186 serum samples from 81 patients with gastric cancer were determined for circulatingimmune complexe (CIC) by using the polyethylene glycol turbidity assay. Compared with 105healthy blood donors, the mean value of CIC were significantly increased in pretreatment pati-ents (47.46?24.52vs.27.67?12.09), and the corresponding figures for stage Ⅰ+Ⅱ, Ⅲ and stage Ⅳpatients were 38.60?14.24, 42.04?13. 18 and 54.31?29. 15 respectively. The incidence of positivityof CIC in pretreatment patients was 32.1%. The mean value of CIC is significantlyhigher in patients whose disease could not be treated with radical surgery than in patientswhose disease could.CIC levels increased significantly during 11～45 days after radical operation.CIC levels were positive correlated with levels of serum IgA, IgM, C_3, and negative corre-lated with the rate of lymphocyte transformation. The patients found positive for ANA hadhigher incidence of positivity of CIC than those found negative for ANA.The clinical signifi-cance of CIC in patients with gastric cancer was also discussed.

ObjectiveTo compare the clinical effect of posterior circumferential fusion with versus without intertransverse process fusion on lumbar instability in aged patients. MethodsThe elderly with lumbar instability were treated with the posterior instrumented circumferential fusion technique in 80 cases. Among 58 patients followed up for at least 2 years, 28 cases (group A)underwent posterior circumferential fusion with intertransverse process, while 30 cases (group B)without intertransverse process. X-ray examination was used before and 1, 3, 6, 12 and 24 months after operation to evaluate the fusion condition of the bone graft, and visul analogue scale (VAS) and Oswestry disability index (ODI) questionnaire were applied to assess the pain of center back and leg,and the conventional activity.ResultsThe operation time and blood loss were more in group A[(185.3±56.6) min and (376.3±92.9) m1] than in group B [(146.4±46.3) min and (234.3±64.5)ml (t=12.37, 37.49, P＜0.01)]. All the 58 cases were followed for at least 2 years. The 27 cases (96.4％) of group A and 28 cases (93.3％) of group B got bone fusion (x2 =0.004, P＞0.05).There were marked differences in the VAS of center back at 1 and 3 months after operation between the 2 groups (t=3.178, 2.158, both P＜0.05), while no difference at the other 3 time point. VAS about the leg pain and the ODI showed no differences between group A and B after operation (all P＞0.05). ConclusionsFor the lumbar instability in the elderly, the posterior circumferential fusion with or without intertransverse process fusion can achieve a similar high rate of fusion and satisfactory clinical results,andtheposteriorcircumferentialfusionwithoutintertranaverseprocess is recommended for less trauma.

Fructose-1, 6-bisphosphatase (FBPase), a rate-limiting enzyme involved in the pathway of gluconeogenesis, can catalyze the hydrolysis of fructose-1, 6-bisphosphate to fructose-6-phosphate. Upon inhibiting the activity of FBPase, the production of endogenous glucose can be decreased and the level of blood glucose lowered. Therefore, inhibitors of FBPase are expected to be novel potential therapeutics for the treatment of type II diabetes. Recent research efforts were reviewed in the field of developing allosteric inhibitors interacting with the AMP binding site of FBPase.

Objective To investigate the clinical manifestations, imaging features, diagnosis and management of pulmonary mycosis.Methods Fifty-four patients were identified with pulmonary mycosis by pathological examination in our hospital from January 2002 to June 2008. Data of clinical manifestations, imaging features, diagnosis and management were retrospectively reviewed.Results Of the 54 cases, 30 (55.6%) were pulmonary aspergillosis, 15 (27.8%) were pulmonary cryptococcosis. Underlying disease was reported in 42 of 54 (77.8%) cases. The diagnosis of all the patients was confirmed by pathological exami-nation. Lung or bronchi tissue was obtained by operation in 30 (55.6%) cases, by bronchofibroscope in 12 (22.2%) cases, by CT-guided percutaneous needle biopsy in 9 (16.7%) cases, and by lymphoid node biopsy in 4 cases. Main symptoms included cough (41, 75.9%), expectoration (30, 55.6%), hemoptysis (20, 37.0%), fever (16, 29.6%), and asymptomatic (6, 11.1%). The X-ray and chest CT showed masses or nodule lesions (41, 75.9%), patchy lesions (8, 14.8%), cavity (12, 22.2%), diffuse milliary nodules (1 case). Bilateral lungs were involved in 7 cases (13.0%);right lung alone in 26 cases (48.1%);left lung alone in 21 cases (38.9%). Among the 54 cases, 41 (75.9%) were misdiagnosed before pathological examination. Thirty (55.6%) cases underwent surgical resection of pulmonary lesions. One patient suffered from cryptococcal meningitis after operation. Twenty (37.0%) patients received systemic anti-fugal therapy. Cure or significant improvement was found in 16 cases. Conclusions The most frequently isolated fungi were Aspergillus, followed by Cryptococcus. Final diagnosis is mainly dependent on pathological examination. Clinical manifestations, imaging features, diagnostic procedures and management are different due to the difference of pathogenic fungi. Satisfactory Results can be obtained by anti-fungal therapy combined with surgical management.

