Objective To evaluate the effect of local infiltration anesthesia with different concentrations of ropivacaine on the healing of incision in rats.Methods Seventy-five adult male Sprague-Dawley rats,weighing 220-250 g,were randomly divided into 5 groups (n =15 each):natural healing group (group C),normal saline group (group NS),0.20％ ropivacaine group (group R0.20),0.50％ ropivacaine group (group R0.50) and 0.75％ ropivacaine group (group R075).0.20％,0.05％ and 0.75％ ropivacaine 1.0 ml/kg were injected subcutaneously 10 min before incision in R0.20,R0.50 and R0.75 groups,respectively,while the equal volume of normal saline was given instead in group NS.Five rats in each group were chosen for recording the healing time.Ten rats were taken in each group for recording the length of the incision 72 h after operation.The skin tissues around the incision were removed for determination of fibroblast counts under light microscope,IL-1β content (by ELISA) and the expression of collagen (by immunohistochemisty) and IL-1β mRNA (by RT-PCR).Results Compared with Cgroup,the healing time and length of the incision were significantly shortened,the fibroblast counts and expression of collagen were increased in R0.20 group,the healing time and length of the incision were shortened,the fibroblast counts and expression of collagen were increased,and the expression of IL-1β mRN A and IL-1β content were decreased in R0.50 group,and the healing time and length of the incision were prolonged,the fibroblast counts and expression of collagen were decreased,and the expression of IL-1β mRNA and IL-1β content were decreased in R0.75 group (P ＜ 0.05).Compared with R0.20 group,the healing time and length of the incision were significantly shortened,the fibroblast counts and expression of collagen were increased,and the expression of IL-1β mRNA and IL-1β content were decreased in group R0.50,the healing time and length of the incision were significantly prolonged,the fibroblast counts and expression of collagen were decreased,and the expression of IL-1β mRNA and IL-1β content were decreased in group R0.75 (P ＜ 0.05).Compared with R0.50 group,the healing time and length of the incision were significantly prolonged,the fibroblast counts and expression of collagen were decreased,and the expression of IL-1β mRNA and IL-1β content were decreased in group R0.75 group (P ＜ 0.05).Conclusion Local infiltration anesthesia with 0.20％ and 0.50％ ropivacaine can promote the healing of incision in rats,0.50％ ropivacaine provides better efficacy than 0.20％ ropivacaine,and 0.75 ％ ropivacaine can inhibit the healing process.

The physiological and biochemical conditions of adults are relatively stable,while children are in the period of rapid growth and development with all kinds of physical and chemical indicators constantly changing,which brings great challenge to the pediatric clinical laboratories.In addition,children in different periods have different disease spectrum,among which many diseases are particular to children.This opens a new world for the pediatric laboratories.In this paper,a brief overview of problems,characteristics and future development of pediatric laboratory medicine is made.

To study the efficacy of small dosage of simvastatin on the treatment of hyperlipidemia, and the effect of polymorphisms in ApoB gene expression. Sixty one patients with hyperlipidemia were selected and simvastatin 5mg/d was used. TC, TG, HDL, LDL, ApoAI and ApoB and the function of liver and kidney were measured in every patient prior to the treatment and 4, 8, 12 weeks after treatment. RFLPs was applied for determination of polymorphisms on Xbal locus of the ApoB gene. In the total of 61 patients, X + X - genotype was found in 5 patients (8.20%), and X - X - genotype in 56 patients (91.80%), but no X + X + genotype was found. The relative frequency of X + allele was 0.041, and X - allele was 0.959, suggesting X - allele was still a dominant one in the patients with hyperlipidemia. The results showed that small dosage of simvastatin could effectively reduce blood levels of TC, TG, LDL C and ApoB. The levels of TC and LDL C lowering was more prominent in X - X - genotype than that in X + X - genotype (27.62% and 35.02% vs. 22.36% and 20.05%, P

Every stage of tumor initiation and development closely relates to immune regulation as tumor cells tend to evade attacks from immune system by employing the programmed death 1 (PD-1)/ programmed death-ligand 1 (PD-L1) interaction.Therefore,targeting the PD-1/PD-L1 pathway has become an attractive approach for cancer immunotherapy.Radiotherapy has long been considered a local tumor treatment modality and it is immune-inhibitory.However,accumulated evidence has shown that radiotherapy might enhance immune function by eliminating the tumor mass and has become a systemic tumor treatment modality.These observations indicate a strong rationale that the radiotherapy and anti-PD1 and anti-PD-L1 immunotherapy may work synergistically to provide a powerful anti-tumor effect.This review discusses current progresses,challenges and perspectives of this novel combination treatment modality.

