Objective To discuss MRI features of bone marrow edema in avascular necrosis of femoral head(ANFH),and to evaluatethe relationship between bone marrow edema and the stage of ANFH.Methods MRI findings of 99 hips in 73 patients with ANFH wereretrospectively analyzed.Using SE T_1WI,T_2WI and STIR scaning,both coronal and axid were performed in all patients.The bone marrow edema in ANFH was graded into 0~3,which correlated with the stage of ANFH was concerned.Results Bone marrow edema of the femur was best demonstrated on T_2WI and STIR coronal images.Grade 1~3 bone marrow edema were seen in 61% diseased femoral heads.Bone marrow edema of the femur was increasing with progressing of the disease.Bone marrow edema was not commonly seen and localized in stageⅠof ANFH,but it was more commonly seen and extensive in stage Ⅱ,Ⅲ of ANFH.Conclusion Bone marrow edema is one sign that isaccompanied with ANFH.The probability and extent of bone marrow edema correlated well with the stage of ANFH.MRI is the mostsensitive and non-invasive means for demonstrating bone marrow edema.

Objective This study evaluates the effectiveness for using acute plateletpheresis (APP) as a blood conservation method to reduce the need of blood transfusion and increase coagulation function in aortic arch surgery with deep hypothermic circulatory arrest (DHCA ). Methods Thirty-six type-A aortic dissections patients (male 31,female 5,age 23-65 years,ASA physical status II-IV)undergoing frozen elephant trunk with total arch replacement (Bentall plus Sun's surgery)were enrolled in the prospective randomized trial.The patients were randomized into two groups:regular blood conservation group (group control,n = 18)and group APP (n = 18).Blood sample was collected respectively after anesthesia induction (T1 ),before heparinization (T2 ),by the end of surgery (T3 )and 24 hours after surgery (T4 ).Data was collected and reviewed in terms of perioperative transfusion needs,normal laboratory examination,clinical outcomes including blood routine analysis (Hb,Plt,MPV,P-LCR)and thrombelastography (TEG-R,TEG-K,TEG-α,TEG-A,TEG-MA,TEG-EPL).Kaolin and heparinase detections were performed for TEG.Results Com-pared with T1 ,TEG-R,TEG-K,TEG-A,TEG-MA,TEG-EPL and Plt were significantly decreased while TEG-CI,MPV,P-LCR significantly increased in T4 in group APP (P <0.05 ).TEG-A,TEG-MA and Plt were significantly greater(P <0.05)in group APP than in group control at T2 ,and TEG-K,TEG-ELP and HBG were significantly less (P <0.05)in group APP than in group control at T3 . Conclusion The utilization of APP technique was associated with the improved coagulation function in aortic arch surgery with DHCA.

The fine ultrastructure and localization of acid phosphatase in cell ultrastructuralevel of a HGPRT-human promyelocytic leukemia cell mutant(HL-60-AR)arestudied by scanning electron microscopy,transmission electron microscopy,freezeetching,and electron microscopic cytochemistry techniques.The results of theobservation show that the ultrastructural characteristics of HL-60-AR cells aresimilar to that of HL-60 cells.There are microvilli and ridges over cell surface.Thecells have large nucleus with prominent nucleoli,and numerous nuclear pores.Thereare less developed Golgi complex,expanded rough endoplasmic reticulum andabundant polyribosomes.After treatment with retinoic acid(RA)at 10~(-6) mol/L for 5days,HL-60-AR cells differentiate along myeloid pathway and have a decreasednucleocytoplasmic ratio accompanied with nuclear condensation and segmention.A (?)ignificant increase of specific granules is demonstrated.Microvilli of the cellsdisappear,surface features of the treated cells become more irregular and largeprotrusion and blunt pseudopodia appear.Increase of acid phosphatase content localizedon azurophilic granules(lysosomes)and Golgi complex is showed.The application offour kinds of electron microscopic techniques might provide the best way foridentifying cell ultrastructure.

