Volume 92  ·   Issue 28  ·  2012

The diagnosis and examination of pulmonary embolism mainly includes CT pulmonary angiography (CTPA), radionuclide pulmonary ventilation perfusion (V/Q) imaging, magnetic resonance pulmonary angiography (MRPA) and direct pulmonary angiography [1-3]. Each examination method has its own characteristics and shortcomings. Only by clarifying the characteristics and advantages and disadvantages of each examination can clinicians choose the corresponding examination for clinical service better, and can diagnose the disease more accurately and quickly.

Objective To analyze the clinical characteristics and prognosis of pediatric inflammatory bowel disease (IBD) through a long-term follow-up so as to improve the diagnosis and management of IBD in children.Methods Seventy-three IBD patients admitted into our hospital from May 2000 to September 2010 were re-evaluated with the uniform diagnostic criteria proposed by the 2010 consensus diagnostic criteria for pediatric IBD.All patients were followed up by questionnaire,telephone and face-to-face interview.Results Among them,56 cases (76.7％) (ulcerative colitis (UC):n =34,Crohn's disease (CD):n =22) were available for follow-up study.Among 34 UC cases,13 cases had their diagnosis confirmed and 21 cases were diagnosed as probable UC.Meanwhile,among 22 CD cases,14 and 8 had definite and probable diagnoses respectively.At diagnosis,46.9％ (15/32) of UC patients had extensive colitis,40.6％ ( 13/32 ) left-sided colitis while 72.7％ ( 16/22 ) of CD patients with had ileocolonic.And 28 cases (82.4％ ) of UC patients and 20 cases (90.9％ ) of CD patients fulfilled the criteria for moderate to severe grade.Among 56 IBD cases,there was no death for CD,but 5 died for UC ( 14.7％ ).In the remaining 29 UC and 22 CD patients,16 cases (55.2％) and 15 cases (68.2％) stayed symptom-free ( P ＞ 0.05 ).Moreover,8 cases ( 27.6％ ) of UC and 3 cases ( 13.6％ ) of CD patients belonged to chronic relapsing type while 16 cases (55.2％) of UC and 15 cases (68.2％) of CD patients were of chronic persistent type.The physical activities of most IBD patients (n =49) were unrestricted.The surgical rate for IBD was 19.6％ (n=11),8.8％ for UC (n=3) and 36.4％ forCD (n=8) (P＜0.05 ).The incidences of surgical complications such as intestinal obstruction,intestinal perforation and hemorrhage of gastrointestinal tract were 7.1％ (n =4),7.1％ (n =4) and 1.8％ (n =1 ).And it was more common in the CD group.Conclusions Most IBD patients belong to chronic persistent type and then chronic relapsing type.Their physical activities are unrestricted.The surgical rate for CD is significantly higher than UC.And surgical complications such as intestinal obstruction,intestinal perforation and hemorrhage of gastrointestinal tract occur more frequently in the CD group.

Objective To evaluate the clinical outcomes of high-dose tirofiban in patients with ST-elevation myocardial infarction (ASTEMI) undergoing primary percutaneous coronary intervention (PCI).Methods A total of 104 consecutive ASTEMI patients undergoing primary PCI were enrolled from January 2010 to February 2011.They were randomized into the high-dose tirofiban group (n =52) and the normal-dose tirofiban group (n =52).We measured the sumST-segment resolution of ECG post-PCI respectively and left ventricular ejective fraction (LVEF) at Day 90 post-PCI.Results After PCI,the sumST-segment resolution of ECG of the high-dose tirofiban group significantly improved than that of the normal-dose tirofiban group (38％ ± 12％ vs 34％ ± 13％,P ＜ 0.05 ).Before PCI,LVEF of two groups is 50.2％ ±1.4％ vs 49.6％ ± 1.1％ (P ＞0.05),but at day 90 post-PCI,LVEF had significant difference between two groups (60.1％ ± 1.1％ vs 56.0％ ± 1.2％,P＜0.05).The rates of major and moderate hemorrhage did not differ significantly between two groups.Conclusion High-dose tirofiban improves myocardial reperfusion and clinical outccme.It re-emphasizes the importance of further platelet aggregation inhibition in ASTEMI patients undergoing primary PCI.