Objective To perform NAT testing on samples negative for HBsAg, anti-HCV and anti-HIV by ELISA, and to learn how many infected blood samples could be missed by ELISA tests.Methods Pooling the donor samples by STAR2000 sampling processor and extracting nucleic acid automatically, HBV DNA, HCV RNA and HIV-1 RNA were amplified and detected by Roche COBAS AmpliScreen TM HBV、HCV V2.0 和HIV-1 V1.5 systems. Samples of 8 donors with negative HBsAg but positive HBV DNA were tested by COBAS HBV MONITOR TM for quantitative determinations. HBsAg confirmation tests were done every 2 weeks by ABBOTT Murex HBsAg V3.Results A total of 16320 ELISA negative donor samples were tested and 8 samples were HBV DNA positive. The missing rate was 0.49‰. No HCV RNA and HIV-1 RNA were detected. Those 8 donor samples, negative for HBsAg but positive for HBV DNA,were all positive for HBcAb by ABBOTT,and 3 of them were positive for HbeAb Low serum HBV DNA loads, in the range of 102~103 copies/ml, were found in the 8 donor samples. HBsAg confirmations were performed and one donor became HBsAg positive after 18 weeks.Conclusion The results show that there is 0.49‰ missing rate of HBV with HBsAg screening by ELISA. HBcAb screening or NAT may be warranted in blood donor screening to limit HBV transmission through blood transfusion.The reason for missing HBV positive samples by ELISA could be occult HBV infection.

Objective To investigate the influence of coix seed triglyceride combined with transcatheter arterial chemoembolization (TACE) therapy on AFP, CD4﹢CD25﹢regulatory T (Treg) cells and cellular immune function in patients with advanced primary hepatocellular carcinoma (HCC). Methods A total of 50 patients with inoperable HCC, whose imaging examination showed no distant metastasis, were divided into the study group (n=25) and the control group (n=25). Coix seed triglyceride together with TACE was employed for the patients of the study group, while only TACE was adopted for the patients of the control group. For the patients of the study group, transcatheter hepatic artery infusion of 100 ml coix seed triglyceride was carried out during the performance of TACE, and postoperative intravenous drip of coix seed triglyceride (200 ml/d) was used for 5 days. The peripheral blood samples were collected one week before and one month after the treatment to detect the changes of AFP and T lymphocyte subsets (CD3﹢, CD4﹢, CD8﹢,CD4﹢/CD8﹢ and Treg) levels. One month after the treatment, enhanced CT, MRI or PET-CT was performed to evaluate the necrosis degree of the tumor. Results After the treatment, AFP levels was decreased in both groups, when compared the preoperative data the differences were statistically significant (P<0.01); the tumor necrosis rate of the study group was (57.7 ±8.2)%, which was slightly higher than (57.7±8.2)% of the control group, however, the difference was not statistically significant (P>0.05). In the study group, the percentage of Treg cells decreased from preoperative (8.27±6.65)%to postoperative (4.22± 1.59)%, the difference was statistically significant (P<0.01). The percentages of CD3﹢ and CD4﹢ and the ratio of CD4﹢/CD8﹢ increased from preoperative (55.78 ±13.66)%, (43.98 ±14.00)% and 1.22 ±0.64 to postoperative (62.29±10.78)%(P<0.01),(51.82±16.32)% (P<0.05) and 1.54±0.80 (P<0.05) respectively, while the percentage of CD8﹢decreased from preoperative (45.71±12.94)%to postoperative (39.70±12.41)%(P<0.05). In the control group, no statistically significant differences in the above mentioned indexes existed between preoperative data and postoperative ones (P>0.05). Conclusion In treating advanced primary HCC, coix seed triglyceride combined with TACE can reduce the percentage of Treg cells, thus, influence the patient’s cellular immune status and possibly decrease the recurrence rate of HCC after TACE therapy.

