Objective To investigate renal expression of ApoE in human lupus nephritis (LN) and its relationship with renal damages.Methods Renal expression of ApoE was examined in 40 LN patient biopsy samples by immunohistochemieal staining.The relationship between ApoE levels" and renal pathologic changes,renal injuries was analyzed.Results Only weak ApoE expression was found in normal renal tissue.The expression of ApoE was significantly higher in LN patients [ glomerular:(31.2±11.0) vs (3.0±1.6);tub-ular:(71.64±8.90) vs (0.60±0.06)].The expression of ApoE was higher in class IV than non-class IV LN [glomerular: (38.4±4.5) vs (18.0±4.6);tubular: (77.6±2.5) vs (60.0±3.2)].Spearman's relation-ship analysis showed that the expression of ApoE in glomerular and tubular was closely related to the renal histological score activity index and functional changes in LN (P＜0.01).Conclusion The expression of ApoE is high in renal tissues of LN,especially in class IV,and the high expression may be associated with LN activity and progressive renal dysfunction.

Objective To discuss the enrichment method of fetal DNA from maternal plasma on size-fractionated separation.Methods Antecubital venous blood (5 ml from each pregnant woman) was collected in EDTA-containing tubes.DNA was extracted from plasma and white blood cells, separately.The DNA was fractionated by agarose gel electrophoresis.Three sections of

Objective To obtain the recombinant protein of an antigen gene Ts88 of Trichinella spiralis and identify the characteristics of the recombinant protein. Methods Ts88 cDNA obtained by immunoscreening the cDNA library of adult T. spiralis was subcloned into the pET 28c(+) expression vector and expressed in E.coli . Mice were immunized with the fusion protein incorporated into Freund’s adjuvant and the immune sera were collected. The titers of the Ts88 immune sera and the antigenicity of the recombinant protein were detected by ELISA and Western blotting. Immuno fluorescence test was performed in order to confirm the distribution of Ts88 protein in the worm. Results The fragment of Ts88 gene was expressed successfully in E.coli and a highly purified fusion protein was obtained. Immunization with the recombinant protein in mice produced high titers of antibodies, which recognized some components of native antigens of soluble proteins from adult worm of T. spiralis. Western blotting analysis showed that Ts88 recombinant antigen was recognized by all the positive sera, such as the sera from infected or immunized rabbits, from infected swine and from patients of trichinosis. Immuno fluorescence test confirmed that Ts88 protein mainly distributed in the cuticle surface of the worm. Conclusion The Ts88 antigen gene from T. spiralis was successfully expressed. The recombinant protein presented antigenicity.

Objective To evaluate the value of diffusion-weighted imaging (DWI) in the differential diagnosis of cystic pancreatic lesions.Methods Thirty-four cystic pancreatic lesions confirmed clinically or pathologically were collected,including 11 case of non-neoplastic pseudocyst,5 cases of simple cyst,6 cases of serous cystadenoma,10 cases of mucinous cystadenoma and 2 cases of mucinous cystadenocarcinoma.All the patients underwent routine serial MR and echo-planar DW imaging examination of the pancreas with b values of 0 and 600 s/mm2.The appearances of signal intensity of DWI with all cysts were recorded.ADC maps were reconstructed,and the ratio of the cysts and cyst-to-pancreas ADC (ADCR) were calculated.The receiver operating characteristic (ROC) curves were constructed to evaluate the diagnostic value of ADC and ADCR.Results Among all the 16 non-neoplastic cysts,2 cysts were slightly hyperintense in DWI,and 14 cysts were isointense.Among all the 18 neoplastic cysts,17 cysts appeared slightly hyperintense or hyperintense in DWI,and 1 cyst was isointense.The difference between the two groups was statistically significant (P ＜ 0.001).The ADC values of non-neoplastic and neoplastic cysts were (3.30 ± 0.30) × 10-3,(2.74 ± 0.34) × 10-3 mm2/s ; and the ADCR values of non-neoplastic and neoplastic cysts were 1.85 ± 0.20,1.31 ± 0.21,the difference between the two groups was statistically significant (P ＜ 0.001).The areas under the ROC curves of ADC and ADCR diagnosing neoplastic cysts were 0.94 ± 0.04,0.98 ± 0.02,respectively.An ADC of 3.105 × 10-3 mm2/s showed 81.3％ sensitivity and 94.4％ specificity for predicting neoplastic cysts.An ADCR of 1.525 showed 100％ sensitivity and 88.9％ specificity for predicting neoplastic cysts.Conclusions Diffusion-weighted imaging is of importance in the diagnosis and differential diagnosis of pancreatic cysts,and can be applied as a complementary tool for routine MRI.

