Background and purpose:Brain is one of the most common sites for distant metastasis in patients with non-small cell lung cancer,and the prognosis of patients with brain metastasis is usually dismal.The purpose of this retrospective study is to document the relationship between the prognosis of lung cancer patients with brain metastasis and the expressions of p53,nm23 and VEGF in resected lung cancer tissues.Methods:Ninety-two patients who were definitively treated with surgery for non-small cell lung cancer but lately developed brain metastasis between 1997 and 2005 were identified in our institution.Their clinical data were retrieved and retrospectively reviewed.All pathological specimens of their resected lung cancer were examined for the expressions of p53,nm23 and VEGF by immunohistochemical staining.The association between the treatment outcome and the expression of the above mentioned biomarkers were analyzed.Results:The median survival time(MST) of patients with p53(+) versus p53(-) was 11.0 versus 11.9 month,respectively.The 1,2,and 3-year overall survival rates were 45.71%,22.86%,and 18.29% respectively for p53(+) patients,and 49.55%,16.12%,and 8.89% respectively for p53(-) patients(P=0.5179);The MST of patients with nm23(+) versus nm23(-) was 13.0 versus 10.1 month,respectively.The 1,2,and 3-year overall survival rates were 54.20%,21.51%,and 16.45% respectively for nm23(+) patients,and 32.0%,12.0%,and 4.0% respectively for nm23(-) patients(P=0.1075);The MST of patients with VEGF(+) versus VEGF(-) was 10.5 versus 12.2 months,respectively.The 1,2,and 3 year overall survival rates were 42.20%,0,and 0 respectively for VEGF(+) patients,and 50.0%,25.41%,and 16.57% respectively for VEGF(-) patients(P=0.0231).Conclusions:VEGF was a significant adverse prognostic factor for patients with non-small cell lung cancer who developed brain metastasis.Lung cancer patients whose tumor tissue demonstrated positive VEGF expression had reduced overall survival rates at 1,2,and 3 years after surgery.The expression of p53 and nm23 are not significantly associated to the prognosis of this group of patients.

Objective This study was to investigate the effect of using laryngeal mask airway (LMA)as a transition method after double lumen endotracheal anesthesia on the stress response dur-ing the extubation period.Methods Ninety patient underwent general anesthesia with double lumen endotracheal intubation were randomly divided into 3 groups:group A,B and C (n=30).Patients in group A were extubated directly after surgery.The double lumen endotracheal tube were changed to single lumen endotracheal tube under deep anesthesia in group B patients,while the double lumen en-dotracheal tube were changed to LMA in group C.MAP,HR and rate pressure product (RPP)at the end of surgery (T0 ),1 minute before extubating the endotracheal tube (laryngeal mask)(T1 ),1 mi-nutes (T2 ),5 minutes after extubating (T3 )were recorded.The reaction of extubation,such as buc-king or restlessness,was also observed.Results Compared with T0 ,the MAP,HR,and RPP were significantly increased in groups A and B at T1-T3 (P <0.05 ).Compared with group A,the MAP, HR,RPP were significantly decreased in groups B and C at T1-T3 (P <0.05 ).The number of buc-king and restlessness in group C were lower than that in group A and group B (P < 0.05 ). Conclusion The use of laryngeal mask during the transition period in double lumen endotracheal anes-thesia to can reduce hemodynamic fluctuations and stress reaction during the extubation.

Objective To investigate the effect of different forbidden drink schemes on anesthesia induction and postoperative nausea and vomiting during pediatric interventional heart surgery.Methods One hundred and twenty pediatric patients underwent cardiac interventional procedures under general anesthesia were randomized into group A,B and C,with 40 patients in each group.Patients in cach group were fasted for 8 h preoperatively.Water was prohibited for patients in group A for 6 h preoperatively.Patients in groups B and C orally took 10％ glucose solution and a multivitamin drink (Outfast) at 2 h preoperatively,respectively.Nausea and vomiting after anesthesia induction were recorded for 24 h postoperatively.Results The sedation and mask acceptance scores were significantly higher in group B and C than those in group A,and were significantly higher in group C than those in group B (P ＜ 0.05,resoectively).Following anesthesia induction,MAP was significantly higher in group B and C than that in group A (P ＜ 0.05,resoectively).Both the severity and incidence of postoperative nausea and vomiting were higher in group B and C than those in group A,and was lower in group C than that in group B (P ＜ 0.05,resoectively).Conclusions Taking clear water orally 2 hours before surgery can decrease the restlessness of pediatric interventional heart surgery during anesthesia induction period,with stable smooth hemodynamics,reducing the degree of PONV.

