Primary cytoreductive surgery followed by platinum-based chemotherapy represents the standard treatment for patients with advanced ovarian cancer.But some patients with advanced ovarian cancer still have suboptimal residual disease after the primary debulking surgery.Neoadjuvant chemotherapy has been suggested as an alternative strategy to achieve no residual disease.It is important to find methods to estimate the likelihood that cytoreductive surgery will leave no residual disease.A number of studies have evaluated the use of serologic markers (such as CA125),imaging modalities (such as CT,PETCT,MRI),and laparoscopic surgery to determine which patients are ideal predictors for neoadjuvant chemotherapy.As a new approach of assessment for preoperative evaluation regarding cytoreduction,laparoscopic surgery deserves further research.

Respiration is one of the most important modulators of heart rate variability(HRV). The modulation mechanism of respiration on HRV were introduced. The effects of respiratory rate, respiratory volume and respiratory patterns on HRV were discussed, and these effects on HRV in patients were also referred. These respiratory effects should be taken into account when HRV is used to predict cardiac vulnerability.

Objective To summarize the experiences in clinical diagnosis and surgical treatment of chest cancers invading the superior vena cava (SVC). Method Retrospective study of 12 cases with chest cancers invading the SVC, SVC and innominate vein were reconstructed with prosthesis in 3 cases, the side wall of the SVC was excised and repaired in 9 cases. Results Complete resection was performed in 10cases,2 cases had incomplete resection. There was no death associated with operation in these patients. All patients were followed up for 1 - 7 years after operation,and 3 cases were lost to follow up,5 of remaining 9cases were dead because of relapse and metastasis, their median survival time was 8 months,other 4 cases lived, their median survival time was 42 months. Conclusions Patients with chest cancers invading the SVC should have surgical treatment of not only tumor resection but also the vessel reconstruction,the prognosis would be better than without surgical treatment. These patients have a high quality of life and live with long-term survival.

Objective:To evaluate the changes of the left atrial systolic function in patients with acute myocardial infarction(AMI)using quantitative tissue velocity imaging(QTVI).Methods:The systolic velocities of the middle of left atrial lateral wall,anterior wall,inferior wall and atrial septum were measured with QTV1 in 45 patients with AMI.The left atrial volume and active atrial emptying fraction(AA-EF)were measured using single-plane Simpson method.Results:(1)Compared with the control group(30 normal subjects),the diameter and volume of the left atrium,as well as AA-EF,increased obviously in patients with AMI(P ＜ 0.01).(2)Compared with the control group,the systolic velocities of the middle of left atrial lateral wall,anterior wall,inferior wall and atrial septum,as well as the average value,increased significantly in patients with AMI (P ＜ 0.05 or P ＜ 0.01).In addition,the average value of left atrial systolic velocity was closely correlated with AA-EF(r=-0.906,tr=14.001,P ＜ 0.01).Conclusion:QTVI could be used to evaluate the left atrial systolic function accurately in patients with AMI.

BACKGROUND: Now, Shock Wave Therapy is used to cure the ununion and delayed union of bone, the avascular necrosis of the femoral head and the chronic injury of locomotor system, what has got a good curative effect. But, the mechanism is not clear. OBJECTIVE: To investigate the expression of c-Fos, c-Jun protein in human bone marrow mesenchymal stem cells (BMSCs) Influenced by shock wave.DESIGN, TIME AND SETTING: Randomized group, the controlled study was performed at the State Key Laboratory of Pathology, College of Basic Medicine, Jilin University, from March 2007 to March 2008. MATERIALS: Bone marrow was obtained from healthy volunteers.METHODS: Human BMSCs were cultured in vitro. And the fourth generation cells were digested into cell suspension with 2.5 g/L trypsin and adjusted at a density of 1.0×10~9/L with DMEM-LG. Then, the cells were divided into 6 1.5-mL Eerrendorf tubes, one was control group and the other five were experimental groups. The experimental groups were treated with an optimal dose of shock wave (8.5 kV, 120 times) by liquid-electric shock wave lithotripsy. Then the protein was extracted at different time points (5, 15, 30 minutes, 1, 2 hours) after treatment.MAIN OUTCOME MEASURES: Inverted microscope was used to observe the morphologic feature of BMSCs. The growth curves were charted by MTT method. The change of activations of c-Fos, c-Jun were tested by western blot. RESULTS: ①BMSCs were seeded in culture plate. The cells began to divide and proliferate slowly 24 hours later, and became fusiform shape after adhering to the wall. 3 days later, the speed of proliferation quickened, and cells accumulated colony. At day 10-14, the number of hMSCs grew till they covered the bottom of the culture plate. The round passage hMSCs adhered to the wall completely in 24 hours, which were similar to primary cells. The cells connected together during one week, and showed vortex-like. The speed of proliferation became slower and the cells became older when hMSCs were passaged to the tenth generation. ②MTT method showed that the growth curve of original, P2, P3 hMSCs looked like S shape, and the third to fifth days were growing period. ③The phosphorylation level of c-Fos and c-Jun began to increase after induced by shock wave and reached a peak at 30 and 15 minutes, respectively. And their phosphorylation level were 2.56-fold and 1.68-fold (P < 0.01) compared with the average level in control groups, respectively. Then they began to decrease. There was no apparent change in the total dose (P > 0.05). CONCLUSION: Following the treatment of shock wave, the activations of c-Fos and c-Jun in BMSCs increased.

