Autoimmune hepatitis (AIH) is a chronic and progressive inflammation of liver caused by the disorder of immunoregulation,and characterized by the presence of autoantibodies,elevated level of immunoglobulin G,and interface hepatitis histologically.As its clinical feature is not particular and the international diagnosis criteria is rarely applied in children,the diagnosis of pediatric AIH is difficult to make.It's essential for the good prognosis to recognize and diagnose the disease in early stage,as well as to treat it promptly and maintain regular follow-up.Now,the recent progress of pathogenesis,diagnostic criteria and management of AIH in children were summarized.

BACKGROUND: Clinical studies demonstrate that the durable stability of the prosthesis depends on a close geometric fit between the prosthesis and femoral medullary cavity.OBJECTIVE: To study the law of the parameters of medullary canal section shape in proximal femur DESIGN: Repeated measurement observation.SETTING: Department of Orthopaedics, Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University MATERIALS: Ten femoral samples without any damage was obtained from corpse in the Staff Room of Anatomy of the Shanghai Second Medical University METHODS: The experiment was carried out in the Department of Or thopaedics, Ninth People's Hospital between January 2000 and March 2000. Section morphology of medullary cavity of proximal femur was dealt with image-processing, and conus curve fitted parameter mathematical method was proposed; and at the same time, section of medullary cavity of proximal femur of 10 patients was measured manually.MAIN OUTCOME MEASURES: Computer-aided method and manual method were applied to measure the coordination at the end of extrude and the coordinate of link joint RESULTS: 10 femoral samples entered the stage of result analysis. Com puter was used to measure the coordination of the end of extrude of the section medullary cavity of proximal femur (X,Y) and the coordination of the connection point (X,Y).There was no significant difference of the measuring results between computer-aided method and manual CONCLUSION: Computer-aided imaging-processing method not only reduces the error but also can be completed by computer automatically in measuring section morphology of medually cavity in proximal femur. It is suitable for a variety of morphology measurement.

Background High myopia is seriously harmful to visual function.To explore the mechanism of high myopia is significant for the prevention and treatment.Complement proteins C1q and C3 have emerged as critical mediators of synaptic refinement and plasticity,however,their effects in retina on myopia remain elusive.Objective This study was to investigate the expressions of complement factors C1q and C3 in the retina with negative lensdefocused myopia in guinea pigs.Methods The use and care of animals complied with the application of Peking Union Medical College Hospital Iaboratory Animal Welfare Ethics Committee.Twelve 3-day-old pigmented guinea pigs were assigned randomly to the lens-defocused group and the normal control group.The left eyes were covered by -10 D PMMA lens for 4 weeks as the defocused eye group,and the right eyes were covered using 0 D PMMA lens in the same way as the fellow control eye group.The right eyes of the normal guinea pigs were used as the normal control eye group.The refractive diopter of guinea pigs was examined by retinoscopy.The animals were sacrificed at the fourth week and the expressions of complement C1q and C3 in the retinas of guinea pigs were detected by Western blot.Results The diptors were (-1.21±0.71)D,(+2.46±0.75)D and (+1.75±0.50)Din the defocused eye group,normal eye group and the fellow eye group at the fourth week,showing a significant difference among the groups (F=51.55,P=0.69),and diopters were insignificantly different between the normal eye group and fellow eye group (q =2.62,P=0.08).However,the diopters of the defocused eye group were significantly higher than those of the fellow eye group (q =10.92,P＜0.01).The expressions of C1q and C3 proteins in the retinas were significantly different among the defocused eye group,fellow eye group and normal eye group (C1 q:F=8.810,P =0.003;C3:F =14.490,P＜0.001),and expression levels of C1q and C3 proteins in the defocused eye group were significant higher than those of the fellow eye group (C1q:q=4.14,P=0.01 ;C3:q=4.71,P=0.005) ;while no significant differences were found between the fellow eye group and the normal eye group (C1q:q =1.61,P =0.27; C3:q =2.82,P =0.070).Conclusions The expression levels of C1q and C3 up-regulate in the retinas with lens-defocused myopic animal model.Excessive complement activation in retinas may be involved in the development of myopia.

