Objective To investigate the expression and role of Caspase-3 during the development of non-traumatic avascular/aseptic necrosis of femoral head(ANFH).Methods Tissue samples were obtained from 22 femoral heads of 21 patients with ANFH.The samples were divided into three groups:early stage(6 cases),middle stage(8 cases) and late stage(8 cases) groups according to the progress of the disease.Meanwhile,19 tissue samples of 19 femoral heads were obtained from 19 cases of acute femoral neck fracture and set as a control group.The level of apoptosis of each group was compared in terms of the percentages of TUNEL positive osteocytes and empty osteocyte lacuna,and then the activity of Caspase-3 was detected by colorimetric method.Results Both the pecentages of empty osteocyte lacunae(F=45.43,P=0.000) and the TUNEL positive osteocytes(F=120.86,P=0.000) increased significantly with the progress of ANFH.The two indexes in the early and middle stage groups were significantly higher than those in the control(q=18.899,P0.05).Caspase-3 activity was not significantly related to the capacity of osteogenesis(r=0.126,P=0.425).Conclusions Caspase-3 is not the major executor of apoptosis in ANFH.It is very likely that it does not play a nonapoptotic role in the progress of the diseases.

ObjectiveTo evaluate combined pneumatic lithotripsy and vacuum suction during ureterorenoscopy.MethodsCombined pneumatic lithotripsy and vacuum suction during ureterorenoscopy was conducted for 52 cases of urolithiasis with the average age of the patients 36 years old.There were 3 cases of renal stone,9 upper ureteral stone,12 middle ureteral and 28 lower ureteral stone.The average surface area of the stones was 79 mm2.ResultsThe average operation time was 31 min and the fragmentation in situ 100.0%.The stone upward displacement rate was 1.7%.Fragmentation of the stone has been incomplete in 2 cases and ESWL was instituted.49 patients have been followed up for 1～3 months and the stone clearance rate was 96.0%.ConclusionsThe procedure would reduce the high instillation pressure which might cause upward displacement of the stone and liquid reflux to the renal parenchyma.The vacuum pressure set to -0.2～-0.4 bar is the most ideal.

Objective To evaluate the safety and efficiency of the treatment with autologous cytokine-induced killer (CIK) cell in patients with hepatocellular carcinoma (HCC). Methods Peripheral blood mononuclear cells (PBMC) were isolated from blood from patients with HCC, then augmented by priming with interferon-gamma (IFN-?) followed by monoclonal antibody (mAb) against CD3 and interleukin-2 (IL-2). The autologous CIK cells thus obtained were infused back to individual patients. Altogether 30 patients undertook such treatment. The changes in subsets of lymphocytes and dendritic cells (DC1, DC2) in peripheral blood were assessed by using flow cytometry. Results The percentages of CD3 +, CD3 + CD8 + , CD3 + CD56 + , and CD25 + were increased significantly, and the proportions of DC1 and DC2 subsets were also increased after autologous CIK cells transfusion. Most (23 of 30) patients developed a fever 1-2 hours after CIK cells transfusion and the body temperature ranged from 37℃ to 40℃, lasting for 2-8 hours. Most (20 of 23) febrile patients recovered without any treatment, antipyretic medicine was given to 3 patients to allay the fever. The HCC symptoms were markedly relieved in most patients. No major side effects were found. Conclusion Our observation indicates that the treatment with autologous CIK cells for HCC patients is safe and efficacious.

According to relevant national laws and regulations, practitioner training was included into laboratory animal science teaching reform.By adjusting the training content and teaching method and use of animal models of typical human diseases, the transformation of training mode was realized and improved.By the assessment of basic theory in combination with practical operation, the thinking ability and hands-on skill of the practitioners are much improved. Through classroom instruction, experimental teaching, quality assessment and tracking survey, the evaluating process of the training quality of training teaching is performed.Therefore, the teaching reform of the laboratory animal science based on the training of practitioners is established.

Objective To study the effect of intestinal trefoil factor(ITF) on nuclear factor-?B(NF-?B) in neonatal rats intestinal tissues with necrotizing enterocolitis(NEC),and to discuss whether ITF had protective function in NEC,and its role in the mechanism of NEC.Methods Fifty neonatal rats were randomly divided into 5 groups:group A as control group,group B as control plus ITF 0.2 mg group,group C as NEC group,group D as NEC plus normal saline(NS),group E as NEC plus ITF 0.2 mg.NEC models of neonatal rats were established.On the 4th day,all subjects were put to death.The intestinal tissue located at the boundary of ileum and cecum were obtained to observe histological changes and NF-?B level.Results The density of NF-?B(p65) increased significantly in group C and D compared with those in group A,B and E(Pa

Objective To investigate the feasibility of using CT texture analysis to differentiate among lipid-poor adrenal adenoma,pheochromocytoma and adrenal metastases.Methods 66 lipid-poor adrenal adenoma,98 pheochromocytoma and 101 adrenal metastases lesions were analyzed retrospectively.All the patients had abdominal non-enhanced CT and adrenal enhanced CT scans.We used TexRAD software to analyze the textural features of CT images and compared the differences in each texture parameter among three adrenal lesions.Results On non-enhanced CT images,there were significant differences in Mean and Kurtosis at all the texture scales(SSF 0-6) among the three types of adrenal lesions (P<0.05),as well as SD at fine and coarse texture scale (SSF 2,6)(P<0.05).Entropy (SSF 0-3, 5-6) and MPP (SSF 0-2, 4-6) were significantly lower in lipid-poor adrenal adenoma and adrenal metastases than that in pheochromocytoma (P<0.05).There were significant differences in Skewness (SSF 0-3) among three types of lesions, which was lowest in pheochromocytoma and highest in adrenal metastases.On enhanced CT images, Mean, SD, Entrophy and MPP showed significantly differences among the three types of adrenal lesions at all the texture scales (SSF 0-6) (P<0.05), which were all highest in pheochromocytoma and lowest in adrenal metastases.Skewness (SSF 0) and Kurtosis (SSF 0, 2) were significantly lower in adrenal metastases than that in lipid-poor adrenal adenoma and pheochromocytoma (P<0.05).Conclusion There are significant differences in CT texture analysis parameters among lipid-poor adrenal adenoma,pheochromocytoma and adrenal metastases.CT texture analysis has potential clinical application values in differentiating these three adrenal lesions.

