Effect of histone H4 on polarization of alveolar macrophages in mice with acute respiratory distress syndrome / 中国职业医学

Objective To investigate the role of histone H4 in the polarization of alveolar macrophages (AM) in lipopolysaccharide (LPS)-induced acute respiratory distress syndrome (ARDS) in mice. Methods i) The specific pathogen free male C57BL/6 mice were randomly divided into control group and 2, 4, 6 and 8 mg/kg LPS groups, with six mice in each group. The mice in the LPS groups were intratracheally administered LPS according to their respective doses, while the mice in the control group received an equivalent volume of 0.9% saline. After 12 hours, the arterial blood gas was analyzed, and the pulmonary edema and histopathological changes in lung tissues of mice in each group were observed. The level of histone H4 in bronchoalveolar lavage fluid (BALF) of mice was detected using enzyme-linked immunosorbent assay , and mice AMs of the five group were isolated using adherent method. ii) AMs from normal mice were isolated using adherent method and randomly divided into control group, histone H4 injury group, BALF injury group and anti-histone H4 antibody (anti-H4) intervention group. In the histone H4 injury group, AMs were treated with histone H4 at a final concentration of 20 mg/L. In the BALF injury group and anti-H4 intervention group, AMs were treated with 200 μL BALF supernatant from mice intratracheally administered 6 mg/kg body weight LPS, with the latter group treated with 25 mg/L anti-H4 antibody. The control group AMs were treated with phosphate-buffered saline. iii) After 12 hours of stimulation, the cells were collected, and the relative expression of tumor necrosis factor-α (Tnfa), interleukin-1β (Il1b), differentiation antigen 206 (Cd206) and arginase 1 (Arg1) in AMs was detected using real-time quantitative polymerase chain reaction. Results i) Compared with the control group, mice in all four LPS groups exhibited rapid breathing, inflammatory reaction and lung edema in lung tissues, which were aggravated in a dose-dependent manner. The ratio of partial pressure of arterial oxygen to fraction of inspired oxygen in mice decreased with the increase of LPS dose (P<0.05). The wet/dry weight ratio of lung, the level of histone H4 in BALF and the relative expression of Tnfa and Il1b mRNA in AMs increased with the increase of LPS dose (all P<0.05). The mice in the 6 and 8 mg/kg LPS groups developed ARDS. The level of histone H4 in BALF and the relative expression of Tnfa and Il1b mRNA in AMs of mice in 6 and 8 mg/kg LPS groups were higher than those in the other three groups (all P<0.05). ii) The relative expression of Tnfa and Il1b mRNA increased (both P<0.05), and the relative expression of Cd206 and Arg1 mRNA decreased (both P<0.05) in AMs of histone H4 injury group and BALF injury group compared with the control group. Compared with BALF injury group, the relative mRNA expression of Tnfa and Il1b in AMs of anti-H4 intervention group decreased (both P<0.05), while the relative expression of Arg1 mRNA increased (P<0.05). Conclusion LPS can induce a dose-dependent increase in histone H4 levels in BALF in mice. Histone H4 drives the development of ARDS by activating AMs to M1 polarization. Antagonizing histone H4 to interfere with AM polarization to M1 could be a target for the treatment of ARDS.

Qualitative research on the construction of pneumoconiosis rehabilitation station in Beijing from the perspective of ecosystem theory / 中国职业医学

Objective: To analyze the existing problems in the construction of pneumoconiosis rehabilitation station in Beijing under the framework of ecosystem theory, and put forward countermeasures. Methods: A total of four managers directly involved in the construction of three pneumoconiosis rehabilitation stations in Beijing and 12 rehabilitation doctors working in rehabilitation stations were selected as the interviewees using the judgment sampling method. Based on the perspective of ecosystem theory, an interview outline was designed to conduct a semi-structured interview with the interview subjects. In combination with literature data, the current situation, existing problems and solutions of pneumoconiosis rehabilitation station construction were analyzed. Results: There were still deficiencies in the construction of pneumoconiosis rehabilitation stations in Beijing. At the microscale level, pneumoconiosis patients could not make full use of family resources for active and effective pulmonary rehabilitation treatment, and family members lack of effective rehabilitation guidance and assistance for patients. At the medium-scale level, the resources of primary rehabilitation institutions were insufficient, the medical support for pneumoconiosis rehabilitation was insufficient, and the pneumoconiosis rehabilitation stations lacked a unified information management and technology platform. At the macroscale level, it has not established clear and specific requirements for the construction management and evaluation of pneumoconiosis rehabilitation stations, and there was social discrimination and prejudice against pneumoconiosis patients. Conclusion: It is necessary to improve the recognition of rehabilitation in primary medical and health institutions, strengthen education on the awareness of the disease and rehabilitation skills guidance for patients and their families, strengthen the responsibilities of technical support institutions in rehabilitation stations, promote the construction of primary rehabilitation stations and personnel training, make full use of information technology, promote information exchange and knowledge sharing, and ensure the quality of rehabilitation of pneumoconiosis.

