The clearance of proteins differing in charge and/or size (IgG4, total IgG and albumin) was evaluated in 95 diabetic patients. Urinary IgG4 values increased in group mi-croalbuminuria. The increased urinary IgG4 excretion correlated significantly with the degree of albuminuria and diabetic retinopathy. Urinary total IgG levels increased obviously only in group with massive macroalbuminuria. The IgG4/total IgG ratio was highest in group mi-croalbuminuria, and its change had a special pattern. Urinary IgG4 and IgG4/total IgG ratio may be sensitive parameters in assessing early protein charge-selectivity impairment and in detecting incipient diabetic nephropathy.

Objective To study the changes of serum procaleitonin(PCT) in the children with acute liver failure,and to investigate the relationship between PCT and severity and prognosis of acute liver failure.Methods A retrospective analysis of 24 children with acute liver failure admitted in Shengjing Hospital Affiliated to China Medical University from October 2010 to November 2013 was performed.The changes of serum PCT,blood routine,C-reactive protein,blood culture,virus,Mycoplasma pneumoniae antibody,blood ammonia,serum alaninetransaminase,serum glutamic oxaloacetic transaminase,international normalized ratio and prothrombin time level were observed.Results The serum PCT of children with acute liver failure originally increased at different degree.The serum PCT of 21 cases was more than 0.5 μg/L.The dynamic monitoring results of serum PCT in 6 cases on day 1,day 3,and day 8 were (12.55 ± 13.65) μg/L,(5.62 ±8.12) μg/L,(0.15 ± 0.26)μg/L,respectively,which showed decrease tendency.In 24 children with acute liver failure,serum PCT,international normalized ratio,blood ammonia of survival cases were significantly decreased compared with death cases[(28.37 ±60.22) μg/L vs(12.24 ± 14.76) μg/L;4.28 ± 2.50 vs 3.16 ±1.41 ; (213.30 ± 185.87) μmol/L vs (128.89 ± 102.17) μmol/L] (P ＜ 0.05).Conclusion Acute liver failure could increase the levels of serum PCT.Serum PCT may be an effective index to evaluate liver function,curative effect and prognosis of patients with acute liver failure.

Bone Neoplasms ; Female ; Humans ; Middle Aged ; Waldenstrom Macroglobulinemia

Objective To analyze the clinical characteristics and risk factors of prognosis in children with brain trauma.Methods We retrospectively analyzed the clinical data of 125 cases diagnosed as brain trauma in PICU of Shengjing Hospital affiliated to China Medical University from January 2009 to December 2014.The risk factors influencing prognosis were analyzed by using single factor analysis and multiple factors Logistic regression methods.The risk factors included Glasgow coma score (GCS) on admission,blood glucose,lactic acid,prothrombin time,international normalized ratio (INR),serum sodium,serum potassiumin,pulse within 24 hours after admission,gender,age,time for therapy,shock,respiratory failure,cerebral hermia and surgery.Results Eighty-four cases survived and 41 cases died.The fatality rate was 32.8％.T test and chi-square test of risk factors showed that GCS score,blood glucose,blood lactic acid,INR,respiratory failure,shock had a significant influence on the prognosis of brain trauma in children (P ＜ 0.05).Multviariable Logistic regression analysis showed that GCS score,blood glucose,blood lactic acid,respiratory failure were independent risk factors affecting the prognosis of brain trauma (OR =7.434,0.473,0.615,0.000,P ＜ 0.05).Conclusion Pediatric brain trauma has a rapid progress and poor prognosis with high mortality and disability rate.GCS score,blood sugar,blood lactic acid,respiratory failure are independent risk factors for prognosis of brain trauma in children.