Objective To explore the relationship between occupational factors and the incidence of bladder cancer.Methods The present research was based on a hospital-based case-control study.The cases were frequency matched.The non-conditional Logistic regression was used to calculate the odds ratio (OR) of each occupation.Results The OR of business and administration professionals,male electricians and electronic workers were 3.88 and 7.40; the OR of janitors and helpers was 0.21 ; the OR of handcrafters and printing clerks was 0.71,but there was no significant difference.Conclusion Business and administration professionals,male electricians and electronic workers tend to have bladder cancer.The occupation of janitors and helpers has a protective effect on bladder cancer while the occupation of printing clerks shows no statistical significance on bladder cancer.

Objective To explore the prevalence of pertussis in hospitalized infants aged under 3 months with persistent cough.Methods The nasopharyngeal secretions and serum samples were collected from hospitalized infants aged under 3 months with cough for over 2 weeks from January 2011 to January 2012.The samples of nasopharyngeal secretion were suctioned and collected.Multiplex PCR assay was employed to identify Bordetella pertussis( B.pertussis)and enzyme-linked immunosorbent assay used to detect antibody to pertussis toxin (PT-IgG).Total bacterial DNA was exacted from nasopharyngeal secretion and two-target IS481/PT of B.pertussis was detected by PCR.Results Fifty-nine infants (32 boys and 27 girls) were enrolled.None of them was pre-immunized with diphtheria-pertussis-tetanus vaccine.Seventeen infants (28.8％ ) were B.Pertussis positive.Among 17 cases,3 infants under 1 month,4 infants 1 -2months,and 10 infants 2 -3 months.Three infants had household contacts with persistent cough and their serum antibodies to pertussis toxin were positive.Sixteen infants with pertussis had the paroxysms of frequent and rapid coughs while another 5 with pertussis had long inspiratory effort accompanied by a high-pitched "whoop" at the end of paroxysms.Seven infants with pertusis had conjunctiva bleeding,a special sign of pertussis.Ten infants had lymphocytosis with a predominant elevation of lymphocytes.Conclusions B.pertussis is an important pathogen for the infants under 3 months with persistent cough.Multiplex PCR may be used to identify B.pertussis with a high sensitivity.The unrecognized close family members of the infants with pertussis are probably an important source of infection.

Objective To evaluate the normal values of fractional exhaled nitric oxide (FENO) for Chinese adults.Methods A total of 200 non-smoking and healthy Chinese adults were recruited according to the inclusion and exclusion criteria.They received lung function and allergen skin prick tests at the Outpatient Department of China-Japan Friendship Hospital from February to August 2011.There were 100 males and 100 females.FENO test was performed according to the standard procedures of American Thoracic Society/European Respiratory Society (ATS/ERS) recommendation.The FENO levels of healthy non-smokers were tested by the NIOXMINO analyzer.All variables,such as age,gender,height,weight,forced expiratory volume at 1 second ( FEV1 )％ predicted and FEV1/FVC,were included for multiple regression analyses.Results The FENO level of healthy non-smokers was ( 14.2 ±5.6) × 10 -9 mol/L with the 95％ normal range of (3.2 -25.2) × 10-9 mol/L The value of FENO was significantly higher in males than females ( ( 15.6 ±5.5) vs ( 12.9 ± 5.4) × 10 -9 mol/L,t =3.48,P =0.001 ).The FENO level of the subjects aged 60 - 80years was ( 15.7 ±5.4) × 10-9 mol/L and it was higher than those aged 18 -60 years ( ( 13.8 ±5.6) × 10-9mol/L,t =2.04,P =0.040).Multiple regression analysis showed that gender was an independent influencing factor of FENO level.Conclusions The FENO level of non-smoking and healthy Chinese adults is similar with that of the westerners.Gender is an independent influencing factor of FENO level.

