Objective To analyze the endoscopic and pathologic characters of acute graft versus host disease(aGVHD) after aUogeneie bone marrow transplantation.Methods The endoscopic and pathologic findings of 4 patients with acute aGVHD were retrospectively analyzed.Results The clinical manifestations of 4 patients were abdominal pain and diarrhea occurred 21～57 days after bone marrow transplantation.The eolonoseopy detected mucosa edema,erosion and multiple ulcers.The pathological findings included epithelial necrosis accompanied with infiltration of lympbocytes and plasmacytes,no cytomegalovirus was found in biopsies,and aGVHD was diagnosed.Three patients recovered after the treatment with corticosteroids,while the other one died.Conclusion The intestine is involved in aGVHD after allogeneie bone marrow transplantation,and the diagnosis depends on eolonoscopy and biopsy.

Background:CXC chemokine receptor type 2(CXCR2)is a member of G protein coupled receptor superfamily,and is mainly involved in the growth of tumor,angiogenesis and the pathogenesis of inflammatory diseases. Studies showed that CXCR2 was associated with the pathogenesis of inflammatory bowel disease(IBD),but the exact role has not yet been clarified. It was found that the interaction of interleukin-8(IL-8)with CXCR1 and CXCR2 played an important role in the pathogenesis of IBD. Aims:To investigate the expressions and significance of CXCR2 and IL-8 in patients with IBD. Methods:A total of 121 IBD patients in active stage from October 2013 to December 2014 at Zhongnan Hospital of Wuhan University were enrolled and assigned into Crohn’s disease(CD)group and ulcerative colitis(UC)group. Seventy healthy subjects were served as controls(HC). Expressions of IL-8 mRNA and CXCR2 mRNA in peripheral blood and intestinal mucosal tissue were determined by real-time PCR;expression of CXCR2 protein in intestinal mucosal tissue was determined by Western blotting. Results:In peripheral blood,expression of IL-8 mRNA in UC group was significantly higher than that in HC group(P = 0. 017),while expressions of CXCR2 mRNA in CD,UC and HC groups were not significantly different (P = 0. 285). In intestinal mucosal tissue,expressions of IL-8 mRNA in CD,UC and HC groups showed no significant difference(P = 0. 206),while expressions of CXCR2 mRNA in CD and UC groups were significantly higher than that in HC group(P = 0. 002;P < 0. 001),and expression of CXCR2 mRNA in UC group was significantly higher than that in CD group(P = 0. 005);expressions of CXCR2 protein in UC and CD groups were higher than that in HC group(P = 0. 049 P =0. 080). Conclusions:Expressions of CXCR2 mRNA and protein in intestinal mucosal tissue of patients with IBD, especially UC are significantly increased. Down regulation of CXCR2 expression in intestinal mucosa may provide a new target for treatment of UC. IL-8 is significantly highly expressed in peripheral blood of patients with UC,which suggests that IL-8 might be related mainly with UC.

Objective To study the expression of gonadotropin releasing hormone receptor (GnRH receptor) in the stomach of Sprague-Dawley rat exposed to light stress. Methods We established illumination stressed models that the rats were exposed to continuous light(totally 64 rats, 32 rats for experiment and control group, respectively). Then,stomachs were taken from the rats when the rats exposed to continuous light for 1 day, 2 days, 3 days, 4 days, 1 week, 2 weeks, 3 weeks, 4 weeks and their control groups, respectively.The localization and the expression of GnRHR and GnRHR mRNA in stomachs mucous membrane were detected using immunohistochemistry, Western blotting and real-time PCR. Results Immunoreactivity was displayed mostly in the parietal cells in gastric gland. There were not differences of this distribution in all groups of constant illumination and their control. The immunoreactive materials were distributed on membrane and in cytoplasm of all positive cells, but not in nuclei. The level of GnRHR in rats exposed to continuous illumination were higher from one week to four weeks compared with that in control(P<0.05), and the level of GnRHR reached the peak when rats were exposed to constant illumination for two weeks (P<0.01). The quantity of GnRH mRNA in rats exposed to continuous illumination were higher from three weeks to four weeks compared with that in control(P<0.05). Conclusion The expression of GnRHR in digestive tract was effected by illumination stress.GnRH might regulate digestive function by interaction with GnRHR, suggesting that GnRH may be acted as a hormone, not only responded to normal physiological function of digestive tract but also responded to stress activity.

