Objective To detect the level of Tnl and T.2 type cytokines in the patients with lym-phoma in order to find out the laboratory evidence of tumor immunotherapy. Methods The levels of serum IFN-γ, TNF-α, IL-2, IL-4, IL-5 and IL-10 were measured by cytometric bead array (CBA) in 92 patients with lymphoma, and 70 normal sera as control. Results The levels of TH1 type cytokincs in 92 patients with lymphoma were: IFN-γ (34.26 ± 33.48) pg/ml, TNF-α (8.17 ± 10. 09) pg/ml, IL-2 (3.74 ±1.72) pg/ml; and the levels of TH2 type cytokines were: IL-10 (6. 28±8.56) pg/ml, IL-5 (3.53 ±3.20) pg/ml, IL-4 (6.22±7.13) pg/ml. The levels of TH1 and TH2 cytokines in lymphoma patients were significantly higher than those in controls(P ＜ 0.01) except TNF-α. And the rate of IL-2/IL-4 was signifi-cantly decreased in lymphoma patients(P ＜0.01). The level of IL-10 in Ⅲ/Ⅳ stage lymphoma patients was much higher than that in Ⅰ/Ⅱ stage patients(P ＜0.01). The level of IFN-γ/was significantly decreased in aged patients with lymphoma (P ＜0. 05). Conclusion TH 1/TH2 is imbalance in lymphoma, which may provide clinical index for the evaluation of progrossien and prognosis. In the lymphoma patients TH1/TH2 shifts to TH2, which may be the mechanism of tumor arising and transferring by immune escape from immu-nosurveillance.

BACKGROUND:Both local infiltration analgesia and femoral nerve block are used for the pain management after total knee arthroplasty. Controversy stil remains regarding the optimal technique for pain relief. OBJECTIVE:To systematical y evaluate analgesic effects of local infiltration analgesia and femoral nerve block after total knee arthroplasty. METHODS:Databases including PubMed, EMBASE, the Cochrane Library, Web of Science and CBM, were comprehensively searched to identify randomized control ed studies comparing local infiltration analgesia with femoral nerve block. Two reviewers independently selected trials, included literatures, extracted data, and assessed the methodological qualities of included studies according to Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. When there were different opinions, it was decided by the third author. Data were analyzed by RevMan 5.3 software. RESULTS AND CONCLUSION:(1) Eleven randomized control ed trials involving 566 patients were included. (2) At 24 and 48 hours (h) after surgery, there were no significant differences between the local infiltration analgesia and femoral nerve block groups, in Visual Analog Scale scores [MD24 h=0.15, 95%CI (-0.26, 1.28), P>0.05;MD48 h=0.19, 95%CI (-0.06, 0.44), P>0.05] in the resting state, and [MD24 h=-0.01, 95%CI (-0.51, 0.48), P>0.05;MD48h=0.18, 95%CI (-0.45, 0.82), P>0.05] in the active state, amount of analgesic drug use [MD24 h=-2.23, 95%CI (-5.63, 1.16), P>0.05;MD48 h=2.44, 95%CI (-1.08, 5.95), P>0.05], hospital stay [MD=0.05, 95%CI (-0.40, 0.50), P>0.05], postoperative nausea and vomiting [OR=1.09, 95%CI (0.39, 3.04), P>0.05] and postoperative infection [OR=0.99, 95%CI (0.44, 2.59), P>0.05]. (3) These results indicated that the analgesic effect of local infiltration analgesia was identical to that of femoral nerve block after total knee arthroplasty. Due to its simple operation, local infiltration analgesia can be used as a standard analgesia method after total knee arthroplasty.

ObjectiveTo investigate whether immune adjuvant can enhance the immunity of dendritic cell vaccine against murine breast cancer. Methods4 groups of mice with tumor are injected saline, immume adjuvant, dendritic cell (DC) vaccine and DC vaccine coupled with immune vaccine, respectively. Tumor volume and weight are measured 21 d later.ResultsThe tumor size in the DC vaccine coupled with immune vaccine group was significantly small compared with control group (P=0.001) and the DC vaccine group (P=0.047).ConclusionImmune adjuvant can enhance the immunity of dendritic cell vaccine against murine breast cancer.

