BACKGROUND:Umbilical cord mesenchymal stem cels are from the umbilical cord of newly born individuals and have no ethical issues, and therefore are promising candidates for seeded cels as a substitute for cel transplantation and regenerative medicine. OBJECTIVE:To investigate the effects of serum from liver injury rats on induced differentiation of human umbilical cord mesenchymal stem cels into hepatocyte-like cels and provide experimental evidence for use of human umbilical cord mesenchymal stem cels in the treatment of patients with end-stage liver disease in the clinic. METHODS: Rat models of acute liver injury were established by intraperitoneal injection of 10% carbon tetrachloride. Rats in the control group were intraperitonealy administered the same amount of soybean oil. Forty-eight hours after modeling, abdominal aorta blood was taken for serum preparation. Passage 3 human umbilical cord mesenchymal stem cels were cultured with 20% serum from liver injury rats and 20% fetal bovine serum. Morphology of human umbilical cord mesenchymal stem cels was observed before and after culture. Levels ofα-fetoprotein and albumin in the supernatant were detected. RESULTS AND CONCLUSION:Cels exhibited shuttle-shaped appearance and grew in whirlpool-like manner at 1 day after culture with serum from liver injury rats, exhibited short shuttle-shaped appearance at 2 days, were oval-shaped at 3 days, and were round and an extremely smal number of cels were floated at 4 days. At 4 days after culture with serum from liver injury rats, level of albumin in the cel supernatant was significantly increased than that before induction and that in the control group (P< 0.001), and there was no significant difference in level of α-fetoprotein in the cel supernatant. These results suggest that serum of liver injury rats can induce differentiation of umbilical cord mesenchymal stem cels into hepatocyte-like cels.

Objective To observe the clinical manifestation and ophthalmoscopic image characteristics of uveal metastatic carcinoma.Methods Thirty-six uveal metastatic carcinoma patients (43 eyes) were enrolled in this study.The patients included 21 males and 15 females.The patients' ages ranged from 28 to 71 years,with a mean age of (47.3 ±10.2) years.Seven patients had bilateral carcinoma and 29 patients had unilateral carcinoma.There were 30 patients with lung cancer,three patients with breast cancer,one patient with gastric cancer and two patients without primary tumors.There were 20 patients with known primary cancer,16 patients visited the Department of Ophthalmology first.All the patients were examined documenting visual acuity,intraocular pressure,slit-lamp microscopy and mydriatic fundus examination.Meanwhile,22 patients (26 eyes) were examined using B-type ultrasound and/or color Doppler flow imaging(CDFI).Twelve patients (12 eyes) were examined using fundus fluorescein angiography (FFA) and/or indocyanine green angiography (ICGA).Seventeen patients (22 eyes) were examined using MRI and/or CT.The clinical manifestation and ophthalmoscopic image characteristics of uveal metastatic carcinoma patients were observed.Results Among 43 eyes,four lesions were in the iris,three lesions in the ciliary body and 32 lesions were in the choroid.Fundus examination showed an isolated mass in 26 eyes and more than two masses in nine eyes.Metastatic tumors of the iris and ciliary body often showed irregular cauliflower-like mass with gray-white or meat-red color and abundant vessels.The choroidal metastasis usually demonstrated flat rounded or irregular intraocular masses with gray-yellow or gray-white color in the posterior pole.B-type ultrasound showed ill-defined,flat,and irregular-shaped masses with uneven internal reflectivity.CDFI showed rich blood flow within the tumor.FFA and (or)ICGA showed pinpoint and mottled leaks against hyperfluorescence background.MRI revealed low or middle signal using T1 WI and low signal intensity using T2WI.Conclusions The uveal metastatic carcinoma usually occurs in one eye with an isolated mass.Most of them show a flat gray-yellow mass in posterior choroids and have the primary cancer sites of the lung.FFA and/or ICGA show pinpoint and mottled leaks against hyperfluorescence background.B-type ultrasound and (or) CDFI show ill-defined,flat,and irregular-shaped mass with rich blood flow within the tumor.MRI reveals low signal intensity on T2 WI.

Hepatocellular carcinoma (HCC) is the fifth most common cancer and the second leading cause of cancer-related death worldwide.Increase in incidence has been shown in HCC over the last few years and more than half of the cases were reported in China,where hepatitis B virus (HBV) infection is the main etiologic factor.Heterogeneity in HCC's distribution worldwide and difference in etiology may result in a more complicated issue about prognosis-estimation and choosing of treatment options for HCC patients.In the past decade,there have been several clinical staging systems developed in terms of relevant prognostic factors.Among them,the Barcelona Clinic Liver Cancer (BCLC) and the Hong Kong Liver Cancer (HKLC) staging system are the only two classifications that link prognostic classification to treatment indications.In this review,we mainly focus on the application of BCLC and HKLC staging systems in guiding decision making for HCC,the respective advantages and disadvantages of each classification,and the future perspective of our own prediction model in which some new clinical factors will be integrated.