Objective To describe the characteristics of organizational culture,to identify the level of quality of work life,and to explore the relationship between each dimension of organizational culture and quality of work life among nurses in tertiary hospitals in Yunnan Province,China.Methods The subjects were 416 nurses from six tertiary hospitals in Yunnan Province.Research instruments were the Organizational Culture Profile (OCP) and the Quality of Work Life Scale (QWLS).Results The results of this study showed that four dimensions of organizational culture including competitiveness (3.56 ± 0.49);performance orientation (4.08 ± 0.22);stability (3.68 ± 0.43) and social responsibility (3.95 ± 0.37) were prominent.The other 3 dimensions,namely supportiveness (3.19 ± 0.79);innovation (3.21 ±.0.62) and emphasis on rewards were perceived (2.42 ± 0.79) as less prominent.The overall mean score of quality of work life was at a moderate level (57.46 ± 15.17).Conclusion There are positive significant correlation between each dimension of organizational culture and quality of work life (P＜ 0.01).Improvement of organizational culture can enhance quality of work life among nurses,and then guarantee the nursing quality.

【Objective】To study the effect of light weight-bearing activity on postmenopausal osteoporosis.【Methods】36 female rats were randomly divided into 3 groups:① Sham,② Ovx (ovarietomized),③ Ovx+Im (ovarietomized and immobilized).All the group's maintained daily activity.And because of being immobilized,the right hind limbs of the third group lacked weight-bearing activity.12 weeks after ovarietomy,the BMD (bone mineral density),histomorphometry and biomechanics of the right femurs of rats were measured and analyzed.【Results】Comparing with the Sham group,the Ovx group's right femurs were manifested with the decrease of BMD,TBV (trabecular bone volume),MTT(mean trabecular thickness) and MCT(mean cortex thickness),while the increase of RS(resorption surface) and OS(osteotoid surface).Meanwhile their biomechanic nature declined.But statistically the BMD,MCT and the criteria of mechanical strength were not significant decrease.Otherwise,the Ovx+Im group's right femurs showed more apparent decrease of BMD,TBV,MTT and MCT.And the biomechanic nature was worse.Comparing with the Sham group,the BMD,MCT and the criteria of mechanical strength of the Ovx+Im group were statistically significant decreased.【Conclusion】If maintaining light weight-bearing activity,the ovarietomized rats were able to maintain relatively better bone quality.A lack of light weight-bearing activity wouldcause thedecline of bone quality.Thusthestudy suggested light weight-bearing activity was significantly effective on the prevention and treatment of postmenopausal osteoporosis.

Objective The aim of this study was to assess the value of △Np63α in predicting tumor recurrence after curative resection in esophageal squamous cell carcinoma (ESCC) patients.Methods We analyzed △Np63α protein cxpression in 304 clinicopathologically characterized ESCC cases by immunohistochemistry.Results We found △Np63α expression was positive in 122 (40％) of 304 cases.△Np63α expression was higher in the cancer tissue than in non-tumorous control tissue at protein level(P =0.034).There was a significant difference of △Np63α expression in patients categorized according to invasive depth (P =0.001),tumor position (P =0.001) and lymph nodes metastasis condition (P =0.001).Multivariate analyses showed that △Np63α was an independent prognostic marker for ESCC recurrence.Conclusion △Np63α is associated with outcome of ESCC and can be a novel predictor for poor prognosis of ESCC patients after curative resection.