Objective To explore the common clinical features and mechanism of HenochSchonlein purpura (HSP) in children,and provide evidence and guidance for clinical diagnosis,therapy and prognosis of HSP.Methods Prospective study.Totally 1 232 HSP children blood samples were collected during January 2010 to December 2013 in the Children's Hospital of Zhejiang University School of Medicine,and the levels of immunoglobulin,complement,T lymphocyte subsets and CRP were detected in the acute phase of HSP.The clinical data were analyzed with these indexes to explore the function of cellular and/or humoral immunity in the pathogenesis of HSP.In addition,this study detected serum IgA levels in 200 cases of sepsis rash,200 cases of urticarial and 200 cases of thrombocytopenic purpura patients and 400 cases of healthy children over the same period to our hospital respectively,in order to find out whether IgA is capable of differentiating allergic purpura rash from other similar skin rashes.Results Compared with healthy children,the IgA level was significantly higher [IgA:2.0 (0.6-7.5) g/L vs 1.1(0.6-2.1) g/L,Z =5.928,P =0.03].When IgA ＞ 1.44 g/L,the diagnostic sensitivity and specificity to differentiate allergic purpura patients from sepsis patients were 77.43 ％ (954/1 232) and 80.00％ (160/200),respectively.When IgA ＞ 1.53 g/L,the diagnostic sensitivity and specificity to distinguish from allergic purpura with urticaria patients were 72.57％ (894/1 232) and 74.51％ (149/200).When IgA ＞0.91 g/L,it had a 95.14％ sensitivity (1 172/1 232) and a 79.45％ specificity (159/200) for the differential diagnosis of allergic purpura and thrombocytopenic purpura patients.When IgA ＞ 1.33 g/L,the sensitivity of distinguishing allergic purpura patients from healthy children was 81.25％ (1 001/1 232),while the specificity was 95.00％ (380/400).Conclusions HSP children show cellular immune dysfunction.Th1/Th2 imbalance and over-activation of Th2 cells result in the increased synthesis and release of immune globulin,causing abnormalities in humoral immune.An increase in serum IgA level of HSP patients can differentiate HSP from other similar rashes.

Objective To master iodine intake ways of children in Yancheng (coastal) and Zhenjiang (inland) cities,analyze their urinary iodine difference and provide solid evidence for adjustment of salt iodine and adequate iodine intake level of local residents.Methods Totally 50％ counties were randomly selected in Yancheng and Zhenjiang cities and 5 towns were sampled in each county in 2014,local water iodine,domestic salt iodine,local eating habits and urine iodine of children 8-10 years old were investigated,and the influences of different iodine intake ways on urine iodine level were analyzed.Results The median of water iodine was 4.76 μg/Lin Zhenjiang (n =40) and 50.80 μg/L in Yancheng (n =50),the difference was statisticelly significant in two cities (Z =6.93,P ＜ 0.05).Totally 2 400 salt samples were tested,the mean of salt iodine was (24.20 ± 5.07) mg/kg in Yancheng (n =1 500) and (22.87 ± 2.77) mg/kg in Zhenjiang (n =900),the difference was statisticelly significant in two cityies (t =7.23,P ＜ 0.05).The salt intake level in Zhenjiang (10.69-± 9.00) g/d appeared to be higher than that in Yancheng (8.40 ± 3.57) g/d,but the difference was not statistically significant (t =1.62,P ＞ 0.05).Totally 1 200urine samples were tested,the urine iodine level of Zhenjiang got higher results (265.83 μg/L,n =450) than that of Yancheng (182.15 μg/L,n =750,Z =12.18,P ＜ 0.05).The ratio of water iodine intake/salt iodine intake was about 1 ∶ 4 in Yancheng and 1 ∶ 50 in Zhenjiang,while residents in Zhenjiang got 21％ of daily iodine through extra ways.Eating habits like eating out did not have significant impact on urine iodine.Conclusions Based on the water iodine level,Yancheng is considered to be a appropriate iodine level area while Zhenjiang is a lack region.However,Zhenjiang has a higher urine iodine level than Yancheng,which is more than adequate to the recommendation.Salt iodine is a main iodine source in both cities.In iodine appropriate and deficiency areas,eating habits and food choices may play a more important role than geochemical factors in iodine intakes among residents.

