To explore the clinical features,diagnosis and treatment of Langerhans cell neoplasms.The data of 6 patients with Langerhans cell neoplasms was analyzed retrospectively.There were Langerhans cell histiocytosis (LCH,n =5) and Langerhans cell sarcoma ( LCS,n =1 ).Among 5 LCH patients,the involved organs included waist,back,scalp,inguinal lymph nodes,parotid gland and left femur.And the symptoms were fever,splenohepatomegalia and destruction of bone.Three patients received surgery,1 had radiotherapy and 1 was discharged without treatment.The follow-up period was 34 - 138 months.Two patients had no relapse,the contra-lateral parotid gland became involved later in another and several organs were involved in other patients.One patient was lost to follow-up.Left occiput of another LCS was involved and both surgery and radiotherapy were administered.Over a follow-up period of 41 months,there was no relapse.Either surgery or radiotherapy is indicated for this rare disease when a single organ is involved.And chemotherapy is administered for the involvement of multiple organs.The patients should be treated individually.

Objective To study the protective effects of propofol against ischemia-reperfusion injury in rat brains.Methods Modified Longa modle of focal cerebral ischemia-reperfusion injury was used. 200 healthy male SD rats, weighing 200-300g were anesthetized with intraperitoneal(I.P.) ketamine and propofol. When righting reflx was abolished, external carotid artery was exposed. A nylon thread with rounded end was inserted cranially until anterior cerebral artery was reached. After 3h ischemia nylon thread was withdrawn for reperfusion which lasted 3h. Bloos samples were obtained from orbit. Skull was opened and brain removed. In control group carotid artery was exposed but nylon thread was not inserted cranially. The animals were divided into four groups: (1)ischemia-reperfusion model group: normal saline 10 ml was administered I.P.,(2)operation control group: normal saline was given I.P.at the end of operation,(3)nimodipine group: nimodipine 1 mg?kg -1 was administered I.P. 10 min before ischemia,(4) propofol group: propofol 110 mg?kg -1 was given I.P. 10 min before ischemia. Brain infarction area, cerebral water content, serum lactate dehydrogenase(LDH) and creatine kinase(CK) levels,brain SOD activity and MDA and Ca 2+ levels were measured. Ultrastracture of brain tissue was examined by electron microscopy.Results Propofol 110 mg?kg -1 reduced mortality after brain ischemia/reperfusion injury. Infarction area of brain was significantly smaller in propofol and nimodipine groups than that in group 1. Propofol significantly inhibited the increases in serum LDH and CK levels induced by ischemia/reperfusion, increased SOD activity and decreased MDA content and Ca 2+ level in brain tissue. There was less brain tissue damage in propofol group.Conclusions Propofol 110 mg?kg -1 has protective effect against cerebral ischemia-reperfusion injury in rats.

ObjectiveTo research in the essence of the caring experience of caregiver for children with eye enucleation, to find out the caring experience and caregiver's needs, to give them physical and mental nursing in order to make them cooperate with us and implement effective treatment to children.Methods12 caregivers for children with eye enucleation were given semi-structured interviews. The materials were analyzed, putted in order, and themes were got.ResultsThrough deep interview of 12 caregivers, five titles were summarized:overburdened psychology, limited schedule, requirement of health information, overload economic burden, to return and rebuild.ConclusionsThe results could help nurses to give more correct health education and psychological care to caregivers. Then caregivers can cooperate with nurses to give effective treatment to children, thus life quality of children with eye enucleation will be improved a lot.

