RET gene is an important oncogene,which is closely associated with the development of various types of human tumors. The mainly mechanisms of RET gene associated tumor are mutation and over-expression of wild type. Activated RET protein participates in the proliferation,apoptosis,metastasis through some signal pathways and influences the tumorigenesis and development.

Objective: To evaluate color velocity imaging-quantitative method (CVI-Q) in estimating cerebral hemodynamic change in patients with cerebral infarction. Methods: The carotids of 60 normal people and 40 cerebral infarction patients were detected by CVI-Q. We observed endangium thickness and atheromatous plaques,and measured the diameter (d), peak velocity(Vmax), resistance index(RI) and blood flow volume(Q) of the common carotid arteries. Results: In cerebral infarction group there were 75% cases with endangium thickening to different degrees, 45% cases with atheromatous plaques and 71% plaques in carotid enlargement section or bifurcation. The data measured in 2 groups were compared: (1)The d value in cerebral infarction cases increased than that in normal（P<0.05 or P<0.01）; (2)The Vmax reduced in cerebral infarction cases(P<0.05); (3)The RI increased in cerebral infarction cases (P<0.05 or P< 0.01); (4) The Q value reduced in cerebral infarction cases (P<0.01). Conclusion: CVI-Q can be used for detecting cerebral hemodynamic changes and provide quantitative indexes for clinicians to estimate ischemia degree and treatment in cerebral infarction patients.

Objective To explore the influence of personality and negative life events on the development of pulmonary tuberculosis among diabetic patients.Methods A hospital-based case-control study was conducted from March 2005 to February 2006.158 newly-diagnosed pulmonary tuberculosis patients with diabetes (DMPTB) were reemited as cases and 281 diabetic patients (DM) as control group.Information on personality and negative life events was collected using Eysenck Personality Questionnaire (EPQ) and Life Events Scale (LES),respectively.Odds ratios(OR) and 95% confidence intervals (95% CI) were estimated using logistic regression models and the potential confounding bias was controlled through adjusted by education,income,glycemic control,previous maximal BMI,weight loss ratio,physical xercises,smoking,negative life events or personality.Results The proportions of introversion,medium,extroversion personality in DM-PTB and DM group were 38.6% ,11.4% ,50.0% vs.53.0% ,11.1% ,35.9% (X~2=9.280,P=0.010).Those with introversion personality had 1.91 (1.26～2.90) times higher risk of DM-PTB than those with extroversion personality,while this association became insignificant after adjustment(P=0.111) ; 35.4% and 19.6% in the two groups had experienced life events during the last one year,and such persons had 2.26(1.15～3.50) (unadjusted) or 1.82(1.07～3.10)(adjusted) higher risk of DM-PTB than those without life events,especially among male and younger (＜60y) diabetics.Conclusion Negative life events are the independent risk factor of pulmonary tuberculosis among male and younger diabetics.Thus,mental measures should be taken in corresponding risk populations to improve their capability of dealing with life events.

Objective To determine the changes of serum glycosylphosphatidylinositol specific phospholipase D(GPI-PLD) activity in patients of several liver disease.Method Glycosylphosphatidylinositol (GPI) anchored placental alkaline phosphatase(PLAP) prepared by ourselves was used as a substrate.After partitioning by triton-X-114,the serum GPI-PLD activity was determined quantitatively and the data was treated by microware of SPSS 10.0.Results On the basis of the percentage of GPI-anchored PLAP conversion,the sera GPI-PLD activities of total 172 patients,included 26 severe acute viral hepatitis as group A,29 liver cirrhosis as group B,32 chronic viral hepatitis as group C,55 mild acute viral hepatitis as group D,30 primary hepatocellular carcinoma as group E,were measured.As compared with 182 healthy presons as control group,the sera GPI-PLD activities of group A and B were significantly reduced;By contraries,the activities of group D and E were significantly raised.The sera GPI-PLD activities of group C compared with healthy control group were not significantly altered.However,when paired Q-test,the changes of serum GPI-PLD activity between all paired groups among this five groups were remarkable.Conclusions The determination of sera GPI-PLD activities in patients can act as a biochemistry index for diagnosis of acute viral hepatitis,liver cirrhosis and primary hepatocellular carcinoma,as well as an auxiliary index for judgment of the curative effect and prognosis of liver diseases.

