Objective To investigate the clinicopathological characteristics,immunophenotype and the differential diagnosis of ectopic hamartomatous thymoma (EHT).Methods Three cases with EHT were studyed for clinicopathological and immunohistochemical features, the available literature on this subject was reviewed as well.Results The tumors of 3 patients with EHT were located at left lower neck,right supraclavicular area,and left supraclavicular area respectively,and were underwent local resection.The well-defined nodular tumors were en-capsulated with gray-yellowish cut surface,with size of 2.5 cm ×1.9 cm,4.5 cm ×4.5 cm,and 3.0 cm ×2.5 cm,respectively.Microscopi-cally,the tumors were composed of spindle cells,epithelium,and adipose tissue with the predomination of spindle cell.A gradual transition from epithelial cells to spindle cells was frequently present.Immunohistochemically,both the spindle cell and epithelial components were dif-fusely and intensely positive for AE1 /AE3,CK7,CK19,and P63.Two patients with EHT were followed up for 18 and 27 months,both without any evidence of metastasis or recurrence.Conclusion EHT is an exceedingly rare benign tumor with distinctive location and histological fea-tures and should be differentiated from biphasic synovial sarcoma,malignant schwannoma with epithelial differentiation,mixed tumor,thymoli-poma,et al.The total focal excision is the first treatment of choice for EHT.

BACKGROUND: In a series of recent studies it was demonstrated thatpolysaccharides play important roles in many physiologic and pathologicprocessions, such as infection, inflammation, inter-cell adherence and sig nal conduction, immune identification, cell proliferation and differentiation, as well as maintenance of cell structure and function. But the protectiveeffect of plant polysaccharides on gastrointestinal mucosa needs further re search. OBJECTIVE: To observe the effect of the total polysaccharides of SijunziDecoction (SJZD) (TPSJ) in different concentrations on the proliferation ofrat intestinal epithelial cell line IEC-6. DESIGN: Observational controlled trial. SETTING: Central Laboratory, Guangdong Hospital of Traditional ChineseMedicine. MATERIALS: ①Cell line: The IEC-6 of normal rats (Catalog No. RL 1592) was purchased from American Type Culture Collection (ATCC). IEC6 cells were originated mainly from intestinal crypt cells. ②Reagents anddrugs: DMEM medium, bovine insulin, gentamicin, fetal bovine serum (FBS) and DPBS were purchased from GIBCO Ltd. Cell proliferation kit(MTT) was purchased from Roche Ltd. Indomethacin was purchased fromSigma Company. SJZD was composed of Dangshen (Codonopsis pilosula),Baizhu (Atractylodes macrocephala), Fuling (Poria cocos) and Gancao (Glycyrrhizae uralensis), and these four drugs were in same ratio as Pharmacopoeia. The four herbs were boiled in water, extracted twice for 8 hours.Extract was combined, decompressed, concentrated, centrifugated with high speed to take out insoluble substance, put in glass paper to receive reverse lotic water dialysis for 2 hours. The final decoction was concentrated by heating followed by extraction with 80% ethanol. After overnight precipitation at room temperature and combination of sedimen, the total polysaccharide was obtained by deproteinating with the Sevag method.METHODS: ①The IEC-6 cell line was maintained in T-150 flasks with DMEM culture solution, and then put in CO2 incubator at 37 ℃, at saturated humidity, cultured at 0.05 volume fraction CO2, after being taken out from dry ice and defrosted rapidly in water-bath at 37 ℃. Flasks were incubated at 37 ℃ in 5% CO2· Stock cells were subcultured at a dilution of1:7 every 5-7 days and the medium was changed once every 2 days. The cells in passage 15-20 were used for testing. ②IEC-6 cells were inoculated at a density of 1×l04 cells/well in 96-well plates. Cultured were supplemented with TPSJ in a final concentrations ranging from 50, 100 and 200 mg/L after 6 hours, which was 3 TPSJ groups. One plate would be taken out for the examination of cell proliferation using MTT assay everyday. The cells that not administrated by any intervention were used as normal control group and cell proliferation was assayed using MTF at corresponding time points. ③IEC-6 cells were inoculated at a density of1×104 cells/well in 96-well plates, and then cultured in the DMEM supplemented with no serum from the following day for 24 hours. For the examiation of mucosal restitution, indomethacin at concentration of 40 mmol/L was employed to induce IEC-6 cells injured, which was indomethacin group. The three concentration of TPSJ was 50, 100 and 200 mg/L, respectively, which was 50,100,200 mg/L TPSJ groups. After drug action for 20 hours, the proliferation of cells was measured using MTT according to the manufacturer's instructions. IEC-cells without any intervention were used in the normal control group. Cell proliferation was determined with TT method at corresponding time points.MAIN OUTCOME MEASURES: MTT assay was used to examine the effects of TPSJ on IEC-6 cell proliferation in different times. MTT assay was used to detect the effect of TPSJ on IEC-6 cell proliferation inhibited by indomethacin.RESULTS: TPSJ could accelerate IEC-6 cells growth at different doses and in different time. After the cells were treated by 40 mmol/L indomethacin for 24 hours, the absorbance (A) of IEC-6 cells apparently declined compared with that in the normal control group (0.17±0.02,0.31±0.03; P ＜ 0.01). The A of IEC-6 cells treated by TPSJ in 100 mg/L group was apparently higher compared with indomechacin group (0.25±0.04, 0.17±0.02; P ＜ 0.01). The A of IEC-6 cells treated by TPSJ did not restored to the normal level, but there was no insignificant difference compared with normal group (P ＞ 0.05).CONCLUSION: TPSJ can accelerate the proliferation of IEC-6 cells. TPSJ can exert regulatory function both in intestinal mucosa absorption and immunity by affecting intestinal epithelial cells.

