Cyclooxygenase-2(COX-2)is an inducible enzyme that regulates prostaglandin synthesis and is overexpressed at sites of inflammation and in several epithelial cancers.Data indicate that COX-2 is involved in the regulation of apoptosis,angiogenesis,and immune response.The biological function of COX-2 appears to be associated with tumorigenesis.Recently, multiple studies have shown that COX-2 plays a critical role not only in maintenance of the endometrium during the menstrual cycle,but also in the progression of endometrial cancer.This review outlines the status of COX-2 expression and its association with clinicopathologic features and clinical outcome in endometrial cancer.

With the advancement research on target therapy,more and more target drugs have been applied in the treatment of endometrial cancer,including anti-TKI or monoclone antibody and inhibitors in molecular signal pathways like mTOR,all of which have shown good therapeutic effects.As there were only on some phaseⅡclinical trials,so randomized stageⅢclinical trials are required to confirm these effects.In this review,the author discusses the advancement of target therapy in endometrial cancer.

Objective Accodring to the guideline of Reference Intervals in the Clinical Laboratory(ISO15189) ,to establish the reference range of Cu ,Fe ,Zn ,Ca and Mg in the peripheral blood of preschool children in Suzhou .Methods Using atomic absorp-tion spectrometry to detect the levels of Cu ,Fe ,Zn ,Ca and Mg in peripheral blood of 3 992 Kindergarden children in Suzhou from Apr to May 2014 ,according the age ,the children were divided into three groups ,1 511 cases in 3 to 4 years old group including 750 boys ,761 girls ,1 169 cases in 4 to 5 years old group including 570 boys ,599 girls ,1 312 cases in 5 to 6 years old group inclu-ding 604 boys 708 girls .According to NCCLS's guideline C28 -A2 to define the reference range .Results The concentration of copper ,iron ,zinc ,calcium ,magnesium had no significant differences in different gender and age groups(P>0 .05) ,the reference ranges in peripheral blood of the preschool children in Suzhou were Cu 11 .47-32 .53 umol/L ,Fe 6 .86-9 .80 mmol/L ,Zn 64 .46-133 .02 umol/L ,Ca 1 .47-2 .09 mmol/L ,Mg 1 .21 -1 .75 mmol/L .Conclusion There are regional difference on the levels of Cu ,Fe ,Zn ,Ca ,Mg in children's peripheral blood ,each region should to establish the local reference range follow the guideline .

Objective To understand the status quo of our young doctors' doctor-patient communi-cation and related influencing factors. Methods Among the doctors under the age of 40 in various clinical departments, according to 30% proportion, we randomly selected 32 doctors, and combined with revised Liverpool communication skills assessment scale (LCSAS) and standardized patients (SP), the doctors' ability of doctor-patient communication was evaluated. Descriptive statistics, t test and variance analysis were per-formed by SPSS 21.0 lines. Results The average score of communication etiquette of young doctors was (2.00±0.15), and the average score of their communication skills was (1.74±0.29), and the average score of their communication technical ability was (3.74±0.39). The detection rate of communication etiquette, communication skills and communication skills evaluation (less than 2) was 33.3%, 81.5%, and 85.2%, respectively. Physicians and surgeons' scores in communication etiquette and communication skills dimen-sion had significant difference (P<0.05). Significant difference was found in different ages doctor communi-cation protocol (F=3.641, P=0.028), and 20 to 25 years old doctors' score in communication manners was significantly lower than other ages (P<0.05). There were significant differences in the scores of doctors of different title in communication etiquette (F=4.410, P=0.023), and the trainee doctors' communication etiquette score was significantly lower than the physician and surgeon (P<0.05). Conclusion The commu-nication skills of young doctors in our hospital are generally in the middle state, and their communication etiquette is good, communication skills are general. There are great individual differences. Hospital should begin from those whose communication ability are low, cultivate their biology-psychology-social medicine thinking mode of the doctor-patient relationship , help new employees complete the role transformation , emotion management, and professional commitment, and encourage patients to participate in the medical process, so as to improve the doctors' communication ability in all directions and at different levels.

