Anticoagulants ; therapeutic use ; Blood Coagulation Tests ; Blood Component Transfusion ; methods ; Disseminated Intravascular Coagulation ; blood ; diagnosis ; etiology ; therapy ; Female ; Fibrin Fibrinogen Degradation Products ; analysis ; Fibrinolysis ; Fibrinolytic Agents ; therapeutic use ; Heparin, Low-Molecular-Weight ; therapeutic use ; Humans ; Infant, Newborn ; Intensive Care Units, Pediatric ; Male ; Platelet Count ; Predictive Value of Tests ; Sepsis ; complications

Many reports have documented a role of insulin and insulin-like growth factor 1 (IGF-1) as growth factors in many cancers. The sequence and structure of insulin receptor (IR) and IGF receptor (IGF-1R) are highly similar. Both receptors are overexpressed in leukemia cells.Studies indicate that insulin can enhance the signal of the phosphoinositide 3-kinase/Akt pathways by activating IR or IGF-1R or hybrid IR/IGF-IR receptors, resulting in the proliferation of leukemia cells. High concentration of insulin may inhibit the growth of leukemia cells, the mechanism of which remains to be unclear. Inhibiting IR and IGF-IR can diminish the proliferation of leukemia cells. Therefore, the assumption of IR/IGF-1R as a potential therapeutic target in leukemia appears reasonable. This article summarizes the recent advancement associated with the signaling pathway of insulin effecting the proliferation of leukemia cells.
Cell Line, Tumor ; Cell Proliferation ; Humans ; Insulin ; Insulin-Like Growth Factor I ; metabolism ; Leukemia ; metabolism ; pathology ; Receptor, Insulin ; metabolism ; Signal Transduction

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Tracheotomy ; methods ; Young Adult

Objective To assess the diagnostic value of MRI on multiple focal nodular hyperplasia (FNH) of the liver. Methods MR images of 9 cases with pathological-confirmed multiple FNH were retrospectively analyzed. MRI features of the lesions were correlated with pathological findings. Results Multiple FNH was considered in all these 9 cases. Among them, the primary diagnosis was FNH in 5,hepatic adenoma in 3 and fibrolamellar hepatocellular carcinoma in 1 case. A total of 31 lesions were detected in the 9 cases. On T2WI, 19 lesions presented slightly high-signal intensity, and the other 12 presented iso-signal intensity. On T1WI, 12 lesions presented slightly low-signal intensity, 7 presented iso-signal intensity, and the other 12 presented high-signal intensity. On opposed-phase, the signal intensity of 1 lesion dropped unevenly. After bolus injection of contrast agent Gd-DTPA, in hepatic arterial phase 18 lesions showed mild to marked heterogeneous enhancement, 11 showed marked homogeneous enhancement, 1 showed moderate ring-like enhancement, and the last one did not have obvious enhancement In portal venous and delayed phase, all the lesions turned to iso- or slightly high-signal intensity gradually. Sixteen of 31 lesions presented central scar, which demonstrated mild star-like enhancement in delayed phase. Conclusion Multiple FNH presented certain MRI features, which contributed to the preoperative diagnosis.

ObjectiveTo investigate the possible pathogenesis of EB virus (EBV) latent membrane protein 1 in inducing systemic lupus erythematosus (SLE).MethodsThe mRNA expression levels of LMP1 and apoptosis-related genes bcl-2,bax in SLE patients and healthy controls were detected by real-time fluorescence quantitative polymerase chain reaction (PCR).The serum BAFF levels of SLE patients and normal healthy controls were detected by ELISA.2 test was used for positive rate analysis,2-△△Ct method was used for comparing the gene expression level,and Student-Newman-Kqeuls method was used for pair-wise comparison between the means.Results① The positive rate of LMP1 expression in 67 SLE cases was 25％,which was significantly higher than the 11％ in 65 healthy controls (P＜0.05).② The 2-△Ct value of bcl-2 mRNA expression level of SLE patients was 0.0257,1.41 times to that (0.0183) of healthy controls and the difference was statistically significant.③ The 2-△Ct value of bcl-2 mRNA expression level of LMP1 positive SLE patients was 0.0427,1.98 times to that of LMP1 negative SLE patients (0.0217),the difference was statistically significant.④ The serum BAFF levels of LMP1 positive SLE patients,LMP1 negative SLE patients,LMP1 positive healthy controls and LMP 1 negative healthy controls were ( 106± 15 ),(82± 19),( 68±19),(64±17) μg/L,respectively.There were significant differences between serum BAFF levels of LMPl-positive SLE patients and other groups(P＜0.0l ).There were significant difference between serum BAFF levels of LMP1-negative SLE patients and the control groups (P＜0.01).ConclusionEBV may induce and/or promote SLE by LMP1 through apoptosis-related genes bcl-2 expression and induction of B lymphocytes that produce BAFF,all these mechanisms can prolong the infected auto-reactive B lymphocytes survival.