Bibliometric analysis on occupational hand-arm vibration disease in China / 中国职业医学

OBJECTIVE: To study the literature characteristics and research status of occupational hand-arm vibration disease in China. METHODS: Literature information on occupational hand-arm vibration disease published before 2018 in China were searched and collected through the China National Knowledge Infrastructure(CNKI) and Wanfang Database. The bibliometrics was used to analyze the publication time, type, journal sources, authors and their institutions, citation situation, funds and high-frequency key words. RESULTS: From 1975 to 2018, a total of 349 papers on occupational hand-arm vibration disease were published. The main article type was monograph, with a total of 179 articles(accounting for 51.3%). The articles were distributed in 79 kinds of journals, among them, 10 journals including China Occupational Medicine and Industrial Health and Occupational Diseases were the main carriers to publish related articles(237 papers, accounting for 67.9%). The main research institutions of the literature were Jining Medical College and Guangdong Province Hospital for Occupational Disease Prevention and Treatment, with 134 papers(accounting for 38.4%) published. Among the 5 core authors of the literature, 4 were from the above 2 research institutions. A total of 121 articles(accounting for 34.7%) were cited, and 77 articles(accounting for 22.1%) were supported by research fund. The top 3 high-frequency key words used were arm vibration disease, hand-transmitted vibration/local vibration and occupational disease. CONCLUSION: Occupational hand-arm vibration disease has attracted the attention of Chinese researchers, however, follow-up research, literature quality and funding support still need to be improved.

The Role of Bmi1 on Migration of HUVECs under Low Shear Stress / 医用生物力学

Objective To investigate the role of Bmi1 on the migration of human umbilical vein endothelial cells (HUVECs) in response to low shear stress. Methods A parallel plate flow chamber system was used to generate low (0.5 Pa) or normal (1.5 Pa) laminar shear stress. HUVECs were isolated, cultured and exposed to flow for 12 hours. The mRNA and protein levels of Bmi1 were analyzed by real-time PCR and Western blot, respectively. Meanwhile, wound healing assay was performed to determine the migration of HUVECs. Bmi1 specific small interference RNA (siRNA) was used to silence Bmi1 gene. Results Low shear stress (0.5 Pa) significantly inhibited migration of HUVECs compared with normal shear stress (1.5 Pa). Similarly, compared with HUVECs exposed to normal shear stress, the expression of Bmi1 significantly increased in HUVECs exposed to low shear stress. Small interfering RNA knockdown of Bmi1 attenuated low shear stress-induced inhibition of HUVECs migration. Conclusions Low shear stress may inhibit the migration of HUVECs through up-regulation of Bmi1 expression. Knockdown of Bmi1 may reverse the HUVECs migration inhibited by low shear stress．

Activation of lung endothelial cells by extracellular histone in mice with acute respiratory distress syndrome / 中华劳动卫生职业病杂志

Objective@#To observe the changes of extracellular histones and pulmonary microvascular endothelial cells, and study the activating role of extracellular histones to pulmonary microvascular endothelial cells in the pathogenesis of acute respiratory distress syndrome (ARDS) .@*Methods@#The correlation of the severity of acute lung injury with extracellular histones and pulmonary endothelial damage was studied through mice model, and acute lung injury was produced by aspiration of different concentrations of hydrochloric acid (0.01、0.1、0.3 and 0.5 mol/L, 2 ml/kg). Tumor necrosis factor-α (TNF-α), soluble thrombomodulin (sTM) and lung pathological change were measured. The pro-inflammatory role of extracellular histones was tested by injecting calf thymus histones (CTH) or specific anti-H4 antibody through tail vein. The direct activating role of extracellular histones to pulmonary microvascular endothelial cells was studied through pulmonary endothelial model.@*Results@#The extracellular histones in plasma were increased obviously 6h after aspiration of different concentrations of hydrochloric acid in mice. A positive correlation was seen between extracellular histones and concentrations of aspirated hydrochloric acid (r=0.9180, P<0.05). The sTM in plasma also showed a positive correlation with concentrations of aspirated hydrochloric acid (r=0.8701, P<0.05). Merely administering CTH could not only increase TNF-α and sTM in plasma but also cause obvious lung injury, while specific anti-H4 antibody could relieve the inflammation and lung damage caused by CTH. Extracellular histones could directly damage pulmonary endothelial cells to release sTM in pulmonary endothelial model in vitro, while anti-H4 antibody could protect the endothelial cells.@*Conclusion@#Extracellular histones are the key endogenic inflammatory mediators during the pathogenesis of ARDS caused by aspiration of hydrochloric acid, which could promote inflammation by directly activating pulmonary endothelial cells.