One case of ectopic twin pregnancy in right fallopian tube after in vitro fertilization embryo transfer (IVF-ET) was admitted in our hospital.The development was in synchrony and the mainly manifestation was vaginal bleeding after menopause and abdominal pain.After surgery,the patient recovered well.Six cases reported in domestic literature occurred after assisted reproductive technology,including 4 cases after IVF-ET and 2 cases after artificial insemination.Two cases developed synchronously with the main manifestation of menopausal vaginal bleeding and recovered well after treatment.In 4 cases of non-synchronous embryos,after medical or surgical treatment irregular vaginal bleeding occurred,adnexal mass on the other side was found by gynecological ultrasound and blood hCG level increased significantly.Three cases recovered well after drug and/or surgical treatment and 1 case lost follow-up.

BACKGROUND: Bone marrow mesenchymal stem cell (MSC) is a kind of stem cell with potential of self-repair and multi-differentiation. It may differentiate into neuron, adipose cell and osteoblasts.OBJECTIVE: To observe the transforming efficacy of human bone marrow mesencymal stem cells (hMSCs) into neurons in vitro in different generations so as to provide reliable experimental data for the clinical application of MSCs.DESIGN: Single sample was designed.SETTING: Department of Neurology, Sino-Japan Friendship Hospital,Jilin UniversityPARTICIPANTS: Marrow tissue was collected from 9 cases of spinal fusion in Department of Orthopedics of First Hospital affiliated to Jilin University. Of 9 cases, all of them were in known of the experiment.METHODS: The experiment was performed in Sino-Japan Hospital affiliated to Jilin University from September 2002 to February 2003. The primary and generative culture of hMSCs was given. Experimental and the control groups were divided.-mercaptoethanol was taken as inducer. hMSCs of the 2rd, 4th, 6th and 8th generations were selected for induction in vitro for 6 h. Cytochemistry staining and immunohistochemistry staining were used to assay the expressions of neuronal and astrocytic marked proteins.MAIN OUTCOME MEASURES: ① Growth curve analysis on genera tive culture of hMSCs. ② Nissel staining. ③ Immunohistochemical staining.RESULTS: ① Common characters of generative culture: The latent phase of generative culture was 12-24 hours, exponential phase was 7-10 days and 11-13 days later, cell culture entered the platform phase. ② After induction of the 2nd, 4th and 6th generated hMSCs, deep blue granular Nissl body presented in cytoplasm. In 6 hours on the 8th induction, there was no obvious deep blue Nissl structure presented in cytoplasm.③ Except GFAP, NSE and NF-M were expressed in hMSCs of different generations after induction for 6 hours. There was no significant difference in positive rates of the 2nd, 4th and 6th generations (P ＞ 0.05), but the significant difference presented in comparison between the 8th generation and the 2nd, 4thand 6th generations (P ＜ 0.05). CONCLUSION:-mercaptoethanol can induce hMSCs differentiating into neuronal cells in vitro. The positive rates of the 2nd, 4th and 6th generationsare higher remarkably than the 8th generation.

Objective To analyze the results of treatment of complicated tibial plateau fractures with open reduction and internal fixation with bilateral plates .Methods 29 elder patients with C type tibial platform fractures underwent internal fixation with bilat-eral plates and bone grafting .Fixation with bilateral plates was performed during operation with dynamic compression plate or 1/3 Tubular steel plate placed medially and the dissection plate or LISS system ones inserted laterally after the underlying separation . Meanwhile ,sufficient bone grafting during operation could effectively support reduction of articular surface .Results All patients were followed up of an average of 13 .8 ± 2 .43 months .According to Rasmussen score standard ,the excellent and good rate was 82 .7% .There was significant difference of TPA and PA between postoperation and postoperation one year later .Conclusion It is a simple and effective method to treat complicated elder tibial platform fractures with bilateral plates .It will improve the effect and re-duce complications significantly to perform sufficient bone grafting intraoperatively ,and make the drainage unobstructed and do the early functional exercises postoperatively .