Objective To explore the relationship between methylation status of XAF1 (X-linked inhibitor of apoptosis protein associated factor-1 ) gene promoter and its protein expression in papillary thyroid carcinoma (PTC).Methods Methylation-specific polymerase chain reaction (MSP) and immunohistochemical substance P (SP) technique were used to detect the methylation status of XAF1 gene promoter and its protein expression in 70 PTC cases and their matched adjacent non-cancerous epithelium (NCE).Results In NCE,there was no promoter methylation of XAF1 gene while the rate was 35.7％(25/70) in PTC (x2 =27.206,P ＜ 0.01 ).And it was correlated with tumor TNM stage,pathological grade and lymph node metastasis ( P ＜ 0.05 ).The positive rates of XAF1 protein expression in NCE and PTC were 100％ (70/70) and 55.7％ (39/70) respectively.And there was significant difference(x2 =36.458,P ＜ 0.01 ).In PTC,the positive rates of XAF1 protein expression in Grades Ⅰ and Ⅱ were 67.5％(27/40) and40.0％ (12/30) respectively.And they were 35.7％ (10/28) and 69.0％ (29/42) in the lymph node metastasis and non-metastasis groups respectively.And there were significant differences between two groups (P ＜ 0.05 ).Futhermore,there was distinct correlation between methylation of XAF1 gene promoter and its protein expression ( x2 =8.864,P ＜ 0.01 ).Conclusion Methylation of promoter may be one of the important inactivating factors of XAF1 gene.And it plays an important role in the carcinogenesis and progression of PTC.

Objective To explore the effects of smoke on the clinical prognosis of patients with acute ST-segment elevation myocardial infarction ( ASTEMI).Methods A total of 1213 consecutive ASTEMI patients were admitted into 20 hospitals in Liaoning province between May 2009 and May 2010.They were stratified into smoke ( n =588 ) and non-smoke ( n =625 ) groups.Basic demographic profiles,treatment data and clinical outcomes were compared between two groups.The primary endpoint was cardiac death and the secondary endpoints included non-fatal myocardial infarction,stroke and revascularization.Cox proportional hazard analyses were performed.Results The proportion of percutaneous coronary intervention (PCI) in the smoke group was significantly higher than that in the non-smoke group (40.8％ vs 22.1％,P ＜0.001 ).During the follow-up period,the medication rate was significantly higher in the smoke group than that in the non-smoke group ( aspirin:75.3％ vs 62.2％,P ＜0.001 ; clopidogrel:40.5％ vs 32.2％,P =0.003 ; β receptor blockade:45.4％ vs 36.0％,P =0.001 ; angiotensin-converting-enzyme inhibitor/angiotensin Ⅱ receptor blocker (ACEI/ARB):38.3％ vs 32.2％,P =0.026; statins:57.3％ vs 44.2％,P ＜0.001 ).During the follow-up period,the rate of cardiac death was lower in the smoke group than that in the non-smoke group ( 10.2％ vs 24.2％,P ＜ 0.001 ).No significant differences existed between two groups.During the follow-up period,the rate of cardiac death was significantly correlated with smoke ( HR 2.777,95％ CI 1.113 - 6.928,P =0.029 ),PCI ( HR 0.208,95％ CI 0.062 - 0.700,P =0.011),age (HR 1.049,95％ CI 1.005 - 1.095,P =0.028),aspirin (HR 0.165,95％ CI0.061 -0.446,P ＜ 0.001 ) and statins ( HR 0.382,95％ CI 0.317 - 0.462,P ＜ 0.001 ).Conclusion Among the ASTEMI patients,the rate of cardiac death is significantly lower in the smoke group than that in the non-smoke group.And it is significantly correlated with such independent risk factors as smoke,PCI,age,aspirin and statins.

