To discuss the academic features of Ding-Ganren’s medical records and to provide the references for learning and applying the theories in the book. With bibliography research method, the academic features of Ding-Ganren’s medical records were investigated in academic thoughts, medication characteristic and clinic experience, etc. The academic features of Ding-Ganren’s medical records were summarized into 4 pointes, which are ①good at classical prescription and determination of treatment based in pathogenesis obtained through differentiation of symptoms and signs of typhus and complicated diseases. ②Focusing on six meridians and proposing the combination of cold and warm treatment. ③Mild treatment and claiming gentle application of the medicine. ④Determination of treatment based in pathogenesis obtained through differentiation of symptoms and signs of scarlet fever and emphasizing to distinguish Qi from Ying. Ding-Ganren YiAn has high academic value in research and clinic application and worth further study.

To investigate the academic features of Waizheng-YiAn-Huibian and provide references for research and application of it. With research approach in bibliography, the academic features of the book were studied from source of medical cases, writing characteristic, academic thought, etc. The academic features of Waizheng-YiAn-Huibian were summarized into the following 5 points, including multiple chosen medical cases but all with unique individual features, precious discussion after each case, named external symptoms, but covered internal symptoms, encouraging mild treatment and against being broad and complicated, emphasis on veins and arteries, positioning and nature determination. Waizheng-YiAn-Huibian is a wonderful masterpiece in medical cases research and worth learning and studying.

Objective To change the two-tiered C/S architecture of traditional PACS.Methods Based on the deeply research of PACS architecture,combination with DICOM and distributed object technology,propose distributed PACS system architecture,the three-tire client/server framework of distributed object technology introduced into the architecture of PACS to design the new architecture.Results In comparison with traditional PACS that were based on DICOM networks,the distributed PACS were improved themselves in system architecture and performance,and PACS were more open and interoperable.Conclusion The new architecture not only enhances the performance of PACS,but also meets the need of open and high interconnectivity and interoperability.

Objective To investigate the genotype in Chinese patients with nonclassical 21 hydroxylase deficiency (NC 21OHD). Methods Eight patients with NC 21 OHD, 35 patients with classical one and 20 normal controls were studied as followed: CYP21 gene was amplified into fragment 1 (exon1→exon3) and fragment 2 (exon3→exon10) through PCR with specific primers. Second round PCRs were performed using fragment 1 and 2 as template, and PCR products were digested by restrictive endonucleases to analyze mutations by 3% 4% agarose gel electrophoresis. Results (1) The most frequent mutation in 8 cases of Chinese NC 21 OHD was P30L(6/16,37.5%), followed by V281L(4/16,25.0%). NC 21 OHD also carried mutations causing moderate or severe degree of enzymatic compromise, such as i2g (3/16, 18.8%), Q318X and R356W (1/16, 6.3% respectively), and I172N (3/16, 18.8%). (2) In ACTH 1 24 stimulation tests of 8 NC 21 OHD patients, basal 17 OH progesterone level was (23.9?28.4)?g/L and stimulated 17 OH progesterone level was (92.0?83.7)?g/L. (3) Genotype had strong correlation with phenotype in 21 OHD patients. Conclusion (1) As compared with caucasians, the most frequent mutation in Chinese NC 21 OHD is P30L, not V281L. (2) Much more attention should be paid to patients with hyperandrogenism to screen NC 21 OHD.

25 years group. Among 129 cases who had taken antihypertensive drugs before operation, only 43 cases continued to use drugs after operation, therefore, rate of antihypertensive drugs administration decreased significantly after operation (P

