Objective To describe the clinicopathological features of histiocytic necrotizing lymphadenitis ( HNL). Methods Routine lymph node biopsies of 10 HNL cases were reviewed and their immunophenotyping were performed using S-P immunohistochemical staining. Results Histologically, HNL had discrete or integrated nodules variable in size in the paracortex,expecially in the interfollicular area,which were full of proliferating pleomorphic histocytes,transformed lymphocytes,and karyorrhectic debris without infiltration of the neutrophils, plasma cells and/or eosinophils. Immunohistochemistry revealed CD45RO + for transformed lymphocytes,CD68 +for histiocytes.and CD20 +for lymphocytes in the residual germinal centers. Conclusion The presence of pleomorphic histiocytes, transformed T-cells, and karyor-rhectic debris in the biopsy of lymph nodes, together with the absence of neutrophils support the diagnosis of HNL.

We built rats model of endometriosis applying autologus endometrial transplants to compare the graft vol-ume of the modeling rats before and after dosing,serum tumor necrosis factor alpha(TNF-α)levels in rats,and the expressions of vascular endothelial cell growth factor(VEGF)in ectopic endometrium.To compare with the control group,the graft volume of DingKunDan group was reduced and the serum TNF-αlevel declined ,and also the ex-pression of VEGF in ectopic endometrium was reduced.Their differences were statistically significant (P <0.05). DingKunDan can inhibit the growth of ectopic endometrium in endometrosis model rats.The mechanism may be re-lated to the decrease of the serum TNF-αlevel and the VEGF expression.

Objective To investigate the difference of differentiation from rat bone marrow mesenchymal stem cells(MSCs) from normal group and hepatic fibrosis model group into hepatocyte-like cells.Methods Wistar rats were randomly divided into two groups: normal group and hepatic fibrosis model group.The liver fibrosis was induced by CCL4.MSCs were isolated by combining gradient density centrifugation with plastic adherence.Pure MSCs were obtained by cultivation and passage.The cells then treated with HGF and FGF-4.Levels of AFP and albumin from supernatant were determined on day 15,21 and 27.On day 27,cells of induced and non-induced were collected,glycogen store of hepatocytes and the expressions of CK-18 and CK-19 were detected.Results The level of AFP in induced MSCs was higher on day 15,21,27,and reached the peak on day 21;there was no significant difference between induced and non-induced MSCs in albumin levels on day 15,but on day 21,27,compared with the non-induced MSCs,the albumin level in the induced MSCs was higher and reaches its peak on day 27;glycogen storage of induced MSCs was measured on day 27 as compared with non-induced MSCs;the induced MSCs expressed CK-18 and CK-19 while the non-induced MSCs did not.Compared by the levels of AFP and albumin,there was no significant difference in differentiation effect of MSCs between the normal group and hepatic fibrosis model group.Conclusion Rat MSCs of hepatic fibrosis model group could differentiate into hepatocyte-like cells with hepatic phenotype and biological function in the presence HGF and FGF-4.

Objective To study the effects of collaborative care model on the negative mood and the quality of life of lung cancer patients. Methods Sixty patients were randomized into the observation group and the control group with 30 cases in each.The control group only received usual care,the observation group Was treated with collaborative care,encouraging patients and their families to participate in health care.Using SDS、SAS、activities of daily living(ADL)scale and St.George's Respiratory Question-naire(SGRQ)to evaluate the effects ofthe patients in both groups on admission and one months after the discharge.Results One months after the discharge,the scores of anxiety and depression among the observation group were lower than those of the control group;ADL grade and quality of life score in the observation group compared with the control group were significantly improved,the difference was statistically significant. Conclusions Application of collaborative care management can improve the state of anxiety and depression,reduce hospitalization time and medical costs as well as improve quality of life.

Objective To investigate the effect and nursing experience of iliacus groin approaches and internal fixation treatment for patients with pelvic fractures. Methods Twenty- six patients with unstable pelvic fracture were obtained iliac groin approaches and internal fixation treatment, the changing symptoms in patients were monitored frequently, and all patients were performed general nursing. Results All patients were followed up for 0.5 to 5.0 years, without obvious complications, the results of surgical treatment included optimal 16 cases, good 7 cases, mean 3 cases. Conclusions Iliacus groin approaches and internal fixation with reconstruction plate treatment on pelvic fractures was proved to be reset accurate, reliable and strong, with better effects. Effective nursing measures can save life of patients with pelvic fractures, speed up rehabilitation of physiological function, improve life quality of the patients.

