Objective:To observe clinical and pathological features of pancreatic solid-pseudopapillary tumor ( SPPT) , and to find some useful immunohistochemical methods for its differential diagnosis.Methods: The clinical features of 14 SPPT patients were obtained. Each case underwent microscopic observation and immunohistochemical staining. The primary antibodies were CgA, Syn, E-cadherin, β-catenin and Cyclin Dl. These results were compared with 5 pancreatic well-differentiated tumors and well-differentiated carcinomas ( WET/WEC). Results: SPPT mainly involved young women, and the head of pancreas was the commonest location. Tumors were always in solid and cystic gross appearance.Although the tumor' s borderlines seemed clear, focal infiltrations could often be identified. The histological features of SPPT were similar in some aspects to those of WET/WEC, especially the solid pattern of WET/WEC. Both of them could express CgA and Syn. But all SPPTs lost E-cadherin membranous signals, and even had some nuclear signals (5/14) , while all WET/WECs remained the same staining pattern with normal pancreas cells, β-catenin positive signals in SPPTs were located both in nuclei and plas mas. WET/WECs' positive signals were all in membranes and plasmas, but negative ones in nuclei. Perinuclear dot-like signals could also be seen in the majority cells, which were similar to normal islet cells' staining pattern. SPPTs' nuclear positive rates of Cyclin Dl were usually more than 70% (12/14). WET/WECs' rates were all lower than 30%. Conclusion: Comprehensive analysis of patients'clinical, pathological features and immunohistoehemistry results, including E-cadherin, β-catenin and Cyclin Dl, was helpful to the diagnosis of SPPT and its differential diagnosis of WET/WEC.

Objective To realize fine management of medical equipment maintenance,effectively improve the efficiency and save the cost of equipment maintenance.Methods A medical equipment maintenance management module was developed with hospital resource planning system and SQL Server 2008 platform so as to implement informatized management for equipment acceptance check,maintenance,processing and etc.Results The module realized fine management,controlled cost and enhanced social and economic benefits of the hospital.Conclusion The module contributes to medical equipment maintenance management informatization,and is of great significance for the improvement of the hospital.

Objective To observe the protein expressions of PI3Kp110, pAkt, pGSK3β of phosphatidylinositol 3-kinase (PI3K) and protein kinase B (Akt) signaling pathway in the whole blood of patients with Kashin-Beck disease and analyze the status of PI3K/Akt signaling pathway. Methods Patients with Kashin-Beck disease ( KBD group ) were from six counties ( Xunyi , Linyou , Yongshou , Qianyang , Changwu and Long County) of Shannxi Province in Kashin-Beck disease areas , and the healthy controls (control group) were matched by age and sex. Venous blood was collected from patients and healthy controls. Trizol method was applied to extract the whole blood protein; protein expression levels of PI3K/Akt signaling pathway in whole blood were detected by Western blotting; the gray values were observed and recorded by the sodium dodecyl sulfate polyacrylamide gel electrophoresis(SDS-PAGE) and GDS-8000 gel imaging analysis system. Differences between the two groups were assessed by Student’s t-test. Results Compared age and sex between KBD group and control group, differences were not statistically significant(t=0.701, P>0.05;χ2=0.400, P>0.05). The protein expression levels of PI3Kp110, pAkt and p-GSK3β in KBD group were higher than that in control group(156.1 ± 92.1 vs. 79.5 ± 21.5, 113.7 ± 15.2 vs. 43.3 ± 10.7 and 105.9 ± 17.5 vs. 37.3 ± 12.0, respectively) and the differences were statistically significant (t=2.563, 6.567, 7.916; all P < 0.05 or < 0.01). Conclusion The PI3Kp110, pAkt and p-GSK3β expressions of signaling pathway proteins in the whole blood of patiens with Kashin-Beck disease are up-regulated significantly and the status of PI3K/Akt signaling pathway is activated.

Objective To study the changes and significance of CD4+CD25+ regulatory T cells and C-reactive protein(CRP) in patients with acute exacerbation of chronic obstructive pulmonary disease(COPD). Methods Flow cytometry was used to detect the frequency of CD4+CD25+ regulatory T cells in peripheral blood from 36 patients with acute exacerbation of COPD( COPD group) and 36 patients with clinical stability of COPD(control group one)and 36 normal individuals(control group two). The level of CRP was detected routinely. Results The ratio of CD4+CD25+ regulatory T cells number in peripheral blood of COPD group to the total number of CD4+T cell was (2.56±1.83 )%, and it was significantly decreased compared to the other two groups (P all<0.01 ). The level of CRP in COPD group was markedly higher than that in the other two groups (P all<0.01 ). The level of CD4+CD25+ regulatory T cells in patients with acute exacerbation of COPD had negative relation with CRP. Conclusions CD4+CD25+ regulatory T cells participate in inflammatory response. The proportion of CD4+CD25+ regulatory T cells decreases in patients with acute exacerbation of COPD, and it may result in maladjustment of cytoimmunity.

