Objective To evaluate short -term clinical efficacy and adverse effects of brucea javanica oil emulsion(BJOE)combined with TP regimen in treating malignant pleural effusion(MPE)of non -small cell lung cancer(NSCLC)by double -way chemotherapy.Methods Totally 91 patients with MPE of NSCLC diagnosed by pathology were builted into the central venous catheter.The patients were assigned to group A,B and C according to therapies.Group A(21 cases)accepted infusion of BJOE 60mL into thoracic cavity twice a week.Group B(33 cases) accepted TP regime therapy,which included paclitaxel(TAX)intravenous chemotherapy at a dose of 150mg/m2 and cisplatin(DDP)injecting into thoracic cavity at a dose of 60mg +0.9% sodium chloride injection 30mL in first day, the therapy was repeated every 3 weeks.Group C(38 cases)combined the therapies of group A′s and B′s.Clinical efficacy and adverse effects were evaluated after 6 weeks.Results The objective response rate(81.6%)for group C was higher than group A or B(χ2 =8.605,P <0.05),the same result were in CR ratio(55.3%)(χ2 =10.384,P <0.05)and PD ratio(5.3%)(χ2 =8.649,P <0.05).There were no serious adverse effects in the three groups.The occurring rate of white blood cell reduction in group A was lower than those of group B and C,there was statistically significance(χ2 =8.999,P <0.05).Conclusion The efficacy of BJOE combined with TP regimen in treating MPE of NSCLC by double -way chemotherapy is better than that of single chemotherapy or alone intrathoracic treatment, and the adverse effects could be well tolerated.

The congenital stricture (idiopathic urethral stricture) mostly lies in the anterior urethra and mainly occurs in boys. Hemangioma is the most common symptom of the idiopathic urethral stricture. Acquired strictures are due to four main causes. latrogenic urethral stricture is mainly caused by performing the transurethral resection, prostate, cystoscopy, prolonged catheterization, hypospadias repair and prostatectomy and so on. Bacteriuria is especially nosocomial with post operative infection in urethral strictures. Virus such as condylomata is another cause. Lichen sclerosis is a chronic progressive inflammatory condition of unknown cause and has the development of urethral strictures. Blunt anterior urethral injury is commonly associated with perineal straddle injury, while posterior urethral injury is accompanied pelvic fracture, penetrating injuries predominantly comes from gunshots involve both anterior and posterior urethra. Urethral injuries in children and females are rare. Here, we mainly investigated the causes of idiopathic and acquired urethral stricture.

Objective To investigate the significance of IL-18R? expression on CD4+ T cells in peripheral blood (PB) of children with Mycoplasma pneumoniae pneumonia (MPP).Methods T cell subtype CD3/CD4/CD8 and expression of IL-18R? on CD4+ T cells in PB from 35 children with MPP and 15 age- and sex-matched control subjects was determined by flow cytometry.Results Compared with that of healthy control, CD3+ and CD4+ positive cells in MPP children were decreased (P0.05).Conclusion There exists cell-mediated immune function disorders and Th1/Th2 imbalance in children with MPP. Th1 immune response is dominant in acute-stage MPP.

[Summary] The incidence of diabetes mellitus is increasing year by year ,which attracts more and more attention. Scientific researches have demonstrated the role of chronic systemic inflammation and immune dysregulation in the development of type 2 diabetes mellitus (T2DM ). Moreover ,the evidence of islet autoimmunity has also been identified in some patients with T 2DM. These discoveries highlight the potential of immune‐modulatory therapies for T 2DM.

Objective To explore the risk factors for urinary tract infections in type 2 diabetes mellitus(T2DM )by analyzing the pathogens distribution characteristics and drug sensitivity. Methods A total of 3 ,065 T2DM patients were retrospectively analyzed for the clinical and etiological characteristics of urinary tract infections in T2DM. All patients enrolled in the study were divided into two groups :T2DM with urinary tract infection group (n= 210) and simple T2DM group (n= 132). Data harvested were analyzed by SPSS 19.0. Results Of 3 ,065 patients with T2DM the incidence of urinary tract infection was 6.85%. Compared with T2DM group ,patients in T2DM+ urinary tract infection group were older , with longer duration of diabetes ,higher levels of FPG ,urea nitrogen ,creatinine and 24 hUAlb ,and lower levels of serum albumin ( P< 0.05 ). Logistic regression analysis showed that age ,gender ,duration of diabetes and 24 hUAlb were risk factors and albumin was protective factor for urinary tract infection in T2DM. 84.2% was gram-negative bacteria among the 210 isolated strains of pathogenic bacteria. The top three pathogens were Escherichia coli (65.2% ) ,Enterococcus faecalis (6.2% ) and Klebsiella pneumoniae (5.2% ). Gram-negative bacteria had high sensitivity to Imipenem (100% ) ,Cefoperazone sulbactam (99.2% ) and Amikacin (99.2% ) but low sensitivity to cephalothin (38.1% ) ,piperacillin (35.7% ) and amoxicillin (28.2% ). Conclusion T2DM patients who have the factors including female ,advanced age , long course of diabetes and renal insufficiency are prone to suffer from urinary tract infection. Gram-negative bacteria are the most common pathogens in T 2DM patients with urinary tract infection but bacteria spectrum has changed with percentage of multiple resistant bacteria rising dramatically.