BACKGROUND: Studies of umbilical cord blood stem cells transplantation for liver function failure have demonstrated that Astragalus membranaceus preparation can stimulate hemopoietic stem/progenitor cell proliferation.OBJECTIVE: To explore the effect of Astragalus membranaceus injection on the differentiation of umbilical cord blood stem cell into hepatocyte in vitro and in vivo for the treatment of liver failure. METHODS: The third and fourth passage of human umbilical cord blood stem cells (HUCBSCs) were collected. In drug screening test, there were 4 groups: cells were separately cultured with 0, 40, 200, and 400 mg/L Astragalus membranaceus injection to screen the appropriate for cell growth. In cell differentiation test, there were 2 groups: HUCBSCs were respectively cultured with hepatocyte growth factor (HGF, 10 μg/L), and HGF (10 μg/L) plus 200 mg/L Astragalus membranaceus injection. D-aminogalactose was intraperitoneally injected to establish a model of acute liver failure. Surviving model rats (48 hours) were randomly divided into six groups: model control, Astragalus membranaceus injection, rat peripheral blood mononuclear cells, combination, combination+Cytoxan, and combination+dexamethasone groups. The alpha fetoprotein mRNA and albumin mRNA expression was determined by RT-PCR, and liver function indexes were observed. RESULTS AND CONCLUSION: Different mass concentration of Astragalus membranaceus injection displayed varied influence on HUCBSC proliferation: 200 mg/L was the best for HUCBSC proliferation. Compared with HUCBSC cultured with HGF alone, the number of albumen-positive cells in HUCBSCs cultured with 200 mg/L Astragalus membranaceus injection and HGF was greater (P < 0.05). Moreover, the expression of albumen mRNA in combination, combination+Cytoxan, and combination+dexamethasone groups was greater than rat peripheral blood mononuclear cells group, while alpha fetoprotein mRNA expression was only greater than rat peripheral blood mononuclear cells group in early stage. At 7 days of treatment, the values of alanine aminotransferase, aspartate amino transferase and total bilirubin were significantly greater in combination, combination+Cytoxan, and combination+dexamethasone groups compared with model control, Astragalus membranaceus alone and rat peripheral blood mononuclear cells groups (P < 0.05), but no differences were observed among model control, Astragalus membranaceus alone and rat peripheral blood mononuclear cells groups (P > 0.05). Results indicate that Astragalus membranaceus injection at 200 mg/L can promote the proliferation and differentiation of HUCBSCs into hepatocyte in vitro and in vivo, ameliorate liver function and improve treatment effect of HUCBSC transplantation for liver failure.

To study injurious effects on rabbit lung from rapid decompression, slow decompression and the rapid decompression were used in two respective groups consisting of 30 rabbits. Slow decompression did not bring about obvious lung injury, but the lung injury in different severity occurred after rapid decompression. The greater the decompression peak value was, the more severe lung injuries was. These results indicated that rapid decompression could inflict lung injury, and the main cause of lung injury might be the temporary high pressure in lungs induced by rapid decompression, leading to over expansion of the alveoli and strong impact of the lung on the chest wall

Late in-the-bag dislocation of intraocular lens bag complex is a rare but potential complication after cataract surgery,which can affect the quality of patients'life seriously,and usually need surgical treatment.People are paying more attention to this complication,because it has been reported with increasing frequency in recent years.This complication may present after a long time frame.There is a research showing that the interval between cataract surgery and the dislocation was 10.9 years.The cumulative risk of IOL dislocation at 10 years,20 years,and 25 years after cataract extraction was 0.1％,0.7％,and 1.7％ respectively.Late in-the-bag IOL dislocation is a result of progressive zonular dehiscence up to many years after cataract surgery,and its genesis is multifactorial.This article reviews the incidence,possible mechanism and risk factors of late in-the-bag IOL dislocation.

Objective To investigate the diagnostic value and safety of thoracoscopy routine pleural biopsy combined with frozen biopsy for pleural effusion. Methods A retrospective analysis was made on the pathological diagnosis rate of pleural effusion. Results 120 cases in thoracoscopy, 103 cases were confirmed with routine biopsy specimens (85.8%), 16 cases found in the lesions with conventional clamp not satisfactory tissue specimens, combined with frozen cut obtained satisfactory specimens, the diagnostic accuracy rate of 16 cases of cryobiopsy was 100.0%, and the total diagnostic accuracy rate of medical thoracoscopy combined with pleural biopsy and cryobiopsy was 95.0%. There was significant difference between conventional biopsy and cryobiopsy (P < 0.05). Conclusion Medical thoracoscopy combined with pleural biopsy and cryobiopsy can achieve a higher rate of pathological diagnosis, and the complications are mild, so it is worthy of clinical promoting.

