Objective To analyze the clinical and pathologieal characteristics of IgA nephmlogy secondary to primary sj(o)gren's syndrome(pSS).Method The clinical and pathological data of 8 patients with pSS and IgA in Changzheng Hospital from 2004 to 2009 were analyzed.Results The average age of seven female and one male was (44±8) years old.Five patients presented with edema and proteinuria.Eight patients presented with microhematuria.The average 24-hour proteinuria was (3±4) g.Two patients had hypertension.Serum creatinine levels of two patients were higher than normal level,the others'were normal.Light microscopy examination showed three patients were mild mesangial proliferation with Lee's classification grade Ⅰ;five patients had global sclerosis with Lee's classification grade Ⅱ,Ⅲ and Ⅳ.Positive IgA was mainly found under immunofluorescence microscopy.Electronic microscopy showed no electron-dense deposits.Conclusion IgA nephrology secondary to pSS is different from primary IgA nephrology under immunofluorescence microscopy.

Objective To investigate the CT characteristics of retroperitoneal extra-adrenal paraganglioma(PGL).Methods CT findings of 11 patients with pathologically confirmed retroperitoneal extra-adrenal PGL were analyzed retrospectively,and the relevant literature was reviewed.All patients received plain CT as well as contrast-enhancement CT scan.Results All of the 11 tumors were located in the retroperitoneal space around large blood vessels,including 2 functional and 9 unfunctional extra-adrenal paragangliomas.Eight of 11 cases were benign tumors which presented as round or oval masses with sharp margins,separated from surrounding structures clearly;while the rest 3 cases,which with indistinct edge,even more with the invasion of surrounding structures (renal artery,renal venous and pancreas),were confirmed to be malignant.Most of the tumors were heterogeneous on plain CT.It was common to see intratumoral necrosis or cystic degeneration in the tumors (9 cases),while hemorrhage or calcification was uncommon,which was found in 3 and 2 cases,respectively.Homogeneous intensity was only observed in 2 masses with diameter less than 4 cm.On contrast-enhanced CT image, the solid part of the tumors presented continuously significant enhancement.Dilated feeding artery was found in or around the masses (8 cases) in artery phase.Conclusion There are certain characteristics of retroperitoneal extra-adrenal paraganglioma on CT scanning, which are helpful for preoperative diagnosis and treatment of this disease.

Objective To study the expression of toll rexeptor-4 in patients with systemic infanunatory response syndrome(SIRS)and multiple organ dysfunction syndrome (MODS) induced by acute cerebral vascular disease(ACVD).Method Totally 153 ACVD patients,admitted to Departments of Neurology Medicine and ICU of the First,the Second and the Forth Hospitals of Jilin University from October 2005 to March 2006,were enrolled in this study.The patients were admitted to the hospitals within 3 days after onset,and were confirmed by CT or MRI.The 153 patients in the prospective study was divided into three groupa:ACVD group(n=60).SIRS group induced by ACVD(n=45),MODS group induced by ACVD(n=48).The diagnosis criteria accorded with the criterion set by the Forth Conference of Cerebrovuscular Disease in China.The exclusion criterion inchided:①patients with infeetion or inflammatory disease two weeks before the onset of AVCD;②patients with cardiac disease,including acute myocarditis,acute myocardial infarction,angina episodes,degenerative calcific valvular disease,and so on;③patients with use of hormone recently;④malignant tumor,autoimmunity system disease,liver disease,kidney disease and hematologic disease.The expression of TLR-4 mRNA gene of the nucleated cell in the peripheral blood in the ACVD patient was measured by using RT-PCR.Statistics methods of t test,q test and simplex factor analysis of variance have been used Statistical analysis was carried out by using T-test,one-way analysis of variances,and q-test.Results The expression of TLR-4mRNA obviously increased on the third day after onset of AVCD.Compared with ACVD group,the expression of TLR-4mRNA in SIRS group was significantly higher (0.61±0.13 vs.0.98±0.15,P＜0.01).Compared with SIRS group,the expression of TLR-4mRNA in MODS group was significantly higher(0.98±0.15 vs.1.32±0.38,P＜0.01).The expression of TLR-4mRNA had a increasing tendency with the severity of AVCD.The expression of TLR-4mRNA was higher in patients with higher MODS score(P＜0.01).In the MODS group,the expression of TLR-4 mRNA was higher in the fatal patients than that in the survivors(1.56±0.16 vs.1.32±0.26,P＜0.01).Conclusions The mechanism of ACVD.which causes SIRS and MODS,may be associated with excessive immunologic respun of the organism.