Objective To investigate the use of free transplantation of peroneal artery perforator-based propeller to the repair of the front feet skin defect.Methods Thirteen cases with front foot skin defect patients repaired through transplation of propeller flap of the peroneal artery from January 2009 to September 2012.The wound range was 5 cm ×4 cm-11 cm × 14 cm.The propeller flap of the peroneal artery designed according to the position of the propeller of the peroneal artery in a leg.The wound of the leg were repaired through suture directly or transplantation of skin.Results All 13 cases of free propeller flap were survived,the wound healing goodly.One case with the postoperatie blood vessels were removed by the surgical exploration.The time of follow-up between 3 and 17 months(mean 9.4 months).The quality of free flap was good.The function of walk of the foot repaired were not significantly affect.The patients were satisfactory to the results.The wound of the leg healed well ; The leg had no obvious muscle cicatricial adhesion.According to the foot disease treatment effect evaluation standard (JOA) evaluation,the result for 77-100 points,an average of 85.5 points.Conclusion Using propeller flap of the peroneal artery to repair the skin defect of front feet with a little injury,the skin texture more close to the repaired area,it is a reasonable approach.

Objective To evaluate risks of symptomatic pulmonary embolism (PE) in deep vein thrombosis (DVT) patients complicating iliac vein compression syndrome (IVCS).Methods Between January 2010 and January 2015,patients diagnosed with lower extremity DVT and IVCS at our institution were included.The odds of symptomatic PE versus lower extremity DVT complicated with IVCS were assessed using Logistic regression models.Its association with age,gender,thrombophilic risk factors,degree of stenosis,filter implantation and symptomatic PE were assessed.Results Of 759 patients,410 patients had inferior vena cava (IVC) filters implanted and 349 had not.In filter placement group,3 patients suffered from symptomatic PE among 32 with thrombi intercepted in IVC filters.In the group with no IVC filters placement,39 cases suffered from symptomatic PE.Symptomatic PE was in positive correlation to respiratory disease and right lower extremity DVT,and negative correlation to IVC filter implantation.Conclusions In lower extremity DVT patients complicated with IVCS,the right lower extrenity DVT and respiratory disease are risk factors of symptomatic PE.IVC filter implantation prevents symptomatic PE from happening in most patients.

BACKGROUND:Tissue-engineered bone scaffold fabricated by 3D-bioprinting technique has good controlability in morphology and structure. However, construction of tissue-engineered bone/cel growth factor complex and time-dose effect of sustained-release factors are needed to be further researched.
OBJECTIVE:To fabricate a sustained-release composite of polylactic-co-glycolic acid (PLGA)/nano-hydroxyapatite (n-HA) scaffold carrying bone morphogenetic protein-2 (BMP-2) using 3D-bioprinting technique, and test the biological properties of the PLGA/n-HA scaffold carrying BMP-2 and the sustained-release properties, thereby to discuss its feasibility as the tissue-engineered bone scaffold composite.
METHODS:Temperature-sensitive chitosan hydrogel was prepared using chitosan andβ-glycerophosphate to construct a sustained-release composite, chitosan nanoparticles carrying BMP-2 . 3D-bioprinting technique was utilized to fabricate the PLGA/n-HA scaffold carrying BMP-2. Biological features of the scaffold composite were tested, and time-dose effect of BMP-2 sustained-release was observed.
RESULTS AND CONCLUSION:The average pore size of the scaffold-cytokine composite was (431.31±18.40)μm, and the porosity was (73.64±1.82)%. The cumulative release rate of BMP-2 from the scaffold-cytokine composite that effectively controled the burst release during 48 hours and 30 days were suitable for the physiological needs. In conclusion, the porosity, pore size, release property, degradation rate, and mechanical strength of the scaffold-cytokine composite al meet the biological requirements of tissue-engineered bone construction.

Objective To explore the curative effect of fibular flap with limbs composite soft-tissue.Methods From February,2013 to February,2016,13 cases with body severe trauma patients were treated,which including 5 cases of upper limbs and 8 cases of lower limbs,and all existed bone defect,soft tissue defect and trunk vessel defect.Three cases with limbs distal non blood supply were emergency treated with debridment and flow-through fibular flap transplantation renovation,peroneal artery repairing defective blood vesscls to rcstorc limbs distal blood supply,fibular flap repairing bone defect,skin flap repairing soft tissue defect.The limb blood supply for other 10 cases were in good condition,but one case with main artery defect did the second phase of fibular flap transplantation and repaired defective blood vessels,bone and skin soft tissue synchronously according to wound condition.According to the postoperative observation for flap survival and appearance,X-ray films to observe fracture healing after 6 weeks,three months and 6 months of operation as well as evaluating limb function recovery,then analyzed the results.Results Flaps survived successfully for 11 cases,and flaps for the other 2 cases were partial necrosis.One Case was edge flap necrosis,heal scabby after dressing,and the other case was necrosis for 1/3 of the area,but the deep fascia survival,and the skin graft healing after dressing.One case with forearm rolling was in vascular crisis after operation,but tbe crisis was relieved after detection,and fingers blood supply was recovered.All the patients were followed up for 6 to 36 months(mean,14 months).All flaps were survived,fractures healed well and limbs distal blood supply was good.Bone healing time was 8 to 24 weeks,and patients with lower limbs injury could bear load after 3 to 8 months.Lower limbs restored walking function.Upper limbs and hands restored rotation function.Transplant flapshad good elasticity and satisfactory appearance.Conclusion Using fibular flap to repair defective blood vessels,bone and soft tissue synchronously,not only can rescue the limbs on the verge of amputation,but also can repair defective composite tissue and get a good prognosis.It is an effective method for open injuries severely treatment in clinic.

