Objective To perform the summary and analysis on the external quality assessment(EQA) results of the clinical im‐munology during 2009 - 2013 to find out the possible problems existing in the laboratory work of the clinical immunology for con‐tinuously improve the quality of clinical immunological detections and ensuring the accuracy of clinical immunological test results . Methods The results of the external quality assessment in the clinical Immunology participating in the National Center for Clinical and Laboratory and the Guangxi Center for Clinical Laboratory during 2009 - 2013 were performed the statistical analysis and sum‐mary .Results 600 samples were detected during these 5 years .The performance was worst in 2012 ,the annual coincidence rate of the results was 98% ;and which in other 4 years was 100% ;each 1 sample of result in the two items of anti‐HCV and anti‐TP was unconformity during these 5 years ,the total coincidence rate was 98 .6% ;the total coincidence rates of HBsAg ,HBsAb ,HBeAg , HBeAb ,HBcAb and anti‐HIV were 100% .Conclusion By participating in the external quality assessment of the clinical immunolo‐gy and retrospectively analyzing the results ,the possible problems would be found and some effective improvement measures could be formulated in time for improving the quality of examinations and ensuring to provide reliable laboratory data for clinic .

Objective To investigate the ultrasonic features and differential diagnosis of superficial neurilemmoma ,and improve diagnostic accuracy of superficial neurilemmoma by ultrasound .Methods Retrospectively analyse the ultrasonic findings of 51 ca-ses ,which confirmed for superficial neurilemmoma by pathology ,and analyse the misdiagnosis reason from the aspects of size , shape ,boundary ,internal echo ,blood flow signals .Results Superficial neurilemmoma had some characteristics in the shape ,bound-ary ,internal echo ,blood flow signals and so on .However ,the key point to differentiate it from other diseases was to identify the re-lationship with peripheral nerve .In this study ,the coincidence rate of ultrasonoic diagnosis with pathologic diagnosis was 78 .4% . Conclusion Superficial neurilemmoma have some similarity with neurofibroma or sebaceous cyst on ultrasonographic images .When making diagnosis ,especial attention should be paid to identify the relationship of neurilemmoma with peripheral nerve .

Objective To summarize the perioperative nursing of undergoing radical cystectomy with ileal neobladder for the treatment of bladder cancer? Method The nursing measures included preoperative psychological care,bowel and body preparation as well as postoperative nursing of drainage tube,ileal bladder irrigation,bladder functional exercise and basic nursing care? Results No patients suffered from postoperative complications such as infections,urinary fistula and anastomotic leakage? Twenty patients recovered autonomous urination within 3-6 months after the operation? One patient got minor urinal incontinence? Conclusions Cystectomy with orthotopic ileal neobladder trauma contributes to more complications due to large surgical trauma? Therefore,good perioperative care is important for the successful operations?

Purpose To study the c1inica1 and patho1ogica1 features of pituicytoma. Methods Ten cases of pituicytoma were re-trieved. Their c1inicopatho1ogic and immunohistochemica1 features were studied,and the re1ated 1iterature was a1so reviewed. Results The 10 patients aged from 4 to 68 years,with 4 ma1es,and 6 fema1es. The fo11ow-up information of 9 cases was co11ected:a11 of them were survived,whi1e one fema1e recurred 2 years after operation. Histo1ogica11y,the tumor was composed of bipo1ar e1ongated spind1e ce11. Immunohistochemica11y,the tumor ce11s showed strong1y positive for S-100(10/10)and vimentin(10/10),whi1e weak or foca1 positive for GFAP(10/10)and EMA(4/10). CKpan was negative in a11 cases and Ki-67 pro1iferation index was 1ow(1% ~5%). Conclusion Pituicytoma is a 1ow-grade spind1e ce11 tumor,typica11y occurs in the se11ar region. It is most common1y found in adu1ts,especia11y in ado1escent patients. The tumor shou1d be distinguished from pi1ocytic astrocytoma and neurohypophysea1granu1ar ce11 tumor. Pituicytoma exhibits strong1y positive for S-100 and vimentin. Genera11y,this tumor behaves indo1ent1y,but some may re-cur.

