SUMMARY Lymphoma is a systemic disease. It is not uncommon to be found involved in digestive or central nervous system. However, lymphoma involved in these two systems at the same time is rare. The clinical feature of a case of lymphoma with gastrointestinal bleeding and limbs weakness was investigated and the literature was reviewed. The patient came to our hospital with melena and hematemesis. She was diagnosed as gastric ulcer by gastroscopy and biopsy showed lymphoma. Two days after she came to hospital, the patient presented with progressing limbs weakness. Magnetic resonance imaging (MRI) showed irregular abnormal signals in T2-T4 vertebra, which was enhanced obviously. A strip abnormal signal could be seen in spinal cord and involved in neighboring centrum and ribbing. The lesion extended to paravertebral tissue. The final diagnosis was lymphoma involved in stomach and spinal cord. Diseases presented with both upper digestive tract bleeding and symptoms of central nervous system were rare, including malignancies, virus infection and some therapy. Lymphoma was one of the causes. On the other hand, spinal cord ischemia might occur after gastrointestinal bleeding. Thus, doctors should examine the patients carefully to diagnose these diseases.

Objective To investigate the clinical features, diagnosis and treatment of acute mesenteric isehe-mic disease. Methods Clinical data of 15 patients with acute mosenteric ischemic disease were analyzed retrospective-ly. Results Operation was performed on 14 patients and 1 patient received conservative treatment, 9 cases recovered and 5 died postoperatively. Conclusion Color ultrasound and selective angiography are effective examinations for early diagnosis of acute mesenterie ischemic disease. Early resection of necrotic bowel and application of anticoagulant post-operatively are effective to reduce the mortality. Conservative treatment is still effective for elective patient.

Objective:To evaluate the effects of human dental pulp stem cells-conditioned medium(HDPSCs-CM)on the osteogenic differentiation of human dental follicle stem cells(HDFSCs) in vitro.Methods:HDFSCs were in vitro cultured,purified and identified.CCK-8 assay was applied to evaluate the HDFSCs viability after 7 days cultured by HDPSCs-CM;the morphological changes of HDFSCs were observed;the osteogenic differentiation was studied by alkaline phosphatase(ALP) staining and alizarin red staining.The mRNA expression of POSTN,Col-Ⅰ,ALP,BSP and OPN was detected by Real-Time PCR.Results:Induced by HDPSCs-CM,HDFSCs exhibited several characteristics of cementoblast or osteoblast lineages.In the induction group the viability of HDFSCs was inhibited(P<0.05 or P<0.01),ALP staining was stronger and there were more mineralized nodules,the expression levels of POSTN,Col-Ⅰ,ALP,BSP and OPN were upregulated(P<0.05 or P<0.01).Conclusion:HDPSCs-CM can promote the osteogenic differentiation of HDFSCs.

Objective To investigate the effect of different sedation depth of anesthesia the BIS settings (BISis 45 and 55) to perioperative hemodynamic. Methods Thirty-two patients were randomly divided into two groups. Through closed-loop target controlled infusion technology, depth of sedation anesthesia in A:the BIS=45, and in B: the BIS=55.12 time points(i.e. before operation, tracheal intubation instant, operation beginning, 20, 40,60,80,100 and 120 minutes after operation beginning, operation accomplishment point, tracheal catheter pulling out point, before patient′s carried out of operation room)perioperativenoninvasivemean arterial blood pressureandheart rate wererecorded. Results Themean arterial blood pressurebetween the two groups at time point T2,T11 was significantly different. Within group B,compared with T1, there wassignificantdifferenceat T2,T11. Heart ratein group B at T5and T10increasedsignificantly compared with A.Within group B,heart rate at T5,T6 increased significantly compared with that at T1. Conclusion Compared with BIS 55, the sedation anesthesia depth of BIS 45 can better keep stable of blood pressureandheart rate.

There were some shortcomings for traditional teaching mode of nutrition and food hygiene course, such as many teaching contents and little teaching time, students much passively learning and little active learning. We explored the combination of the WeChat and the TBL teaching to conduct the flipped classroom to solve the deficiency. The teaching pattern was conducted in 60 students majoring in preventive medicine from Grade 2012. The learning task of nutrition and food hygiene was released on the WeChat before the class. Students learned knowledge in the form of discussion based on case in the class. After the class, the discussion, answer the question and test were conducted on the WeChat. The survey showed that 85% of the students were satisfied with teaching pattern,especially satisfied with its role of broadening students' knowledge and vision, improving their autonomous learning ability, teamwork ability, and their ability to analyze and solve problems.

Objective To investigate the specific application of ergonomics for design of operation field in sanitary train. Methods The use of ergonomics theory, the layout of operation field, personnel operating capacity, environmental comfort and operation security were analyzed, surveyed and discussed. Results The principles and guidelines for design of opera- tion field in sanitary train were proposed in order to make full development the efficiency of "operator-equipment-environ- ment" mode. Conclusion The application of ergonomics for design of operation field in sanitary train can be improved the rationality of the layout of field of operation, environmental comfort and work efficiency.