Objective To observe the effects of all-trans retinoic acid (ATRA) and oxaliplatin (L-OHP) on the proliferation of human gastric cancer BGC-823 cells. Methods Human gastric cancer cells BGC-823 were treated with ATRA and/or L-OHP,respectively. The cell proliferative activity was assessed by MTT assay. Cell morphological changes were observed under inverted microscope while apoptosis rate and cell cycle were assayed by flow cytometry. The expressions of Bcl-2 and Survivin protein were detected by immunocytochemistry. Results The proliferation of the cells treated with ATRA was inhibited obviously and the morphology of the cells changed. The apoptosis rate of BGC-823 cells increased gradually and the effect was enhanced when ATRA was combined with L-OHP. After treatment with ATRA,the expressions of Bcl-2 and Survivin protein in BGC-823 cells were both down-regulated obviously. With the combination of ATRA and L-OHP,the expressions both further decreased. Conclusion ATRA can inhibit the proliferation of human gastric cancer BGC-823 cells,and the inhibitory effect is synergistic when ATRA is combined with L-OHP. The mechanism might be related to the down-regulation of Bcl-2 and Survivin protein expressions.

Experimental acute serum sickness was produced in 20 rabbits By a sensitizing injection with bovine serum albumin (BSA) through the auricular vein. Five days after the sensitization, ten of the 20 animals were given a total body irradiation of 300 r from a 60Co sourse. No radiation was given to the other 10 animals which served as controls. Blood samples were taken from the rabbits of both groups before and 2 , 4 , 6 , 8 , 10, 12, 14, and 16 days after antigen injection. After the sera were seperated, the concentrations of the circulating immune complexes were determined with the PEG complement consumption test. It was found that the dynamic curves of the concentrations of the circulating immune complexes of the two groups were essentially similar. This result strongly suggests that total body irradiation of gamma rays given five days after the sensitization of an antigen exerts no influence on the formation of the circulating immune complexes though acute radiation sickness is well established.

Objective To evaluate the diagnostic utilities of CD64,CDllb,sICAM-1 and sE-selectin in early identification of neonatal sepsis related to bacterial infection. Methods The group of sepsis consisted of 36 newboms and the control group included 26 healthy newboms. The blood samples were collected right after being admitted to hospital and at recovery stage in the group of sepsis,as for the control the blood samples were collected only once in the study. In the sepsis group,blood samples were also taken in bacterial culture before treatment CD64 and CDllb were quantified with direct immunofluorescence staining and the whole blood cell flow cytometry analysis. sICAM-1 and sE-selectin level were determined by ELJSA assay,along with CRP. Results The expression level of CD64 in neonates with sepsis was (60. 37 22. 70) .shown in MFI,which was significantly higher than that in the group of control (23. 14 ±5. 10) MFI(P <0. 01). The expression level of CDllb in neonates with sepsis was (1645. 14 ±463. 68) MFI,which was significantly higher than that in the group of control (1041.48 ±260. 34) MFI (P < 0. 01). The concentration of blood sICAM-1 in neonates with sepsis was (240. 20 ± 83.46) μg/L, which was significantly higher than that in the group of control (100. 24 ±51.03)μg/L(P <0. 01). The concentration of blood sE-selectin in neonates with sepsis was (29. 63 ±9. 88μg/L,which was significantly higher than that in the group of control (14. 12 ±5. 33)μg/L(P <0. 01). In the sepsis group,the level of CD64,CDllb,sICAM-l and sE-selectin in the primary stage was higher than the recovery stage significantly (P <0. 01). The sensitivity of above-mentioned molecular markers were 95. 7% , 82. 6% , 81. 8% and 87. 0% , respectively, and the specificity were 95. 8% , 79. 2% ,86.9% and 79.2% . CD64 was the best one. Conclusions CD64 may serve as one of the reliable biomarkers in the early diagnosis of neonatal sepsis, and it may play important role in the treatment of neonatal sepsis.