Objective To investigate whether cytomegalovirus (CMV) infection is associated with chronic allograft nephropathy (CAN). Methods 131 patients underwent kidney transplantation from August 1, 1999 to November 30, 2000 were enrolled in this study. CMV-pp65 antigen load (the number of CMV-pp65-positive leukocytes) in peripheral blood within 6 months of posttransplant was detected, and TGF-? 1 mRNA expression in renal allograft biopsy was measured at the 7th month after transplant. The renal functions of the patients were followed up at least three years. Results The TGF-? 1 mRNA level in allografts of the patients with long-time and high-level CMV-pp65 antigen load was obviously higher that that of the patients without. 3 years after transplant, there were lower Ccr and more renal dysfunction in the patients with long-time and high-level CMV-pp65 antigen load than in the patients without, the difference of which was significant between the two groups of patients. Conclusion Serious CMV infection with long duration can damage the function of kidney graft, and is a risk factor for renal dysfunction.

Purpose:To explore the clinical feature,and treatment of primary cervical lymphoma. Methods:Clinical data and follow-up survey data of 26 cases were retrospectively analyzed with SSPS software. Results:Primary cervical lymphoma could occur in any age group of women. The misdiagnosis rate was as high as 57.69% (15/26 case).Three of 26 patients died,the five years survival rate was 88.46%.Conclusions:Primary cervical lymphoma is rare,which was very often misdiagnosised. The treatment consisted of an combination of chemotherapy,operation and radiotherapy,which could improve curative results and reduce relapse.

Purpose:To investigate the feasibility of detecting intraoperatively blue sentinel lymph node (BSLN) in patients with cervical cancer and to evaluate the accuracy of predicting pelvic lymph node disease. Methods:Between May 2002 and Jun 2003,29 patients with cervical cancer FIGO stage Ⅰb ( n =3),stage Ⅱa ( n =21),stage Ⅱb ( n =5) underwent BSLNs detection. During operation 4ml of methlene blue or lymphazurin was injected into the cervical tissue around the tumor or 3′,6′,9′,12′ of normal appearance of cervix about 0.5cm deep. Blue lymph duct and BSLNs were observed and located carefully for 10 minutes. Tumor characteristics,surgical findings,and location and number of BSLNs were recorded and correlated with pathologic results to get the accuracy and false-negative rate.Results:Among 29 patients underwent this technique,BSLNs were seen in 24 patients. Total detection rate was 83%(24/29). Location of BSLNs was mainly in obturator and internal iliac group. BSLNs located in left internal iliac group in 11 patients and 13 patients in right internal iliac group,10 patients in left obturator group,and 14 patients in right obturator group. 3 patients had BSLNs in both iliac and internal iliac group. Among 24 patients with BSLNs,there were 6 patients with lymph node metastases. 5 patients had only SLN metastases and one patient had both SLN and other lymph node disease. 18 patients had neither SLNs nor other pelvic lymph nodes metastases. The false-negative rate was 0.Conclusions:Intraoperatively BSLN detection was feasible and safe. Sentinel lymph node was representative of the lymphatic basin.

