Objective To observe the influence of low epidural anesthesia on heart rate variability (HRV) and blood pressure,heart rate in elderly hypertensive patients.Methods 125 patients who were adopted routine selective pelvic cavity operation or lower limb operation were divided into the two groups,the observation group(56 cases) complicate with hypertension,control group (69 cases)with normal blood pressure.The heart rate,blood pressure and low frequency,high frequency of HRV before and 5min,15min,45min after anesthesia were monitored and compared.Results Before operation and 5,15,45 min after anesthesia,the systolic blood pressure were (150.2 ±12.4)mmHg,(142.6 ±12.9)mmHg,(127.6 ±12.9)mmHg,(123.7 ±11.3)mmHg,diastolic blood pressure were(84.2 ±12.3)mmHg,(75.3 ±10.4)mmHg,(73.7 ±8.61)mmHg,(71.7 ±7.3)mmHg,heart rates were (88.4 ±11.3)times/min,(82.3 ±9.1)times/min,(78.4 ±10.5)times/min,(77.5 ±10.5)times/min,low frequency ofHRV were (87.5 ±23.7)Hz,(76.4 ±22.2)Hz,(55.4 ±22.1)Hz,(62.4 ±21.3)Hz,high frequency of HRV were(50.2 ±22.2)Hz,(32.3 ±16.7)Hz,(29.5 ±18.3)Hz,(26.3 ±18.4)Hz in the observation group;The systolicblood pressure were (133.6 ±11.4)mmHg,(123.1 ±9.5)mmHg,(121.6 ±10.1)mmHg,(120.3 ±16.3)mmHg,diastolic blood pressure were (77.3 ±11.8)mmHg,(71.4 ±10.5)mmHg,(70.4 ±10.2)mmHg,(71.2 ±8.6)mmHg,heart rate were (85.8 ±10.7 )times/min,(85.8 ±10.7 )times/min,(84.3 ±11.4)times/min,(84.5 ±11.9)times/min,low frequency of HRV were (69.1 ±20.7)Hz,(59.6 ±22.1)Hz,(45.7 ±26.8)Hz,(56.3 ±17.4)Hz,high frequency of HRV were (39.5 ±20.3)Hz,(34.6 ±18.9)Hz,(40.6 ±21.7)Hz,(41.1 ±18.1)Hzin the control group;The systolic blood pressure and diastolic blood pressure in the observation group after anesthesiawere lower than those before operation(systolic blood pressure:t =4.622,5.361,5.732,all P <0.05;diastolic bloodpressure:t =4.778,5.246,5.835,all P <0.05),The systolic blood pressure and diastolic blood pressure in the control group after anesthesia were lower than those before operation(systolic blood pressure:t =3.135,3.526,3.778,allP <0.05;diastolic blood pressure:t =3.636,3.578,3.467,all P <0.05),The systolic blood pressure and diastolicblood pressure in the observation group declined by a larger margin than those in the control group(t =3.782,3.825,3.562,all P <0.05),the heart rate after anesthesia were lower than those before operation both groups(observationgroup:t =4.613,5.724,6.146,all P <0.05;control group:t =3.143,3.672,3.572,all P <0.05),the heart rate inthe observation group declined by a larger margin than those in the control group(t =3.052,3.462,3.782,all P <0.05),low frequency of HRV and high frequency of HRV in the observation group after anesthesia were lower thanthose before operation(low frequency of HRV:t =4.144,5.156,4.714,all P <0.05;high frequency of HRV:t =4.614,4.352,4.667,all P <0.05),low frequency of HRV and high frequency of HRV in the control group after anesthesia were lower than those before operation(low frequency of HRV:t =2.625,3.622,3.725,all P <0.05;highfrequency of HRV:t =3.273,3.605,3.726,all P <0.05),low frequency of HRV and high frequency of HRV in theobservation group declined by a larger margin than those in the control group(low frequency of HRV:t =3.578,3.061,3.136,all P <0.05;high frequency of HRV:t =3.851,3.414,3.684,all P <0.05).Conclusion Low epidural anesthesia would exert huge impact to the autonomic nervous system of elderly hypertensive patients.

Objective To investigate the effects of imatinib mesylate on recurrent or metastatic gastrointestinal stromal tumor.Methods Thirty-five cases of patients with recurrent or metastatic gastrointestinal stromal tumors treated with Imatinib mesylate from January 2007 to February 2010 in our hospital were analyzed retrospectively.Results After treated with Imatinib mesylate for 3 months,complete remission rate was 2.9％( 1/35 ),partial remission rate was 45.7％ ( 16/35 ),stable disease rate was 51.4％ ( 18/35 ) and progressive rate was 0;clinical benefit rate was 100％.The 2-year overall survival rate was 97.1％.The 2-year progression free survival was 82.9％.Conclusion Imatinib mesylate is effective for recurrent or metastatic gastrointestinal stromal tumors and the treatment is safe and reliable.