Objective To evaluate the value of diffusion weighted imaging in differential diagnosis of endometrial carcinoma stagedⅠa.Methods A retrospective analysis of 18 patients with endometrial carcinoma staged Ⅰ a which was confirmed by pathology. Other 22 patients with benign endometrial diseases were also enrolled in the study including endometrial hyperplasia in 9,endometrial polyp in 8 and degenerative submucous myoma in 5.DWI with b value of 0 s/mm2 and 1 000 s/mm2 was performed with single shot sequence of EPI,and the ADC values were measured.Results The mean ADC values of endometrial carcinoma staged Ⅰa,endome-trial hyperplasia,endometrial polyp and degenerative submucous myoma were (0.89±0.21)×10 -3 mm2/s,(1.45±0.19)×10 -3 mm2/s, (1.29±0.32)×10 -3 mm2/s and (1.32 ±0.29)× 10 -3 mm2/s,respectively.There were statistical significant differences between them (F =48.021,P =0.00).Furthermore,statistically significant differences also existed between endometrial carcinoma and other groups (P <0.05).Conclusion ADC value shows a good value in differential diagnosis of endometrial carcinoma staged Ⅰa.

Objective To discuss combined detection of pleural biopsy under medical thoracoscopy and pulmonary serum tumor markers in diagnosis of pleural effusion with unknown reason.Methods 76 patients with pleural effusion caused by unknown reason from January 2014 to March 2016 were retrospectively analyzed. Pleural biopsy was conducted under medical thoracoscopy and sent for pathological examination, and 10 ml venous blood was collected from these patients upon admission for testing serum tumor markers (CEA, SCC-AG, ProGRP and CYFRA21-1).Results Among the 76 patients, there were 32 cases with benign lesions (14 with pulmonary tuberculosis, 9 with inlfammatory lesions, 6 with granulomatous inlfammation, 2 with empyema and 1 with hamartoma) and 44 cases with malignant lesions (18 with adenocarcinoma, 13 with squamous carcinoma, 6 with small cell lung cancer, 3 with adeno-squamous carcinoma, 2 with mesothelioma, 1 with large cell carcinoma and 1 with thymoma). The detection of serum tumor markers showed statistically significant differences in the levels of CEA, SCC-AG, ProGRP and CYFRA21-1 in serum between the malignant pleural effusion group and benign pleural effusion group (P = 0.021,P = 0.006,P = 0.003 andP = 0.010). The levels of various serum tumor markers in the malignant pleural effusion group were obviously higher than those in the benign pleural effusion group. According to the pathological results, patients with pleural effusions not caused by lung cancer (2 with mesothelioma and 1 with thymoma) were eliminated from 44 patients with malignant pleural effusions. The rest 41 patients with pleural effusions caused by lung cancer were divided into non-small cell lung cancer and small cell lung cancer according to the pathological types. The results showed that there were statistically signiifcant differences in the levels of CEA, ProGRP and CYFRA21-1 between non-small cell lung cancer and small cell lung cancer (P = 0.036,P = 0.005 andP = 0.008), while there was no statistically signiifcant difference in the level of SCC-AG (P = 0.811).Conclusions Due to high detection rate and high accuracy in detecting pleural effusions caused by unknown reason, medical thoracoscopy is of great signiifcance, especially for the diagnosis of malignant pleural effusions of pleural metastases. However, serum indicators may provide important reference values for us before the pathological results are available. Thus, it is an important means of diagnosing malignant pleural effusions caused by lung cancer and should be promoted in clinic.

Objective To discuss the postoperative efficacy of postoperative fossa decompression on patients with Chiar 0 type combined with the literature review.Methods A retrospective analysis of 8 patients fufilled the criteria for Chiari malformation Type 0 were surgically treated between Jan.2013 and Jan.2015 in Shanxi Provincial People's Hospital,and then observed the patients' postoperative efficacyaccording to Tator evaluation criteria.Results After 8 patients were performed by posterior fossa decompression,their clinical symptoms improved significantly,postoperative sagittal MR image with 1 weeks after operation revealing significantly decreased syringomyelia.In March and 1 years after surgery,the patients were followed up and the MRI showed no significant changes in the 1 week after surgery,and the symptoms were not deteriorated.Conclusions Posterior fossa decompression may be one of reasonable and effective operation for Chiari malformation Type 0 patients.This paper will be discussing with the observing the patient's postoperative efficacy and the past related literature.