BACKGROUND: In clinical, propofol can contract cerebral vessels, decrease cerebral blood flow, decrease brain metabolic oxygen consumption,which can decrease pressure in brain. Studies prove that propofol can protect endothelial cell that may be injuried by active oxygen injury and also decrease nerves injury of experimental rats with cerebral ischemia.OBJECTIVE: To investigate the protective effects of propofol on cerebral ischemia-reperfusion injury in rat and its mechanism.DESIGN: Randomized and controlled study.SETTING:Anesthesiological Department of the Second Affiliated Hospital of Xi'an Jiaotong University.PARTICIPANTS: The experiment was conducted at Pharmacological Laboratory of Medical College of Xi' an Jiaotong University in 2004. Totally 40 healthy male SD rats, aged 3-4 months, weighting 200-300 g, were divided randomly into four groups: Model group, control group, nimodipine group and propofol group, with 10 in each group.METHODS: The rats were anesthetized by intraperitoneal methods with ketamine and propofol separately. When righting reflex was abolished, external carotid artery was separated and ligated. A nylon thread was put at the stump site of external carotid artery without ligation. Model group: 10 mL normal saline was injected into intraperitone in 10 minutes before ischemia.Control group: 10 mL normal saline was injected into intraperitone at the end of operation. Nimodipine group: 10 g/L nimodipine (1 mg/kg) was injected into intraperitone in10 minutes before ischemia. Propofol group: 10 g/L propofol (110 mg/Kg) was injected into intraperitone in 10 minutes before ischemia. When ischemia was lasted for 3 hours, nylon thread was with drawed for reperfusion. When reperfusion was lasted for 3 hours, blood samples were obtained from orbit. Skulls were opened and brains were removed.Effect of propofol on cerebral ischemia-reperfusion injury was observed.MAIN OUTCOME MEASURES: Infarction area, cerebral water content,serum lactate dehydrogenase (LDH) and creatine kinase (CK) levels, brain superoxide dismutase (SOD) activity, malondialdehyde (MDA) and Ca2+levels were measured. Ultrastructure of brain tissue was examined under electron microscope.RESULTS: ①Infarct area in propofol group was significantly smaller than that in model group [(10.45±3.65, 19.68±4.03)%, (t=3.493,P ＜ 0.01)]. ② CK level was lower in propofol group than that in model group [(471±200,1 930±917) IU/L, (t=3.493, P ＜ 0.01)]; and LDH level in propofol group [(8 240±2 580) U/L] was significantly different from that in model group [(15 470±2 680) U/L, (t=3.441, P ＜ 0.01)]; And water content in brain tissue was lower in propofol group than that in model group [(78.2±2.4,82.9±2.9)%, (t=3.321, P ＜ 0.01)]. ③ The death rate of rats was 13.6%in propofol group, and 47.6% in model group, the former was decreased obviously as compared with the latter, and the difference was significant (t=6.21,P ＜ 0.05). ④ SOD activity was (1 690±780) U/g in propofol group and (830±110) U/g in model group, the difference was significant (t=3.420, P ＜ 0.01); but MDA content was obviously lower in propofol group than that in model group [(0.058±0.014, 0.115±0.047) μmol/g, (t=3.336, P ＜ 0.01)].CONCLUSION: Propofol has protective effect on cerebral ischemia-reper fusion injury in rats, and the mechanism is related with inhibition of Ca2+overloading and lipid peroxidation.

BACKGROUND: Shape memory polyurethane (SMPU) may be employed for bone repair capable of resisting stress shielding and bone non-union due to the shape memory effect responding to changed external temperature. Evaluating the cytocompatibility of SMPU is important for its further in vivo experiments and applications. However, few have been done to investigate the cytocompatibility of SMPU after encounted from deforming and shape recovering.OBJECTIVE: To evaluate the osteoblast compatibility of SMPU before and after stretching-shape recovering process. METHODS: Solvent casting method was used to fabricate SMPU films; the obtained SMPU films were stretched to 200%, and then fixed and finally recovered to its odginal shape at T_g+15 ℃, T_g-15 ℃ and T_g+15 ℃, respectively. Atomic force microscope (AFM) with tapping mode was employed to probe the surface morphology and phase separation of SMPU. Primary osteoblasts at 3-5 passages were seeded on SMPU films in vitro to evaluate the adhesion, proliferation and spreading of osteoblasts. RESULTS AND CONCLUSION: There were obvious and regular phase separation resulted from soft segments and hard segments in SMPU, and some groove-ddge architectures within a scale of micrometers were produced by the stretching-shape recovering process. These special micropatterned structures promoted osteoblast adhesion and proliferation, and also resulted in partially oriented cell growth along the grooves. Shape memory process, i.e. stretching-shape recovering process may obviously change the surface morphology of SMPU films, and suggesting better biocompatibility with osteoblasts.