Objective To explore changes of serum fibroblast growth factor 2 (FGF2) levels after treatment with imatinib mesylate in patients with unresectable or metastatic gastrointestinal sromal tumor.Methods Serum FGF2 levels (with ELISA) were determined in 27 patients with unresectable or metastatic gastrointestinal stromal tumor both before and after treatment with imatinib mesylate.Results Before treatment with imatinib mesylate,of 27 cases of unresectable or metastatic gastrointestinal stromal tumor,17 cases (63.0 ％) were found positive for serum FGF2,after treatment with imatinib mesylate,9 cases (33.3 ％) were found positive for serum FGF2 (P ＜ 0.05).Using imatinib mesylate for 3 months,complete remission rate was 0,partial remission rate was 51.9 ％ (14/27),stable disease rate was 48.1％ (13/27) and progressive rate was 0.Conclusion Patients with unresectable or metastatic gastrointestinal stromal tumor have elevated serum FGF2 levels.Imatinib mesylate treatment can reduce serum FGF2 levels in patients with unresectable or metastatic gastrointestinal stromal tumor.

Objective To investigate the clinical characteristics and current condition of treatment for systemic lupus erythematosus (SLE) associated pulmonary arterial hypertension (PAH).Methods 10-year inpatients cases were reviewed and followed up.Cases were divided into 2 groups:group A:patients with baseline pulmonary arterial systolic pressure (PASP) lower than 70 mmHg； group B:patients with baseline PASP higher than 70 mm Hg.Pearson's correlation analysis,Chi-square test,Logistic regression,Cox-Mantel and Wilcoxon test were used for statistical analysis.Results There were totally 155 cases with 184 records of admission which accounted for 4.16％ among total lupus cases.The main clinical characteristics included Raynaud's phenomenon (47.3％),pericardial effusion (41.9％) and high titer of anti-RNP antibody (55.4％).There were 132 cases enrolled for prognostic statistical analysis.There were 47 cases of death (35.6％) in total,among which 9 cases (19.1％) were in group A and 38 cases (80.9％) were in group B.In group A,there was a positive correlation between PASP and lupus disease activity index score.Single therapy analysis by Chi-square test showed that cyclophosphamide (CTX) (P＜0.05) and PAH targeted drugs (P＜0.01) were significantly associated with favorable outcome but logistic regressive analysis only confirmed the efficacy of target drugs (P＜0.01).PAH target drugs significantly improved the one year survival rate of the severe cases.Conclusion The main clinical characteristics of SLE associated PAH include Raynand's phenomenon,pericardial effusion and positive anti-RNP antibody.The severity of PAH may not be related to lupus disease activity.PAH targeted drugs are effective in SLE-PAH.CTX may be effective in some cases.For severe cases,the combination therapy of CTX and PAH targeted drugs could significantly improve the prognosis.

Objective To investigate the effect and mechanism of EGFR in inducing vasculogenic mimicry (VM)formation.Methods Immunohistochemistry was used to detect the expression of EGFR protein and CD34-PAS double staining was used to detect the VM in gliomas paraffin blocks.The migration and VM formation of U87 cell in hypoxic and normoxic groups were detected by transwell and three-dimensional culture.Then we used Western blot to detect the expressions of EGFR,AKT and PI3K protein.Results The positive rate of EGFR expression in VM positive patients was 94.4%,which was significantly higher than that in VM negative patients (71.8%).In hypoxic group,the abilities of migration and VM formation were significantly higher those in normoxic group.The expressions of EGFR,AKT and PI3K were higher in hypoxic group.Conclusion VM formation can be induced by the activation of EGFR/AKT/PI3K signaling pathway.EGFR is very important for VM formation.

Objective To compare serum protein fingerprint among Uygur patients with thyroid cancer and benign thyroid nodules, and Han patients with thyroid cancer, and to screen ethnic-specific protein markers of thyroid cancer. Methods Using the technology of two-dimensional polyacrylamide gel electrophoresis (2D-PAGE), the protein expression profiles of Uygur and Han patients with thyroid cancer and Uygur patients with thyroid nodules were established and compared by image analysis software between two groups. Liquid chromatography-mass spectrometry/mass spectrometry coupling techniques ( LC-MS/MS) were used to identify differential protein. The protein′s name, cellular localization and functional classification were searched in Swissport database. Results There are 11 differentially expressed proteins by comparison of sera in Uygur patients with benign thyroid nodules and thyroid cancer, in which complement C3 and C4b levels were down-regulated in the serums of Uygur patients with benign thyroid nodules, and 9 proteins such as heme-binding proteins etc were up-regulated. There are 7 differentially expressed proteins by comparison of serums in Uygur and Han patients with thyroid cancer, in which transferrin level was up-regulated in the serum of Uygur patients with thyroid cancer, and 6 proteins such as cytokeratin-1 etc were down-regulated in serum of Uygur patients with thyroid cancer. Conclusion Combined screening of multiple labelled proteins including heme-binding protein,α2-macroglobulin, and transferrin protein etc may provide the basis for the diagnosis of thyroid cancer in Uygurs and Hans.