Objective To study the effect and possible mechanism of diazoxide on myocardial ischemia/reperfusion (I/R) injury in diabetic rats, and the influence of insulin intervention which aims to maintain blood sugar levels within the normal range on the protective function of cardiomyocytes. Methods 126 health male Sprague-Dawley (SD) rats were intraperitoneally injected with one dose of 60 mg/kg streptozotocin (STZ) to reproduce diabetic model. The diabetic rats were randomly divided into seven groups, with 18 rats in each group. Myocardial I/R model was established by 30 minutes ligation of the left anterior descending branch of the coronary artery, and 120 minutes blood circulation recover. Sham group was only threaded without ligation. Rats in I/R group, diazoxide group (DZ group), and Ottawa vine penicillin (WNT) group were infused intravenously with 2 mL of 0.1% dimethyl sulphoxide (DMSO), DZ (7 mg/kg), and WNT (15 μg/kg), respectively, after 25 minutes of ischemia. Sham group was only injected with 2 mL of 0.1% DMSO. DZ+WNT group was infused with WNT 5 minutes before the injection of DZ. Insulin intervention (RI) group received a continuous insulin infusion to maintain the blood sugar at the level of 4-6 mmol/L. RI+DZ group was infused with DZ after ischemia for 25 minutes based on blood sugar control. Hemodynamic parameters in each group were monitored continuously. The pathological changes of myocardium were observed with hematoxylin and eosin (HE) staining. The expressions of phosphorylated protein kinase B (p-Akt) and phosphorylated glycogen synthase kinase-3β (p-GSK-3β) were determined by Western Blot. Results Compared with sham group, the cardiac functions of the intervention groups were significantly decreased, and severe myocardial injury was observed. Compared with I/R group, the cardiac functions of intervention groups were not obviously improved. However, after insulin intervention by which blood sugar was maintained within normal range, the cardiac function and myocardial injury were further aggravated. Compared with sham group (the expression value of sham group was set as 1), the expressions of p-Akt in other groups including I/R group, DZ group, RI group, and RI+DZ group showed no statistically significant difference (gray value: 1.07±0.09, 1.03±0.07, 1.07±0.07, 1.02±0.08 vs. 1.00, all P > 0.05). However, the expressions of p-Akt were decreased in WNT group and DZ+WNT group as compared with those of sham group and I/R group (gray value: 0.54±0.06, 0.51±0.05 vs. 1.00 and 1.07±0.09, all P < 0.05). The expressions of p-GSK-3βshowed no statistically significant difference in I/R group, DZ group, WNT group, and DZ+WNT group as compared with sham group (gray value: 0.97±0.08, 1.00±0.11, 0.98±0.06, 0.97±0.09 vs. 1.00, all P > 0.05). However, the expression of pGSK-3β was increased in RI group, RI+DZ group as compared with sham group and I/R group (gray value: 1.68±0.08, 1.70±0.05 vs. 1.00 and 0.97±0.08, all P < 0.05), and it was significantly higher in RI+DZ group than that of DZ group (gray value: 1.70±0.05 vs. 1.00±0.11, P < 0.05). Conclusions Diazoxide after myocardial injury could not protect the myocardium from I/R injury in diabetic rats, and did not trigger the activation of the phosphoinositide 3-kinase (PI3K)/Akt signaling pathway. Insulin intervention by which blood sugar was maintaine d within the normal range exacerbates myocardial I/R injury in diabetic rats.