Objective To explore the impact of environment factors and social economic factors(environment interference factors for short)and control measures on the endemic status of schistosomiasis in Poyang Lake Eco?economic Region. Meth?ods The grey relational analysis model was applied to analyze the relationships between the key indexes of schistosomiasis epi?demic status and the environment interference factors and control measures in Jiujiang City of Poyang Lake Eco?economic Re?gion. Results Six environment factors,which included the annual average water level of Poyang Lake,average annual tempera?ture,storm frequency,annual average relative humidity,annual sunshine duration,and annual precipitation,had the most closed relationship with the indexes of schistosomiasis epidemic status(all ri>0.9). Among the socioeconomic factors,the num?ber of health technicians and beds of health facilities were most associated with the indexes of schistosomiasis epidemic status. Among the control measures of schistosomiasis,the number of cattle treated with extending chemotherapy,chemically killing of Oncomelania hupensis snails and eco?renovation were most associated with the indexes of schistosomiasis epidemic status. Con?clusion The various environment interference factors and their interaction should be considered in formulating the comprehen?sive control strategy for schistosomiasis,and the control strategy should be adjusted according to the epidemic dynamic and schistosomiasis?focused targets,so as to further strengthen the scientificity and validity of the control strategy.

Objective To discuss the application value of DWI and ADC on predicting therapeutic effect of radiotherapy treatment in NPC. Methods Twenty four local recurrent cases and 38 non-recurrent cases after radiotherapy treatment in NPC were reviewed. MRI and DWI-MRI were performed at pre-radiotherapy and 3, 6, 12 months after treatment, the ADC values of the lesions were analyzed by SPSS 18.0 statistical software. ROC curves based on the ADC values were measured in 3, 6, 12 months after treatment plotted to analyze the threshold ADC value for confirming recurrence. Results The recurrent group and newly diagnosed group showed significantly high signal on DWI, while the non-recurrent group acquired low or mixed signal. The ADC values of the primary tumor in the recurrent group and the non-recurrent group were (0.709 ± 0.078) × 10-3 and (0.693 ± 0.089) × 10-3mm2/s, respectively, t=-0.717,P>0.05, respectively.The ADC values of the primary and recurrent tumor in the recurrent group were (0.730± 0.068) × 10-3mm2/s and (0.709 ± 0.078) × 10-3mm2/s, t=-1.000,P>0.05 , respectively.There were statistical differences between the recurrent group and the non-recurrent group for ADC in 3, 6, 12 months after treatment:(1.128 ± 0.179) × 10-3 and (1.358 ± 0.145) × 10-3mm2/s, t=5.567,P<0.01;(1.164 ± 0.174) and (1.450 ± 0.102) × 10-3mm2/s, t=7.310,P<0.01;(1.107 ± 0.180) × 10-3 and (1.584 ± 0.125) × 10-3mm2/s, t=11.189,P<0.01;respectively. Take 1.29 × 10-3 mm2/s,1.32 × 10-3mm2/s,1.37 × 10-3mm2/s respectively in 3, 6, 12months after treatment as the diagnostic threshold to predict tumor recurrence. The sensitive , specificity, and accuracy were (83.3%, 73.7%, 77.4%), (83.3%, 89.5%, 87.1%), (100.0%, 94.7%, 96.3%).Conclusions Both DWI and ADC value are important for diagnosing and predicting recurrent NPC after radiotherapy treatment, DWI and ADC can be used to regular follow-up after radiotherapy, to further improve the rate of early diagnosis of recurrent NPC.

