Objective To investigate the effects of p53 protein and mRNA expression in rat liver tumor promotion by phenobarbital(PB). Methods Male Wistar rats were randomly divided into 6 groups,i. e. higher dose group,middle dose group,lower dose group,tumor-initiating control group,tumor-promoting group and normal control group. The rat liver tumor DEN-initiating-PB-promoting model was established among higher dose group,middle dose group,lower dose group and tumor-initiating control group. The rats in higher dose group,middle dose group and lower dose group were fed with feed containing 500,100,50 mg/kg PB respectively. The rats in liver-tumor promoting control group were only fed with normal feed. The rats in tumor-promoting group weren't initiated by DEN,were only fed with feed containing 500 mg/kg PB. The rats in normal control groups weren't treated by any factors. At the 1st,5th,10th,15th,20th,30th week of the exposure to PB,the expression of p53 protein and p53 mRNA of the rats in every group were determined by immunohistochemistry and in situ hybridization respectively. Results The expression of the mutant type p53(mtp53) protein was found in liver tumor-initiated rats which revealed precancerous lesion. The expression of p53 protein of rats increased in higher and middle dose groups,and showed higher levels in lower dose group and liver tumor-initiating control group compared with those of normal control group which didn't variate significantly with the prolongation of period of exposure to PB. The expression of wild type p53 (wtp53) mRNA showed lower levels in rats of normal control group and liver tumor-promoting group,showed higher levels in higher dose group,middle dose group,lower dose group and liver tumor-initiating control group compared with those in normal control group. The expression of wtp53 mRNA decreased in higher dose group and middle dose group,increased a little in lower dose group and liver-tumor-initiating with the prolongation of period of exposure to PB. Conclusion During the promoting stage of rat liver tumorigenesis tumor promotor PB might reduce the expression of wtp53 and induce mtp53 expression,which affected the cell cycle arrest and apoptosis,and might favor clonal expansion of preneoplastic hepatocytes,which promoted the formation of liver tumor.

Objective:To investigate the risk factors and predictive effect of lateral cervical lymph node metastasis of papillary thyroid carcinoma (PTC) by applying the concept of central lymph node metastasis intensity.Methods:This study retrospectively analyzed integrated clinic data of 106 cases with PTC undergoing treatment of cervical lymph node dissection in Department of Thyroid and Breast Surgery of the Affiliated Hospital of Inner Mongolia Medical University from Dec. 2009 to Jan. 2014. Based on whether lateral cervical lymph nodes had metastasis, patents were classified into lymph node metastasis positive group ( n=75 cases) , lymph node metastasis negative group ( n=31 cases) . This study explored metastasis-associated risk factors of age, gender, triiodothyronine (T3) , thyroxine (T4) , free triiodothyronine (FT3) , free thyroxine (FT4) , thyroid stimulating hormone (TSH) , thyroglobulin antibody (TGAb) , thyroid peroxidase antibody (TPOAb) , whether combined with Hashimoto’s disease, tumor location, infringing the membrane, mulifocality, tumor glands distribution, tumor diameter, number of central lymph node metastases, central lymph node metastasis ratio, and analyzed the effects of central lymph node metastasis intensity on lateral cervical lymph node metastasis. SPSS 21.0 software was used for data analysis, the metering data of normal distribution was expressed as ± s, and t test was used for comparison between groups. Count data was expressed as a rate (composition ratio) , and comparisons between groups were performed by χ2 test or Fisher exact probability method. Results:Univariate analysis found that whether combined with Hashimoto’s disease ( P=0.087) , tumor location ( P=0.249) , tumor glands distribution ( P=0.219) and tumor diameter ( P=0.224) had no correlation with lateral cervical lymph node metastasis, which showed no statistical significant differences ( P>0.05) . Infringing the membrane ( P=0.030) , mulifocality ( P=0.031) , number of central lymph node metastases ( P=0.022) and central lymph node metastasis ratio ( P=0.001) had correlation with lateral cervical lymph node metastasis, which showed statistical significant differences ( P<0.05) . The number of central lymph node metastases and the increase of central lymph node metastasis ratio had positive correlation with the occurrence of lateral cervical lymph node metastasis; when the number of central lymph node metastases was ≥4 or (and) the central lymph node metastasis ratio was ≥20%, the incidence of lateral cervical lymph node metastases increased significantly, and the difference was statistically significant ( P<0.05) . Conclusion:Infringing the membrane and mulifocality are risk factors for lateral cervical lymph node metastasis. When central lymph node metastasis intensity: number of metastases ≥4 or (and) metastasis ratio ≥20%, lateral cervical lymph node dissection is recommended.