BACKGROUND: Magnetic labeling of stem cells is a recently developed stem cell in vitro labeling technique. Through in conjunction with magnetic resonance imaging (MRI), it can monitor transplanted stem cells in vivo. OBJECTIVE: To identify the method of superparamagnetic iron oxide (SPIO) labeling pig bone marrow mesenchymal stem cells (BMSCs), to investigate the characteristics of stem cells labeled by various SPIO following MRI, and to determine the minimum amount of labeled cells fer MRI. DESIGN, TIME AND SETTING: A control observation was performed at the laboratories of Department of Cardiovascular Surgery, Medical College of Soochow University, and Medical Imaging Centre, First Affiliated Hospital, Soochow University between September 2006 and March 2007. MATERIALS: Fresh porcine iliac bone marrow was collected from Taihu Meishan pigs. SPIO nanometer particles were purchased from Schedng, Germany. Ultramicro SPIO (USPIO) nanoparticles were provided by School of Chemistry and Chemical Engineering, Soochow University. For such particles, crystal nucleus surface was coated with dextran, and following coating, they were named 1#, 2#, 3# for short according to particle size. METHODS: Following isolation, purification, and culture, BMSCs were in vitro labeled by various kinds of SPIO nanoparticles. The labeled cells were subjected to Prussian blue staining and fluorescence microscope observation. The cell growth was observed using MTT method and the growth curve was plotted. For Feridex-labeled cells, 1×106), 5×105, and 1×105 three cell amount groups were set, for unlabeled cells, a 5×105 cell amount group was included, and for 1#, 2#, and 3# SPIO-labeled cells, only 5×105 cell amount group was used. MRI was conduced for measurement of signal intensity of cells labeled by different scanning sequences, followed by statistical analysis. MAIN OUTCOME MEASURES: Detection of SPIO nandparticles-labeled cells by Prussian blue staining; Growth curves of SPIO nanoparticles-labeled cells; Detection of cellular apoptosis by double staining; Determination of signal intensity of cell masses from different Ependoff tubes using MRI with T1WI, T2WI, and fast field echo (FFE) sequences. RESULTS: BMSCs could be labeled with SPIO and the labeling efficiency was 100%. Different amounts of blue-stained Fe particles could be observed in the cytoplasm by Prussian blue staining. SPIO labeling caused a significantly lower signal attenuation effect in T2WI and FFE (T2*WI) images than in T1WI images. In a labeling concentration of 25 mg/L Fe solution, the minimum cell amount for MRI was 1 x 105. The signal intensity exhibited significant difference in 2#, 3#USPIO- and Feridex-labeled cells in no matter T2WI or T2*Wl images(P < 0.01). But no significant difference was found between 1#USPIO- and Feridex-labeled cellss in no mater T2WI or T2*WI images(P > 0.05). There was significant difference in signal intensity of Feridex-labeled BMSCs between T2WI, T2*WI and T1Wl images (P < 0.01). CONCLUSION: BMSCs can be easily and efficiently labeled by SPIO nanoparticles without interference, at proper concentrations on cell viability and proliferation. MRI visualization of SPIO-labeled BMSCs is feasible in both T2WI and T2*WI images.

Objective To study the clinical features of spontaneous rupture of the right cardiac atrium. Methods Two cases of spontaneous rupture of right cardiac atrium were reported, and related literature was reviewed. Results Spontaneous rupture of the right cardiac atrium which was a rare disease, presented symptoms including stifling sensation in the chest, chest pain and symptoms of cardiac tamponade. The diagnosis should be differentiated with by ultrasonic examination and CT from cardiac infarction, cardiac rupture caused by external injury and dissecting aneurysm of aorta. Conclusion Spontaneous rupture of right cardiac atrium is rare disease, and an early diagnosis and prompt operation are necessary.

Objective To investigate the prevalence and symptoms of post - traumatic stress disorder(PTSD) and the self-esteem of the workers at mineral processing plant 45 days after Wenchuan earthquk. Methods PTSD Checklist Civilian version(PCL - C) , Self -Esteem Scale(SES) , Simplified Coping Style Questionnaire and a self- designed questionnaire were administered to a sample of 81 workers one and a half month after Wenchuan earthquake. Results The prevalence of PTSD among the workers was 26.3% , and the mean total scores of PCL - C was 39.63?10.73.The prevalence difference between the male and the female was not statistically significant (P =0.527). The top psychological activity was worry (86.8%). The mean self- esteem score had no statistical difference with domestic normal level(t = -0.484,P =0.630). Neither self - esteem(P =0.469) nor coping style(P =0.780) was associatied with PCL -C total scores. Conclusion To act more effectively in the intervention, it is important to exactly understand the normal stress response after severe disaster, and correctly grasp the key point in different stage.

