Objective To study the relationship between E2F2 and the pathological features of RA and the mechanism of E2F2 expression.Methods The interference efficiency was detected by RT-PCR after RA FLs transfected with E2F2 siRNA.The cell proliferation was analyzed by MTS and the expression of numerous genes was tested by ELISA.To analyze the influence of E2F2 in the immune response by RT-PCR,RA FLs were separately treated with TNF-t and PDTC.The way of regulating E2F2 experssion was tested by Chip.Results Compared with negative control groups,the level of E2F2 mRNA were decreased in the cells transfected with E2F2 siRNA (P ＜ 0.01).Silencing E2F2 suppresses the proliferation of RA FLs (P ＜ 0.05).TNF-α regulates the expression of E2F2 in RA FLs via the NF-κB pathway.Conclusion Up-regulation of E2F2 is associated with the process of RA and TNF-α regulates the expression of E2F2 in RA FLs via the NF-κB pathway.Thus E2F2 might be a potential target for use in the development of new therapeutic approches of RA.

Objective To investigate the impact of human adipose-derived stem cells(hASCs) -plastelet-rich plasma(PRP) composite on the wound healing of radiation skin injury of nude mice.Methods ASCs were isolated from healthy adults after liposuction, conducted primary culture and subculture.PRP was prepared by two-step ultracentrifugation.The ASCs-PRP composite was prepared with ASCs (1 ×107cells/ml) at passage 6 and PRP.Twenty-four nude mice were randomly divided into 4 groups (n=6).A round shaped full-thickness skin defect (D=1cm) was made on the mice back after 20Gy (60Co) round shaped exposure (D=2cm).Right after radiation, wounds were treated as follows,in group A,there was ASCs+PRP, in group B, PRP,in group C, ASCs,in group D, sham group.The wounds were observed at postoperative 7 and 14 days.HE and CD31 stain were observed at 14th days after surgery.Results The wound healing of group A healed completely at 14th days.In group D,the wound healing were slowest and still filled with granulation tissue at 14th days.The wound healing of group B and group C were faster than that of group D, but they haven′t healed completely at 14th days.The inflammatory cells were significantly lower and the blood vessel density positive rate were significantly higher in ACSs+PRP group than in ACSs group,PRP group and sham group (P<0.05).Conclusion ASCs-PRP Composite can accelerate the wound healing of radiation skin injury by promoting wound angiogenesis.

Objective To explore the early diagnostic marker and mechanism of the injury of in- testinal mucosal barrier induced by intestinal ischemia-reperfusion in rats.Methods Sixty male Wistar rats were randomly divided into six groups:the sham operation group(SO),the ischemia 15 minutes group(A),the ischemia 45 minutes group(B),the ischemia 45 minutes plus reperfusion 2 hours group (C),the ischemia 45 minutes plus reperfusion 6 hours group(D),and the ischemia 45 minutes plus reperfusion 12 hours group(E).Using clamping and then releasing superior mesenteric artery the model of intestinal ischemia-reperfusion in rats was made.The sham operation group only underwent laparotomy. At different time points after ischemia and reperfusion the levels of serum CK,LDH,D-lactate and intes- tinal fatty acid binding protein(IFABP)in each group were examined.The morphological changes of in- testinal tissues were observed with light microscopy.Results Compared with group SO,the level of se- rum IFABP in group A was(374.74?48.85)pg/ml,significantly higher(P＜0.01),but the level of CK,LDH and D-lactate had no significant difference(all P＞0.05).In group B,the level of CK was (1090.40?187.51)u/L,peaking at 45 minutes after ischemia,meanwhile,D-lactate and IFABP levels were significantly increased(P＜0.01,respectively).In group C,D-lactate and IFABP were (2.51?0.19)?g/ml and (1601.42?286.81 )pg/ml,respectively,peaking at 2 hours after reperfusion (P＜0.01).At 6 hours after reperfusion,compared with ischemia 45 minutes,CK level was significantly de- creased(P＜0.01),LDH had no significant difference(P＞0.05),but the levels of D-lactate and IF- ABP were(2.03?0.24)?g/ml and(1443.76?174.52)pg/ml,respectively,all sustained a high lev- el(P＜0.01 ).At 12 hours after reperfusion,D-lactate and IFABP levels were gradually decreased(P＜0.01).At 45 minutes after ischemia the morphological changes of intestinal mucosa could be observed. At 6 hours after reperfusion part of the mucous layer appeared necrotic,some intestinal mucosal cells shed to enteric cavity,and submucous layer had hyperemia and edema obviously.Injury scores of intestinal mucosa were significantly correlated to the serum level of D-lactate and IFABP,correlation coefficients were 0.456,0.612(P＜0.01).Conclusion The monitoring of serum IFABP combined with D-lac- tate is a early,sensitive and specific biochemical marker in the diagnosis of intestinal mucosal barrier in- jury after ischemia-reperfusion.