Objective To explore the positive rate of crab intolerance and its related factors in a healthy physical examination population in Beijing,China.Methods A cross-sectional survey was carried out from August 1,2008 to July 30,2009.It recruited a total of 12 765 adults with crab intorlerance at Health Sciences Center,Chinese PLA General Hospital.The epidemiological data were entered into computer by two persons and organized by Epidata3.0.Non-conditional Logistic regression model was used to calculate the values of odd ratio (OR) and 95％ CI.Statistic analysis was performed by SPSS 13.0.Results The incidence rate of crab intolerance was 24.5％ (3128/12 765 ) and increased with age.Grades of crab intolerance were associated with age and gender and there was a linear correlation tendency (P＜0.05).Incidence rate of crab intolerance in females (27.5％,1077/3912)was higher than that of males(23.2％,2051/8853).Multiple regression analysis showed that crab intolerance was correlated with age,gender,body mass index and helicobacter infections(all P＜0.05).In comparison with age group ＜40 years old,the values of OR(95％ CI)of age groups 41 -50,51 -60 and ＞ 60 years old were 1.224( 1.095 - 1.368),1.616( 1.431 - 1.827 ) and 2.177 ( 1.799 - 2.634 ) respectively.In comparison with males,the OR ( 95％ CI) of females was 1.286(1.174 -1.408).The OR(95％CI)of Helicobacter pylori infections was 1.303( 1.201 -1.413).In comparison with normal weighters,the OR(95％ CI)of obese subjects was 1.154 ( 1.026 - 1.298 ).Conclusions Crab intolerance may be correlated with age,gender,Helicobacter pylori infections and body mass index.Health education should be targeted at its characteristics.

Objective To explore the expression and clinical significance of signal protein Sema4C in esophageal cancer,gastric cancer and rectal cancer.Methods Fifty esophageal cancer,75 gastric cancer,50 rectal cancer and 20 corresponding normal mucous membrane specimens,collected during the period of January 2008 to December 2010,were detected with streptavidin-perosidase immunohistochemistry to detect the expression levels of Sema4C And the relationships of the Sema4C expression with clinicopathological data was analyzed.Results The expression levels of Sema4C in three kinds of cancers were significantly higher than the corresponding normal mucous membranes ( 80.0％ ( n =40 ) vs 20.0％ (n=4),77.3％ (n=58) vs25.0％ (n=5),80.0％ (n=40) vs15.0％ (n=3),allP=0.000).Furthermore,the percentage of Sema4C positive cells was significantly higher in carcinoma nests of tumors with lymphatic metastasis than those without (90.3％ ( n =28 ) vs 63.2％ ( n =12),85.0％ ( n =51 ) vs 46.7％ (n=7),92.0％ (n =23) vs 68.0％ (n=17),P=0.049,0.005,0.034).However,no significant correlations were found between the Sema4C expression with gender,age,location of tumors,types of cancer cells,cell differentiation,tumor size,depth of invasion or tumor stage (all P ＞ 0.05 ).Conclusion There is a high expression of Sema4C in esophageal cancer,gastric cancer and rectal cancer.And it is strongly correlated with lymphatic metastasis.Thus Sema4C may play critical roles in the invasion and lymphatic metastasis of esophageal cancer,gastric cancer and rectal cancer.

