?-Synuclein (?-SYN ) .previously identified as a breast cancer specific gene, has a wildly tumor expression profile mainly in advanced stage. As a special chaperone,?- SYN stimulates the proliferation and metastasis of tumor cells through interacting with estrogen receptor and (or) BubR1. Meanwhile, it is also detectable in the serum or urine from tumor patients, which indicates that?- SYN could be potential as a tumor marker for diagnosis and prognosis.

Objective To compare the immunogenicity of pneumococcal surface adhesion A (PsaA) and pneumococcal surface protein A (PspA). Methods The variability of the genes and the expressed pneumococcal proteins PsaA and PspA was investigated by electrophoresis. Cross-reactivity of proteins with the antibodies induced by the corresponding proteins of Streptococcus pneumoniae serotype 5, 6B,1, 19F and 23F was researched by Western blot. The enzyme-linked immunosorbent assay (ELISA) was adopted to detect the antibody subclasses and the accessibility of antibodies induced by PsaA and PspA to the surface of the above intact strains. Cross-protection against challenging with Streptococcus pneumoniae strains was indagated in mice. Results Both proteins showed to induce the similar level of antibody subclasses.This study demonstrated that cross-reactivity of pneumococcal PspA was restricted in the same clade, which showed less extensive than pneumococcal protein PsaA. But antibody induced by pneumococcal protein PspA could be bound to the surface of the intact strains, which conduced the stronger cross-protection against inva sive strains. Conclusion The mice immunized with PspA protein cross-protected well against the invasive strains in which PspA belonged to the same clade 1 of family 1. It showed that pneumococcal protein PspA was more effective than PsaA in protection as composition of vaccine.

Objective To determine the clinical value of the multi-slice spiral CT virtual endoscopy (CTVE) for the detection of biliary pancreatic junction lesions. Method MSCT and virtual endoscopic reconstruction were performed in 30 healthy volunteers, 18 cases of common bile duct stones and 7 cases of ampullary carcinoma to observe patterns of duodenal papilla and measure its size.Results Reconstructed image of CTVE showed that the normal duodenal papilla was nodular in 16,shaped like "V" in 8 "Y-shaped" in 6 of the healthy volunteers. Its diameter was (0.84±0.17)cm. In the patients with common bile duct stones, it was nodular and its diameter (1.72±0.32)cm. In the patients with ampullary cancer, it was of irregular protruded type and its diameter (2.30±0.85)cm.There was significant difference among the 3 groups in the overall mean values (P＜0.01). Conclusion CTVE is a convenient, non-invasive and precise clinical examination to observe the shape of duodenal papilla and determine its size.

Objective To evaluate the value of PLR-△SVV for the septic shock patients with autonomous breathing. Methods 60 patients were included in the study. Hemodynamic data of PICCO were collected before and after treatment. After rehydration, the group (△SV≥10%) was defined volume responder group, and then the predictive value of PLR-△SVV was analyzed. Results Compared with the nonresponders group, PLR-△SVV was increased significantly in response group[(10 ± 4)mL vs (14 ± 6)mL,P<0.05]. The ROC curve for PLR-△SVV were 0.881, and the sensitivity was 85.7%, the specificity was 92.0%. Conclusion PLR-△SVV can be used to predict fluid responsiveness for septic shock patients with spontaneously breathing.

OBJECTIVETo compare the clinical effects of different surgical methods for the epicanthus corrective surgery.

METHODSCanthoplasty with asymmetric Z-flap is applied in 46 cases, Y-V advancement procedure for epicanthoplasty is applied in 42 cases. The epicanthus aesthetic measurement were measured and calculated by software before and after surgery, the diameter of the iris was measured as a reference value,and the postoperative scar was assessed by VSS scale. At the same time, by measuring the lateral canthal distance, the accuracy of the measurement method can be verified.

RESULTSAll patients were satisfied with the long-term results and there were no recurrences of the epicanthal fold. The shortening ratio of the ICD is 8.36% in the group with the Z-plasty, and 5.88% in Y-V plasty. the lateral canthal distance have no diffrence before and after surgery.

CONCLUSIONSTwo surgical methods can get good results. The magnitude of correction in Z-plasty may larger than Y-V plasty, but postoperative retraction may existed in Z plasty.