Objective To determine levels of nuclear factor (NF)-κB, interleukin (IL)-10, and visfatin in adipocytes treated by different degrees of intermittent hypoxia (IH), and to investigate the mechanism of IH leading to insulin resistance (IR). Methods The cell model of intermittent hypoxia/re-oxygenation (IH/ROX) in obstructive sleep apnea (OSA) was established. Differentiation mature 3T3-L1 adipocytes, were randomly divided into 10 groups including four different-frequency intermittent hypoxia groups(IH1-4, fixed intermittent hypoxia scheme for 1.5%O2 45 s and then re-oxygen 21%O2 for 2 min 15 s, 4 min 15 s, 5 min 45 s and 8 min 45 s, 60 times circulation), and their normal oxygen control groups (SC1-4, instead each IH group 1.5%O2 to 21%O2, the rest groups were treated as same as IH group), continuous hypoxia group (CH, 10%O2 for 6 h) and normal oxygen control group (CC, 21%O2 for 6 h). ELISA method was used to determine the levels of IL-10 and visfatin in the supematant of adipocytes. Western blot method was used to determine the protein levels of NF-κB p65 and visfatin. Real-time PCR method was used to determine the mRNA levels of IL-10 and visfatin. Results The protein and mRNA expressions of IL-10 were significantly lower in IH group and CH group than those of control groups (P<0.01). The levels of NF-κB p65 protein were significantly increased in IH group and CH group than those of control group. The protein and mRNA expressions of visfatin were significantly higher in IH1, IH2 and CH groups than those of control group (P<0.01). Conclusion As a prominent feature of OSA pathophysiology, IH may take part in insulin resistance of OSA patients by abnormally secreting NF-κB, IL-10 and visfatin in adipocytes.

Objective To investigate an appropriate megavoltage computed tomography ( MVCT ) protocol to guide helical tomotherapy ( HT) for multiple metastases. Methods According to the location of target volume, 48 patients with multiple metastases undergoing HT were divided into head/chest group ( n=15), head/pelvis group (n=15), and chest/pelvis group (n=18). Each target volume received MVCT scans during the treatment. The obtained MVCT images were registered to CT images and the setup errors were recorded. The CTV?PTV margins were calculated. Comparison was made by paired t test. Results In the head/chest group, there was no significant difference in the setup error in x?axis between the head and chest (-0.15±1?25 vs. -0.21±2?34, P=0?71), while the head had significantly smaller setup errors in y?and z?axis than the chest (0.73±1?22 vs. 1.56±2?54, P=0?00;0.93±1?44 vs. 2.65±1?88, P=0?00). In the head/pelvis group, the head had significantly smaller setup errors in x?, y?, and z?axis than the pelvis (-0.16±1?31 vs. -1.29±3?72, P=0?00;0.81±1?34 vs. 3.20±3?90, P=0?00;1.24±1?75 vs. 5.49±2?80, P=0?00) . In the chest/pelvis group, there were no significant differences in setup errors in x?or y?axis between the chest and pelvis (-0.25± 2?90 vs. -0.22± 3?65, P=0?06;0.35± 3?60 vs. 0.38± 3?78, P=0?87), while the chest had a significantly smaller setup error in z?axis than the pelvis (1.95±2?81 vs. 3.35± 3?05, P=0?00) . In the three groups, the CTV?PTV margins of lower target volume were reduced in three dimensions after the correction of upper target volume, in which y?axis showed the largest reduction of CTV?PTV margins (5?13 vs. 4?01;9?17 vs. 8?30;8?52 vs. 7?13). Conclusions The setup error of individual target volume should not be used for correction of the overall setup error in HT for multiple metastases with isolated target volume. An MVCT protocol that provides image?based guidance for multiple target volumes is recommended.

Objective To explore the emergent nursing care of peritonsillar abscess in an infant. Methods The process of observation, treatment and nursing care of an infant with peritonsillar abscess were reviewed, and the nursing experiences were summarized. Results Through close observation of the rate, rhythm and depth of the respiration, the early signs of airway obstruction, guide parents with children right, keep the children quiet, open the airway, at the same time to prepare relevant emergency use objects to be prepared for emergency surgery, we saved time for the operation. Postoperative management of the airway and observation for the signs of bleeding in the area of incision were provided. The infant recovered well and was discharged after the treatment and nursing. Conclusions This case reminds nurses to pay attention to the airway obstruction while caring for the infants with peritonsillar abscess. The key points of nursing are observation and management of the airway obstruction, emergent preoperative preparation, postoperative monitoring, management of the airway and observation for the bleeding of the incision area.