Objective To investigate the clinical value of high frequency ultrasound in discovering secondary pathological changes in infant with developmental dysplasia of the hip (DDH).Methods Thirtyfour infants with 36 dislocation hips were involved.Among them,32 were with unilateral dislocation of hip joint,2 were with bilateral dislocation of hip joint.High frequency ultrasound were used to observe the morphological changes of hip glenoid labrum,adipose hyperplasia in acetabulum,thickness variation of articular capsule,and development of the ossification center of the femoral head.Besides,the morphological changes of hip glenoid labrum and adipose hyperplasia in acetabul were compared with those from MRI.Results The sensitivity and specificity of ultrasound in diagnosing glenoid labral introversion were 82 ％ and 100％ respectively.The coincidence rate of diagnosing glenoid labral introversion and glenoid labral extroversion were both 83％.Adipose hyperplasias in acetabul were clearly seen in 31 hips using ultrasound.The thickness of articular capsule in the affected hip and in the healthy hip was (2.8 ± 0.6)mm versus (1.7 ± 0.4) mm,and the difference was obviously significant (P ＜0.01).The ossification center of the femoral head in the 34 infants were classified as the following four types:① which was smaller in the affected side than in the healthy side (22/34);②which was shown in the healthy side (7/34) but not in the affected side;③ which in both sides were not shown (4/34);④ which in both sides were small (1/34).Conclusions Ultrasound is a method of simple,rapid,non-invasive in diagnosing DDH,and it can be used to discover secondary pathological changes in infant with DDH,which provide important reference for clinical diagnosis and treatment.

Objective:To observe the protein and mRNA expressions of microtubule-associated protein 1 light chain 3 (LC3)B, P62 and Beclin1 in the liver of rats with chronic fluorosis, and to explore the role of autophagy in pathogenesis of liver injury induced by fluorosis.Methods:Using a group design, 54 SD rats were divided into 9 groups according to their weight (100 - 120 g) using a random number table method, each group with 6 rats, half male and half female. They were control group (NC group), low fluoride group (LF group), high fluoride group (HF group), NC + rapamycin (RAP) group, LF + RAP group, HF + RAP group, NC + chloroquine (CQ) group, LF + CQ group, and HF + CQ group. The NC group drank tap water (fluoride concentration was 0.5 mg/L), LF group drank fluoride water (fluoride concentration was 5.0 mg/L), HF group drank fluoride water (fluoride concentration was 50.0 mg/L); NC + RAP group, LF + RAP group and HF + RAP group were fed with corresponding drinking water, respectively, for 3 months, and then RAP (1.5 mg/kg) was intraperitoneally administered for 10 d; NC + CQ group, LF + CQ group and HF + CQ group were fed with corresponding drinking water, respectively, for 3 months, and then CQ (60 mg/kg) was intraperitoneally administered for 10 d. Bone and 24-hour urine samples of rats in each group were collected to detect the contents of bone fluoride and urine fluoride; liver histomorphological changes were observed through hematoxylineosin staining; protein and mRNA expressions of LC3B, P62 and Beclin1 in liver were detected by immunohistochemistry and real-time fluorescence quantitative PCR, respectively.Results:Compared with the NC group [(0.03 ± 0.00) mg/kg, (0.34 ± 0.08) mg/L], the contents of bone fluoride [(3.86 ± 0.08) mg/kg] and urine fluoride [(1.11 ± 0.16) mg/L] in HF group were higher ( P < 0.05). In the NC group, the lobule structure of liver tissue was clear, the hepatic cords were arranged in order, and the cell structure was normal. There were different degrees of hepatocyte edema in LF and HF groups. After intraperitoneal injection of RAP, compared with the corresponding fluoride group, the morphology of hepatocytes did not change significantly. After intraperitoneal injection of CQ, compared with the corresponding fluoride group, the liver cells showed obvious edema, and the degree of edema aggravated with the increase of fluoride concentration. Compared with the NC group, the protein expressions of LC3B and Beclin1 in HF group were higher ( P < 0.05), and the protein expression of P62 was lower ( P < 0.05). After intraperitoneal injection of RAP, the protein expressions of LC3B and P62 in LF + RAP group was lower than that in LF group ( P < 0.05); Compared with HF group, the protein expressions of LC3B and Beclin1 in HF + RAP group were lower ( P < 0.05). After intraperitoneal injection of CQ, protein expression of P62 in LF + CQ group was higher than that in LF group ( P < 0.05); Compared with HF group, protein expression of P62 in HF + CQ group was higher ( P < 0.05). Conclusions:Early (3 month) fluoride intake could promote autophagy and induce edema of hepatocytes in rats, and RAP had similar effects. CQ may induce liver injury by inhibiting autophagy of hepatocytes.

