Objective To discuss the relationship between the expression of programmed death-1 (PD-1) in liver with traditional Chinese medicine (TCM) syndromes and pathological diagnosis in chronic hepatitis B.Methods 156 CHB patients treated in our hospital of infectious diseases department were recruited as an observation group. Based on the principle of informed voluntary and approved by the ethics committee, liver biopsy was adopted to make clear liver tissue pathology. According to TCM classification criteria, CHB patients were divided into five groups: a blood stasis group, a damp heat resistance group, a liver and spleen deficiency group, a liver and kidney yin deficiency group, and a spleen and kidney yang deficiency group. In the same period, 12 healthy persons were recruited as a control group. The PD-1 expression was detected with immunohistochemical SP method, and the correlation between expression of PD-1 in liver tissue and TCM syndrome type and liver pathology was analyzed.Results Different degrees of positive cell expression were found in the liver tissue. With the liver inflammation and fibrosis severity, the number of PD-1 positive cells also increased. The PD-1 expression levels varied with mild, moderate, and severe CHB patients (0.24 ± 0.03, 0.36 ± 0.05 vs. 0.43 ± 0.05) , which were statistically significant (P<0.05) . PD-1 expression levels also varied among different TCM type CHB patients, of which, PD-1 expression of blood stasis type was the highest (0.35 ± 0.04), while the liver and spleen deficiency type was the lowest (0.23 ± 0.03).Conclusion The expression levels of PD-1 has a certain correlation with the patients illness, chronic mechanism, and TCM syndromes. CHB patients can be treated by controlling the expression of PD-1.

Objective To study the clinical and pathologic features, diagnosis, treatment and prognosis of splenic marginal zone lymphoma (SMZL). Methods We reported the detailed clinical and pathologic presentation of a patient with SMZL, and monitored fellow-up to 16 years. Results Patients present with splenomegaly. SMZL usually involve bone marrow, peripheral blood and hilar splenic lympha nodes. Peripheral lymph nodes and nonhematolymphoid organs can be involved as well, but to a lesser extent.Microscopically, tumor cells are small to medium in size, with dispersed chromation. Tumor cells are slgM(+),CD+20, CD+79a,, bcl-2(+), CD-3, CD-5, CD-10, CD-23 and CyclinDl(-). Conclusion SMZL is a rare low-grade B-cell lymphoma with an indolent clinical course. Spleneetomy and chemotherapy are effective treatment but SMZL cannot be completely cured and may transform to large B-cell lymphoma at last.

0.05)],which less than in control group [(4.614?1.683) IU/cm,(0.119?0.068) IU/cm,(564.2?53.8) ?m Pa

Animals ; Cold Temperature ; adverse effects ; Heart ; physiopathology ; Inflammation ; physiopathology ; Myocardium ; metabolism ; Oxidative Stress ; Particulate Matter ; adverse effects ; Rats

Objective To explore the similarities and differences between finger photoplethysmogram (PPG) and CSI in monitoring the depth of anaesthesia in Chinese adults under general anaesthesia. Methods Ninety-three patients, ASA ⅠorⅡ, aged 20-67, under general anaesthesia were enrolled. Anaesthesia was induced with target-controlled infusion (TCI) of propofol. The initial TCI concentration of propofol was set at 0.5 mg·L-1 followed by increments of 0.5 mg·L-1 at 3-min interval until the score of Modified Observer's Assessment of Alertness/Sedation Scale (MOAAS)reached 0. PPG and CSI were continuously monitored and their values were recorded every 2-4 seconds. MOAAS was recorded every 30 seconds to evaluate the sedation level in the study period. ResultsFor the periodfrom pre-induction to pre-intubation, the difference of photoplethysmogram amplitudevalues had statistical significance between level 4 and level 3, level 3 and level 2 of MOAAS (P<0.05). CSIvalues declined along with the decrease of MOAAS levels and were statistically different between every two neighboring levels of MOAAS (P < 0.05). Photoplethysmogram amplitude (PPGA) and pulse beat interval (PBI) values showed significant differences before and after intubation, pre- and post-incision (P < 0.05). Conclusions PPGA and PBI appear to be suitable to monitor the nociceptive component of balanced general anesthesia , while the CSI exhibits a good performance in monitoring the sedation or hypnotic component of balanced general anesthesia , thusthe combination of PPGA and CSI would benefit the monitoring of the adequacy of depth of anaesthesia.

Objective To study the features of CT and MRI diagnosis of intracranial germ cell tumors ,and to improve the un-derstanding of its imaging findings .Methods Fifteen cases of intracranial germ cell tumors proved by pathology and follow-up were retrospectively analyzed .Results Among the 15 cases with intracranial germ cell tumors ,9 cases in pineal body , tumours showed like-round masses,the margin of the masses were well defined .CT was slightly high density,MRI revealed isointense or hypointense signals on T1 weighted and homogeneous hyperintense signals on T 2 weighted image without edema around tumors and homogeneous en-hancement.One cases in CSF spread.Four cases were identified in the saddle-up area, among the 2 cases was cystic,1 cases was sol-id-cystic and 1 cases was solid,CT was isointense or high density in solid,low density in cystic,without edema around tumors.MRI re-vealed slight-hypointense signals on T 1 weighted and hyperintense signals on T 2 weighted image clearly enhanced in solid , cystoid with-out enhance .In the other 2 cases of intracranial germ cell tumors in the basal ganglia region ,CT was inhomogeneous high density ,inho-mogeneous signals on T2 and T1 weighted image, inhomogeneous enhancement .Conclusions Intracranial germ cell tumors show char-acteristic manifestations on CT and MRI,according to location,shape,signal,age characteristic,which is helpful in diagnosis and differ-ential diagnosis and guide treatment plan .

