Objective To explore the effectiveness of sandplay therapy combined with family counseling in children with school phobia and its influence of child′ self-consciousness. Methods Integrative sandplay therary with family consulting were used to treat 28 patients with school phobia regularly for 2 months. Sandplay and family consulting therapy were given once a week for 45 minutes . Clinical outcomes were assessed using CGI-GI and Piers-Harris children′s self-consciousness scale before and after treatment as well as 3 months posttreatment. Results Overall response rate was 85%. In addition, the physical appearance and characteristic factor before and after treatment were no significant difference (P>0.05). The rest of the various factors and total score compared with pre-treatment significantly improved (P<0.05). After treatment for 3 months, every factor in self-consciousness of children and total score were no significant difference (P>0.05). Conclusion Integrative sandplay therapy with family counseling has better and long-lasting treatment effect to self-consciousness of children with school refusal.

Objective To investigate the expression of caspase-3 in colon carcinoma,colon adenoma and normal colon mucosa and its clinical significance.Methods The expression of caspase-3 was detected with immunohistochemical EnVision in 60 cases of colon carcinoma,30 cases of colon adenoma and 30 cases of normal colon mucosa.Results The positive expression rates of caspase-3 in colon carcinoma,colon adenoma and normal colorn mucosa were 18.3％(11/60),50.0％(15/30),86.7％(26/30).There was significant difference among three groups(P＜0.01).The expression of caspase-3 was closely related to Dukes clinical stage,differentiation degree,lymph node metastasis and the degree of infiltration(P＜0.01).Conclusion The low expression of caspase-3 may play an important role in the carcinogenesis of colon carcinoma and it is involved in the metastasis and infiltration.

Objective To study the impact of physical stimulus on periosteal chondroplasia with an in- tention of reconstructing cartilage tissue that has a biomechanical function and can be created either entirely in vivo or in vitro and subsequently implanted into the patient.Methods A series of biomechanical test methods were designed in order to investigate the mechanical properties of engineered cartilage under a variety of mechanical stress stimulations.The periosteal explants were harvested from proximal medial tibias of New Zealand rabbits and secured onto poly-?-caprolactone(PCL)scaffolds.The composites(periosteum/PCL)were suspended in the spinner flask bioreactor and the spinner flask was located on the stirring machine.The stem cells were stimulated by fluid shear stress under magnetic bar stirring.Results In gross observation,the thickness and length of neo-cartilage with shear force stimulation were significantly greater than those without shear force.The direction of elongation was parallel with fluid flow direction,regardless of composite orientation.Secondary,two different zones based on various cell morphology and distribution were clearly observed.The thickness of the superficial zone was greater in samples exposed to high shear force compared with low shear force.The superficial zone protein and lubricant were found in the engineered cartilage under shear stress stimulation.Conclusion The results reveal that shear stress can not only influence proliferation and differentiation of stem cells,but also change chondrocyte morphology and increase extracellular matrix production.