Objective To investigate the growth inhibition effect of evodiamine (Evo) on renal carcinoma 786-0 cells and to explore its molecular mechanism. Methods After treated with Evo, methyl thiazolyl tetrazolium ( MTT) assay was used to detect the vitality of 786-0 cells, flow cytometry was employed to examine the cell cycle distribution in 786-0 cells, and immunoblotting was utilized to determine the expression levels of target proteins related to cell cycle progression. Results Evo remarkably inhibited 786-0 cells vitality in dose-dependent manner. Cell cycle analysis indicated that 786-0 cells were arrested in G2/M phase followed by Evo treatment. Furthermore, the results of immunoblotting showed that Evo up-regulated the protein expression levels of P53, P21 and its downstream target gene CyclinB1 in 786-0 cells. Conclusion Evo treatment can induce 786-0 cell cycle G2/M arrest, and its underlying mechanism might be dependent on the P53/P21 signal pathway.

Objective To explore the early clinical characteristics and influencing factors in children with autism spectrum disorders(ASD).Methods From January 2005 to December 2014,193 children with ASD were collec-ted by continuous grouping method from Children's Rehabilitation Training Center in Xi'an.According to the 1∶1 matched case-control study requirements,and the other 193 children from kindergartens and primary schools in the urban areas of Xi'an were collected as healthy control group from March 1 to July 1,2016.The age of children in the case group was(40.78±14.86)months and the age of the healthy control group was(40.61±14.40)months.There were 167 boys and 26 girls in 2 groups and the ratio of boys to girls was 6.42∶1.00.The general status questionnaires,medical history questionnaire,diagnostic chart,Autism Behavior Checklist(ABC)and Family Environment Scale of Chinese version(FES-CV)were completed by parents between 2 groups.Childhood Autism Rating Scale(CARS)was completed by doctors in the case group.By using Excel software,the original questionnaires were completed in 2 entries by 2 persons to set up the database.All data were analyzed by SPSS 17.0 statistical software and conditional Logistic regression was used for multivariate analysis.Results Seventy point eight percent(137/193 cases)of children with ASD had been found abnormal under 2 years old or at 2 years old,and 54.9％(106/193 cases)had been diagnosed under 3 years old or at 3 years old.The average delay from the discovery to the diagnosis was 17 months.The initial abnormalities appea-rances were mainly manifested as no response to calling in 153 cases(79.3％),very little active contact with others in 141 cases(73.1％),silent or less use of oral language in 137 cases(71％),avoiding contact with the eyes of others or lack of facial expressions in 121 cases(62.7％).Their signs were easy to be misdiagnosed as mental retardation and language retardation.Children in the case group began to walk alone at the age of 8 months to 3 years old,and only 62.2％(120/193 cases)of them could walk alone at the age of 18 months or before.The age of conscious speech was at 8 months to 4 years and 4 months,and only 39.4％(76/193 cases)of the ASD children could speak at the age of 18 months or before.The total scores of the ABC scale of the case group were(56.520±22.140)scores and the sub-scales and total scores were significantly higher than those of the healthy control group,and the difference was statistically significant(t=16.845,27.390,16.527,26.320,23.371,32.206,all P<0.001).The positive consistent rate of ABC and clinical diagnosis was 56.5％.The total scores of CARS in the case group was(36.4±8.6)scores,and the positive consistent rate of CARS and clinical diagnosis was 78.8％.There was a statistical significance between the 2 groups in parental education,mother's occupation,family history(x2=29.670,44.593,15.439,6.095,all P<0.05),and there were statistical significance in the main caregivers,family harmony and family income(x2=19.006,7.129,109.027,all P<0.05).There was no statistical significance between the 2 dimensions of independence and achievement orientation between the 2 groups(t=-1.559,-0.139,P=0.120,0.890).The case group in the family cohesion,expressiveness,intellectual-cultural orientation,active-recreational orientation,moral-religious emphasis,organization and control of the 7 dimension scores were significantly lower than those in the healthy control group,and the differences were statistically significant(t=-7.683,-5.734,-8.762,-14.109,-2.026,-4.530,-2.464,all P<0.05).In the case group,the scores of the conflict dimension were higher than those of the healthy control group,and the difference was statistically significant(t=4.925,P<0.001).There was a statistical significance between the 2 groups in gestational age and birth hypoxia(x2=6.898,27.180,all P<0.05).According to multivariate analysis of Logistic regression,people other than parents serving as the primary support,anoxia of newborn,mother of non professional and technical personnel and lower scores of family active-recreational orientation might be the risk factors of ASD,family per capita income of 3 000 Yuan RMB or more monthly,mother education level of high school and above,and lower scores of family conflict might be the protective factors for ASD.Conclusions Clinical features of most ASD children can be easily identified under 2 years old,but if the diagnosis is delayed,the related intervention is late,so importance should be attached to early diagnosis.Mother's occupation and education level,family economic status,family environment,their supervisors,and anoxia of newborn may be the effective entry points in the prevention and treatment of ASD.