Paediatric nodal marginal zone lymphoma: a clinicopathological study of seven cases / 中华病理学杂志

Objective@#To investigate the pathological features and clinical manifestation of pediatric nodal marginal zone lymphoma(NMZL).@*Methods@#Histological morphology and immunophenotype of 7 cases of pediatric NMZL were retrospectively reviewed at Beijing Friendship Hospital Affiliated to Medical University between January 2008 to October 2018. Clonal rearrangement analysis was performed. Clinical information including patient follow-up data were analyzed.@*Results@#All 7 patients were male with a median age of 15 years aged from 10 to 26 years. All patients presented with only lymph node enlargement without B symptoms, including cervical lymph node (5 cases), preauricular lymph node (1 case) and retroauricular lymph node (1 case). Histologically, all cases showed irregular large follicles on the edges with widened marginal areas and intervesicular areas, and lesional cells were uniform with progressive transformation of germinal center centers along with a small amount of intrinsic lymphoid tissue. All 7 cases showed diffuse CD20 positivity both follicle and interfollicular region along with 30%-40% positivity in the interfollicular region (pathological region). Markers of other B-cell lymphomas werenot expressed. All 7 cases were positive for immunoglobulin(Ig) gene rearrangement. None of the patients showed no recurrence up on after follow-up for an average of 13 months.@*Conclusions@#Pediatric NMZL is a rare type of lymphoma that has a unique morphology and occurs almost exclusively in male children and young adults and often in head and neck lymph nodes. It has an excellent prognosis. Therefore, awareness of the disease with accurate diagnosis is important.

Clinicopathologic features and prognosis of mantle cell lymphoma: an analysis of 349 cases / 中华病理学杂志

Objective@#To investigate clinicopathologic features and prognostic factors of mantle cell lymphoma(MCL).@*Methods@#The clinical data of 349 MCL patients diagnosed at Beijing Friendship Hospital from January 2004 to January 2016 were retrospectively collected. Corresponding histological sections were reviewed. Additional studies included immunohistochemical staining using the MaxVision two-step method, IgH/CCND1 fusion gene detection by fluorescent in situ hybridization (FISH), and correlative statistical analysis.@*Results@#Of 349 patients with MCL, the median patient age was 61 years (range: 25-83 years, M∶F=2.7∶1.0) and the age of 243 patients ranged from 51 to 70 years (69.6%). Those with B symptoms accounted for 22.4% (70/313). Most of the patients presented with superficial lymphadenopathy and the clinical stage Ⅲ-Ⅳ accounted for 76.1% (235/309). Extranodal involvement was seen in 47.9% (148/309), among which the gastrointestinal tract accounted for 31.8% (47/148) and splenic involvement accounted for 15.4% (47/305). Three hundred and nine (88.5%) cases were of classical type and 40 (11.5%) cases were of aggressive variant type, and all were composed of proliferating lymphoid cells. All the tumors were positive for CD20 and cyclin D1, and 98.6% (344/349) tumors were weakly positive or positive for CD5. FISH test was positive in 12 cases that were CD5 negative and with cyclin D1 partial expression.Two hundred and forty-three (69.6%) patients had a median follow-up of 26 months (range: 3-108 months). The 3- and 5-year overall survival rates for patients were 63.0% and 34.8%, respectively. Single factor analysis showed that age of >60 years, splenic involvement, aggressive variant type, incompletely overlapping type [Based on the degree of overlap ≥90% and <90% between the follicular dendritic cell (FDC) meshwork and tumor cells, the tumors were divided into the completely overlapped type and incompletely overlapped type] and Ki-67 index >40% had poor prognosis (P<0.05). Multiple factor Cox proportional risk regression analysis after removing the aggressive variant type showed that age, splenic involvement, the degree of overlap between the FDC meshwork and tumor cells and Ki-67 index were independent prognostic factors for overall survival rate of MCL patients (P<0.05).@*Conclusions@#MCL is more commonly found among middle-aged and elderly men. Patient age, splenic involvement, degree of overlap between FDC meshwork and tumor cells and Ki-67 index are the independent prognostic indicators for MCL.