OBJECTIVE To investigate the infection status and drug resistance of Ureaplasma urealyticum (Uu) and Mycoplasma hominis (Mh) isolated from female genitourinary tract. METHODS The specimens of 1890 cases were collected from Jan 2003 to Dec 2006. The results of mycoplasma cultivation and susceptibility test were analyzed retrospectively. RESULTS Among 1890 cases, there were 756 cases with positive mycoplasma cultivation. Positive rate was 40.0%. Positive rate was the highest at the age of 21 to 40. Among 11 commonly used antibiotics, sensitivity of tetracyclines was the highest,followed by macrolides. Four quinolones all showed the higher resistance. CONCLUSIONS The resistance of commonly used antibiotics in mycoplasma isolated from female genitourinary tract is greatly severe.We should think highly of it.

OBJECTIVE To investigate pathogen distribution and drug resistance in infection of operative incision and provide the reference for clinical prevention and cure.METHODS Referring to National Rules of Operation in Clinical Laboratory,strains were isolated and identified,and drug-sensitivity test was performed by DADE BEHRING panel.RESULTS Among total 140 strains of pathogenic bacteria,the most were Gram-negative bacilli that accounted for 58.6%(82 strains),followed by Gram-positive cocci that accounted for 41.4%(58 strains).Staphylococcus aureus and Pseudomonas aeruginosa had the higher detection rate.The former was 29.3% and the latter was 27.1%.Among the total S.aureus,meticillin-resistant S.aureus(MRSA) accounted for 31.7%.Detection rate of extended-spectrum beta-lactamases(ESBLs) producing Escherichia coli and Klebsiella pneumoniae was 40.9%.CONCLUSIONS Effective measurement should be taken to prevent and control infection of operative incision.

ObjectiveTo evaluate clinical-pathological features, diagnosis and therapy of gestational trophoblastic tumor (GTT) misdiagnosed as ectopic pregnancy. MethodsFrom 1999 to 2003, a total of 13 patients with GTT misdiagnosed as ectopic pregnancy were retrospectively analyzed. ResultsThe main symptoms were amenorrhea, abdominal pain, irregular vaginal bleeding. Serum beta-human chorionic gonadotrop in(hCG) was measured in 10 patients. Eight had hCG values above 10 000 IU/L; 3 had hCG values above 50 000 IU/L. The lesions of GTT misdiagnosed as ectopic pregnancy were fallopian tube, horn of uterus, peritoneal cavity, greater omentum, recto-uterine pouch. According to standards of the International Federation of Gynecology and Obstetrics(FIGO) the 13 patients were categorized as 6 of stage Ⅰ, 2 of stage Ⅱ, 3 of stage Ⅲ and 5 of stage Ⅳ. Histologically they included 10 cases of choriocarcinoma and 3 of invasise mole. All patients were treated by complete surgical resection combined with subsequent adjuvant chemotherapy. ConclusionsMisdiagnosis leads to delay in therapy with resultant increased morbidity of GTT.Analysis on serial hCG is helpful to differential diagnosis between ectopic pregnancy and GTT.

