Objective To study the change of pancreatic hemocirculation in patients with acute pancreatitis by magnetic resonance perfusion (MRP) and to explore its relationship with pancreatic severity. Methods With a prospective investigation method, APACHEⅡscores, systemic inflammatory response syndrome (SIRS) scores, Binder scores and C-reactive protein (CRP) values were recorded within 72 h in patients with severe acute pancreatitis (SAP,n=15) and mild acute pancreatitis (MAP,n=17), while other 19 volunteers were as controls. MRP were performed on 32 patients and 19 controls. Patients in SAP group were evaluated by above criteria after two-weeks treatment and MRP were performed in 12 of them. All cases with bolus injection of Gd-DTPA (0.2 mol/kg) were scanned by transversal same slice and fast spoil phase gradient echo. Three groups datum of MIR and MSR were gained by ROI time-signal graphy of pancreatic head, body and trail which were calculated by Perfxproject software. Results ① The rates of MIR and MSR in SAP group were lower than MAP group (P0.05).Conclusion MRP is an objective imaging technique, which can reflect the hemocirculatory variety in acute pancrea-titis.It may have a considerable value in evaluating the severity of acute pancratitis.

In eukaryotic cells ,NF-κB transcription factor family regulates many processes like cell sur-vival,growth,and apoptosis.It participates in the development of a variety of diseases ,including inflammatory,im-mune disease ,and cancer .As an inflammatory factor , NF-κB mediates the transformation of chronic colitis to cancer during the course of colorectal cancer .Furthermore,it could inhibit cell apoptosis through regulating cell cycles,which promotes the development of colorectal cancer and mediates the multidrug resistance of the tumor cells.Therefore,targeting NF-κB,a large number of preparations involved both Chinese and western medicine has been researched .The further research and the use of them may be an effective method to cure the colorectal cancer in clinical work .

Objective To analyze the clinical characteristics of pulmonary infection in patients with multiple myeloma for improving early prevention,diagnosis and treatment.Methods A retrospective analysis was conducted for 70 patients with multiple myeloma admitted to our hospital from January 2012 to April 2015.The clinical data of pulmonary infection were reviewed and analyzed in terms of radiological findings,pathogen distribution,and related risk factors.Results The peripheral white blood cell count and neutrophil percentage could be normal in pulmonary infection of patients with multiple myeloma.However,erythrocyte sedimentation rate increased significantly.Radiological study revealed that infection of bilateral lungs was common.The most frequently identified pathogens were gram negative bacteria,especially Pseudomonas aeruginosa.The main predisposing factors of pulmonary infection were agranulocytosis,stage Ⅲ multiple myeloma,and complications.Conclusions The clinical symptoms of pulmonary infection are diverse in patients with multiple myeloma.Poor immunity is the primary predisposing factor.The common pathogens are gram-negative bacteria.Beta-lactam/beta-lactamase inhibitor combinations or fluoroquinolones are effective empiric treatment for controlling the progression of pulmonary infection.

BACKGROUND:Regulatory T cels (Treg) are classified into two subsets, nature Treg (nTreg) and induced Treg (iTreg). Although there is consensus that CD4+CD25+FoxP3+CD127-is the widely accepted phenotype of Treg, it remains unclear what is the difference in phenotypes including cytokine patterns of nTreg and iTreg. OBJECTIVE:To understand and compare the plasticity of nTreg and iTreg and to search the exact mechanism of cytokine secretion in Tregs. METHODS: We investigated the frequency and cytokine pattern of CD4+CD25+FoxP3+CD127-nTreg in freshly separated peripheral blood mononuclear cels of five healthy individuals using 8-color fluorescence flow cytometry (FACSCanto II). Subsequently, after 9 days of alostimulation in mixed lymphocytes, the frequency and cytokine pattern of CD4+CD25+FoxP3+CD127-iTreg were determined and analyzed. RESULTS AND CONCLUSION:In fresh cels, (1.5±0.70)% of CD4+ T cels were CD4+CD25+FoxP3+CD127- nTregs. Almost al these cels expressed interferon (IFN)-γ-, interleukin (IL)-2- or transforming growth factor-β+, and partial cels expressed IL-10+ or IL-10-. After 9-day alostimulation, the number of CD4+CD25+FoxP3+CD127- iTreg expressing IFN-γ+, IL-2-, IL-2+, IL-10+ or TGF-β+increased strongly. The main subsets of human nTregs were CD4+CD25+FoxP3+CD127-IFN-γ-IL-2-IL-10+TGF-β+and CD4+CD25+FoxP3+CD127-IFN-γ-IL-2-IL-10-TGF-β+ T cels. The proportion of each subset in CD4+ T cels was (1.1±0.59)% and (0.39±0.16)%, respectively. Whereas the main subsets of human iTregs were CD4+CD25+FoxP3+CD127-IFN-γ+IL-2-IL-10+TGF-β+ and CD4+CD25+FoxP3+CD127-IFN-γ+IL-2+IL-10+TGF-β+. Human nTregs were characterized as IFN-γ-IL-2- double negative, producing IL-10 and TGF-β or only TGF-β without IL-10, and not proliferatingin vitro. During the alostimulation in mixed lymphocytes, IFN-γ+ iTregs proliferated remarkably. One-third of IFN-γ+ iTreg expressed IL-2+, and two-thirds of IFN-γ+ iTregs expressed IL-2, both of which produce IL-2 and TGF-β. Our results imply that CD4+CD25+FoxP3+CD127- Treg are potentialy immunosuppressive probably because of their mandatory TGF-β and optional IL-10 production.

