Objective To analyze the clinical and histological features of drug-induced autoimmune hepatitis (DI-AIH).Methods From January 2008 to June 2011,five patients with auto-immune hepatitis (AIH),having a definitive history of medicine taking prior to the onset of disease and accepted liver biopsy were retrospectively analyzed.The general information was collected,which included gender,age,onset of the disease,medication,clinical manifestations,treatment and follow-up.The laboratory findings were also collected,which included total bilirubin (TBil),direct bilirubin (DBil),alanine transaminase (ALT),aspartate transaminase (AST),alkaline phosphatase (ALP),gamma glutamyl transpeptidase (GGT),globulin,γ-globulin percentage,albumin (Alb),eosinophils,antinuclear antibodies,antimitochondrial antibodies,anti-smooth muscle antibodies and the type of live injury.The liver tissue sections of patients were stained with hematoxylin-eosinstaining (HE) and reticular fiber staining and then pathological changes were observed.Patients with DI-AIH were scored with AIH scoring scale.Results All five patients with DI-AIH were female,average age was 48.0--+7.5.Prior to the onset of disease,all patients had taken Chinese traditional medicine.Anorexia and fatigue were the most common clinical symptoms.Among laboratory findings,the level of ALT ((795.0+467.4) U/L),AST ((730.44-451.5) U/L),TBil ((80.3-+ 64.1) μmol/L) and DBil ((65.2 +_ 58.0) μmol/L) significantly increased.One patient was antinuclear antibody positive.One patient had drug-induced liver injury,pathological features were spotty necrosis of liver cells,liver tissue eosinophil infiltration and liver cell microbubble type degeneration.All the patients had interface hepatitis,periportal infiltration of lymphocytes or lymphocytes-plasma cells,liver cells adjacent to lesion showed rosette-like structure.All the patients received glucocorticoid treatment.After glucocorticoid withdrawal,the liver function was normal during the follow-up period.Conclusion There are no specificity of clinical manifestations,laboratory findings and histological features in patients with DI-AIH.

Numerical simulation is one of the most significant methods to predict the temperature distribution in high-intensity focused ultrasound (HIFU) therapy. In this study, the adopted numerical simulation was used based on a transcranial ultrasound therapy model taking a human skull as a reference. The approximation of the Westervelt formula and the Pennes bio-heat conduction equation were applied to the simulation of the transcranial temperature distribution. According to the temperature distribution and the Time Reversal theory, the position of the treatable focal region was corrected and the hot spot existing in the skull was eliminated. Furthermore, the influence of the exposure time, input power and the distance between transducer and skull on the temperature distribution was analyzed. The results showed that the position of the focal region could be corrected and the hot spot was eliminated using the Time Reversal theory without affecting the focus. The focal region above 60 degrees C could be formed at the superficial tis sue located from the skull of 20 mm using the hot spot elimination method and the volume of the focal region increases with the exposure time and the input power in a nonlinear form. When the same volume of the focal region was obtained, the more power was inputted, the less the exposure time was needed. Moreover, the volume of the focal region was influenced by the distance between the transducer and the skull.
Computer Simulation ; High-Intensity Focused Ultrasound Ablation ; Hot Temperature ; Humans ; Neoplasms ; therapy ; Skull

Background and purpose:In the primary cutaneous CD30 positive lymphoproliferative disorders, despite the common reports about the primary cutaneous anaplastic large cell lymphoma and lymphomatoid papulosis, such reports about the bordline disease-lymphomatoid papulosis (type C) were rare. This article was to introduce and discuss its clinical manifestations and morphological and immunophenotypic features. Methods:Based on the related literature, we reviewed the clinical,pathological and immunohistochemical features from one case presented in Huashan Hospital. Results:The patient, male, was 56 years old with systemic red papuloid skin lesions accompanied with pruritus, which were sporadic, chronic, recurrent and self-healing. The duration of the disease persisted more than 26 years. Recently, the multiple papuloid lesions developed to be agrias, ulcerations and black eschars. Histopathologically, besides the ulcerated epiderm exfoliation, there were medium and large atypical lymphocytes in? trating in dermis layer. These cells showed postive for CD30,TIA-1 and CD3, and negative for ALK and CD20. Conclusions:When diagnosing LyP (type C),a rare disease, we should differentiate it from the primary cutaneous anaplastic large cell lymphoma (C-ALCL) and systemic anaplastic large cell lymphoma involving the skin, and also combine the clinical and histopathological characteristics and immunophenotype to identify its defi nition and nature.

