[Objective]The article summarizes the essentials of clinical dialectical experience by PENG Jianming on using Goujutang in curing epididymits and orchitis.[Methods]From following teacher PENG's clinical studies, recording teacher PENG's three medical cases and making analysis,we can summarize the thoughts and experience on using Goujutang in treating epididymits and orchitis.[Results]Teacher Peng considers that epididymits and orchitis have disease much due to the liver channel downward flow of damp-heat, causing local blood stagnation, so treatment Goujutang as basic party to smooth liver regulating qi,resolve dampness and clear away heat;and then plus the herbal medicine which can clear away heat and toxic materials,clearing damp and promoting diuresis,softening hardness to dissipate stagnation,removing stasis to ease pain.So we use Goujutang to treat epididymitis and orchitis, which can obtain good effect.[Conclusion]Teacher PENG's experience on using Goujutang in treating epididymits and orchitis has positive effect and is worthy of further study.

Objective To investigate the infection situation of HIV in patents in hospital ,and to provide basis for the prevention of AIDS in the hospital .Methods Three kinds of enzyme‐linked immunosorbent assay(ELISA)kits(Beijing wantai ,Beijing kewei , French BIO‐RAD)were used for screening HIV antibody and antigen in 240 781 samples from Jan .2011 to Dec .2013 .All HIV re‐peated positive screening samples were confirmed by western blotting in Chongqing shapingba Center for Disease Control and Pre‐vention .Results Among 240 781 samples from 2011 to 2013 ,593 samples(0 .246% ) were HIV positive at the first screening ,558 samples(0 .231% ) were HIV positive in at the repeated screening ,29 samples(0 .012% ) were HIV indeterminate ,6 samples(0 . 002% ) were HIV negative.Male and female ratio was 3 .39:1 .Conclusion Screening in hospital patients could be an important way to discover cases with HIV infection .It is nesscessary to strengthen the promotion and propaganda of HIV detection ,and new technology of HIV detection could be used to strengthen the inspection of HIV .Moreover ,the consciousness of self protection should be promoted in the treatment of HIV patients .

Purpose:To study the clinical and imaging characteristics of childhood malignant lymphoma with bony erosion, and explore the treatment protocol and prognosis.Methods:Through pathologic tests, immunohistochemical studies and imaging analyses, 6 patients were diagnosed as malignant lymphoma with bony infiltration. The 6 cases were treated and followed up. Results:There were different kinds of bony involvement in CT and MIRI imaging in 6 patients. All cases were type B as to immunology classification. Following treatment by protocol MCP, 1 case was dead and the others are in constant compete remission (CCR). Conclusions:The childhood malignant lymphoma with bony involvement is rarely seen, it is relatively easy to diagnose by CT/MRI and pathologic tests. The prognosis is related to clinical classification. It can be treated by protocol MCP.

Objective:To investigate the expression of tissue factor pathway inhibitor-2 (TFPI-2) and synuclein gamma (SNCG) in esophageal cancer and their correlation with local invasion, lymph node metastasis and apoptosis. Methods:The expression of TFPI-2, SNCG, and matrix metalloproteinase-9 (MMP-9) was detected by immunohistochemical SP methods in 82 cases of esophageal cancer tissues, 20 cases of atypical hyperplasia tissues, and 54 cases of para-cancerous tissues. The apoptosis of esophageal cancer cells was detected by TUNEL staining and apoptosis index (AI) was calculated. Results:The positive rates were 30.4%, 60.0%, and 87.0% for TFPI-2 protein and 63.4%, 30.0%, and 3.7% for SNCG protein in the tumor tissues, atypical hyperplasia tissues,and tumor-adjacent normal tissues, respectively. There was a significant difference between the three groups(P<0.01). The positive expression of TFPI-2 and SNCG correlated with the lymph node metastasis, invasion depth, TNM staging, and differentiation degree of esophageal cancer (P<0.01), but did not correlate with age at surgery, gender, tumor location, and pathologic classification(P>0.05). The expression of TFPI-2 and MMP-9 was negatively correlated (r=-0.636, P=0.000). The expression of SNCG and MMP-9 was positively correlated(r=0.393,P=0.000). AI was related with TFPI-2 and SNCG expression (P<0.05). Conclusion:TFPI-2 not only inhibited the expression of MMP-9 but also induces apoptosis of esophageal cancer to prevent tumor invasion and metastasis, however, SNCG plays a contradictory role in cancer development. TFPI-2 and SNCG might serve as new tumor markers and the new targets for tumor gene therapy.