OBJECTIVE To study the isolation,distributive characteristics and drug resistance of AmpC enzyme producing Gram-negative bacilli in nosocomial infection of two years and provide the evidence for treatment. METHODS A total of 528 strains of Gram-negative bacilli collected from daily specimens were identified with Bio-Fosun-Ⅰ,and AmpC enzyme was screened by cefoxitin disk and then corroborated by EDTA disk method. All data were analyzed statistically. RESULTS Among 528 strains collected,136 (25.75%) were AmpC enzyme producing strains,the respective percentage of Pseudomonas aerugionsa,Echerichia coli,Enterobacter cloacae,Klebsiella pneumoniae and Citrobacter was 32.35%,28.67%,18.38%,8.09% and 5.15%,respectively. Most strains (38.9%) were detected in ICU. The common infection sites were lungs. The resistance rate of AmpC enzyme producing strains to the first,second and third-generations cephalosporins was 71.3-99.5%. The susceptive rate of AmpC enzyme producing strains to imipenem,cefepine,amikacin and piperacillin/tazobactant were low. CONCLUSIONS For effective supervision and control of AmpC enzyme producing Gram-negative bacilli in nosocomial infection,detection of AmpC enzyme shoud be paid much attention by clinical microbiology laboratory.

5 cases diagnosed with Dandy-Walker Syndrome from May 2006 to November 2009 were investigated and relevant literature reviewed. Dandy-Walker Syndrome was characterized by retarded motordevelopment and cerebellar signs. The latter was observed in 3 cases in our series. The disorder, mostly influencing childhood, typically causes the fourth ventricle enlarged, and the cauda cerebelli atrophic or even absent. MRI is the most optimal radiological method to diagnose it.

Objective: To investigate the effect of medication on left ventricular myocardial matrix remodeling in neuroendocrine hypertensive rats and the mechanism and inhibitive method thereof. Methods: A neuroendocrine hypertensive model was established with adult Wistar rat. A total of 34 rats were randomly divided into four groups: parzosin (Hα), cilazapril (Hace), pentoxifylline(Hptx) and hypertensive control group(Hc). Ten normal-tensive Wistar rats were used as normal control (Nc). The systemic blood pressure, serum procollagen type Ⅲ level, serum TNF-α level, collagen volume fraction(CVF) were detected. Results: In Hace group, systolic pressure, left ventricular weight, the levels of serum procollagen type III and TNF-α were all reduced obviously compared to those in Hc group(P < 0.05). In Hα group, the systolic pressure and left ventricular weight were reduced obviously compared to those in Hc group(P < 0.05), however, the levels of serum procollagen type III and TNF-α were higher than those of Nc group(P < 0.05). In group Hptx, the systolic pressure and left ventricular weight were not decreased, while the levels of serum procollagen typeⅢ,TNF-α and CVF were reduced to normal levels. Conclusion:The angiotensin coverting enzyme inhibitor is the effective agent to reverse myocardial fibrosis, which can be achieved mostly by the inhibition of AngⅡ. Pentoxifylline may inhibit and reverse myocardial fibrosis which correlated with inhibiting TNF-α.

Objective:To investigate the changes of left ventricular mass index(LVMI),plasma brain natriuretic peptide (BNP),interJeukin-6(IL-6)and interleukin-10(IL-10)in patients with congestive heart failure(CHF),and their values in risk stratification and prognostic evaluation of CHF thereof.Methods:Ninety-five patients with CHF in accordance with 2001ACC/AHA guidelines were enrolled and stratified as stage A(n=21),B(n=23),C(n=31)and D(n=20).The levels of plasma BNP,IL-6 and IL-10 were measured and compaired with those in 20 healthy subjects(control group).The patients were followed up every three months in two years.The end point was the rehospitalization and the cardiac death.Results:(1)The level of LVMI increased early in patients with CHF at stage B.(2)The plasma BNP levels were initially elevated in CHF patients at stage B,and the concentrations of BNP closely paralleled disease severity.(3)The levels of plasma IL-6 and IL-10 were increased,and the ratio of IL-10/IL-6 was decreased,with the progression of CHF at stage C and D.The plasma BNP level was positively correlated with the levels of IL-6 and IL-10.(4)The new CHF stratification was surperior to NYHA functional classification in regard to CHF prognosis prediction.(5)Multivariate COX regression analysis showed the levels of BNP and IL-6 were the independent risk factors in prognostic evaluation(P＜0.01,P=0.026).(6)Patients in high-risk groups stratified by the combination of BNP and stage classification had obviously higher end point events rate.Conclusion:(1)LVMI was a better marker for the evaluation of left ventrieular remodeling.(2)The intrinsic mechanism of CHF progression was inflammatory reaction deterioration.(3)BNP was a good marker in predicting onset and prognosis of CHF.The combination of BNP and the stage classification could improve the prognostic evaluation in patients with CHF.

AIM: To investigate the effects of recombinant human interleukin-13 (rhIL-13) on the expression of proto-oncogene c-mpl in Dami cells, a human megakaryobiastic leukemia cell line. METHODS: The expression of c-mpl mRNA in Dami cells was investigated with RT-PCR. The expression of membrane-bound protein c-mpl on Dami cells was investigated with ligand combination experiment. RESULTS: In RT-PCR experiment, we found the quantitis of expression of c-mpl mRNA in 25 ?g/L rhIL-13 group increased by 24.8%. In ligand combination experiment, we found quantitis of expression of membrane-bound protein c-mpl in 100 ?g/L rhIL-13 group increased by 28.5% ( P