Objective To investigate the clinical presentation, endoscopy and pathological features of subclinical cellular rejection (SCR) of small bowel allotransplantation. Methods Three times of SCR in a patient after isolated small bowel transplantation were studied by endoscopy and microscopy, and the clinical data and literature were reviewed. Results SCR was an unusual type of acute rejection after small bowel transplantation. SCR showed low-grade morphological changes of acute rejection, and may be relived after low-dose steroid or bolus steroid was given. Conclusion The causes of SCR are not clear now. SCR may be the early stage of clinical acute rejections, and may be correlated with unexpected high grade acute rejection, and chronic loss function of graft. The biopsy through ileoscopy is a "golden standard" of diagnosis of SCR in small bowel transplantation.However, the vessel lesions of graft, ileus, and inflammation should be excluded before diagnosis.

Objective To assess the preventive effect of artesunate against reinfection of Schistosoma japonicum.Methods Volunteers were divided into 3 groups,Medication Group Ⅰ took artesunate 6 mg/kg ,once a week for 4 weeks,Medication Group Ⅱ took artesunate 6 mg/kg in the 1st and 3rd week,twice a week,and a control group was given a placebo.The 3 teams took praziquantel 40 mg/kg on the 4th weekend.The effects of artesunate in early treatment were observed at the 8th weekend,and the preventive effects of artesunate against reinfection were assessed at the 12th weekend.The positive rate of fecal examination was used as the indicator.Results In the stage of early treatment,the positive rates of fecal examination in Medication Group Ⅰ ,Ⅱdecreased significantly compared with the data before the study with all P values less than 0.05 ;in the stage of preventing reinfection,compared with the data before the study,the positive rates of the fecal examination declined significantly in Medication Group Ⅰ,Ⅱ ,with all P values less than 0.05.While in the control group,the positive rates of the fecal examination had no significant changes in the two stages.Conclusions Artesunate has a valid effect against schistosome infections in the early treatment and can prevent residents from reinfection,and the suitable dosage is 6 mg/kg,once a week for 4 weeks.

Objective Cytomegalovirus (CMV) has remained the most significant pathogen that threatens the outcome of small bowel transplantation (SBTx). This paper To outline preliminary experience of prophylaxis and treatment of cytomegalovirus (CMV) in 15 cases subject to small bowel transplantation (SBTx) and also review current progress of diagnosis and treatment of CMV.Methods Fifteen cases of SBTx were divided into 3 eras: era Ⅰ (1994-1995)-3 SBTx treated with cyclosporine-based immunosuppression; era Ⅱ (2003-2006)-7 SBTx treated with tacrolimus-based immunosuppression; and era Ⅲ (2007-present)-5 SBTx treated with Alemtuzumab induction therapy and maintenance tacrolimus monotherapy. No antiviral prophylaxis after SBTx was applied during era Ⅰ; in era Ⅱ, ileoscopic and pathological diagnosis of CMV graft enteritis was defined, and plasma diagnosis tools including CMV-IgM, CMV pp65 and CMV DNA with PCR were introduced. 2-3 weeks intravenous ganciclovir prophylaxis of CMV was underway, followed by 3 months oral acyclovir; In era Ⅲ, more precise real-time PCR technique was used to detect CMV DNA copies, and the schedule of the CMV surveillance was set up, antiviral prophylaxis therapy was modified to 2-3 weeks intravenous ganciclovir and 3 months oral ganciclovir, and preemptive therapy to halt the progression of asymptomatic infection to clinical disease was also introduced.Results Two of 15 SBTx recipients suffered from CMV with the occurrence rate of 13.3%. One recipient in era Ⅱ suffered from CMV graft enteritis on postoperative day 45, and CMV pneumonia on postoperative day 64, he received intravenous ganciclovir and thymus peptide, paused tacrolimus maintenance, and finally he died from severe acute cellular rejection. 94 100 copies/ml of CMV DNA in periphery blood of a recipient in era Ⅲ was detected with real-time PCR at 3rd month after SBTx, and a preemptive therapy successfully halted the CMV infection.Conclusion Antiviral prophylaxis therapy and close surveillance of CMV infection after SBTx should be performed, and preemptive therapy can also halt the CMV infection. When CMV disease occurs, the recipient should receive effective antiviral therapy, and acute cellular rejection also should be closely monitored at same time.

