OBJECTIVE: To raise awareness of granulomatosis with polyangiitis by summarizing its nasal mani- festations and treatment experience. METHOD: Retrospective studies were done to the nasal clinical manifestations and treatment processes of 21 GPA patients in this study. All were treated by the combined treatment of glucocorticoid, cyclophosphamide as well as tripterygium wilfordii, and 4 of them who had much heavier nasal symptoms were treated by endoscopic sinus operation at the same time. RESULT: Eighteen cases were effective treated by medical treatments besides 3 were died of all 21 cases. The nasal symptoms of those 4 patients were obviously improved, and still had effective drainage of sinus after operation with 8-22 months follow up, although the sinus ostiums were reduced comparing to themselves intraoperation at different degree. CONCLUSION GPA is always been ignored which will lead to delay treatment due to the lack of specificity of its clinical manifestations. So, enough attention is the key point of avoiding misdiagnosis as well as providing timely treatment for these patients.
Combined Modality Therapy ; Diagnostic Errors ; Drainage ; Endoscopy ; Granulomatosis with Polyangiitis ; complications ; diagnosis ; therapy ; Humans ; Nose ; Paranasal Sinuses ; Retrospective Studies

BACKGROUND:The research for mesenchymal stem cels in the treatment of liver cirrhosis has made great progress. However,t-test analysis is often misused in clinical practice. OBJECTIVE:To analyze the efficacy and safety of umbilical cord mesenchymal stem cel therapy for liver cirrhosis by repeated measurement method. METHODS: A total of 27 patients with decompensated liver cirrhosis underwent conventional medical treatments, including liver protection treatment and symptomatic treatment. At 1 week after hospitalization, patients were given intravenous transplantation of umbilical cord mesenchymal stem cels (passages 2-4), cel viability≥ 90%, stem cel counting≥ 2×107 cels, four times with an interval of 5-7 days. Analysis of variance based on repeated measurement data was performed to analyze the liver function changes at different time after umbilical cord mesenchymal stem cel transplantation. RESULTS AND CONCLUSION: The results of univariate repeated measurement showed that at 2 and 3 months after treatment, the serum albumin level was increased and the total bilirubin level in serum was decreased significantly (P < 0.05); at 3 months after treatment, the content of aspartate aminotransferase decreased, and the content of cholinesterase increased significantly (P < 0.05). No patient appeared to have liver and other organ tumors during the observation period. These findings indicate that umbilical cord mesenchymal stem cel transplantation is effective and safe in the treatment of liver cirrhosis, which can significantly improve patient's liver functions.

The astrocyte reaction to cerebral trauma was reviewed in this paper,which included the study model,detection technique,as well as the astrocyte changes in the morphology and metabolism.It was also prospected to their significance in medicolegal expertise.

ObjectiveTo investigate the effects of different ways of fluid resuscitation on uncontrolled traumatic hemorrhagic shock. MethodsThe retrospective analysis of data from 220 casualties with uncontrolled hemorrhagic shock admitted from September 2006 to October 2010 was carried out.There were two ways of fluid resuscitation used to treat casualties with hemorrhagic shock,conventional fluid resuscitation (group A) and limited fluid resuscitation (group B).The systolic pressure was maintained at 90 ～ 135 mm Hg in the group A and at 70 ～ 90 mm Hg in the group B.The data of body temperature,central venous pressure,quantity of blood transfused,urine output,renal function,hemoglobin,blood osmotic pressure (Osm) ,MODS and DIC rates,treatment costs and mortality of two groups were statistically analyzed and compared. Results After analyses of above mentioned variables except renal function and comparison made between two groups,the method of limited fluid resuscitation was much superior over conventional fluid resuscitation (P ＜ 0.05 ).There was no noticeable difference in rate of compromised renal function between two groups ( P ＞ 0.05 ). Conclusions In the case of uncontrolled exsanguination,the method of limited fluid resuscitation can maintain blood perfusion of vital organs,reduce the blood loss and decrease the incidence of MODS and mortality.

Objective To investigate the improved approach and bile duct approach of laparoscopic biliary tract exploration for the treatment of the elderly patients with common bile duct stones. Methods Ninety-two elderly patients with common bile duct stones were enrolled and randomly divided into the improved group and the conventional group ,with 46 cases in each group. The time of hemorrhage ,the time of common bile duct suture,the recovery time of gastrointestinal function,the time of hospitalization,body temperature,albumin and total bilirubin levels,complications and recurrence of stones were recorded and compared between the two groups. Results The time of hemorrhage,the time of common bile duct suture,the recovery time of gastrointestinal func-tion and the time of hospitalization in the improved group were lower than those in the conventional group(P<0.05, respectively). The body temperature of patients in the improved group was lower than that in the conventional group on 3 days after surgery(P<0.05). The overall incidence of postoperative complications in the improved group was lower than that in the conventional group (P < 0.05). No recurrence of stones was observed in both two groups. Conclusion The improved approach for laparoscopic common bile duct exploration surgery results in less bleed-ing,short common bile duct suture time,rapid postoperative recovery,less body temperature fluctuations and less complications,deserving popularization.