Objective To investigate the effects of the zinc finger protein A20 on LPS-TLR4 signaling pathways in severe acute pancreatitis(SAP) rats.Methods 24 SD rats were randomly divided into 3 groups:group A(the sham operation group),group B (the SAP group),group C (the SAP group treated with LPS).SAP model was induced by retro-injection of intraductal 5％ sodium taurocholate into the biliary-pancreatic duct as previously described.The protein expression of A20,TLR4,NF-κBp65 and p38MAPK in pancreatic tissues was evaluated by immunohistochemistry.Results The positive area of A20 in pancreatic tissues was decreased in group B and group C compared with that in group A (t =17.234,19.698,all P ＜ 0.05).On the contrary,the expression of TLR4,NF-κBp65 and p38MAPK in pancreatic tissues were up-regulated(t =15.909,20.432,16.543,18.629,22.105,19.006,all P ＜ 0.05).A20 was decreased in group C than that in group B (t =14.894,P ＜ 0.05),while TLR4、NF-κBp65 and p38MAPK were increased in group C than those in group B (t =14.047,15.582,17.070,all P ＜0.05).Conclusion The expression of A20 reduced and TLR4,NF-κBp65 and p38MAPK enhanced in the pancreas of rats with SAP,which indicated that A20 inhibited LPS-TLR4 signaling pathways which play important roles in the pathogenesis of SAP.

Objective To analyze the percentage and functional changes of natural killer T (NKT) cells in peripheral blood and bone marrow of severe aplastic anemia (SAA) children before immunosuppressive therapy (IST) comparing to that of healthy children.Methods Ten children with severe aplastic anemia were included in the study and ten healthy children at the same age were selected as the control group. By lfow cytometry, the percentage of CD3+CD1d tetramer+ NKT cell in peripheral blood and bone marrow were detected from March 2014 to December 2014 in our hospital. Immune magnetic bead separation was used to isolate and purify iNKT cells .The puriifed iNKT cells were cultured in the OCH(50 ng/ml,100 ng/ml or 200 ng/ml)+rhIL-2+rhG-CSF culture systems. The ampliifcation of iNKT cells after cultured in different systems were calculated. Elispot method was used to analyze the spotting form cells (SFCs) of IFN-γ or IL-4 expressed by activated iNKT cells.Results The percentage of CD3+CD1d tetramer+ NKT cells in peripheral blood of SAA group(0.72±0.03)% was signiifcantly lower than that of the control group(0.92±0.02)%(P=0.000). The percentage of CD3+CD1d tetramer+ NKT cells in bone marrow of SAA group(0.82±0.02)% was signiifcantly lower than that of the control group(1.05±0.05)%(P=0.000).In vitro iNKT cell ampliif-cation ability of bone marrow in SAA group was signiifcantly lower than the control group, and in medium concentration(50±6) and high concentration OCH group(52±6), the ampliifcation ability was higher than that in low concentration OCH group(30±5) (P<0.05). The secretion of IFN-γ in the iNKT cells of SAA bone marrow was signiifcantly lower in medium concentration(33±3) and high concentration(35±3)OCH group than that of the low concentration(50±3)OCH group(P<0.01). The secretion of IL-4 in the iNKT cells of SAA bone marrow was signiifcantly higher in medium concentration(50±3)and high concentration(75±3) OCH group than that of the low concentration(33±3) OCH group(P<0.01).Conclusions The quantity and function of NKT cells from children with SAA are lower than that of the healthy children.In vitro, they had better ampliifcation ability and could improve IL-4/IFN-γ imbalance in medium concentration and high concentration OCH group than in low concentration OCH group.

