0.05).The metastasis rate in patients with both C-erbB-2(+) and MDR1(+) was higher than the others.Their prognosis was negative.The metastasis rate in patients with both C-erbB-2(+) and Nm23(-) was higher than the others.Conclusion There are correlation between C-erbB-2,Nm23,MDR1 expressions and metastasis of breast cancer.Multi-predictors are better guide to patients than single predictor.

Objective To assess whether end-tidal carbon dioxide partial pressure (PET CO2) can predict the fluid responsiveness in septic shock patients.Methods Septic shock patients under mechanical ventilation without spontaneous breathing and with the need of a fluid challenge test were included in this study.Heart rate,central venous pressure,pulse pressure,PErCO2,and CI before and after the fluid challenge test were conducted in all the patients.Results Of the 48 septic shock patients included,34 had preload responsiveness,14 had no responsiveness.△CI and △PET CO2 after the fluid challenge test involume responders were (0.85 ± 0.47) L · min-1 · m-2 and (3.5 ± 2.5) mmHg respectively,which were higher than those in no volume responders (P ＜ 0.05).The fluid-induced changes in PET CO2 and CI were correlated (r =0.072,P ＜ 0.05).The AUCRoc of fluid challenge-induced △PET CO2 as the predictor for volume responsiveness was 0.943,and its sensitivity was 87.9％ and specificity was 93.4％ with a critical value of 5％.The AUCRoc of △PP as the predictor for volume responsiveness was 0.801,and its sensitivity was 68.1％ and specificity was 73.2％ with a critical value of 10％.Conclusion The changes of PETCO2 induced by a fluid challenge test can predict fluid responsiveness with reliability,and have a better sensitivity and specificity than the changes of PP.

The morphological and functional changes of the lungs of rats in blast injury were analyzed and related with a microcomputer-assisted morpho-metry.The results were as follows:1.Significant correlation or partial correlation existed between stereological and functional indices,2.Changes of endothelium and epithelium rather than the interstitium contributed to the increase of harmonic and arithmetic mean thickness of the air-blood barrier.3.The regression equations included the following:a.PaO2=3.56 + 1.62DL (O2),r=0.678,P=0.032b.PaO2=2.99+3.49DL(O2)-0.0005SA+0.0035SC-38.2VC-0.257Tap -0.028Dt (O2)ry=0.999,P=0.008c.PaCO2=7.69+0.0001SA-4.35Tat+19.7Tht-46.2Thp-4.4Taen-5.87Tacp ry=0.9999,P=0.014d.pH=3.058 + 0.0005SA-1.79Tat + 12.2Tht-50.8Thp-2.52Taent+0.69DL(O2)ry=0.9999,P=0.01The significance and application of stereology in the establishment of the quantitative relationship between morphological and functional indices were discussed.It is possible to correlate morpheme trie parameters with the functional changes of an organ.

Objective To investigate the expressions of caspase-6,-7 during skin wound healing and the applicability of the time-dependent expressions of caspase-6,-7 to determination of the wound age.Method The expressions of caspase-6,-7 were studied in skin incised wound in mice by immunohistochemical SABC method,and the non-incised mouse skin was used as control.Results Expressions of caspase-6,-7 were detectable in polymorphonuclear cells (PMNs) in the wound specimens aged 6h. In the wound specimens aged from 12h to 24h after injury, caspase-6,-7 were identified in a large number of infiltrating PMNs and part of mononuclear cells (MNCs). Afterwards, the MNCs and fibroblastic cells (FBCs) accounted for the most part of the caspase-6,-7-positive cells. Morphometrically, the ratios of the number of the caspase-6,-7-stained PMNs, MNCs and FBCs to total number of the cells in the wounds were evaluated and calculated. The ratios of the caspase-6,-7-positive cells were low in the wound specimens aged from 0h to 3h, and maximized in the wound specimens aged 3 day. Thereafter, the ratios decreased and minimized in the specimens aged 14 day.Conclusion The results suggest that caspase-6,-7 were expressed in neutrophils, macrophages and fibroblasts during healing process of skin incised wound in mice. Caspase-6,-7 may be used as a marker for the wound age determination.

