Purpose: Hypoxia is common in breast cancer and may influence gene expression to promote malignancy. Estrogen receptor (ER) -? status is an important predictor for both prognosis and clinical response to endocrine therapy. The aim of our current study is to demonstrate the relationship between hypoxia and ER-? in breast cancer tissue. Methods: We have examined ER-a expression by immunohistochemistry in parallel with indicators of hypoxia in 51 ER-a ligand binding assay positive breast tumors for in vivo evidence of this phenomenon. Results: Overall, 49 tumors were ER-a positive by immunohistochemistry. Regional loss of ER-a expression was consistently present in peri-necrotic as compared to distant regions in both in situ (n =29, P

The aim of this study was to investigate if there are abnormal fibroblasts derived from the skin surrounding keloids in order to have a better understanding for keloid progression. All the samples were used for cell culture. Flow cytometry was used to compare the apoptotic rate of fibroblasts derived from keloid and its surrounding skin, when it was cultured in serum-deprived medium for 24 hours or was induced by Fas antibody. After cultured in serum-deprived medium for 24 hours, the apoptotic rate of fibroblasts derived from the surrounding skin of keloid increased to an amount between that of normal skin and keloids. The apoptotic rate of normal skin fibroblasts increased more than that of keloids. Moreover, when induced by Fas antibody, the apoptotic rate of fibroblasts derived from the surrounding skin increased not so high as that of normal skin(P0. 05). Therefore, at least there are some fibroblasts in the surrounding skin of keloids, in which apoptosis can not be induced as in normal skin.

Objective To investigate the effect of all-trans retinoic acid (ATRA) on the expression of matrix metalloproteinases-9 (MMP-9) in perihematomal brain tissue after intracerebral hemorrhage in rats.Methods Forty Sprague-Dawley rats were randomly allocated into ATRA and normal saline control groups.Each group was redivided into 2 h,48 h,72 h,and 7 d subgroups (n = 5 in each subgroup).The autologous blood was injected into the rat caudate nucleus for establishing a model of intracerebral hemorrhage under the guidance of stereotaxic apparatus.Intraperitoneal ATRA (1 mg/d) and the same volume of saline were injected respectively after the success of modeling.The expression of MMP-9 at different time points was detected by using immunohistochemical staining.Results The expression of MMP-9 in microvascular endothelial cells in perihematomal brain tissue in rats was upregulated 24 h after intracerebral hemorrhage in the ATRA and normal saline control groups,and it reached the peak at 48 to 72 h.The expression of MMP-9 in the ATRA group at different time points was lower than that in the normal saline control group (all P＜0.05).Conclusions ATRA inhibits the expression of MMP-9 in perihematomal brain tissue after intracerebral hemorrhage in rats,and thus may reduce the brain edema.

Objective To explore the cellular localization of chemokine (C-X-C motif) ligand 1 (CXCL1) in brain tissue and its expres-sion in brain tissue and blood in patients with severe traumatic brain injury (TBI), as well as its correlation with the injury severity. Methods From September, 2013 to October, 2015, 78 cases of TBI with craniotomy admitted to our hospital were involved as TBI group. A total of 78 peripheral blood samples and 19 brain tissue samples were studied. According to the scores of Glasgow Coma Scale (GCS) at admission, the TBI group was classified as severe TBI group (6~8, n=35) and particularly severe TBI group (3~5, n=43). Ten cases of control brain tissue were taken from patients with cerebral aneurysms or benign tumor and also undergoing craniotomy during the same time. Peripheral blood from ten healthy people were involved as the healthy control group. Immunofluorescent double staining was used to detect the cellular local-ization of CXCL1 in brain tissues, and ELISA was used to detect the expression of CXCL1 in brain tissue and blood. The relationship be-tween the level of CXCL1 in peripheral blood at different time and the score of Glasgow Outcome Scale (GOS) was analyzed with Spear-man correlation analysis. Results In normal brain tissue, CXCL1 mainly localized in astrocytes. For severe TBI, CXCL1 mainly expressed in neurons and astrocytes. The level of CXCL1 was higher in brain tissue in the particularly severe TBI group than in the severe TBI group (t=-12.58, P<0.05). In the severe TBI group, the level of CXCL1 in blood reached a peak before surgery, then gradually decreased, and was still higher than that in the healthy control group 14 days after surgery (P<0.05), however, no significant difference was found 30 days after surgery compared to the healthy control group (P>0.05). In the particularly severe TBI group, the level of CXCL1 in blood reached a peak before and one day after surgery, then gradually decreased, and was still higher than that in the healthy control group 30 days after surgery (P<0.05). The level of CXCL1 in blood was higher in the particularly severe TBI group than in the severe TBI group at all time points (P<0.05), and the level before surgery was negatively correlated with the score of GOS in the particularly severe TBI group (r=-0.351, P<0.05). Conclusion The CXCL1 protein of injury brain tissue was mainly colocalized in neurons and astrocytes in severe TBI patients, and the ex-pression was associated with injury severity and outcome.

