Objective: To investigate the first appearance and geographic distribution of hantaviruses in China. Methods: Some sequences of M segment of hantaviruses isolated in China were retrieved from GenBank. Some recently sequenced viruses which have not been registered in GenBank were obtained from authors who reported them. Program MEGA 3. 1 was employed for the phylogenetic analysis of the above virus sequences. Nucleotide divergence rates were estimated by comparing the closely related sister sequences isolated in the same geographical region at no less than a 5-year interval. Based on these calculated divergence rates, together with their isolating time and region, we explored the first appearance and geographic distribution of hantaviruses in China. Results and conclusion: The distribution of hantaviruses was in cluster, with Guizhou Province having the most subgenotypes. which supports the previous hypothesis that hantaviruses first appeared in Guizhou Province of China. A novel subgenotype virus was found in Anhui Province, indicating that it might be easier for the virus to have mutation in Anhui Province. We also found that Gou3 strain might be the earliest one to separate from a common ancestral strain; it is speculated that hantaviruses migrated in China about 315 years ago.

Objective To compare the changes of serum cystatin C(CysC),cytokeratin 19 fragment(CYfra21-1)and neuro-spe-cific enolase(NSE)levels before and after surgery in the patients with lung cancer.Methods ELISA and the chemiluminescence method were adopted to detect the levels of serum CysC,CYfra21-1 and NSE before and after operation in 33 patients with lung cancer and the detection results were compared with those in 35 health people.Results The serum CysC,CYfra21-1 and NSE levels in the lung cancer patients were significantly higher than those in the normal control group(P <0.01);which had statistically sig-nificant difference between before and after operation(P <0.05);the serum CysC,CYfra21-1 and NSE levels in 3 months after op-eration still had statistically significant difference compared with the normal people(P <0.05),moreover the serum CysC level was positively correlated with serum CYfra21-1and NSE levels(r =0.601 8,0.596 6,P <0.01 ).Conclusion Detecting serum cyscC, CYfra21-1 and NSE level change has certain clinical value for evaluating the prognosis and the disease condition monitoring of the patients with lung cancer.

Objective To evaluate the influence of lumbar disc herniation type on the curative effect of percutaneous lumbar discectomy (PLD). Methods 158 patients were classified into two groups including contained and discontained herniation according to clinical symptoms and diagnostic images. They were treated by meanes of the same technique in nonvascular intervention. Their curative effects were compared with each other in this study. Results The curative and total effective rates were 81.1% and 98.5% respectively in contained group, 7.7% and 38.5% in discontained group without serious complications. The duration of follow up ranged from 3 months to 73 months. Conclusions PLD is a effective procedure for lumbar disc herniation, which is relatively simple and safe with rapid recovery and without serious complications. It should be confirmed in simple contained herniation only.

Hepatocellular carcinoma ( HCC) , as one of the most common malignant neoplasms , has a relatively high morbidity and mortality rate worldwide.MicroRNAs (miRNAs),a type of comparatively conserved endogenous small non-coding RNAs, function as pivotal regulators involved in various biological functions through the post -transcriptional regulation of gene expression .Some miRNA genes are arranged into a intandem model and reside close together on the same chromosome , forming miRNA clusters . These clustered miRNAs are mostly located on polycistronic transcripts and expressed at similar levels.In the human imprinted 14q32 region, 52 miRNA genes are organized as a large cluster which spans about 220 kb of the long arm ( q) .Lines of evidence show that dysregulation of miRNAs in this cluster are involved in the development of HCC .This review summarizes the structural characteristics of 14 q32 miRNA cluster as well as its impact on HCC in initiation and progression .