Objeetlve To evaluate the role of IL-1β and TNF-α in the spinal cord in a murine model of bone cancer pain(BCP)induced by activation of glial cells.Methods Three hundred and sixty male 8-10 weeks old C3H/He mice weighing 18-22 g were randomly divided into 6 groups(n=60 each):group I nomal control (group N);group Ⅱ sham operation (group S);group Ⅲ BCP+aCSF(group aCSF);group Ⅳ BCP+FC (group FC);group V BCP+MI(group MI) and group Ⅵ BCP+FC+MI (group FC-MI).BCP was produced by inieeting fibrosarcoma cells of bone into the medullary cavity of left ealcaneus bone.Intrathecal catheter was placed in the 4 BCP groups(group Ⅲ-Ⅳ).FC 0.5 nmol/5 μl or/and MI 16 μg/5 μl were injected IT once a day for 21 consecutive days after operation.The mechanical threshold to von Frey filaments was measured at 0.5 h(T0)before injection of fibrosarcoma cells and at 3,5,7,10,14,21 d(T1-6)after injection of fibrosarcoma cells.Twelve animals of each group were killed and L4.5 segment of the spinal cord was removed at T0,1,3,5,6 for determination of IL-1β and TNF-α content (by ELISA) and expression (by immuno-flurorescence) in the spinal cord. Results The mechanical threshold was significantly decreased at T1-6, while IL-1β content at T1,3,5,6 and TNF-α content at T5,6 was significantly increased in group BCP, FC, MI and FC + MI compared with those at T0 and group C (P < 0.05). Compared with group BCP, the mechanical threshold was significantly increased at T1-6 in group MI and FC + MI and at T4-6 in group FC, IL-1β content was significantly decreased at Ts,3,5,6 in group MI and FC + MI and at T5,6 in group FC and TNF-α content was significantly decreased at T5,6 in group FC, MI and FC + MI ( P < 0.05). Conclusion IL-1β and TNF-α in the spinal cord is involved in the process of glial cell activation-induced BCP.

Objective To analyze the clinical characteristics of pneumomediastinum in patients with dermatomyositis and polymyositis for demonstrating its pathogenesis and for predicting its prognosis. Methods The clinical records of 96 patients with PM/DM were reviewed, focusing on for perdicting its pneumomediastinum. Five patients with pneumomediastinum are described in detail. Case reports of pneumomediastinum in PM/DM in English publications are reviewed. Results Five DM cases complicated by pneumomediastinum all had lung infections. Twenty-nine cases (including our five cases) of DM/PM with pneumomediastinum have taken methylprednisolone, four cases alive, and six died. Nine cases have taken CsA,seven cases alive and two died. Conclusion The infections was strongly suspected as being responsible for the pneumomediastinum. Methylprednisolone has poor effect. CsA can be an effective therapeutic agent in PM/DM.

Objective To study the expression of VEGF,Cox2 and mPGES in colon cancer.Methods VEGF,Cox2 and mPGES mRNA expression in 32 paired samples(tumor and adjacent normal tissue)were de- termined by using real time RT-PCR.Results VEGF was overexpressed in 19 of 32(59.3 %)tumor tissues compared with that in 6 of 32(18.7 %)adjacent normal tissue;COX2 was overexpressed in 20 of 32(62.5 %) tumor tissues compared with that in 5 of 32(15.6 %)adjacent normal tissue;mPGES was overexpressed in 24 of 32(75 %)tumor tissues compared with that in 9 of 32(28.12 %)adjacent normal tissue.Conclusion Our result suggested that VEGF165,mPGES and COX2 overexpressed in colon cancer.

Objective To investigate the effect of TGF-β1/SMAD signaling pathway on K562 cells growth inhibition caused by HMBA. Methods After establishing the in vitro differentiation model with HMBA on K562 cells, the MTT assay was used to detect the proliferation of K562 cells, the cell cycle profile was detected by flow cytometry, and the mRNA expression of TGF-β1, SMAD3, SMAD4 and EVI1 was measured by RT-PCR assay. Results HMBA could inhibit the proliferation and promote the differentiation of K562 cells obviously, which was time and concentration-dependent, and the 72 h corresponding IC50, was about 2 mmol/L. Within 72 h, flow cytometry assay indicated that the ration of G0-G1 phase cells was up-regulated, and the results of RT-PCR showed that relative mRNA expression of TGF-β1, SMAD3 and SMAD4 at mRNA level was increased gradually while that of EVI1 was decreased gradually. Conclusion HMBA can inhibit K562 cells proliferation through TGF-β1/SMAD signaling pathway.

OBJECTIVETo explore the myeloid-derived suppressor cell (MDSC) expression in the peripheral blood and lesions of 4NQO-induced tongue carcinoma in mouse.