Objective To expiore the aging-related changes of insulin secretion and insulin sensitivity among nornmal glucose tolerance (NGT) individuals in China Methods A total of 34 293individuals were recruited.All of them were described as NGT by 75 g oral glucose tolerance test(75 g OGTT) according to the diagnotic criterion of WHO,1999.HOMA-β,△I30/△G30,InsAuc30/GluAuc30,InsAuc120/GluAuc120 were calculated to estimate insulin secretion; HOMA-IR and Matsuda index measured to estimate insulin sensitivity; Dispositon index:DI30 and DI120 were used to estimate β-cell function.Results HOMA-β,△I30/△G30,InsAuc30/GluAuc30 and InsAuc120/GluAuc120 were all lower in the elder group then the younger group ( P trend ＜ 0.05 ).The mean HOMA-β dropped from 192 ± 16(20 -29 years) to 115 ±7 (70 or elder) among men and from 162 ±8 (20 -29 years) to 120 ± 12 (70 or elder) among women.The mean △I30/△G30 dropped from 20.0 ±2.0 (20 -29 years) to 8.6 ±0.6 (70 or elder) among men and from 22.4 ±1.6 (20-29 years) to 12.5 ±1.7 (70 or elder) among women.The above index were negatively correlated with age in univariate linear regression (P ＜ 0.05 ),the results among men and overall still existed after adjusted for BMI and waist circumference in mutilivariate linear regression,while the relation between HOMA-β and age disappeared among women.Matsuda Index was positively correlated with age ( β =0.02,P =0.001 ) and HOMA-IR were negatively correlated with age ( β =-0.01,P =0.001 ) among men even after adjusted for BMI and waist circumference and the above correlation between Matsuda Index/HOMA-IR and ageing was not significant until adjusted for BMI and waist circumference in mutilivariate linear regression.Among women HOMA-IR ( β =- 0.01,P =0.000 ),Matsudaindex ( β =0.03,P =0.000).DI30 and DI120 were negatively correlated with age in both univariate and mutilivariate linear regression.Conclusions The basal,postchallenge insulin secretion and postchallenge islet compensatory function decreases with ageing,while insulin sensitivity does not deteriorate with ageing and its related change of body composition and weight gain.

Objective Iron is an essential micronutrient for human beings but its overload induces various diseases of liver,the main body storage site for iron,such as liver fibrosis.Curcumin is a natural polyphenol derived from turmeric and has been used widely.Its pharmacological action has attracted great attention in recent years.The apoptosis of rat cultured hepatocytes was induced by FeNTA (ferric nitrilotriacetate)-induced Iron overload.The present study was to examine the effect of curcumin at low concentrations on FeNTA-induced apoptosis of hepatocytes and elucidate the underlying mechanisms.Methods After the incubation of hepatocytes with 100 μmol/L FeNTA in the presence or absence of 1 - 10 μmmol/L of curcumin,a series of analyses were performed,including the analyses of hepatocytic apoptosis,the expressions of proteins relating with the regulations of cell apoptosis,caspase-3 activity,the production of reactive oxygen species (ROS) and nuclesr factor NF-κB activity.Results Curcumin reduced the FeNTA-induced hepatocytic apoptosis by 46.65％ and significantly down-regulated the protein levels of Bcl-2 and Bcl-XL In contrast,it had no effect on the protein levels of Bax and Bad.The curcumin treatment reduced FeNTA-caused production of ROS and caspase-3 activity by 45.01％ and 59.71％respectively.And the NF-κB activity was also inhibited.Conclusion Curcumin at low concentrations reduces iron overload-caused hepatocytic apoptosis and NF-κB activity,the key regulatory transcription factor for the inflammation-related gene expression in cultured hepatocyte.

