Objective To study clinicopathologic features of ALK-positive large B-cell lymphoma.Methods The clinical data,histopathological characteristics,immunophenotype and fluorescence in situ hybridization (FISH) result of a patient with ALK-positive large B-cell lymphoma were analyzed and discussed combined with related literatures.Results A 30-years-old male patients with the left neck lymphadenectasis was studied.Histological evaluation revealed the tumor grew in sheets in the nodal,with round nuclei,dispersed chromatin,a single prominent central nucleolus and moderate amounts of eosinophilic to amphophilic cytoplasm.The neoplastic cells exhibited immunoblastic/plasmablastic morphology.Immunohistochemistry measurement showed that the tumor cells were marked positively by CD138,ALK-1,CD45RO,CD4,Perforin,CD117 and Kappa proteins,while negatively by CD3,CD8,CD20,CD30,CD38,CD57,CD79a,Pax-5,EMA and AE1/AE3 proteins.FISH test demonstrated the presence of ALK gene translocation.The patient was given 4 cycles of CHOP chemotherapy after surgery.However,the conditions deteriorated after 4 months.Now the patient continued to receive treatment.Conclusion ALK-positive large B-cell lymphoma represents a distinct variant of diffuse large B-cell lymphoma,and the tumor has special histological features along with a distinct immunophenotype and ALK gene rearrangement.

0.05). However, there was significant difference between the "open-window" or hemilaminectomy group and total laminectomy group. The time of returning to work and the rate of returning to previous work were 4.3 months and 84.6% in "open-window" group, 4.6 months and 86.4% in hemilaminectomy group and 4.4 months and 77.8% in total laminectomy group respectively. The height loss of involved disc spaces was discovered in the postoperative radiographs in all the patients. However, no segmental instability was found in the majority of these patients. Conclusion 1) "Open-window" or hemilaminectomy may achieve satisfactory long-term results for treatment of lumbar disc herniation. 2) No definite correlation exists between the height loss of involved disc space and segmental instability or nerve root entrapment. 3) Discectomy is still a reliable and effective surgical procedure for the treatment of lumbar disc herniation before the reliability of any disc replacement is confirmed in the long-term follow-up survey.

Objective To evaluate the clinical efficacy of domestic bisphosphonates (etidronate and alendronate) in the treatment of postmenopausal osteoporosis. Methods Eighty three patients with postmenopausal osteoporosis were divided randomly into three groups: group Ⅰ(37 cases),group Ⅱ(15 cases) and group Ⅲ(31 cases). Etidronate(400 mg/d) and placebo were given with intermittent cyclical therapy in group Ⅰ and group Ⅲ respectively, and alendronate(10 mg/d) was given continuously in groupⅡ for 9 months. Eeach group was given calcium agents(equal to elementary calcium 500 mg/d). Before and after treatment, the bone mineral density(BMD) was measured by dual energy X ray absorptiometry. The biochemical markers such as blood calcium, phosphate, alkaline phosphatase and urine calcium/creatinin were examined. Results After treatment the BMD of groupⅠ and groupⅡ wee increased obviously(P0.05). The BMD of group Ⅱ was increased more than that of groupⅠ(P

0.05).Their a verage values were 6.47?0.80,4.36?0.68,9.89?0.73,5.83?1.63, 3.55 ?0.69 an d 6.81?0.93 respectively. In the male and famale LRa-TC was 3.84?1.16 and 3.1 5?0.76(P0.05).Their average v alues were 5.44?1.03,4.09?1.58,3.75?0.75,4.20?0.84 and 7.70?1.13 respective ly. In the male and famale URa-PC was 7.14?1.16 and 6.62?0.88(P0 .05).Their average values were 6.06?0.91,3.20?1.48,4.52?0.69 and 8.53?0.98 r espectively. In the male and femal URa-PC was 7.49?1.01 and 6.94?0.74(P