EB virus-positive T/NK lymphoproliferative diseases: an analysis of 156 patients / 中华病理学杂志

Objective@#To investigate the clinicopathological features of EBV-positive T/NK cell lymphoproliferative diseases (EBV+ T/NK-LPD).@*Methods@#The clinical characteristics of 156 cases of EBV+ T/NK-LPD were collected from August 2002 to March 2015 at Beijing Friendship Hospital, Capital Medical University. Immunohistochemical staining, EBER in situ hybridization and clonal analysis of TCR gene were performed. All patients were followed up.@*Results@#There were 106 male and 50 female patients; patients′ age ranged from 1 to 75 years (median 20 years). The course of the diseases before diagnosis ranged from 2 to 540 months (median 20 months). Fever was noted in 122 patients (78.2%), 108 patients had lymphadenopathy (69.2%), and 75 patients had hepatosplenomegaly (48.1%). Thirty-three cases were grade 1, 68 cases were grade 2, and 55 cases were grade 3. TCR gene arrangement analysis was performed in 45 cases, and 33 cases (73.3%) showed clonal rearrangement. The follow-up period ranged from 1-134 months, and 44 patients (28.2%) died. There was a trend of increased death rate associated with increasing grade (P>0.05).@*Conclusions@#There are many types of EBV+ T/NK-LPD, and they can be classified as systemic, relatively localized and localized. The prognosis should be based on a comprehensive analysis of pathology and clinical data. There is no significant correlation between morphological grade and mortality. An important goal of therapy is to prevent serious complications.

Effect of family education methods and parental rearing or not on the psychological problem tendency of primary school students / 中华行为医学与脑科学杂志

Objective To explore the impact of family education methods and parental rearing or not on the psychological problem tendency of primary school students.Methods The mental health test (MHT) was used on getting mental health data of the 2 838 primary school students from Dongguan city.Results (1) The results of MHT showed that 94.28％ of primary school students had no psychological problems,the tendency rate of psychological problems was 4.29％,and 1.43％ of them were suffering from serious psychological problems.Learning anxiety,physical symptoms and allergy tendency were more prominent.(2) The total MHT scores of primary school students with authoritarian,democratic,permissive and neglected family education methods were (34.84±14.58),(31.04±13.60),(35.19±12.82) and (41.19±13.10)respectively.There was no statistically significant difference in the terrorist tendency dimension scores of primary school students with different education methods (F=2.33,P=0.054),and the differences in the MHT total score and other dimensions were statistically significant (F=4.35-16.88,P＜0.01).(3) There were statistically significant differences in the scores of the total score of psychological problem tendency,dimensions of learning anxiety,anxiety to people,allergy tendency and impulse tendency of primary school students who were parental rearing or not (t=2.09-3.67,P＜0.05).However,there was no statistically significant difference in the dimensions of loneliness tendency,self-accusation tendency,physical symptoms and terrorist tendency (P＞0.05).Conclusion Family education methods and parenting styles has a impact on the mental health of primary school students.

Analysis of CT features of early asymptomatic active pulmonary tuberculosis in adolescence / 实用放射学杂志

Objective To analyze the CT features in the early stage of asymptomatic active pulmonary tuberculosis (PTB)in adolescence after PTB outbreak.Methods After PTB outbreak in a boarding school of a certain county in northern Jiangsu province,the clinical data, X-ray and CT findings of 47 cases with active PTB were analyzed retrospectively and compared with CT findings after treatment.Results In 47 cases,the incidence of male was higher than that of female,and 27 cases were negative on chest X-ray.The difference of X-ray and CT detection rate in the early stage of active PTB was statistically significant (P<0.001).Of 47 cases,46 patients had pulmonary parenchymal lesions and 1 had pleural effusion on CT.The lesions were found on 58 lobes and 60 lung segments,and 35 cases demonstrate lesions on the upper lobes,22 cases on the lower lobes,1 case on the middle lobe.CT images showed tree-in-bud opacities (68.1%),micronodules (89.4%) and consolidation (21.3%).All of patients got better after antituberculous therapy.Conclusion Active PTB should be considered first when CT scan shows micronodules or tree-in-bud signs in adolescences with PTB exposure.