Aim To investigate the Yiqi Yangyin Qingre Oral Liquid(YYQ) on insulin resistance in hyperglycemic fatty rats.Methods The model of hyperglycemic fatty rats was induced by intravenous injection with a low dose of streptozotocin(STZ) and a fed high fat and high caloric diet.The YYQ was given via gavage for a period of 4 weeks.The fasting blood glucose(FBG),oral glucose tolerance(OGT),serum insulin(INS),triglyceride(TG),total cholesterol(TC),free fatty acid(FFA)levels,glucose infusion rate(GIR) by euglycemic hyperinsulinemic clamp technique as well as erythrocyte insulin receptors(INSR)of rats were tested when the experiment was finished.The weight of the epididymal fat pads and the perirenal fat pads were measured.The IR,IRS-1mRNA expressions in liver tissue were measured by RT-PCR technology.Results YYQ treatment decreased the levels of FBG,TC,TG,LDL-C,FFA and increased the level of HDL-C in hyperglycemic fatty rats.As compared with the model rats,glucose tolerance was improved and body weight was reduced in hyperglycemic fatty rats treated with YYQ.Moreover,YYQ treatment upregulated IR,IRS-1mRNA expressions in liver tissue and increased insulin receptor amounts on the erythrocytes surface as well as GIR in the hyperinsulinemic euglycemic clamp experiment.Conclusions YYQ ameliorated insulin resistance in hyperglycemic fatty rats,and its mechanism might be related to increment of INSR and stimulation of insulin pathway.

Objective:To investigate the expression of Rho GTPases signaling pathway in non-small cell lung carcinoma (NSCLC)and its clinical significance.Methods:Molecules of Rho GTPases signaling pathway including RhoC, E-cadherin, MMP-2, and MMP-9 were detected by RT-PCR and immunohistochemistry in 36 specimens of non-small cell lung carcinoma (NSCLC). The relationship between RhoC mRNA and prognosis of patients was evaluated by using Kaplan-Meier survival curve analysis.Results:There was a significant difference in the expression of RhoC mRNA between NSCLC tissues and para-cancerous tissues (P<0.01). The expression of RhoC mRNA in NSCLC was not correlated with gender, age, invasion degree, lymph node metastasis, tumor size, histological classification, and differentiation degree but correlated with different TNM stage (P<0.05). There was a significant positive correlation between the expression of RhoC protein and MMP-2 protein (r=0.474, P=0.003). The survival time of patients with weak expression of RhoC mRNA was longer than those with over-expression of RhoC mRNA, but there was no significant difference between the two groups (P>0.05). Conclusion:Over-expression of RhoC mRNA is closely correlated with the tumorigenesis and progression of NSCLC, and may be related with invasion and metastasis of NSCLC early to middle stage.

Objective: To compare the sequence diversity of HVR1 in the putative envelope protein E2 of the genotypeⅡand genotype Ⅲ HCV in Chinese. Methods: The cDNAs[nucleotide(nt)1449-1586(HCV-J) or nt1460-1582(HCV-J6)] derived from plasma of 55 patients infected with genotype Ⅱ HCV and 38 patients infected with genotype Ⅲ HCV were amplified,purified and directly sequenced by RT-nested polymerase chain reaction(PCR) and dideoxynucleotide chain termination method. Results: The HVR1 was found in amino acid(aa) 384-408 positions of both types HCV E2 protein. There were 5 similar conserved amino acids in 2 types HCV HVR1:aa385(Thr), aa389, 390, 406(Gly)and aa403(Phe).Besides, 401(Ser) was also highly conserved in genotype Ⅱ HCV HVR1. Although the variation characteristic of 2 types was similar, but the sequence diversity(SD),the kinds and frequency of some amino acids in some HVR1 positions and the conserved region near the HVR1 had some differences between 2 genotypes. Conclusion: Further study on the diversity of HVR1 and its biological significance will be helpful to understand the mechanism of HCV persistent infection and the development of HCV vaccine.