Purpose:To evaluate the significance of duct endoscopy on the early diagnosis of breast cancer with nipple discharge. Methods:From Oct. 1997 to Aug.1999,11 cases of breast cancer were found in 393 patients who underwent duct endocopy for nipple discharge. These 11 cases were followed up, and their endoscopic presentation were reported. Results:The presentation of ductal cancer under duct endoscopy was characterized by irregularity of the duct wall and the lumen, such as patch like elevation and aberrant bleeding. However,the presentation of a ductal neoplasm had no particularity. The diagnostic sensibility and specificity of duct endoscopy on breast cancer was 82%(9/11) and 98.7%, respectively. All patients received sugical biopsy. 5 non palpable breast cancers, who received surgical biopsy were located by ductoscopy and diagnosed as DCIS with/without micro invasion. Conclusions:Through duct endoscopy, breast cancer can be diagnosed early due to the finding of intraductal change on duct wall and lumin. We can also succeed in locating the malignant lesion and carrying out biopsy directly by using duct endoscopy. The highly suspecious lesion found by duct endoscopy should be further confirmed by histological diagnosis.

Objective To investigate the effect of group feedback and formative assessment respectively on teaching effectiveness of endotracheal intubation (ETI).Methods After atheoretical lecturing and theoretical test,eighty three undergraduates were randomized into concurrent-feedback group and groupfeedback group.ETIsimulation training was given respectively by providing concurrent or group feedback in the two groups,and then undergraduates received a skill assessment.After atheoretical lecturing and theoretical test,other 91 undergraduates were randomized into final-assessment group and formative-assessment group.ETIsimulationtraining and skill assessment were given in final-assessment group.Before training,first skill assessment was performed in formative-assessment group,and then feedback was delivered based on the assessment.After training,second skill assessment was given again.Skill assessment was evaluated using the criterion-based task specific checklist combined with global rating scale.t-test was used for comparison between groups.Results There was no statistical difference (P=0.212) in theoretical scores between group-feedback group,and concurrent-feedback group.Skill assessment score of group-feedback group (39.4 ± 4.9) was higher than that in concurrent-feedback group (35.4 ± 4.7),with statistical difference (P=0.000).There was no statistical difference (P=0.395) in theoretical scores between formative-assessment group and final-assessment group.Score of formative-assessment group (39.3 ± 6.2) was higher than that in final-assessment group (32.2 ± 2.4),with statistical difference (P=0.000).Conclusion Terminal feedback or formative assessment could enhance teaching effectiveness of endotracheal intubation among medical students.

Objective To investigate the clinical significance of fiberoptic ductoscopy-guided intraductal biopsy in diagnosing nipple discharge.Methods From May 2006 to April 2007,screening fiberoptic ductoscopy was performed for intraductal papillary lesions in 53 ducts among 51 patients.Fiberoptic ductoscopy-guided intraductal biopsy was carried out followed by open microdochectomy. Results Except for a failure in 5 ducts,biopsy found papilloma in 29 cases,ductal hyperplasia in 15 cases,severe ductal hyperplasia in 2 and carcinoma in 2.Microdochectomy revealed 43 benign diseases (12 solitary intraductal papillomas,12 multiple intraductal papillomas,and 25 ductal hyperplasia)and 4 malignancies (3 ductal carcinoma in situ,1 invasive ductal carcinoma).Surgeries performed for the 5 ducts failing a biopsy attempt revealed papilloma in one and adenosis in 4.Compared with conventional microdochectomy,fiberoptic ductoscopy-guided intraductal biopsy can significantly increase the detection rate of solitary papilloma(40.7% vs. 92.6%,P＜0.05).It might also underestimate multiple intraductal papilloma and breast cancer. Conclusion Fiberoptic ductoscopy-guided intraductal biopsy is microinvasive,safe,convenient with a high success rate,and could be as a routine procedure after intraductal lesion found by screening fiberoptic ductoscopy.

