Objective To investigate the expression level and clinical significance of p53 ,C-myc and CerbB-2 in papillary thy-roid carcinoma patients .Methods The expression level of p53 ,C-myc and CerbB-2 were detected in 45 cases of papillary thyroid carcinoma tissue specimens and 45 cases of nodular goiter tissue specimens by using immunohistochemical staining .Their correla-tions with clinic pathological features in papillary thyroid carcinoma were analyzed further .Results The positive expression rates of p53 ,C-myc and CerbB-2 in the papillary thyroid carcinoma tissue specimens were significantly higher than that of the nodular goiter tissue specimens(all P< 0 .01) .The expression of C-myc and CerbB-2 significantly correlated with lymph node metastasis(P< 0 . 05) .The expression of CerbB-2 significantly correlated with tumor size ,local infiltration ,TNM stage ,differentiated degree and lymph node metastasis (all P< 0 .05) .p53 positive expression ,C-myc positive expression and CerbB-2 positive expression were the independent factors of cervical lymph node metastasis .Conclusion p53 ,C-myc and CerbB-2 were highly expressed in papillary thy-roid carcinoma and correlated with cervical lymph nody metastasis .The detection of p53 ,C-myc and CerbB-2 might be helpful for diagnosis of papillary thyroid carcinomas .

Objective To probe into the variations of hospital admissions and rate of hospital bed occupancy of medical institutions in the recent ten years in Tianjin, for the purpose of formulating a regional health plan and optimizing regional health resources allocation. Methods The health statistics yearbooks of Tianjin from 1998 to 2008 and the four health service survey data from 1993 to 2008 were analyzed, with the descriptive statistics and ordinal logistic regression of SPSS 16. 0. Results From 1998 to 2008, the amplitude of hospital admissions and rate of hospital bed occupancy in community health service centers (stations) was the lowest, and the occupancy rate of hospital beds in community health service centers and rural hospitals was always lower than that in secondary and above hospitals. The influence factors of options of medical institutions for residents consist of hospital charges, gender,occupation, and regional classification. Conclusion Tianjin needs to strengthen its community health service centers , and improve service capacity of primary care of health organizations.

Objective:To detect A20 mutation and to investigate its relationship with clinicopathologic features, prognosis, and re-sistance to therapy of diffuse large B cell lymphoma (DLBCL). Methods:A total of 104 cases with DLBCL and their clinical data were collected;follow-up was performed on a few of DLBCL patients. The expression of P-gP and Ki-67 protein was detected with immuno-histochemical staining. The A20 gene mutation in exons 3, 6, and 7 were examined by polymerase chain reaction and DNA sequencing. Finally, the correlation of genetic abnormality of A20 with clinicopathologic features was analyzed. Results:Missense mutation in ex-on 3 of A20 gene was identified in 18 of 104 patients (17.3%). The A20 gene mutation at site 73 of exon 3 was greater in the cases with activated B cell-like-DLBCL than with germinal center B-cell-like-DLBCL (18.5%vs. 2.5%, P=0.010). In contrast to the advanced clin-ical stage and high International Prognostic Index (IPI) cases, the rate of A20 mutation was superior to the opposite (P<0.05). The ex-pression for P-gP was higher in the cases with mutation than that of those with wild-type A20 gene (16/18 vs. 52/86, P=0.021). The dif-ference in A20 mutation between the groups of low and high positive expression for Ki-67 (1/17 vs. 26/60, P=0.030) was significant. DLBCL with A20 mutation had an increasing recurrence tendency (P=0.06) and a worse survival (P=0.016) compared with those with wild-type A20 gene. Conclusion:The A20 mutation has a certain influence on the clinicopathologic characteristics and survival condi-tions of BLBCL patients. Probably, A20 mutation is a factor associated with a poor prognosis of DLBCL.

Genistein, as one kind of phytoestrogens, can stimu-late osteoblastic proliferation, differention and mineralization, and can also inhibit bone resorption activity of osteoclast. The effect of genistein on bone metabolism lies in various molecular mechanisms. This paper reviews the research progress of the an-ti-osteoporotic action of genistein and its mechanism, which may provide a basis for the research and development of new agents to treat osteoporosis.

Objective To investigate the expression of doublecortin-like kinase 1 (DCLK1) in colorectal cancer and colorectal adenomas,and it's role in the development and progression of colorectal carcinoma,and explore the relationship of the DCLK1 expression and prognosis in colorectal cancer patients with diabetes medical history.Methods Expression of DCLK1 in 70 cases of colorectal cancers,70 cases of para-carcinoma tissues,and 35 cases of tubulovillous adenomas were detected by immunohistochemical method.Results (1) The DCLK1 high expression rate in colorectal cancers was 41.4％ (29/70),and 45.7％ (16/35) in tubular villous adenomas,both significantly higher than the para-carcinoma tissues (4.3％;3/70) (P ＜0.01).(2) DCLK1 high positive expression had statistical significance with pathological grading (P ＜ 0.01),infiltration depth (P ＜ 0.05),lymph node metastasis (P＜ 0.05),vascular invasion (P ＜0.05),and distant metastasis (P ＜0.01).(3) There was no obvious correlation between the Diabetes medical history,expression of DCLK1,and prognosis of patients.Conclusions DCLK1 has high positive expression in colorectal carcinomas,and may have certain significance for the early clinical diagnosis and prognostic judgment of colorectal cancers.The expression of DCLK1 and prognosis of colorectal cancers has no obvious correlation with diabetes medical history.

