Objective] Summarize the experience of diagnosis and treatment of plasma cell mastitis by Gu ’s surgery department. [Method] By collecting medical records, from the teachers, pathogenesis, to summarize the inheritance and development of diagnosis and treatment of plasma cell mastitis by Gu ’s surgery department three generations, according to the present situation, analysis of the problems existing in the treatment of the disease. [Results] The disease was first discovered and reported by Dr.Gu Bohua in the domestic.Gu’s surgery department gradually gropes for a set of solution method in treatment of plasma cell mastitis after three generations from the treatment based on the external therapies in the initial, to later, internal and external therapies, at present based on the internal therapies. Clinical studies have found that the internal and external therapies have advantages of high cure rate, short treatment time, but the scar is larger, while the internal therapies in the long treatment cycle achieve the same cure rate, but the scar is smaller, less expensive. But the exploration of the cause of the disease, diagnosis and standardized treatment is still fraught with problems. [Conclusion]Developing by three generations, Gu ’s surgery department provides a more complete mentality and pragmatic value in treating plasma cell mastitis.

Objective: To investigate the chemical constituents from the whole plants of Gynura procumbens. Methods: The chemical constituents were isolated and purified by repeated silica gel column chromatography, Sephadex LH-20 gel column chromatography, medium pressure column chromatography, and semi-preparative HPLC, and their structures were elucidated by chemical properties and spectroscopic analyses. Results: Sixteen compounds were identified to be quercetin (1), apigenin (2), luteolin (3), kaempferol (4), astragaline (5), kaempferol-5-O-(6″-O-acetyl)-β-D-glucopyranoside (6), negletein (7), 4-methoxycinnamic acid (8), benzyl-O-β-D-glucopyranoside (9), 2-phenylethyl-O-β-D-glucopyranoside (10), 3,5-dicaffeoylquinic acid methyl ester (11), 3,5-dicaffeoylquinic acid ethyl ester (12), 3,4-dicaffeoylquinic acid methyl ester (13), 4,5-dicaffeoylquinic acid methyl ester (14), protocatechuic acid (15), and eugenol glucoside (16). Conclusion: Compounds 7, 8, 12, 14, and 16 are obtained from the plants in Gynura Cass. for the first time, and compounds 3, 6, 9-11 and 13 are obtained from this plant for the first time.

This paper is to build a finite element model of brain with a real brain shapeon which simulation studies of electrical impedance tomography EIT in the brain is based. A curve of a real brain shape is simulated with the curve-fitting methods and EIT in the brain is finished with finite-element methods and Equipotential Lines Back-Projection algorithm.The locationarea and amplitude of the change of the resistivity are reconstructed accurately. But the image quality has to be further improved.This paper provides a basis for clinical applications of EIT in brain.

Objective To investigate the protective effects of recombinant human erythropoietin (rHuEPO) on caecal ligation and puncture (CLP)-induced acute kidney injury (AKI).Methods A total of 260 healthy male Sprague-Dawley rats (250-300 g) were randomly divided into 6 groups:normal control group,sham group,CLP model group,the large dose rHuEPO (5000 U/kg)group,the middle dose rHuEPO (1000 U/kg) group,and the small dose rHuEPO (500 U/kg) group.The rat models of sepsis were established by CLP.In treatment groups,rats were treated with rHuEPO through caudalis injection after CLP surgery.Each group was divided into 2-,6-,12-,24-,36-hour subgroups with 10 rats.Rats were sacrificed and the tissue samples including kidney and blood samples were collected.The kidney function,plasma cytokines [interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-α)],kidney injury moleclue 1 (KIM-1) and inducible nitric oxide synthase (iNOS)were measured.Cytokines were determined by ELISA method.The expression of nuclear factor-kappaB (NF-κB) protein in kidneys were detected by immnunohistochemistry method.Pathological changes of kidney tissues were observed by light and transmission electron microscopy for cytokine content and apoptosis.Results Compared with CLP model group,renal function,the levels of TNF-α,IL-6,KIM-1 and iNOS in serum,the expression of NF-κB,significantly decresed in large dose rHuEPO group (all P ＜ 0.05).rHuEPO also lessened the histological changes in large dose group.rHuEPO did not lessen the histological changes in others.Conclusion rHuEPO can inhibit the levels of TNF-α,IL-6 and iNOS in serum,thus modify the inflammatory response and provide protective effects against acute kidney injury induced by sepsis.