Clinicopathologic features and prognosis of gastrointestinal mantle cell lymphoma / 中华病理学杂志

Objective@#To investigate the clinicopathologic features and prognosis of gastrointestinal mantle cell lymphoma (GI-MCL).@*Methods@#Clinical data of 38 GI-MCL patients diagnosed at Beijing Friendship Hospital from January 2002 to January 2016 were retrospectively reviewed morphologically and immunophenotypically. IgH/CCND1 gene fusion was assessed by fluorescent in situ hybridization (FISH). For comparison, 60 cases of non-GI-MCL were randomly selected to extract the differences inclinicopathological features and patient survival between the two groups.@*Results@#Of 38 patients with GI-MCL, the median age was 62 years (range: 35-78 years, 23 males and 15 females), of which patients of 60 years of age or older accounted for 55.3%. Patients with clinical course of less than 6 months accounted for 81.1%(30/37). The main symptoms included abdominal pain, diarrhea, anorexia and hematochezia. Those with B symptoms accounted for 32.4%(12/37). The tumor most often involved lleocecal region (57.9%, 22/38), followed by rectum (36.8%, 14/38) and sigmoid colon (28.9%, 11/37), and the stomach accounted for 18.4%(14/38). Endoscopic polypoid lesions were found in 33 cases (86.8%, 33/38), of which 22 cases (66.7%, 22/33) were multiple. Five cases (13.2%, 5/38) presented with local protuberant neoplasm. According to Ann Arbor staging, 3 cases (7.9%, 3/38) were at stage Ⅰ, 4 cases (10.5%, 4/38) were at stage Ⅱ, and 31 cases (81.6%, 31/38) were at stage Ⅳ. The number of patients with tumor involvement of abdominal and retroperitoneal lymph nodes accounted for 45.7%(16/35), including 41.7%(15/36) involving the superficial lymph node, 17.1%(6/35) involving extranodal sites, and 23.5%(8/34) having splenomegaly. All of the 38 cases were classic MCL, and the tumor was composed of uniform lymphoid cells and effacing normal mucosal structure. All tumors were positive for CD20 and CD5. 97.4% (37/38) tumors were positive for cyclin D1, and 92.0% (23/25) tumors were positive for SOX11. FISH test was positive in 1 case of cyclin D1 negative tumor. Twenty-eight patients (73.7%) had a median follow-up of 25.0 months (range: 3-79 months). The 3-year survival rate for stage Ⅰ-Ⅱ and stage Ⅲ-Ⅳ of patients were 80.0% and 69.1%, respectively (P> 0.05). The 3-year survival rate for GI-MCL and non-GI-MCL patients were 71.7% and 72.5%, respectively (P>0.05). Single factor analysis showed that age of >60 years and splenomegaly were correlated with a worse overall survival rate (P<0.05).@*Conclusions@#Gastrointestinal malaise is the most common presenting symptom in GI-MCL patients. GI-MCL more commonly involves colorectum with more frequent multiple polypoid lesions. Patients of age >60 years and with splenomegaly have poor prognosis. There is no difference in the prognosis between GI-MCL and non-GI-MCL patients.

Cut-off value of Ki-67 labeling index in the pathologic grading of follicular lymphoma / 中华病理学杂志

Objective@#To determine the cut-off values of Ki-67 labeling index (LI) in the histological grading of follicular lymphoma (FL).@*Methods@#Clinicopathological data of 350 FL patients diagnosed at Beijing Friendship Hospital from June 2014 to January 2016 were analyzed retrospectively by quantitative evaluation and statistical analysis of Ki-67 LI.@*Results@#Of the 350 patients with FL, the male and female ratio was 1.1 and the average age was (50.2±14.0) years with a median age of 51 years (range 4 to 82 years). The tumors were graded as grade Ⅰ-Ⅱ in 215 cases (61.4%), grade Ⅲ A in 105 cases (30.0%), and grade Ⅲ B in 30 cases (8.6%). The average Ki-67 values were (22.8%±8.3%) for the FL low (grade Ⅰ-Ⅱ) and (50.4%±10.7%) for high grade (Ⅲ A and Ⅲ B) and were statistically significant by Mann Whitney U test (P<0.01). Receiver operated characteristic curve analysis showed that the best diagnostic cut-off value of low grade FL was 35% (sensitivity of 96.3% and specificity of 93.3%) with the largest area under curve (AUC=0.990, P<0.01, 95%CI for 0.982-0.998). According to the analysis of four lattice diagnostic tests, Ki-67 LI >40% was an important factor (χ2=230.733, P<0.01) in predicting high grade FL. When the cut-off value of Ki-67 LI was set at 40%, high grade LF could be diagnosed with the greatest sensitivity (98.1%) and specificity (87.7%). Moreover, a significant correlation between the Ki-67 LI and the pathological grade of FL (r=0.836, P<0.01) was observed.@*Conclusions@#Ki-67 LI of below a cut-off value of 35% is a reliable indicator of low grade FL.Ki-67 over 40% is consistent with high grade FL. These Ki-67 cut-off values may serveas an important auxiliary indicator in the grading of FL.

