Objective To determine the clinical manifestation,pathologic behavior,therapy and related factors of rare aggressive fibromatosis.Methods Canceration from aggressive fibromatosis to fibrosarcoma in one case of aggressive fibromatosis was analyzed and relevant literatures were reviewed.Results Aggressive fibromatosis was a benign or semimaligrant,non-metastatic proliferations of fibrous tissue that infiltrated surrounding tissues and tended to recur after surgical resection.Pathology showed fibroblastic monoconal proliferation between the cellular center and the collagen periphery.Electron microscope showed an abundant collagen network enclosing a pelymorphous cellular proliferation.Immunohistochemistry defined vimentin and actin positive desmoid tumors.Complete surgical excision was a chief treatment.Several operations were needed in most cases.Recurrence rates may be as high as 10%～70%.Chemotherapy and radiotherapy may be used together with surgery in recurrence or unsatisfactory surgical margin.The disease recurred after operation and one radiation therapy,reoperation and pathology showed fibrosarcoma.Conclusion Aggressive fibromatosis is a rare benign,non-metastatic proliferation tumour of fibrous tissue with a tendency of local recurrent after surgical resection.The cornerstone of therapy is surgery.Radiation therapy and chemotherapy can be used as adjuvant therapy.It is scarce that aggressive fibromatosis cancerates to fibrosarcoma.Maybe surgical stimulus and radiation therapy are the main factors to promote it to cancerate.

Objective:To investigate the distribution and expression of the cyclooxygenase-2(COX-2)in lung tissues and the effect of its inhibition in bleomycin(BLM)-induced pulmonary fibrosis in rats.Methods:72 male SD rats were randomly divided into three groups:the control group,model group and celecoxib group.Immunohistochemical method was used to detect the distribution of COX-2 in the stage of acute pulmonary alveolitis.HE and Masson staining methods were used to evaculate the degree of alveolitis and pulmonary fibrosis.Results:(1)In early stage of pulmonary fibrosis except in the control group,COX-2 expression was found in small bronchial epithelial cells in the other two groups,especially the model group.(2)Compared with the control group,the other two groups had alveolitis(P

BACKGROUND:In oral warm and moisture circumstance, al oy which contains Be is easily to be eroded to release Be2+. But there is stil no research focusing on beryl ium influence on genotype of Porphyromonas gingivalis fimbriae gene cluster. OBJECTIVE:To investigate Be 2+effect on genotype of Porphyromonas gingivalis fimbriae gene cluster. METHODS:The revived Porphyromonas gingivalis was resuscitated for 48 hours in the anaerobic culture medium with different concentration of Be 2+(10×10-6, 5×10-6, 1.25×10-6). Through PCR amplification and sequencing, we investigated the effects of Be2+RESULTS AND CONCLUSION:(1) When Be on genotypes of Porphyromonas gingivalis fimbriae gene cluster. 2+concentration was 5×10-6, we found the peak of 217 and 257 sites on DNA sequence expressing G/A overlap peak, different from G single peak of the other groups, suggesting the suspicious bases changes, part of the single base G mutated into A. (2) On al concentrations, we found a base group composed of seven A bases was inserted into the 101 site of DNA sequence. Up to now, there is no direct contacts of the mutations occurring to Be2+concentration. Changes of gene may lead to the shifting of the reading frame, the abnormal synthesis of proteins, the change of Porphyromonas gingivalis fimA gene toxicity, and lastly the unbalance of the micro-ecological environment.

Objective To study influencing factors in patients with rheumatic diseases.Methods One hundred and twenty patients with rheumatic diseases were selected from November 2013 to February 2014 in our hospital for the study.The influencing factors in patients with rheumatic diseases were obtained by proposed questionnaires,and then the univariate and multivariate Logistic regression analysis were performed to study factors affecting the treatment.Results Patients older than 50 of the observation group accounted for 38％ (18/48),the proportion of farmer,patients with primary school education level or below,and monthly income ＜3 000 RMB was 35％(17/48),60％(29/48),and 46％ (22/48) respectively.Compared with the control group,they were significantly higher than the control group,which were 64％(46/72),58％ (42/72),79％(57/72),65％(47/72) (x2=8.058,P=0.005; x2=6.025,P=0.014; x2=4.986,P=0.226; x2=4.456,P=0.035) respectively.Using the treatment as the dependent variable,age ≥50 years of age,farmer,primary school and lower education level,and monthly income ＜3 000 RMB as the independent variable,we carried out the regression analysis.Age (OR=1.124,95％CI:1.084-7.236),occupation (OR=1.871,95％CI:1.054-7.243),education level (OR=1.982,95％CI:1.157-6.256),monthly income (OR=1.363,95％CI:1.012-8.227) are the influencing factors of rheumatism's treatment.Conclusion The treatment of rheumatic diseases are influenced by many factors,and more societal support should be provided to help patients with rheumatic disease receive professional treatment and better control of the disease.

