Background Many researches have reported the high proliferation ability of pterygium tissue.However,the origin of cells in pterygium tissue and their role in pathogenesis and recurrence of pterygium are below understand up to now.Objective This study is to explore the role of bone marrow derived stem cells and progenitor cells in the pathogenesis of pterygium.Methods Informed consent was obtained from 12 patients with the pterygium stretching the edge of the pupil prior to this trail.Pterygium specimen was obtained from 8 patients with primary pterygium and 4 patients with recurrent pterygium during the operation.The normal conjunctival tissue was obtained from the location of 10 mm from the pterygium in the operation eye.The expression levels of marker of the primitive haematopoietic progenitors(AC133),marker of the haematopoietic progenitor cells and endothelium (CD_(34)),marker of haematopoietic and stromal progenitor cells (C KIT ),and differentiation antigen of bone marrow fibroblast cells and nonhaematopoietic progenitor cells 1 (STRO 1) were detected by using immunohistochemistry.Results Various progenitor cell markers originated from bone marrow,including CD_(34),AC133,C KIT,STRO 1,were positively expressed in pterygium specimen rather than normal conjunctival specimen mainly in the basal epithelium or stroma of pterygia tissue.Majority of the positive cells were seen in the head of pterygium.C KIT positive cells were observed mainly in the basal epithelium and stroma of pterygium.The morphology of positive cells varied upon different distribution.Fibroblast like and spindle shaped positive cells were seen in the stroma layer of pterygium,and round or ovoid shaped cells were in basal epithelial layer.The distribution and shape of positive cells for AC133 and CD_(34) were similar to ones of C KIT but numbers of cells were varied between them.C KIT,AC133 and CD_(34) positive cells were coexpressed in basal epithelium and vascular endothelium.Expression of STRO 1 was found in the stroma layer not in the basal epithelium of pterygium.Similar distribution,numbers and shape of positive cells were seen between recurrent and primary pterygium.Conclusion The cells with stem cells markers and progenitor cells markers originated from bone marrow may play a role in the pathogenesis of pterygium.

The specialized teacher troop is the discipline construction,the development key,the teaching leading force and the personnel training quality guarantee. At present stage the quantity and quality of the specialized public health management teacher staff in our school have gradually become the bottleneck for the career development. Only by sharpening teachers' scientific research ability unceasingly, enhances teachers ' individual accomplishment and the teacher troop's overall quality,improving their work quality,can we adapt to the career devel-opment under the new situation.

Objective:To observe the reliability and clinical implement of flexible ureteroscope combined with extracorporeal shock wave lithotripsy to treat the kidney stones with a diameter of more than 2cm. Methods:The diagnosed 80 cases of kidney stones (all with a diameter of more than 2cm) patients in our hospital were chosen, randomly divided into two groups, URL group and PCNL group,each of them with 40 cases. Surgical curative effect, operation time, postoperative complications, hospitalization days and the change of NGAL levels and the change of urine levels Kim-1 preoperative and postoperative blood 3 days of two groups were observed and compared. Results: Comparing with the PCNL group, the surgical curative effect, operation time and postoperative complications of the URL group have no significant difference, but the hospitalization days between are significantly different(t=8.433, P<0.05);In terms of NGAL, Kim-1, the postoperative 1d of PCNL group is significantly higher than preoperative, NGAL postoperative 1d of URL group is significantly higher than preoperative (t=3.319, P<0.05). Conclusion:It was reliable that flexible ureteroscope combined with extracorporeal shock wave lithotripsy to treat the kidney stones with a diameter of more than 2cm, lower complication rate, worthy of clinical.

Objective To study the effect of gambogic acid on apoptosis and autophagy in human hepatoma cells HepG2, and to detect its possible mechanism. Methods After exposure of HepG2 cells to gambogic acid at different concentration for 24 h, cell proliferation rates was determined by MTT assay, apoptosis rate was detected by the flow cytometry (FCM), formation of autophagic vacuoles was observed by the monodansyl cadaverine (MDC) fluorescence staining, expression level of apoptosis-related proteins Bax, bcl-2 and autophagy related protein Beclin 1 was detected by Western blot. Results HepG2 cell growth was inhibited by the gambogic acid dose dependence. After exposure to gambogic acid at 0, 2.0, 4.0 and 8.0 μmol/L for 24 h, cell apoptosis rate was significantly increased to 5.31 %, 29.18 %, 31.50 % and 46.09 %(P <0.05), MDC average fluorescence intensity was also significantly increased to 6.3 ±1.1, 82.6 ±4.5, 132.9±15.7 and 157.7±9.0 (P<0.01). Western blot showed that gambogic acid could promote the expression of apoptosis protein Bax (0.17 ±0.02, 0.75 ±0.06, 0.78 ±0.05, 0.89 ±0.10, P <0.05), and decrease the expression of anti-apoptosis protein bcl-2 (1.18 ±0.04, 0.90 ±0.06, 0.64 ±0.08, 0.57 ±0.05, P <0.05), meanwhile, it could also increase the expression of autophagy related protein Beclin (0.67±0.03, 0.92±0.04, 0.95±0.07, 1.04±0.06, P<0.05). Conclusion Gambogic acid can inhibit the growth of human hepatoma HepG2 cells by inducing apoptosis and autophagic cell death.