Objective:To study the changes of the NKT like cells after HIV infected. Methods:We collected peripheral blood from 47 untreated HIV infected individuals and 31 healthy controls,and analyzed the expression of Annexin-V,Ki-67,HLA-DR and other surface molecules in NKT like cells by flow cytometry. Results:The NKT like cell percentage of untreated HIV infected group was (3. 03±1. 61)%,the NKT like cell percentage of normal control group was (8. 30±7. 42)%,the percentage of NKT like cells in HIV infected individuals was significantly lower than the healthy controls ( P<0. 05 );the NKT like cell HLA-DR expression of untreated HIV infected group and normal control group were (5. 40±4. 10)% and (0. 89±0. 83)%,the NKT like cell Annexin-V expression of untreated HIV infected group and normal control group were (30. 21±13. 15)% and (5. 40±8. 05)% ,and the activation and apoptosis of NKT like cells was significantly higher after HIV infection compared with health individuals (P<0. 001,P<0. 01),the degree of activation was negatively correlated with CD4 count (r=-0. 885 7,P<0. 05);and the NKT like cell Ki-67 expression of untreated HIV infected group and normal control group were (11. 15±4. 76)% and (27. 63±18. 31)%,the proliferation ability was significantly lower after HIV infection compared with healthy controls(P<0. 05). Conclusion:HIV infection can significantly reduce the number of NKT like cells and its ability to proliferate,and increase its ability to activation and apoptosis.

Objective To analyze the changes of Blood Cell Count and D-dimer concentration in lung cancer patients with thrombosis.Methods ①554 cases of patients with lung cancer were included between January 2012 and November 2013,75 patients with other diseases which lead to high coagulation state were excluded,blood cell count and D-dimer concentration were compared between 64 lung cancer patients were the cases with thrombosis with 415 lung cancer patients were the con-trol group without thrombosis.②Color doppler ultrasonography was taken as the golden standard,receiver operating charac-teristic curves (ROC)were drawn for indexes which had significance in method.Results ①Compared with lung cancer pa-tients without thrombosis,lung cancer patients without thrombosis had decreased red blood cell count (RBC),increased white blood cell count (WBC)and D-dimer.And there were no significant change in platelet (PLT).②The area under curve (AUC)of ROC in RBC,WBC and D-dimer were 0.662,0.637 and 0.896,respectively.By thecut-off values of RBC>4.06× 1012 L,WBC<5.37×109/L and D-dimer<4.02 mg/L,the negative predictive values of RBC,WBC and D-dimer for diagno-sis of lung cancer patient with thrombosis were 93%,93% and 96%,respectively.By the cut-off value of D-dimer>4.02 mg/L,the positive predictive value of D-dimer for diagnosis of lung cancer patient with thrombosis was 6 6%.Conclusion RBC,WBC and D-dimer were related with the progress of thrombosis in lung cancer patients.RBC,WBC and D-dimer have good negative prediction effect on lung cancer patients with thrombosis.D-dimer had positive effect for diagnosis of lung cancer with thrombosis.

Objective:To better understand the changes of the NKT like cells after HIV infection and HAART treatment.Methods: Peripheral blood from HIV-infected individuals, HAART-treatment AIDS patients and healthy controls were collected, the expression of CD57 and the proliferation ability of NKT like cells before and after HAART were analyzed by flow cytometry.Results:We found that the percentage of NKT like cells before HAART was significantly lower than the healthy controls ( P<0.01 ) , and recovered after HAART treatment ( P<0.05 );the aging of NKT like cells was significantly higher before HAART compared with health individuals (P<0.01),and recovered after HAART treatment(P<0.05)the proliferation was significantly lower in vitro before HAART compared with healthy controls,and partial recovered after HAART.Conclusion: After HAART treatment,the number of NKT like cells,CD57 expression and the proliferation ability of HIV infected patients were restored.

Objective To observe the contrast sensitivity (CS) of patients with branch retinal vein occlusion (BRVO) without involving the macular region.Methods 92 BRVO patients (93 eyes) and 56 cases (112 eyes) without eye diseases (control group) were included in the study.According to different region,BRVO patients were divided into the nasal BRVO group (31 eyes) and temporal BRVO (62 eyes) group,and the average corrected visual acuity was 1.02 ± 0.13 and 0.98 ± 0.12 respectively.According to the type of ischemia,BRVO patients were divided into the nonischemic BRVO group (58 eyes) and ischemic BRVO group (35 eyes),the average corrected visual acuity was 1.01 ± 0.14 and 0.99 ± 0.12 respectively.The average corrected visual acuity of the control group was 1.03 ± 0.11.There was no statistically significant difference of the average corrected visual acuity between nasal BRVO group,temporal BRVO group and control group (F=3.03,P =0.06),and between nonischemic BRVO group,ischemic BRVO group and control group (F=1.60,P=0.20).Contrast sensitivity (CS) was measured by OPTEC 6500 vision tester (Stereo Company,USA) under the standard lighting conditions and different spatial frequencies including low (1.5 and 3.0 c/d),medium (6.0 c/d) and high frequencies (12.0 and 18.0 c/d).Results The CS under each spatial frequency of the nasal BRVO group was the same as the control group (t=4.25,9.48,3.08,5.86,0.94;P＞0.05),but the CS under each spatial frequency of the temporal BRVO group was different from the control group (t=8.59,19.11,10.38,17.28,6.01;P＜0.05).The CS under high spatial frequency of the temporal and nasal BRVO group was statistically different (t=11.42,6.95;P＜0.05).The CS under each spatial frequency of the ischemic BRVO group was different from the control group (t=8.88,10.56,11.64,19.06,6.67;P＜0.05).The CS under 6,12 and 18 c/d spatial frequency of the nonischemic BRVO group was statistically different with the control group (t =10.14,11.54,2.82;P＜0.05).The CS under 12 and 18 c/d spatial frequency of the nonischemic BRVO group was statistically different with the ischemic BRVO (t=7.52,3.84;P＜0.05).Conclusions The CS of the temporal BRVO and ischemic BRVO decreased more significantly under each spatial frequency.CS is a better indicator to evaluate the visual function than the visual acuity in BRVO without involving the macular region.