Objective To evaluate the effect of pediatric renal transplantation using donation after cardiac death (DCD).Methods The male DCD meeting Chinese standard Ⅲ (C-Ⅲ) was 49 years old,and the recipient with chronic renal failure was 14 years old.The right kidney of the donor was transplanted to the recipient.The renal artery and renal vein of the donor were end-to-side anastomoscd to the common iliac artery and common iliac vein of the recipient,respectively.The graft was transplanted into the fight iliac fosse.Warm ischemia time was 12 min,and cold ischemia time was 2 h.Immunity induction therapy was performed with basiliximab.Tacrolimus + mycophnolate mofetil + Pred were used as immunosuppressive regimen.Results The transplantation was done successfully.One day after operation,ALT was increased dramatically.The recipient was diagnosed as acute drug-induced liver injury.There was no occurrence of acute rejection and delayed graft function.The recipient was discharged one month after the operation,and followed up for 6 months with normal graft function.Conclusion Pediatric renal transplantation using DCD is effective and safe,even though the long-term effect still needs to be further observed.

Two patients with typical Gitelman syndrome were diagnosed by gene and their clinical data and endocrine and metabolic status were evaluated.The etiology,clinical manifestation,laboratory findings,genetic diagnosis,and treatment for Gitelman syndrome were reviewed.

Objective:To study the effect of psoralen on the proliferation, invasion and migration of HTB-47 and CRL-1932 renal cancer cells cultured in vitro, and to further explore the internal mechanism of psoralen inhibiting renal cancer.Methods:The experimental group was HTB-47 and CRL-1932 renal cancer cells treated with dimethyl sulfoxide solution containing 30 μg/ml psoralen, and the control group was renal cancer cells treated with dimethyl sulfoxide. Scratch test, CCK8, Transwell, and Western blot were used to detect the effect of psoralen on renal cancer cells.Results:Compared with the control group, the proliferation, invasion and migration of renal cancer cells treated with psoralen in the experimental group were significantly inhibited. In the renal cancer cells treated with psoralen, the protein expression levels of MKI67, PCNA, MMP2 and MMP9 were significantly decreased (all P<0.05). Conclusions:Psoralen can significantly inhibit the proliferation, invasion and migration of HTB-47 and CRL-1932 renal cancer cells in vitro. The mechanism may be to inhibit the progression of renal cancer by regulating MKI67, PCNA, MMP2 and MMP9.

Objective To evaluate the feasibility and clinical efficacy of retroperitoneal laparoscopic adrenalectomy for the treatment of Cushing disease.Methods Clinical data collected from 38 cases retroperitonel laparoscopic adrenalectomy for Cushing disease,from February 2006 to February 2017 were analyzed retrospectively.Among them,there were 6 males and 32 females aged from 13 to 66 years old,with an average age of 38 years old.The disease history ranged from 2 to 96 months,with an average of 28.3 months.Besides,there were 32 cases that had previous history of transsphenoidal pituitary tumor surgery and or radiotherapy.All 38 cases underwent retroperitoneal laparoscopic adrenalectomy therapy.There were 8 cases accepted right adrenalectomy and left subtotal adrenalectomy at the same time,24 cases accepted unilateral adrenalectomy,another 6 cases of pituitary tumors without lesions in medical imaging underwent unilateral adrenalectomy.Results All operations were completed sucessfully without conversion to open surgery and mortality.There was no blood transfusion during the period of operation.The operation time ranged from 30 min to 270 min (mean 88.3 min),the amount of bleeding was among the range of 10 ml to 200 ml (mean 38.33 ml).During 2 to 13 years of the follow up (mean 7 years),the 24 h urine cortisol concentration in the first day after surgery of piatients with subtotal resection was 90.35-220.84 μg/24h (mean 102.83 μg/24h),and 6 cases were in the normal range.After surgery 6-11 months,the clinical symptoms completely disappeared.The hormone replacement therapy was discontinued 1-3 months after surgery.However,There were 3 cases treated with residual adrenalectomy because of the recurrence after 1,3.5,5.0 years respectively.30 cases underwent unilateral adrenalectomy,whose 24 h urine cortisol concentration in the first day after surgery was 99.80-550.84 μg/24h (mean 372.83 μg/24h),among which 24 cases were beyond normal range,and another 6 cases were within the normal range.Reviewing 24 h urine cortisol concentration one month later after operation,it was 382.16-520.34 μg/24h (mean 461.62 μg/24h),with the results of all cases being higher than the normal range,the clinical symptoms were not relieved satisfactorily.During 2 to 7 months after surgery,there were 22 cases further underwent contralateral subtotal adrenalectomy (80％),the remaining 8 cases underwent contralateral adrenalectomy and autologous transplantation of adrenal tissue.Immediately one day after surgery,the 24 h urine cortisol concentration level of patients was ranged from 62.58 to 182.34 μg/24h (mean 92.83 μg/24h),and all 22 cases were within the normal range.The clinical symptoms completely disappeared during next 6 to 9 months after surgery,and hormone replacement therapy was discontinued 3 months after surgery.There were 2 cases received residual adrenalectomy because of the recurrence.Lifelong hormone replacement therapy after surgery occurred in 13 cases and 5 cases developed Nelson syndrome.Conclusions Retroperitoneal laparoscopic of unilateral adrenalectomy and contralateral subtotal adrenalectomy for the treatment of Cushing disease was safe and effective.The contralateral adrenal subtotal resection could be performed at an appropriate time in the case of that the clinical symptoms not obvious.By doing so,it could significantly alleviate the clinical symptoms as well as avoiding lifelong hormone replacement therapy.Once recurrence,residual adrenalectomy can be considered.

