Objective To evaluate the diagnostic value of four common pleural fluid tumor markers.Methods A total of 126 patients (52 with definite malignant effusions, and 74 with benign effusions) were enrolled. Tumor markers [carcinoembryonic antigen (CEA), cancer antigen 125(CA125), carbohydrate antigen 15-3 (CA 15-3) and cytokeratin 19 fragments (CYFRA21-1)] in pleural fluid were determined by electrochemiluminescence immunoassay. The sensitivities, specificities, accuracies and youden index(YI) of single and combination of those markers were calculated. Results Malignant pleural effusions had higher levels of pleural fluid markers than effusions due to benign conditions. CA125 had the highest sensitivity (90.4 %), and CYFRA21-1 had the highest specificity (79.7 %), CEA and CYFRA21-1 had the highest accuracy (71.4 %), CEA had the highest YI (0.41). The combination of several serum tumor markers had higher sensitivities than the single marker for diagnosis of malignant pleural effusion. When the three tumor markers were combined with CEA, the combination of CEA, CYFRA21-1 and CA15-3 yielded the best results,with a sensitivity of 92.3 %, a specificity of 78.4 %, and an accuracy of 84.1%, YI of 0.71, while the combination of four tumor markers had a sensitivity of 94.2 %, a specificity of 75.7 %, and an accuracy of 83.3 %, YI of 0.70, and there was no statistical significance between the two combinations (P ＞0.05).Conclusion Single tumor marker had limited diagnostic value for malignant pleural effusions, while CEA,CYFRA21-1 and CA15-3 yielded the best and the most economic method, that guiding the selection of patients who might benefit from further invasive procedures.

EML4-ALKfusiongeneisoneofthenoveltargetsinthetherapyoflungcancer,whichcan be detected in several kinds of tumors.A specific ALK inhibitor has been shown to exert anti-tumor effects in non-small cell lung cancer with the EML4-ALK fusion gene.Correlative study between EML4-ALK gene fusion and EGFR-Kras mutations might cast new insight on the tumor target therapy.

AIM:ToinvestigatetheregulationofmiR-21onFasLexpressionanditseffectonthegrowthand apoptosis in glioma cells , and to evaluate the molecular mechanism .METHODS:Differential expression levels of miR-21 in human glioma U251 cells were achieved by transfecting with miR-21 mimics, miR-21 inhibitor or scramble .The viability and apoptosis of U251 cells were detected by CCK-8 assay and flow cytometry with Annexin V-FITC/PI double staining. The recombination vector pmirGLO-FasL was constructed .Dual-luciferase reporter experiment was performed to validate the target genes of miR-21.The expression vector pcDNA3.1-FasL was also constructed , and the biological activity and regula-tory role of miR-21 in U251 cell apoptosis were analyzed by a restore experiment .RESULTS:Exogenous overexpression of miR-21 increased the viability and decreased the apoptosis of U 251 cells ( P<0.05 ) , while miR-21 inhibitors generated the opposite results (P<0.05).Dual-luciferase reporter assay and restore experiment revealed that miR-21 negatively reg-ulated the expression of FasL gene which was regarded as the target gene , thus decreasing the apoptosis of U 251 cells. CONCLUSION:miR-21 increases the viability of glioma U251 cells, in which FasL may be one of the target genes .

The study aims to investigate the effect of the ratio of long axis to short axis (RLS) of upright polypropylene infusion bag on discharging process and to search the best RLS. Aiming at five different RLS (1. 5 : 1, 2 : 1, 3 : 1, 4 : 1 and 5 : 1, respectively) with the volume of 100 mL, 250 mL and 500 mL, respectively, based on finite element method, analyzing the variation of stress distribution, emptying rate, drugging space and steadiness coefficient, etc. For the bags of the same volume, emptying rate increased with increasing of RLS, but the steadiness coefficient decreased with increasing of RLS. The specific increasing amplitude of emptying rate and decreasing range of steadiness coefficient were as follows: 20% and 49% for 100 mL infusion bag, 9% and 51% for 250 mL infusion bag, and 11% and 46% for 500 mL infusion bag, respectibvely, when RLS increased from 1. 5 : 1 to 5 : 1. Comparatively speaking, the increasing amplitude of the emptying rate is remarkably less than the decreasing range of the steadiness coefficient. By comprehensive consideration of both emptying rate and steadiness coefficient, lower RLS is recommended for upright polypropylene infusion bag.
Drug Delivery Systems ; instrumentation ; Finite Element Analysis ; Polypropylenes

Objective To analyze the prognostic indicators in gastric cancer patients underwent radical resection.Methods Clinical data of 257 patients with gastric cancer underwent radical resection from Jan. 2003 to Oct. 2008 in our hospital were analyzed retrospectively. Univariate analysis using Kaplan-Meier analysis and log-rank analysis,multivariate analysis using COX proportion risk model were performed. Results Univariate analysis indicated that tumor site (P <0. 05) .Borrmann type (P <0. 01) .histological type (P <0. 01),depth of infiltration (P < 0. 01 ) , lymph node metastasis rate ( P < 0. 01 ) , tumor size ( P < 0. 01 ) ,complication ( P < 0. 01 ) and accessorial chemotherapy (P<0. 01) influenced the patients' prognosis. Cox regression analysis indicated that lymph node metastasis rate, depth of infiltration, Borrmann type and tumor size were the independent risk factors of prognosis(P<0. 05). The relative risk will increase 3.374 times,2. 337 times,1.657 times and 1.580 times with each additional level of lymph node metastasis, depth of infiltration, Borrmann type and tumor size. Conclusions There are various factors influencing the prognosis of gastric cancer,of which lymph node metastasis rate is the most important prognosis indicator.

