Objective To investigate the expression of serum tumor markers in pancreatic carcinoma and to assess the value of serum tumor markers in the diagnosis and prognosis of pancreatic carcinoma. Methods Five serum tumor markers including AFP, CEA, CA199, CA125 and CA242 were detected in 95 patients with pancreatic carcinoma by chemi-luminescence immunoassay (CLI) and enzyme linked immunosorbent assay (ELISA), 80 patients with other malignant tumor and 65 patients with benign disease served as controls. Five tumor markers in pancreatic carcinoma diagnosis for TNM staging were compared. The value of tumor markers for prognosis was analyzed. Results Among these 5 kinds of tumor marker, CA199, CAI25, CA242 were valuable in diagnosis of pancreatic carcinoma, and CA199 was the most valuable one, whose sensitivity and specificity were 76.2 % and 74.8 % respectively. CA199, CA125, CA242 were increased with progression of pancreatic carcinoma. Conclusion Serum CA199, CA125 and CA242 are the preferred tumor markers to be used in the diagnosis and prognosis of pancreatic carcinoma.

Objective This retrospective study was perform to assess risk factors of the type A aortic dissection after aortic valve replacement,in order to provide a basis for devising a strategy for future treatment.Methods From 2009 to 2012,23 patients were found type A aortic dissection and 20 patients were found aortic aneurysm after aortic valve replacement in Beijing Anzhen hospital.Analysis the clinical,pathology and surgery procedure characteristics of these patients,and assess the risk factors for type A aortic dissection after aortic valve replacement.Results After aortic valve replacement,There were significant different in age (P =0.012),bicuspid aortic valves (P =0.014),aortic valve regurgitation (P =0.009) and postoperative pathoanatomical characteristics(P =0.001) between type A aortic dissection group and ascending aortic aneurysm group.Multivariate logistic regression analysis indicated that age(P =0.032),aortic valve regurgitation(P =0.046) and pathoanatomical characteristics(P =0.002) were important risk factor for type A aortic dissection after aortic valve replacement,respectively.Conclusion Older age,aortic regurgitation combined and thinned or fragile aortic walls with systemic hypertension in patients with ascending aortic dilatation (≥45 mm diameter) at the time of AVR might be predisposing factors for postsurgical type A aortic dissection.These patients should be considered for concomitant replacement or repair of the ascending aorta unless the patient has a high operative risk.

[Objective]To discuss the spinal single side structure illness to the spinal column stable influence characteristic and the method of treatment,and to analyze the character of comparing the traditional three-column theory with the newly three-pyramidal-column theory.[Method]Through 2001-2006 year our hospital admited preservation integrity spinal single side structure illness 42 cases,among the total single side articular process illness 21 cases,single side vertebral plate illness 10 cases,Single side pedicle of vertebral arch illness 7 cases,single side more structure illness 4 cases.Through conservatively treats 11 cases,Single stage fixed 4 cases,the single stage two-sided fixed surgery treats 27 cases,thus,to analyze and revaluate three-pyramidal-column theory essence.[Result]Forty-two cases obtained the revisit completely,average follow-up for 28 months.Evaluates according to the Shi Shushan 's standard,the excellent 31 cases;the good 8 cases,the fair 3 cases.Good and excellent rate reached above 93%.[Conclusion]The spinal single side structure illness may lead to spinal pyramid tropic or scoliosis,and very little causes spondylolisthesis.The spinal colarnn is a three-pyramidal column lives by many triangles.Any colarnn or the angle being destructed will affect its stability.

OBJECTIVE: To investigate the expression of CXCR4 in maxillary sinus carcinoma cells IMC3 under hypoxia. METHOD: IMC3 cells were cultured for 6 h, 12 h, 24 h and 48 h under normoxia and hypoxia. Real-Time PCR was applied to detect the expression of mRNA of CXCR4 and immunohistochemisrty was applied to investigate its protein level. RESULT: CXCR4 mRNA level was about 0.035 under normal conditions, which was obviously upregulated by hypoxia. The mRNA levels after culturing under hypoxia for 6 h, 12 h, 24 h and 48 h were 0.283, 0.313, 0.426, 0.510 respectively. There was statistically significant difference between the mRNA levels of each two groups (P < 0.05, Mann-Whiney Test) with a time dependent course, except for the difference between the groups of 6 h and 12 h. Immunohistochemistry showed that there was almost negative staining for CXCR4 in the cell cultured in nomoxia, while stong positive staining of CXCR4 was observed in cells cultured in hypoxia . The positive staining was located mainly in the cell membrane and cytoplasm and little in the nucleus. CONCLUSION Hypoxia could induce expression of CXCR4 in IMC3 cells at both mRNA and ptrotein levels. The upregulation of CXCR4 by hypoxia showed an obvious time dependent course.
Cell Hypoxia ; Cell Line, Tumor ; Gene Expression Regulation, Neoplastic ; Humans ; Maxillary Sinus ; metabolism ; pathology ; Receptors, CXCR4 ; metabolism

