30%, older or senior recipient, diabetes mellitus, high level blood lipid, re transplantation, DGF, impaired liver function, perioperative infection etc. The follow up period was at least one year. The end points of observation included graft and recipient survival rates, acute rejection, and reversal rate after immunosuppressive drugs bolus, side affects of CsA and FK506 and infection rates in the tow groups. Results The one year patients/grafts survival rate in FK506 and CsA groups was 100% / 100% and 93.3% / 86.7% respectively, the incidence of acute rejection was 14.3% and 16.7% respectively, and reversal rate after immunosuppressive drugs bolus was 100% and 60% respectively. The side effects of FK506 were milder than those of CsA. Conclusion FK506 is the first choice for the renal transplantation recipients with high risk factors.

By now,the mutations of C-KIT gene and PDGFRA have been regarded as the most important primary incidences.The latest results have revealed the fact that the abnormal expressions of p53,p16,p21 WAF-1,p27 and E-cadherin(cDH1) which were labeled as anti-oncogenes in most of human tumors,existed in the progression of gastrointestinal stromal tumor.Therefore,we put forward the theory that gene mutaion may lead to the instability of DNA that further promotes mutation of short tandem repeat in anti-oncogene coding region,on basis of which,that finally lead to the malignant progession of gastrointestinal stromal tumor by anti-oncogene mutation.

Objective To study the relationship between oxidative stress and endothelial progenitor cells(EPCs)count in the first-degree relatives of diabetes mellitus(FDRs).Methods Three groups were evaluated with 40 type 2 diabetes mellitus(T2DM)patients,38 FDRs and 30 healthy individuals as the control(NC).Fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),TG,TC and fasting plasma insulin concentrations were measured and homeostasis model assessment-insulin resistance(HOMAIR)was calculated.Quantity of EPCs and flow-mediated dilation(FMD)were evaluated.Malonaldehyde(MDA),glutathion peroxidase(GSH-Px),erythrocuprein(SOD)and total anti-oxidative capacity(TAO-C)were measured.Results In T2DM group FPG[(7.86 ±0.77)mmol/L]and HbA1c[(7.24 ±0.20)％]were significantly higher than those in NC[FPG(4.90 ± 0.35)mmol/L,HbA1 c(5.34 ± 0.37)％]and FDRsgroup[FPG(5.13±0.95)mmol/L,HbA1c(5.36 ±0.36)％](all P values ＜0.05).TC in T2DM group[(5.88 ±0.76)mmol/L]was higher than in NC[(4.66±0.90)mmol/L]and FDRs [(4.95 ± 0.76)mmol/L].HOMA-IR was 0.48 ± 0.25 in NC,0.81 ± 0.46 in FDRs and 1.47 ± 0.24 in T2DM group,P ＜ 0.01.In T2DM group,the plasma levels of SOD[(69.30 ± 2.21)U/ml],TAO-C [(7.30 ± 0.29)U/ml]and GSH-Px[(856.5 ± 9.01)U/ml]were significantly lower than those in NC [SOD(75.33 ±3.63)U/ml,TAO-C(8.17 ±0.58)U/ml and GSH-Px(938.1 ± 19.35)U/ml]and FDRs group[SOD(74.91 ±4.53)U/ml,TAO-C(8.24 ±0.46)U/ml and GSH-Px(936.9 ± 15.78)U/ml](all P values ＜ 0.01).Serum level of MDA was(2.87 ± 0.63)μmol/L in NC,(3.28 ± 0.71)μmol/L in FDRs and(3.69 ± 0.39)μmol/L in T2DM group(P ＜ 0.01).The quantity of EPCs and FMD％ were 96.75 ±8.11 and 8.36 ± 2.21 in NC,83.34 ± 12.43 and 6.78 ± 0.98 in FDRs and 58.45 ± 7.58 and 2.86 ± 0.35 in T2DM group with statistical differences between different groups(all P values ＜ 0.05).Pearson correlation analysis showed that lnHOMA-IR was positively correlated with MDA(r =0.486,P ＜0.05)and negatively correlated with SOD,TAO-C,GSH-Px(r =-0.426,-0.601,-0.524,all P values ＜ 0.05)in FDRs group.Conclusions Insulin resistance,oxidative stress,decreased quantity of EPCs and impairment of endovascular function have already occurred in the FDRs of T2DM with normal glucose tolerance and they are correlated with each other.

Cellular schwannoma is a rare benign tumor of the peripheral nerves.The tumor is consist of spindle cells which arranged in interwoven bundles,and lacking the mesh district and palisading structure.The tumor cells are abundant,with coarse chromatin,deeply stained nuclei and in multiforms.So the tumor may easily be misdiagnosed as various types of spindle cell sarcoma.Intraperitoneal cellular schwannoma may also be mistaken as gastrointestinal stromal tumors.In this article,the clinical characteristics,diagnosis and treatment of cellular schwannoma were analyzed based on the clinical data of a patient with cellular schwannoma in the gastric wall misdiagnosed as gastric stromal tumor.