Objective To investigate the molecular expression and clinical significance of Vimentin and E-cadherin during epithelial-mesenchymal transformation of hepatocellular carcinoma (HCC) tissues.Methods Hepatocellular carcinoma and paracancerous tissue were collected from 55 patients,while nonneoplastic nonnal liver tissue were collected from 20 patients without cancerous diseases as control group.Expressions of Vimentin and E-cadherin were examined by immunohistochemistry staining.Clinicopathological features of the relative expression of Vimentin and E-cadherin,and its influence on prognosis were discussed as well.Results Vimentin was positively expressed in 69.1％ cancer tissue,and was significantly higher than paracancerous tissues and normal liver tissues(P ＜ 0.05).E-cadherin was positively expressed in 27.3％ cancer tissue and was significantly lower compared with paracancerous tissues and normal liver tissues(P ＜0.05).The expression of Vimentin and E-cadherin was negatively correlated(r =-0.653,P ＜ 0.05).Vimentin expressions in subgroups of TNM stage Ⅲ-Ⅳ,poor differentiation,multiple tumor nodules,metastasis and recurrence were all significantly higher than the respective subgroups as TNM stage Ⅰ-Ⅱ] (x2 =7.267,P ＜ 0.05),moderate to well differentiation (x2 =4.045,P ＜ 0.05),single tumor node (x2=12.143,P ＜0.05),without metastasis or recurrence (x2 =7.267,P ＜ 0.05).On the contrary,Ecadherin showed higher expression in the subgroup of single tumor node compared with multiple tumor nodules(x2 =6.878,P ＜ 0.05).The follow-up of patients further demonstrated that patients with positive Vimentin expression had a significantly lower disease-free survival compared with the Vimentin negative group (P ＜0.05).Conclusions Vimentin and E-cadherin both participated in epithelial-mesenchymal transition process of hepatocellular carcinoma.High expression of Vimentin and low expression of E-cadherin were closely correlated with occurrence and development of HCC.Vimentin and E-cadherin may serve as impottant biomarkers in clinical diagnosis and prognosis prediction of HCC.

Through the analysis of current situation of the setup of local professional institutions,the principles and characteristics,the author put forward countermeasures and suggestions to optimize the local medical professional institutions’ setup,to help local medical institutions’development and improve the quality of medicinal higher education.

Objective To discuss a new procedure to treat Pilon fractures with combined by the using of external fixation and arthroscopy. Methods The external fixation was used to keep the broken bone in line, and the facet of the ankle joint was made smooth under the arthroscope. Several lag screws were put to fix the fracture. 31 cases, 21 male and 10 female, were treated from Nov. 2002 to Mar. 2004 with this technique. There were 22 cases of type B, and 9 type C1,C2 according to AO classification. Results The follow ups ranged from 4 to 12 months, averaging 7.3 months. No nonunion or infection was found. The average bone healing time was 3.7 months. Conclusion The combined use of arthroscopy and external fixation to treat Pilon fracture is an efficient procedure, for it can provide stable fixation, cause limited incision or trauma, and allow early recovery exercises of the ankle joint.

Objective To investigate the changes in circulatory and pulmonary monary angiotensinⅡin rats with acite lung injury(ALI)and explore the role of angiotensinⅡin ALI.Method Thirty S-D rats were randomly divided into control group(n=6)and ALI group(n=24).The ALI group was further divided into four subgroups of observation at various intervals,3,6,9 and 12 hours after administration of lipopolysaccharide (LPS)into the femoral vein(each n=6).The indices rate,blood gas analysis,wet weight/dry weight(W/D)ratio of lung lobes,and pathological changes were successively observed at 3,6,9,and 12 hours after injury.The content of angiotensinⅡin lung tissue and blood plasma were detected at above set intervals by radioimmunoassay.Data of these assays were analyzed by one-factor analysis of variance.Results Compare with the control group,pH and PaO2 of arterial blood in ALI group decreased significantly(P＜0.05)at all intervals and PaCO2 of arterial blood in ALI group decreased significanfly(P＜0.05).at all intervals and PaCO2 of arterial blood and lung W/D weight ratio increased significantly(P＜0.05),and scores of lung histopathology denoted the lung injuried(P＜0.01).After injury of lung,angiotensin Ⅱ content increased markedly in lung homogenate and blood plasma (P＜0.05).Angiotensin Ⅱ content in blood plasma reached peak value at 9 hours,and content of angiotensin Ⅱ in lung homogenates kept on increasing at allintervals of observation.Conclusions A large amount of angiotensin Ⅱ releases into lung tissue and blood plasma during ALI,suggesting systemic and pulmonary rennin-angiotensin systems are activated.