Background The underlying mechanism of choroidal neovascularization(CNV) is multifactorial and complex.Focal adhesion kinase(FAK) plays a crucial role in controlling essential cellular processes and influencing distinct steps of the angiogenic response.But to our knowledge,seldom study on the effect of FAK on CNV formation has been reported previously.Objective In this study,the effect of several CNV risk factors on the expression of FAK in cultured retinal pigment epithelium(RPE) cells was investigated to illuminate effect of FAK on CNV.Methods Human RPE cells were isolated from donor eyes and exposed to H2O2,swallow of outer segment of photoreceptors(POS) and extracellular matrix(ECM) separately with the treating as follows:RPE cells were co-cultured with 10,20,50 and 100μmol/L H2O2 for 20 days;POS(1×106/ml) were co-cultivated with RPE cells for 20 days(setting control group,POS group,hypoxia group with 200μmol/L CoCl2,and POS+hyoxia group);RPE cells were cultured on the plates coated with 100mg/L fibronectin(FN),laminin(LN) or collagen typeⅠfor 30minutes or 1 hour.The expression of FAK and pFAK in RPE cells were examined by Western blot analysis.Results FAK was highly expressed in the 20μmol/L and 50μmol/L H2O2 groups compared with control group(P＜0.01);while he expression level of pFAK was reduced after treated with H2O2 in comparison with the control group(P＜0.01).After cultured with POS for 20 days,the undigested lysosome could be observed in RPE cells.The expressions of FAK and pFAK in RPE cells were not significantly changed between control group and POS groups(P＞0.05),but those in hypoxia group were significantly up-regulated in comparison with control group(P＜0.01).Compared with the hypoxia group,the expression amount of pFAK was elevated in POS+hyoxia group(P＜0.01).In comparison with control group,the increased pFAK expression was seen in FN,LN and collagen typeⅠtreating for 1-hour groups(P＜0.05,P＜0.01).Conclusion FAK pathway participates in several CNV-initiated signaling,such as H2O2,POS and ECM,in cultured RPE cells.It is reasonable to believe that FAK potentially plays an important role in CNV-dependent disorder.

Objective To observe the relationship between serum lipid concentration profiles and thyroid function after thyroid hormone withdrawal( THW) in patients with differentiated thyroid carcinoma( DTC) .Methods Sixty-five post-operative DTC patients who prepared to receive radioiodine ablation were included in this study.Serum thyroid hormones ( TSH, FT4 , FT3 ) and lipid profile [ total cholesterol ( TC ) , triglycerides ( TG ) , low-density lipoprotein-cholesterol(LDL-C), and high-density lipoprotein-cholesterol(HDL-C)] levels were measured before and 3 weeks after THW.The relationship between serum lipid profile concentrations and thyroid hormone levels were measured.Results Before surgery, HDL-C level showed a significant positive correlation with TSH level(r=0.273, P=0.041), whereas other lipid profile did not show any significant correlation with thyroid hormones levels.Before THW, no correlation was observed between thyroid hormones and lipid profile.After 3 weeks′THW, the TC level was correlated with FT4 and FT3 levels(r were-0.321 and-0.415, respectively, both P<0.01).The LDL-C level was correlated with FT4 level(r=-0.347, P=0.005).The HDL-C level was significantly correlated with TSH, FT3, and FT4 levels (r were 0.342,-0.452, and-0.478, all P<0.01).The serum LDL-C level in patients with TSH above 50 mU/L(n=50) was higher than that in patients with TSH below 50 mU/L(n=15, P=0.001), while serum TC, TG and HDL-C levels were not significantly different between those two groups(P>0.05).Conclusion The serum lipid profile varies with the change of serum thyroid hormones after THW in postoperative DTC patients.

Objective Investigate the prognosis of patients undergoing liver transplantation (LT) for end-stage autoirnmune liver disease (ALD).Method The clinical data of 45 patients with endstage ALD undergoing LT from April 2001 to March 2015 in the first affiliated hospital of Zhejiang University were analyzed retrospectively.The postoperative cumulative survival rate of the recipients was calculated,and the causes of death were analyzed.The postoperative rejections,new onset viral hepatitis and ALD recurrence were also analyzed.Result In 45 ALD recipients,33 cases survived and the postoperative 5-year cumulative survival rate was 78.8％.Causes for 12 dead cases were mnultiple organ failure,liver graft failure,respiratory complications,hemorrhage and hepatic artery embolization.In 45 ALD recipients,6 cases suffered rejection after operation with the incidence bing 13.3％.One case suffered new onset hepatitis B infection 8 years after opcration.One recipient suffered primary disease (primary biliary cirrhosis) recurrence 2 years after operation,and 1 recipient with primary disease (primary sclerosing cholangitis) developed into overlap syndrome.They all survived for a long term after active treatments.Conclusion Most LT recipients with endstage ALD can obtain a long term survival.Attentions should be paid to the immunosuppressive regimens in early period after LT,prevention of infection,rejection and postoperative new onset viral hepatitis,and timely diagnosis of primary disease recurrence.