BACKGROUND: The degree of neurofilament (NF) phosphorylation is closely correlated with the occurrence of Alzheimer disease (AD), and apolipoprotein E4 (apoE4) is a generally acknowledged liability factor for AD, but the effect and mechanism of apoE4 on the NF phosphorylation in neurons are not very clear. It has been reported that in the neurons cultured in vitro and in brain tissue of AD patients, the amino acid residues of apoE4 protein C terminal (272-299) could be truncated by hydrolysis,and produce truncated-apoE4 fragment. The latter interacts with the NF phosphorylation in neurofibrillary tangles (NFTs), which are the characteristic pathological changes of AD.OBJECTIVE: To observe the effect of truncated-apoE4 overexpression on the NF phosphorylation in the cultured neurons.DESIGN: A non-randomized controlled observation.SETTING: Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Tongji Medical College, Huazhong University of Science and Technology.MATERIALS: The experiment was carried out in the Laboratory of Biochemistry and Molecular Biology, Tongji Medical College, Huazhong University of Science and Technology in December 2005. The mice neuroma cell strain N2a was provided by Dr. Xu.METHODS: The truncated-apoE4(△272-299) cDNA was subcloned into pEGFP-c3 to form pEGFP-T-apoE4 recombinant. Then pEGFP-c3, pEGFP-apoE4 and pEGFP-T-apoE4 were transfected into N2a cells by lipofectamine2000 respectively. NF phosphorylation was detected by Western blot assay. The activities of glycogen synthase kinase-3 (GSK-3) and cyclin-dependent kinase 5(CDK-5) were measured.MAIN OUTCOME MEASURES: The degree of NF phosphorylation and the activities of GSK-3 and CDK-5 were mainly observed.RESULTS: In the transfected groups, the contents of phosphorylated NF were significantly increased, the GSK-3 activities were significantly increased, which were the most significant in the pEGFP-T-apoE4 transfected group (P＜0.05), but the CDK-5 activities were not significantly different from that in th e control group (P＞0.05).CONCLUSION: These results indicate that in vitro overexpression of truncated-apoE4(△272-299) can lead to NF hyperphosphorylation by activating of GSK-3 but not CDK-5, which may be the underline mechanism of AD induced by truncated-apoE4(△272-299).

Objective:To explore the relationship between the pathophysiological changes in TCM spleen de ciency syndromes and precancerous lesion of gastric mucosa.Method:160 cases with spleen de ciency syndromes accompanied by gastric mucosa intestinal metaplasia,IM and / or atypical hyperplasia,AHP,(spleen de ciency is divided into spleen qi de ciency or SQD,spleen yin de ciency or SyinD and spleen de ciency with qi stagnation or SDQS) and 22 cases in health control group were taken as the study object.The detection was conducted on such trace elements as Zn,Cu of gastric mucosa epithelial cell nuclei and mitochondrion under the direct view of CM200FEG –TEM by adopting 9100/60 -Energy Dispersion X-ray Analyzers;detection was conducted on epithelial cell nucleus DNA by using IBAS2000 image analyzer;detection was conducted on the expression of P53,Ki67,CerbB2,P21ras in gastric mucosa tissue slices by adopting ElivisionTM Plus'.Result:The quantitative changes of gastric mucosa epithelial cell nucleus DNA,Zn,Cu and the positive expression rates of P53,P21ras,CerbB2 and Ki67 increased in the sequence of SQD group,SyinD group and SDQS group,while mitochondrial Cu,Zn decreased in the same sequence,there was signi cant di erence between the groups(P

Objective To observe the clinical efficacy of point injection at Xialiao point (BL 34) for levator ani syndrome. Methods A hundred levator ani syndrome patients were randomly allocated to a treatment group and a control group, 50 cases each. The treatment group received point injection at Xialiao point (BL 34) and the control group was intervened by biofeedback therapy. The Visual Analogue Scale (VAS), component scores of the MOS 36-item Short-From Health Survey (SF-36), anal resting and squeeze pressures were recorded in the two groups before and after the treatment. The therapeutic effects and therapy costs were compared between the two groups.Results The VAS, component scores of SF-36, anal resting and squeeze pressures were significantly changed after intervention in the two groups (P<0.05). After treatment, the VAS, a part of the SF-36 score [physiological function (PF), body pain (BP), vitality (VT) and social function (SF) scores], anal resting and squeeze pressures in the treatment group were significantly different from that in the control group (P<0.05). The total efficacy rate was 88.0% in the treatment group versus 80.0% in the control group, and the difference was statistically significant (P<0.05). The therapy costs in the treatment group were (327.31±13.42) RMB and (408.45±21.56) RMB in the control group, and the difference was statistically significant (P<0.01).Conclusions Point injection at Xialiao point (BL 34) is an effective method for levator ani syndrome.