ObjectiveTo investigate the effects of selective splenectomy on modulation of portal vein flow and prevention of small-for-size syndrome (SFSS) in living donor liver transplantation.MethodsTwenty six recipients who received LDLT from September 2007 to March 2008 were reviewed.The data of the portal vein flow of these recipients were collected during the operation.Simultaneous splenectomy was performed in patients with portal blood flow ＞250 ml/(min · 100g).No splenectomy was performed when the portal blood flow was less than 250 ml/(min · 100g).The effect of selective splenectomy on modulation of portal vein flow and whether splenectomy prevented the occurrence of SFSS were analyzed.ResultsThe portal vein flow decreased significantly after splenectomy in 8 patients who received splenectomy (P＜0.01),No SFSS occurred in the patients with or without splenectomy.Actual graft-to-recipient weight ratio (GRWR) of patients with splenectomy was significantly smaller than those with no splenectomy (P=0.044).The portal vein flow of patients with splenectomy was much higher than those with no splenectomy (P＜0.01).ConclusionAccording to the portal blood flow,selective splenectomy in LDLT decreased the portal vein flow and prevented the incidence of SFSS.

Objective To investigate the feasibility and clinical effect of one-stage total knee arthroplasty for old femoral condyle fractures combined with knee osteoarthritis.Methods From January 2003 to December 2010,11 patients with old femoral condyle fracture combined with knee osteoarthritis,including 4males and 7 females,aged from 38 to 77 years (average,58.3 years),underwent one-stage total knee arthroplasty.There were 8 cases of supracondylar fracture,and 3 cases of intercondylar fracture.Moreover,there were 2 cases of knee fibrous ankylosis with mild amyotrophy,3 cases of collateral ligaments injury of the knee,2 cases of fibrous union,and 2 cases of infective nonunion.Results All patients were followed up for 6 to 72 months (average,41.3 months).The HSS score improved from preoperative 6.65±7.01 (range,0-13)to 88.5±6.18 (range,81-95) at final follow-up.The range of motion of the knee improved from preoperative 32.7°±17.6° (range,0°-50°) to 101.3°±9.8° (range,85°- 115°) at final follow-up.One case underwent knee disarticulation 6 years after operation owing to infection.For other patients,there were no complications such as infection,deep vein thrombosis,knee instability,component loosening and inequality of lower limb.Conclusion One-stage total knee arthroplasty is a technically difficult but effective method for patients with old femoral condyle fracture and knee osteoarthritis.

Objective To explore the genotype distribution of lipoprotein lipase gene polymorphism at Ser447Stop locus and its possible association with metabolic syndrome and dietary intakes. Method Ser447Stop polymorphism was determined by PCR-PFLP method in 222 adults with MS and 222 normal adults as control. Their physical examination,dietary investigation and levels of biochemical profile,including BG,TG,TC and HDL-C were analyzed. Results (1) The genotype frequencies of Ser447Stop SS,SX and XX were 85.6%,13.3% and 1.1% respectively,which were in agreement with Hardy-Weinberg equilibrium. There was no significant difference in frequencies of genotypes or allele between MS and the control,and between male and female. (2) After adjusting age and gender,the levels of serum TG were significantly different among three genotype groups,the highest in SS genotype and the lowest in XX genotype. (3) After adjusting age,gender and body mass index,the intakes of protein and carbohydrate were significantly different among three genotype groups. (4) There was significantly different in negative correlation between the intakes of protein and serum TG levels after adjusting age,gender and body mass index. Conclusion Lipoprotein lipase gene polymorphism influenced serum TG levels,while associated with protein intakes. It might contribute to the predisposition in metabolic syndrome response to dietary intervention.

Objective To investigate the effect of one-stage total hip arthroplasty (THA) for advanced active tuberculosis of the hip.Methods Data of 19 patients who had received one-stage THA for advanced active tuberculosis of the hip in our hospital from September 1998 to October 2010 were retrospectively analyzed.There were 14 males (15 hips) and 5 females (5 hips),aged from 21 to 74 years (average,44.1 years).According to the clinicoradiologic classification of tuberculosis of the hip introduced by Babhulkar and Pande,there were 3 cases of grade Ⅲ and 16 cases of grade Ⅳ.The average time interval from onset of symptoms to THA was 15.1 weeks (range,5-26 weeks).Chest radiographs showed old pulmonary tuberculosis in 3 patients.One patient had a sinus tract in hip skin.The diagnosis was confirmed by histopathology in all patients.The antituberculous medication was applied for at least 2 weeks preoperatively and 9 to 12 months postoperatively.Results All patients were followed up for 12 to 142 months (average,57 months).Dislocation of the hip occurred in 1 patient 6 days after operation,which was cured by manual reduction.Tuberculosis recurrence occurred in 1 patient 5 months after operation,which was cured after debridement without removing component and antituberculous medication for 1 year.Cup loosening was found in 1 patient 9 years after operation.No reactivation of infection or implant loosening was found in other patients.The average Harris score improved from preoperative 35 (range,27-46) to 90 (range,65-96) at final follow-up.Conclusion One-stage THA can be safely performed in advanced active tuberculosis of the hip,which can relief symptoms and improve hip function.

0 05) CONCLUSION:UH is effective and safe in treatment of congestive heart failure and its ARDs are rare It is worth popularizing in clinical use