BACKGROUND: A middle cerebral artery occlusion and reperfusion(MCAO/R) model in rats with suture has been widely used in the researches of acute focal ischemic cerebral infarction, while the model in rabbits by the same method is relatively rare. Magnetic resonance diffusion weighted imaging (MR DWI) has been paid close attention recently for its sharp sensitivity of cerebral ischemia.OBJECTIVE: To establish rabbit models of MCAO/R by intraluminal thread, and study the characteristics of MR DWI after cerebral ischemia and reperfusion.DESIGN: Random controlled animal experiment.SETTING: Institute of Cerebrovascular Diseases, Affiliated Hospital of Qingdao University Medical College.MATERIALS: The experiment was accomplished at the Key Laboratory of Brain Diseases Prevention and Cure of Shandong Province from March to June in 2005. A total of 103 adult healthy New Zealand rabbits of either sex, 10-12 weeks old and 1.8-3.3 kg weight were provided by the Experimental Animal Center of Shandong Agricultural Academy (SCX20040013).They were bred at quiet, sanitary and dry conditions.METHODS: Animal groups: 103 rabbits were divided randomly into group A (n=53) and group B (n=50). The rabbits in group A were treated with suture of 0.51-0.55 mm as the diameter of thread, while group B was reassigned into B1 (0.46-0.50 mm), B2 (0.51-0.55 mm) and B3 (0.56-0.60 mm).The successful MCAO/R models in 57 cases were randomly divided into permanent ischemia group (n=30, ischemia 1, 3, 6, 12, 24 andl 48 hours, 5ones at each time point) and ischemic reperfusion group (n=27, reperfusion 0, 2 and 5 hours, 5 ones at each time point; reperfusion 11, 23 and 47hours, 4 ones at each time point). Another 10 rabbits receiving sham operations were regarded as contrasts for permanent ischemia group and ischemia reperfusion group, with 5 ones in each.MAIN OUTCOME MEASURES: The changes of hyperintensity area on DWI and apparent diffusion coefficient (ADC) were measured in permanent ischemia group and ischemic reperfusion group.RESULTS: The data of 57 successful model rabbits were involved in the result analysis.①The successful rate in group A (26 cases, 49.1%) was significantly lower than that in group B (31 cases, 62.0%).②In ischemia group:The hyperintensity area on DWI with declined ADC appeared at ischemia 1 hour. The hyperintensity areas on DWI at different times increased gradually from ischemia 1 hour and unchanged within 24 hours. The mean ADC at different times declined at first and then gradually increased.③In reperfusion group: Comparing with ischemia 1 hour, the hyperintensity area on DWI reduced while ADC increased at reperfusion 2 hours and 5 hours, and enlarged with ADC high at reperfusion 11 hours, then continued to enlarge with ADC reduced significantly at 23 hours and 47 hours.CONCLUSION: The diameter of thread tip and the inserting distance of thread are main factors for establishing successful MCAO/R models. The hyperintensity area on DWI and the decreasing ADC after acute cerebral ischemia can be improved by early reperfusion, but the secondary decreasing ADC may be induced by continuously reperfusion.

Objective To study the effect of acupuncture on the ratio of CD4+ CD25+ regulatory T cells and expression of transcription factor Foxp3 in patients with septic shock.Methods Sixty-four patients with septic shock were randomly divided into two groups by using the random number table method.Acupuncture group (34 cases) was treated with both western medicine and acupuncture,and control group(30 cases) was treated with western medicine.The period of treatment was 7 days.After treatment,the ratio of CD4+ CD25+ T cells in peripheral blood was determined by flow cytometry.And the expression of Foxp3 mRNA in peripheral blood was detected by quantitative real time PCR.Results After treating for 7 days,the ratios of CD4+ CD25+ Treg cells and CD4+ CD25+ Foxp3 + Treg cells were (20.23 ± 1.12) ％ and (78.70 ± 7.65) ％ respectively in peripheral blood of the control group,which in the acupuncture groupwere (17.32 ± 0.78) ％ and (68.53 ± 8.01) ％,the differences were statistically significant between the two groups(t =2.587,2.749,all P ＜ 0.05).The levels of Foxp3 mRNA in peripheral blood were (1.21 ±0.02) and (1.02 ± 0.04) in the control group and acupuncture group,the difference was statistically significant(t =2.119,P ＜ 0.05).Conclusion Acupuncture can adjust immune status of patients with septic shock by reducing the ratio of CD4+ CD25+ Treg cells and down-regulating the expression of Foxp3 mRNA.