Objective To improve the prenatal echocardiographic diagnostic accuracy for fetus with isolated mirror-image right aortic arch which combined with vascular ring by analyzing and accumulating its echocardiographic features.Methods Echocardiographic signs were analyzed retrospectively and fetal echocardiographic features were accumulated in 16 cases with prenatal diagnosis of isolated mirror-image right aortic arch with left-side ductus arteriosus which formed vascular ring between January 2014 and February 2016.All cases were confirmed by neonatal echocardiography.Results The fetal echocardiography characters:① In 3-vessel and trachea view,fetal right aortic arch was demonstrated a Ushaped appearance of the great vessels,the right arm of the ‘ U’ represented the aortic arch and its left branch with ductal continuation.② In 3-vessel and trachea view or upper axial mediastinal transverse view,left innominate artery passed straightly to the left of the trachea.Left innominate artery and right-side ductus arteriosus were overlapped and the distance of two vessels was very close.③ In double arch view and longitudinal view for ductus,Left innominate artery did not connect to descending aorta or ductus arteriosus and did not involve in the formation of vascular ring.④ Color Doppler played an important role in diagnosis of this disease.Power Doppler or high-definition imaging easily showed color overflow and wrongly displayed the crossed relationship of left innominate artery with descending aorta as the anatomical connection,and caused the misdiagnosis of this disease as double aortic arch.Conclusions Isolated mirrorimage right aortic arch with vascular ring is not rare in the fetal period.Because ductus arteriosus is large and patent during the prenatal period,it is easily mistaken for the crossed relationship of left innominate artery with descending aorta as the anatomical connection and finally misdiagnoses this anomaly as double aortic arch.The keys to accurate diagnosis of the disease are clearly visualization of the innominate artery and its relationship with descending aorta and ductus arteriosus by scanning different views.

Objective To investigate the impact of MDR1-targeting small interfering RNA (siRNA) on diffuse large B-cell lymphoma cell OCI-LY1 proliferation.Methods A20 gene was silenced using RNA interference.An optimal concentration and treatment duration of vincristine were selected using MTT.Before and after siRNA transfection, proliferation of OCI-LY1 cells was assayed using MTT assay, and cellular apoptosis was detected using FCM before or after the treatment of the cells with VCR.Detection of A20, NF-κB (p65) and Pgp proteins were conducted using Western blot whereas mRNA of the A20 and MDR1 genes were examined using real time PCR.Results1)Proliferation of OCI-LY1 cells was enhanced (P<0.001) after the transfection with siRNA-2,(P<0.05).In addition, cell proliferation curve was declined after VCR stimulation, but the decrease was slower in siRNA-transfected cells than the untransfected counterparts.2)Apoptostic rate was lower in siRNA-transfected cells than theuntransfected counterparts, and the rate was higher in the cells after treatment with the drug for 24 h (P<0.05).Increased apoptosis was more obvious in control OCI-LY1 cells than in siRNA-transfected cells after treatment with VCR(P<0.05).3)The expression of MDR1 mRNA and Pgp (P<0.001) was significantly increased after transfection, but the expression of MDR1 mRNA and Pgp were significantly decreased (P<0.05).The expression in VCR group was significantly lower than that in siRNA-transfected cells+VCR group (P<0.01).ConclusionsA20 siRNA could effectively enhance NF-kappa B expression in OCI-LY1 cells.NF-kappa B may up regulate the expression of its downstream genes such as MDR1 and cause apoptosis, in turn enhancing the inhibition of cell proliferation.VCR can reduce MDR1 mRNA and Pgp expression in OCI-LY1 cells and the effect of VCR could be attenuated by A20 siRNA.

Salvia miltiorrhiza is a traditional Chinese medicine for the treatment of cardiovascular diseases .Recently, increasing evidence demonstrates that the water-soluble compounds isolated from Salvia miltiorrhiza,including tanshinol and salvianolic acid B, exert a regulatory influence on bone metabolism .The under-lying mechanism of these compounds involves various pathways , such as Wnt/β-catenin, ERK, BMP, OPG/RANKL/RANK and FoxO mediated oxidative stress pathway .This paper reviews pre-vious effects and mechanism of polyphenolic acids in Salvia milt-iorrhiza , which may provide the base for the research and devel-opment of the new agents to treat osteoporosis .