Objective To investigate the diagnostic value of apparent diffusion coefficient (ADC)for discriminating orbital lymphomas from other orbital mass lesions.Methods In this prospective study,87 subjects (22 orbital lymphomas and 65 other orbital mass lesions) were enrolled.These patients underwent serial MR and echo-planar DW imaging examination of the orbits with b values of 0 and 700 s/mm2 at 1.5 T MR (GE Signa Excite).ADC maps were reconstructed,and the ADC values of the orbital masses were calculated.Mass ADC was also compared with that of normal-appearing white matter (ADC ratio,ADCR).The receiver operating characteristic curves (ROC) were constructed using optimal cut point of ADC and ADCR to differentiate between orbital lymphomas and other orbital mass lesions.The areas under the ROC curve for ADC and ADCR were also calculated.Results The mean ADC and ADCR of orbital lymphomas were (0.77 ± 0.17) × 10-3 mm2/s and 0.89 ± 0.21,respectively.The mean ADC and ADCR of other orbital mass lesions were (1.36 ± 0.38) × 10-3 mm2/s and 1.51 ± 0.43,respectively.Lymphomas had lower ADCs and ADCRs than other orbital mass lesions (t =-9.620,-9.003,P =0.000).The areas under the ROC curves of ADC and ADCR diagnosing lymphoma were 0.94±0.03 and 0.91 ±0.03,respectively.An ADC of less than 0.804 × 10-3 mm2/sec and ADCR of less than O.956 were optimal for predicting lymphoma (sensitivity,77.3％ for both; specificity,98.4％ and 92.3 ％,respectively ; and accuracy,93.1％ and 88.5 ％,respectively).Compared with pathological results,both ADC and ADCR had high correlations (Kappa values were 0.806 and 0.696,respectively).Conclusion Diffusion-weighted imaging can be applied as a complementary tool in the detection of orbital lymphomas.

Objective To study the polymorphisms of short tandem repeat (STR) loci in intron 1, 24, 13 and 22 (STR 1,24, 13, 22) of factor Ⅷ (FⅧ) gene in Chinese population, and establish single tube multiple fluorescent PCR method for rapid diagnosis of haemophilina A(HA). Methods Four STRs from genomie DNA of 220 females without blood relationship were amplified in a single tube using quadri-fluorescence PCR. Capillary electrophoresis was analyzed in ABI PRISM 310 Genetic Analyzer. DNA sequencing was used to assay the number of dinueleotide repeats. Gene diagnosis were performed in 96 HA families. Results It was observed that 7, 9, 10 and 7 different alleles were found in STR1, 24, 13 and 22, respectively. The PIC (polymorphism information contents) were 0. 3789, 0. 4055, 0. 5239 and 0. 4713 in STR1,24, 13 and 22, respectively, and the HR (heterozygesity rate) were 34. 55% (76/220), 38. 18% (84/220), 49. 55% (109/220) and 43.64% (96/220). In 96 HA families, the diagnosis rate of STR1, 24, 13 and 22 were 38. 54% (37/96), 38. 54% (37/96), 54. 17% (52/96), 42. 71% (41/96), respectively. Whereas it achieved 79. 17% (76/96) when combining the four STR markers. Conciusion The single tube multiple fluorescent PCR of four STR loci is an effective, simple, quick method for linkage analysis and gene diagnosis of haemophilia A.

Objective To investigate the effect of oral nutritional supplementation on the nutritional status and quality of life in patients with gastric cancer after operation.Methods In this prospective,single blind,randomized,controlled clinical study,25 postoperative patients with gastric cancer received neoadjuvant chemotherapy in outpatient clinic were enrolled.All patients received dietary guidance.In the intervention group,in addition to standard diet,oral nutritional supplements with 2 090 kJ/d of Intacted Protein Enteral Nutrition Powder were added,which lasted 90 days.The changes of body mass,body mass index(BMI),hemoglobin,prealbumin,albumin,gastrointestinal function score,and life quality score 30,60,and 90 days after discharge were recorded.Patients on standard diets were used as the control group.Results In the intervention group,the body mass increased by(0.66 ±1.47)kg 60 d after discharge and(-0.90±1.82)kg on 90 d after discharge,which were [60 d:(-5.13±1.79)kg,90 d:(-9.56±2.44)kg] in the control group,and the difference was statistically significant(P=0.027,P=0.015).The BMI of intervention group increased by(0.20 ±0.55)kg/m2 on 60 d and(-0.32±0.55)kg/m2 on 90 d after discharge,which were(-2.06±0.67)kg/m2 on 60d and(-3.21± 0.73)kg/m2 on 90 d in the control group(P=0.014,P=0.003).There was no significant difference in terms of serum albumin,prealbumin and other laboratory indicators.Intestinal functional status and quality of life also showed no significant difference between these two groups.ConclusionOral nutrition supplementation can reduce the body mass loss and improve the nutritional status in patients with gastric cancer during chemotherapy after operation.