BACKGROUND: Environment pollution due to lead is severe day by day,and the lead-induced developmental toxicity of central nervous system is prominent.OBJECTIVE: To observe the effect of lead at low exposure level on neurobehavioral function of preschool children and provide basis for preventing childhood behavior disorders.DESIGN: Sampling survey.SETTING: Department of Children and Adolescent Health, Public Health College, Sun Yat-sen University.PARTICIPANTS: Totally 211 children of 4-6 years (109 boys and 102girls) were enrolled from a kindergarten of a populated area of Zhuhai City by randomized cluster sampling from September to October 2004.METHODS: 20 mL peripheral blood of finger tip was collected. Blood lead was determined with graphite stove atomic absorption spectrometry.According to the amount of blood lead, the children were divided into high blood lead exposure group (＞100μg/L) and low blood lead exposure group (＜100μg/L). Furthermore, they were also assigned into ＜50 μg/L group, 50μg/L- group, 100μg/L- group, 150 μg/L- group, 250- μg/L group. Achenbach's Child Behavior Checklist (CBCL) and self-designed questionnaire (composed of possibly effective factor on children's neurobehavioral function, such as age, sex, cultivation, family background and so on) were applied, filled by their parents under the instruction of professional staffs. Results and blood lead value were analyzed with first order correlation and multiple factors stepwise regressive analysis.MAIN OUTCOME MEASURES: ①Blood lead level and each factor scores of CBCL, ②correlation analysis between blood lead value and behavioral factor score.RESULTS: A total of 211 questionnaires were sent out, and 211 were retrieved with 211 effective questionnaires. The effective rate was 100%. ①Score on externalizing and behavioral disorder rate in the high blood lead exposure group (13.28±6.26,18.26%) was significantly higher than those in the low blood lead exposure group (9.98±5.46,7.29%)( t=4.067 7,χ2=5.470, P＜0.05). There was insignificant difference in score on internalizing and total score of CBCL between the low and high blood lead exposure groups. ②The behavioral disorder rate of different blood lead level had significance (χ2=13.695,P＜0.01). The behavioral disorder rate in blood lead ≥ 150 μg/L was obviously higher than that of the former 3groups after further pairwise comparison (χ2 were 4.727, 6.261, 5.168;4.503, 5.911, 4.928, P＜0.05), which revealed that the child behavioral disorder rate markedly increased when the blood lead was ≥ 150 μg/L.③Blood lead logarithm value had positive correlation with the scores on hyperactivity, aggression and defiance (r=0.316 4,0.282 8,0.188 6,P ＜0.05), and had no correlation with obesity, desintegration, truculence and sexual questionnaire (r=0.102 4,0.094 2,0.118 3,0.092 6,P ＞ 0.05). ④After the stepwise regression analysis, the scores on hyperactivity, aggression and defiance factors were included in the regression equation. The results suggested that the effect of lead on child externalizing behavior still remained, and kept statistical meaning after confounding factors, such as controlling family and society, etc.CONCLUSION: Low-level lead exposure has adverse effects on externalizing behavior in preschool children.