Objective To investigate the effects of integrin β1 gene expression inhibited by short hairpin RNA (shRNA) on invasion of pancreatic carcinoma PANC1 cells in vitro,and investigate the mechanism.Methods The eukaryotic expression plasmid of shRNA targeting integrin β1 gene ( integrin β1 shRNA) and control eukaryotic expression plasmid shRNA (c-shRNA) was constructed and was transfected into PANC1 cells.The cells without plasmid transfection were used as control.The expressions of integrinβ1,MMP 2,MMP 9 mRNA and protein were detected by real-time PCR and Western blotting.The invasive ability of PANC1 cells was observed with Transwell cell culture chamber.Results Integrinβ1 mRNA expressions in integrinβ1 shRNA group,c-shRNA group and control group were 0.0029 ± 0.0004,0.0131 ± 0.0009,0.0138 ± 0.0005 ; the expressions of integrinβ1 protein were 0.0159 ± 0.0062,0.3215 ± 0.0126,0.3107 ±0.0094; the inhibitory rate of integrinβ1 mRNA and protein expression in integrinβ1 shRNA group was (78.6 ±7.2 ) ％ and (92.9 ± 3.2) ％ ( P ＜ 0.01 ).But there was no difference between the c-shRNA group and control group (P =0.2999).Number of penetrating cells in integrinβ1 shRNA group decreased from 52 ±5 to 21 ±4( P ＜ 0.01 ) ; the expression of MMP 2 and MMP 9 mRNA decreased from 0.592 ± 0.073,0.847 ± 0.069 to 0.102 ± 0.034,0.273 ± 0.071 ; the expression of M MP2 and MMP 9 protein decreased from 0.225 ± 0.046,0.416 ±0.081 to 0.059 ±0.013,0.106 ±0.022(P ＜0.05).Conclusions Recombinant integrinβ1 shRNA expression plasmid can effectively inhibit the expression of integrinβ1 gene and suppress the invasion of PANC1 cells in vitro by down-regulating MMP 2 and MMP 9 gene expression.

Objective To investigate the effect of hepatopoietin Cn(HPPCn) on liver stem cells.Methods In this study, WB-F344 cell line was used, and MTT and flow cytometry assay were conducted to determine cell proliferation and apoptosis.Transwell assay was used to test the migration of WB-F344 cells.A 2AAF-partial hepatectomy(PH) mouse model was used to observe the effect of HPPCn on liver stem cell proliferation in vivo.Results HPPCn enhanced WB-F344 cell proliferation and migration and activated the SphK1, Erk and Stat3 signal pathways.The analysis of the 2AAF-PH mouse model showed that oval cells in the experimental group far outnumbered those in control and the regeneration of the liver was improved post PH.Conclusion HPPCn can increase the liver stem cell proliferation and survival while promoting the regenenation of the liver by augmenting oval cell proliferation.

Objective To study the influence of transferring a dominant-negative Stat3 gene, Stat3?on colon cancer cells' proliferation and apoptosis in vitro. Methods Cell culture of human colon cancer cell line SW480 and transient transfection were used to evaluate the effect of transferring Stat3?to cancer cells. Cell proliferation, cell cycle and apoptosis were quantified by MTT and flow cytometry, respectively. The mRNA expression of Stat3's target gene cyclin D1 and bcl-xL was detected by reverse transcription polymerase chain reaction. Independent t tests were used for data statistics. Results 36 h after Stat3?plasmids transfection, proliferation of SW480 cells was significantly inhibited (t =5. 216,P = 0.006); cell proportion of G0/G1 phase increased from 40.37% to 67.25% and early apoptosis cells increased from 5. 34% to 24. 42% ; mRNA expression of cyclin Dl and bcl-xL declined significantly (t = 5.288,P=0.010;t=3.517,P=0.025). Conclusion Blocking Stat3 signaling pathway by transfection of Stat3?plasmid inhibits the proliferation and promotes apoptosis of colon cancer cells, which provides a experimental foundation of Stat3 targeted colon cancer gene therapy.