Clinicopathologic characteristics of Burkitt-like lymphoma with chromosome 11q aberration / 中华病理学杂志

Objective@#To analyze clinical, pathological, molecular and genetic characteristics of Burkitt-like lymphoma with chromosome 11q aberration.@*Methods@#A case of Burkitt-like lymphoma with 11q aberration was presented at Beijing Friendship Hospital in November 2016 with detailed clinicopathological features, immunophenotypes, Epstein-Barr virus(EBV) status and molecular genetic characteristics.@*Results@#The patient was a 38-year-old man presenting with the cervical lymphadenopathy. In morphology, the tumor had the similar characteristics of Burkitt lymphoma, including diffuse infiltration of medium to large lymphoid cells, and presence of"starry sky"phenomenon. Immunophenotypically, the tumor cells were positive for CD20, CD10, bcl-6, but negative for bcl-2. MUM-1 showed weak and patchy positivity. Ki-67 index was more than 95%. C-MYC expression was seen in about 50% of tumor cells. EBV in situ hybridization was negative. IgH and IgK genes were clonally rearranged.Fluorescence in situ hybrization detection using MYC break probe was negative but ATM gene amplification on chromosome 11q was detected. The patient did not receive any chemotherapy or radiotherapy and had not recurrence during the 10 months follow-up.@*Conclusion@#Burkitt-like lymphoma with chromosome 11q aberration has similar clinical, morphological and immunological characteristics to classic Burkitt′s lymphoma.

Clinicopathologic characteristics and prognositic indicators of tonsillar mantle cell lymphoma / 中华病理学杂志

Objective@#To investigate clinicopathological features and prognosis of tonsillar mantle cell lymphoma(TMCL).@*Methods@#Clinical data of 25 patients with TMCL at Beijing Friendship Hospital, Capital Medical University from 2002 to 2016 were included. All the cases were reviewed microscopically. Various immunohistochemical stains were performed using the MaxVision two-step method. IgH/CCND1 gene fusion was detected by fluorescent in situ hybridization(FISH). Additionally, randomly selected 40 cases of non-tonsil MCL of the same period were compared.@*Results@#Among all mantle cell lymphomas (MCL), TMCL accounted for 5.6%(25/449). The median age of the patients was 60 years(range: 44-82 years) with a M∶F ratio of 5.3 to 1.0. The main symptoms were sore throat and foreign body sensation and patients usually presented with enlargement or mass of tonsil. At the early stage of the disease, 18 cases(72.0%) were clinically misdiagnosed as tonsillitis. Lymph node involvement was present in 76.0%(19/25) of the patients. There were 4 cases(16.0%)with current splenic involvement, 11 cases(44.0%) with pharyngeal focal recidivism, and 3 cases(12.0%) with involvement of other non-lymphoid organs. Morphologically, tonsillar architectures were effaced at various degrees. Eighteen MCL cases showed classical type and 7 cases were blastoid variant. All tumors were positive for CD20 and cyclin D1. 92.0%(23/25) tumors showed weakly positive or positive expression for CD5. FISH test that IgH/CCND1 gene fusion was positive in two CD5 negative classical cases. 18 patients(72.0%) had a median follow-up time of 26 months(range: 6-81 months). The difference of survival rate between stage Ⅰ-Ⅱ and stage Ⅲ-Ⅳ patients was not statistically significant(P>0.05). Compared with NTMCL, TMCL was found to have higher proportion of stage Ⅰ-Ⅱ disease (χ2=12.789, P<0.01), lower the proportion of non-lymphatic organ involvement (χ2=8.125, P<0.01), and better prognosis (χ2=4.351, P=0.037).@*Conclusion@#The incidence of TMCL is low and prone to be misdiagnosed as tonsillitis. Patients with TMCL are more likely at stage Ⅰ-Ⅱ at presentation and the prognosis is better than that of NTMCL.

