Objective To analyze the imaging features of mycobacterium in AIDSpatients.Methods Twenty-three cases of mycobacterium tuberculosis and 13 patients of non-tuberculous mycobacteria were proved etiologically and included in this study.All patients underwent X-ray and CT examinations,imaging data were analyzed and compared.Results The imaging findings of mycobacterium tuberculosis in AIDS patients included consolidation (n =11),pleural effusion (n =11),mediastinal lymphadenopathy (n =11).Pulmonary lesions were always diffuse distribution,and 14 patients of extrapulmonary tuberculosis were found.Pulmonary lesions in non-tuberculous mycobacteria tend to be circumscribed.Conclusions Non-tuberculous mycobacterial infection in AIDS patients is more common and usually combined with other infections.Imaging features are atypical.

Aim To study the interfering effects of picrosideⅡ on the expressions of nuclear transcription factor kappaB(NF-κB)and inhibitor of NF-κB(I-κB)after cerebral ischemic reperfusion in rats.Methods Intraluminal thread methods were applied to establish the middle cerebral artery occlusion reperfusion models in rats.PicrosideⅡ(10 mg·kg~(-1))and salvianic acid A sodium(10 mg·kg~(-1))were injected from the tail vein for treatment.TUNEL positive cells were counted by immunofluorescence assay.The expressions of NF-κB and I-κB were determined by immunohistochemical assay,and the concentration of NF-κB and I-κB in brain tissue was determined by ELISA.Results The exprssions of NF-κB and I-κB were weakly and the apoptotic cells were scattering at cortex,striatum and hippocampus in the sham operative group.In the negative control group,the number of TUNEL positive cells and the expressions of NF-κB and I-κB increased,the absorption(A)values and the concentration were significantly higher than those in the sham operative group(P<0.05).While in the positive control and picroside groups,the expressions(A values)and concentration of NF-κB and I-κB and the number of TUNEL positive cells were significantly lower than those in the negative control group(P<0.05).There was no significant difference between the positive control group and picroside group(P>0.05).Conclusion Picroside Ⅱ might downregulate the expressions of NF-κB and I-κB to inhibit neuronal apoptosis induced by inflammation after cerebral ischemia reperfusion injury in rats.

Aim To study the interfering effects of picroside Ⅱ on the expressions of nuclear transcription factor kappaB(NF-?B)and inhibitor of NF-?B(I-?B) after cerebral ischemic reperfusion in rats. Methods Intraluminal thread methods were applied to establish the middle cerebral artery occlusion reperfusion models in rats. PicrosideⅡ(10 mg?kg-1) and salvianic acid A sodium(10 mg?kg-1 ) were injected from the tail vein for treatment. TUNEL positive cells were counted by immunofluorescence assay. The expressions of NF-?B and I-?B were determined by immunohistochemical assay,and the concentration of NF-?B and I-?B in brain tissue was determined by ELISA. Results The exprssions of NF-?B and I-?B were weakly and the apoptotic cells were scattering at cortex,striatum and hip-pocampus in the sham operative group. In the negative control group,the number of TUNEL positive cells and the expressions of NF-?B and I-?B increased,the absorption(A) values and the concentration were significantly higher than those in the sham operative group(P0.05 ). Conclusion Picroside Ⅱ might downregulate the expressions of NF-?B and I-?B to inhibit neuronal apoptosis induced by inflammation after cerebral ischemia reperfusion injury in rats.

Objective To explore the characteristic findings of 1H-MR spectroscopy(1H-MRS) in the prefrontal cortex and amygdala of patients with heroine dependence(HD), and the relationship to total cumulative dose of inhaled heroine.Methods Fourteen male HD patients and 12 healthy controls (HC) underwent 1H-MRS at the prefrontal cortex and amygdala regions.The total cumulative in haled heroin dose was (852±341) g in HD.Ratios of N-acetylaspartate/creatine(NAA/Cr) and choline/creatine (Cho/Cr) were respectively measured in the prefrontal cortex and bilateral amygdale regions.The student's t test and the linear correlation were employed for statistical analysis.Results Compared to HC group, HD patients had a significant lower ratio of NAA/Cr in the prefrontal cortex (1.44±0.46 vs 1.50±0.75, t=1.77 ,P <0.05), left amygdala region (1.32±0.08 vs 1.42±0.08, t=3.41, P < 0.05), and right amygdala region (1.34±0.09 vs 1.44±0.10, t=2.63, P <0.05), the HD patients had a significant increased ratio of Cho/Cr in the prefrontal cortex (0.92±0.06 vs 0.86±0.08, t=2.31, P < 0.05), left amygdala region (1.20+0.12 vs 1.07±0.04, t=3.60,P<0.05) and right amygdala region(1.26±0.15 vs 1.12±0.11,t=2.60,P <0.05).There was a negative linear correlation between the total cumulative inhaled heroine dose and the ratio of NKA/Cr in the prefrontal cortex (r=-0.9159, P < 0.01), left amygdala region (r=-0.8756, P < 0.01), and right amygdala region (r=-0.9399, P < 0.01) respectively.Conclusions The study indicates that neuronal damage and glial proliferation may occur in the prefrontal cortex and amygdala region, which suggests the abnormalities of executive function and emotion in patients with HD.A relationship exists between the heroin-induced metabolic abnormality and the total cumulative dose of inhaled heroine.