Objective To explore the effects of N-benzyloxycarbonyl-Val-Ala-Asp-fluoromethylketone (Z-VAD-FMK),a broad caspase inhibitor,on the elicitation of murine allergic contact dermatitis (ACD) and examine the effects on T lymphocytes.Methods 1-fluoro-2,4-dinitrobenzene (DNFB) was used to establish the classical murine model of ACD.Different concentrations of Z-VAD-FMK were applied before ear provocation.Several parameters were detected,including ear swelling degree,weight differences and thickness of ear tissue under microscope between 2 ears.Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels ofThl cytokines (INF-γ and IL-2) in ear tissues.Real-time reverse transcription-polymerase chain reaction (RT-PCR) was used to detect their levels of mRNA and the results were shown as "copies relative to one million housekeeping genes".Local lymph node assay (LLNA)was conducted.Bromodeoxyuridine-flow cytometry was used to detect the proliferation of T lymphocytes in local lymph node and flow cytometry to detect the activation of T lymphocytes.Results The right ear swelling degree,weight differences and thickness between two ears in the 1.25 mmol/L Z-VAD-FMK group were ( 12.6 ± 1.2) × 10-2 mm,(3.1 ±0.2) mg,and ( 12.1 ± 1.1 ) × 10-2 mm respectively.And they were all significantly lower than those of the negative control group( ( 17.4 ± 1.6) × 10 -2 mm,(4.2 ±0.3)mg,( 16.7 ± 1.5) × 10 -2 mm;q =3.25,2.98,3.12,all P ＜0.05 ).The levels of INF-γ and IL-2 in the ear skin lesions of 1.25 mmol/L Z-VAD-FMK group were (856 ±45) and ( 167 ± 12) pg/ml respectively and they were both significantly lower than those of the negative control group( ( 1 180 ±58) and (225 ± 16)pg/ml;q =3.11,3.14,both P ＜0.05).The mRNA levels of the above two cytokines were 152 ± 12 and 96 ±8 respectively and they were both significantly lower than those of the negative control group (220 ± 15and 156 ± 11 ;q =3.15,3.42,both P ＜0.05).In LLNA,the mean intensity of BrdU in T lymphocytes of 1.25 mmol/L Z-VAD-FMK-treated group was significantly weaker than that of the negative control group ( 185 ± 15 vs 298 ±21,q =3.02,P ＜0.05 ).The percents of activation markers-positive T lymphocytes of the Z-VAD-FMK group were 7.8％ ±0.7％,9.8％ ±0.8％ and 31.2％ ±2.8％ respectively and they were all significantly lower than those of the negative control group ( 10.5％ ± 1.0％,14.5％ ± 1.1％,46.5％ ±3.2％,q =3.16,3.52,3.11,all P ＜0.05).Conclusion Topical use of Z-VAD-FMK prior to ear provocation can suppress the proliferation and activation of T lymphocytes in both skin tissues and local lymph nodes and thus result in the inhibitory effect of allergic contact dermatitis.

Objective To explore the role of neuregulin 1β (NRG-1β) in airway hypersecretion induced by interleukin ( IL)-1β.Methods After stimulating the airway epithelial cell line HBE16 with IL-1β,the expressions of NRG-1β mRNA and mucin (MUC) 5AC mRNA were detected by reverse transcription-polymerese chain reaction (RT-PCR),the proteins of NRG-1β and MUC5AC measured by enzyme-linked immunnsorbent assay ( ELISA ) and phosphorylated erythroblastic leukemia viral oncogene homolog (ErbB)1 -4 detected by Western blot.The cells were pre-treated with antibodies of ErbBI -4,inhibitors of p38 mitogen-activated protein kinase ( MAPK),ERK1/2,mitogen- and stress-activated protein kinase (MSK)1 and antibody of cAMP-response element-binding protein (CREB).After the addition of stimulant NRG-1β,MUCSAC was measured by ELISA.Results IL-1β could increase markedly the levels of NRG-1 β mRNA and MUC5AC mRNA and also the proteins of NRG-1β and MUC5AC in a dose-dependent fashion.NRG-1β at concentrations of 1,10,100,200 nmol/L increased the expression of MUC5AC (0.328±0.055,0.364 ±0.086,0.650 ±0.134,0.586 ±0.068) versus the control group (0.227 ±0.019 ).And the results had statistical significances (P ＜ 0.05 ).The expressions of phosphorylated ErbB2 and ErbB3 stimulated by NRG-1 β were positive while those of phosphorylated ErbB1 and ErbB 4 negative.After a pretreatment of antibodies of ErbB2,ErbB3,inhibitors of p38MAPK,ERK1/2,MSK1 and antibody of CREB and a stimulation of NRG-1β,the expression of MUC5AC decreased (0.221 ±0.033,0.238 ±0.044,0.386 ±0.021,0.352 ±0.022,0.294 ±0.017,0.252 ±0.019) versus the NRG-1β group (0.650 ± 0.134).And the results had statistical significances ( P ＜ 0.05 ).Conclusion IL-1 β may cause airway hypersecreton probably through the combination of NRG-1β with ErbB2 and ErbB3 heterodimers and the activation of MAPK/MSK1/CREB signal conduction.

