Objective To study the changes of IgA,secretory component(SC)and ZO-1,occludin of gut in severe hepatitis and to understand the reason of abdomen symptom in severe hepatitis patients.Methods IgA,SC,ZO-1 and occludin of gut were assayed by immunohistochemistry.Results Compared with the controls,the staining of IgA,SC,ZO-1 and occludin in severe hepatitis were notably decreased.Conclusion In severe hepatitis,IgA,SC,ZO-1 and occludin expression of gut decrease,leading to the abnormality of barrier of gut,which is one the reasons of resuhings in abdomen symptoms in severe hepatitis.

Objective To investigate the cause and countermeasures of frequent shocks in patients with implantable cardioverter defibrillators (ICD). Methods Eighty ICD patients with heart failure and malignant ventricular arrhythmias were followed up, including sixty-two male and eighteen female patients. There were 35 patients with single-chamber ICD, 23 with dual-chamber ICD and 22 with three-chamber ICD. Patients in this study were followed up for 1-6 years to analyze the reasons for ICD discharge. According to the specific circumstances, patients were treated. Results Twenty-three pa-tients in 80 patients suffered from shock treatment. Ten patients (12.5%) experienced frequent shocks. The causes of fre-quent shock included repeated episodes of ventricular tachycardia, invalid shock due to increased defibrillation threshold (DF) and false identification of the frequent episodes of paroxysmal ventricular tachycardia or arrhythmias. The management included the identification process adjustment of ventricular tachycardia and supraventricular tachycardia, increased num-bers of beats of ventricular tachycardia judgment and increase the basic pacing rate. The anti-arrhythmic drugs should be combinedly used, especially metoprolol and amiodarone. The ICD shock was significantly reduced after parameter optimiza-tion and anti-arrhythmic therapy. Conclusion The ICD shocks were effectively reduced with rational use of anti-arrhyth-mic drugs and valid ICD programming.

Objective To study curative efficacy of dezocine in treatment of receiving laparoscopic appendectomy and its effects on white blood cell count and c reactive protein.Methods 90 patients of laparoscopic appendectomy who received therapy from January 2015 to October 2016 in our hospital were selected as research objects,according to random number table,those patients were divided into the observation group and the control group,45 cases in each group.The control group was treated with sufentanil, while the observation group was treated with dezocine.Then operation index, T0 (preoperative),T1(extubation),T2(after extubation) mean arterial pressure(MAP),heart rate(HR), respiration rate(RR),isual analogue scale/score ( VAS) , ramsay score ( RSS) , white blood cell count and c reactive protein of two groups after treatment were compared .Results After treatment, MAP,HR in the observation group were significantly lower than control group [(78.30 ±6.20)mmHg vs.(86.08 ±6.09)mmHg,(76.45 ±5.90)mmHg vs.(80.48 ±5.80)mmHg,(90.82 ±9.50)time/min vs.(96.73 ±9.83)time /min,(87.21 ±8.15)time /min vs.(93.59 ±9.90)time /min](P<0.05); VAS, RSS score were significantly lower than the control group[(2.60 ±0.70)score vs.(5.29 ±0.83)score,(3.53 ±0.92)score vs.(6.38 ± 1.21)score](P<0.05); White blood cell count, c reactive protein were significantly lower than the control group[(7.92 ±2.01) ×109/L vs.(14.98 ±2.11) ×109/L,(7.90 ±2.30)mg/L vs(12.46 ±3.10)mg/L](P<0.05).Conclusion Dezocine is well for receiving laparoscopic appendectomy, obvious analgesic effect, can significantly reduce the white blood cell count and c reactive protein.