OBJECTIVE: To compare the difference in bond strength between titanium alloy with different surface roughness and dentin. METHODS: Thirty titanium alloy cylindrical specimens were fabricated and randomized to 6 groups. All groups of specimens were rubbed separately with 60, 80,100,150, 240, and 320 grit silicon carbide (Si-C) sand paper. The surface roughness of each group was measured. The occlusal surfaces of 30 human molars freshly extracted within 1 month were flattened to expose an adequate area of lower dentin. The dentin bonding surface was produced using 320, 400, and 600 grit Si-C sand paper, respectively. Titanium alloy and dentin specimens were bonded with Ketac~(TM) Cem Easymix ionomers. All bonded specimens were stored for 24 hours at 37 ℃. The microtensile bond strength was measured through the use of universal testing machine. The fractured surface of titanium alloy was observed under scanning electron microscopy.RESULTS: The titanium alloy group rubbed with 80 grit Si-C sand paper yielded the strongest bond strength, 6.65 MPa, compared with other groups (P < 0.05). The surface roughness of titanium alloy in this group was (2.69±0.32) μm. Scanning electron microscopy results revealed that all fractured surfaces appeared at the interface of dentin and ionomer cement. CONCLUSION: The surface roughness could influence the bond strength between titanium alloy and dentin. Titanium alloy with (2.69±0.32) μm surface roughness bonding to dentin showed the maximum bond strength.

OBJECTIVE: To survey the immediate bond strength of the two glass ionomer cements with different pressure times.METHODS: Totally 70 teeth were prepared to expose the dentin, and then divided into the Ketac~(TM)Cem Easymix GIC glass ionomer cement group (3M group), and the TOKUSO glass ionomer cement (TOKUSO group). Each group was divided into 7 subgroups according to pressure times. The immediate tensile strengths of all specimens were measured after pressed for 5,10,15, 20, 25, 30 and 35 minutes.RESULTS: The immediate bond strengths of the two glass ionomer cements with different pressure time showed obviously significant differences (P < 0.01), which exhibited the greatest immediate bond strengths at 25 minutes after pressure. The bond strength of 25 minutes subgroup of 3M was higher than that of TOKUSO group, but the difference had no significance.CONCLUSION: Both Ketac~(TM) Cem Easymix and the TOKUSO glass ionomer cement can harvest the maximum bond strength after 25 minutes pressure.

Purpose:To evaluate the relationship between the expressions of MDR and GST-? and the response to neoadjuvant chemotherapy and prognosis in cervical carcinoma. Methods:The expressions of MDR and GST-? were examined by Envision immunohistochemistry using pretreatment biopsy specimens. The stage distribution of 57 patients in the study was 7 stage Ib, 35 stage IIa, 15 stage IIb. Treatment consisted of 2 courses of neoadjuvant chemotherapy followed by radical hysterectomy and lymphonectomy. If the patient was found to have parametrial involvement, pelvic lymph node metastasis, microscopic tumor emboli or disease in vagina stemp, she was given adjuvant radiotherapy after operation. All patients were followed up and the median follow-up time was 35 months (21-66 months). Statistical method used was SPSS 8.0 package. Results:There were 14 patients with cervical carcinoma who had expression of MDR. The rate of expression of MDR was 24.6% (14/57). Also there were 29 patients who had expression of GST-?. The rate of expression was 50.8% (29/57). The total response rate of neoadjuvant chemotherapy was 81%. The complete clinical response rate was 19% (11/57) and partial response rate was 61% (35/57). All patients were treated by operation following chemotherapy and 13 patients were given adjuvant radiotherapy after operation. The 5-year survival rate in stage Ib was 100%, stage IIa 90% and stage IIb 78.5%. The results showed the expression of MDR was related to response of neoadjuvant chemotherapy and 5-year survival. It is 93%(40/43) in group of MDR(-) and 43%(6/14) in group of MDR(+)( P =0.001). But it was not related to FIGO, histopathologic, parametrial involvement, and pelvic lymph nodes metastasis. The expression with GST-? only related to response of chemotherapy. The response rate in the group with expression of GST-? is 69% and it is 93% in the group with GST-?(-)( P =0.02).Conclusions:The response rate of neoadjuvant chemotherapy in group of MDR(-) and GST-?(-) was better than in the group with expression of MDR and GST-?. The measure of MDR and GST-? is helpful to predict the response of neoadjuvant chemotherapy in cervical cancer and MDR may related to prognosis of cervical cancer.