Stromal cells are the important part of the bone marrow microenvironment. They provide a suitable environment for the self-renewal, proliferation and differentiation of the hematopoietic stem cells. Stromal cells include dendritic cells, macrophages, fibroblasts, endothelial cells and adipocytes. They secrete cytokines,extracellular matrix and provide direct cellular contaction to regulate hematopoiesis. Dysfunction of the stromal cells will lead to all kinds of hemopathy and immune system diseases directly.

OBJECTIVE To describe the sonographic features of carotid body tumor(CBT), and determine the utility of ultrasonography as a diagnostic study in the preoperative patients. METHODS Sonograms of 60 patients with 65 CBT were reviewed with gray scale and duplex Doppler sonography. The evaluated features included the location, size, margins, shape, internal echogenicity, the relationship between the tumor and the carotid artery,and blood flow velocity. RESULTS All carotid body tumors were located at the carotid artery bifurcation. Well-defined, solid, weakly hypoechoic masses were noted on gray scale sonography in the carotid bifurcation. Color Doppler sonography showed hypervascularity in 61 masses. Pulsed Doppler analysis of blood flow within the tumor mass was possible in 61 CBT, and low-resistance waveforms were obtained from multiple sites within the mass in all cases. CONCLUSION The ultrasound characteristics of the CBT possess specificity to some extent. Duplex Doppler ultrasound can provide the relationship between the tumor and the carotid artery,and provide important information of intratumor blood flow,which has important value in the diagnosis of CBT.

Motivational interviewing was a consultation model which centered on patients, and changed patients′unhealthy behaviors by changing their motivations, and promoting their health. Motivational interviewing had been widely used in improving the capacities of patients′self-management with chronic diseases in abroad. Through reviewing the application in chronic disease self-management of motivational interviewing at home and abroad, the paper pointed out the prospect and problems that needed to be solved in our country and provided references for further research on motivational interviewing in self-management of chronic diseases.

Objective To evaluate the value of 18F-FDG PET/CT in histological grading and staging of follicular lymphoma (FL) and prediction of prognosis after first-line treatment.Methods From May 2007 to April 2013,24 patients (11 males,13 females; median age 55 years) with histopathological proof of FL were retrospectively studied.All patients were evaluated by 18F-FDG PET/CT before the first-line treatment and were divided into indolent FL and aggressive FL according to their histological grades and clinical stages.The sensitivity,specificity and SUVmax were calculated.Analysis of variance of factorial design was used to analyze the data.Within the same study period,18F-FDG PET/CT was also performed in 16 FL patients (9 males,7 females; median age 50.5 years) after first-line treatment (7/16 patients belonged to the aforementioned group with pretreatment PET/CT performed) ; and they were then divided into PET/CTpositive and PET/CT-negative groups.All 16 patients were followed for 6-49 months to evaluate the prognosis.The rates of overall survival (OS) and progression-free survival (PFS) were calculated.Results (1)The sensitivities of PET/CT in indolent and aggressive FL were 92.3％ (12/13) and 100％ (11/11),respectively.The SUVmax was 5.26± 1.70 vs 9.54±5.09 (F=5.196,P＜0.05).(2) According to PET/CT,3patients(12.5％,3/24) were upstaged from Ⅰ-Ⅱ to Ⅲ-Ⅳ,and 2 patients(8.3％,2/24) were downstaged from Ⅲ-Ⅳ to Ⅰ-Ⅱ.The SUVmax of stage Ⅰ-Ⅱ and Ⅲ-Ⅳ FL was 5.22±2.92 and 8.04±4.46(F=2.904,P＞0.05).(3)For the 16 FL patients with PET/CT after first-line treatment,the negative and positive groups had different OS and PFS.The 6-month OS,1-year OS and 3-year OS were 100％(13/13),9/9,4/5,respectively for the negative group,and 2/3,2/3,1/2,respectively for the positive group; while the corresponding 6-month PFS,1-year PFS and 3-year PFS were 92.3 ％ (12/13),8/9,3/5 and 2/3,0/3,0/2,respectively.Conclusions 18F-FDG PET/CT is valuable in the evaluation of histological grading and clinical staging of FL patients and in the prediction of prognosis after fist-line treatment.

Child ; Coronary Aneurysm ; diagnostic imaging ; physiopathology ; Coronary Thrombosis ; diagnostic imaging ; physiopathology ; Coronary Vessels ; diagnostic imaging ; physiopathology ; Female ; Humans ; Mucocutaneous Lymph Node Syndrome ; complications ; diagnosis ; diagnostic imaging ; physiopathology ; Ultrasonography, Doppler