Objective To determine the changes of peripheral levels of T helper cell cytokines of patients with chronic hepatitis B (CHB) during antiviral treatment,and to further explore its clinical significance.Methods The plasma levels of interleukin (IL)-2,IL-6,IL-10,interferon (IFN)-γ and tumor necrosis factor(TNF)-α of thirty-three CHB patients during antiviral treatment (entecavir) were measured using enzyme linked immunosorbont assay (ELISA).And their biochemical indicators of liver function were determined.The differences of cytokines levels before and after antiviral treatment were compared using ANOVA.The correlations between the changes of cytokines and alanine transaminase (ALT),hepatitis B virus (HBV) DNA levels were analyzed.Results Levels of IFNγ before and 12,24,48 weeks after treatment were (5.98±2.77),(5.95±3.37),(2.93±2.15) and (9.29±4.65) pg/mL,respectively (F=3.845,P＜0.05),which were positively correlated with ALT levels (r =0.396,P＜0.05).Both TNF-α and IL-10 levels declined after antiviral treatment,which were significantly different at different time points (F=20.156 and 16.695,respectively; both P＜0.05),and both levels of TNF-α and IL-10 were positively correlated with ALT levels (r=0.354and 0.316,respectively; both P＜0.05) and positively correlated with HBV DNA levels (r=0.382and 0.386,respectively; both P＜0.05).While both IL-2 and IL-6 levels were not significantly different between before and after antiviral treatment (F=0.010 and 0.932,respectively; both P＞0.05).The serum levels of ALT and HBV DNA before and after antiviral treatment were all significantly different (F=17.69 and 198.98,respectively; both P＜0.05),which declined gradually during treatment and were positively correlated (r =0.581,P＜0.05).Conclusions IL-10,IFNγand TNF-α may be involved in the pathologic process of CHB,and closely related to the deterioration of the disease.Monitoring plasma levels of these cytokines during antiviral treatment could be useful to understand the immune status and evaluate the efficacy of antiviral drugs.

Objective To evaluate the feasibility,effectiveness and safety of Carto3 three-dimensional electrophysiological mapping system in guiding radiofrequency ablation (RFA) for paroxysmal supraventricular tachycardia (PSVT).Methods The clinical data of a total of 28 patients with PSVT (Carto group),who received RFA guided by Carto3 three-dimensional electrophysiological mapping system during the period from March 2015 to February 2016,were retrospectively collected.Other 36 parents with PSVT,who received fluoroscopy-guided RFA during the period from March 2014 to February 2015,were collected as control group.The X-ray irradiation time,success rate of operation,operation time,complication and recurrence rate were calculated and the results were compared between the two groups.Results The mean fluoroscopy time in Carto group was (2.6±2.3) min,which was significantly less than (15.8±9.5) min in the control group (P＜0.001),and among them zero X-ray irradiation was obtained in 8 patients who had atrioventricular nodal reentrant tachycardia (AVNRT).The operation success rates of Carto group and the control group were 100％ (28/28) and 94.4％ (35/36) respectively (P＞0.05).The operation time in Carto group and the control group was (162.7±34.4) min and (149.4±46.2) min respectively (P＞0.05).In Carto group no any complications occurred,and in the control group one patient with AVNRT developed transient degree Ⅱ atrioventricular block during ablation process.All patients were followed up for 6 months,and no recurrence was observed in all patients of both groups.Conclusion For the treatment of PSVT,RFA guided by Carto3 three-dimensional electrophysiological mapping system is safe and effective,it can significantly reduce the X-ray irradiation time,even zero X-ray radiation in some AVNRT patients,meanwhile,this technique does not increase operation time and operation risk.

