BACKGROUND:Epidural scar after laminectomy is one important reason for the secondary spinal stenosis, and local application ofSanqi sodium hyaluronate gel can prevent epidural scar adhesion after laminectomy. OBJECTIVE: To study the effects ofSanqisodium hyaluronate gel on α-smooth muscle actin expression in the process of rabbit's epidural scar formation. METHODS: In this study, there were ninety-six rabbits which were randomized into four groups and given 0.5 mL normal saline, 0.5 mLSanqi concentrated solution, 0.5 mL sodium hyaluronate and 0.5 mLSanqisodium hyaluronate gel around the dura. At 1, 2, 4, 8 weeks after treatment, immunohistochemistry staining was employed for analysis of α-smooth muscle actin expression. RESULTS AND CONCLUSION:At the end of weeks 1 and 2, the expression of α-smooth muscle actin antibody in the normal saline group was significantly higher than that in the other three groups (P < 0.01 orP < 0.05), but there were no significant differences among the Sanqi, sodium hyaluronate andSanqisodium hyaluronate gel groups (P> 0.05). At weeks 4 and 8, the expression of α-smooth muscle actin antibody in theSanqi sodium hyaluronate gel group was significantly lower than that in the other three groups (P < 0.01 orP < 0.05), and there was no significant difference among the latter three groups (P > 0.05). These findings suggest thatSanqi sodium hyaluronate gel can inhibit the expression of α-smooth muscle actin, and thus ease scar contracture.

Objective To investigate the predictive value of Alberta stroke program early CT score on diffusion-w eighted imaging (DWI-ASPECTS) for predicting new cerebral microbleeds (CMBs) in patients w ith acute middle cerebral artery infarction. Methods The patients w ith acute middle cerebra artery infarction w ere enroled prospectively. MRI examinations w ere completed w ithin 48 h on admission and they w ere examined again at 10 to 14 d after onset. Susceptibility-w eighted imaging (SWI) w as use to detect
CMBs. DWI-ASPECTS w as used to assess the infarction extent. Results A total of 82 patients w ith acute middle cerebra artery infarction w ere enroled, including 27 females and 55 females. Their ages w ere 71.7 ± 8.9 years. Eighteen patients (22.0%) had old CMBs, 25 (30.5%) had new CMBs, 57 (69.5%) did not have new CMBs. Compared w ith the non-new CMB group, DWI-SPECTS (3.20 ±1.73 vs.7.11 ±1.69;t = 9.573, P <0.001) w as low er, NIHSS scores (16.20 ±4.06 vs.12.63 ±5.06; t = 3.111, P = 0.003) w ere higher, there w ere more patients w ith atrial fibrilation ( 40.0% vs.15.8%; χ2 = 5.722, P = 0.017), proportion of intensive antiplatelet therapy ( 0% vs.28.1%; P = 0.002) w as low er, there w ere more large artery atherosclerosis type ( 60.0% vs.29.8%; χ2 = 6.650, P = 0.010 ), more cardiogenic cerebral embolism type (36.0% vs.5.3%; P = 0.001), and less smal artery occlusion type ( 0% vs.57.9%; P <0.001) in the new CMB group, and there w ere no statistical differences in the other indexes. Multivariate logistic regression analysis show ed that after adjusting age, sex, alcohol, histories of hypertension, hyperlipidemia, diabetes, atrial fibrilation and previous stroke or transient ischemic attack history, the higher the DWI-ASPECT scores ( > 5), the risk of new CMBs w ould decrease 86 % (odds ratio 0.14, 95%confidence interval 0.17 -0.48; P < 0.001). Receiver operating characteristic curve analysis show ed that the sensitivity of prediction of DWI-ASPECTS ≤5 for the new CMBs w as 87.7%, specificity w as 88.3%, and the area under the curve w as 0.940. Conclusions DWI-ASPECTS can effectively predict the new CMBs in patients w ith acute middle cerebra artery infarction.