Objective To investigate the diagnosis and treatment of cervical intraepithelial neoplasia and their clinical effect Methods The cases who were diagnosed as CIN through cytology, colposcopy biopsy and histopathological diagnosis were collected from January 2004 to June 2009 in Songjiang Hospital Affiliated to Shanghai Jiaotong University School. Drug therapy, physical therapy, cervical conization and hysterectomy were performed according to the lesion degree of CIN and patients' willingness. Some cases were further treated with surgery, radiotherapy or chemotherapy according to the pathological findings of the initial excision specimens. With long-term follow-up at 6,24 months after the treatment,we performed a comparative analysis on pathological diagnosis and therapeutic effects. Results Seven hundred and fifty cases of CIN were diagnosed after cervical cancer screening,among which,460 cases of CIN Ⅰ ,180 cases of CINⅢⅡ and 110 cases of CIN Ⅲ. Five hundred and Senventy-eight cases received treatment, among which, 46 cases received drug treatment After 6 months, focus disappeared in 32 cases, sustained in 10 cases, upgraded in 2 cases and canceration occurred in 2 cases. 13 cases received physical therapy,no recurrence occured. Four hundred and thirty-five cases received conization treatment, 34 cases with focus upgraded and 4 case recurred after the operation. 84 cases received hysterectomy, of which, 11 cases focus upgraded after the operation and no recurrence. The cases with focus upgraded or recurred all received additional treatment. The effective rate of physical therapy,conization treatment and hysterectomy on all grades of CIN was more than 98% at 2 years, and 69. 7% of drug treatment. The omission diagnostic rate of colposcopy guided biopsy on invasive carcinoma was 2. 2% , and the residual rate of focus of hysterectomy specimens after conization was 16. 2% . Conclusion Colposcopy including multi-point biopsy has high accuracy and specificity in early diagnosis of CIN . Cervical conization is the main method of the treatment of CIN. Patients with CIN Ⅲ and without desire of fertility should consider the removal of the uterus after cervical conization. Drug conservative therapy of CIN should be chosen carefully.

One hundred and twenty-two patients with confirmed cervical intraepithelial neoplasia (CIN), as a result of occasional screening for uterine cervix cancer in our out-patient clinic between July 2006 and August 2007, and 122 control patients with cervicitis who received colposcopy during the same period were enrolled in this study. Our results showed that 72% participants didn't receive uterine cervix cancer screening during the past 2 years; 55% women had premarital sexual behavior. CIN was most commonly seen in 30 to 34 year old women. Occasional screening could identify 75% CIN. In comparison with the control group, the incidence of earlier first sexual behavior, marriage, and delivery, multiple pregnancy, and frequent abortion was significantly increased in the study group (P < 0.05). We suggest that increased access to uterine cervix cancer screening might be more important than technical improvement.

Objective To explore the surgical technique and clinical effect of combined great toe wraparound flap and second toe tissue flap transfer for subemergency reconstruction of grade Ⅲ and Ⅳ thumb defect.Methods From July,2011 to March,2014,12 patients of grade Ⅲ and Ⅳ thumb defect were treated by transfering combined great toe wrap-around flap and second toe tissue flap transfer.The second toe tissue flap was carried out to cover donor site defect of the big toe.Results All the 12 transplants survied and were followed up for 6 to 24 months.The reconstructed thumbs had near nomal appearace and good fuction,2-point discrimination ranged from 0.6 cm to 0.8 cm.According to the trial standard of upper limb part of functional assessment of the Hand Surgery Branch of Chinese Medical Association,among the 12 eases,there were excellent in 9,good in 3.Impact on the donor foot was minor with limited complications.The patients were able to weight-bearing walking after one months of operation.For long-term follow-up,no case had successive ulces,obvious pain and claudication.Conclusion The reconstructed thumbs by great toe wrap-around flap combined with the tissue flap of second toe had near nomal appearace and good fuction.