ObjectiveTo evaluate the curative effect of reconstruction of the hand and foot defects with bones and tendons exposure using free medial sural artery perforator flap(MSAP). MethodsRadiographs of 2 cadavers injected with a modified lead oxide-gelatin mixture were digitally analyzed. Between April 2007 and December 2010, thirty-four patients with soft tissue defects in the distal limb were treated with the free MSAP flap transplantation. The sizes of the defect ranged 6 cm × 4 cm-13 cm × 8 cm, and the flaps ranged 7 cm× 5 cm-14 cm × 9 cm. These clinical cases included 25 hands and 9 feet, all of them with bones and tendons exposure.In these defects,twenty-two were clean,twelve got infections.In our cases, twenty-three flaps were nourished with single perforator vessel and else 11 with two;perforator vessel fifteen flaps were dissected one superficial vein to anastomose with that of the recipient sites in addition to accompanying vein anastomosis;The sensation of 9 flaps recovered the hands were reconstructed with cutaneous nerve anastomosis. ResultsA partition of the calf skin blood vessels,and three-dimensional reconstruction image of the sural artery were obtained.All flaps survived,five of them appeared partially violet and bubbles. Followed up 6-21 months, the cosmetic results were satisfactory and without apparent bulkiness.The flap colors were similar to recipient sites. The flap senses reconstructed with neural anastomosis recover to S2-S3. ConclusionThe new flap is very suitable to repair the soft tissue defect in the distal limbs,because the fairly constant perforator vessel,the reliable blood supply and the cosmetic shape of the MSAP flap are all advantages of it in addition to no damage to low leg chief artery and gastrocnemius.

Objective To provide anatomical landmarks with which to facilitate flap dissection,we studied the perforator artery of the dorsal forearm including its source,quantity,origination,caliber,variation and pedicle length. Methods Ten fresh cadavers were injected with a modified lead oxide-gelatin mixture,and three-dimensional graphics of the perforator vessels of the dorsal forearm were reconstructed with a computed tomography. In addition, twenty upper extremity specimens were injected with red latex via the axillary artery.The integument of the forearm was dissected,and perforators were identified,including type,course,size and location were documented.Surface areas were measured with Scion Image. Results The average number of the posterior interosseous artery cutaneous perforators in the dorsal forearm was (5±2),the average outer diameter of the perforator artories was (0.5 ± 0.1) mm,and the pedicle length was (2.5 ±0.2) cm.The average cutaneous vascular territory was (22.0 ± 15.0) cm2.The dorsal branch of the anterior interosseous artery dispersed on the wrist dorsum or the distal third of the dorsal forearm. It's average diameter was 0.8 mum. Conclusion The free transplantation of the posterior interosseous perforator artery flaps or rotary flap pedicled by the dorsal branch of the anterior interosseous artery for defect reconstruction are feasible.

Objective:To investigate the uncertainty in illness of patients with systemic lupus erythematosus (SLE) and to explore the influencing factors and humanistic care strategies.Methods:The general situation questionnaire and the uncertainty in illness scale were used to investigate the influencing factors of uncertainty in illness and positive humanistic care strategies in patients with SLE.Results:Patients with SLE were at a high level of uncertainty in illness,of which the unpredictability and uncertainty scored higher but lack of information and complexity were of lower scores.Educational status,family income,and self-perceived severity of disease were the main influencing factors of uncertainty in illness (P ＜ 0.05).Conclusion:Patients with SLE were at a high level of uncertainty in illness,mainly from the unpredictable progress of disease and prognosis and unclear symptoms of the disease.Educational status,family income,and self-perceived severity of disease were the main influencing factors of uncertainty in illness.The clinical staff should pay attention to uncertainty in illness among patients with SLE and adopt positive humanistic care measures so as to reduce the sense of uncertainty in illness.

Objective:To investigate the damaging traits of cognitive function in late-onset depression.Methods:In this cross-sectional study,30 elderly out-and in-patients whose first onset of major depression occurred at 60 years of age and older were included as the case group,and 30 age-and gender-matched normal elderly people were included as the controls.The diagnoses of moderate to severe depressive episode or recurrent depression were made according to the International Statistical Classification of Diseases and Related Health Problems,Tenth Revision (ICD-10) diagnostic criteria.The Wisconsin Card Sorting Test (WCST),Stroop Test and Verbal Fluency Test (VFT) were used to assess attentional set shifting,attentional inhibition and working memory.The severity of depression was evaluated with the Hamilton Depression Scale-17(HAMD-17).Results:The performance scores of errors,perseverative responses,perseverative errors,percent of perseverative errors in the WCST were significantly higher in the patient group then in the control group[(61 ± 23) vs.(41 ± 25),(44 ± 27) vs.(27± 19),(36 ± 20) vs.(23 ± 16),(28 ± 15) vs.(19 ± 11),P ＜ 0.01].The scores of conceptual level responses [(36±24) vs.(54 ±26)],the correct scores of consistent group in Stroop test[(19 ±3) vs.(20 ±2)] and the scores of VFT in WCST[(10 ±2) vs.(11 ±2)] were lower in the patient group than in the control group (Ps ＜0.01).The scores of perseverative responses in the WCST were positively correlated with retardation factor scores(r =0.38,P ＜ 0.05).The correct scores of consistent group in the Stroop test were negatively correlated with retardation factor scores(r =-0.41,P ＜ 0.05).The scores of VFT were negatively correlated with retardation factor scores(r =-0.52,P ＜ 0.01).Conclusion:There may be impairment of cognitive function in late-onset depression,especially severe executive dysfunction.

ObjectiveTo explore the methods of low temperature preservation for alginate-polylysine-alginate (APA) microcapsules.MethodsAPA microcapsules were prepared with static electricity, and underwent hypothermal treatment respectively through methods of program control, gradient by icebox and put in liquid nitrogen directly, finally preserved in liquid nitrogen. The form and permeability of APA microcapsules were checked after rewarming.ResultsThe rates of integrity, crenation and damage were (91.2±1.57)%, (3.1±0.81)% and (5.7± 2.62 )% in the program control group; (85.3±1.42)%, (5.2±0.74)% and (9.5± 3.81 )% in the gradient by icebox group; (14.5±1.57)%, (84.1±3.47)% and (1.4±2.62)% in the directly put in liquid nitrogen group. The membrane permeability of full APA microcapsules after frozen and reworming was not changed obviously.ConclusionThe program control method can preferably preserve APA microcapsules at low temperature and keep them having normal form and permeability.