BACKGROUND: At present, the transplantation of bone marrow-derived endothelial progenitor cells (BM-EPCs) or bone marrow-derived hepatocyte stem cells (BDHSCs) is common in the treatment of liver fibrosis, but the combined treatment for liver fibrosis is rarely reported. Combined transplantation of BM-EPCs possessing the function of angiogenesis and BDHSCs possessing the function of hepatocyte regeneration might play a dual anti-fibrosis role. OBJECTIVE: To evaluate the reversal effect on liver fibrosis by the combined transplantation of BM-EPCs and BDHSCs in rats. METHODS: The liver fibrosis rat models were induced with CCl4 subcutaneous injections for 6 weeks. BM-EPCs of rats with liver fibrosis were obtained by culture induction in vitro.BDHSCs of rats with liver fibrosis were obtained by magnetic bead cell sorting.BM-EPCs and/or BDHSCs were transplanted into liver fibrosis rats via the tail vein and branch of the portal vein,and then the effects of BDHSCs transplantatiron on liver fibrosis and liver function were observed. RESULTS AND CONCLUSION: (1) Masson staining results showed transplantations of BDHSCs and BM-EPCs, alone or both, could suppress the formation of collagen fibers. However, the staging scores of liver fibrosis showed that only the combined transplantation of BM-EPCs and BDHSCs could significantly improve liver fibrosis,which was significantly different from the model group(1.75±0.25 vs. 3.00±0.19, P < 0.05). (2) The liver biochemical assay in the blood showed that the levels of all five parameters of alanine aminotransferase, aspartate aminotransferase, total bilirubin, prothrombin time, and activated partial thromboplastin time in the BM-EPCs/BDHSCs group were significantly improved to be equivalent to normal levels, compared with those in the model group (P < 0.05). To conclude, it is an effective treatment for liver fibrosis by the co-transplantation of BM-EPCs and BDHSCs.

Objective To develop a new method for simultaneous quantifying and genotyping of HBV in a single reaction based on dual molecular beacon real-time PCR.Methods Genotype B and C recombinant plasmids were constructed as the standards and genotype-specific primers and molecular beacons were designed for each genotype.The molecular beacons of genotype B and C were labeled with FAM and Hex respectively.In this way,a simultaneous qualification and genotyping method for HBV DNA in a single real-time PCR reaction system was developed.Firstly,10-fold gradient dilution of genotype B and C standard plasmids (103-1011 kIU/L) were utilized to evaluate the linear ranges and sensitivity of this approach.The clinical specificity was tested with twenty different serum specimens (5 cases with hepatitis C virus,5 cases with herpes simplex virus and 5 cases with human papilloma virus as well as 5 healthy volunteers) ; the reproducibility was assessed by intra-assay and inter-assay coefficient of variation (CV) of cycle threshold (Ct) value through 10 repeated detections within a batch and between batches of the B,C standard plasmids (108,106 and 104 kIU/L).Then the accuracy of qualifying and genotyping of the self-built method was evaluated by a parallel examination with 132 HBV infected patients by use of two commercial kits as the references.Finally,these HBV-positive patients were divided into 4 groups:asymptomatic carrier (n =21),chronic hepatitis (n =77),liver cirrhosis (n =25) and hepatocellular carcinoma (n =9) to investigate the relationship of genotypes,stages of disease progression and HBV DNA load.Results A simultaneous qualification and genotyping assay was successfully built and its genotyping sensitivity was 103 kIU/L and the linear range was 103-1011 kIU/L.The intra-assay CV of B genotyping was 1.51％ to 1.80％ and the interassay CV was 2.11％ to 3.03％,while the intra-assay CV of C genotyping was 1.79％ to 1.95％ and the inter-assay CV was 2.53％ to 2.91％.The results of non HBV infected cases and healthy volunteers showed negative.In the test of 132 HBV infected patients,the general coincident rate of genotyping results comparing our assay and HBV DNA genotyping kit was 90.9％ (120/132,Kappa =0.832,P ＜ 0.05).The HBV DNA quatitive results between the assay[5.07 (3.89-6.33)] and HBV DNA quatitive kit [5.19 (4.15-6.32) lg kIU/L] were well correlative (R2 =0.8477,P ＜ 0.05).69 genotype B cases,51 genotype C cases and 12 B/C mixed-genotype cases were detected by dual molecular beacon real-time PCR method and their HBV DNA load were 4.54 (3.83-6.17),5.53 (4.02-6.55),4.58 (3.68-4.98) lg kIU/L respectively.Where the patients with genotype C had higher DNA load than the patients with other two genotypes (Z =-2.195and-2.162,P ＜ 0.05).The HBV DNA load of asymptomatic group,chronic hepatitis group,liver cirrhosis group and hepatocellular carcinoma group were 7.02 (6.35-7.84),4.94 (4.16-6.25),4.37(3.50-5.17) and 3.45 (3.25-4.92) lg kIU/L,respectively.Among them,the asymptomatic group was significantly higher than those of other three groups (Z =-4.244,-4.568 and-3.489,P ＜0.001) and DNA load comparing with the chronic hepatitis group,liver cirrhosis group and hepatocellular carcinoma group also showed statistically different (Z =-2.894 and-2.413,P ＜ 0.05).However,compared with the liver cirrhosis group and hepatocellular carcinoma group there was no significant difference (Z =-0.995,P =0.335).Conclusion A dual molecular beacon real-time PCR assay which can simultaneously quantifying and genotyping HBV DNA with highly accuracy,sensitive and specificity is successfully developed.(Chin J Lab Med,2013,36:333-338)