Objective To investigate the relation between the expression of Caspase recruitment domain-containing membrane-associated guanylate kinase protein 1 (CARMA1),clinicopathological features of gastrointestinal mucosa-associated lymphoid tissue (MALT) lymphoma,diffuse large B cell lymphoma (DLBCL),and Helicobacter pylori (H.pylori) infection.Methods From January 1999 to March 2011,34 patients with DLBCL and 20 patients with MALT lymphoma were selected,and at same period 21 cases with reactive hyperplasia of gastrointestinal lymphoid tissue were enrolled in as control.The expression of CARMA1,Ki-67 and cytotoxin-associated gene A (CagA) at protein level were examined by immunohistochemistry.The relative expression quantity of CARMA1 mRNA was detected by real-time polymerase chain reaction (PCR).The condition of H.pylori infection in 25 gastric lymphoma and 10 controls was detected by methylene boric acid and blue staining or semi-nested PCR.Chi-square test was used for counting data analysis,t test for measurement data.Multivariate COX regression analysis was implemented for survival analysis.Survival curve was drawn by Kaplan-Meier method and analyzed by Log-rank test.Results The relative expression quantity of CARMA1 mRNA of 28 patients with DLBLC (3.073±1.846) was higher than that of 14 patients with MALT lymphoma,and the difference was statistically significant (F 0.975,P＜ 0.05).The positive rate of CARMA1 expression at protein level of gastrointestinal lymphoma group (75.9 ％,41/54) was higher than that of control group (47.6％,10/21),and the difference was statistically significant (x2 =5.568,P＜0.05),and the positive rate of CARMA1 expression of MALT lymphoma group (11/20) was lower than that of DLBCL group (88.2％,30/34),and the difference was statistically significant (x2 =5.900,P＜0.05).Among 42 patients with gastrointestinal lymphoma who received surgery,the relative expression quantity of CARMA1 mRNA in cases with high proliferation (2.885±1.837) was higher than that in cases with low proliferation.The expression of CARMA1 mRNA in the cases at advanced stage of the disease (4.416± 1.010) was higher than that in cases at early stage,and the difference was statistically significant (F=3.317 and 2.972,both P＜0.05).Among 54 patients with gastrointestinal lymphoma,the positive rate of CARMA1 expression at protein level of patients with high proliferation (88.6％,31/35) was higher that that of patients with low proliferation (10/19),and the difference was statistically significant (x22 ＝ 6.847,P＜0.05).There were no significant differences in relative expression quantity of CARMA1 mRNA and the positive rate of CARMA1 expression at protein level between 11 gastric lymphoma patients without H.pylori infection and 14 gastric lymphoma patients with H.pylori infection (both P＞0.05).The positive rate of CARMA1 expression at protein level of CagA positive and CagA negative H.pylori infected gastric lymphoma patients was 11/11 and 2/3.The expression of CARMA1 at protein level was correlated with the prognosis of gastrointestinal lymphoma (RR＝4.160,P＜0.05).In the 29 cases of patients with gastrointestinal MALT lymphoma and 18 cases of patients with DLBCL who were followed up,the survival situation of gastrointestinal lymphoma patients with CARMA1 positive expression rate over 50％ was worse than that of patients with the rate less than 50％,and the difference was statistically significant (x2=5.383 and 4.028,both P＜0.05).Conclusions CARMA1 might be involved in the pathogenesis and progression of MALT and DLBCL; and it might be a related factor of poor prognosis.There was no correlation between the expression of CARMA1 and H.pylori infection in these two lymphomas.

Objective To improve the understanding to transposition of the great arteries with posterior aorta and decrease the clinic misdiagnosis by summarizing their echocardiography features . Methods Echocardiography images were retrospectively reviewed for 7 cases with transposition of the great arteries with posterior aorta who diagnosed in Anzhen Hospital ,and their echocardiography features were summarized .Results In 7 patients ,5 patients had operation ,including 3 for arterial switch operation ,1 for right GLEEN ,1 for right GLEEN and Fortan surgery ,and 2 patients were lost to follow‐up .The echocardiography characters:① Artery short view showed aorta and pulmonary artery existed the half‐surrounding relationship .The aorta was situated posteriorly and the pulmonary artery anteriorly .②Multiple views showed aorta was completely and mostly arised from the right ventricle ,while the pulmonary artery was came off the left ventricle .③ Ventricular septal defects were presented in all cases and aorta could ride the defect of ventricular septal .④ In most cases ,fibrous continuity between the aortic and mitral valve through a ventricular septal defect was found and there was no conus under the aorta .⑤ Some cases could combine the different degree stenosis of the outflow tract of subpulmonary valve and pulmonary valve . Conclusions The connection relationship between two arteries and ventricles can displayed clearly on the long axis view of double outflow tracts of two ventricles under xiphoid process .The acoustic window under the xiphoid process is the key for diagnosis and differential diagnosis of the disease .