Objective To explore the role of viral infection in the development of drug eruption in patients with HIV infection, and to evaluate the efficacy of antiviral treatment. Methods This study enrolled 87 HIV-positive patients, including 11 with and 76 without drug eruption, all of whom received highly active antiretroviral therapy(HAART). Clinical data on, baseline CD4+ and CD8+ T cell counts and CD4/CD8 ratio in these subjects were retrospectively analyzed. Results The severity of drug eruption was mild in the 11 HIV-positive patients, with a mean latency period of (14.00 ± 8.10)(range, 8 - 34)days. Of the 11 patients with drug eruption, 7 had liver function impairment, which was not in accordance with the severity of skin lesions. Drug eruption was controlled in all the 11 patients after anti-anaphylactic treatment without withdrawal of antiviral drugs. Compared with 75 HIV-positive patients without drug eruption, the 11 HIV-positive patients with drug eruption showed significantly increased baseline CD4 + T cell counts (493.00 ± 245.68 (range, 42 - 810)/μl vs. 347.81 ± 167.00 (range, 11 - 814)/μl, t = 647.50, P < 0.05), but decreased proportion of patients with baseline CD4+ T cell counts below the lower limit of normal(3/11 vs. 48/75(64.00%), X2 = 3.95, P < 0.05). There were no significant differences between 10 patients with drug eruption and 69 patients without drug eruption in the baseline CD8+ T cell count(1472.30 ± 858.55/μl vs. 1356.59 ± 684.06/μl, P > 0.05), CD4/CD8 ratio(0.40 ± 0.27 vs. 0.29 ± 0.16, P > 0.05), or percentage of patients with a CD4/CD8 ratio below the lower limit of normal (9/10 vs. 68/69 (98.55%), P >0.05). Conclusions The latency period of drug eruption seems to be long in HIV-positive patients receiving HAART, and mild drug eruption can be complicated by liver function impairment in the patients. Relatively high CD4 + counts may be a risk factor for the development and aggravation of drug eruption in HIV-positive patients.

Objective:To investigate the risk factors of postoperative continuous renal replacement therapy application in Stanford type A acute aortic dissection.Methods:This retrospective study included 527 patients with Stanford type A acute aortic dissection from November 2015 to February 2018 in Beijing Anzhen Hospital. They were divided into 2 groups according to whether or not needed postoperative continuous renal replacement therapy, group CRRT(78 cases) and group None CRRT(449 cases). Binary logistic regression analysis was used to analyze the risk factors of continuous renal replacement therapy. Results:Of all the patients, the percentage of using continuous renal replacement therapy was 14.8%(78/527), and the mortality of 30 days after surgery was 8.5%(45/527). The independent risk factors associated with CRRT were preoperative serum creatinine(sCr)( OR=1.012, 95% CI: 1.005-1.019, P<0.001), transfusion of red blood cell in surgery( OR=1.141, 95% CI: 1.071-1.216, P<0.001), transfusion of platelet in surgery( OR=1.307, 95% CI: 1.084-1.576, P=0.005), the total amount of drainage( OR=1.000, 95% CI: 1.000-1.000, P=0.036), and the time of extubation after surgery( OR=1.004, 95% CI: 1.001-1.008, P=0.013). Conclusion:The risk factors of CRRT after emergency surgery of Stanford type A acute aortic dissection are preoperative serum creatinine, transfusion of red blood cell in surgery, transfusion of platelet in surgery, the total amount of drainage and the time of tracheal extubation after surgery. We need to focus on those risk factors in our daily job and manage them timely and properly, in order to improve patients’ prognosis.