Lifetime risk of cardiovascular disease can provide a more comprehensive assessment of the general population's overall disease burden now and in the future, helping to guide public health policy.The vast majority of current studies on lifetime risk assessment of cardiovascular disease ignore the potential impact of changes in long-term risk factors or medical-induced differences in birth cohorts.There is a lack of studies on lifetime risk assessment of cardiovascular disease in adults of different ages in black and white.Recently, the New England Journal reported the results of a meta-analysis (CLRPP study) evaluating lifetime risk of cardiovascular disease in different birth cohorts based on age,sex,ethnicity and other risk factors (N Engl J Med, 2012, 366:321-329).

In the aging population of developed countries, the vascular dysfunction of atherosclerosis and diabetes mellitus is related to the pathogenesis of cardiovascular diseases. There is a DNA repair mechanism in normal organisms, which can repair the damaged DNA. However, with the increase of age, this repair ability decreases, resulting in the accumulation of DNA errors. In this study, it was observed that the mutation of nucleotide repair DNA gene-ERCC1 leads to premature aging in mice. Therefore, the researchers speculated that vascular DNA damage is closely related to cell senescence, and cumulative DNA damage will lead to vascular dysfunction during the aging process (Circulation, 2012, Jun 15. [Epub ahead of print]).

Heart failure is a complex clinical syndrome, which is the ultimate fate of many cardiovascular diseases and the main cause of death. In recent years, the prevalence of heart failure is increasing day by day, and the rehospitalization rate and mortality rate are high, which brings great challenges to medical and health care. In heart failure, neuroendocrine is over-activated, and there is an interaction between inflammation and oxidative stress. Activated inflammatory mediators, reactive oxygen species free radicals and neuroendocrine system form a mutual regulatory network, which jointly participate in the occurrence and development of heart failure. Scientists have found that heart failure affects more than 750,000 people in Britain, and mitochondrial DNA plays an important role in the wrong activation of human immune system in patients with heart failure, which can start the natural response of human body to infection, so as to make a contribution to heart failure. Immune cells of patients with heart failure invade the heart, and this process is called inflammation.

Objective To introduce an independently developed remote-control locating device under the radiographic guidance for percutaneous nephrolithotomy (PCNL) and conduct small-scale animal experiment to test its application effect.Methods Five experimental minipigs were selected.And an animal model of nephrolithotomy was established by implanting stones from outside the body.This locating device for PCNL was used to locate before puncture under the radiographic guidance and then begin puncturing to the target stone following the located angle.Results Four pigs achieved single puncture after localization.During the puncture process,no obvious hemorrhage occurred.The average time from starting locating to finishing puncture was 20.7 min,the average time of locating 15.6 min and the average time of puncture 5.1 min.Conclusions This remote-control type of locating device can improve the accuracy and safety of puncture and minimize the radioactive exposure to operators.Thus it has an excellent perspective of further development and clinical application.

Case Abstract A 40-year-old male was found to have a mass in the supraclavicular area of the left neck for 2 weeks and went to our hospital on May 23, 2011. Physical examination showed a mass of about 5.0 cm ×3.0 cm in size at the left sternoclavicular joint, which was hard in texture, with clear boundary and no tenderness. Enhanced CT of the neck showed an oval soft tissue mass of about 2.8 cm ×4.6 cm in size in the intermuscular space above the lateral paraclavular head of the left thyroid gland. The internal density was uniform and the boundary was clear after plain scan. No obvious enhancement was found after enhanced scan, and there was a space-occupying effect. The surrounding soft tissue was compressed and moved, the left common carotid artery and vein were compressed and moved backward, the jugular vein was compressed and flattened, and the lumen of obstructed blood flow back was obviously expanded. The muscular space around the mass was clear. No obvious destruction of the bone of the left clavicle was observed. No obvious enlargement of the cervical lymph nodes was observed. Considering a benign tumor, the neurogenic tumor may be large, and the corresponding left jugular vein was compressed, and the lumen of obstructed blood flow back in the upper segment was obviously expanded. No clear abnormalities were found in the mediastinum and chest and lung. No clear evidence of malignant tumor was found in other examinations. A benign soft tissue tumor was considered clinically, and surgical resection was performed on May 27th.