Objective:To observe the hypoglycemic effects of Cortex Lycii Radicis (CLR) on alloxan induced diabetic mice.Methods:The alloxan induced diabetic mice were given drug decoction of CLR[2.5g/(kg?d) -1 , or 5.0g/(kg?d) -1 )] for successive 2 weeks, The blood sugar level was determined with GOD method.Results:There were remarkedly differences in the levels of blood sugar between before and after treatment of various groups. ( P

Objective To observe whether appropriate intermittent exercise at the ischemic threshold can safely promote collateral circulation in an ischemic area of the myocardium through the increased expression of vascular endothelial growth factor(VEGF)and its receptor fetal liver kinase-1(Fik-1). Methods A balloon constrictor was surgically implanted in the first obtuse marginal coronary artery(OM1)of miniature pigs.The subjects were divided into 3 groups:a sham-operation group,a pure ischemia group,and an exercise training group.Subjects in the exercise training group performed individualized treadmill programs 30 min daily,5 d per week,for 8 weeks,including 2 two-minute episodes of exercise-induced ischemia.Two pre-exercise episodes of pure ischemia induced by brief OM1 occlusion were also conducted.Only pure ischemia was induced in the pure ischemia group,and the sham-operation group remained sedentary for the experimental period.Relative myocardial blood flow(RMBF)was measured using microspheres.VEGF and Flk-1 expression levels were measured by Western blotting and real time RT-PCR analyses.Cardiac troponin I(ctnI)levels were determined using an enzyme-linked immunosorbent assay(ELISA). Light and electron microscopy were employed to examine myocardia damage in the ischemic area.Results RMBFs in the exercise training group were significantly higher than those in the pure ischemia and sham-operation groups. RMBFs in the pure ischemia group were significantly higher than those in the sham-operation group.The expression of VEGF and Flk-1 proteins and mRNAs in the exercise training group were significantly higher than those in the pure ischemia and sham-operation groups,and the levels in the pure ischemia group were also significantly higher than those in the sham-operation group.After training,no myocardial damage and no ctnI increase was observed in the pure ischemia group.Microscopy revealed no obvious structural changes. Conclusion Intermittent exercise at the isehemia threshold intension can safely promote coronary collateral formation through upregulation of VEGF and Flk-1 expression in the ischemic myocardial area of a porcine model.

Objective To evaluate the effects of ulinastatin postconditioning and combination of ulinastatin preconditioning and postconditioning on myocardial apoptosis in patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Eighty New York Heart Association (NYHA) class Ⅱ or Ⅲ patients of both sexes,aged 21-59 years,scheduled for cardiac valve replacement with CPB,were randomly divided into four groups (n =20 each):normal saline control group (group C),ulinastatin preconditioning group (group U1),ulinastatin postconditioning group (group U2) and ulinastatin preconditioning plus postconditioning group (group U3).In group U1,uinastatin 20000 U/kg was infused via the central vein at 500-1000 U·kg-1 · min-1 after endotracheal intubation until 10 minutes before blocking the ascending aorta.In group U2,ulinastatin 10000 U/kg was infused via the aortic root at 4000-5000 U· kg-1 · min-1 at 5-7 minutes before opening the aorta.In group U3,ulinastatin preconditioning and postconditioning were performed as described in groups U1 and U2.In group C,the same volume of normal saline was infused instead of ulinastatin.Blood samples were taken from the radial artery at 10 minutes before blocking the ascending aorta,40 minutes after blocking the ascending aorta,45 minutes after opening the aorta and at the end of operation for determination of plasma concentrations of tumor necrosis factor-alpha (TNF-α) and soluble tumor necrosis factor receptor 1 (sTNF-R1).Myocardial tissues were obtained from the right atrial appendage at 45 minutes after opening the aorta for determination of the expression of TNF-α,bcl-2,bax,caspase-3,and apoptosis.The bcl-2/bax ratio and apoptotic index were calculated.Results Plasma concentrations of TNF-α and sTNF-R1 and the expression of TNF-α,bax,caspase-3 and apoptotic index were lower and the expression of bcl-2 and bcl-2/bax ratio were higher in groups U1,U2 and U3 than in group C and they were lower in group U3 than in groups U1 and U2 (P ＜ 0.05).Conclusion Ulinastatin postconditioning can inhibit myocardial apoptosis in patients undergoing cardiac valve replacement with CPB,and the efficacy of combination of ulinastatin preconditioning and postconditioning is stronger than that of ulinastatin postconditioning.The mechanism is involved in balancing the expression of bax and bcl-2 and down-regulating the expression of TNF-α and its receptor.