[Objective] Examine the expression of Galectin-3 (Gal-3),B cell lymphoma-2 protein (Bcl-2) in epithelial ovarian cancer tissues with regard to clinicopathological and survival variables,testing whether they can serve as prognostic markers and provide evidence for further research.[Methods] 98 EOC tissues and 10 normal ovarian tissues were collected,as well as their clinical documents.The expression of Gal-3 and Bcl-2 was tested via immunohistochemical staining analysis.Then the correlation between these two proteins and the clinicopathological and survival variables of these patients were evaluated.[Results] Of the 98 EOC,Gal-3 and Bcl-2 were all cytoplasmic staining.Gal-3 was observed in a majority of the EOC tumor cell proper (75/98,76.5％) but not in normal ovarian tissues.Bcl-2 was observed in a majority of the EOC tumor cell proper (50/98,51.0％) but not in normal ovarian tissue.Spearman bivariate correlation test show that there was no correlation between the expression Gal-3 and Bcl-2 (P =0.867).Gal-3 expression in EOC was associated with histology and platinum sensitivity (P =0.043,P =0.038),while Bcl-2 was associated with FIGO stage (P =0.029).Cox univariate analysis revealed that Gal-3,Bcl-2 expression,platinum sensitivity,stage were associated with overall survival (P =0.008,P =0.021,P ＜ 0.001,P ＜ 0.001).Further multivariate analysis showed that only Gal-3 expression,platinum sensitivity,stage affected the survival of these patients (P =0.014,P =0.021,P ＜ 0.001).[Conclusions]The expression of Gal-3 and Bcl-2 in EOC was significantly higher than that in normal ovarian tissue,supposed that they may involve in the development and progression of EOC.Gal-3 expression was associated with histology,platinum sensitivity and survival,it may be an independent predictive factor for EOC prognosis.There was no correlation between the expression Gal-3 and Bcl-2 in EOC,the functional mechanism between these two protein need further research.

Objective:To observed the effects of electroacupuncture frequency on the nerve function and postsynaptic destination-95 (PSD-95), growth associated protein-43 (GAP-43) in brain tissue of rats with cerebral ischemia were observed.Methods:Healthy adult male SD rats were randomly divided into the blank group, sham operation group, model group and 2 Hz, 50 Hz, 100 Hz electroacupuncture groups. MCAO models were prepared in each group, except blank group and sham operation group. After modeling, Qiansanli and Waiguan acupoints were given stimulation with 2 Hz, 50 Hz and 100 Hz respectively in 2 Hz electroacupuncture group, 50 Hz electroacupuncture group and 100 Hz electroacupuncture group, 1 time/d and 20 min/time for 21 consecutive days. All groups were scored by Bederson score on the 1st, 3rd, 7th, 14th and 21th day after operation. The ultrastructure of synapses was observed by transmission electron microscope, and the positive expression of PSD-95 and GAP-43 was detected by immunohistochemistry. Results:After modeling 7, 14 and 21 days, compared with the model group, the Bederson behavioral score (1.70 ± 0.52 vs. 2.40 ± 0.56, 1.20 ± 0.65 vs. 2.30 ± 0.46, 0.70 ± 0.72 vs. 2.00 ± 0.86) in 50 Hz electroacupuncture group significantly decreased ( P<0.01 or P<0.05). The expression of PSD-95 (58.67 ± 1.72, 55.22 ± 2.45, 60.10 ± 2.49 vs. 70.87 ± 2.34) intergral optical density of rats’ cortex in 2 Hz, 50 Hz, 100 Hz electroacupuncture groups significantly decreased ( P<0.01), the expression of GAP-43 in 2 Hz and 50 Hz electroacupuncture groups (58.89 ± 1.28, 64.76 ± 3.94 vs. 53.24 ± 2.58) significantly increased ( P<0.01). Conclusions:Electroacupuncture with different frequency can improve motor nerve disfunction of cerebral ischemia rats, and 50 Hz electroacupuncture group showed the most obvious effect. It can regulate PSD-95 and GAP-43 expressions of ischemic area, lower neural excitatory toxicity, increase neuronal axon regeneration and exert the neural protect function.