Objective To summarize the timing and diagnostic value of endoscopic biopsy of intestinal graft after small bowel transplantation (SBTx).Methods Fifteen cases of SBTx were divided into 3 eras:era Ⅰ (1994-1995)-3 cases of SBTx treated with cyclosporine-based immunosuppression; era Ⅱ (2003-2006)-7 cases of SBTx treated with tacrolimus-based immunosuppression,and era Ⅲ (2007-present) than CVC group 5 cases of SBTx treated with Atemtuzumab induction therapy and maintenance tacrolimus monotherapy.The scheme of endoscopic surveillance was initially used in era Ⅲ, the first endoscopic biopsy was performed on postoperative day 3,2 times weekly during the first month, followed once weekly during months 2-3, once every other week during months 4-6 and once monthly thereafter.When clinical signs and symptoms of rejection were present, and during rejection episodes, the additional endoscopic biopsies were also performed.Results A total of 276 biopsies of these 15 SBTx recipients were obtained.Fifty-one biopsies (18.5%) were diagnosed as acute cellular rejection (ACR), which included IND to mild (n = 32,11.6 %), moderate (n = 9,3.3 %), and severe (n = 1 0, 3.6 %), two biopsies (0.7 %) were diagnosed as cytomegalovirus (CMV) enteritis and other 2 biopsies (0.7 %) bacteria enteritis.The ACR episodes verified by biopsy pathology and undergoing anti-rejection treatment were 20 (11 IND to mild,5 moderate,and 4 severe) ,and 1 episode of CMV enteritis and 1 episode of bacteria enteritis were observed.Conclusion Endoscopic surveillance and biopsy pathology is crucial diagnostic tool for ACR and sepsis.ACR surveillance after SBTx and early diagnosis of ACR could be made with scheming endoscopic biopsies.Endoscopic biopsy can be used to make differential diagnosis when clinical signs and symptoms were present, and to guide the treatment during anti-rejection episode.

ObjectiveTo investigate the continuous pathological features of biopsy specimens from five cases of small bowel allotransplantation (SBT) in order to provide more reliable information for the diagnosis and treatment of acute rejection (AR) in SBT.Methods324 biopsy specimens of intestinal mucosa after SBT from 5 patients were collected and studied by histology,histochemistry and electron microscopy.ResultsIn the early stage after operation (0～3 months),AR IND-1 grade was diagnosed for four times on 3 of 5 patients.During 3-6 months,AR IND-1 grade for three times was diagnosed in 2 cases,and AR 2 grade for two times during 7 ～ 12 months. All the patients suffered ischemia reperfusion injury, lymphatic vessel reconstruction and AR.Conclusion The pathological examination of biopsy specimens of intestinal mucosa is still the most reliable detecting method to diagnose AR,and continuous observation may play an important role to monitor the occurrence,development,and treatment response of AR. The final diagnosis of AR depends on structure of intestinal mucosa,crypt epithelium injury and inflammatory cells infiltration. The communication among the pathologist and surgeon is the best way to reduce misdiagnoses.Ultrastructural examination is used to verify the pathogenic microorganism.