Objective To investigate the influential factors for the colonoscopic polyp detection rate (PDR) and adenomade detection rate(ADR) in high-risk population in community colorectal cancer screening.Methods Data of patients who were determined as high-risk population in community colorectal cancer screening tests and received colonoscopy in the Digestive Endoscopic Center of Tongji Hospital from May 2014 to November 2014 were collected.PDR and ADR were calculated by different genders, ages, history of abdominal operation, anesthesia assistance, quality of bowel preparation and experience of operators.Thex2 test and logistic regression analysis were used to compare the PDR and ADR between different groups.Results A total of 417 patients received complete colonoscopies.The total PDR was 35.25％.Univariate analysis revealed that gender (OR =2.298,95％ CI: 1.525-3.463), history of abdominal operation (OR =0.596,95％CI:0.390-0.910), anesthesia assistance (OR =1.864,95％ CI: 1.086-3.200) and quality of bowel preparation were significantly associated with PDR while multivariate analysis revealed that only gender, history of abdominal operation and quality of bowel preparation were independent influential factors for PDR.The total ADR was 30.22％.Like PDR, univariate analysis revealed that gender(OR =2.113,95％CI: 1.382-3.229), history of abdominal operation(OR =0.604,95％ CI:0.387-0.941), anesthesia assistance(OR =2.344,95％ CI: 1.283-4.281) and quality of bowel preparation were significantly associated with ADR.However, multivariate analysis revealed that only gender, history of abdominal operation and quality of bowel preparation were independent influential factors for ADR.Conclusion For patients who were highrisk in community colorectal cancer screening, men have greater risk to develop polyps and adenomas than women.Colonoscopy should be more careful in patients with history of abdominal operation, for quality of bowel preparation is directly related to PDR and ADR.

OBJECTIVE To know the clinical antibacterial use by line category in pediatric outpatients and emergency departments.METHODS The antibacterial use by line category from the 38998 prescriptions of pediatric outpatient and emergency departments of a hospital from Jul 1st to Dec 31st 2008 according to the medicament amount and frequency were surveyed and analyzed.RESULTS First-line antibacterial drug DDDs accounted for 37.4% and 24.7% of the total amount;second-line drug DDDs accounted for 48.7% and 40.8% of the total amount and the third-line drug DDDs accounted for 13.9% and 35.0% of the total amount.The top three by total amount were cefmetazole sodium injection,azithromycin sodium injection and Cefuroxime sodium injection.According to the sorting method of DDDs,the top three were cefprozil dry suspension,azithromycin sodium injection and amoxicillin sodium clavulanate potassium injection.CONCLUSIONS Frequency of the third-line antibacterial drug using is relatively high.Clinicians have a tendency to skip a line category in using drugs.Effective measures should be taken to strengthen the management of antibacterials.

· AlM: To explore the correlation of center retinal thickness and axial length in non-proliferative diabetic retinopathy ( DR) .
· METHODS:A total of 80 cases ( 155 eyes ) of non-proliferative DR patients were divided into three groups according to the axial length, 22~24mm of 27 cases (51 eyes) were normal group, 24 ~26mm of 28 cases ( 55 eyes) were long axis group, >26mm of 25 cases ( 49 eyes) were super long axis group.The center retinal thickness and ocular axial length of three groups were measured and the correlation of center retinal thickness and axial length were analyzed.
· RESULTS:Among the inner ring and outer ring, the center retinal thickness of upper and lower, bitamporal and nasal side of super long axis group was thicker than that in normal group, with statistically significant difference ( P<0.05 ); Among the inner ring and outer ring, the center retinal thickness of upper and lower, bitamporal and nasal side of super long axis group was thicker than that in long axis group, with statistically significant difference ( P<0.05); The DR central macular of retinal thickness was no correlation of the axial length ( P >0.05 ), but retinal thickness get thinning with increased of axial length on the inner ring and outer ring area, showed a negative correlation ( rinner ring =-0.63, router ring=-0.67, P<0.05).
·CONCLUSlON:Center retinal thickness and ocular axial length in non -proliferative DR patients, and center retinal thickness of super long axis patients are thinning obviously.