Objective Adult isolated ACTH deficiency ( IAD) is an uncommon and underestimated disorder with high rate of misdiagnosis.This paper aimed to analyze and summarize the clinical features of 6 patients with IAD to have deeper understanding of the disease. Methods Retrospective analysis was made on the data of 6 IAD cases enrolled in Nanjing Hospital of Nanjing Medical University from 2007 to 2015.Statistical analysis was made on the clinical manifestations, therapeutic schemes, laboratory and imaging results, along with outpatient follow-up(ranging from 0.5-10 years), in order to analyze clinical efficacy and prognosis result. Results Of 6 IAD patients, 4 patients showed main symptoms of long-term fatigue, anorexia, weight loss;5 patients were with differ-ent degrees of hypoglycemia (fasting blood glucose2.70 [1.2-3.0]mmol/L), among which 3 had hypoglycemic coma (fasting blood glucose <1.8mmol/L), 1 had chronic hypoglycemia and 1 had asymptomatic hypoglycemia( asymptomatic hypoglycemia by continu-ous glucose monitor system).4 of them had refractory hyponatremia (Serum Na+117 [110-120]mmol/L).ACTH values of all the patients were less than 0.01ng/L.After glucocorticoid replacement therapy, all the patients were followed up for six months after treat-ment and cortisol rhythm, plasma cortisol, urine cortisol, fasting blood glucose, serum sodium of the patients were in normal range, but still at a low level of ACTH. Conclusion The clinical manifestation of IAD is characterized as hypoglycemia, hyponatremia, low ACTH with other normal pituitary hormones.Long-term glucocor-ticosteroid therapy has favorable prognosis for patients with adult isola-ted ACTH deficiency.

Graves′disease ( GD) is an organ-specific、autoimmune and hyperthyroid thyroid disease closely related to the TSH receptor antibody ( TRAb) .Oxygen free radicals and the oxidative damage caused by these are closely related to the development and progression for GD .Researches on oxidative stress are providing novel therapeutic targets of GD .

To investigate the protective effects and possible mechanism of Mycelium of Hirsutella hepiali Chen et Shen (MHCS) on metabolic syndromes, free fatty acid and MHCS-treated hepatocytes were used for detecting autophagy-related LC3, p62 and lipid accumulation. Moreover, high fat diet fed mice were used to establish metabolic syndromes model. 50-weeks age mice were randomly divided into: control group, model group and MHCS group. At 80-weeks age, 15 mice were randomly chosen from each group separately for examining oral glucose tolerance, serum insulin, insulin-like growth factor 1 (IGF-1), hepatic LC3, p62, p-NF-kappaB p65, NF-kappaB p65, IL-6 and CXCL-8. Moreover, insulin resistance index (IRI) was calculated. Hepatic pathological changes, including vacuoles, lipids accumulation and fibrosis were observed. Remaining mice were fed with diet separately to 110 weeks-age for statistics of mortality. MHCS promoted autophagy of free fatty acid treated hepatocytes. Mice fed with high fat plus MHCS diet exhibited improved oral glucose tolerance, insulin resistance, hepatic pathology, inflammation, mortality and activated autophagy. The protective effects of MHCS against metabolic syndroms might be through the activation of hepatic autophagy.

Objective To investigate the effect of δ-aminolevulinic acid(ALA)-induced photodynamic reaction on biological characteristics of skin fibroblasts.Methods Human skin fihroblasts were isolated from the foreskin of children and cultured in the presence of 0.5 to 5.0 mmol/L ALA;three hours later,they were irradiated with 632.8 am laser followed by additional 12-hour culture.Then,MTI"assay and flow cytometry were used to measure the proliferation and apoptosis of cells.The levels of matrix metallopmteinase(MMP)1,-2 and-3 and hydroxyproline in the culture supematant of irradiated cells were determined by avidinbiotin complex-based ELISA and alkaline hydrolysis-based method,respectively.Results With the rise of ALA concentration from 0.5 to 5.0 mmol/L.the proliferation level of fibroblasts expressed as the absor-bance at 570 nm dropped from 0.45±0.05 to 0.32±0.04.and cell death rate increased from 6.4%±2.0% to 29.6%±2.2%.Meanwhile,the contents of MMP-1,-2 and -3 increased at the early stage,but decreased at the late stage,whereas the hydroxyproline level showed an inverse tendency during the increase of ALA concentration from 0.5 to 5.0 mmol/L.Conclusions Proper intensity of photodynamic reaction induced by ALA could enhance the secretion of MMP and inhibit the synthesis of collagen by skin fibroblasts,however,high concentration of ALA may exert an inverse effect.

Fifty cases of acinic cell carcinoma(ACC) of salivary glands were observed in a period of 22 years(l960-1982) in this hospital. 25 tumors out of the 50 occurred in the parotid gland, 7 in the submaxillary gland, and 18 in other minor salivary glands. Conventional microscopy revealed that ACC of salivary glands are composed of granulated acinic cells, clear cells, vacuolated cells, and intercalated duct cells. According to the different histological features, the authors suggest that ACC are to be classified into 6 types: cystic papillary, solid ethmoid, tra-beculopapillary, acinic adenoid, acinic nestlike and diffuse types. This classification facilitates the clinicians and pathologists to grasp the pathological cha- racteristies and diagnostic criteria and assessable prognosis and to accumulate the clinical material for research purposes.Thirty-seven patients out of the 50 have been followed up for years, the longest up to 19 years. 14 patients(37.8%)developed local recurrences. The five and ten year survival rates are 62.2% and 37.8% respectively.The differential diagnosis, histochemistry, histogenesis, and prognosis of ACC were discussed with a brief review of the literature concerned. Our data supports the assumption that ACC originates from the intercalated duct cells rather than from fully differentiated serous cells.