Fibroblast growth factor (FGF) is a key regulator of developmental processes. A FGF homolog (vFGF) is found in all lepidopteran baculoviruses. Autographa californica nucleopolyhedrovirus (AcMNPV) and Bombyx mori NPV (BmNPV) vFGFs are chemotactic factors. Here we analyzed the vfgf of Helicoverpa armigera NPV (HearNPV), a group Ⅱ NPV. The HearNPV vfgftranscripts were detected from 18 to 96 h post-infection (hpi) of Hz-AMI cells with HearNPV and encoded a 36 kDa protein, which was secreted into the culture medium. HearNPV vFGF had strong affinity to heparin, a property important for FGF signaling via an FGF receptor. Unlike its AcMNPV homolog, HearNPV vFGF specially chemoattracted Hz-AM 1, but not other insect cells such as Sf9 and Se-UCR and not the mammalian cells 293 and HepG2. HearNPV vFGF is also associated with the envelope of BV but is absent in occlusion-derived virus, which coordinated to the chemotatic activity analysis.

Baculoviruses produce two viral phenotypes, the budded virus (BV) and the occlusion-derived virus (ODV). ODVs are released from occlusion bodies in the midgut where they initiate a primary infection. Due to the lack of an in vitro system, the molecular mechanism of ODV infection is still unclear. Here we present data demonstrating that Helicoverpa armigera nucleopolyhedrovirus (HearNPV) ODV infected cultured Hz-AM1 cells in a pH dependent manner. The optimal pH for ODV infection was 8.5, which is same to that in the microvilli of midgut epithelial cells, the ODV native infection sites. Antibodies neutralization analysis indicated that four HearNPV oral infection essential genes p74, pif-1, pif-2 and pif-3 are also essential for HearNPV ODV infection in vitro. Thus, HearNPV-HzAM1 system can be used to analyze the mechanism of ODV entry.

Objective To explore the clinical diagnostic value of 18 F-FDG PET/CT in patients with kidney neoplasms.Methods Seventy-nine patients (52 males,27 females,average age (57.3 ± 14.1) years),who had definitive diagnosis of kidney neoplasms by 18F-FDG PET/CT and pathological or clinical comprehensive diagnosis in recent five years,were analyzed retrospectively.The diagnosis by PET/CT was made according to the changes of kidney shape,tumor density and FDG uptake (SUVmax).The diagnostic efficacy was calculated.Results Among the 79 patients,70 cases were finally diagnosed as malignant tumors (including 40 cases of renal cell carcinoma,5 cases of renal pelvis carcinoma,8 cases of lymphoma,16 cases of metastatic tumor,and 1 case of renal fascia capsule liposarcoma) and 9 cases of benign tumors (including 7 cases of angiomyolipomas,1 case of renal acidophilic cell adenoma,1 case of metanephric adenoma; the benign tumors did not contain small lipid sample hamartoma cases).The detective rate of kidney neoplasms with 18F-FDG PET/CT was 97.5％ (77/79).For the identification of benign and malignant lesions,the sensitivity of 18F-FDG PET/CT was 92.9％ (65/70),specificity was 7/9,accuracy was 91.1％ (72/79),positive predictive value was 97.0％ (65/67),and negative predictive value was 58.3 ％ (7/12).Conclusions 18 F-FDG PET/CT can detect and identify most of kidney tumors.Whole-body checking and comprehensive evaluation on kidney cancer patients are still the main advantages of PET/CT.

Objective To study the image examination of renal injuries and discuss renal explorative indications so as to spare the kidney or nephron as much as possible and improve curative rate of diagnosis and treatment. Methods An analysis was done on 286 cases that included 231 cases with close injury, 54 with open injuries, one with iatrogenic injury and 91 with combined injuries. Of all, 212 cases were examined by B-ultrasonography, 163 by CT and 132 by intravenous urography(IVU) and 6 by digital subtraction angiography(DSA); 202 cases were treated with conservative treatment and 84 with operation. Results The diagnostic positive rates of IVU, B-ultrasonography and CT were 67.4%, 72.2% and 87.7%, respectively. Among the operation cases, 42 cases were treated by renal repair, 12 by partial nephrectomy and 30 by nephrectomy. The operation rate was 29.4% and the nephrectomy rate 35.5%. Interventional treatment of the kidney was carried out in three cases. Conclusions For renal injury cases, the first and most important step is to evaluate the injury condition so as to correctly determine whether an operation exploration is needed. The injury conditions and severity are mainly determined by the image examinations that change according to injury cause, injury type and clinical symptoms. Renal exploration or not, and the operation time exert great influence on renal reservation rate and complication rate.

Objective To observe the pathological changes of major organs in rats with acute Dysosma versipellis poisoning and investigate the toxic mechanismand the injuries of target tissues and organs. Methods Forty Sprague-Daw ley (SD) rats were random ly divided into three experimental groups, which were given the gavage with 0.5, 1.0 and 2.0LD50 doses of Dysosma versipellis decoction, and one con-trol group, which was given the gavage with 1.0LD50 dose of normal saline. The rats were sacrificed 14 days after Dysosma versipellis poisoning and sam ples including brain, heart, liver, lung, and kidney were taken. After pathological process, the pathological changes of the major organs and tissues were observed by light microscope and electron microscope. The experimental data were statistical analyzed by x2 test. Results The observations of light microscopy: loose cytoplasmof neurons with loss of most Nissl bodies;swelling of m yocardial cells with disappearance of intercalated disk and striations;hepato-cellular edema with ballooning degeneration; and swelling epithelial cells of renal proximal convoluted tubule with red light coloring protein-like substances in the tube. The observations of electron microscopy:the structures of cell mem brane and nuclear mem brane of neurons were destroyed;cytoplasmof neurons, obvious edema;and most organelles, destroyed and disappeared. The mortalities of rats after acute poi-soning of the four groups increased with doses (P<0.05). Conclusion Acute Dysosma versipellis poisoning can cause multi-organ pathological changes. There is apositive correlation between the toxic effect and the dosage. The target tissues and organs are brain (neurons), heart, liver and kidney.