Objective To study and to optimize culture conditions of islet-like cells induced in vitro from fetus bone marrow(BM) mesenchymal stem cells(MSCs).Methods BM was obtained from miscarried human fetus.The MSCs between three to eight passages were used to differentiate into islet-like clusters-through three stages of culture supplemented with 2mercaptoethanol,epidermal growth factor(EGF),basic fibroblast growth factor(bFGF),B_(27) and nicotinamide.Results The 2nd stage cells expressed nestin and/or panceatic and duod-enal homeobox 1(PDX-1),and the 3rd stage cells formed islet-like clusters expressing insulin and glucagon together with positive dithizone staining.Specific insulin secretion could be detected(81.3?23.6?u /ml) from differentiated MSCs which have the capacity to respond to different glucose concentrations.Conclusion Fetal bone marrow MSCs can be differentiated into pancreatic islet-like clusters,and 20mmol/L nicotinamide could be the optimal concentration in culture.

Objective To observe the mortality of fragile hip fractures and evaluate the death-associated risk factors.Methods 100 men and 186 women aged 50 to 97 (mean,77.09± 10.65) years old who had fragile hip fracture over 50 years old from 2010 to 2012 were followed up,and the clinical data were retrospectively analyzed.Three months,one year and the total mortality of following time were calculated.Mortality-related risk factors were evaluated including age,gender,and surgery,duration from injury to operation,pulmonary infection,number and kind of complications.Results The 286 patients were followed up between 6 months and 42 months,with 21.42±9.88 months in average.The three month mortality was 7.69％,the patients who were followed up over one year were 231 cases,the one year mortality was 16.02％,and the total mortality of following time was 17.48％.The mortality was associated with age,gender,surgery,duration from injury to operation,number of complications,pre-injury cardiovascular disease and respiratory system diseases,and pulmonary infection.A Binary Logistic Regression analysis revealed that the independent risk factors affecting the mortality included age (OR=5.385,P=0.003),surgery (OR=21.217,P=0.000),number of complications (OR=9.038,P=0.000),pre-injury cardiovascular disease (OR=3.201,P=0.041).Conclusion The early mortality of fragile hip fractures was high and was associated with many risk factors.Age,surgery,number of complications and pre-injury cardiovascular disease were the independent risk factors affecting the mortality of fragile hip fractures.The positive treatment with complications,early surgery in condition allowed,can lower the early mortality.

ObjectiveTo investigate the health status and incidence of alcohol abuse of Xinjiang community residents.MethodsThrough multi-stage random sampling,1992 community residents ( 15-65years old) were assessed using socio-demographic information questionnaire,alcohol use disorders identification test (AUDIT) and self-rated health measurement scale-prior test(SHRMS).Single factor analysis and rank sum test were used to identify the incidence of alcohol abuse,the distribution of different populations,and the self-rated health status of abusers.ResultsTotally 298 cases of alcohol abuse were identified,and accordingly,the prevalence rate of alcohol abuse for general population was 15.1％ ( male 26.4％,female 4.8％ ).Key factors for alcohol abuse included male,middle-aged,well-educated,at work,administrative work,high income levels and large number of household.The differences among groups were statistical significant.Presumably the workplace population was at high risk of alcohol abuse.Alcohol abusers were significantly worse than general population in self-rated health status(P ＜ 0.01 ),especially in mental health and social health.ConclusionThe incidence of alcohol abuse is relatively high in Xinjiang rcgion,and the problem need more attention.Further survey and early intervention work for highrisk group are advised to achieve the purpose of prevention and control.