METHODSThe established 4NQO mouse model was used to analyze the distribution of MDSC and T cell subsets in the peripheral blood by flow cytometry. The relations of MDSC with T cell subsets and CD4⁺/CD8⁺ changes were evaluated. The distribution of MDSC in the lesions of tongues was analyzed by immu- nohistochemistry, and the expression of arginase 1 (ARG-1) in tongue tissues was detected by real-time polymerase chain reaction.

RESULTSDuring tumor progression, a significant increase was observed in the frequency of MDSC in the peripheral blood of 4NQO treated mice (P < 0.01). The frequency of MDSC was positively correlated with systemic CD3⁺CD8+T cells but negatively correlated with the CD4⁺/CD8⁺ ratio. Squamous cell carcinomas were extensively infiltrated with MDSC, whereas dysplastic area and normal tongue mucosa had only sparse MDSC infiltration. The majority of MDSCs were located in the stroma, particularly along the tumor invasive front. Moreover, 4NQO-treated mice showed significantly higher ARG-1 mRNA levels in the tumor site (P<0.01).

CONCLUSIONMDSC may contribute to oral tumor progression and represents a potential target for immunotherapy of oral cancer.

4-Nitroquinoline-1-oxide ; Animals ; Arginase ; Cell Count ; Flow Cytometry ; Mice ; Models, Animal ; Myeloid-Derived Suppressor Cells ; immunology ; Real-Time Polymerase Chain Reaction ; T-Lymphocyte Subsets ; immunology ; Tongue Neoplasms ; immunology

OBJECTIVE: To analyze the characteristics of medical malpractice from different grades of hospitals and to explore forensic investigation strategies in assessing medical dispute. METHODS: A total of 206 cases of medical dispute from 2009 to 2010 investigated by the Department of Forensic Medicine in Nanjing Medical University were selected and analyzed according to fault incidence, fault-prone part, and degree of causality in the treatment. RESULTS: Among the 206 cases analyzed, tertiary hospitals, secondary hospitals and primary hospitals showed medium, high and low error rate, respectively. A majority of medical malpractice cases were distributed in the departments of surgery, medicine and gynecology. CONCLUSION The frequency and severity of medical malpractice in primary hospitals were high, which were gradually reduced in tertiary and secondary hospitals.
Dissent and Disputes ; Expert Testimony ; Forensic Medicine ; Gynecology/statistics & numerical data* ; Hospital Departments/statistics & numerical data* ; Humans ; Incidence ; Malpractice/statistics & numerical data* ; Medical Errors/statistics & numerical data* ; Retrospective Studies ; Time Factors

Aim To investigate the effect of intrathecal injection(it) of minocycline(MC),a selective microglia inhibitor,on the maintenance of pain in a murine model of cancer pain.Methods Forty-two male C3H/He mice were randomly divided into 3 groups(n=14 each):sham+PBS group was operated and received 10 ?l PBS injection into calcaneus medullary space;sarcoma+PBS group and sarcoma+MC group were operated and received 2?105 sarcoma cells/10 ?l PBS implantation into calcaneus medullary space.On the PID11(post-implantation day 11),10 mice were taken from each group randomly,sarcoma+PBS group and sham+PBS group were received 0.9% NS(5 ?l) it sarcoma+MC group was received MC(1 nmol,5 ?l) it Mechanical pain threshold and cold hyperalgesia assay were measured before and after it at 0.5,1,2,4,8,24 h.The last 4 mice of each group were received a normally non-noxious palpation of the ipsilateral heel 90 min on the PID12 after it,then the animals were killed and L4-6 segment of spinal cord was removed for analysing the c-fos expression(by immunohistochemistry).Results Bone cancer pain decreased the mechanical and cold pain threshold and activated the c-fos expression in the spinal cord;MC it transient attenuated bone cancer pain-induced hyperalgesia and allodynia and suppressed the expression of c-fos protein.Conclusion The activation of microglia in the spinal cord may be involved in the maintenance of bone cancer pian.