10.3969/j.issn.2095-4344.2013.24.007

Objective To investigate the current situation of thyroid disease by analyzing retrospectively the color poppler ultrasonography data of neck discomfort in Heilongjiang Province.Methods A total of 13 020 cases (18-93 years old) of thyroid ultrasound examination data collected from September 2009 to October 2012 at the Department of Ultrasound,Fourth Affiliated Hospital of Harbin Medical University,were retrospectively analyzed.According to the sonographic features of thyroid (thyroid morphology,size,echo characteristics,blood flow,nodular location,number,calcification,etc),combined with ultrasound diagnosis,the relationships between gender and disease,age and disease,ultrasound diagnosis and disease classification,gender,number of nodules and benign and malignant were analyzed.Results Among the 13 020 cases,524 cases was excluded.There were 2 291 male cases; abnormalities were detected in 1 679 cases,and the abnormal ratio was 73.29％; there were 10 205 female cases; 7 946 cases were abnormal,and the abnormal ratio was 77.86％.The proportion of abnormal thyroid cases of the total number of female was higher than that of male,and the ratio of male and female was 1.00 ∶ 4.73 (1 679∶7 946); gender differences were statistically significant(x2 =18.476,P ＜ 0.01).There were nodular type 5 018 cases,diffuse type 2 012 cases and mixed type 2 603 cases in sonographic findings.The nodular type on ultrasound images showed mainly nodular goiter(79.21％,3 975/5 018).The diffuse type on ultrasonic images showed mainly Hashimoto Thyroiditis(59.24％,1 192/2 012).The mixed cases on ultrasound images showed mainly nodular goiter (89.83％,2 331/2 595).Ultrasound diagnostic results showed that nodular goiter accounted for 65.52％ (6 306/9 625) and Hashimoto Thyroiditis accounted for 17.97％ (1 730/9 625).Proportion of thyroid disease increased gradually with age,reached a peak [29.93％(2 557/8 544) and 28.84％ (2 464/8 544)] between the ages of 41-50 and 51-60 years old.The proportion gradually decreased into[14.17％(1 211/8 544),7.26％(620/8 544)] between the age of 61-71 and ＞ 71 years old.The incidence differences of malignant nodules between different age groups were statistically significant (x2 =407.796,P ＜ 0.01).Among malignant nodules,solitary nodule accounted for 95.76％ (113/118) ; multiple nodules accounted for 4.24％ (5/118),and there were more solitary nodule than multiple nodules(x2 =15.286,P ＜ 0.01).About malignant solitary nodules,women accounted for 87.61％(99/113); men accounted for 12.39％ (14/113),and women's were significantly higher than man's(x2 =360.960,P ＜ 0.01).Correlation analysis showed that the results of ultrasounddiagnosisofvarious thyroid diseases were highly correlated with the ultrasonic types of diseases(r =0.139 99,P ＜ 0.01).Conclusions Nodular goiter and Hashimoto Thyroiditis are the most common adult neck discomfort diagnosed by ultrasound in Heilongjiang Province.The high-risk age of thyroid disease is between 41-60 years old.Thyroid malignant is more common in single nodular,and the number of female patients is significantly higher than that of men.