OBJECTIVETo investigate the blood supply of the pedicle fat grafts with the third lumbar segmental artery and its clinical effects on reoperation for lumbar disc herniation.

METHODSTwelve sides of 6 adult cadaver examples were contributed to investigate the courser of lumbar segmental vessels and the distribution of hypodermic capillary net of the dorsal branch of the third lumbar segmental artery. From January 2000 to January 2007,49 patients needed reoperation to treat lumbar disc herniation,including 26 males and 23 females with an average age of 55.6 years (ranged from 39 to 70 years). Duration between two operations ranged from 8 months to 15 years with an average of 6.9 years. Reoperative reasons included recurrent lumbar disc protrusion(30 cases)postoperative epidural scar formation (17 cases), postoperative epidural cyst formation (2 cases). Of them,9 patients underwent posterior lumbar interbody fusion at the second operation. The pedicle fat grafts with the third lumbar segmental artery were covered on the sites of the laminectomy in these patients. After negative pressure drainage tube were pulled out, 2 ml Chitsan were injected to the sites of the laminectomy and around epidural nerve root through epidural catheter. VAS score and the Oswestry Disability Index (ODI) were used to assess clinical outcomes before and after operation.

RESULTSThe courser of third lumbar segmental vessels were invariant at the lateral face of the lumbar vertebral body. The dorsal branch of the third lumbar segmental artery penetrated thoracolumbar fascia and formed rich hypodermic capillary net in the region. All patients were followed up from 5 to 8 years with an average of 5.6 years. VAS score of low back pain and leg pain decreased respectively from preoperative 7.6 +/- 1.2, 8.9 +/- 0.9 to 3.6 +/- 0.5, 3.0 +/- 0.4 at final follow-up (P < 0.01); and ODI score decreased from preoperative 44.1 +/- 6.2 to 13.9 +/- 3.6 at final follow-up (P < 0.01). According to ODI score to evaluate the clinical outcomes, 29 cases got excellent results, 11 good, 7 fair, 2 poor.

CONCLUSIONThe pedicle fat grafts with the third lumbar segmental artery and Chitsan can reduce epidural scar formation and prevent peridural fibrosis and adhesion and improve clinical effects of reoperation for lumbar disc herniation.

Adipose Tissue ; pathology ; Adult ; Aged ; Arteries ; pathology ; physiopathology ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc Displacement ; pathology ; physiopathology ; surgery ; Lumbar Vertebrae ; blood supply ; pathology ; surgery ; Male ; Middle Aged ; Reoperation ; Transplantation ; Treatment Outcome

Objective To investigate radiological features of patients with heroin spongiform leukoencephalopathy(HSLE)of different clinical stages and discuss the evolutional characteristics of the disease.Methods Thirty two patients with HSLE underwent precontrast MRI and postcontrast MRI.The history of addiction,clinical presentations,and brain MRI were analyzed and summarized according to the patient's clinical staging.There are 6 cases in Ⅰ stage,21 cases in Ⅱ stage,5 cases in Ⅲ stage.Results All patients had history of heroin vapor inhalation.Most of the cases developed subacute cerebellar impairment in earlier period.Brain MRI revealed symmetrical lesion within bilateral cerebellum in all patients.Splenium of the corpus callosum,posterior limb of the internal capsule,deep white matter of the occipital and parietal lobes,were gradually involved with progressive deterioration of HSLE.The brain stem and deep white matter of the frontal and temporal lobes were involved in some cases.Conclusions The history of heated heroin vapor inhalation was the prerequisite for the diagnosis of HSLE.Brain MRI presented the characteristic lesion and its evolution of HSLE.Brain MRI was very important for accurate diagnosis and helpful to judge the clinical stages according to the involved brain region.

OBJECTIVETo investigate the effect of chronic endurance exercise on microcirculatory reserve capacity of biceps brachii in Chinese rowers and provide a certain basis for the date standard foundation of monitoring of functional status and the foundation of database of reserve capacity of blood of Chinese rowers.

METHODSEmpty stomach in the morning, 77 rowers from different groups and 24 common health people were noninvasive tested by using PeriFlux System 5000, the test indexes include the microcirculatory reserve capacity and other related indexes of biceps brachii. The test sites of all athletes were the same space in biceps brachii of the right side of body, there was no space differences of all athletes . All athletes were tested in the relatively stable functional status, common people were healthy. The test value included basic values and heating values, put the before and after heating of microcirculatory blood perfusion (MBP) as the microcirculatory reserve capacity.