Objective:To explore the effectiveness and safety of levosimendan treating severe decompensated heart failure (SDHF) .Methods :A total of 80 patients with SDHF caused by various caused were selected ,randomly and equally divided into levosimendan group and dobutamine group .Both groups received intravenous drip of corre‐sponding drug based on routine treatment ,and the course was 24h .After two weeks ,therapeutic effects were com‐pared between two groups .Results:After two weeks ,total effective rate of levosimendan group was significantly higher than that of dobutamine group (95.0% vs .72.5% , P= 0.005) .Compared with dobutamine group ,after two weeks , there were significant reductions in dyspnea status score [ (2.57 ± 0.80 ) scores vs . (1.89 ± 0.70 ) scores] ,general status score [(3.23 ± 0.65) scores vs .(2.95 ± 1.29) scores] ,respiratory frequency [(24.32 ± 0.98) times/min vs .(20.6 ± 1.58) times/min] and level of brain natriuretic peptide [(1584 ± 325.63) mg/ml vs .(1011.92 ± 302.31) mg/ml] ,and significant rise in left ventricular ejection fraction [(40.16 ± 4.85)% vs .(46.53 ± 3.37)% ] in levosimendan group , P<0.05 or <0.01. Conclusion:In short-term therapeutic effect on severe decompensated heart failure ,levosimendan is superior to dobutamine ,it possesses good safety and tolerance ,which can be used as an effective drug for severe decompensated heart failure .

Objective To study osteoporosis in patients after orchiectomy for prostate cancer. Methods 64 patients were divided into two groups.In the first group,31 patients with prostate cancer treated by orchiectomy.The other 33 patients were taken as contrast(second group) which were benign prostate hyperplasia (BPH) treated by finasteride.BMD,X ray,serum testoterone and parameters of bone metabolism were measured both before and 6 months after treatment for both groups.Osteoporosis was defined according to WHO criteria. Results A significant reduction of BMD and serum testoterone were observed in the first group 6 months after orchiectomy ( P 0.05).All the patients in first group were classified as osteoporosis 6 months after orchiectomy. Conclusions It is suggested that androgen deprivation would induce osteoporosis which should be treated in early stage.

Objective To clarify whether the regulatory effect of all-trans-retinoic acid (atRA) on the antigen presentation function of dendritic cell(DC) is tightly associated with NF-κB signaling pathway.Also to clarify atRA mainly affected differentiated DC or influence the differentiation procedure from bone marrow cell to DC.Methods MOG35-55 immunized C57BL/6J mice received administration of atRA or not,splenic DC and CD4 cells isolated from immunized mice were subjected to in vitro cross-culture,treated with IL-12 and IL-23 respectively.Th1 and Th17 polarization of stimulated CD4 cells were determined by intracellular staining and FACS analysis,while the production of their corresponding cytokines,IFN-γ and IL-17,were measured by ELISA.Bone marrow cells were isolated from the femurs of the na(i)ve mice,treated with IL-4 and GM-CSF with or without synergistic RA treatment.MHC Ⅱ and CD11c molecules on the DC were assayed by immune staining and FACS analysis,their antigen presentation functions were decided by the proliferation and cytokine production of the Th1 effecter cells stimulated by antigen pulsed DC.To investigate the status of the NF-κB signaling pathway,the amount of phospho-Ser536 NF-κB p65 in the whole DC lysate and total NF-κB p65 in the nucleus were detected by Western blot.Finally,selective RA receptor antagonists were studied to figure out which receptor was majorly involved in the regulatory effect of RA on DC.Results Splenic DC from RA treated mice showed significantly decreased function of presenting antigen to stimulate CD4 cell polarization and cytokine production.Compared with untreated control,RA in vitro treated DC showed decreased expression of MHC Ⅱ and CD11c on its cell surface,which was accompanied with depressed function of stimulating Th1 cell proliferation and IFN-γ production.Further study revealed that RA mainly affect the differentiation procedure from BMC to DC,however,has no significant effect on differentiated DC as the aspects of MHC Ⅱ,CD11c expression,responder cell proliferation and cytokine production were evaluated.Decreased amount of phosphor-Ser536 NF-κB p65 in the whole cell lysate and total NF-κB p65 in the nucleus was investigated in RA treated DC,and decreased antigen presentation function of RA treated DC always came together with diminished activation of NF-κB signaling pathway.Finally it was demonstrated that RARβγ antagonist,but not RARα antagonist,could entirely block the RA effect on DC.Conclusion Retinoic acid inhibit the differentiation of DC as well as decrease its antigen presentation function,which might be resulted from the inactivation of NF-κB p65 signaling pathway and mediated by RARβγ.