Objective To clarify the inhibitory effect of low molecular weight chitosan(LMCTS)on hepatic fibrosis induced by carbon tetrachloride (CCl4 )in the rats, and to investigate its effect on the expression of Toll-like receptor-4(TLR4 )and to lay the foundation for the development of the clinical candidate drug of liver fibrosis. Methods 72 male Wistar rats were randomly divided into blank control group, CCl4 group (model group), glycyrrhizinate (DG)group,50,100 and 150 mg·kg-1 LMCTS groups (low,middle and high doses of LMCTS groups).In addition to blank control group,the rats in the remaining groups were given 40% CCl4-vegetable oil (1.75 mL·kg-1 ),2 times per week for 8 weeks,by intraperitoneal injection to establish the model of rat hepatic fibrosis.And the rats in blank control group were injected with the same amount of 100% vegetable oil agent. From the ninth week, the rats in DG and LMCTS groups were given DG and LMCTS by intragastric administration, 1 time/week for 4 weeks. Then all rats were sacrificed, the activities of serum glutamic acid aminotransferase (ALT),aspartate aminotransferase (AST)and alkaline phosphatase (ALP)were detected with ELISA kit;the pathological changes in liver tissue were observed under light microscope, and the TLR4 expressions were detected by RT-PCR and Western blotting method. Results The serum ALT, AST and ALP activities in middle and high doses of LMCTS groups were lower than those in model group (P<0.05).The serum ALT activity in middle dose of LMCTS group was lower than that in low dose of LMCTS group (P<0.05),but the activities of AST and ALP had no statistically significant change(P>0.05).There were statistically significant differences in the serum ALT, AST and ALP activities between high dose of LMCTS group and middle dose of LMCTS group (P<0.05).There were obvious hepatocyte steatosis,inflammatory cell infiltration,collagen fiber hyperplasia and hepatic lobule damage in the rats in model group.However,all the changes in liver tissue of the rats in LMCTS group were significantly reduced, especially in high dose group. The results of RT-PCR and Western blotting method showed that the expression of TLR4 was declined in LMCTS groups compared with model group (P<0.05,P<0.01),especially in high dose of LMCTS group,and there were statistically significant differences between different doses of LMCTS groups (P<0.05).Conclusion High dose of LMCTS can decrease the serum transaminase activity of liver fibrosis rats and improve liver function,and this process may be related to declining the expression of TLR4 .

Objective To evaluate the effects of ulinastatin postconditioning and combination of ulinastatin preconditioning and postconditioning on myocardial apoptosis in patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Eighty NYHA class Ⅱ or Ⅲ patients of both sexes,aged 21-59,scheduled for cardiac valve replacement with CPB,were randomly divided into 4 groups ( n =20 each):normal saline control group ( group C ),ulinastatin preconditioning group ( group U1 ),ulinastatin postconditioning group (group U2 ) and ulinastatin preconditioning plus postconditioning group(group U3 ).In group U1,uinastatin 20 000U/kg was infused via central vein at 500-1000 U·kg-1 ·min-1 from after tracheal intubation until 10 min before ascending aortic cross-clamping.In group U2,ulinastatin 10 000 U/kg was perfused via aortic root at 4000-5000 U· kg-1 · min-1 at 5-7 min before aortic unclamping.In group U3,ulinastatin preconditioning and postconditioning were performed as described in groups U1 and U2.In group C same volume normal saline was infused instead of ulinastatin.Blood samples were taken from radial artery at 10 min before ascending aortic cross-clamping,40 min after ascending aortic cross-clamping,45 min after aortic unclamping and the end of operation for determination of plasma concentrations of TNF-α and soluble tumor necrosis factor receptor 1 (sTNF-R1).Myocardial tissues were obtained from right atrial appendage at 45 min after aortic unclamping for determination the expression of TNF-d,Bcl-2,Bax and caspase-3 and apoptosis.The Bcl-2/Bax ratio and apoptotic index were calculated.Results Plasma concentrations of TNF-α and sTNF-R1 and the expression of TNF-α,Bax,caspase-3 and apoptotic index were lower,the expression of Bcl-2 and Bcl-2/Bax ratio were higher in groups U1,U2 and U3 thah group C and in group U3 than groups U1,U2 ( P ＜ 0.05 ).Conclusion Ulinastatin postconditioning can inhibit myocardial apoptosis in patients undergoing cardiac valve replacement with CPB,and efficacy of combination of ulinastatin preconditioning and postconditioning is stronger than that of ulinastatin postconditioning.The mechanism is involved in balancing the expression of Bax and Bcl-2 and down-regulating the expression of TNF-α and its receptor.