Objective:To explore the correlation and mechanism between thalamic network abnormality and cognitive decline in patients with temporal lobe epilepsy (TLE).Methods:A total of 53 patients with unilateral TLE were consecutively enrolled through the epilepsy clinic of the First Affiliated Hospital of Guangxi Medical University from December 2018 to February 2020. During the same recruitment interval, 37 health controls(HC) with matching demographic characteristic were recruited. All subjects were received the Montreal cognitive assessment(MoCA) test and multimodal MRI scanning. Voxel-based morphometry method was used to study the changes of thalamic gray matter volume in patients with unilateral TLE. The structural covariance network and functional connectivity network based on seed points were used to analyze the changes of thalamic network in TLE patients. In addition, the correlations among abnormal thalamic structure, thalamic network and cognitive function score were analyzed. SPSS 22.0 software was used for statistical analysis. Independent sample t-test and Mann Whitney U test were used for inter group comparison. In order to explore the relationship between thalamus and thalamic network and cognitive performance in TLE patients, thalamic volume and gray matter volume and functional connection value of brain areas with abnormal synergistic changes were extracted and correlated with MoCA score. Results:The total score of MoCA in TLE patients (27.0(25.0, 29.0)) was significantly decreased compared with HC (29.0(28.0, 30.0))( Z=-4.601, P<0.001). Whole brain gray matter volume analysis showed that compared with HCTLE patients showed significant volume reduction in left cerebellum, right temporal pole, right fusiform gyrus, straight gyrus, bilateral middle temporal gyrus, thalamus, medial and paracingulate gyrus (GRF adjusted, voxel-level P<0.001 and cluster-level P<0.05). The thalamus-associated structural covariance network analysis revealed that compared with healthy controls, TLE patients exhibited decreased connectivity in right fusiform gyrus (MNI: x=28.5, y=-15.0, z=-34.5), left insula (MNI: x=-33.0, y=-18.0, z=-1.5), right middle temporal gyrus (MNI: x=55.5, y=-51.0, z=9.0), left complementary motor area (MNI: x=-10.5, y=1.5, z=57.0) and right posterior central gyrus (MNI: x=31.5, y=-33.0, z=51.0) ( P<0.001, cluster > 100). The thalamus-associated functional connectivity network analysis revealed that TLE patients exhibited decreased connectivity in left insula (MNI: x=-38, y=-7, z=-7), left lingual gyrus (MNI: x=-6, y=-81, z=-12), right lingual gyrus (MNI: x=15, y=-105, z=0) and left triangular inferior frontal gyrus (MNI: x=-39, y=36, z=-6) (GRF correction, voxel-level P<0.001 and cluster-level P<0.05). Volume of left insula which had decreased structural connectivity with thalamus were positively correlated with the MoCA score in TLE patients( r=0.279, P=0.043). Volume of left complementary motor area which had decreased structural connectivity with thalamus was positively correalated with the MoCA score and language score in TLE patients( r=0.323, P=0.018; r=0.334, P=0.015). Volume of left lingual gyrus which had decreased functional connectivity with thalamus was negatively correalated with the memory score in TLE patients ( r=-0.331, P=0.016). Conclusion:Thalamic volume, thalamic structural covariant network and functional connection network are changed in TLE patients. The abnormality of thalamic network is associated with cognitive performance in TLE patients, which may be the neural mechanism of thalamus participating in the cognitive impairment of TLE patients.

OBJECTIVETo explore clinicopathologic characteristics, surgical features and prognostic factors in patients with primary gastrointestinal lymphoma(PGIL) in order to provide evidence for optimizing surgical treatment.

METHODSClinicopathological data of 57 PGIL patients undergoing abdominal surgery in Sun Yat-sen University Cancer Center between October 1990 and January 2015 were retrospectively collected. The survival rates were compared among patients with different clinicopathologic characteristics by Kaplan-Meier method, while Cox regression model was employed to analyze the prognostic factors.

RESULTSAmong 57 patients, 43 were male and 14 were female, with a median age of 48 (range 16 to 80) years. Seventeen (29.8%) cases were classified as Musshoff I( stage, 19 (33.3%) cases as II( stage, 9 (15.8%) cases as III( stage, and 12(21.1%) cases as IIII( stage. Forty-four (77.2%) cases underwent selective operation, 13(22.8%) cases underwent emergent operation due to acute abdomen. Thirty-two(56.1%) cases had radical resection, 18 (31.6%) cases had partial resection and the rest 7(12.3%) cases failed to perform resection. Four (7.0%) cases received simple surgical operation, and 53 (93.0%) cases received comprehensive treatment, including 5(8.8%) cases with preoperative chemotherapy and surgery, 40 (70.2%) cases with surgery and postoperative chemotherapy, and 8 (14.0%) cases with surgery and perioperative chemotherapy. Stage III( and IIII( accounted for 76.9%(10/13) in patients undergoing emergent operation and accounted for 25.0%(11/44) in patients undergoing selective operation, whose difference was statistically significant (χ=9.503, P=0.002). Univariate prognostic analysis showed that T lymphocyte source pathological cell phenotype (P=0.000), clinical Musshoff stage III( and IIII((P=0.001), emergent operation (P=0.000) and incomplete tumor resection(P=0.007) had worse 5-year overall survival. Multivariate Cox regression analysis indicated that tumor pathological cell phenotype (HR=13.75, 95%CI:3.546-53.308, P=0.000) and surgical timing (HR=7.497, 95%CI:1.163-48.313, P=0.034) were independent prognostic risk factors of patients with stage I( and II(.

CONCLUSIONSSurgical operation is an important part of comprehensive treatment for PGIL. T lymphocyte source and ulcerative lymphoma indicates poorer prognosis.