Objective To study the expressions of anaplastic lymphoma kinase (ALK-1) and cytotoxic proteins in primary systemic anaplastic large cell lymphoma (S-ALCL) and their relationship with clinical outcome. Methods 51 S-ALCL cases were collected from Lymphoma Lab of Peking University Health Science Centre & Peking Children's Hospital. The morphologic characteristics were studied under routine microscope, and essential immunohistochemical stainings were performed and reviewed to confirm the diagnosis of S-ALCL. Immunohistochemical stainings for ALK-1 and cytotoxic proteins (TIA-1 & granzyme B) were performed using standard SP method. Patients related clinical data including follow-up materials were collected. Results Survival time of 44 cases with completely clinical follow up materials ranged from 0.5～66months. 36 out of 51 cases(37 %) was positive for ALK-1 protein. While 20 cases out of 47 S-ALCL cases ( 42.55 % ) positive for granzyme B and 22 out of 28 cases (81.48 %) were positive for TIA-1. The prognosis of patients with ALK-1 protein positive and granzyme B negative expression was better, but TIA-1 expression might have nothing to do with clinical outcome (P＞0.05). In addition, multivariate analysis confirmed that ALK-1 protein expression, granzyme B protein expression and Ann-Arbor stage system were possible for prognosis(P＜0.05), Conclusion Expression of ALK-1 and granzyme B protein expression may serve as two independent prognostic predictors in S-ALCL patients.

Objective To analyze the value of dynamic enhanced multi-slice spiral computed tomography (MSCT) combined with two-dimensional (2D) curved reconstruction technique in the differentiation of benign and malignant intraductal papillary mucinous neoplasm (IPMN) of pancreas,and compare with magnetic resonance cholangiopancreatography(MRCP).Methods MSCT and MRCP data of a total of 50 patients with IPMNs confirmed by pathology after surgery was retrospectively reviewed.The benign and malignant IPMNs were differentiated based on the presence of mural nodules,main pancreatic duct (MPD) ≥ 10 mm,septum thickness ≥2 mm,calcification,surrounding vascular infiltration,enlarged peripancreatic lymph nodules,distant metastatic lesions and maximal branch duct type IPMN lesions ≥30 mm shown in the images.The sensitivity,specificity and accuracy were calculated and the receiver-operating-characteristics (ROC) analysis were drawn.Area under the curve (AUC) was calculated.Results Mural nodules in MSCT had a sensitivity,specificity,and accuracy of 77.1％ (27/35),80.0％ (12/15) and 78.0％ (39/50) for diagnosing malignant IPMN,respectively;which in MRCP were 77.1％ (27/35),86.7％ (13/15),and 80.0％ (40/50) in comparison.When MPD diameter ≥10 mm was used for diagnose malignancy,MSCT and MRCP had the sensitivity,specificity,and accuracy of 96.3％ (26/27),81.8％ (9/11),92.1％ (35/38),and 96.3％ (26/27),90.9％ (10/11),94.7％ (36/38),respectively.For thick septum ≥2 mm,MSCT and MRCP had the sensitivity,specificity,and accuracy of 4.8.6％ (17/35),93.3％ (14/15),62.0％(31/50),and 51.4％ (18/35),93.3％ (14/15),64.0％ (32/50),respectively.Out of 50 cases,calcifications were detected on MSCT in 6 patients,and 5 of them were pathologically diagnosed as malignant IPMN.MRCP failed to identify calcifications in any of these lesions.For MSCT,the AUC of MPD diameter ≥ 10 mm,mural nodules and thick septum ≥ 2 mm were 0.973 (P =0.000),0.825 (P =0.002) and 0.704(P =0.051),respectively.For MRCP,the AUC of the three factors above were 0.976(P =0.000),0.825(P =0.002),0.722 (P =0.034),respectively.For the predicting of IPMN malignancy,MSCT had an overall sensitivity,specificity,and accuracy of 94.3％ (33/35),73.3％ (11/15) and 88.0％ (44/50),respectively;in comparison,MRCP had values of 94.3％ (33/35),80.0％ (12/15) and 90.0％ (45/50),respectively.Conclusions Presence of mural nodules,MPD ≥10 mm and thick septum ≥2 mm on MSCT combined with 2D curved reconstruction or MRCP have a high value for predicting the malignancy of IPMN.The values of MSCT and MRCP were basically consistent in the differentiation of benign and malignant IPMN.MSCT can be used as the preferred examination for diagnosing IPMN in the primary hospitals without MR equipment.