Organ system based integrated teaching model has been adopted in several medical schools, and these schools face some challenges in this teaching process. In order to provide new sights for organ system based integrated teaching reform in eight-year medical education program, ex-ploration of setting up three-staged-dimensional integrated teaching models was conducted in urinary system by hematuria, and designing related teaching objectives, teaching programs and assessment form to optimize teaching quality in this teaching methods, according to characteristics of the urinary systemic diseases, cultivating objectives of eight-year medical education program and teaching experi-ence of Xiangya School of Medicine.

Objective To explore the clinical efficacy of marginal liver from elderly donors in liver transplantation. Methods According to the inclusion and exclusion criteria, the clinical data of 127 donors and recipients were retrospectively analyzed. According to the age of donors, 127 donors were divided into the elderly group (n=27) and control group (n=100). The recovery of liver function, the occurrence of postoperative complications and survival rate of the recipients after transplantation were statistically analyzed between two groups. Results The incidence of primary nonfunction (PNF) and initial poor graft function (IPGF) did not significantly differ between the elderly and control groups (both P > 0.05). Within postoperative 2 weeks, the average levels of alanine aminotransferase (ALT) and serum total bilirubin (TB) of liver transplant recipients in the elderly group was not significantly different from those in the control group (both P > 0.05). There was no significant difference in the incidence of postoperative complications in the postoperative elderly group compared with the control group (all P > 0.05). The 1-and 3-year survival rates of the recipients in the elderly group were 84% and 78% respectively, which did not significantly differ from 89% and 79% in the control group (both P > 0.05). Conclusions Strict and sufficient quality evaluation and functional maintenance should be done for elderly donor livers. It can achieve good transplantation results by intraoperative fine operation, reducing bleeding and trauma, shortening the time of cold ischemia and operation, strengthening postoperative monitoring and implementing enhanced recovery after surgery.

OBJECTIVETo study transforming growth factor-beta1 (TGF-beta1) autoproduction in keloid fibroblasts and the regulation effect of blocking TGF-beta intracellular signaling on rhTGF-beta1 autoproduction.

METHODSKeloid fibroblasts cultured in vitro were treated with either rhTGF-beta1 (5 ng/ml) or recombinant adenovirus containing a truncated type II TGF-beta receptor gene (50 pfu/cell). Their effects of regulating gene expression of TGF-beta1 and its receptor I and II were observed with Northern blot.

RESULTSrhTGF-beta1 up-regulated the gene expression of TGF-beta1 and receptor I, but not receptor II. Over-expression of the truncated receptor II down-regulated the gene expression of TGF-beta1 and its receptor I, but not receptor II.

CONCLUSIONSTGF-beta1 autoproduction was observed in keloid fibroblasts. Over-expression of the truncated TGFbeta receptor II decreased TGF-beta1 autoproduction via blocking TGF-beta receptor signaling.

Activin Receptors, Type I ; biosynthesis ; pharmacology ; Cells, Cultured ; Down-Regulation ; Fibroblasts ; drug effects ; metabolism ; Gene Expression ; Humans ; Keloid ; metabolism ; Protein-Serine-Threonine Kinases ; RNA, Messenger ; genetics ; metabolism ; Receptors, Transforming Growth Factor beta ; biosynthesis ; metabolism ; Sensitivity and Specificity ; Signal Transduction ; Trans-Activators ; metabolism ; Up-Regulation

Letrozole,a third generation non-steroidal aromatase inhibitor,has been approved for the treatment of breast cancer in women.In recent years,it has been used in the field of growth and development in children,such as childhood dwarfism,somatic delayed pubertal growth and precocious puberty,but the long-term effects on liver and kidney function,lipid metabolism,reproductive function and bone metabolism are unclear.Studies have shown that letrozole can cause abnormal testicular morphology,changes in seminiferous tubules and interstitial tissues,reduce bone density,affect the bal-ance of bone metabolism,and cause cognitive impairment and apoptosis of nerve cells.The mecha-nism of reproductive toxicity of letrozole may be related to its influence on the development and matura-tion of testicular cells,the expression of sex hormones and gonadotropins in vivo,and the distribution and expression of estrogen receptors in testicular tissues.The mechanism of bone metabolic toxicity is related to its increase in the proliferation and differentiation of osteoclasts induced by receptor activator of NF-κB ligand,as well as the increase of apoptosis,oxidative stress and NF-κB activity of osteo-blasts.The mechanism of cognitive toxicity is related to its regulation of classical and nonclassical effects of the hippocampus,reduction of glutamate uptake by astrocytes,and reduction of L-type calcium channel blockade of caspase 3 activation.This article is to provide reference for safe and effective use of letrozole in clinical pediatrics.