AIM: To observe the outcome of donor bone after vascularized allograft bone transplantation under immunoregulation. METHODS: The experiment was conducted at the Microsurgery Institute, Medical College, Wuhan University from December 2002 to March 2004. Totally 21 male flap-eared Japanese rabbits were selected as donor and 42 female ones as recipients. Recipients were composed of 21 rabbits in the experimental group and 21 rabbits in the control group. ①Anastomotic vascularized massive shaft of femur allograft was performed in Japanese flap-eared rabbits of either sex. ②The experimental animals were assigned into experimental group (treated with ciclosporin A, 25 mg orally, once a day, for 3 weeks) and control group (no any immunosuppressive agent). ③X-ray and histology examinations were performed at months 1, 4 and 9 after operation. Bone grafts were analyzed with Sry semi-quantitative polymerase chain reaction. RESULTS: A total of 42 rabbits were involved in the result analysis. ①X-ray manifestation at different time points after rabbit transplantation in the two groups: X-ray showed typical fracture healing mode at different phases after operation in the experimental group, whereas the increase of bone graft density, and around by a mass of bony callus in the control group. ②Histology manifestation of rabbits in the two groups after operation: At different time phases it showed typical fracture healing mode in the experimental group after operation, and 9 months later the marrow cavity was filled with myeloid tissues, and the internal and external cortex was flat; Haversian canal had revered to the normal size; Bone cells appeared in the bone lacuna; Peripheral cortex was wrapped with fibrous tissues. In the control group, it showed inflammatory cell infiltration with rejection, bone marrow necrosis in marrow cavity, formation of fibra tissues, bone cell loss in bone lacuna, and the bone grafts were wrapped with woven bone that was from recipients. ③Outcome of Sry semi-quantitative PCR analysis: The Sry semi-quantitative PCR analysis showed that the relation between the ratio of male DNA and the postoperative period was positive; the ratio of experimental group at month 9 postoperative was near to 100%, while control group only reached 11.8%. CONCLUSION: Under the immunoregulation, bone graft can unite with the recipient bone in an earlier postoperative period and replace by recipient bone rapidly in vascularized allograft bone transplantation.

Objective To investigate the pharmacodynamics of remifentanil required to prevent laryngeal mask airway (LMA) insertion response in patients anesthetized with propofol by TCI. Methods Thirty-six ASA Ⅰor Ⅱ patients aged 18-59 yr with body mass index ＜ 30 kg/m2 undergoing elective breast operation were enrolled in the study. Propofol was administered by TCI at an effect-site concentration of 4.0 μg/ml. When the patients lost conciousness, TCI of remifentanil was started. The initial target plasma concentration of remifentanil was set at 2.9 ng/ml, and the ratio of two consecutive effect-site concentrations was 1.2. LMA was inserted at 3 min after the target effect-site concentration and the plasma concentration achieved the balance. Criteria of successful insertion were defined as Muzi score≤2 and the increase in MAP and HR≤ 15% of the baseline values within 3 min after insertion. EC50 was determined by modified Dixon's up-and-down sequential trial and the 95 % confidence interval was calculated. Results The EC50 of remifentanil was 2.75 ng/ml. The 95% confidence interval was 2.51-3.01 ng/ml. Conclusion The EC50 of remifentanil for suppression of cardiovascular response to LMA insertion is 2.75 ng/ml in patients anesthetized with propofol by TCI.

Objective The aim of this study was to evaluate the clinical factors contributing to the operative effects in patients with acetabular fracture.Methods A total of 129 cases of patients with acetabular fracture were retrospectively analyzed from Jun 2006 to Jan 2011 in The Second Hospital of Shaoxing.Of the 129 acetabular fracture patients,96 cases were in the superior group and 33 patients in the inferior group according to Merled'Aubigne-Postel methods.The potential clinical factors related to the operative effects in acetabular fracture patients were evaluated by the method of logistic regression analysis.Results The superior rate was 74％ in this study.Single factor analysis demonstrated that the diaplastic quality(x2=21.53,P ＜0.01),the femoral cartilage defect(x2 =17.50,P ＜0.01),the inra-aticular free bone(x2=12.18,P =0.0005),the type of fracture (x2 =7.24,P =0.0071) and the timing of operation (x2 =4.36,P =0.037) were correlated with operative effects in acetabular fracture patients.The binary logistic regression analysis indicated that non-anatomic diaplastic (OR =4.17,P =0.01)and the femoral cartilage defect(OR =3.11,P =0.03) were independent risk factors for operative effects in patients with acetabular fracture.Conclusions The prognosis of patients with acetabular fracture,which was complex,was affected by multiple factors.And introperatively,the anatomic reestablishment should be performed in order not to affect the post operative hip function.