Objective To discuss the diagnosis and management and prevention of spontaneous renal allograft rupture. Methods A retrospective analysis of 12 spontaneous renal allograft rupture was conducted. Clinical presentations were similar in all patients: sudden pain and swelling over the graft and declining blood pressure accompanied by anufia. Color-ultrasound combined with clinical manifestation had higher sensitive in detecting a case. Eleven cases were performed emergency operation, 3 of them lost their kidneys, 8 of them were performed transplant-preserving operation,2 cases lost their allograft because of rerupture of the kidney. Conservative therapy was carried on 1 case. Results Five cases of transplant nephrectomy were given hemodialysis to maintain, 6 eases who had accepted surgery to retain kidney transplantation and 1 case of using conservative treatment were cured and discharged. Conclusions Acute rejection and acute tubular necrosis are the main causes of spontaneous renal allograft rupture. Color-ultrasound combined with clinical manifestation have higher sensitive in detecting a case. As soon as possibly adopting internal medicine, surgery for a joint deal with the breakdown of renal aUograft rupture is important.Prevention should begin with the removal of the kidney, operation of the renal graft, rational use of immunodepressants, and early management of transplant rejection.

Objective To investigate the effectiveness of ultrasound in evaluating the degree of xerostomia in the patients with nasopharyngeal carcinoma ( NPC) receiving intensity?modulated radiotherapy (IMRT). Methods A total of 30 NPC patients who were admitted to our hospital from May 2013 to December 2014 were enrolled in this study. The degree of xerostomia in these NPC patients was scored according to the Radiation Therapy Oncology Group scoring criteria. Color Doppler ultrasound was used to measure the peak systolic blood flow velocity of the parotid gland and submandibular gland and the changes in vascular diameter of the parotid gland in the NPC patients before, during, and after IMRT. The correlation between each parameter and the degree of xerostomia was determined by analysis of variance. Results In the 28 NPC patients included in the statistical analysis, the degree of xerostomia during IMRT was significantly higher than that before IMRT ( P=0024 ) , and the degree of xerostomia at 3 months after IMRT was significantly lower than that during IMRT ( P=0035) . The peak systolic blood flow velocity of the parotid gland and submandibular gland and the proportion of patients with decreases in vascular diameter of the parotid gland during IMRT were significantly higher than those before IMRT ( P=0001 and 0003;P=0001);the above parameters at 3 months after IMRT were significantly lower than those during IMRT ( P=0008 and 0012;P=0001) . During IMRT and after IMRT, the degree of xerostomia was significantly correlated with the peak systolic blood flow velocity of the parotid gland ( r=0563, P=0026;r=0409, P=0031) . Conclusions Ultrasound can be used as a noninvasive detection for the hemodynamic changes in the parotid gland, and it has a certain clinical reference value for evaluating the degree of xerostomia in NPC patients during and after IMRT.

Objective To compare the dose distribution between three dimensional conformal radiothera -py(3DCRT) and simplified intensity modulated radiotherapy ( sIMRT) for middle-third esopheagal cancer .Meth-ods Twenty middle-third esopheagal cancer patients were enrolled in this study .Dosimetric values for sIMRT and 3DCRT were calculated for total dose of 66 Gy using 2 Gy/day.The parameters included the conformal index (CI),homogeneity index(HI),mean dose and hot spot(V105%)for the planned target volume(PTV)as well as the monitor units(MUs)for plan efficiency,the mean dose(Dmean)for the organs at risk(OAR).The percentage of the normal lung volume receiving≥30,>20 and >5 Gy(V30 Gy,V20 Gy and V5 Gy)were evaluated to deter-mine lung toxity.Results sIMRT achieved significant better Dmin ,Dmean,V105%,HI,CI and spinal cord than 3DCRT(P<0.05).The normal lung V30 Gy and V20 Gy of 3DCRT and sIMRT were 11.61 ±3.68 vs.10.33 ± 3.02(P=0.010)and 23.37 ±8.38 vs.18.89 ±4.45(P=0.001),respectively.Comparable sparing of normal tissue including heart and the normal lung V 5 Gy with both two plans .The number of MU was 542 .24 ±76 .32 for 3DCRT and 530.8 ±97.13 for sIMRT(P=0.677).Conclusion sIMRT provides favorable tumor coverage , homogeneity and conformity and can get better normal lung sparing than 3DCRT.However sIMRT is not superior to 3DCRT in terms of treatment efficiency .

Objective To investigate the effects of intense pulse light(IPL)on the content of colla- gens and mRNA expression of procollagen in BALB/c mouse skin.Methods The BALB/c mice dorsal skin was irradiated by IPL.Skin specimens were taken at different time points after irradiation.Histopatho- logical changes were observed by hematoxylin-eosin-staining,quantitative assessment of collagenⅠand collagenⅢwas performed with immunohistochemical staining,and mRNA expression levels of procollagen were de- tected by RT-PCR.Results After the irradiation,no obvious change was observed for the staining intensity of collegen at 1 week;however,the thickening of dermis began at 2 week,and continued until 8 week.The staining of collagenⅠandⅢwas also stronger in IPL-irradiated regions than in sham-irradiated areas at 2 week(P