Objective To investigate the presence and significance of Th9 cells and the related transcription factor ( PU.1 ) and cytokine ( IL-9 ) in peripheral blood of patents with hashimoto thyroiditis ( HT) .Methods Thirty patients with HT and thirty age/gender matched healthy subjects were recruited in this study.The peripheral blood and serum samples were collected from each subject.The percentages of Th9 cells and the transcriptional levels of PU.1 in peripheral blood mononuclear cells ( PBMCs) were meas-ured by flow cytometry analysis and real-time RT-PCR.The concentrations of IL-9, the functions of thyroid and the titers of thyroid-specific autoantibodies ( TPOAb and TgAb) in serum samples were detected by using enzyme-linked immunosorbent assay ( ELISA ) and electrochemiluminescence immunoassay analysis ( ECLIA) .Results Compared with healthy subjects, the percentages of Th9 cells and the expression of PU.1 at mRNA level in PBMCs and the concentrations of IL-9 in serum samples were all significantly in-creased in patients with HT [(1.49±0.68)%vs (0.87±0.24)%], 4.91±2.14 vs 1.66±0.52, (26.90± 7.74) pg/ml vs (16.71±5.87) pg/ml, all P<0.01).Serum concentrations of IL-9 were positively correla-ted with the percentages of Th9 cells (r=0.419, P=0.021).Moreover, the percentages of Th9 cells were positively correlated with the titers of TPOAb and TgAb in serum samples (r=0.394, P=0.032;r=0.457, P=0.011) of patients with HT.Conclusion The levels of Th9 cells and the related cytokine IL-9 were in-creased in the peripheral blood of patients with HT.A positive correlation was found between the percentage of Th9 cells and the titers of thyroid-specific autoantibodies.This study indicated that Th9 cells might be in-volved in the pathogenesis of autoimmune damage in thyroid.

Objective To investigate an effective method of breathing apparatus management. Methods According to the defect in process of breathing machine management, breathing apparatus management center was set up, related standards and procedures were established, the staff training was intensified and the management mode was expanded. Results The qualified rate of ventilator sterilization and breathing apparatus function were improved to 100% by applying zero defect quality management. Conclusion It is an effective method to ensure the safety and accuracy in breathing machine manage- ment with applying zero defect quality management.

Objective To study the effects of abiotic elicitors methyl jasmonate (MeJA) and salicylic acid (SA) on the alkaloids accumulation and related enzymes metabolism inPinellia ternata suspension cell cultures. Methods Using the leaf petioles-derived suspension cell cultures as the study object, the culture duration, concentrations of MeJA and SA were determined to get the optimal alkaloids accumulation, and the activities of metabolic enzymes IMP dehydrogenase and sAMP synthase were also measured.Results A 9-fold of dried biomass and a 3-fold of alkaloids accumulation were observed inP. ternata suspension cell cultures after culture for 21 d. Both MeJA and SA could significantly promote the accumulation of alkaloids inP. ternata suspension cells. 150 μmol/L MeJA enhanced alkaloids content (4.7 mg/gDW) by 3.6 folds in comparison with control group, whereas 50 μmol/L SA showed a 2.5-fold increase. Meanwhile, 100 μmol/L MeJA and 50 μmol/L SA promoted the increase in IMP dehydrogenase activity by 3.0 and 3.7 fold respectively, and 150 μmol/L MeJA and 100 μmol/L SA showed the increase by 2.6 and 4.4 fold respectively.Conclusion Proper adding exogenous MeJA and SA can promote the accumulation of alkaloids inPinellia ternata suspension cell cultures.