Objectives To study the effect of bone mineral density measurement on the diagnosis and treatment of osteoporosis in patients with fragility hip fracture.Methods A retrospective analysis was conducted on 560 cases of elderly patients with fragility hip fracture in our hospital from January 2010 to December 2012.They were divided into two groups with and without the bone mineral density measurement,and compared to study the bone turnover markers detection and osteoporosis treatment.Results Among the 80 cases with the DXA bone mineral density detection,36 cases received the bone turnover markers detection(45.0%),and the rate of osteoporosis treatment in hospital was 70.0%,while the rate of osteoporosis treatment after discharge was 57.5%.Among the 480 cases without DXA bone mineral density detection,none received bone turnover markers detection,and the rate of osteoporosis treatment in hospital was 42.1%,while the rate of osteoporosis treatment after discharge was 36.7%.Conclusions The detection rate of bone mineral density and the diagnosis and treatment rate of osteoporosis are low in patients with fragility hip fracture.DXA bone mineral density measurement is helpful to improve the detection rate of bone turnover markers and the treatment rate of osteoporosis.

BACKGROUND:StageIorIIKummel’s diseaseisusualy suggested to be treated with percutaneous vertebroplasty (PVP) orpercutaneous kyphoplasty (PKP). Stage IIIKummel’s diseasewith neurologic deficit is treated with open decompression, cement-augmented combined with internalfixation. However, surgical options for stage IIIKummel’s diseasewithdural saccompression butwithnonervous symptoms arein disputeand rarely reported. OBJECTIVE:To investigatethesurgical options of Kummel’s disease with vertebral posterior walcolapse. METHODS:Fourteen patients with Kummel’s disease with vertebral posterior wal colapse wereenroled as experimental groupandtreated with PVP or PKP based on the degree of postural reduction.Another28 patients with osteoporotic vertebral fracture as control group were treated with PKP. Thenalpatients were folowed up to observe vertebralheight, Cobb angle, visual analog scale and the Oswestry disability index. RESULTS AND CONCLUSION:After folowed up for 10 to 42 months, therestoredvertebralheight, Cobb angle, visual analog scale and Oswestry disability index were significantly improved inthetwo groups (P<0.05). Thepostoperativevertebralheight intheexperimental group was significantly higher than thatinthe control group(P< 0.05).Butno significant differencesin Cobb angle, visual analog scalescoresand Oswestry disability indexwere found between thetwo groups after operation (P> 0.05). These data suggest that based on the degree of postural reduction, individualizedPVP or PKP for Kummel’s disease with vertebral posterior wal colapsecanattain satisfactoryoutcomes.

Objective To investigate the correlation of incident pneumonia and serum 25-hydroxyvitamin D[25(OH)D] levels in elderly patients with fragility hip fractures.Methods 132 patients with fragility hip fractures were divided into the pneumonia group [n=43,14 males and 29 females,aged 63-97 years,a mean age of (83.8±7.1) years] and the non-pneumonia group [n=89,28 males and 61 females,aged 60-93 years,a mean age of (77.1±8.1) years].Fasting venous blood samples were taken on the second day after admission.Serum 25 (OH)D levels were measured by radioimmunoassay.Results Vitamin D deficiency was found in 90.7％ of the patients in the pneumonia group,52.8％ in the non-pneumonia group (x2=24.953,P＜0.05).The age and smoking rate were higher in the pneumonia group than in the non-pneumonia group (t=4.661,P＜ 0.05;x2 =4.459,P=0.035).Logistic regression analysis showed that serum 25(OH)D levels,age and smoking were independent impact factors for pneumonia.When serum 25(OH)D levels were less than or equal to 20 g/L,the incidence of pneumonia was increased and the risk of pneumonia was 8.66 times higher than that for patients with normal 25 (OH)D levels.Conclusions The risk of pneumonia in patients with brittle hip fractures is correlated with age,smoking and the serum 25-hydroxyvitamin D level,with the latter as a major risk factor.Patients with brittle hip fractures should be supplemented with vitamin D as early as possible in order to reduce the risk of incident of pneumonia.