Objective To investigate the effect of ischemic preconditioning (IPC) on pancreas transplantation(PT) in rats. Methods Steptozozin-induced diabetic SD rats were randomly assigned to 2 groups: group I/R (ischemia/reperfusion), consisted of 30 diabetic rats which received PT; group IPC, consisted of 30 diabetic rats which received pancreas transplantation and IPC. Six rats in each group were randomly sacrificed at 2 days before PT, and 3 days and 7days after PT, to detect the level of blood sugar and amylase,and pancreatic sections were stained with HE simultaneously; 6 rats were used to observe various metabolic indexes , and other 6 rats were used to observe the rat survival rate. Results The rats of group IPC had a higher 1 month survival rate than group I/R (5/6 vs 3/6, P

1-(4-Methylbenzyl)-2-methyl-octahydro-isoquinoline hydrochloride(1)is the key intermediate to prepare a new type of antitussives agent phosphate dimemorfan. 4-methyl-phenylacetic acid as a raw materials, was chlorinated with thionyl chloride to obtain 4-methyl-phenylacetyl chloride, followed by reaction with 2-cyclohexenyl amine, then cyclization, reduction, methylation and salt formation by HCl were taken out to give the desired product 1. The total yield is 54%, and the purity is greater than 98%. This synthetic process is characterized with available raw materials, simple in operation with high yield and purity, and suitable for large-scale production.

Objective : To understand the status of rural environmental sanitation and summer diarrhea among rural residents in Zhejiang Province,and to provide evidence for improvement of rural environmental sanitation and prevention and control of summer diarrhea. Methods : The stratified random sampling method was used. Five or six counties each were selected from the east,middle and west of Zhejiang Province;five townships（excluded Chengguan Town）were selected from each selected county;four villages were selected as field survey points from each township;five households were selected from each survey point;one family member（householder or housewife）was selected from each selected household. The information about the environmental sanitation status and prevalence of summer diarrhea were obtained by literature review,interviews,questionnaire suvey,field investigation and laboratory tests. Logistic regression model was used to analyze the influencing factors for occurrence of summer diarrhea among rural residents. Results : There were 2 000 households surveyed. In the past two weeks,108 households had families with diarrhea and the prevalence of diarrhea was 5.40%. A total of 1 828 households disposed the household waste in the garbage bins or pools,accounting for 91.40%. There were 1 926 households with organized sewage discharge,accounting for 96.30%. There were 768 households with nymphs found in the kitchen,accounting for 38.40%;404 households with live egg sheaths found,accounting for 20.20%;592 households with cockroach traces found,accounting for 29.60%;564 households with rat traces found,accounting for 28.20%;and 1 206 households with flies found,accounted for 60.30%. There were 1 314 households with disease vectors around the house,accounting for 65.70%. There were 1 944 household with sanitary toilets,accounting for 97.20%. A total of 1 915 households had habits of drinking boiled water,accounting for 96.57%. The results of multivariate logistic regression analysis showed that rat traces found in the kitchen（OR=2.026,95%CI: 1.362-3.013）were a risk factor for summer diarrhea in rural residents,while drinking boiled water（OR=0.272,95%CI: 0.091-0.811）was a protective factor. Conclusion The sanitary environment and family health habits of rural residents were related to the prevalence of diarrhea in summer. Paying attention to kitchen hygiene and drinking boiled water could prevent summer diarrhea.

In order to improve the yield and simplify the operation, the synthesizing process of JAK3 inhibitor tofacitinib citrate was improved based on the analysis of the methods previously published.Using 2, 4-dichloro-7H-pyrrolo [2, 3-d] pyrimidine and (3R, 4R)-1-benzyl-N, 4-dimethylpiperidin-3-amine dihydrochloride as starting materials, tofacitinib citrate was obtained through four steps of nucleophilic substitution, catalytic transfer hydrogenation, cyanide acetylation and citrate salt, and its crystal form was consistent with the original research.After optimization, the yield was better than those reported in literature, and the mild reaction conditions were suitable for industrial production.