Objective To explore the ultrasound imaging characteristics of thyroid papillary carcinoma complicated cervical lymph node tuberculosis, and to elucidate the key points of ultrasound diagnosis and to distinguish with cervical lymph node metastasis of papillary thyroid carcinoma.Methods In total, 1 5 well-documented cases of papillary thyroid carcinoma diagnosed definitely were selected, and there were 6 cases of concomitant lymph node metastasis. The ultrasonography of lymph node enlargement was analyzed, and the differences of the ultrasonographic characteristics between lymph node tuberculosis and metastatic lymph node including the location, swelling, calcification, blood flow and regional nodal liquefaction. Results Thyroid papillary carcinoma complicated with cervical lymph node tuberculosis was often found in the areas of Ⅲ,Ⅳ and Ⅴ, especially in the area of Ⅴ. Variety of echo was mixed in tuberculous of lymph node, and the echo was inhomogenous. The tuberculosis of lymph node calcification was patchy inhomogeneous distribution.The echo in part of liquefaction of lymph node tuberculosis was cottony weak. The flow signal of tuberculous lymph appeared the surrounding or internal punctate distribution,and the soft tissue was echogenic and disorder around the lymph node tuberculosis. Conclusion When ultrasonography examination is performed in the patients with the thyroid papillary carcinoma complicated with cervical lymph node enlargement, the history should be considered to analyze the ultrasound characteristics to dignose by observing the lesions of the surrounding soft tissues.

Objective To observe the effect of Jianpi Buxue Decoction on the protein expression of neurokinin 1 receptor (NK1R) and CD34 in C57BL/6 mice of lung cancer after chemotherapy, and to explore the improvement of chemotherapy-induced nausea and vomiting and myelosuppression treated with Jianpi Buxue Decoction. Methods Forty C57BL/6 mice were transplanted with Lewis lung cancer cells in the armpit of left anterior limb after being fed for 7 days, and then were randomly divided into lung cancer group, model group, and high-, middle- and low-dose Chinese medicine groups. Model group and Chinese medicine groups were injected intraperitoneally with cyclophosphamide (80 mg/kg) for one day. Lung cancer group and model group were given normal saline. Chinese medicine groups were administered with high-, middle- and low-dose of Jianpi Buxue Decoction (25, 12.6, 6.25 g/kg respectively) for 14 days. After the modeling, all of the mice were sacrificed, and then the brains and spleens were sampled. Western blotting method was used to detect the protein expression of NK1R and CD34. Results Compared with lung cancer group, the protein expression of cerebral NK1R and splenic CD34 in the model group was increased significantly ( P<0.01) . Compared with the model group, the protein expression of NK1R in mice brain tissues of high-, middle- and low- dose Jianpi Buxue Decoction groups was decreased significantly (P<0.01) , while the protein expression of CD34 in spleen tissues of middle-and low-dose Jiangpi Buxue Decoction groups was increased obviously ( P<0.05) . Conclusion Jianpi Buxue Decoction has an effect on down-regulating the protein expression of NK1R in brain tissues and on up-regulating the protein expression of CD34 in spleen tissues of C57BL/6 mice with lung cancer after chemotherapy, indicating that Jianpi Buxue Decoction probably can relieve chemotherapy-induced nausea and vomiting, and can improve the myelosuppression after chemotherapy.

Objective To investigate the expression of FcγRⅡb on peripheral B cells and its clinical significance in primary Sj(o)gren's syndrome (pSS).Methods FcγRⅡb expression on peripheral B cells from 19 pSS patients and 15 healthy controls was examined by flow cytometry.The levels of serum anti-SSA and SSB antibodies were determined using enzyme-linked immunosorbent assay (ELISA).Data were analyzed with t test,one-way ANOVA,SNK-q test and Pearson's correlation test.Results The percentage of memory CD19+CD27+ B cell subpopulation was significantly lower in pSS patients [ (20.8±2.7)％] when compared to normal controls [(37.8±2.2)％ ](t=-4.002,P＜0.01).The level of expression of FcγRⅡb in active pSS memory CD19+CD27+ B cells [ MFI(74±8)] was significantly reduced when compared to inactive [ MFI( 132±11)] and normal controls [ MFI (139±12)] (F=10.699,P＜0.01).The level of expression of FcγRⅡb on memory CD19+CD27+ B cells from pSS patients was inversely correlated with Sj(o)gren's syndrome disease activity index (SSDAI) (r=-0.744,P=0.0003 ).pSS patients with the serum anti-SSA/SSB antibodies positive group [ MFI(75+3),(48±7)] displayed a lower expression of FcγRⅡb on memory CD19+CD27+ B cell than in patients with the serum anti-SSA/SSB antibodies negative group [MFI( 122±11),(108±9)] (t=-4.336 and -3.776 respectively,the P value of both tests were less than 0.01).The level of expression of FcγRⅡb in the memory CD19+CD27+ B cells of patients with active pSS was inversely correlated with anti-SSA antibody titers (r=-0.685,P=0.014).Conclusion The expression of FcγRⅡb on peripheral memory B cells from active pSS patients is inversely correlated with SSDAI and is also inversely associated with anti-SSA antibody levels.Decreased expression of FcγRⅡb might play an important role in the pathogenesis of pSS.