The comparison of heparan sulfate and its fragments on the protection against extracellular histones during the pathogenesis of acute respiratory distress syndrome / 中华劳动卫生职业病杂志

Objective@#In order to explore the role of heparan sulfate (HS) during the pathogenesis of acute respiratory distress syndrome (ARDS) , the protective effect of HS and its fragments against extracellular histones was compared.@*Methods@#Calf thymus histones (CTH) were injected via femoral vein to induce ARDS in rats. HS, HS fragments or saline was intraperitoneally injected (10mg/kg, Q6h, 24h) to test the protective effect against CTH. The ratio of wet/dry lung weight, protein content in bronchoalveolar lavage fluid (BALF) , total leukocyte and neutrophil count in BALF were measured.@*Results@#After CTH injection, the ratio of wet/dry lung weight (5.7±0.95) was much higher than the saline control group (3.1±0.15). The protein content (0.47±0.086mg/ml) , total leukocyte[ (97.4±15.6l) ×104/ml] and neutrophil (18±3.4/LPF) in BALF were obviously increased compared with the saline control group. The intervention of HS evidently decreased ratio of wet/dry lung weight (4.2±0.41) , protein content[ (0.26±0.019) mg/ml], leukocyte[ (61.3±5.74) ×104/ml] and neutrophil (12±1.8/LPF) in BALF. HS fragments also decreased ratio of wet/dry lung weight, protein content, leukocyte and neutrophil count in BALF though the strength was much less than HS.@*Conclusion@#HS and its fragments could provide protection against extracellular histones during the pathogenesis of ARDS. For the protective effect full length HS was much better than HS fragments.

Effects of baicalin on the changes in hemorheology of acute respiratory distress syndrome in rats / 中华劳动卫生职业病杂志

Objective@#To investigate the effect of baicalin on the changes in hemorheology and its mechanism during the development of Acute Respiratory Distress Syndrome(ARDS) induced by oleic acid (OA) in rats.@*Methods@#Rats were randomized into 3 groups: control, ARDS (OA induction, 0.12 mg/kg) and ba-icalin-treated group (300 mg/kg). The blood samples were collected at 30 min, 1, 2, 3, 6, 12 and 6 h after OA injection. The whole blood viscosity, plasma viscosity, Maximum erythrocyte deformability index (DImax) were detected. Meanwhile, blood gas analysis and Routine blood test were also performed.@*Results@#The level of arte-rial oxygen partial pressure and oxygenation index decreased (P<0.01 vs. control) and oxygenation index (178 mm Hg, 1 mm Hg=0.133 kPa) reached the diagnostic standard of ARDS at 2 h in ARDS group. In baicalin-treated group, the level of arterial oxygen partial pressure and oxygenation index increased versus the ARDS group. The platelet count (PLT) decreased in baicalin-treated and ARDS groups. Compared with the ARDS group, the level of PLT increased significantly in baicalin-treated group at 30min, 1, 2, and 3 h. Hematocrit (HCT) increased in baicalin-treated and ARDS groups. Compared with the ARDS group, the level of HCT de-creased significantly in baicalin-treated group at 2, 3, 6 and 12 h. Meanwhile, all the index of hemorheology improved in baicalin-treated group.@*Conclusion@#Baicalin may improve hypoxemia of ARDS induced by OA in rats. It may be due to the Improvement of microcirculation of lung.

Diagnosis and treatment of insulinoma in 16 cases / 重庆医学

Objective To analyze and investigate the diagnosis method and treatment measures of insulinoma.Methods The clinical data in 16 cases of insulinoma in the hepatobiliary surgery of our institute from Dec.2008 to Dec.2015 were retrospectively analyzed.Results All cases had typical Whipple′s triad,the biochemical examination suggested that all cases had plasma glucose decrease and plasma insulin increase during the onset period.The imaging examinations included preoperative ultrasonography,enhanced CT,MRI,EUS and intraoperative ultrasound (IOUS).Their diagnosis positive rates were 56.3% (9/16),77.8% (7/9),80.0% (8/10),100.0%(2/2) and 100.0%(5/5) respectively.Sixteen cases all received surgical treatment,including local tumor excision in 6 cases,simple distal pancreatectomy in 3 cases,distal pancreatectomy plus splenectomy in 5 cases and pancreaticoduodenectomy(PD) in 2 cases.Plasma glucose level in all cases was significantly increased after tumor removal.Postoperative follow-up lasted for 1-5 years without recurrence and metastasis.Conclusion The first choice of insulinoma localization diagnosis is CT and MRI,intraoperative palpation combined with IOUS is the main method of intraoperative localization,and the surgical resection is the only effective method for treating this disease.