Objective To study the influence of continuous blood purification(CBP)on the intra-abdomi-nal pressure (IAP ) and the gastrointestinal dysfunction of intra -abdominal hypertension (IAH ).Methods 80 patients with IAH were selected and divided into observation group and control group(n=40)according to random number table method.The observation group was given 3d CBP therapy.The control group was given conventional treatment.The mean arterial pressure (MAP ),IAP and abdominal perfusion pressure (APP ) were detected.The number of gastrointestinal symptoms was observed,sequential organ failure score(SOFA score)was used to assess the organ function of the two groups before and after treatment.Results The MAP,IAP,APP,SOFA score of the two groups before treatment had no statistically significant differences(P>0.05).The MAP of the two groups after treat-ment[(88.46 ±8.93)mmHg vs.(87.76 ±8.04)mmHg]had no statistically significant difference(P>0.05).The IAP[(9.02 ±1.06)mmHg]and SOFA score[(1.32 ±0.45)]of the observation group after treatment were signifi-cantly lower,the APP [(85.34 ±7.59)mmHg]was obviously higher than before treatment and the control group [(19.54 ±4.23)mmHg,(5.24 ±2.05)points,(70.76 ±6.43)mmHg],the differences were statistically significant (t=3.575,2.855,3.274,3.563,3.114,3.782,all P<0.05).Before treatment,the number of the gastrointestinal symptoms of the two groups[(44.56 ±8.53)times vs.(45.32 ±8.21)times]had no statistically significant difference (P>0.05).The number of gastrointestinal symptoms of the observation group after treatment [(6.54 ±2.24)times] was obviously lower than before treatment and the control group [(15.45 ±4.43)times],the difference was statisti-cally significant(t =3.022,P<0.05 ).The 30 d and 60 d survival rates of the observation group were 87.5%(35/40)and 65%(26/40),which of the control group were 80.0%(32/40)and 55%(22/40),although which of the observation group were higher than the control group,but there were no statistically significant differences(P>0.05 ).Conclusion CBP could significantly reduce the IPA of the patients with IAH,raise the APP,improve gastro-intestinal perfusion,reduce gastrointestinal symptoms,has positive significance to improve the gastrointestinal dysfunction.

BACKGROUND:Recent studies have found that adipose mesenchymal stem cells can inhibit immune responses of T cells, B cells and dendritic cells. But it is unclear whether adipose mesenchymal stem cells are able to regulate the immune responses of macrophages. OBJECTIVE:To observe the expression of interleukin-6 and tumor necrosis factorαin J774.1 cells co-cultured with adipose mesenchymal stem cells co-cultured. METHODS:Adipose mesenchymal stem cells at a density of 2×107 per wel were inoculated into the upper chamber of the transwel and 24-wel plates. Then, J774.1 cells were suspended with cellculture medium containing 1 mg/L lipopolysaccharide and planted into the lower chamber of the transwel and 24-wel plates containing adipose mesenchymal stem cells as co-culture group. Meanwhile, inactive J774.1 cells to lipopolysaccharide-activat J774.1 cells served as negative and positive control groups, respectively. After 48 hours, the J774.1 cells were col ected to extract the RNA samples. Then, mRNA expressions of interleukin-6 and tumor necrosis factorαwere measured by real-time quantitative PCR. RESULTS AND CONCLUSION:Compared with the positive control group, direct-contact co-culture of adipose mesenchymal stem cells and J774.1 cells significantly reduced expressions of interleukin-6 and tumor necrosis factorαin J774.1 cells, but non-contact co-culture only reduced interleukin-6 expression. These findings indicate that adipose mesenchymal stem cells can inhibit the immune response of J774.1 cells activated by lipopolysaccharide.

Objective To measure the daily nursing workload by simplified therapeutic intervention scoring system and provide information for reasonable dynamic management of nursing manpower and improving nursing service satisfaction of patients in elderly ICU.Methods 113 patients in elderly ICU were selected from July 2012 to June 2013.The Therapeutic Intervention Scoring System 28(TISS-28) was used to measure the nursing workload,reasonably arranged the nursing staff according to the daily total nursing workload.The average daily working time and service satisfaction were compared before and after the application of dynamic management of nursing manpower.Results After the application of dynamic management of nursing manpower,the average daily working time of nurses decreased,satisfactory degree of patients with nursing service increased,and satisfactory degree of medical workers with nursing manpower management also increased.Conclusions Measurement of nursing workload by TISS-28 can provide the basis for the dynamic management of nursing manpower in elderly ICU and improve satisfaction degree of medical workers.