[Objective] To investigate the characteristics of PD-1/PD-L1 expressed on T cell and bladder cancer cell and clinical significance.[Methods] 64 patients with primary bladder cancer were into experiment group and 10 normal people were into control group.Peripheral bloods were used to test the PD-1 expressed on CD8+ T lymphocytes by flow cytometry.Immunohistochemistry staining was used to detect the PD-L1 expression in tumor and normal specimen.[Results] PD-1 expressed on CD8+T lymphocytes was (2.25 ± 0.60)％ in experiment group and (0.68 ± 0.17)％ in control group,respectively (P ＜ 0.001).And the PD-1 expression on T cell in invasive bladder cancer patient was significant higher than superficial bladder cancer patients [(3.04 ± 0.46)％ vs (0.68± 0.17)％,P ＜ 0.001].The expression of PD-L1 in experiment group was higher than control group,(26/64 vs 0/15,P ＜ 0.001).But there was no different between invasive and superficial bladder cancer patients,(41.3％ vs 38.8％,P ＞ 0.01).[Conclusions] Expression of negative stimulatory molecule PD-1 in CD8+T lymphocytes of peripheral blood is significantly correlated with bladder cancer advanced.Bladder cancer cell was strongly expressed PD-L1,and this expression is not related to cancer advanced.

Objective To explore the application value of end-to-side closed in situ pancreaticojejunostomy in pancreaticoduodenectomy.Methods The clinical data of 22 patients with obstructive jaundice who were admitted to the Second Affiliated Hospital of Harbin Medical University from January to March 2014 were retrospectively analyzed.All the patients were explored whether tumors invaded inferior vena cava, superior mesenteric vein and portal vein after gallbladder decompression under general anesthesia by tracheal intubation.The standard or extended pancreaticoduodenectomy was applied according to the intraoperative results.The method of pancreaticojejunostomy was end-to-side closed in situ anastomosis of pancreatic duct and jejunal seromuscular layer.The operation time, intraoperative blood loss, postoperative gastrointestinal function recovery time, amylase concentration of drainage at postoperative day 1,3,5, postoperative complication, pathological classification and duration of hospital stay were observed.Patients were followed up by outpatient examination and telephone interview till May 2014.The out-patient follow-up included color Doppler ultrasound examination of effusion near the pancreatic stump, and the telephone interview included whether there were diarrhea of exocrine pancreatic insufficiency.Measurement data with normal distribution were presented as-x ± s (range) , and measurement data with skewed distribution as M(range).Results All the 22 patients underwent successfully the operation, including 17 undergoing standard pancreaticoduodenectomy and 5 undergoing extended pancreaticoduodenectomy, with end-to-side closed in situ anastomosis of pancreatic duct and jejuna seromuscular layer.The operation time of pancreaticoduodenectomy and end-to-side closed in situ pancreaticojejunostomy were (313 ± 37)minutes (range, 228-360 minutes) and(13 ± 4) minutes (7-22 minutes) , respectively.The intraoperative blood loss was (400 ± 207) mL (range, 100-800 mL).The mean tumor size was 3.69 cm2(range, 0.72-1.68 cm2).The recovery time of gastrointestinal function was (5 ±2)days (range, 4-7 days).The serum amylase at postoperative day 1, 3, 5 in the 21 patients was (145±30)U/L (range, 116-180 U/L), (136±40)U/L (range, 105-176 U/L), (147 ±38)U/L(range, 110-175 U/L), and the drainage amylase was (220 ±56)U/L (range, 172-289 U/L), (240 ±54)U/L (range, 192-300 U/L) , (245 ± 52) U/L (range, 190-298 U/L) , respectively.The serum amylase at postoperative day 1, 3, 5 in the patient with pancreatic fistula was 156 U/L, 178 U/L and 177 U/L, and the drainage fluid amylase was 500 U/L, 620 U/L and 605 U/L, respectively.There was 1 patient in the 22 patients with pancreatic duct stent and without death.Among the 4 patients with postoperative complications, 1 patient with grade A postoperative pancreatic fistula recovered after continuous external drainage, the other 3 including 1 case of infection,1 case of pneumonia and 1 of stress ulcer bleeding also recovered after symptomatic and supportive treatment.Postoperative pathological examinations of the 22 patients showed 12 cases of ductal adenoeareinoma, 2 of neuroendocine tumors, 1 of simple cyst, 1 of cystadenocarcinoma, 1 of squamous carcinoma, 1 of adenocarcinoma, 1 of ampullary carcinoma, 1 of tubular adenoma, 1 of leiomyoma and 1 of atypical intraductal hyperplasia.The average length of hospital stay was (11 ±3)days (range, 2-15 days).There were no effusion near the pancreatic stump showed in color Doppler ultrasound examination and diarrhea of exoerine pancreatic insufficiency.Conclusion End-to-side closed in situ pancreaticojejunostomy is safe and feasible, and can be applied to any pancreatic duct size and texture.