Objective To evaluate the diagnostic value of dermoscopy and reflectance confocal microscopy (RCM) alone or in combination for melanocytic nevus.Methods A total of 37 patients with clinically diagnosed melanocytic nevus were collected.Skin lesions were firstly examined by dermoscopy and RCM,then were resected to be subjected to histopathological examination for final diagnosis.The imaging features of melanocytic nevus were summarized.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of different skin imaging techniques were calculated,and the consistency was analyzed between skin imaging techniques and histopathological examination.Results Based on the dermoscopic and RCM findings,2 kinds of nevus cells with different morphological features were observed in the dermis of intradermal nevus.One kind of nevus cells was characterized by a nonfusional,highly-refractive round structure in the papillary dermis under RCM,and by a brown or light brown homogenous pattern under dermoscopy,which was observed in 5 skin lesions.The other kind of nevus cells appeared as irregular,highly-refractive cell clumps in the papillary dermis under RCM,and by a cobblestone or globular pattern under dermoscopy,which was observed in 31 skin lesions.For the diagnosis of melanocytic nevus,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of RCM combined with dermoscopy were 91.7％,87.5％,90.9％,97.1％ and 70％ respectively,those of RCM were 86.1％,75％,84％,93.9％ and 54.5％ respectively,and those of dermoscopy were 77.8％,87.5％,75％,96.3％ and 41.2％ respectively.All the diagnostic indices of RCM combined with dermoscopy were higher than those of RCM or dermoscopy alone,except that the specificity was equal to that of dermoscopy alone.RCM showed higher sensitivity,accuracy and negative predictive value,but lower specificity and positive predictive value compared with dermoscopy.There were no significant differences in the diagnostic yield in melanocytic nevus between RCM combined with dermoscopy or RCM alone and histopathological examination (x2 =0.25,0.57,P =0.63,0.45,Kappa value =0.72,0.53,respectively).However,a significant difference in the diagnostic yield in melanocytic nevus was observed between dermoscopy and histopathological examination (x2 =5.81,P =0.012).Conclusion RCM combined with dermoscopy shows higher diagnostic accuracy for melanocytic nevus compared with RCM or dermoscopy alone.

Humans ; Adenocarcinoma, Mucinous/pathology* ; Stomach Neoplasms/pathology*

OBJECTIVETo evaluate the clinical effectiveness of transurethral seminal vesiculoscopy (TUSV) combined with finasteride in the treatment of recurrent hemospermia.

METHODSThis study included 32 patients with recurrent hematospermia, with the disease course of 3 months to 4 years. After administration of finasteride at 5 mg/d for 2 weeks, the patients underwent TUSV for both exploration of the causes and treatment, followed by medication with finasteride at the same dose for another 2 weeks. Postoperative follow-up was conducted for observation of the outcomes and complications.

RESULTSTUSV was successfully accomplished in all the 32 cases, which revealed 16 cases of seminal vesiculitis, 10 seminal calculi, 1 seminal vesicle cyst, 2 seminal vesicle polyps, and 3 seminal vesicle abscess. The operative time was 20 to 51 (31.0 +/- 5.2) minutes. Postoperative complications included 1 case of acute epididymitis and 3 cases of breast discomfort within the first 4 weeks. No incontinence, urethral stricture, rectal injury, retrograde ejaculation, and sexual dysfunction occurred postoperatively. All the patients but 1 were followed up for 6 months to 2 years. Twenty-nine of the cases were cured, and 2 experienced recurrence.

CONCLUSIONTransurethral seminal vesiculoscopy combined with finasteride is safe and effective for the treatment of recurrent hemospermia.

Adult ; Endoscopy ; methods ; Finasteride ; therapeutic use ; Follow-Up Studies ; Hemospermia ; therapy ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

Objective Typical carcinoma(TC), atypical carcinoma(AC) and large cellul neuroendocrine carcinoma (LC-NEC) are rare pulmonary neuroendocrine tumor (PNET) possessing different pathological features , biological behaviors and clinical prognosis .The paper aimed to investigate the characteristic CT findings of rare pulmonary neuroendocrine carcinoma in comparison with pathological diagnosis . Methods A retrospective analysis was conducted on clinical data , CT findings and pathological results of 22 patients admitted in the Affiliated Hospital of Nanjing University of TCM from 2010 to 2016, followed by statistical analysis . Results Among the 22 cases, there were 9 females and 13 males, 12 cases of central type and 10 cases of peripheral type , 7 cases with calcifi-cations, 10 cases with focal necrosis , 6 cases with combined bronchial obstruction sign , 5 cases with lymph node metastasis , and 1 case with distant metastasis.TC was presented with younger onset age , while AC and LCNEC with older onset age (P=0.003).TC ten-ded to be central type (P=0.044), mainly charaterized by bronchial lumen nodules (P=0.005) with smooth edges (P=0.000) and often accompanied with obstructive pneumonia and atelectasis ( P=0.019) without pleural involvement .AC mostly belonged to central type , charaterized by multilobulated soft tissue masses , elongated or"iceberg"in typical ones , with rare obstruction signs and no obvi-ous pleural involvement.LCNEC was mostly peripheral, with lobulated lesion margin (P=0.000), no obvious obstruction signs, and frequent pleura involvement ( P=0.000 ) . Conclusion Rare pulmonary neuroendocrine tumors have certain characteristic clinical features and CT findings .TC has the youngest onset age , mainly characterized by bronchial lumen nodules with smooth edges and often accompanied with obstruction signs , while LCNEC has the oldest on-set age and tends to be peripheral , mostly without obstruction signs and with frequent pleura involvement .