ObjectiveTo establish a new biomechanical test for evaluating biomechanical properties of femoral metaphysis in ovariectomized rats.MethodsTwenty-five-month-old female Sprague-Dawley rats were randomly divided into ovariectomized (OVX) group and the sham-operated (Sham) group (n=10).Twelve weeks after operation,femur BMD and histomorphometry of distal femur were detected.Furthermore,femur biomechanical parameters were determined by diaphysis three-point bending test and a new designed metaphysis bending test.The relationships between the biomechanical parameters and BMD or bone histomorphometry were assessed with Pearson correlations.ResultsThe femur BMD,bone histomorphometrical indexes(％Th.Ar,Tb.N,Tb.Th),and biomechanical parameters(maximum load,yield load and stiffness) of OVX group significantly decreased compared with Sham group.In metaphysis bending test,the mean difference of the maximum load(Fmax),yield load(Fy) between group OVX and Sham were significant higher than that in diaphysis three-point bending test.Positive correlations between biomechanical parameters and femur BMD or bone histomorphometry indexes were observed in both the diaphysis bending and metaphysis bending test.The biomechanical parameters in the metaphysis bending test showed stronger correlations with BMD and bone.ConclusionFemur metaphysis bending test could be used to evaluate the biomechanical properties of osteoporosis.When compared with diaphysis bending test,femur metaphysis bending test is more sensitive in evaluating the change of biomechanical properties of femur in osteoporotic rats.

BACKGROUND: Epidural block(EB) is one of the effective and widely used remedies for lumbar disc herniation(LDH) . Animal experiments have been conducted to study the changes in the local tissue structure in the spinal canel after several treatments with EB.OBJECTIVE: To study the effect of EB for LDH on the local tissue structures in the spinal canel.DESIGN: A non-randomized and controlled clinical observation.PARTICIPANTS: Department of Pathology and Laboratory of Electron Microscope of an Affiliated Hospital of a University.SUBJECTS: Forty patients with LDP, who failed to respond to EB treatment and subsequently received discectomy in the Department of Orthopaedics,First Affiliated Hospital of Sun Yat-sen University from May 1992 to December 1997, were enrolled in this study, with 20 patients receiving discectomy but not EB treatment serving as the control group.METHODS: From the 60 cases, totally 120 specimens of yellow ligament and the disc tissues were obtained during discectomy for optical microscopical examination. A portion of the yellow ligament and the lumbar disc tissues were chosen from EB group(12 cases) and non-EB group(10 cases), respectively, for electron microscope examination(involving altogether 44specimens) . The changes in histology and ultrastructnres in the specimens were compared between the two groups.MAIN OUTCOME MEASURES: ① Main results: the reactive proliferation of the tunica adventitia and inflammatory reaction of the intervertebral disc and yellow ligament; ② Secondary results: changes in the ultrastructure of the anulus fibrosus, nucleus pulposus and yellow ligament.RESULTS: No significant difference was found between the two groups either in light microscopy or electron microscopy in the degree of smoothness and the inflammatory reaction of the cavosurface of the yellow ligament and the disc tissues, nor in the cellular ultrastructures and fibrous arrangement.CONCLUSION: There is no direct relationship between lumbar EB and epidural scar adhesion formation. EB does not affect the ultrastructures of the local tissues in the spinal canal, but care must be taken of the sterilization in the surgical procedure, as chronic inflammatory reaction in the yellow ligament and disc tissues can be present in some patients.

ObjectiveTo assess the balance between regulatory T (Treg) cells and T helper 17 (Th17) cells in patients with serofast syphilis.MethodsBlood samples were collected from 26 patients with serofast syphilis and 23 normal human controls.Flow cytometry was performed to determine the proportion of Treg and Th17 cells in peripheral blood and to quantify the expression of specific transcription factors Foxp3 and ROR-γt in CD4+ T cells of these subjects.Correlation analysis was carried out.ResultsThe proportion of Treg cells in CD4+ T cells in the patients with serofast syphilis was 33.28％ ± 11.84％,significantly higher than that in the normal controls(22.13％ ± 7.79％,P ＜ 0.01 ),while the proportion of Th17 cells was significantly lower in the patients than in the normal controls(3.17％ ± 2.32％ vs.8.87％ ± 2.00％,P ＜ 0.01 ).Enhanced expression of Foxp3 and attenuated expression of ROR-γt were observed in CD4+ T cells from the patients compared with the controls(2994.86 ± 1099.18 vs.2539.72 ± 1086.96,P ＜ 0.05; 1473.12 ± 752.20 vs.1778.34 ± 388.13,P ＜0.05).There was a negative correlation between the expression of Foxp3 and ROR-γt in CD4+ T cells from all the subjects (r =-0.481,P ＜ 0.01 ).ConclusionThe Treg/Th17 cell balance is abnormal in peripheral blood of patients with serofast syphilis.