had some positive manifestations. The indication for cholecystectomy was symptometic cholelithiasis in all cases. MR imaging was performed with a 1.5 T clinical imager including all of the sequences of: ①T1 weighted imaging (T1WI) was performed in transverse and coronal plane before and after gadolinium enhanced. ②T2 weighted imaging (T2WI) was performed in transverse plane. ③A true fast imaging with steady state precession sequence (True fisp) was performed in coronal plane. ④MR cholangiopancreatography was also obtained. Results The bile duct complications after cholecystectomy including: 22 cases of cholelithiasis, 15 cases of chronic cholangitis with or without bile duct abscess. Bile duct strictures or abruption at the confluence of hepatic and common bile duct in 6 and 3 cases respectively. Tumors of bile duct or pancreas in 9 cases. The other complications after cholecystectomy including bile leak with choleperitonitis and/or biloma and acute pancreatitis.Conclusion MR imaging was a valuable method for the assessment of bile duct complications after cholecystectomy. MR imaging could assess the etiology of bile duct complications. If there were bile duct obstruction, MR imaging could assess the location and the severe of obstruction. For bile duct or pancreatic tumors, MR imaging could assess the areas of tumor infiltration and resection and was helpful to select treatment methods. Before lapatoscopic cholecystectomy, the overall and careful imaging assessment for bile duct and gallbladder and its adjacent hepatic tissue and pancreas so to avoid missing the relative tumors.