Objective To investigate the effects of Simo decoction on ghrelin and calcitonin gene-related peptide (CGRP) in diabetic rats.Methods A total of 48 SD rats were divided into healthy control group,diabetes group (DM),DM treated with low dose Simo decoction group (DMTL),DM treated with medium dose Simo decoction group (DM-TM),DM treated with high dose Simo decoction group (DM-TH) and DM prevented with medium dose Simo decoction group (DMPM) ; there were eight rats in each group.The rats of DM group and other intervention groups were intraperitoneally injected with 1％ streptozotoein (STZ) to establish the model.The rats of healthy control group were injected with solvent.At eight weeks after the model successfully established,the rats of each intervention group were gavaged with low dose of Simo decoction (0.15 ml · kg-1 · d-1 ),medium dose of Simo decoction (1.5 ml · kg-1 · d-1 ) and high dose of Simo decoction (3.0 ml · kg-1 ·d-1 ) for two weeks; the rats of control group and DM groups were gavaged with equal volume of 0.9％NaCl.The rats of DM-PM group were gavaged with Simo decoction at 1.5 ml · kg-1 · d-1 for 10 weeks after the model successfully established.Rats were sacrificed at the end of drug intervention and gastric antrum tissues were dissociated for detecting the expression of ghrelin and CGRP by real time polymerase chain reaction (PCR).The data were analyzed by one way ANOVA and t test.Results There was no significant difference in ghrelin expression at mRNA level in gastric antrum tissues between diabetic rats and control group.However after intervened by low dose and medium dose of Simo decoction,the ghrelin expression increased (1.45 ± 0.34,1.87 ± 0.68 compared with 0.87 ±0.28,Dunnett's T3 test,P＜0.05).There was no effects of high dose Simo decoction on the expression of ghrelin in diabetic rats.There was no significant difference in ghrelin between DM-TM and DM-PM.The expression of CGRP at mRNA level in gastric antrum tissues of diabetic rats was significantly higher than that of control group (4.61 ± 1.67 compared with 1.06 ± 0.40,t =5.843,P＜0.01).There was no effects of low dose Simo decoction on CGRP expression of diabetic rats.The expression of CGRP of diabetic rats was down-regulated by medium and high dose of Simo decoction intervention.There was no significant difference in CGRP expression between DM-TM and DM-PM.Conclusions Simo decoction can promote ghrelin expression in gastric antrum of diabetic rats.The expression of CGRP in gastric antrum of diabetic rats significantly increased,but Simo decoction may down-regulate the expression of CGRP in gastric antrum of diabetic rats.

Objective To analyze ultrasonic elastography (UE) score of breast carcinoma and to explore the correlation between UE and pathological collagen content in stroma.Methods UE scores of 60 breast carcinoma before operation were retrospectively studied.The correlation between the UE scores and the pathological collagen content grading in stroma after operation were analyzed.Results UE score of 60 breast carcinoma were (4.07 ± 0.78) scores,the diagnosis coincidence rate of UE score was 80.0％ (48/60).Positive correlation existed between UE score and the pathological collagen content grading in stroma of breast carcinoma (r =0.440,P =0.015).Conclusion UE score of breast carcinoma is related to the pathological collagen content in stroma,and it can evaluate collagen content in stroma of breast masses in some degree.

Objective To evaluate the reproducibility of quality intima-media thickness(QIMT) and quality arterial stiffness (QAS) technique in assessment of carotid under different measuring methods.Methods Between December 2012 and January 2014,carotid QIMT and QAS examinations were carried out in 30 health volunteers.QIMT and QAS indicators included IMT in QIMT and distensibility coefficient (DC),compliance coefficient(CC),stiffness index α(α),stiffness index β(β),pulse wave velocity(PWV) in QAS.The measurement employed unilateral/once,bilateral/twice,and unilateral/twice methods.Using intra observer and inter-observer variability,the reproducibility was compared between different QIMT and QAS indicators and measuring methods.Results Extremely high level of intra-observer reproducibility was found for both QIMT and QAS technique (ICC＞0.8).QIMT also showed an excellent inter observer reproducibility (ICC＞0.8).In contrast,the reproducibility of QAS technique varied in different indicators (PWV ＞ β ≈ α ＞ CC ＞ DC) and method ( unilateral/once ＞ bilateral/twice ＞ unilateral/twice).Conclusions QIMT measurement was highly reproducible.Whereas the reproducibility of QAS technique varied in different indicators and methods.Due to low reproducibility,the study result did not support the clinical application of DC indicator and unilateral/once method.

Objective To evaluate the accuracy and feasibility of 64-slice spiral CT (64SCT) in assessing coronary artery disease.Methods A total of 30 suspected patients (male 21 cases, female 9 cases, and mean age of 54.6 years) were undergone both 64SCT and selective coronary angiography (SCA). Volume redering (VR) ,multiplanar reconstruction (MPR), maximum intensity projection (MIP) and transverse section were reconstructed. The results of coronary reconstructions were compared with SCA to analyze the accuracy of the 64SCT in detecting coronary artery stenoses.Results In the 396 segments of coronary artery(diameter≥2 mm)of 30 patients, 385 were judged to be evaluable by 64SCT. The evaluable rate was 97.2%. The sensitivity, specificity, positive predictive value and negative predictive value of the 64SCT in detecting coronary artery stenoses(≥50% of stenosis) were 96.22%, 94.56%, 89.44% and 96.88%. The accuracy rate of 64SCT in detecting ≥50% stenosis of coronary artery was 95.90%.Conclusion 64SCT has high accuracy in detecting coronary artery stenoses, as a noninvasive method,it can be used for screening patients with known or coronary artery diseases.

As one of the "three key virtues" of Confucianism,wisdom played a significant role in the thousands of years of traditional Chinese culture.The nature of medical skills is humanity.However,as the great development of medical technology in modern society,tension and conflicts also arise in the current physician-patient relationship.Under this circumstance,this paper explores the origin of Confucian wisdom and its connection with modern physician-patient relationship,and comes up with suggestions for constructing a modern harmonious physician-patient relationship.