10.3969/j.issn.1000-3606.2013.06.007

Objective To provide the applied anatomy of the posterior intercostal artery perforator flap and the clinical results of repairing the soft tissue defects with lateral perforator flap. Methods Six fresh adult cadavers were injected with a lead oxide-gelatin mixture for three-dimensional visualization reconstruction using a 64-slice spiral computed tomography scanner and specialized software (Materiaise's interactive medical image control system,MIMICS).The origin,course,diameter,and distribution of the the 6-10th posterior intercostal artery perforators in the thoroax region were observed and measured.Clinically,nine cases were treated with the lateral perforator flap supplied by 7-10th posterior intercostal artery transplantation for repairing wounds in upper limbs.The flap size was 9 cm × 7 cm-16 cm × 12 cm. Results The 6-10th posterior intercostal artery perforator (outer diameter 1.70 ± 0.14 mm) were from the artery in the chest region, which pierce in deep fascia near midaxillary line. The average pedicle length from the deep fascia was (87.56 ± 6.48) mm.All of 9 cases were repaired successfully,the clinical results were satisfactory.Conclusion The posterior intercostal artery perforator flap can be used to form many kinds of axial skin flaps,it is a good option for repairing soft-tissue defect.

Objective To investigate the therapeutic effect of intensive glycemic control on patients with early diabetic nephropathy. Methods A total of 41 type 2 diabetes patients who developed microalbuminuria were divided into two groups randomly. Patients in Group A received intensive glycemic control and the blood glucose in Group B was regularly controlled. Glycemic monitoring and control were followed for 12 weeks to observe the changes of microalbuminuria in both groups; meanwhile the levels of serum lipids and coagulation indices were also recorded. Results The urine albumin excretion rate (UAER) in Group A decreased significantly from (47.91±13.86)mg/24h to (35.31±14.56)mg/24h after 12 weeks (P<0.05), and this decrease was significantly greater than that in Group B. However, Group B had no significant difference in UAER decrease [(48.93±13.32)mg/24h to (40.48±19.62)mg/24h, P>0.05]. The decrease of triglyceride (TG) and low-density lipoprotein cholesterol (LDL cholesterol), and the increase of high-density lipoprotein cholesterol (HDL cholesterol) showed no significant differences (P>0.05). And the level of plasma fibrinogen (FIB) showed no significant decrease after 12 weeks, either (P>0.05). Conclusion Intensive glycemic control reduces the level of microalbuminuria and may ameliorate the progression of early diabetic nephropathy.

Objective To investigate the role of cyclin-dependent kinase 9 ( CDK9) in regulating lytic replication of Kaposi′s sarcoma-associated herpesvirus ( KSHV) .Methods Percentages of red fluores-cent protein (RFP) positive cells were counted after treating and stimulating iSLK .219 cells with FIT-039, a CDK9 specific inhibitor , and doxycycline ( Dox ) , respectively , or transfecting and stimulating them with CDK9 siRNA (si-CDK9) and Dox, respectively.Quantitative real-time PCR was used to detect the expres-sion of KSHV genes at mRNA level in TREx-K-Rta BCBL-1 cells treated with FIT-039 or transfected with si-CKD9 in the presence of Dox.Chromatin immunoprecipitation (ChIP) assay was used to examine the enrich-ment of RNA polymerase Ⅱ( RNA PolⅡ) and phosphorylated CTD-S2 of RNA PolⅡon the PAN promot-er in TREx-K-Rta BCBL-1 cells treated with FIT-039.Results Both FIT-039 intervention and CDK9 knockdown dramatically deceased the percentage of RFP-positive iSLK.219 cells and suppressed the expres-sion of ORF50, PAN and K2 in TREx-K-Rta BCBL-1 cells at mRNA level.Furthermore, FIT-039 signifi-cantly inhibited the enrichment of RNA Pol Ⅱand phosphorylated CTD-S2 of RNA Pol Ⅱon the PAN pro-moter in TREx-K-Rta BCBL-1 cells.Conclusion CDK9 is involved in regulating the lytic replication of KSHV through promoting the phosphorylation of CTD-S2 of RNA Pol Ⅱ.