Hitherto, it is reported that caspase family includes 14 members at least, which play important roles in executing cell apoptosis. Experimental studies have proved that caspases are expressed and activated in the injured skin and during skin wound healing, which suggests that cell apoptosis induced by caspases may occur. Further investigation on the roles that caspases play in the injured skin and during skin wound healing may offer a new way for the clinical treatment of the skin wound and the medico-legal wound age determination. The article reviews the biologic characters of caspases and the advances in the studies on the caspases in the skin wound and wound healing. It is suggested that caspases exert significant parts during skin wound healing, which are worthy of further investigation.

Objective To evaluate the influence of different antigen retrieval methods and pH values of fixatives on immunostaining of incised wound skin.Methods 3d-post-incision mouse skin were sampled and fixed in 4% formalin buffered with PBS at pH 5.0,6.0,7.0,8.0 and 9.0.The deparaffinized sections were treated 0.01mmol citrate buffuer(pH 6.0)in high pressure cooker or by microwave heating,or with pepsin,trypsin or microwave+pepsin.Thereafter,immunostainings of caspase-3,caspase-6,caspase-7,IL-8,and IL-10 were evaluated by immunohistochemical SABC method with ratio of immunostaining-positive cells,respectively.Results The immunostaining-positive cell ratios in sections treated by heating retrieval was higher than by proteinase treatment.The positive cell ratio was slightly higher by high pressure than by microwave heating.Sections were more easier peeled off during high pressure treatment than during micrwave heating.Sections treated with pepsin were fallen off easier than with trypsin digestion.The highest positive cell ratio was detected in sections by microwave+trypsin treatment without section peeling off among all antigen treatment methods.The best result was obtained in sections fixed in buffered formalin at pH 7.0 and 8.0.Conclusion The best immunostaining result may be obtained in mouse incised wound sections fixed in buffered formalin at pH 7.0 and 8.0 with microwave+trypsin treatment.

Purpose To study X-ray and CT findings of pulmonary infection in AIDS. Methods We evaluate 10 cases who have chest abnormalities. The all patients have X-ray and CT examination. Results Imaging of pulmonary tuberculosis in AIDS, including infiltrative imaging and diffuse patchy imaging, enlarged mediastinum lymph nodes and extra chest enlarged lymph nodes. The imaging of legionella species is infiltrative imaging. Carinii pneumonia appearances diffuse infiltrative and interstitial abnormalities. Conclusion Pulmonary tuberculosis, legionella species and carinii pneumonia are common infections in AIDS. The patchy, consolidations, diffused diseases and enlarged lymph nodes are important imaging appearances.

Objective To evaluate the application value of hip joint traction device in treating serious developmental dysplasia of the hip. Methods From April 2006 to October 2008, 6 cases Crowe Ⅳ hip dysplasia and 1 case dysplasia of acetabulum in coxa vara underwent arthroplasty. There were 2 males and 5 females with an average age of 30 years (range, 12-45). All patients were admitted to the hospital for the distraction, which was 1.0-2.0 cm on the first day and 1 mm/d thereafter, until slowly pulling femur head to the real acetabulum. Changing to the skin distraction with 3 kg, arthroplasty was performed after pin sites healing. Results Seven femur heads of 5 cases and two greater trochanters of 1 case were pulled into the real acetabulum, average distraction length was 4.45 cm, and average time was 43 d, no nerve injury and infection of pin sites. Soft tissue release and femur shortening were not required in arthroplasty. One case accelerated pulling speed to 1.25 mm/d when left femur head was distracted to 6.0 cm, so that the partial left deep peroneal nerve injury happened after 12 h. Ending distraction, bilateral THA was undergone by stages and femur shortening 3 cm in operation, nerve injury restored after half year. All patients were followed up for average 2.5 years (range, 1.5-3.0). In all patients, two limb lengths were equal, middle gluteal muscle myodynamia improved about 1-2 grades. The mean Harris hip score improved from 56.2 to 92.2 one year after operation. Conclusion The hip joint traction device could pulled femoral head to the real acetabulum rotating center, as a result, femur shortening and soft tissue release were not required while performing arthroplasty, and through which wound and operative time were decreased, middle gluteal muscle function was improved. However, we should strictly pulled the femur head at 1 mm/d to avoid nerve injury.