Objective To study the influence of 4-aminopyridine(4-AP)on proliferation,production,and apoptosis through inhibiting voltage-gated K+channel(Kv)in ovarian luteinized granulosa cells.nethods Ovarian luteinized granulosa cells were recovered from 25 women with regular menses who underwent in vitro fertilization programme.The cultured granulosa cells were divided into 4 groups:blank group,4-AP treated group,human chorionic gonadotropin(hCG)-induced group and hCG+4-AP cotreated group.The final concentrations of hCG and 4-AP were 1250 U/L and 5 nmol/L respectively.The progesterone production WaS detected by the chemoluminescence method.The expression of Kv mRNA on human ovarian luteinized granulosa cell was detected by RT.PCR The influence on the early apoptosis of gTanulosa cells bv 4-AP was observed by flow eytometry.Cellular caSpage-3 activities were observed with colorimetric method and the inhibition of the cell proliferation was studied using methyl thiazolyl tetrazolium(MTT)method.Results(1)Kv mRNA wag expressed in granulosa cell.(2)The progesterone production64),(206±32),(1991±172)and(763±79)nmol/L,respectively after24 hours culture.Exposure of the(3)The flow cytometry analysis and the cellular caapase-3 A405 showed that 4-AP increased the percentage ofearly phase apoptosis(P<0.01):4-AP treated group VS blank group[(40±5)%and 0.049 ±0.009]VS[(17±4)% and 0.029±0.008],hCG+4-AP CO-treated group VS hCG-induced group[(25±4)%and0.039 ±0.0081 VS[(15±3)%and 0.022 ±0.007].(4)24 hours after treated with 4-AP and hCG,theinhibitory rate of cultured granulosa cells of 4-AP treated group was higher than the blank group(19.7%VS0).and that of hCG+4-AP co-treated group was obviously higher than hCG-induced group(34.6% VS O,P<0.01).Conclusions The voltage-gated K+ channels expressed by ovarian luteinized granulosa cellplay an important role in cell proliferation,production,and apoptosis.4-AP may inhibit differentiation ofprogesterone in granulosa ceHs through the inhibition of proliferation and induction of apoptosis.

Purpose To study the clinical features,pathological manifestation and immunohistochemical phenotype and improve the diagnosis and treatment of myoepithelial carcinoma in salivary glands.Methods Histomorphology and immunohistochemical phenotype were analyzed after the sections were stained with routine HE and immunohistochemical methods,and the relevant literatures were reviewed.Results The tumours were predominantly composed of pale-stained clear cells.In some cases,plasma-like cells,epithelioid cells and spindle cells were also seen.The cells were arranged in nest,solid or cords.Mitosis was easily seen,cytological atypia was obvious and necrosis existed in 4 cases.The results of immunohistochemical staining showed that CK was expressed in all cases.EMA was expressed in 8 cases.p63 and CK5/6 were expressed in 11 cases.S-100 was expressed in 10 cases.vimentin was expressed in 4 cases.Calponin was expressed in 2 cases.SMA was expressed in one case.The proliferation index of Ki-67 was 5％ to 40％.Conclusion The histological changes of myoepithelial carcinoma cells are diverse,and pathological and immunohistochemical methods are helpful for improving the rate of right diagnosis.Sugery is the main treatment for myoepithelial carcinoma.

Objective To investigate the epidemiological, clinical and pathogenic characteristics and prognosis of the first imported case of Chikungunya fever in China in 2008. Methods Epidemiological and clinical data of this mate adult patient were analyzed retrospectively. Chikungunya virus (CHIKV)-IgM was detected using enzyme linked immunosorbent assay (ELISA) and colloidal gold immunoassay. CHIKV-RNA was detected using real-time fluorescent polymerase chain reaction (RT-PCR). Results This patient had onset of fever on March 2 in 2008 and lasted for 5 days. In addition, he felt joint and muscle pains, headache and found generalized engorged maculopapule. The laboratory tests showed leukopenia and thrombocytopenia. CHIKV-IgM was detected positive at day 9 after the onset and CHIKV-RNA was all positive at day 3, 5, 7, 9 after the onset. A 575 bp fragment of RT-PCR product was sequenced and detected the nucleotide homology was 99% compared with CHIKV sequences in GenBank. The patient recovered with symptomatic supportive treatment.Conclusion This imported case of Chikungunya virus infection is reported for the first time in China.It shows similar clinical manifestations with dengue fever.