Objective:To study the feasibility of rapid tooth movement by periodontal ligament distraction osteogenesis. Method: Periodontal ligament distraction osteogenesis technology was applied on the experimental side; traditional orthodontic tooth movement technology on the control side in 8 dogs. The treatment was countinued for 14 days. Tooth movement and alveolar bone remodeling were studied by in vivo measuring,roentgenogram, histology and immunohistochemistry 2,3,6 and 10 weeks after treatment respectively. Results:2 weeks after application of treatment tooth movement(mm) with periodontal ligament distraction osteogenesis and that with traditional orthodontic method was 3.49?0.57 and 1.06?0.32 (P0.05) respectively. Active osteogenesis was obsered on the tension loaded side, BMP expression on the experimental tension-loaded side was stronger than that in the control side (P

The application of covered stent in vascular malformation such as aneurysm,pseudoneurysm(PSA) ,arteriovenous fistula(AVF) has outcome to an encouraging result.Recently,it has also been effectively used for PTA,TIPS,traumatic lesions of peripheral vessels,and pseudoneurysm of dialysis grafts,etc.But there still remain some issues on the restenosis and endothelialization after the performance with covered stent.This review will pay attention to them.

Objective To explore the clinical significance and the dynamic changes of serum anti-inflam-mation factor interleukin-10(IL-10)and inflammatory factor interleukin-8(IL-8)in cerebral infarction.Methods The serum levels of IL-10 and IL-8 in 30 patients were measured by double-antibody sandwich enzyme-linked inunu-nosorbent assay(ELISA)on days 1.3,7 and 14 respectively after infarction.Results The serum levels of IL-10 and IL-8 were higher in patients than those in control group on days 1,3 and 7(P<0.05).Conclusion IL-10 and IL-8 are involved in the pathophysiology of acute cerebral infarction.

Objective: To investigate molecular markers associated with lymph node metastasis in esophageal squamous cell carcino-ma. Methods: Patients who meet the inclusion criteria were assigned into two groups, with and without lymph node metastasis. The statistically significant risk factors were evaluated using univariate analysis and multivariate Logistic regression analysis. The diagnostic threshold, sensitivity, and specificity were analyzed by Youden's index. The area under the ROC curve (AUC) was used to evaluate the power of test. Result: Univariate analysis and multivariate Logistic regression analysis showed that GC% of wild type base in the first somatic mutational position of the codons was a risk factor for lymph node metastasis [OR (95% CI): 0.931 (0.874-0.991), P<0.05]. AUC was 0.639 (P<0.05, 95% CI: 0.522-0.756). The Youden's index was 0.277, and the sensitivity and specificity were 56.6% and 71.1%, re-spectively. Conclusions: GC% of wild type base in the first somatic mutational position of the codons is significantly associated with lymph node metastasis in esophageal squamous cell carcinoma. The marker was found to be a protective factor for lymph node metas-tasis and has potential significance in clinical applications.

OBJECTIVETo explore the baseline clinical characteristics of patients with pulmonary arterial hypertension after operation for congenital heart disease (AO-CHD-PAH) in China.

METHODSA total of 122 consecutive patients diagnosed as AO-CHD-PAH in Shanghai Pulmonary Hospital from September 1, 2006 to August 31, 2011 were retrospective analyzed.