In order to explore more reasonable and scientific accounting method of community health service costs, to improve the accounting method system of community health service cost. In the current existing community health services costing methods, based on the analysis of hospital cost accounting methods system, analyze and imitate the accounting method of hospital costs, establish a more scientific and implemented accounting method system of community health service costs: divide parts of clinics scientifically, redesign the center acollation method of indirect cost, confirm different cost accounting methods for different cost accounting objective and provide suggestion for the improvement of project cost accounting.

Objective To evaluate the imaging features of phyllodes tumor of the breast.Methods 35 patients with phyllodes tumor of the breast confirmed by surgery and histopathology were collected.All clinical and imaging findings were analyzed.Results 35 cases with 36 lesions were classified as benign (1 9 lesions),borderline (8 lesions),and malignant (9 lesions).The typical ap-pearances on mammography were ellipse (1 6/36)or lobulated (20/36)mass.Most of them were high density (30/36)and clear boundary (28/36).No evidence of calcification,spiculated margin,skin thickening,nipple retraction and enlargement of axillary lymph nodes were detected.On MRI,1 lesion presented as lobulated mass with nonuniform hypointensity on T1 WI,hyperintensity on T2 WI and DWI.The time-intensity curve was Ⅱ type on dynamic contrast enhancement MRI.Conclusion The clinical and ima-ging features of phyllodes tumor are characteristic.These features are helpful to preoperatively diagnose,the final diagnosis would confirmed by histopathology.

ObjectivesTo explore the serum insulin-like growth factor-1 (IGF-1)levels in the patients with unresectable or metastatic gastrointestinal stromal tumors before and after imatinib treatment and to discuss its clinical significance.MethodsThe serum samples of27 patients with unresectable or metastatic gastrointestinal stromal tumors were collected before imatinib treatment(before treatment group) and three months after imatinib treatment(after treatment group).The other serum samples were collected from 20 healthy volunteers who were accepting health examination (control group). The serum IGF-1 levels of the samples were determined by enzyme-linked immunosorbent assay (ELISA).ResultsThe mean serum IGF-1 levels were significantly higher in before treatment group than in control controls[(463.61±120.98)ng/ml vs.(115.75±39.27) ng/ml, t=12.355,P=0.000)]. Three months after imatinib treatment,the mean serum IGF-1 levels were significantly lower in after treatment group than in before treatment group [(244.64±100.11)ng/ml vs.(463.61±120.98) ng/ml, t=7.582,P=0.000].ConclusionsSerum IGF-1 levels may help to judge therapeutic effect,progression,recurrence or metastasis of the gastrointestinal stromal tumor.

BACKGROUND:Recent studies have found that adipose mesenchymal stem cells can inhibit immune responses of T cells, B cells and dendritic cells. But it is unclear whether adipose mesenchymal stem cells are able to regulate the immune responses of macrophages. OBJECTIVE:To observe the expression of interleukin-6 and tumor necrosis factorαin J774.1 cells co-cultured with adipose mesenchymal stem cells co-cultured. METHODS:Adipose mesenchymal stem cells at a density of 2×107 per wel were inoculated into the upper chamber of the transwel and 24-wel plates. Then, J774.1 cells were suspended with cellculture medium containing 1 mg/L lipopolysaccharide and planted into the lower chamber of the transwel and 24-wel plates containing adipose mesenchymal stem cells as co-culture group. Meanwhile, inactive J774.1 cells to lipopolysaccharide-activat J774.1 cells served as negative and positive control groups, respectively. After 48 hours, the J774.1 cells were col ected to extract the RNA samples. Then, mRNA expressions of interleukin-6 and tumor necrosis factorαwere measured by real-time quantitative PCR. RESULTS AND CONCLUSION:Compared with the positive control group, direct-contact co-culture of adipose mesenchymal stem cells and J774.1 cells significantly reduced expressions of interleukin-6 and tumor necrosis factorαin J774.1 cells, but non-contact co-culture only reduced interleukin-6 expression. These findings indicate that adipose mesenchymal stem cells can inhibit the immune response of J774.1 cells activated by lipopolysaccharide.