Objective To establish two models of long-term chronic allograft rejection (CR)following orthotopic small bowel transplantation and compare the two models induced by cyclosporine A (CsA) or tacrolimus (Tac).Methods F344 and Lewis rats severed as donors and recipients,respectively.Transplantation was performed by anastomosing the graft superior mesenteric artery to the recipient infrarenal aorta and the graft portal vein to the recipient infrarenal inferior vena cava in an end-to side fashion.The recipients intestine was replaced with the graft by performing end-to-end small bowel anastomosis.In the study I,the rat was given intramuscularly CsA (5 mg · kg-1 · day-1) from postoperative day (POD) 0 to 13; In the study Ⅱ,the rat was given intramuscularly FK 506 at a dose of 0.3,0.5 and 1.0 mg· kg-1 · day-1 on POD 0-13,20,27,respectively.The body weight gain,survival rate and histology were observed.Results In the study I,there were significant changes of the CR histologically,including villous architecture,interstitial fibrosis,leukocyte infiltration,and obliterative arteriopathy.There was no significant difference in features of CR between POD 60 and POD 90,however,the serious villous blunting was not found; In the study II,the rats received Tac at dose of 0.3 and 0.5 mg·kg-1 ·day-1 and survived up to POD 126.The recipients received Tac at dose of 1.0 mg·kg-1 · day-1 and survived more than POD 180 and the body weight gain was the same as the isogenic groups.The histopathological analysis revealed distinctive features of CR including villous blunting.The characteristics of CR induced by CsA or Tac in the rat model of orthotopic small bowel transplantation could be demonstrated,however,the Tac-induced model was more closer to clinical small bowel transplantation pathology of CR.Conclusion Using the protocol of CsA or Tac,we developed a rat CR model of orthotopic small bowel transplantation,however,the Tac-induced recipients survived longer and had more classic characteristics of CR than CsA.

OBJECTIVE: To explore the influence of granules for nourishing kidney and strengthening brain (GNKSB) on main symptoms of kidney-yin deficiency and blood stasis syndrome and the hemorrheological characteristics of brain atrophy patients. METHODS: Ninety patients of brain atrophy with kidney-yin deficiency and blood stasis syndrome were randomly divided into two groups. Sixty cases in treatment group were treated with GNKSB, and the 30 cases in control group were treated with piracetam for 8 weeks. RESULTS: The effective rate of treatment group was 73.3%, with significant difference as compared with 46.6% of the control group (P<0.01). The scores of symptom-assessment of the two groups were also significantly different (P<0.01). The mini-mental state examination of treatment group was obviously improved, and was significantly different as compared with the control group (P<0.01). The scores of Hasegawa's dementia scale and activities of daily living were increased, but without significant difference as compared with the control group. The platelet aggregation rate was improved, with significant difference as compared with the control group (P<0.05). The whole blood viscosity was also improved obviously, but without significant difference as compared with the control group. CONCLUSION: GNKSB is effective for kidney-yin deficiency and blood stasis syndrome of brain atrophy patients and can improve their mental state and the hemorrheological indexes.

Objective To explore the effect of praziquantel on schistosomal ovum granuloma in the lung of mice.Methods Forty-eight mice were divided into 4 groups.Group A:first,the mice were injected with schistosomal ova hypodermicly in abdomen and 10 days later,injected with schistosomal ova intravenously in the cauda;Group B:in addition to the injection of schistosomal ova as the same of Group A,the mice were administered with praziquantel [300 mg/(kg?d)] for 3 days from the last day of the intravenous injection of the ova;Group C:in addition to the injection of schistosomal ova as the same of Group A,the mice were administered with praziquantel(75 mg/kg,B.i.d.)for 5 days weekly until the mice were sacrificed;Group D:the same as Group C but praziquantel was given to the mice from the 29th after the intravenous injection of the ova.Three mice of each group were sacrificed on the 7th,14th,28th,56th day after the intravenous injection of the ova and the lung tissues were fixed with formalin and the slices were HE stained.Fifteen-thirty pieces of schistosomal ovum granuloma were examined and their areas were measured and the mean areas of each group were calculated and compared.Results On the 7th,14th and 28th days after the intravenous injection of the ova,the mean area of schistosomal ovum granuloma in Group C was significantly less than that in Group A,and there was a significant difference between the two groups,P 0.05.On the 56th day,the mean areas of schistosomal ovum granuloma in Group B,C,D were significantly less than that in Group A,all P