Objective To study the correlation between CD8 + T cells' balance and prognosis for patients with diffuse axonal injury(DAI).Methods To collect the 41 patients with DAI as observation group,with 33 cases light craniocerebral injury (LCI) patients and 35 healthy volunteers as control group.We detect the peripheral blood CD8 + CD28 + T cells and CD8 + CD28-T cell percentage,and calculate the ratio of both.The subjects working curve method (ROC) of.the above CD8 + T cells and its ratio were used to predict the prognosis of patients with DAI efficiency evaluation.Results (1) Compared with control group,CD8 + CD28 + T cells in patients with DAI and LCI increased significantly,and DAI was significantly higher than that of LCI group (P ＜ 0.05).Compared with control group,CD8 + CD28-T cells in patients with DAI were decreased,but no statistical difference was found between LCI and the control group,but DAI group was significantly lower than the LCI group (P ＜ 0.05).(2) CD8 + CD28-T cells and CD8 + CD28 +/CD8 + CD28-ratio were correlated with DAI diagnosis (P =0.003,0.000).When the percentage of CD8 + CD28-T cells =2.95％,the sensitivity of the diagnosis of DAI was 87.49％,86.21％;When the ratio of CD8 + CD28 +/CD8 + CD28-=7.39,the sensitivity was 92.63％,90.71％.(3) a total of 7 cases of patients died within 1 week after injury,CD8 + CD28 + T cells and CD8 + CD28 +/CD8 + CD28-ratio were significantly negative correlated with survival time (r =-0.739,-0.834,P =0.021,0.002),and CD8 + CD28-T cells were significantly positive correlated with survival time (r =0.782,P =0.006).Conclu sions Decreasing CD8 + CD28-T cells and higher CD8 + CD28 +/CD8 + CD28-ratio in patients with DAI immunological characteristics,especially the ratio (balance) is closely corrected with the diagnosis and prognosis of DAI.

Objective To investigate the clinical features and prognosis of antimyelin oligodendrocyte glycoprotein-IgG （MOG-IgG） associated disorders （MOGAD）.Methods Eight cases met the diagnostic criteria of MOGAD were reviewed，and the demographics，clinical manifestations，laboratory and imaging results，treatment and prognosis were analyzed. The Expanded Disability Status Scale （EDSS） and the modified Rankin Scale （mRS） were used to dynamically evaluate the neurological disability. Results The ratio of male to female in this 8-case series was 1∶1，the median onset age was 34 years old，and the median disease duration was 42 months. The most common initial symptom is optic neuritis （ON，50%），followed by meningitis and/or encephalitis （25%）. Recurrence occurs in 50% of cases，and the recurrence rate of patients with high serum MOG IgG titer （≥1∶32） is 60%. The white blood cells in the cerebrospinal fluid in cases with meningitis/encephalitis or longitudinally extensive myelitis is often>100×10-6/L，which is higher than other phenotypes. There are 6 cases （75%） of patients with different MRI abnormalities，including hypertensity on T-2/Flair image with enhancement at affected optic nerve and orbital tissue，asymptomatic diencephalon/thalamus lesions on T2 and contrasted image，and MRI findings mimic typical multiple sclerosis may also be present. Cases with myelitis can show short-segment eccentric lesions or long-segment central lesions on MRI. Cases with meningitis/encephalitis showed unilateral cortical high T-2/Flair lesions on cranial MRI with various enhancements. After medication and rehabilitation，the peak EDSS of this case series was 5±1.069，and 2.19±1.689 points at the last visit；mRS was 3.25±1.165 points at the peak and 1.25±1.035 points at the last visit. The difference was statistically significant.Conclusions MOGAD is a rare type of demyelinating disease in central nervous with various manifestations，which is highly treatable. Fully understanding of the clinical characteristics，making a early diagnosis through comprehensive tests，and initiating immunization and rehabilitation treatment in time，will contribute to better prognosis for patients.