Blepharoplasty ; methods ; Cicatrix ; Esthetics ; Eyelids ; surgery ; Humans ; Recurrence ; Software ; Surgical Flaps

Background and Purpose:Kaposi's sarcoma(KS) cases occurring in renal allograph recipients was considered to be due to long-term immunosuppressive therapy.But the exact carcinogenetic process has not been elucidated so far.The lesions could not be distinguished from other KS types by histopathological study.Endemic KS cases seemed to be more common in Xinjiang,especially in the Uygur ethnic group,and their relation to other types of KS was investigated in three cases by histopathology and immunohistochemistry for the present study.Methods:Biopsy specimens from three cases of renal tronsplantation related KS,including two Uygur and one Han patients,were obtained from this hospital(No.474 hospital of PLA).Formalin-fixed and paraffin embedded blocks were cut for routine HE and immunohistochemical staining to study respectively.Monoantibodies of CD34,Ⅷ-factor,Vimentin,actin and FN were detected by S-P techniques for immunohistochemistry.Results:Histopathologically,the typical histology of traditional KS was found in almost all the specimens of the three patients.In the early stage of the disease,there are only a few vessel fissures with irregular dilation and clustering obese(epithelioid)cells.In the middle stage,the changes are wider in scope with proliferation of spindle cells,in the form of beams and weaves.The proliferating vessels are dilated and hyperemic around the lesion.In the late stage,the spindle cells proliferation are markedly atypical,and karyokinesis is increased.Immunohistochemistry showed CD34 to be more strongly positive,Ⅷ-Factor(+),Vimentin(+) showed a weak reation;while actin(-),FN(-) were negative.Conclusions:Renal transplantation related KS is not essentially different from other types of KS both in histopathohogy and immunohistochemical characters which may reflect that they have a similar etiopathogenetic procession.However,the distinctive distribution of morbidity among different ethnic groups or districts strongly suggested that the genetic background plays a critical role on KS carcinogenesis.

Objective To investigate prognostic factors in patients with primary central nervous system diffuse large B-cell lymphoma (PCNS-DLCBL).Methods The clinical data of 71 patients with PCNS-DLCBL confirmed by pathology and clinical tests, who were admitted to our hospital from 1991 to 2015, were retrospectively analyzed.All patients received chemotherapy, mainly with high-dose methotrexate (HD-MTX, 66/71), and 59 patients received radiotherapy, mainly with whole brain radiotherapy (WBRT)±local boost.The Kaplan-Meier method was used to calculate survival rates, the log-rank test was used for survival comparison and univariate prognostic analysis, and the Cox model was used for multivariate prognostic analysis.Results Fifty-eight patients achieved a complete response (CR), ten achieved a partial response (PR), and three had progressive disease (PD).The 5-year overall survival (OS) rate was 43%, and the 5-year progression-free survival (PFS) rate was 34%.The univariate analysis showed that the factors associated with OS included the following:age of onset, Karnofsky Performance Scale (KPS) score, single or multiple lesions, whether to receive radiotherapy, evaluation results after radiotherapy and chemotherapy, and the presence or absence of recurrence (P=0.000-0.047);the multivariate analysis showed that the three factors that affected OS were age of onset, KPS score, and the presence or absence of recurrence (P=0.000-0.022).The univariate analysis revealed that chemotherapy regimen, whether to receive radiotherapy, total radiotherapy dose, WBRT dose, evaluation results after radiotherapy and chemotherapy, and the presence or absence of recurrence were the factors associated with PFS (P=0.000-0.028);the multivariate analysis revealed that KPS score and the presence or absence of recurrence were associated with PFS (P=0.000-0.011).Conclusions Among patients with PCNS-DLCBL, younger age, higher KPS score, and no recurrence are associated with better OS, and single lesion, radiotherapy, and better evaluation results after radiotherapy and chemotherapy may be associated with better OS;higher KPS score, better evaluation results after radiotherapy and chemotherapy, and no recurrence are the factors associated with better PFS, and HD-MTX chemotherapy, radiotherapy, higher total radiotherapy dose, and higher WBRT dose may be associated with better PFS.Whether to receive radiotherapy after achieving a CR with chemotherapy and the target area and dose of radiotherapy need to be further studied.