Atrioventricular Block ; chemically induced ; Child ; Humans ; Male ; Mercury Poisoning ; complications

Objective To construct the gall-stone patients' nursing workload measurement project by Delphi method,so as to measure single disease workload scientifically and reasonably.Methods The gall-stone patients' nursing workload measurement project were designed on the basis of consulting literature and experts discussion,then two rounds of consultations were made with experts by using the Delphi method.Results The valid recovery rate of questionnaires of two rounds consultations were all 100％ (22/22).The expert authority coefficient was 0.886 1.Nursing workload measurement project,directly related to the gall bladder calculi 54 nursing projects,including technical 46,unskilled 7;indirectly related to the gall bladder calculi 36 nursing projects,including technical 17,unskilled 19.Conclusions The measurement project of gall-stone patient determined by Delphi method has high reliability,which is significant to the scientific measuring of nursing single disease workload.

Objective To summarize the clinical and pathological features of exaggerated placental site (EPS),explore its pathogenesis regularity,diagnosis and treatment strategies.Methods The clinical data related to 34 patients with EPS were analyzed retrospectively.Results In 34 patients,11 patients performed full-term cesarean section,2 patients performed normal vaginal delivery,the other 21 patients had abortion.Thirty-one patients had pregnancy history.Fifteen patients performed hysterectomy,13 patients performed dilatation and curettage,6 patients performed exploratory hysteroscopy and lesions resection.All the patients survived after treatment.Conclusions The patients can not be diagnosed in the antepartum and intrapartum,but can be diagnosed relying on the pathological diagnosis.When it is ineffective to stop bleeding after delivery or abortion by conventional treatment,we should consider the possibility of EPS.Timely perform hysterectomy is theeffective method to stop bleeding,can save the life of patients.If bleeding is not much,curettage or exploratory hysteroscopy can get a significant effective treatment and avoid hysterectomy.

Objective To investigate the appearance and characteristics of hepatic tuberculosis lesions on low mechanical index contrast-enhanced ultrasound. Methods Eight patients with hepatic tuberculosis lesions were studied with conventional ultrasound and contrast-enhanced ultrasound. Lesions,distribution.size,echogenieity,blood flow,enhancement phase,enhancement patterns and intensity were studied. ResuIts Fifteen lesions were found in eight patients. On conventional ultrasound,mean size of the lesions was(21.7±10.7)mm×(30.3±22.4)mm,and 66.7%(10/15)lesions located under liver capdule,and 33.3%(5/15)were in hepatic parenchyma.All lesions were hypoechoic except the largest one (50 mm x 102 mm)which demonstrated heterogeneous.Doppler signals were not demonstrated in all 15 lesions.After administration of SonoVue,satisfied image data were obtained in 13 lesions for aterial phase,and 15 lesions for portal venous phase and parenchyma phase.84.6%(11/13)of the lesions demonstrated hyperenhancing on aterial phase,mean enhancing start time was(8.6±1.6)s,ranging from 5 s to 10 s.and mean enhancing end time was(25.6±2.8)s,ranging from 20 s to 29 s. Of 13 lesions,6 lesions demonstrated circle periphery hyper-enchanCement,5 lesions demonstrated whole hyper-enchancement,and 2 lesions appeared hypoenhancement on arterial phase. All lesions demonstrated either hypoenhancing or non-enhancement on portal venous phase and parenchyma phase. Conclusions Low mechanical index contrast-enhanced ultrasound can reveal the blood flow status of hepatic tuberculous lesions and will facilitate the diagnosis of hepatic tuberculosis.