Objective To investigate the potential role of Lycium bararum polysaccharide (LBP) with or without interferon -inducible protein 10 ( CXCL10) in inducing dendritic cells ( DC) functional maturation by monitoring the alteration of cytokines for inducing DC maturation in peripheral blood and by detecting the expression of S-100 protein in tumor tissue, thus to reveal its mechanism of inhibiting experimental liver cancer. Methods H22 bearing mice model was established. The mice were randomized into model group, LBP group (50 mg/kg, ig), CXCL10 (right axillary subcutaneous injection of 15 μg/kg), LBP + CXCL10 group (LBP 50 mg/kg, ig, and right axillary subcutaneous injection of CXCL10 15 μg/kg), 5- fluorouracil (5FU) group ( intraperitoneal injection of 12mg/kg) , 12 mice in each group. The mice were administered the corresponding medicine once a day. After treatment for 2 continuous weeks, blood was sampled from infraorbital vein, and the tumor mass, spleen, thymus were extracted for the calculation of anti-tumor rate, thymus index and spleen index separately . The mRNA expression levels of interleukin 12 (IL-12) and tumor necrosis factor-α (TNF-α) in peripheral blood were detected by fluorescence quantitative PCR, the expression of S-100 protein in tumor tissues was detected by immunohistochemical assay. Results Compared with the model group, tumor growth in LBP group and LBP+CXCL10 group was obviously inhibited, and tumor-inhibitory rate was 55.90%, 50.91%, respectively. Meanwhile, the mRNA expression level of IL-12 was 2.94 folds higher in LBP group and 3.39 folds higher in LBP + CXCL10 group, and TNF-α mRNA expression level was 1.55 folds higher in LBP group and 4.74 folds higher in LBP+CXCL10 group than the model group, the differences being statistical significant ( P<0.05 or P<0.01). Results of immunohistochemical assay showed that S-100+DC number in LBP group and LBP+CXCL10 group was larger than that in the model group (P<0.05 ). Conclusion LBP and LBP+CXCL10 exert significant effect on inhibiting experimental liver cancer. The mechanism may be related with inducing the secretion of IL-12 and TNF-α, which plays a key role in inducing DC maturation, and with the increase of the number of DC in tumor microenvironment.

Objective To determine the frequency of Th22 cells and expression of their related cytokines in peripheral blood of patients with alopecia areata(AA), to investigate their significance, and to explore the role of T lymphocytes in the occurrence of AA. Methods A total of 38 patients with AA were enrolled from Central Hospital of Minhang District in Shanghai between January 2015 and May 2016, and served as the case group. At the same time, 38 healthy people served as the control group. Peripheral blood samples were obtained from these patients and controls. Flow cytometry was performed to determine the percentage of Th22 cells, and enzyme?linked immunosorbent assay(ELISA)to measure serum levels of interleukin?22(IL?22)and IL?17. Results Compared with the control group, the case group showed significantly increased percentages of Th22 cells, Th17 cells, IL?17+IL?22+CD4+T cells and IFN?γ+IL?22+CD4+ T cells(all P < 0.01), as well as serum levels of IL?22 and IL?17(both P < 0.05). A significant increase was observed in percentages of Th22 cells, Th17 cells, IL?17+IL?22+CD4+T cells and IFN?γ+IL?22+CD4+T cells, as well as serum levels of IL?22 and IL?17, in patients with severe AA compared with those with mild AA, and in patients with active AA compared with those with stable AA (all P < 0.05). Conclusion Th22 cells and their related cytokines may participate in the occurrence, development and prognosis of AA.