Objective: To investigate the association between the CYP3A5 genetic polymorphism and the serum concentrations of carbamazepine (CBZ), to provide guidance for individualized drug dosing. Methods: Eighty-four epilepsy patients taking CBZ were included in this study. Their clinical data were recorded and CBZ serum concentrations were measured. The CYP3A5 6986 genetic polymorphism was assessed using a polymerase chain reaction-restriction fragment length polymorphism (PCRRFLP) assay. Patients were divided according to genotype into CYP3A5 expressor (CYP3A5*1/*1 genotype and CYP3A5*1/*3 genotypes) and non-expressor groups (CYP3A5*3/*3). The two groups were compared for the total dose of CBZ, dose of CBZ/kg body weight, serum drug concentration, dose-corrected serum concentration, and standardized serum concentration. Results: The total dose of CBZ and the dose of CBZ/kg body weight was higher in the CYP3A5 expressor group than the non-expressor (P = 0.043 and P = 0.014, respectively). The dose-corrected and standardized serum concentrations were lower in the CYP3A5 expressor group than the non-expressor (P = 0.001 and P < 0.001, respectively). There was however, no signifi cant difference in serum drug concentration between the two groups (P = 0.487). Conclusions: There was a close relationship between CYP3A5 genetic polymorphism and the serum concentrations of carbamazepine.

Objective To predict the response of induction chemotherapy in advanced nasopharyngeal carcinoma (NPC)by using pretreat-ment apparent diffusion coefficient (ADC)values.Methods 35 patients with advanced NPC underwent DWI examination prior to 2-week in-duction chemotherapy.The patients were divided into CR (complete response)group,PR (partial response)one and SD (stable disease)one according to the tumor response of treatment.The effective responders included CR and PR groups.The patients were divided into children-adolescents(below 20 years)group and adults one according to the age,into non-keratinizing undifferentiated carcinoma group and non-kera-tinizing differentiated carcinoma one according to the pathological type,and also into T2,T3 and T4 groups according to the T-staging (UICC2010).Statistical analysis was used to compare the pretreatment ADC values between different groups.Results The average pre-treatment ADC values of CR,PR,responders and SD groups were (0.70±0.06)×10 -3 mm2/s,(0.72±0.04)×10 -3 mm2/s,(0.71± 0.04)×10 -3 mm2/s and (0.85±0.02)×10 -3 mm2/s respectively.The average pretreatment ADC value of the SD group was signif-icantly higher than that of PR group and responders,and the differences were significant (P <0.05).The average pretreatment ADC value of children-adolescents and adults groups were (0.73±0.07)×10 -3 mm2/s and (0.75 ±0.07)× 10 -3 mm2/s,which showed no significant differences.The average pretreatment ADC value of non-keratinizing undifferentiated carcinoma and non-keratinizing dif-ferentiated carcinoma groups were (0.76 ±0.08)×10 -3 mm2/s and (0.74±0.06)×10 -3 mm2/s,which showed no significant differ-ences.The average pretreatment ADC values of T2,T3 and T4 groups were (0.78±0.05)×10 -3 mm2/s,(0.77 ±0.07)×10 -3 mm2/s and (0.75±0.08)×10 -3 mm2/s.Although there were no significant differences between T2,T3 and T4 groups,a trend towards lower ADC was observed with increasing tumor T-staging.Conclusion Pretreatment ADC value is a valuable quantitative parameter,and it can be used for predicting induction chemotherapy response in advanced naso-pharyngeal carcinoma.

Objective To summarize the CT features of anaplastic thyroid carcinoma (ATC).Methods CT manifestations of 12 patients with ATC confirmed by surgery or biopsy were analyzed retrospectively.Results 1 1 (91.7%)patients had single lesion. The lesions appeared as low attenuation mass with cord-like,flocculent or patchy high attenuation areas.The lesions had mild to moderate enhancement in 1 1 cases (91.7%).Coarse calcifications were detected in 8 cases (66.7%),4 of them were incomplete rim or eggshell.11 cases (91.7%)showed invasion into adjacent structures,including trachea (6 cases,50%),esophagus (4 cases,33.3%),strap muscles (7 cases,58.3%),larynx (2 cases,1 6.7%),blood vessels (6 cases,50%).5 cases (41.7%)had tumor thrombus in the internal jugular vein.10 cases (83.3%)had lymph nodes metastasis.The enhancements of lymph nodes were divided into 3 types:mild homogeneous enhancement (4 cases,40%),mild enhancement with internal low-attenuation areas (7 cases,70%)and ring-like enhancement without internal enhancement (7 cases,70%).Conclusion CT features of ATC include low-density mass with cords,flocculent and patchy high-density areas,coarse calcification and mild to moderate enhancement,invasion to adjacent structure and lymph node metastasis with necrosis are common.