Objective To explore the role of severity of limb ischemic injury in the treatment of popliteal artery injury.Methods A retrospective analysis was conducted of 259 patients with popliteal artery injury who had been treated from January 2002 to December 2014.They were 187 males and 72 females with a median age of 37.6 years (range,from 14 to 68 years).The time from injury to revascularization was from 4 hours to 29 days.According to the Rutherford classification system,the limb ischemic injury was categorized into 4 grades:grade Ⅰ:presence of sense and motion;grade Ⅱ:presence of sense but loss of active motion;grade m:loss of sense or motion;grade Ⅳ:stiffness.For all the patients with injury of grades Ⅰ and Ⅱ,limb salvage was adopted and opening decompression to osteofascial compartment was performed depending on the intraoperative and postoperative limb swelling.For the patients with grade Ⅲ injury,opening decompression to osteofascial compartment was performed to explore the activity of muscles in those with a strong will to preserve their limbs.When the muscle activity was poor but bright red bleeding was found at the broken muscle ends and there were no fish-like changes in muscles,limb salvage was suggested;otherwise amputation was chosen.For all the patients with grade Ⅳ injury,amputation was suggested.Results Of the 146 cases of limb salvages,142 were successful and 4 failed due to uncontrollable infection,giving a total success rate of 54.83％ (142/259).Complete rupture of the popliteal artery occurred in 23 cases,incomplete rupture or tear in 17,contusion and thrombosis in 219.No patient died due to popliteal artery injury or its complications.The patients with injury of grades Ⅰ,Ⅱ,Ⅲ and Ⅳ were respectively 51,88,67 and 53;their success rates of limb salvage were respectively 100.00％ (51/51),96.59％ (85/88),8.96％ (6/ 67) and 0.For the patients whose time from injury to revascularization was ＜ 6 h,6 h to 12 h,13 h to 24 h,25 h to 1 w,and ＞ 1 w,the success rates of limb salvage were respectively 80.77％ (42/52),54.58％ (73/134),20.51％ (8/39),33.33％ (6/18),and 81.25％ (13/16).The 142 patients whose limbs had been salvaged obtained an average follow-up of 31.4 months (range,from 6 months to 8 years).Of them,those with grade Ⅰ injury obtained normal plantar sensation and active ankle flexion and extension.Of the 85 patients with grade Ⅱ injury,all recovered normal or nearly normal plantar sensation,29 achieved partial recovery of active ankle and digital flexion and extension,but the other 56 obtained no recovery of active ankle motion.Of the 6 patients with grade l injury,none obtained recovery of motion function,4 achieved partial recovery of plantar sensation but the other 2 had no recovery.Conclusion The classification of popliteal artery injury into 4 grades according to its severity of ischemic injury can provide helpful guidance to the treatment and prognosis assessment of the popliteal artery injury.

Objective To study the X ray and CT findings of pneumocystis carinii pneumonia in AIDS. Methods Five AIDS patients who had chest abnormalities were analyzed. Results Pneumocystis carinii pneumonia appeared as diffuse infiltrative and interstitial fine nodules. Conclusion If the diffuse and infiltrative interstitial fine nodule are the appearances in patients with AIDS, the pneumocystis carinii pneumonia should be considered.