Objective To investigate the effect of ultrasound-and nerve stimulator-guided femoral nerve and lateral femoral cutaneous nerve block versus general anesthesia on knee joint surgery in elderly patients.Methods The 110 elderly patients with spinal anesthetic contraindication and undergoing lower extremity surgery from June 2014 to June 2015 were randomly divided into observation group (n =55) and control group (n =55).The observation group received both ultrasound-and nerve stimulator-guided femoral nerve and lateral femoral cutaneous nerve block,and the control group was given general anesthesia.Anesthesia procedure,sensory block onset time,changes in heart rate and mean artery pressure (MAP) after anesthesia,the total quantity of fluids infusion,dosage of vasopressor and hypotensor,adverse anesthetic reactions,anesthetic fees,anesthetic effect were recorded.Results Anesthetic preparation and practicing time had no difference between the two groups [(8.3 ± 1.7) min vs.(7.7 ± 1.2) min,(t =1.661,P=0.139)].The block onset time was longer in observation group than in control group [(10.3 ± 1.4) min vs.(3.2±0.6) min,t=50.180,P＜0.01].The changes in MAP had significant difference between the two groups [5 min after anesthesia:(89.24 ± 8.30) mmHg and (77.90 ± 8.05) mmHg;after operation:(96.60±8.03) mmHg and (106.22±8.88) mmHg;P＜0.05].There were significant differences in the fluid infusion quantity,dosage of vasopressor and hypotensor,adverse reactions during or after anesthesia,and anesthetic fees between the two groups [(1150.9± 231.6) ml vs.(1400.0±256.5) ml,(3.91±1.21) mg vs.(10.83±2.19)mg,(1.80±0.37) mg vs.(8.27±1.25)mg,3.6％ vs.18.2％,(1239.1±202.9) Yuan vs.(2307.2±205.6) Yuan,all P＜0.05].No significant difference was found in anesthesia effect between the two groups (P =0.198).Conclusions The ultrasound-and nerve stimulator-guided femoral nerve and lateral femoral cutaneous nerve block versus general anesthesia is more simple and safe for the knee joint surgery in elderly patients,with less complications,lower cost and higher satisfaction of patients.

Objective To investigate the expressions of CDX2 and β-catenin in acute lymphoblastic leukemia (ALL) and their correlation. Methods Real-time PCR was used to determine the expressions of CDX2 and β-catenin mRNA in 43 de novo ALL and 30 non-malignant patients (used as control). Results The positivity rate of CDX2 mRNA expression in ALL group was 93%, but CDX2 mRNA expression couldn′t be detected in the control group (P<0.01). The mRNA expression of β-catenin could be detected in patients in both two groups, butβ-catenin mRNA expression in the ALL group was significantly higher than in the control group (P < 0.01). And mRNA expressions of CDX2 andβ-catenin were significantly correlated with WBC counts and LDH level (P<0.01). When the ALL patients acquired complete remission (CR), the mRNA expressions of CDX2 and β-catenin were significantly decreased compared with their newly diagnosed status , while disease-relapsed the mRNA expressions of CDX2 andβ-catenin were increased again. There was significantly positive correlation between CDX2 and β-catenin mRNA expressions (r = 0.835, P = 0.000). Conclusion Up-regulation of CDX2 and activation of Wnt/β-catenin pathway coexist in the ALL patients and the mRNA expressions of CDX2 and β-catenin are positively correlated.

An ultra performance convergence chromatographic ( UPC2 ) method was established for the attribution analysis of the main peaks as well as the quantitative determination of echinacoside andβ-ecdyserone in Bushen Jiannao Grains. The samples were extracted with ethanol and separated on Waters ACQUITY UPC2TM BEH column (100 mm × 3. 00 mm, 1. 7 μm), with a gradient supercritical CO2-0. 05%phosphoric acid-methanol solvent system at 40 ℃. The flow rate was 0. 8 mL/min, the detection wavelength was set at 248 nm and the injection volume was 1 μL. Results showed that all the main peaks in the fingerprint were clearly attributed. The peak named 12 wasβ-ecdyserone with the content of 380μg/g and the peak named 15 was echinacoside with the content of 9. 562 mg/g. The method was simple, eco-friendly, accurate and reliable compared with HPLC and UPLC.