Objective: To investigate the current status of smoking behavior among adolescents in Chongqing and associated factors at both individual and school levels, so as to provide scientific evidence for the development of smoking control strategies for adolescents. Methods: From September to October 2021, adolescents tobacco epidemic monitoring was carried out in Chongqing. A total of 9 588 students from 10 monitoring districts and counties in Chongqing were selected to complete the Chinese adolescent tobacco epidemic survey questionnaire by multi stage stratified cluster probability sampling method. Multi level Logistic regression model was used to analyze smoking behavior among adolescents and associated factors. Results: The attempted smoking rate among young people was 17.1%, and the current smoking rate was 3.9% in Chongqing. There was a clustering of smoking behavior among participants the school level. Multi level Logistic regression models showed that general high school, vocational high school, male students, smoking at home, seeing someone smoking in indoor public places, seeing someone smoking at school, smoking among good friends (some smoking, most smoking, all smoking), feeling more comfortable of smoking in social occasions, using electronic cigarette, which were positively correlated with smoking attempts ( OR=1.45, 1.40, 1.91, 1.50, 1.42, 1.43, 2.05, 5.38, 6.53, 1.36 , 5.04, P <0.05). Smoking making people look less attractive and feeling more uncomfortable of smoking in social occasions were negatively correlated with smoking attempts ( OR=0.76, 0.48, P <0.05). Vocational high school, male students, smoking at home, seeing someone smoking in indoor public places, smoking among good friends and using electronic cigarette, which were positively correlated with smoking now ( OR=1.62, 1.67, 1.69, 1.83, 5.84, 23.02, 35.84, 6.28, P <0.05). Feeling more uncomfortable of smoking in social occasions was negatively correlated with current smoking ( OR=0.29, P <0.01). Conclusions There is a cluster of attempted smoking and current smoking behaviors at the school level among adolescents in Chongqing, and the influencing factors include school type, gender, family environment, social factors, etc. It should strengthen the implementation and broaden the scope of smoking control regulations in public places, and promote the healthy growth of young people through social school family cooperation.

Objective: To observe the efficacy of herbal cake-partitioned moxibustion for lumbar disc herniation (LDH) due to kidney deficiency and blood stasis and observe the influence of this method on lumbar functions and inflammatory factors in patients with this condition. Methods: A total of 120 LDH patients who met the inclusion criteria were randomly divided into three groups, including a herbal cake-partitioned moxibustion group, a flour cake-partitioned moxibustion group, and a Western medication group, with 40 patients in each group. The patients in the Western medication group were treated with diflunisal tablets, 0.5 g per dose, 2 doses a day. Those in the herbal cake-partitioned moxibustion group were treated with additional herbal cake-partitioned moxibustion group at Back-Shu Points and Jiaji (EX-B2) Points once a day. Those in the flour cake-partitioned moxibustion group were treated with the same methods as in the herbal cake-partitioned moxibustion group, except that the herbal cake was replaced by a flour cake. All the patients were treated for 10 d. After treatment, the scores of the visual analog scale (VAS) and Japanese Orthopaedic Association (JOA) and the changes of the interleukin (IL)-6, tumor necrosis factor (TNF)-α, and substance P (SP) levels were observed, and the efficacy was evaluated. Results: After treatment, the VAS score and the levels of IL-6, TNF-α, and SP were lower than those before treatment, and the JOA score was higher than that before treatment in the three groups, indicating intra-group statistical significance (P<0.05). The VAS score and the levels of IL-6, TNF-α, and SP of the herbal cake-partitioned moxibustion group were lower than those of the flour cake-partitioned moxibustion group and the Western medication group, while the JOA score of the herbal cake-partitioned moxibustion group was higher than that of the other two groups, indicating inter-group statistical significance (P<0.05). The total effective rate of the herbal cake-partitioned moxibustion group was 92.5％, higher than that of the flour cake-partitioned moxibustion group (80.0％) and the Western medication group (72.5％), indicating inter-group statistical significance (P<0.05). Conclusion: On the basis of Western oral medication, additional herbal cake-partitioned moxibustion can alleviate the pain and improve the lumbar functions in patients with LDH due to kidney deficiency and blood stasis. The efficacy of the integrated method is better than that of either flour cake-partitioned moxibustion or Western medication alone, which may be related to the reduction of serum inflammatory factors.