Objective To investigate the efficacy of dexmedetomidine-assisted topical anesthesia in patients undergoing bronchoalveolar lavage ( BAL). Methods Twenty-four ASA Ⅱ or Ⅲ patients in ICU, aged 24-64 yr, weighing 50-80 kg, scheduled for BAL, were randomly divided into 2 groups ( n = 12 each) : topical anesthesia group (group A) , topical anesthesia + dexmedetomidine group (group B) . In group A, 0.9% normal saline 5 ml was injected intravenously 30 min before operation, 2% lidocaine 5-10 ml was given via a tracheal tube or cannula 5 min before operation and then an increment of 2% lidocaine 5 ml was given using fibreoptic bronchoscope every 15-30 min as required (the total amount was within 20 ml) . In group B, dexmedetomidine 0.5-1.0 μg/kg was injected (time of injection≥ 10 min) followed by infusion at 0.1-0.5 μg·kg-1 ·h-1 and the topical anesthesia was performed as the method described in group A. The time of lavage, adverse reactions and adverse cardiovascular events were recorded. Blood samples were taken 20 min before lavage, 20 min after the start of lavage and 20 min after the end of lavage (T1-3 ) for determination of the concentrations of plasma catecholamine and serum cortisol. Results The incidences of adverse reactions and adverse cardiovascular events were significantly lower and the operation time was significantly shorter in group B than in group A ( P < 0.05). The concentrations of plasma catecholamine and serum cortisol were significantly higher at T2，3 in group A, while lower at T2，3 in group B than at T1 ( P < 0.05) . The concentrations of plasma catecholamine and serum cortisol were significantly lower in group B than in group A ( P < 0.05). Conclusion Dexmedetomidine-assisted topical anesthesia can be used safely and effectively in BAL.

Objective To analyze clinical and pathological features of dermatomyositis with panniculitis as a skin manifestation.Methods Clinical data were collected from 9 cases of dermatomyositis with panniculitis as a skin manifestation in Department of Dermatology of Zhongshan Hospital affiliated to Fudan University from October 2012 to July 2016,and their clinical and pathological features were analyzed.Results Of the 9 cases,6 were female and 3 were male,and the age ranged from 28 to 73 years.Panniculitis lesions of the 9 patients all manifested as painful indurated plaques or nodules on the buttock,thigh,waist,back,abdomen,upper extremities and cheeks.These lesions occurred before,after or simultaneously with the onset of characteristic skin and muscle lesions of dermatomyositis,especially preceded the onset of characteristic lesions of dermatomyositis by 30 years in 1 case.Histopathological examination of lesions showed liquefaction degeneration of basal cells,inflammatory infiltration of lymphocytes and plasma cells around blood vessels,in the fat lobules as well as between the lobules and septa in the dermis.The necrosis and calcification of lipocytes,lipomembranous changes,fibrinoid necrosis of damaged vessel walls and microvascular occlusion were observed in some cases.Because panniculitis preceded the onset of characteristic lesions of dermatomyositis,2 patients were misdiagnosed with lupus panniculitis and morphea profunda for several times.Most patients had good response to systemic glucocorticoids combined with immunosuppressive agents,while the patients with lipomembranous fat necrosis had poor response to the combination therapy.Conclusions Panniculitis lesions of dermatomyositis are histologically characteristic,and may do not coincide with the onset of characteristic lesions of dermatomyositis.If panniculitis lesions precede characteristic lesions of dermatomyositis,patients will be easily misdiagnosed.Thus,persistent follow-up visit will be of great importance for the diagnosis.