A 10 year-old female child developed erythema on the scalp,perioral area,neck,trunk,buttocks,palms and soles within 1 month after birth.Her skin was dry and rough,and the hairs were fine,soft,sparse and easily broken.As age advanced,typical hyperkeratosis and thickening of the skin occurred on an erythematous base.At the age of 5 years,the child developed photophobia and vision impairment.When the child was 8 years old,progressive hearing loss was observed.Physical examination revealed that the height and weight were 109 centimeters and 19 kilograms respectively.Skin examination showed fine,soft,sparse and easily-broken hair,large areas of brown plaques with crusts on the scalp,perioral area,neck,trunk and buttocks,and fissured,purulent and foul-smelling verrucous hyperplasia over these plaques.Brown to black hyperkeratotic plaques were scattered over the extremities,and diffuse hyperkeratosis occurred on the palms and soles.Both fingernails and toenails became thickened,cloudy and white with distal separation and deformation of the nail plate.As ophthalmic examination showed,the patient had photophobia,bilateral bulbar conjunctival hyperemia,corneal opacity and corneal vascular proliferation,and the visual acuity was 0.5 in the left eye and 0.2 in the right eye.Otolaryngological examination revealed moderate binaural sensorineural deafness.Stomatological examination showed enamel hypoplasia and diastema widening.Genetic testing showed a heterozygous mutation (c.C50T) in exon 2 of the gap junction protein beta 2 (GJB2) gene.Based on these clinical manifestations and examinations,the patient was diagnosed with keratitis,ichthyosis,and deafness (KID) syndrome.Skin lesions of the patient were significantly improved after the treatment with oral acitretin.

Background and purpose: Since the detection of renal neoplasm is increasing, it's important to distinguish myomatous angiomyolipoma (mAML) from malignant tumors. This study aimed to investigate the imaging features of renal mAML on computer tomography (CT) and improve the accuracy of diagnosis and differential diagnosis. Methods: Ten patients were diagnosed with mAML. The cases were composed of 4 men and 6 women, with a mean age of 53.2 years (range 38-64). Among all of the cases, the percentage of spindle cell is more than 70%. Two radiologists reviewed all of the images to evaluate general characteristics, imaging features on unenhanced CT and enhanced CT. The mean attenuation on the unenhanced CT of mAML, normal renal parenchyma and skeletal muscle was compared by the paired-sample t test. Results: Among all of the tumors, nine lesions were solitary, and the other one was accompanied with typical AML. Six lesions were at the left kidney while four lesions were at the right side. Five lesions located intracapsularly. All the lesions were well-defined, nine of them were regular. The tumor sizes ranged from 15 to 80 mm with mean (43±19) cm. Intratumoral macroscopic fat, cystic degeneration and vessels were found in two lesions, two lesions and three lesions, respectively. Calcification or hemorrhage was not detected in any cases. On unenhanced CT, 70% cases were hyperattenuating. Eight cases were homogeneous or slightly heterogeneous. The mean attenuation of the tumor lesions on unenhanced CT was (48.60±5.50) HU, which was higher than that of normal renal parenchyma (39.70±6.67) HU (P<0.05), and similar to that of skeletal muscle (48.9±2.28) HU (P>0.05). After intravenous injection of contrast media, seven cases were categorized as the slightly heterogeneous or heterogeneous enhancement type. Four cases showed a weak enhancement whereas five cases were with a moderate enhancement. The gradual, prolonged and early washout enhancement patterns were observed in 40%, 40%, and 20% of the cases, respectively. Conclusion: The radiological appearance of mAML had a tendency to be hyperattenuating on unenhanced CT images without macroscopic fat; it could be homogeneous or slightly heterogeneous on unenhanced scans. After the injection of contrast agent, mAML tended to have a weak or moderate, lightly heterogeneous to heterogeneous enhancement, and it could demonstrate gradual and prolonged enhancement patterns.

AIM: To examine the relationship between corneal lymphangiogenesis and hemangiogenesis after keratoplasty.METHODS: Nineteen human corneas were obtained from 19 patients undergoing a second corneal transplantation in Zhongshan Ophthalmic Center in 2005. Blood and lymphatic vessels in human transplanted corneas were identified by lymphatic vessel endothelial receptor(LYVE-1) and platelet endothelial cell adhesion modecule-1(PECAM-1) immunohistochemistry, and double enzyme-histochemistry; then the association of corneal blood vessel counting (BVC) with lymphatic vessel counting (LVC) was examined.RESULTS: Corneal hemangiogenesis was present in 12 cases (63%), and lymphangiogenesis occurred in 5 cases (26%) of human transplanted corneas. In addition, corneal lymphangiogenesis was only present in vascularized corneas. LVC was strongly and positively correlated with BVC(r=0.725;P<0.01).CONCLUSION: Corneal lymphangiogenesis develops after keratoplasty, and strongly associates with hemangiogenesis.