The estrogen receptor (ER) coregulators regulate the transcriptional activities of ER,and then affect the transcription and translation of target genes mediated by ER.ER coregulators not only plays an important role in the initiation,progression and metastasis of breast cancer,but also involves in the response to endocrine therapy of breast cancer via the genomic and nongenomic function.

Humans ; Infant ; Male ; Mycoses ; pathology ; Penicillium ; isolation & purification

ObjectiveTo explore the influence of life events on the emotional state ot heart transplantation patients.Methods All the heart transplantation outpatients were interviewed by a certain psychiatrist in Zhongshan Hospital during Oct.2010 to Oct.2011.The demographic data,life events and the self-reported influenced degree were recorded by the same psychiatrist.A grounded theory-based approach with thematic content analysis of the field notes was used.ResultsEighty-eight patients were enrolled,including 69 males,and19 females.The average age of the patients was 46.5 ±14.3 years old.The average duration after operation was 39.3 ± 39.6 months.The life events were classified into 4 groups,which were medical financial problems,physical condition,family support and future life.The most frequently reported event was physical condition (50.2％ ) and the influenced degree was the highest (9.2 ±1.2),while most patients (96.6％) complained high medical and relevant cost and the influenced degree was (6.5 ± 2.1). Family support was reported by13.6％ patients and its influenced degree was (7.6 ±1.2).The age of the reporter of future life (6.8％) was under 33 years.ConclusionDifferent events have different influence to patients.Improving the social support of patients is helpful to improve quality of life.

Objective　To investigate the clinical results of the medial multiplex flap pedicled with the posterior tibial vessel. Methods　Twelve cases with soft tissue defects and bone defects of limbs were treated with the medial multiplex flap pedicled with the posterior tibial vessel from September 1992 to May 1999. Among them, bone and soft tissue defects following opened fracture in 7 cases, chronic ulcer following chronic osteomyelitis in 2 cases, melanoepithelioma in 2 cases, bone and soft tissue defects following osteoma resection in 1 case. The bone defect area was from 2.5 cm×5.0 cm to 4.5 cm ×11.0 cm. Free graft was performed in 5 cases, bridged transposition in 3 cases and reversal transposition in 4 cases, among them, periosteal myocutaneous flap with autogenous or allogeneic bone grafting in 8 cases, myocutaneous flap in 4 cases. The area of the flaps from 6 cm ×8 cm to 12 cm×25 cm. Results　All flaps were healed by first intention, but in the distal fragments of bigger flaps were partially necrosed in 2 cases. In 10 cases bone healing were obtained after 16 weeks of operation according to the X-ray photos. All cases were followed up from 6 to 18 months. All cases achieved satisfactory result but 1 case died because of lung metastasis of osteoma. Conclusion　The multiplex graft pedicled with the posterior tibial vessel is an ideal graft for repairing the large soft tissue defects and bone defects, because it has such advantages as adequate blood supply, big vascular diameter, long pedicle and big dermatomic area.

Objective To investigate the prevalence of systemic fungal infection in patients at auto-psy and its association with clinical data.Methods The materials from unselected adult patients were exa-mined at necropsy in our hospital from1971to2000,and the fungal species were identified by their mor-phologies in pathology.The clinical and pathological data were compared.Results The rate of fungal infec-tion was7.8%(31/396)among396cases.Seventeen(54.8%)of the31cases were infected with as-pergillus.The frequencies of organs involved with fungal infection were83.87%in lungs,48.39%in kid-neys,35.48%in brain and29.03%in heart,respectively.The fungal infection attributed directly to death in21cases.Conclusion Systemic fungal infection is one of the most common fatal causes among the critically ill patients,and aspergillosis becomes a major pathogenic fungus for patients with systemic fungal infection at autopsy.