Objective To study the feasibility of TNF-α promoting migration of rat mesenchymal stem cells (MSCs) to local damaged tissues. Methods The MSCs was exposed to TNF-α at different concentrations and the expression rate of surface adheslon molecules and specific markers as well as their adhesion to endothelial cells were detected.Based on the above steps,the MSCs stimulated with the optimal concentration of TNF-α were obtained and were injected intravenously to the rats whose hindlimbs experienced ischemia damage.The rats were executed for achieving the muscle samples in the ischemic area,which were made into frozen section to count the number of MSCs. Results ( 1 ) Twenty-four hours after the TNF-o stimulation,the expression of adhesion molecule (VCAM-1) of MSCs increased in a concentration-dependent manner,while the expression of adhesion molecules (ICAM-1,L-Selectin and VLA4) of MSCs showed no significant changes.Besides,the expression rate of specific markers of MSCs was also obscure.(2) Exposed to 10 ng/ml TNF-o,MSCs presented an obviously increased ability in adhesion to the endothelial cells.(3) MSCs stimulated with 10 ng/ml TNF-α showed a larger number in the ischemia-damaged tissue of rat hindlimbs than that in the control group. Conclusion TNF-α at concentration of 10 ng/ml is effective within a short term in increasing VCAM-1 expression in rat MSCs and promoting the adhesion of MSCs to endothelial cells without affecting their character.

BACKGROUND:Previous studies have shown that monocytes can transdifferentiate into vascular endothelial cells under the induction of various factors including vascular endothelial growth factor(VEGF).It remains poorly understood whether monocytes can be induced to transdifferentiate into lymphatic endothelial cells in vitro.OBJECTIVE:To explore the possibility of the transdifferentiation of monocytes into lymphatic endothelial cells under inflammatory condition.METHODS:Fresh monocytes from peripheral blood were collected by Ficoll density gradient centrifugation and cultured in an endothelial cell medium,followed by incubation in fibronectin-plated well or treated with tumor necrosis factor a for 24 hours,respectively.The expression of specific markers of lymphatic endothelial cells,such as LYVE-1,Podoplanin,Porx-1 and VEGF receptor 3(VEGFR-3),as well as the endothelial cells markers,such as vWF,endothelial nitric oxide synthase(eNOS)and VEGFR-2,were detected by RT-PCR and immunochemical methods.RESULTS AND CONCLUSION:Prior to induction,monocytes were positive to LYVE-1,but negative for Podoplanin,Porx-1,and VEGFR-3,vWF,eNOS,as well as VEGFR-2.Following induction,the cultured mononcytes were positive for Podoplanin,Prox-1 and VEGFR-3,but remained negative for vWF,eNOS and VEGFR-2.It suggested that monocytes can be induced to express the markers of lymphatic endothelial cells stimulated by fibronectin or tumor necrosis factor a.

BACKGROUND: Following bone marrow mesenchymal stem cells (BMMSCs) infusion therapy, which factor promotes BMMSCs migrated to correct position is a key point, currently, adhesion molecule is thought to be playing an important role in mediating BMMSCs migration. OBJECTIVE: To investigate the expression of vascular cell adhesion molecule 1 (VCAM-1) and intercellular adhesion molecule 1 (ICAM-1) in rat BMMSCs. METHODS: BMMSCs were in vitro separated from rat bone marrow by directly adherence method. The expression of VCAM-1 and ICAM-1 were identified by using immunocytochemical staining, and the expression rates of antigen were tested by flow cytometry, in addition, their mRNA expressions were measured by RT-PCR. RESULTS AND CONCLUSION: Immunocytochemistry demonstrated that BMMSCs weakly expressed VCAM-1, but strong expressed ICAM-1. Flow cytometry showed that the expression rate of VCAM-1 was 6%, and the expression rate of ICAM-1 was 100%. RT-PCR showed that BMMSCs expressed a low level of VCAM-1 mRNA but a high level of ICAM-1 mRNA. It revealed under physiological condition, BMMSCs expressed a low level of VCAM-1, whereas they expressed a high level of ICAM-1.