Objective Methicillin-resistant Staphylococcus aureus (MRSA) is a growing public health concern that has been associated with pediatric fatalities. This study investigated the genotypes of staphylococcal cassette chromosomal mec (SCCmec) and Panton-Valentine Leukocidin (PVL) in MRSA strains isolated from Shanghai Children's Hospital by PCR. Methods A total of 30 strains of MRSA were isolated from various clinical specimens from October 2005 to June 2006. The antimicrobial susceptibility was measured by agar diffusion method. SCCmec typing was conducted using a novel multiplex PCR assay allowing for concomitant detection of methicillin resistance (mecA gene) to facilitate detection and classification of all currently described SCCmec typesⅠ, Ⅱ, Ⅲ, Ⅳa, b, c, d andⅤ. PVL gene was also determined by PCR. Results mecA gene was positive in all the strains. SCCmecⅡ was identified in 6(20.0%) isolates, SCCmecⅢ in 15(50.0%) isolates, SCCmecⅤ in 2 and SCCmecⅣa in 1 isolate. Six MRSA strains were non-typeable. The isolates with SCCmecⅡ or SCCmecⅢ were resistant to multiple antibiotics. The strains harboring SCCmecⅣa or SCCmecⅤwere susceptible to all antibiotics except β-lactams. Eleven (36.7%) isolates were PVL positive. The genotypes and subgenotypes of staphylococcal chromosomal cassette mec of eleven PVL-positive MRSA were SCCmecⅡ(1 isolates), SCCmecⅢ (5 isolates), SCCmecⅣa (1 isolate), SCCmecⅤ (2 iso-Lates) non-typeable (2 isolates). Conclusions SCCmecⅡ and SCCmecⅢ are the major genotypes of MRSA in our hospital. These isolates are multi-resistant to antibiotics. The prevalence of PVL gene is higher in SCCmecⅡ- or SCCmeⅢ-positive MRSA. The isolates with SCCmecⅡ or SCCmecⅢ were resistant to multiple antibiotics.

The present hospital information systems are analyzed,with finding that hospital information isolated island phenomenon getting worse due to failure of interconnection of various systems and equipment vendors with different technologies.An integrated platform based on an enterprise service bus is proposed for hospital information,which can be connected into these heterogeneous systems,effectively minimizing the inter-system coupling,and achieving data and service interconnection,enabling an integrated and intelligent hospital architecture.

The effect of pH on the extracellularpolysaccharide synthesis by Aureobasidium pullulans was studied by addding CaCO3and HCI. Cultivated in P2 liquid medium for 24h,pH dropped to 3. 6 because of strongly producing acid. Under this low pH environment, further fermentation for 120h,only 5. 9g/L of polysacharide was obtained. When grown in MP2 medium contaning0. 5 % CaCOs,the pH was kept above 5.0 during 144 hours,production of polysaccharide increased to 31g/L. The detailed information of effects of controlled pH on polysaccharide production showed an optimal pH value 5. 0 must be maintained through the fermentative period.