Objective To analyze clinical pathologic characteristics of patients with primary biliary cirrhosis autoimmune hepatitis overlap syndrome (PBC AIH OS),the incidence of extrahepatic autoimmune disease,malignant tumor and the abdominal lymph node enlargement.Methods From January 2000 to January 2012,the clinical data of 49 patients with PBC AIH OS were retrospectively analyzed,which included general information,clinical manifestations,biochemical parameters,immunological parameters,liver histopathological features,the incidence of extrahepatic autoimmune disease and malignant tumor,imaging findings and the efficacy.Results Among 49 PBC-AIH OS patients,the percentage of patients between 51 and 60 years old was 59.2％ (29/49),and the mean age of onset was (57.2±8.9) years old.Female was 83.7％ (41/49).The percentage of jaundice and pruritus in the main symptoms of initial visit was 42.9％ (21/49).The serum level of alanine aminotransferase (ALT),aspartate transaminase (AST),alkaline phosphatase (ALP),γ-glutamyl transpeptadase (GGT) and total bilirubin (TBil) of 49 patients all increased.Among 31 patients who accepted IgA,IgG and IgM level test,the level of IgM increased in 58.1％ (18/31) of patients,and the level of IgG increased in 61.3％ (19/31) of patients.Ninety-eight percent of patients were antinuclear antibody (ANA) positive,6.1 ％ (3/49) were anti-smooth muscle antibody (SMA) positive,89.8％ (44/49) of patients were anti mitochondrial antibody (AMA) and or AMA-M2 positive.All patients had interface hepatitis.Forty-nine percent (24/49) of patients had both histological features of autoimmune hepatitis (AIH) and primary biliray cirrhosis (PBC).After being treated with ursodeoxycholic acid (UDCA) and immunosuppressant,the percentage of remission,incomplete response and failure was 65.3％ (32/49),26.5％ (13/49) and 8.2％ (4/49),respectively.After remission,five of six patients with medicine withdrawal relapsed.Among 49 patients,40.8％ (20/49) with extrahepatic autoimmune disease and the percentage of Sjogren's syndrome,autoimmune thyroid disease,interstitial pneumonia,systemic lupus erythematosus,psoriasis,sarcoidosis and membranous nephropathy was 16.3％ (8/49),12.2％ (6/49),4.1％ (2/49),2.0％ (1/49),2.0％ (1/49),2.0％ (1/49) and 2.0％ (1/49),respectively.Among 49 patients,14.3％ (7/49) with malignant tumor and the percentage of endometrial cancer,breast cancer,thyroid cancer and lymphoma was 4.1％ (2/49),4.1％ (2/49),4.1％ (2/49) and 2.0％ (1/ 49).Among 49 patients,abdominal ultrasound showed abnormality in 93.9％ (46/49) of patients.Abdominal lymph nodes enlargement was found in 91.8％ (45/49) of patients.Conclusions Autoimmune disease and malignant tumor should be screened when patients with PBC-AIH OS were assessed.Abdominal lymph nodes enlargement found by imaging examination may have guiding significance to the diagnosis.

BACKGROUND:There are a variety of methods for establishing osteoarthritis animal model, and different methods and different animals have their own characteristics.
OBJECTIVE:To review the status of the research on osteoarthritis animal models.
METHODS:The relevant articles to the osteoarthritis animal models were searched in Medline database from January 2002 to October 2011, with the key words of“animal model, osteoarthritis”in English by the computer. Similarly, Chinese Journal Ful-text Database was retrieved for related articles published in Chinese from January 2002 to October 2011, with the key words of“animal model, osteoarthritis, research development”in Chinese. Total y 423 relevant articles were col ected and 128 of them conformed the standard. At last 40 articles were included to review after ful-text reading.
RESULTS AND CONCLUSION:The artificial induced animal models are the principal means to establish animal models of osteoarthritis and they have been widely used in the study of osteoarthritis pathogenesis, drug efficacy, cartilage physiology and pathology. Spontaneous osteoarthritis animal models have great advantages in the study addressing the initial mechanism of osteoarthritis, the biochemical changes of articular cartilage and the comparison of prevention and cure effects. Transgenic animal models have great application prospects on studying cartilage repairing mechanisms and testing a gene to prevent, delay or reversal the morphological changes. Accordingly the choice of models should be based on research needs.

Objective To explore prognostic factors of renal cell carcinoma and investigate the association of neutrophil-to-lymphocyte ratio (NLR) with the prognosis of renal cell carcinoma (RCC) in patients who received nephrectomy treatment.Methods We retrospectively reviewed the records of 1325 patients with renal cell carcinoma who underwent nephrectomy between January,2008 and December,2012.We retrospectively analyzed the clinicopathologic characteristics of patients.The optimal cutoff value for NLR was determined using receiver operating characteristic curve (ROC) analysis.We defined them as high NLR group when NLR ≥ 2.7 and low NLR group when NLR ＜ 2.7.Overall survival (OS) and recurrence free survival (RFS) were estimated using the Kaplan-Meier method and compared using the logrank test.Multivariate models were used to analyze the association of NLR with clinicopathologic outcomes.Results By the end of the study, 1220 cases were followed up.The follow-up rate was 92.1％.Mean follow-up was 40 months (range 2 months to 87 months).The three-year and five-year overall survival rate were 91.3％ and 86.9％, respectively.Meanwhile the three-year and five-year recurrence free survival rate were 88.2％ and 85.8％ ,respectively.2.7 was selected as the optimal cutoff value to differentiate between low NLR and high NLR.A NLR ≥2.7 was significantly associated with worse 5-year overall survival and worse 5-year recurrence free survival than a NLR ＜2.7,91.4％ vs 87.3％ ,89.6％ vs 71.9％ (P ＜0.05).Age ＞65, presentation mode with symptom, higher tumor stage, higher Fuhrman grade,histologic subtype,neutrophil count ≥ 4.5, lymphocyte count ＜ 1.7, NLR ≥ 2.7 significantly correlated with poor OS on univariate analysis.Multivariate analysis revealed that higher tumor stage, preoperative NLR ≥ 2.7 at diagnosis were poor independent prognostic factors for OS of renal cell carcinoma.Conclusion High NLR was independent poor predictor of renal cell carcinoma.