Objective To explore the effect of different temperature of the forced- air warming system on the prevention of hypothermia during laparotomy of infants. Methods A total of 60 infants undergoing laparotomy under general anesthesia were recruited and divided into three groups by random digits table method with 20 cases each according to admitting time; when used the force- air warming system intraoperatively, the three groups were respectively setting on 45℃(automatic adjustment for 43 ℃ after 45 minutes), 43 ℃ and 38 ℃.The core temperature were respectively recorded before anesthesia and 15, 30, 45, 60 minutes after anesthesia (every 30 minutes after 1 hour).The hypothermia incidence and anesthesia recovery conditions were recorded simultaneously. Results There was no significant difference on the core temperature among three groups before anesthesia (P > 0.05). 30 minutes after the anesthetic, the core temperature of 45 ℃ group was (36.31±0.20) ℃,43 ℃ group was (36.32±0.24) ℃ and 38 ℃ group was (36.08±0.21) ℃.The differences among three groups was statistically significant (F=8.12, P < 0.01), but there was no significant difference between 45 ℃ group and 43 ℃ group (P > 0.05). 60 minutes after the anesthetic, the core temperature of 45 ℃ group was (36.39±0.26) ℃,43 ℃ group was (36.19±0.22) ℃ and 38 ℃ group was (35.92±0.15) ℃. The differences among three groups was statistically significant(F=25.19, P<0.01).The hypothermia incidence of 45℃group, 43℃ group,38℃ group was 10.0%(2/20), 25.0%(5/20), 50.0%(10/20)respectively and the differences among three groups was statistically significant( χ2=8.04, P<0.05). The time to complete consciousness of 45 ℃ group was (15.40±5.09) minutes,43 ℃ group was (19.80±4.10) minutes and 38 ℃ group was (22.00±4.36) minutes. The differences among three groups was statistically significant (F=10.96, P<0.01). The time to tracheal extubation of 45 ℃ group was (18.10±5.97) minutes, 43 ℃ group was (21.85±4.02) minutes and 38 ℃ group was (24.90±5.54) minutes.The differences among three groups was statistically significant (F=9.83, P<0.01). Conclusions The forced-air warming system can increase the infants′peripheral tissue heat content and reduce the heat losing.So that it will help decrease the intraoperative hypothermia incidence and shorten the anesthesia recovery period.Meanwhile the higher temperature of the forced-air warming system is setted ,the better effect it is.

Objective Through comparision of HER2/neu status detected by immunohistoehemistry (IHC),fluorescence insitu hybridization(FISH)and chromogenic insitu hybridization(CISH),to explore the clinical significance of FISH and CISH on detecting gene status of HER2.Methods Sixty-four paraffinembedded breast samples whose pathological types were infiltrating ductal carcinomas were tested by IHC for HER2 protein overexpression and CISH,FISH for HER2 gene status.The rate of chromosome 17 polysomy was also analyzed.Results Among the cases of HER2 protein overexpression(+++)group,the concordant ratios of IHC and CISH.FISH detecting HER2/neu status were 100%.Among the cases of HER2 protein overexpression(++)group,the concordant ratios were 95.83%and 91.67%.Among the cases of HER2 protein overexpression(+/-)group,the concordant ratios were also 100%.One case in which FISH and CISH were performed yielded the different results.so the general coincident rate was 98.41%.The incidence of chromosome 17 polysomy Was 45.16%,45.83%and 11.11%in three IHC(+++,++,+/-)groups,and the total incidence was 40.62%.ConclusionIHC is a preliminary screening method;HER2 gene status detected by CISH and FISH have high concordant ratio,CISH is a more convenience and viable method to detect HER2/neu status,when doubling interference of fichromosome 17 polysomy,we need to select FISH further.