Objective To explore the impact of high-fat diet on bone marrow-originated endothelial progenitor cells(EPCs),oxidative stress and glutathione peroxidase-1 (GPx-1) expression in rats.Methods 23 male Wistar rats were randomly divided into normal control group (NC goup,n=13) and high-fat fed group (HF group,n=10).Rats in NC group were fed with a standard lab diet,and rats in HF group were fed with a high-fat diet (502 kcal/100 g).Lee's index,body weight were measured to evaluate whether the obese rat model was established at 16 weeks after feeding.Blood samples were collected via carotid arterial cannula.Serum insulin,lipids and oxidative stress index were measured.Perirenal and epididymis adipose tissues were obtained and weighed.EPCs were detached,cultivated and evaluated by multi-wave laser confocal microscopy.Protein and gene expressions of GPx-1 were determined by Western blot and reverse transcription real time polymerase chain reaction(RT real-time PCR).Results After 16 weeks of high-fat diet,the body weight,Lee's index and visceral adipose tissue were increased in HF group as compared with NC group [(465.11 ±27.69) gvs.(404.38±17.01) g,(312.08±9.82) vs.(297.74±8.75),(20.07±1.94) g vs.(5.31±1.11) g,all P＜0.001].The levels of fasting blood glucose,cholesterol,triglyceride were increased in HE group as compared with NC group[(5.85±0.77) mmol/L vs.(4.285±0.74)mmol/L,(1.35±0.21) mmol/L vs.(0.95±0.14) mmol/L,(1.02±0.21) mmol/L vs.(0.65±0.19)mmol/L,all P＜0.01].The levels of fasting insulin(FIns)and HOMA-IR were higher in HF group than in NCgroup [(3.46±0.77) mmol/L vs.(2.04±0.51) mmol/L,(0.90±0.24) vs.(0.40±0.19),both P＜0.001].Levels of serum glutathion peroxidase(GSH-Px)and erythrocuprein SOD,and total anti-oxidative capacity were decreased in HF group as compared with NC group [(759.13 ±60.71) mU/L vs.(826.26±65.83) mU/L,(72.76±5.41)mU/L vs.(80.44±7.91) mU/L,(5.18±0.35) mU/L vs.(6.01±0.93) mU/L,all P＜0.05].Malonaldehyde (MDA) level was increased,EPCs count and protein and mRNA expressions of GPx-1 were decreased in HF group as compared withNC group [(6.09±0.96) mol/L vs.(5.14±0.89) μmol/L,(62.55 ± 4.85) vs.(71.19±5.95),(0.50±0.13) vs.(1.29±0.42),(0.50±0.13) vs.(1.29±0.42),all P＜0.05 or 0.01].Multiple linear regression analysis showed that MDA was an influential factor for EPCs,Lee's index was an influential factor for GSH-Px,total cholesterol (TC) was an influential factor for TAO-C and SOD,and FINs was an influential factor for MDA.Conclusions High-fat diet can induce obesity and insulin resistance,increase the visceral adiposity,decrease the quantity of EPCs and protein and mRNA expressions of GPx-1 in rats.Oxidative stress is one of influential factors for the decrease of EPCs quantity in high fat diet induced obese rats.

To explore the originating sites,clinical manifestations,imaging features,pathologic findings,treatments and prognosis of low-grade fibromyxoid sarcoma.Among 54 cases,6 came from our hospital and the other 48 cases were reported in literatures from 1998 to 2012 in China Knowledge Resource Integrated Database (CNKI).Their data were reviewed for analysis.The usual presentation was a slowly growing,painless mass commonly located in extremities.The optimal treatment of extended resection could significantly reduce recurrence and improve survival.And a long-term follow-up was necessary.

Objective To investigate the clinical characteristics,treatment methods,and clinical outcomes of open injury of foot and ankle in children.Methods From February 2004 to June 2010,35 children with open injury of foot and ankle were treated,including 22 males and 13 females,aged from 3 years to 14 years (average,8.4 years).Twenty-eight cases resulted from traffic accidents; 7 cases occurred from sharp instruments and machine-related crush injuries.Thirty cases were associated with bone fractures,and according to the Gustilo classification of open fractures,five cases were Type Ⅰ injuries,eight cases were Type Ⅱ injuries and 22 cases were Type Ⅲ.Twenty three cases (type Ⅰ,type Ⅱ and type Ⅲ) underwent surgical debridement and/or internal fixation with skin flap grafting.Twelve type Ⅲ cases underwent debridement,temporary Kirschner wire or plaster fixation and VSD in the first stage of treatment.In the second stage of treatment,fracture reduction and internal fixation (with or without bone graft) + skin flap grafting was performed in all 12 cases.Results Thirty patients (85.7％) were followed-up for an average of 38.7months (range,6-89 months).Skin grafting was performed in two Type Ⅱ cases that developed necrosis in parts of the wound.Wound healing time was an average of 8.3 weeks (range,3-15 weeks).One Type Ⅲ case suffered chronic osteomyelitis with the formation of a sinus tract.Two cases suffered from club foot ab normalities 3 years postoperatively.All three patients above mentioned healed after treatment.In 12 type Ⅲpatients with staged treatment,the flap survived,and its color and elasticity were good.Healing time ranged from 3 to 8 weeks (average,6.8 weeks).According to the Maryland standard,17 cases were excellent,9good,3 fair,and 1 bad; the excellent and good rate was 86.7％.Conclusion Traffic accidents are the major causes of open foot and ankle trauma in children.A good surgical outcome can be achieved when patients receive staged treatment that is appropriate to injury severity.