Objective To investigate the effect of natural killer (NK) cells treated by serum of severe preeclampsia patient on the function of endothelial cells.Methods Fifteen patients with severe preeclampsia and 15 normal pregnant women from the Obstetrics department,Shengjing Hospital,China Medical University were admitted into this case-control study from January 1,2006 to December 31,2008.NK cells from healthy non-pregnant woman were incubated with 20% serum from severe preeclampsia patients or normal pregnant women for 20 hours.Then,human umbilical vein endothelial cells ( HUVEC) and serum-treated NK cells were co-incubated for 24 hours.Apoptosis of HUVEC was checked by flow cytometry and electronic microscope.Endothelin-1 (ET-1) levels in the supernatants of HUVEC and NK cells were examined by radioimmunologic method.Results In severe preeclampsia group,the percentage of early apoptosis cell (Annexin V-FITC+ /PI+ ) was (23.81±4.79)%,that of late apoptosis cell (AnnexinV-FITC+/PI+ ) was (3.29±1.04) %,while those were (16.59±5.13)% and (2.24±0.72)% respectively in normal pregnant group (P＜0.01).There was no significant difference in dead cells (Annexin V-FITC- /PI+ ).Under electronic microscope,typical morphologic changes of apoptosis were shown in severe preeclampsia group.Level of ET-1 in

Objective To analyze the clonal gene rearrangement and complementarity determining region 3 (CDR3) repertoire of TCR β-chain in fine needle aspiration biopsy (FNAB) specimens of lymph node metastasis in patients with breast cancer. Methods The TCR CDR3 region genes of 24 TCR Vβ subfamilies were amplified by utilizing RT-PCR technology, and the CDR3 lengths of TCR β-chain were analyzed with gene scan technology for 2 cases with lymph node reactive hyperplasia and 3 patients with lymph node metastasis of breast cancer. The clonality of T cells presumed by spectra typing was further confirmed by CDR3 sequencing. Results TCR β-chain presented specific repertoire skewing in metastatic lymph node,and only 3-5 TCR Vβ subfamily of T cells were identified, respectively. Clonal expanded T cells, including oligoclonal, polyclonal patterns, in one or more Vβ subfamilies were found in all cases. The oligoclonal expanded T cells had different CDR3 amino acid sequences. Conclusion There are characteristic T cells cloning proliferation and selected usage of TCR Vβ subfamily T cells could be found in metastatic lymph node.The sequences of CDR3 in different TCR clone proliferation are mostly different.

protrusion measured by ultrasound for diagnosing bladder outlet obstruction.Methods A literature search of medline (1966.1-2011.6),embase(1984.1-2011.6),CNKI (1994.1-2011.6) and WEIPU Data (1989.1-2011.6) from 1999 to 2009 was performed by two reviewers independently.QUADAS items was applicated to assess trial quality.Golden standard was BOOI measured by urodynamics (BOOI more than 40 indicates bladder outlet obstruction).Heterogenous studies and meta-analysis were conducted by Meta-Disc 1.4 software.Results Totally 6 studies was included at last,involving 682 subjects.No threshold effect was found,but there was heterogeneity due to other factors.The meta-analysis showed that the sensitivity was 70.8 ％,specificity was 87.6 ％,positive LR was 5.132,negative LR was 0.303,the diagnostic OR was 22.18,the area under SROC curve was 0.8723 and Q index was 0.8028.Conclusions Intravesical prostatic protrusion measured by ultrasound is a good index for diagnosing bladder outlet obstruction in patients with benign prostate hyperplasia when intravesical prostatic protrusion is equal or more than 10mm.

The non-specific accumulation and release of drugs are the main factors affecting the therapeutic effect as well as causing toxic side effects of chemotherapeutic drugs. Nowadays, the application of nanotechnology and responsive drug release is an important strategy to improve the tumor-specific accumulation of drugs and reduce their side effects. In this study, an α-enolase targeted peptide (ETP)-modified polyethylene glycol poly-lysine block copolymer loaded with oxaliplatin prodrug was synthesized first, and then, polymer-coating Fe₃O₄ nanoparticles were prepared by phase transfer dialysis method to improve the blood circulation stability and tumor targeting of oxaliplatin. At the same time, the physicochemical properties, reductant-responsive drug release, cellular uptake, tumor targeting and other biological functions of ETP modified oxaliplatin-loaded Fe₃O₄ nanoparticles were studied in vitro and in vivo. First, the results of reductant-triggered drug release study showed that the drug-loaded nanoparticles could achieve rapid release of more than 80% of the prototype oxaliplatin within 3 h under the reduction conditions simulating the tumor cytoplasmic microenvironment. Secondly, the results of flow cytometry showed that the modification of ETP could increase the ratio of cellular uptake of drug-loaded nanoparticles in tumor cells, and the way that drug-loaded nanoparticles endocytosed by tumor cells were mainly through the energy-dependent and receptor protein and fossin-mediated endocytosis pathway. The animal procedures were approved by the Institutional Animal Care and Use Committee of School of Pharmacy of Fudan University. Moreover, the results of pharmacokinetic experiment showed that the area under the curve (AUC_0-∞) of oxaliplatin could be significantly increased by nano-formulation which was about 5 times than that of free oxaliplatin. Besides, the pharmacokinetic results also showed that the drug-loaded Fe₃O₄ nanoparticles constructed by covalent linkage and chelation had good overall stability in vivo. Finally, the in vivo imaging results showed that ETP modification could increase tumor accumulation of drug-loaded nanoparticles, which would be conducive to the efficacy of oxaliplatin in tumor lesions. In summary, the oxaliplatin-loaded Fe₃O₄ nanoparticles with the capability of reductant-responsive drug release have good drug release characteristics, blood circulation stability and tumor targeting ability, and have the potential to improve the anti-tumor therapeutic effect of oxaliplatin.