Objective To evaluate the efficacy of pneumocystoscopy for congenital malformation of the vesicoureteral junction. Methods A total of 18 children (male 11 and female 7, aged from 3 months to 7 years with a mean of 3.6 years) with congenital malformation of the vesicoureteral junction (22 ureters) were enrolled in this study. Among the patients, 9 had vesicoureteral reflux (4 of them had bilateral reflux), 2 had bladder diverticulum complicated with urethral stenosis, and 7 had urethral stenosis and ipsilateral hydronephrosis. After the bladder was insufflated with CO2 through a Foley catheter (16 mm Hg), three trocars were inserted into the bladder, and the bladder was fixed on the abdominal wall using silk thread. By pneumocystoscopy, the Cohen procedure was done through the trocars. A Foley catheter was indwelled at the end of the procedure. Results The procedure was completed in all but one patient, who was converted to open surgery because the contraction of the urethra. The mean operation time was 130 min (110 to 145 min) for unilateral cases (13), and 242 min (225 to 250 min) for bilateral cases. The patients were discharged form hospital 9 to 12 days after the operation, and were followed up fro 6 months to 5 years with a mean of 3.8 years. During this period, MUC showed no ureteral reflux. One of the cases developed mild infection of the urethra, and was cured by circumcision. Conclusion Pneumocystoscopy is effective for congenital malformation of the vesicoureteral junction.

Objective The aim of this study was to explore the minimally invasive treatment for palpable undescended testes in the inguinal area.Methods Between August 2007 and March 2008,60 cases(74 testicular units)with palpable undescended testes in the inguinal area were treated by scrotal incision orchiopexy or/and laparoscopic orchiopexy depending on the location of inguinal testes.Results Among the 60 patients,26 cases who had the testes located between the external inguinal ring and the upper scrotum,received scrotal incision orchiopexy,of which the testes were fixed at the bottom of the scrotum in 23 cases,and at the upper scrotum in 1 case;the other 2(both had the undescended testis at the right side,between the external inguinal ring and the upper scrotum)were converted to laparoscopic orchiopexy because of unsatisfying surgical outcomes.The other 34 cases received laparoscopic orchiopexy,of which the testes were located in the groin in 16(41.1%)cases,close to the external inguinal ring in 18(52.9%),and complicated with indirect inguinal hernia in 8(23.5%,ligation of the hernia sac was performed at the level of internal inguinal ring);the testes were fixed at the bottom scrotum in the cases.The 60 patients were followed up for 3-6 months(mean,4.3 months)by B-ultrasonography,none of them showed atrophy or retraction of the testes,or indirect inguinal hernia.ConclusionsScrotal incision orchiopexy is feasible for palpable inguinal testes if the testis can be pulled upon to the upper scrotum,if not or the testis cannot be fixed on the bottom scrotum,laparoscopic orchiopexy should be used.Both of the procedures are effective.

Objective To investigate the role and significance of E selectin in the pathogenesis of neonatal acute lung injury (ALI).Method Ninety neonatal Sprague Dawley (SD) rats (6 or 7 days after birth) were randomly assigned to the control group (n =10) and ALI group (n =80).The rats in the ALI group received intraperitoneal injection of lipopolysaccharide (LPS) at dose of 4 mg/kg and they were divided into eight subgroups with 10 rats in each group according to different sacrifice time (0.5 h,1 h,2 h,3 h,4 h,8 h,12 h and 24 h after injection).Rats in the control group were injected intraperitoneally the same volume of normal saline and they were sacrificed at 4 hours after injection.Expression of the E-selectin in lung tissue was detected dynamically by immunohistochemistry and the serum soluble endothelial selectin (sE-selection) was detected by enzyme-linked immunosorbent assay (ELISA).The pathological changes of the lung tissue and the wet/dry lung weight ratio (W/D ratio) were recorded.Result The strong expression of a large number of E-selectin was detected in the vascular endothelial cells of the lung tissue in the ALI group,while only moderate expression of E-selection was observed in the control group.The W/D ratio in the ALI group gradually increased from 0.5 h after intraperitoneal injection of LPS,reached the peak at 8 h,and then began to decline.The ratio was significantly higher in the ALI group than that of the control group from 4 to 12 h after injection (P ＜ 0.05).The mean optical density of E-selectin in lung tissue of ALI group was also higher than that of the control group and the average optical density of ALI group at 2 h,3 h,4 h and 8 h was significantly higher [2 h:(0.36 ±0.09),3 h:(0.38 ±0.01),4 h:(0.44 ± 0.06),8 h:(0.30 ± 0.09),control group:(0.24 ± 0.01),P ＜ 0.05].The level of serum sE-selectin gradually increased after intraperitoneal injection of LPS,reached the peak at 2 h,and then decreased gradually.The level of sE selection was significantly higher than that of the control group at the point of 2 h,3 h,4 h and 8 h (P ＜ 0.05).The level of serum sE-selectin increased along with the expression of E-selectin in lung tissues,and they were positively correlated (r =0.730,P ＜ 0.01).Conclusion The increased expression of E-selectin and the elevation of serum sE-selectin level may reflect the injury of pulmonary vascular endothelial cells induced by systemic inflammatory response.