Objective To investigate the protective effects of recombinant human erythropoietin (rHuEPO) on caecal ligation and puncture (CLP)-induced acute liver injury.Methods Ninety-six healthy male Sprague-Dawley rats weighing 250-300 g were randomly divided into 3 groups:normal control group (sham group,n =32),CLP model group (sepsis group,n =32) and rHuEPO treatment group (n =32).The rat model of sepsis was established by caecal ligation and puncture.In treatment group,rats were treated with rHuEPO 5000 U/kg administered through caudalis vein after CLP procedure.Continuous observation was carried out until 24 h after modeling.Of each group,8 rats were sacrificed at 2 h,6 h,12 h and 24 h,respectively,and then the liver tissue samples and blood samples were collected.Blood samples were assayed for determining the levels of serum cytokines [tumor necrosis factor-alpha (TNF-α)],and inducible nitric oxide synthase (iNOS) by using the enzyme-linked immunoadsorbentassay (ELISA) method.The levels of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were also detected.Histopathological changes of liver tissues were observed under optical and transmission electron microscopy.Results (①)The levels of ALT,AST,TNF-a,iNOS in serum of rats in control group were lower than those in model group and rHuEPO group (P ＜0.01).The levels of TNF-α,IL-6 and iNOS in serum of rats in rHuEPO group were decreased significantly compared with model group (P ＜ 0.01).(②) The optical microscopy and the transmission electron microscopy showed hepatocyte edema,liver focal necrosis,inflammatory cell infiltration in portal area and severe congestion of interlobular veins,hepatocyte karyopyknosis,mitochondrial and endoplasmic reticulum (ER) obviously decreased in sepsis group at 24 h.Hepatic injury was attenuated after employment of rHuEPO.Conclusions Recombinant human erythropoietin can inhibit the levels of ALT,AST,TNF-a,iNOS in serum,thus modifying the inflammatory response and providing protective effects against acute liver injury in the wake of infection.

Objective To investigate the effects of intravitreal injection of conbercept on diffuse macular edema (DME) of diabetes mellitus.Methods Together 51 diabetic patients (51 eyes) with diffuse macular edema were collected between July 2016 to July 2017,and randomly divided into three groups (n =17):group A,in which patients received solely intravitreal injection of 0.5 mg conbercept,group B,those who was intravitreally injected with 0.5 mg of conbercept and modified macular grating photocoagulation,and group C,patients undergoing modified grid photocoagulation (GPG).Then,before treatment and 1 week,1 month,3 months and 6 months after treatment,all patients were examined by optical coherence tomography for determining central macular thickness (CMT),followed by fundus fluorescein angiography (FFA),the best corrected visual acuity (BCVA),slit lamp,intraocular pressure for compare the efficacy and safety of the three procedures.Results All the three treatments improved BCVA,CMT,retinal neovascularization (RNV) leakage in diffuse DME patients,but group A and B were better than group C (both P ＜ 0.05),while there was no significant difference in BCVA improvement between A and B group (P ＞ 0.05),whereas the improvement in CMT of group B patients was better than that of group A [(197.47 ±45.26) μm vs.(205.59 ± 47.33) μm] (P ＜ 0.001),and this was true of RNV leakage [(9.91 ±3.18)mm vs.(13.24 ±4.87) rnm] (P＜0.001),without related complications.Conclusion Combination of modified macular grid photocoagulation and intravitreal injection of conbercept can quickly relieve diabetic macular edema and alleviate neovascularization,thus improving the patients' vision acuity,of which the efficacy is superior to the pure modified macular grid photocoagulation and conbercept injection.

BACKGROUND:The effects of advanced glycation end products (AGEs) on osteoclast-induced bone resorption is controversial and the underlying mechanisms remain unclear. Most of the studies indicate that AGEs can enhance bone resorption, while some othersshowthe opposite effects.
OBJECTIVE:To investigate the effects of AGEs on osteoclast-induced inorganicmatrixdissolution and organic componentdegradation and the underlying mechanisms.
METHODS:RAW 264.7 cels were induced to generate osteoclasts,and AGEs (50-400 μg/mL) or control-bovine serum albumin (100 μg/mL) was added since the beginning of the induction. The effect of AGEs on bone resorption was evaluated by analyzing the area of resorption pits on the Osteo Assay Surface plates and the expression of cathepsin K. Furthermore, the number of tartrate-resistant acid phosphatase (TRAP)-positive multinucleated cels, nuclei per osteoclasts and the expression of integrinανβ3were detected.
RESULTS AND CONCLUSION:The area of resorption pits and expression of cathepsin K in AGEs groups were significantly decreased compared withthecontrol group, and this inhibiting effect became more obvious with the increase of AGEs concentration. TRAP staining also showed that number of TRAP-positivemultinucleated celsand nuclei per osteoclast were significantly reduced in an AGE dose-dependent manner. Quantitative PCR revealed that the expression of integrin ανβ3decreased significantly with the extension of AGEs incubation time. These data indicate that AGEs can exert inhibitory effects on organic and inorganicmatrixdegradation induced by osteoclasts. The underlying mechanism may be involved in the inhibitory effects of AGEs on directed differentiation and cel fusion of osteoclast precursor cels, and migration and adhension of osteoclasts.