Based on the competition reaction of target protein, aptamer probe, padlock probe and complementary sequence, a highly sensitive fluorescent aptasensor was developed in this study in combination with rolling circle amplification. In the absence of target protein, the ligation-rolling circle amplification reaction was repressed because the complementary sequence hybridized with aptamer probe to form double-stranded duplex. While in the presence of target protein, the target molecules bound specifically with aptamer probe, inducing displacement of the complementary sequence and hybridization with padlock probe. The padlock probe was circularized with the assistance of E. coli DNA ligase, and the rolling circle amplification process could be accomplished by Phi 29 DNA polymerase. The amplification product contained thousands of repeated sequences which could hybridize with the loop of molecular beacon ( the detection probes) , resulting in a significant fluorescence signal. The effects of length of complementary DNA ( CDNA ) sequence and concentration of padlock probe were investigated. Under the optimized experimental conditions, the model target protein thrombin could be highly sensitively detected by the proposed aptasensing system in a linear range of 0 . 067-32 . 4 nmol/L with a detection limit of 0 . 03 nmol/L ( approximately 90 amol target molecules). Moreover, the presented sensing method was universal for other target analysis by skillfully design of the sequence of aptamer probe and related oligonucleotides.

Objective To explore the prevalence,subtype,distribution characteristics and risk factors of IBS met ROME Ⅲ criteria in local adult residents of Shanghai Songjiang area.Methods With multi-stage,stratified cluster random sampling method,from April to May in 2010,residents of45 shanghai Songjiang communities were interviewed by questionnaire survey.IBS diagnosis was based on Rome Ⅲ criteria,and the subtypes were according to Bristol stool scale.Self-rating anxiety scale (SAS),self-rating depression scale (SDS) and Athens insomnia scale (AIS) were also simultaneously finished. Results There were 7648 individuals who completed the survey with qualified questionnaires; the efficient rate was 90％. The sample size accounted about 1.62％ of total population in Shanghai Songjiang area.Total 970 patients were detected,who met the Rome Ⅲ criteria,of those 492 males and 478 females.The adjusted prevalence of IBS was 13.1％,13.8％ in males and 12.7％ in females.The ratio of male to female was 1 ∶ 0.92.There was no significant difference in detection rate between males and females (P＞0.05).The prevalence was highest in the 18 to 29 years age group (18.2％,P=0.000).IBS unsubtyped (IBS-U) was the most common type in patients who met the Rome Ⅲ criteria (45.3 ％),IBS with diarrhea (IBS-D) type was more common in male (27.0％) and IBS with constipation (IBS-C) was more common in female (19.5％).The IBS prevalence of obesity group (x2 =4.046,P=0.044),higher education group (x2=31.210,P=0.000),mental group (x2 =8.409,P =0.015),unmarried group(x2 =26.933,P =0.000) and no abdominal surgery history group(x2 =5.894,P=0.015) was higher than that of control group.The risk of IBS prevalence in those who had the history of gastrointestinal infection,abdominal surgery,taking antibiotics or analgesics increased by 5.105,3.388,2.949 and 2.811 times respectively(P=0.000).Multivariate analysis indicated that the risk of IBS prevalence was increased by 1.69 times if took more spicy food,however high-protein diet was a protective factor (OR=0.900,P=0.000).Anxiety (OR=2.452,P=0.000) and insomnia (OR=1.923,P=0.000) were also risk factors of IBS.Conclusion IBS is a common and frequently occurring disease in Shanghai Songjiang community.The history of gastrointestinal infection,abdominal surgery,taking antibiotics or analgesics,intake of more spicy food,anxiety and insomnia may be risk factors of IBS.

Objective To investigate the association of sleep quality with prevalence of irritable bowel syndrome (IBS) in communities of Shanghai.Methods A survey on prevalence of IBS in communities of Jiangqiao County,Jiading District of Shanghai was conducted using a stratified,randomized cluster-sampling method.A total of 11 569 questionnaires was collected.The IBS was diagnosed according to Rome Ⅲ criteria,and Athens Insomnia Scale (ALS) was used for selfassessment.The relationship between sleep quality and IBS was analyzed.Results The prevalence of insomnia was 21.00% in community groups,33.02% in IBS patients and 18.74% in non-IBS patients.The incidence of insomnia was significant higher in IBS group than non-IBS group (P =0.004,OR = 2.14,95 % CI:1.92- 2.39).Among IBS patients,the incidence of insomnia was higher in females than in males (37.24% vs 28.41%,P = 0.000).A logistic analysis for psychological contributing factors in IBS revealed that insomnia might be one of the risk factors for IBS (OR= 2.11,95% CI:1.89-2.36).Conclusion IBS patients have poor sleep quality,especially in females.