Objective There is a paucity of data regarding hepatic dysfunction (HD) following type A and B aortic dissection repair with deep hypothermic circulatory arrest (DHCA). We determine the incidence and outcomes for postoperative HD, and analyze the risk factors of death for HD. Methods Between January 2006 and June 2008, 208 patients have undergone open repairs of aortic dissection with DHCA. Indications for surgical intervention were type A aortic dissection in 181 patients and type B in 27 patients. 18 patients had postoperative hepatic dysfunction with abnormal hepatic enzyme and bilirubin.The mean patient age was 43 years and one third were women. Perioperative data including age, sex, type, surgery intervention, CPB time, aortic-clamp time and ICU retention time were collected. Complications were classified as bleeding, low cardiac output, acute renal failure, hypoxemia, infection, temporary neurologic dysfunction, multiple organ dysfunction and death.Serum GPT, LDH and TBIL were assayed and recorded before and after operation, as well as 12 h, 1 d, 3 d, 5 d, 7 d. Risk factors for death of hepatic dysfunction were ascertained by univariate and multivariable analysis. Results The incidence of hepatic dysfunction within one week following surgery is 8.7%. The mortality associated with HD was 39% compared with 1.6% (P＜0.0001) in patients without HD. ICU retention time were significantly different (P＜0.001) between HD grorp (11.9days) and non-HD group (4.2days). In this group, intraoperative and postoperative 24 hours blood transfusion volume (PRBC) ＞20 U occurred in 6 patients, reopen for bleeding in 3 patients, low cardiac output in 6 patients, sepsis in 1 patients, acute renal failure in 7 patients, hypoxemia in 5 patients, severe infection in 2 patients, temporary neurologic dysfunction in 5 patients, multiple organ dysfunction in 10 patients. Bleeding( P = 0. 024 ), low cardiac output (P = 0. 024 ), acute renal failure ( P = 0. 024), MOD ( P = 0.002) are the risk factors of death for hepatic dysfunction. And independent determinants were bleeding (P= 0.019) and MOD ( P = 0.001 ). Conclusion Multiple risk factors impact the onset of postoperative hepatic dysfunction. Bleeding and MOD after aortic dissection surgical repairs were associated with an increased mortality.

Objective To evaluate the role of using non-invasive ventilation with bi-level positive airway pressure (BiPAP) in order to reduce the need of re-intubation in pediatric patients with respiratory failure after cardiac surgery. Method From January 2007 to December 2007, 25 patients aged from three months to 11 years with median 2.3 years operated on for cardiac surgery with respiratory insufficiency after extubation and re-intubation indicated were enrolled in this study. They were put on non-invasive nasal (mask) BiPAP ventilation before re-intubation. The arterial blood gas, A-aDO2 and PaO2/FiO2 were measured. In addition, clinical data including heart rate, respiratory rate, and the product of heart rate and systolic pressure were recorded before and after BiPAP. The software SPSSD 13.0 was used to process by ANOVA test for statistical analysis. Meanwhile, the outcome of these patients was analyzed. Results Twenty-five patients with 30 episodes of respiratory insufficiency were treated with BiPAP ventilation with median duration of 1.96 days ranged from 0.03 to 12 days. Of these respiratory failure episodes, 25 ones (83.3%) could be controlled by BiPAP and the needs of re-intubation were avoided. Five episodes of respiratory failure in 4 patients could not be quelled and the endo-tracheal tubes were inserted in these patients. All patients were saved with a median of mechanical ventilation duration of 3.4 days and ICU stay of 10.6 days. No major complications were observed. The heart rate, respiratory rate and the rate-pressure product were decreased significantly one hour after BiPAP (P < 0.05 all). Meanwhile, patients showed rapid improvement of oxygenation. The pH, SpO>2 and PaO2/FiO2 were increased significantly and A-aDO2 was decreased significantly (P < 0.05 all). The PaCO2, was decreased significantly four hours after BiPAP (P < 0.05). Conclusions Non-invasive nasal mask BiPAP can be used safely and effectively in children after cardiac surgery to improve oxygenation/ventilation, decreasing the work of breathing. It may be particularly useful in patients with high risk of re-intubation.

BACKGROUND:Sensorineural hearing loss is mainly caused by missing or damaged hair cells in the inner ear. Application of adipose-derived mesenchymal stem cells to regenerate inner ear hair cells is an effective treatment for hearing loss. OBJECTIVE:To explore the feasibility of in vitro inducing adipose-derived mesenchymal stem cells to differentiate into inner ear hair cel-like cells in guinea pigs. METHODS:Adipose-derived mesenchymal stem cells from guinea pigs were isolated and cultured to the 3rd generation. cellphenotype was detected using flow cytometry. Cytokines were added for induction and differentiation by stages, including epidermal growth factor, basic fibroblast growth factor, insulin-like growth factor-1, al-trans retinoic acid, brain-derived neurotrophic factor, neurotrophin 3. RESULTS AND CONCLUSION:Adipose-derived mesenchymal stem cells of guinea pigs cultured in vitro were fusiform and showed a swirled adherent growth. Passage 3 cells were positive for CDCD29 and CD44, but negative for CD34 and CD45. After induction, the cells were positive for nestin and GFAP positive at early stage;after 10-day continuous induction, the cells expressed Myosin VIIa and Math1, specific markers of hair cells, indicating that cytokines can directly induce adipose-derived mesenchymal stem cells to differentiating into inner ear hair cells in guinea pigs.