Wnt-β-catenin signal molecule expression level in acute kidney injury rats renal tissue / 中国免疫学杂志

Objective:To explore the Wnt-β-catenin signal molecule expression level in acute kidney injury rats renal tissue. Methods:A total of 48 rats accorded to the random number table method were divided into normal control group ( Control group) ,sham operation group ( Sham group) and ischemia reperfusion group ( IRI group) ,each group with 16 rats,Control group was given normal fed,IRI group were established ischemia reperfusion injury rats model,Sham group opened dorsal skin and then wound was closed. 4 rats were sacrificed respectively at 1,3,5,7 d after surgery,the pathological changes of kidney tissue were observed in the three groups,and the serum creatinine,urea level was detected in the three groups. Wnt4,β-catenin,Lrp6 protein expression was detected in three groups of rats by Western blot,Wnt4,β-catenin,Lrp6 mRNA in renal tissues were detected by Real-time quantitative RT-PCR. Results:There was no significant difference in renal injury score and serum creatinine between Control group and Sham group (P>0. 05),IRI group kidney injury score and serum creatinine,urea first increased and then gradually decreased,which was the highest in 3 d after surgery,IRI group renal injury score and serum creatinine,urea were significantly higher than those in Control group and Sham group 1,3,5,7 d after surgery (P0. 05),IRI group Wnt4,β-catenin,Lrp6 protein gradually increased,which reached to peak at 5 d after surgery,and then gradually decreased,IRI group Wnt4,β-catenin,Lrp6 protein were significantly higher than those in Control group and Sham group 1,3,5,7 d after surgery(P0. 05),IRI group Wnt4,β-catenin,Lrp6 mRNA gradually increased,which reached to peak at 3 d after surgery,and then gradually decreased,IRI group Wnt4,β-catenin,Lrp6 mRNA were significantly higher than those in Control group and Sham group 1,3,5,7 d after surgery (P<0. 05). Conclusion: The expression of Wnt-β-catenin signal molecule are significantly increase in acute kidney injury,and the activation of Wnt-β-catenin signal pathway is involved in the repair process of renal tissue.

Qualitative research on the effect of the implementation of electronic medical records based on electronic medical records / 中国实用护理杂志

Objective To explore the reasons for disharmony between medical staff and medical staff because of electronic clinical ordering,to specificate electronic medical order in ward in order to create a harmonious relationship between doctors and nurses. Methods The methods of qualitative research conducted in-depth interviews of 12 medical staff, field recordings and transcripts, and the method of content analysis were used. Results Two themes were sublimated:medical staff reasons:lack of communication between the medical staff;new doctors didn't have a good command of medical norms of specialist electronic orders; on the responsibility of checking the doctor's advice problems may lead to potential adverse events occurrence. System equipment reason: the electronic doctor's advice system set up the problem; the office computer quantity is insufficient. Conclusions Nonstandard electronic medical management leads to the disharmony of health care. It is suggested to standardize the management of electronic medical advice by implementation of the responsibility to avoid medical coupling errors. The health care workers need to strengthen communication, mutual understanding and forgiveness, in order to create a harmonious medical environment.

The clinical study on the correlation of lysophosphatidic acid and vascular endotheli growth factor and endothelin in serum of pneumoconiosis / 中华劳动卫生职业病杂志

Objective@#To explore the role of lysophosphatidic acid, vascular endothelial growth facor and endothelin in the pathogenesis of pulmonary fibrosis in coal workers’pneumoconiosis patients, the relationship of lysophosphatidic acid, VEGF and ET in serum was studied.@*Methods@#Sixty two pneumoconiosis patients were selected as cases group, which included 23 cases of stage Ⅰ, 25 cases of stageⅡand 14 cases of stageⅢ. Twenty workers were selected as dust exposure group who exposed to coal dust for more than 2 years and had not been diagnosed as pneumoconiosis. Ten healthy people who had no occupational dust exposure were simultaneously selected as the control group. The serum levels of LPA, VEGF and ET were measured by ELISA.@*Results@#The serum levels of VEGF and ET in coal dust exposed group and pneumoconiosis group were much higher than in the control group. The differences were statistically significant among the three groups (P<0.01) . The serum levels of LPA increased in the dust exposed group, stage Ⅰand stage Ⅱgroup. The serum levels of LPA correlated positively with the levels of VEGF and ET (P<0.05) .@*Conclusions@#The serum levels of LPA, VEGF and ET had evident correlation with the pulmonary fibrosis caused by coal dust, which indicate that LPA, VEGF and ET may play a pivotal role in the process of pulmonary fibrosis. The study will throw light on both pathogenesis and early intervention for pneumoconiosis.