10.3969/j.issn.2095-4344.2013.24.026

Objective To estimate reliability of magnetic resonance elastography (MRE) in measuring liver stiffness of volunteers and patients with chronic liver disease and to assess inter-rater consistency.Methods MRE was performed on a 3.0 T scanner in all subjects,including 24 volunteers (control group) and 64 patients with liver disease (chronic liver disease group).Liver stiffness was measured blindly by two raters.The pathological fibrosis score was applied as a standard reference for liver fibrosis in 22 patients.The intraclass correlation coefficient (ICC) was used to evaluate inter-rater reliability.The differences of liver stiffness between two groups were evaluated using non-parametric MannWhitney U test.Spearman analysis was used to analyze the correlation between fibrosis stages and liver stiffness.Results The intraclass correlation coefficient of liver stiffness was perfect (ICC =0.99,P ＜ 0.01)between two raters.There was significant difference of mean stiffness between control group and patient group (U =90.5,P ＜0.01) with(2.35 ±0.34) kPa and(4.17 ± 0.47) kPa,respectively.The correlation between fibrosis stage (3,3,5,5 and 6 patients in fibrosis stage S0,S1,S2,S3 and S4) and stiffness (2.13,3.25,3.82,5.45 and 7.35 kPa) was very strong (r =0.96,P ＜0.01).Conclusion MRE is a reliable and promising tool to measure liver stiffness and to assess liver fibrosis.

ObjectiveTo explore the risk factors of obstructive hydrocephalus secondary to intracranial hemorrhage in premature infants.MethodsA total of 304 premature infants were selected who were diagnosed as sever intracranial hemor-rhage (grade III and IV) by cranial bedside ultrasound admitted to our hospital from Jun. 2013 to Sep. 2014. According to wheth-er the obstructive hydrocephalus was followed, all infants were divided into hydrocephalus group (n=59) and non-hydrocephalus group (n=185). The risk factors of obstructive hydrocephalus secondary to intracranial hemorrhage were analyzed and the lateral ventricle size was measured dynamically.ResultsThe univariate analysis showed the factors related with obstructive hydro-cephalus were as follows: gestational age≤32 weeks, birth weight< 1500g, severe asphyxia, cesarean section, RDS, neonatal infection, heart failure, PDA, acidosis, thrombocytopenia, coagulation abnormalities, and intracranial hemorrhage (gradeⅢ orⅣ) (allP<0.05). Multivariate logistic regression analysis showed that acidosis, thrombocytopenia, coagulation abnormalities, gesta-tional age≤ 32 weeks, severe asphyxia, intracranial hemorrhage (gradeⅢ orⅣ) were independent risk factors for obstructive hydrocephalus (OR: 1.76~20.46, allP<0.05). At each time point after birth, the ratio of posterior horn of lateral ventricle was signiifcantly higher in hydrocephalus group than that in non-hydrocephalus group (P<0.05). There were signiifcant differences in the changes of the posterior horn ratio of left or right lateral ventricle with time in hydrocephalus group (P=0.000), increasing at 14 days and reaching the peak at 28 days after birth.ConclusionsThe risk factors for obstructive hydrocephalus secondary to intracranial hemorrhage in neonates are important. Regular and dynamical monitoring of ventricle size by cranial ultrasound is needed in infants with sever intracranial hemorrhage.

BACKGROUND:Acute myeloid leukemia after liver transplantation is a rare complication with high mortality. OBJECTIVE:To study the clinical features of acute myeloid leukemia after liver transplantation. METHODS:One case of acute promyelocytic leukemia after liver transplantation was reported, and literatures were reviewed. RESULTS AND CONCLUSION:Case presentation was post-odontectomy bleeding with associative abnormal coagulation test at 85 months after liver transplantation. Routine blood test, bone marrow test and chromosome analysis and examination diagnosed as acute promyelocytic leukemia and promyelocytic leukemia/RARαpositive chimeric gene, and clearly diagnosed as acute promyelocytic leukemia combined with disseminated intravascular coagulation. The patient received fresh frozen plasma transfusion to correct the abnormal coagulation, and then received induction chemotherapy with retinoic acid, arsenic trioxide and daunorubicin to obtain bone marrow complete remission. The patient was treated with daunorubicin combined with cytarabine and mitoxantrone combined with cytarabine regimens after remission induction to consolidate the chemotherapy for two courses of treatment, and then subsequently subjected to arsenous acid chemotherapy, and the bone marrow was sustained for remission. During chemotherapy, the dose and type of immunosuppressive agents were adjusted, and the patient had stable liver function without serious infection or complications. The results indicate that acute myeloid leukemia is common and often occurs after liver transplantation. When the patient displays hematological abnormality, acute promyelocytic leukemia should be considered. Early diagnosis and treatment can reduce the mortality.