Objective To investigate clinical features and treatment strategy for pancreatic duct stent displacement complicated with acute pancreatitis.Methods Ten cases of pancreatic duct stent displacement complicated with acute pancreatitis were retrospectively analyzed.All the cases were confirmed by lab examination,X-ray examination,endoscopy and computed tomography (CT) examination.After operation,the clinical symptoms of patients were observed.Time consumed for stent removing and blood amylase level before endoscopic retrograde cholargio-pancreatography (ERCP) and 1st,4th,7th day after ERCP were recorded.Clinical features,the time of stent displacement,time of clinical cure and therapeutic strategy were summarized.Results The average age of the ten cases (four male and six female) was 55.9 years.All the displaced pancreatic duct stents were pancreatic duct stent with side wing,length five to seven cm.Obstruction was observed in one case.The end of the pancreatic duct stent of two cases dislocated at the neck of pancreats,seven cases at the head of pancreas and one at the body of pancreas.Ten cases presented with abdominal pain,seven with nausea and vomiting and one with fever.The average time of the occurrence of pancreatic duct stent displacement was 2.9 months.All the stents were successfully taken out,which of two cases were removed with balloon,seven cases with forcep and one with snare,and the average time duration was 17.7 min.After the stents taken out,pancreatic duct stent was replaced in one case and the left nine cases received nasal-pancreatic drainage treatment.After the operation,no severe complications such as pseudocyst of pancreas,pancreatic abscesses,pancreatic necrosis and gastrointestinal bleeding were observed in all the patients.Average blood amylase level at 1st,4th and 7th day after ERCP was 508 U/L,137 U/L and 86 U/L,respectively.The average time of recovery was 6.7 days,and the average time of keeping the nasal-pancreatic tube was 8.6 days.Conclusions For patients with pancreatic duct stent displacement complicated with acute pancreatitis,it is safe and effective to take out the stent and perform pancreatic duct drainage by ERCP as soon as possible,which could improve the symptoms in a short time.

The results of RT-PCR and immunohistochemistry showed that the expressions of vascular endothelial growth factor (VEGF) and its receptor ( flk-1 ) in the renal cortex of insulin-resistant rats during the phase of normal blood glucose were significantly increased, which were decreased by telmisartan. The result suggests that telmisartan may ease kidney damage via decreasing VEGF and flk-1 expressions.

In this study, the buffering capacity of amphiphilic pH-sensitivity copolymer poly(2-ethyl-2-oxazoline)-cholesteryl methyl carbonate (PEOZ-CHMC) was evaluated. The ammonium sulfate gradient method was used to prepare doxorubicin hydrochloride (DOX x HCl)-loaded liposomes (DOX-L), and then the post-insertion method was used to prepare PEOZ-CHMC and polyethylene glycol-distearoyl phosphatidyl ethanolamine (PEG-DSPE) modified DOX x HCl-loaded liposomes (PEOZ-DOX-L and PEG-DOX-L). The physico-chemical properties, in vitro drugs release behavior, cellular toxicity and intracellular delivery of liposomes were evaluated, separately. The results showed that PEOZ-CHMC has a satisfactory buffering capacity. The sephadex G-50 column centrifugation method and dynamic light scattering were used to determine the encapsulation efficiency (EE) and particle size of liposomes. The EE and particle size of DOX-L were (97.3 ± 1.4) % and 120 nm, respectively, and the addition of PEOZ-CHMC or PEG-DSPE had no influence on EE and particle size. The zeta potentials of three kinds of liposomes were negative. The release behavior of various DOX liposomes in vitro was investigated by dialysis method. In phosphate buffer solution (PBS) at pH 7.4, DOX x HCl was released from PEOZ-DOX-L in a sustained manner. While in PBS at pH 5.0, the release rate of DOX x HCl from PEOZ-DOX-L increased significantly, which suggested DOX x HCl was released from PEOZ-DOX-L in a pH-dependent manner. The intracellular delivery of liposomes was investigated by confocal laser scanning microscopy (CLSM). The CLSM images indicated that PEOZ-DOX-L showed efficient intracellular trafficking including endosomal escape and release DOX x HCl into nucleus, as well as the DOX-L and PEG-DOX-L had no this effect. The cytotoxicity of liposomes against MCF-7 cells was detected by using MTT assay. The results showed that antiproliferative effects of PEOZ-DOX-L enhanced with pH value decreased, whereas DOX-L and PEG-DOX-L did not have any significant difference in inhibitions at different pH conditions. Therefore, the problems of the inhibition of cellular uptake of liposomes and the failed endosomal escape of pH-sensitive liposomes by PEG chain can be overcome by the pH-sensitive liposomes constructed by PEOZ-CHMC.