Objective To observe the effects of different doses of dexmedetomidine combined with ropiva-caine for ultrasound-guided fascia iliaca compartment block on postoperative analgesia and rehabilitation in patients undergoing total hip replacement surgery. Methods 80 patients with ASAⅠ~Ⅱundergoing total hip arthroplasty were ramdonly divided into 4 groups. Records of patients with ultrasound guided fascia iliaca compartment block onset time,block fading time,VAS at 4 h,8 h,12 h,24 h,48 h;duration of operation,intraoperative remifent-anil and propofol requirement;24 h and 48h of sufentanil use;after the operation were recorded for the first time , ambulation time,hospitalization time and observe whether bradycardia,intraoperative awareness and other adverse reactions. Results Compared with group A and B,the onset time of C were shorter(P<0.05);the VAS was less (P<0.05);the remifentanil equirement was significantly was reduced(P<0.05);the amount of sufentanil after operation 24 h and 48 h was reduced(P<0.05);the first time out of bed time and total hospitalization time was shorter(P < 0.05);patient satisfaction increased(P < 0.05);The extubation time was significantly longer and the occurrences of tachycardia were significantly increased in group D compared to other groups respectively. Conclusion 1.0μg/kg dexmedetomidine combined with 0.3%ropivacaine ultrasound-guided fascia iliaca compart-ment block can provide better postoperative analgesic and recover rapidly with fewer side effects in total hip replace-ment surgery.

Objective To OxplorO thO rOlationship bOtwOOn diffOrOnt vOntilation modO and hypocapnia in prOtOrm infants.Methods From April 2014 to OctobOr 2017,a total of 302 prOtOrm infants with rOspiratory distrOss syndromO in Suining COntral Hospital who rOcOivOd diffOrOnt assistOd vOntilation wOrO sOlOctOd in this rOsOarch. According diffOrOnt vOntilation modO, thOy wOrO dividOd into convOntional mOchanical vOntilation(CMV) group( n=66),thO mOchanical vOntilation modO was CMV, continuous positivO airway prOssurO(CPAP) group(n=149),thO mOchanical vOntilation modO was CPAP, high frOquOncy vOntilation(HFOV) group(n=87),thO mOchanical vOntila-tion modO was HFOV. ThO morbidity of hypocapnia in diffOrOnt groups and prOvOntion mOthods wOrO analyzOd. Results Among 302 childrOn,52casOs had hypocarbonOmia,thO total morbidity of hypocapnia was 17.2%. ThO morbidity of hypocapnia in thO HFOV group was 37.9% (33/87),which in thO CMV group was 21.2% (14/66), which in thO CPAP group was 3.4% (5/149),thO diffOrOncO among thO thrOO groups was statistically significant(χ2 =47.013,P=0.000).Conclusion ThO incidOncO of invasivO vOntilation should bO carOfully considOrOd in prOtOrm infants, OspOcially high frOquOncy vOntilation. To prOvOnt and trOatmOnt of hypocapnia, timOly adjustmOnt of vOntilator paramOtOrs according to blood gas during diffOrOnt vOntilation modO should bO donO.