Objective To investigate the effects and the migration mechanisms of stromal derived factor-1 (SDF-1) and CXC chemokine receptor-4 (CXCR-4) in rats with white matter damage treated with human umbilical cord mesenchymal stem cells (hUC-MSCs).Methods A total of 108 three-day old Sprague-Dawley rats were randomly divided into the experimental group,control group and sham group.The left common carotid artery was ligated and then exposed to hypoxia of 6％ O2 and 94％ N2 in rats in the experimental and control groups.Rats in sham group were neither ligation nor hypoxia.After 24 hours,rats in the experimental group were administered 0.5 ml hUC-MSCs (1 × 106/ml) intraperitoneally,and rats in control and sham groups were administered 0.5 ml saline by the same way.Immunohistochemistry and reverse transcription-polymerase chain reaction were used to determine the expression of SDF-1 and CXCR-4 protein and mRNA in 5-,7-and 14-day-old rats.Analysis of variance and the LSD test were used for statistical analysis of the data.Results HE staining showed that,in 14 day-old rats of the experimental group,bilateral cerebral ventricles were similar with no cellular edema or necrocytosis.In the sham group,bilateral cerebral ventricles were also normal.However,in the control group,ventriculomegaly,cellular degeneration and necrocytosis were observed on the left side.On the 5th,7th and 14th day,SDF-1 protein levels were 0.15±0.06,0.24±0.01 and 0.12±0.01,and CXCR-4 protein levels were 0.35±0.16,0.60±0.21 and 0.72±0.25,respectively,in the experimental group; SDF-1 protein levels were 0.13 ± 0.01,0.16± 0.01 and 0.08± 0.01,and CXCR-4 protein levels were 0.18 ± 0.04,0.17 ± 0.09 and 0.25 ± 0.06,respectively,in the control group,and all were higher than those in the sham group (SDF-1 protein levels were 0.03 ± 0.01,0.04± 0.01 and 0.02±0.01; and CXCR-4 protein levels were 0.04±0.02,0.05±0.03 and 0.05±0.03,respectively) (LSD test,all P＜0.05).SDF-1 protein increased to a peak on the 7th day and decreased on the 14th day in the experimental group,however,these values were both higher than those in the control group (LSD test,both P＜0.05).CXCR-4 protein increased on the 5th day and continued to increase up to the 14th day in the experimental group,and these values were higher than those in the control group at the three time points (LSD test,all P＜0.05).In 5-,7-and 14-day-old rats,SDF-1 mRNA levels were 3.52 ± 0.33,4.18± 0.28 and 2.60± 0.21,respectively,in the experimental group,which were higher than those in the control group (2.07± 0.34,3.73 ± 0.28 and 2.08± 0.15,respectively),and were even higher than those in the sham group (0.99±0.17,1.00±0.16 and 1.31 ±0.32,respectively) (LSD test,all P＜0.05).In the experimental group,SDF-1 mRNA levels reached a peak on the 7th day,and on the 14th day,it decreased to the level lower than that on the 5th day (LSD test,all P＜0.05).In the control group,SDF-1 mRNA levels also reached a peak in 7-day-old rats,but not in 14-day-old rats,which was similar to 5-day old rats (LSD test,9＞0.05).In 5-,7 and 14-day-old rats of the experimental group,CXCR-4 mRNA levels were 1.32±0.29,1.75±0.36 and 2.33±0.49,respectively,higher than those in the sham group (1.00±0.16,0.94±0.16 and 0.81±0.14,respectively) and the control group (0.97±0.14,0.97±0.15 and 1.07±0.25,respectively) (LSD test,all P＜0.05).In the experimental group,CXCR-4 mRNA levels were higher in 14-day-old rats than that in 5-and 7-day-old rats (LSD test,both P＜0.05).Conclusions SDF-1/CXCR-4 may play a vital role in the migration of hUC-MSCs homing to damaged brain.