The Department of Obstetrics and Gynecology has performed series of teaching reforms for the seven-year medical students.For the theory classes,all the teachers are the senior ones who can enhance the bilingual teaching and combine the clinical cases with the latest development in the subject.We let the interns follow the diagnosis and treatment of the patients just as the patients'relatives.We also let a tutor to guide each intern to help him master the basic clinical art.During the ward inspection for teaching,we let the students be the main speaker,hoping that we can build a new student-centered teaching model.

Objective To observe the formation process with 3.0 T MRI dynamically, and to discuss the feasibility of molecular imaging studies on restenosis. Methods The models were built with balloon (2.0 F) injury which were separated into restenosis group (n=48) and control group (n=48). Zero h, 24 h, 1 week, 2 week, 4 week and 8 week after surgery, 3.0 T MRI scanning (T1WI, T2WI, PDWI) was performed respectively, the vascular of injured side were obtained for HE staining to observe the pathological changes, to analyze the measurement of neointimal area (IA), intimal proliferation index (IHI), lumen area (LA) and stenosis rates, correlation between HE staining measurements and MR images were analyzed. Two weeks after the injury, the restenosis model of rats (n=8) and control rats (n=8) were injected ultrasmall superparamagntiec iron oxide (USPIO,1 mmol/kg) by tail vein, respectively. 3.0 T MRI scanning (T2WI) was underwent at 0 h and 24 h after injection, the change of the arterial wall T2 signal was quantitatively analyzed and the relative signal intensity (rSI) and relative change rate (rSIC) of the vessel wall were calculated. Reference to MRI images, corresponding line segments were taken for Perl's blue staining and immunohistochemically staining of macrophages. One-way ANOVA, Pearson and t test were used for statistical analysis. Results In the early?term (0 h,24 h), the wall and surrounding high signal organization boundary was not clear, there was no obvious morphological change of the lumen. In the medium?term (1, 2 week), signal of the injured wall increased with different extents, wall thickening and luminal narrowing was progressive, the inwall was coarse. In the later?term (4, 8 week) wall signal got slightly lower, wall thickness, lumen change were not significant, the wall area and LA were significantly associated with pathologic measurement result (r value were 0.978, 0.732; P<0.05). In the control group, signal of wall and lumen morphological change were not significant among the different time points. IA were (0.131 ± 0.011) mm2, (0.588 ± 0.017) mm2, (1.061 ± 0.033) mm2, (1.192 ± 0.034) mm2;1, 2, 4, 8 week after injury, respectively, IHI were 0.235 ± 0.022, 0.578 ± 0.013, 0.715 ± 0.011, 0.737 ± 0.009, respectively, stenosis rates were (5.586 ± 0.987)%, (25.395 ± 1.112)%, (40.019 ± 1.298)%, (41.890 ± 0.951)%, respectively, difference between groups were statistically (P<0.05). In the control group, there was no significant differences of medium area, luminal stenosis and neointimal formation respectively at different time points (P>0.05). rSI was 1.582±0.051 after the injection of USPIO, then 24 h after injection of USPIO, T2 signal of the vessel wall was reduced significantly, rSI was 1.260 ± 0.088, rSIC was (-20.249 ± 6.489) % with statistical difference (t value was 8.924,P<0.05). But there was no statistical difference in control rats (P>0.05). Perl's staining combined with immunohistochemical staining confirmed that the iron particles were taken by the macrophage's phagocytosis just in the neointimal. Conclusion 3.0 T MRI is capable of demonstrating the vessel wall and lumen changes dynamically, and the measurements are correlated with pathological results. USPIO can be consumed by macrophages in the neointimal, resulting in T2 signal of the vessel wall decreased significantly.