OBJECTIVE: To analyze the MR imaging findins of acinic cell carcinoma(ACC) in parotid gland and develop the diagnosis of this disease. METHOD: The MR imaging fearures of 11 patients with pathologically proved ACC were retrospectively analyzed. MR imagings were analyzed in relation to the follow:amount, location, size, shape, margin, pseudocapsule, MR signal intensity and enhanced pattern and the cervical lymphadenopathy. The clinical analysis on patients included age, sex, and follow-up. RESULT: There were 11 patients, 7 lesions was located in the right parotid gland and 4 lesions was located in the left parotid gland; the average maximum diameter was (2.66±0.99)cm; 7 lesions showed lobulated,and 4 lesions showed round; 8 lesions had no pseudocapsules and 3 lesions had incomplete pseudocapsule. All lesions showed homogeneous or heterogeneous isointense and slight hyperintense on T1 WI and T2WI. On post contrast images, the tumor parenchyma ingredients showed remarkable enhancement in all lesions. CONCLUSION The MR imaging of ACC in the parotid gland don't have specific features, but when the tumor of the parotid gland showed no pseudocapsule (or showed incomplete pseudocapsule), lobulate, small cysitc and remarkable enhancement, it may indicate ACC, and the correct diagnosis depends on clinical pathology.
Carcinoma, Acinar Cell ; pathology ; Contrast Media ; Humans ; Magnetic Resonance Imaging ; Parotid Gland ; Retrospective Studies ; Salivary Gland Neoplasms ; pathology

Objective:To discuss the essentials of anesthesia management and treatment strategies for emergency transcatheter aortic valve replacement (TAVR), and to provide standardized recommendations for the development of emergency TAVR technology in China.Methods:This study retrospectively analyzed the relevant data of patients undergoing emergency TAVR surgery in the Second Affiliated Hospital of Zhejiang University School of Medicine from March 2019 to February 2021, including baseline patient characteristics, perioperative echocardiography data, prognosis and 30-day follow-up. Post-operative data were compared with pre-operative data using paired-sample test.Results:Thirteen patients, aged (75.62±9.63) years, underwent emergency TAVR surgery, and 6 of them were male. Eleven patients were New York Heart Association class Ⅳ. The preoperative Society of Thoracic Surgeons score was (20.31±15.15)%. The trans-aortic valve differential pressure was significantly reduced after surgery [(68.92±30.66)mmHg vs. (2.70±2.36)mmHg, P<0.01]. Two patients died within 30 days after surgery, one patient developed a new third degree atrioventricular block, one patient had a stroke, and 4 patients developed pulmonary infection. Conclusions:Emergency TAVR surgery is a feasible and effective rescue strategy for patients with aortic stenosis in critical condition. The establishment of anesthesia standard operation procedure process for TAVR surgery helps ensure homogenized medical behavior and good teamwork.

OBJECTIVETo investigate the effects of secondary dust exposure after whole-lung lavage (WLL) on the clinical symptoms, arterial blood gas parameters, and pulmonary function in subjects with pneumoconiosis and patients with stage I coal workers' pneumoconiosis (CWP).

METHODSThe subjects with pneumoconiosis and patients with stage I CWP who underwent WLL in our hospital during the study period were selected. All patients were divided into postoperative dust exposure group (n = 86) and lavage control group (n = 86) according to whether they were exposed to dust after conventional operation. In addition, their workmates with similar age, history of dust exposure, and type of dust exposure were selected as non-lavage control group (n = 86). Follow-up was performed before and at one month and one year after WLL to evaluate clinical symptoms, arterial blood gas parameters, and pulmonary function.

RESULTSOne month after operation, the clinical scores of the postoperative dust-exposure group and lavage control group were significantly reduced compared with their preoperative scores and the clinical score of the non-lavage control group (P < 0.01). One year after operation, the clinical scores of the postoperative dust-exposure group and lavage control group were significantly reduced compared with their preoperative scores and the clinical score of the non?lavage control group (P < 0.01), and the lavage control group had a significantly lower clinical score than the postoperative dust exposure group (P < 0.01). One month after operation, the arterial partial pressure of oxygen (PaO2) of the postoperative dust-exposure group and lavage control group were significantly higher than their preoperative values and the arterial PaO2 of the non-lavage control group (P < 0.01). One year after operation, the lavage control group had significantly higher arterial PaO2 than the postoperative dust exposure group and the arterial PaO2 of the non-lavage control group was significantly lower than its preoperative value and the arterial PaO2 of the postoperative dust exposure group and lavage control group (P < 0.05 or P < 0.01); the postoperative dust exposure group showed a significant decrease in arterial PaO2 (P < 0.01), while the lavage control group showed a significant increase in arterial PaO2 (P < 0.01). The partial pressure of carbon dioxide showed no significant differences between the three groups before and at one month and one year after operation (P > 0.05).

CONCLUSIONDust exposure should be avoided after WLL to ensure the treatment outcome.

Anthracosis ; physiopathology ; therapy ; Blood Gas Analysis ; Bronchoalveolar Lavage ; Coal ; Coal Mining ; Control Groups ; Dust ; Humans ; Lung ; physiopathology ; Occupational Exposure ; adverse effects ; Oxygen ; Pneumoconiosis ; physiopathology ; Treatment Outcome