RESULTSHeavyweight female (198. 97 ± 98. 81) > heavyweight male (183. 45 ± 64. 31) > lightweight male (151. 01 ± 65. 96) > lightweight female(140.53 ± 43.22) > common male people(127.21 ± 56.38) > common female people(103.54 ± 33.41), the microcirculatory reserve capacity of each group athletes were higher than common people, except the comparison between lightweight female and common male people, and there was no significant difference among the different group athletes.

CONCLUSIONChronic endurance exercise can improve the microcirculatory reserve capacity of rowers, especially the heavyweight rowers; the normal value of microcirculatory reserve capacity of heavy weight rowers should be more than 160, and lightweight rowers should be more than 120. There was no significant difference among different sex athletes, if the value of microcirculatory reserve capacity is significant lower than normal, it shows that athletes are in the state of fatigue.

Arm ; Athletes ; Female ; Humans ; Male ; Microcirculation ; Muscle, Skeletal ; blood supply ; Sports

Objective (1) To evaluate the effect of insertion of two 15-amino-4,7,10,13-tetraoxapentadecanoic (2 PEG4 ) linkers into cyclic Arg-Gly-Asp (RGD) Dimer E [c(RGDfK)]2 on receptor binding in vitro, (2) to assess its biodistribution in vivo and (3) to investigate the value of 99Tcm labeled 2PEG4-Dimer for integrin αvβ3-positive tumors imaging.Methods The expression of U87 human glioma cells and integrin αv β3 was determined by immunofluorescence staining.The half-inhibition concentrations (IC50) for 125 I-cyclo (Arg-Gly-Asp-D-Tyr-Lys) (c(RGDyK) ) of c ( RGDyK ), hydrazinonictinamide ( HYNIC )-Dimer and HYNIC-2PEG4-Dimer binding to integrin αvβ3 were measured.99Tcm-HYNIC-Dimer and 99Tcm-HYNIC-2PEG4-Dimer were synthesized using non-SnCl2 formulation.Biodistribution and imaging studies were performed in nude mice bearing human glioma xenografts.The unpaired t test was used for statistical analysis.Results The labeling yield of the two radiotracers was more than 95%, and the radiochemical purity was more than 99% through Sep-Pek C18 cartridge.HYNIC-2PEG4-Dimer had significantly higher binding affinity of integrin αvβ3 than c(RGDyK) and HYNIC-Dimer (IC50 = 0.8 nmol/L, 27 nmol/L and 2.4 nmol/L, respectively).Biodistribution study showed that 99Tcm-HYNIC-2PEG4-Dimer was mainly excreted via the kidney.The tumor uptake of 99Tcm-HYNIC-2PEG4-Dimer was higher than that of 99Tcm-HYNIC-Dimer at 2h post injection ((5.71 ±0.96) and (2.10 ±0.50) % ID/g, t =4.80, P＜0.05).The xenografted tumors were visible at 0.5 h post injection and the image contrast increased with time due to the tracer clearance of the background tissue.Conclusion 99 Tcm-HYNIC-2PEG4-Dimer is a promising radiotracer for integrin αvβ3-positive tumor imaging.