Case Abstract A 62-year-old male was admitted to the Department of Endocrinology of Peking Union Medical College Hospital on April 11, 2011 due to erectile dysfunction for 5 years, hair loss, darkening of skin color, enlarged breasts, and enlarged hands and feet for more than 1 year. Since 2006, the patient had erectile dysfunction, accompanied by weight loss (a total of about 15 kg by the end of 2009). In October 2009, the hair, eyebrows, eyelashes and pubic hair fell out, and the growth of beard slowed down. In December 2009, the patient began to have slow response, poor spirit, memory loss, difficulty in concentration, decreased interest in things, easy fatigue, love sleep, and fear of cold. Hypoesthesia in distal extremities; The front end of the nail is curled inward, and the nail is easy to crack; Skin melanin deposition (obvious in wrinkles), areola and glans also have melanin deposition; The skin is rough and thickened, accompanied by itching; Bilateral breast enlargement, swelling and pain, no lactation;

Langerhans cell histiocytosis (LCH) is a rare clonal proliferative disease characterized by cellular infiltration of single or multiple organs with similar phenotypes to Langerhans cells (LC) [1]. The incidence of this disease is very low, with the incidence rate of (2~10) /1 million in children and (1~2) /1 million in adults [2]. The clinical characteristics of 33 patients with LCH from 1999 to 2011 were retrospectively analyzed and reported as follows.

After severe planing (burn) injury, the body is in a high catabolic state, which can quickly fall into negative nitrogen balance, which seriously affects the prognosis of patients. Skeletal muscle accounts for more than 50% of the total cell mass of the body, and is the largest nitrogen pool in human body. Skeletal muscle consumption is the most important manifestation of catabolism, which has a great influence on the overall metabolism of the body [1]. At present, it is believed that the maintenance and repair of skeletal muscle are mainly regulated by satellite cells [2]. The biological characteristics of satellite cells and their role in skeletal muscle consumption are summarized as follows.

A 41-year-old male was admitted to Qilu Hospital of Shandong University on December 9, 2011 due to "low back pain accompanied by pain in both lower limbs for 10 days and aggravated for 2 days". Ten days before admission, the patient had low back pain and persistent dull pain in his right lower limb. He had undergone lumbar magnetic resonance imaging (MRI) in a local hospital, considering the possibility of lumbar metastasis. After asking about the medical history, the patient had undergone laser and chemoradiotherapy treatment in Beijing 8 years ago for choroidal malignant melanoma in his right eye. Regular review of ophthalmic ultrasound, whole body bone imaging and other related examinations every six months after operation; No abnormalities were found in 8 years. In order to further clarify whether there were other organ metastases, positron emission computed tomography (PET-CT) examination was performed in the outpatient department of our hospital, which showed that the right fundus melanoma was treated with laser, radiotherapy and chemotherapy; There was no obvious local recurrence sign, suggesting metastasis of lymph nodes in right hilar and abdominal cavity (right stomach), and metastasis in right lung; liver metastases; Left subdiaphragmatic peritoneal metastasis; The patient suffered from multiple bone metastases. The lower back pain and left lower limb pain were worsened 2 days before admission. According to the results of PET-CT examination, the patient was admitted to the Department of Gastroenterology for further definition of the pathological classification of the tumor by liver biopsy.