RESULTSSixty-seven percent patients were female. The median age at procedure and diagnosis were 14.8 and 24.8 years old, respectively. The median duration from procedure of CHD to diagnosis of PAH was 7.3 years. The most frequent initial symptom (109/122, 89.3%) attributed to PAH was dyspnea on exertion. The frequent sign was accentuation of second heart sound on pulmonary valve area (113/122, 92.6%).Incidence of WHO functional PAH classes I/II was 53.3% (65/122) and mean 6 minutes walk distance was limited to (408.4 ± 103.3) m. Borg dyspnea score was 2.0 (1.0, 3.0).Right heart catheterization demonstrated severe elevated mean pulmonary arterial pressure [(71.6 ± 24.2) mmHg, 1 mmHg = 0.133 kPa] and pulmonary vascular resistance index [(29.1 ± 16.0) Wood U·m(2)] in this patient cohort. Cardiac index was (2.7 ± 0.9) L·min(-1)·m(-2), 90.2% (110/122) patients received PAH-specific therapy. The majority of PAH-specific therapy was phosphodiesterase type 5 inhibitor, which is somehow different from PAH-specific therapy regimen of American-European developed countries.

CONCLUSIONSPAH-specific therapy rate is satisfactory for pulmonary arterial hypertension after operation for congenital heart disease in China and phosphodiesterase type 5 inhibitors are predominant PAH-specific medication in China.

Adolescent ; Adult ; Child ; China ; Female ; Heart Defects, Congenital ; surgery ; Humans ; Hypertension, Pulmonary ; etiology ; Male ; Postoperative Complications ; Retrospective Studies ; Young Adult

Objective: To assess the efficacy and safety of thrombolytic treatment with reteplase in patients with intermediate-risk acute pulmonary embolism. Methods: Ten consecutive patients with intermediate-risk acute pulmonary embolism who received thrombolytic treatment with reteplase at Thrombosis and Vascular Medicine Center, Fuwai Hospital from March to November in 2016 were included.Vital signs, right ventricular diameter, systolic pulmonary artery pressure, and biochemical markers were assessed before and after thrombolytic therapy with reteplase, and bleeding complications were also observed during 3 months follow up. Results: (1) For the efficacy outcomes: at 48 hours after thrombolytic treatment with reteplase, echocardiography-derived diameter of right ventricular was significant reduced from (27.9±3.8) mm to (24.8±2.6) mm (P=0.03), systolic pulmonary artery pressure decreased from (63.9±21.6) mmHg(1 mmHg=0.133 kPa) to (34.4±19.8) mmHg (P=0.02). Heart rate and breathing rate were also decreased significantly (both P<0.05), blood pressure remained unchanged post therapy.Hypoxemia was quickly corrected with an significant elevation of PaO₂ and SaO₂ ((65.2±14.3) mmHg vs. (80.0±9.6) mmHg, P=0.006; (90.8±3.5)% vs. (95.2 ±1.6)%, P=0.002 respectively). PaCO₂ was also increased significantly (P<0.05). Serum NT-proBNP and cTnI were decreased significantly (both P<0.05). There was no recurrent pulmonary embolism or deep-vein thrombosis during the 3 months follow-up. (2) For the safety outcomes: a thrombolytic relevant hemoptysis (about 70 ml) occurred in 1 patient, and was controlled by PCC therapy.No other clinically relevant events were observed during thrombolytic treatment. Eight patients were followed more than 3 months, there was no major bleeding complication or death during the follow up period. Conclusion Treatment of intermediate-risk acute pulmonary embolism with reteplase is effective and safe and there are no obvious side effects.

The temperature during the brain tumor therapy using high-intensity focused ultrasound (HIFU) should be controlled strictly. This research aimed at realizing uniform temperature distribution in the focal region by adjusting driving signals of phased array transducer. The three-dimensional simulation model imitating craniotomy HIFU brain tumor treatment was established based on an 82-element transducer and the computed tomography (CT) data of a volunteer's head was used to calculate and modulate the temperature distributions using the finite difference in time domain (FDTD) method. Two signals which focus at two preset targets with a certain distance were superimposed to emit each transducer element. Then the temperature distribution was modulated by changing the triggering time delay and amplitudes of the two signals. The results showed that when the distance between the two targets was within a certain range, a focal region with uniform temperature distribution could be created. And also the volume of focal region formed by one irradiation could be adjusted. The simulation results would provide theoretical method and reference for HIFU applying in clinical brain tumor treatment safely and effectively.