Objective:To evaluate the clinical application of virtual and simulation techniques to aid pre-operative design for precise screw placement into the sustentaculum tali in the treatment of intra-articular calcaneal fractures.Methods:From January 2016 to January 2019, 68 patients were treated at Department of Orthopaedics, Suqian Hospital Affiliated to Xuzhou Medical University for intra-articular calcaneal fractures of Sanders types Ⅱ-Ⅳ. According to different designs of screw placement into the sustentaculum tali, they were assigned into a control group (38 cases and 42 feet) and an observation group (30 cases and 33 feet). There were 24 males and 14 females with an age of 39.3 years±8.8 years in the control group. There were 17 males and 13 females with an age of 42.0 years ± 7.6 years in the observation group. The control group was given a routine placement design based on the X-ray and MSCT scanning images of the injured feet. In the observation group, a Mimics model was first constructed using the X-ray and MSCT scanning images of the normal or less injured feet for further virtual screw placement into the sustentaculum tali on a 3D printed model. The disparity was investigated between the parameters designed and the actual values in both groups. The 2 groups were compared in terms of average placements, screw distribution, placement accuracy, placement time and Maryland scores of foot function one year after operation.Results:There were no significant differences in the preoperative general data between the 2 groups, showing comparability ( P>0.05). The design parameters and actual values in the control group were respectively as follows: 17.7°±3.2° versus 15.1°±5.9° in upward oblique angle, 20.3°±2.1° versus 16.2°±6.8° in backward oblique angle, and 47.9 mm ± 3.8 mm versus 45.4 mm ± 4.2 mm in length of screw path, showing significant differences ( P< 0.05). The design parameters and actual values in the observation group were as follows: 16.5°±3.5° versus 17.1°±3.9° in upward oblique angle, 20.9°±4.3° and 19.6°±3.8° in backward oblique angle, and 48.1 mm ± 3.1 mm versus 47.3 mm ± 3.8 mm in length of screw path, showing insignificant differences ( P>0.05). The average screw placements into the sustenta culum tali in the observation group (1.6±0.5) were significantly more than those in the control group (1.2±0.4). Compared with the control group, the observation group had a higher rate of placement of 2 screws[60.6 % (20/23) versus 16.7% (7/42)], higher accuracy of placement [94.3% (50/53) versus 77.6% (38/49)], less placement time for each screw (9.6 mm±3.9 min versus 13.2 mm±4.7 mm), less placement time for each foot (15.6 mm±4.8 min versus 20.5 mm±3.8 mm), and higher Maryland scores at one year after operation (94.2±6.5 versus 89.7±6.9). All the above comparisons were statistically significant ( P<0.05). Conclusions:Application of virtual and simulation techniques to aid pre-operative design for precise screw placement into the sustentaculum tali can improve the outcomes of intra-articular calcaneal fractures, because it increases the number of screws placed, enhances quality of screw placement, shortens operation time, and thus facilitates functional recovery of the injured foot.

Objective To evaluate effect and safety of first-line chemotherapy regimen combined with rh-endostatin for osteosarcoma of the extremities.Methods Sixty three patients with osteosarcoma were randomly divided into experiment group and control group.There were 32 patients in experiment group,and 31 patients in control group.Nine patients 9 were rejected because they did not meet the standard.Finally,54 patients were enrolled in this study,including 29 patients in experiment group,and 25 patients in control group.In the experiment group,the patients were treated with rh-endostatin combined with MTX,IFO,DDP,and ADM,while patients in control group were treated with MTX,IFO,DDP,and ADM.Several indexes including median progression-free survival time,clinical benefit rate,progression-free survival rate,limb salvage rate,and survival rate were used to assess clinical effect.The safety of rh-endostatin was evaluated by comparing incidence of adverse events in the two groups.Results The median progression-free survival time of experiment group and control group was 18.9 months and 13.1 months,respectively; there was no significant difference.In the experiment group,the clinical benefit rate,progression-free survival rate,survival rate and limb salvage rate were 89.7％,37.9％,65.5％,and 89.7％,respectively; while in the control group,the clinical benefit rate,progression-free survival rate,survival rate,and limb salvage rate were 88.0％,36.0％,68.0％,and 96.0％,respectively.There was no significant difference in 4 indexes mentioned above between two groups.Conclusion After being combined with first-line chemotherapy regimen,rh-endostatin doesn't show significant advantage in controlling tumour progression and improving survival rate.No more toxicity and new side effects are found after using rh-endostatin.

Objective: To examine the Quality of life among school-aged children with dyslexia in target city and to provide scientific evidence for improving the quality of life of children with dyslexia. Methods: By using cluster sampling,students from grade 3 to grade 6 from 6 primary schools in a middle-sized were selected and administered with questionnaire survey. According to the criteria of dyslexia, dyslexic children and non-dyslexic children were identified and the difference of the Quality of Life was compared. Results: Totally 3 673 children were collected, and 119 of them were identified as dyslexia(3.24%).The prevalence of dyslexia differed by gender,grades,educational level of parents(χ2=24.77,11.75,18.50,9.79,P<0.05). The Quality of Life which below the average proportion accounted for 30.3% of dyslexic children and 16.7% of normal children. Quality of life scored signiticantly different between dyslexic children and non-dyslexia children, including psychosocial functioning domain(134.54±30.88)(143.49±32.53), physical and mental health domain(2.71±0.84)(2.92±0.81) vs (2.83±0.90)(3.06±0.87), the living satisfaction domain(2.95±0.87)(3.14±0.87)(t=-6.09，-5.48，-5.44，-4.50，P<0.01),with dyslexic group significantly lower than that of non-dyslexic group. Conclusion The Quality of Life of Dyslexic children was in a poor condition.