Objective To evaluate the value of (1 ,3)‐β‐D‐glucan(G test) in the diagnosis of invasive pulmonary fungal infection (IPFI)in patients with chronic obstructive pulmonary disease (COPD) .Methods 96 COPD patients with high risk of IPFI were en‐rolled in the study ,and were divided into IPFI group and non‐IPFI group .The G test were performed on those people while the tra‐ditional methods sputum smear and fungal culture were also performed .The (1 ,3)‐β‐D‐glucan concentrations of IPFI group and non‐IPFI group were compared ,and then the areas under receiver operating characteristic curve (ROC) were calculated .The sensi‐tivity ,specificity ,positive predictive value ,negative predictive value ,and the area under ROC of the two methods (G test and tradi‐tional methods) were compared .Results The sensitivity ,specificity ,positive predictive value ,negative predictive value of G test were 89 .5% ,89 .6% ,68 .0% ,97 .2% ,respectively ,when 20 pg/mL was the critical value .Areas under curve were 0 .942 for G test ,and 0 .790 for traditional method .Conclusion The detection of (1 ,3)‐β‐D‐glucan might be faster and with higher positive rate than traditional method ,and could be used for the early diagnosis of IPFI ,provide reference for the treatment .

Objective:To investigate the inhibitory effect and its possible molecular mechanisms of MicroRNA-34a(miR-34a) on the human nasopharyngeal carcinoma CNE-2 cell line subcutaneous xenograft tumor in nude mice.Methods: The human nasopharyngeal carcinoma CNE-2 cell line was cultured in vitro.miR-34a and Scrambled miRNA recombinant plasmids were successfully established and stably transfected into CNE-2 cells.Fifteen six-week-old male nude mice were divided randomly into three groups:miR-34a group(5 mice) ,Scrambled miRNA group(5 mice) ,Blank control group(5 mice).Different CNE-2 cells were subcuta-neously injected on the back near right lower limb.Tumor volumes were examined every 7 days.Mice were executed on the 35 days,and the eventual average tumor volumes and weights were examined.Total RNA and protein were isolated from tumors,and the expression of miR-34a,CDK6,and Bcl-2 mRNA and protein were determined by qRT-PCR and western blot,respectively.Results: The relative expressions of miR-34a was significantly up-regulated in miR-34a transfected group compared to Scrambled miRNA transfected group (P<0.05).Eight subcutaneous xenograft tumor models were successfully established.The nude mice of miR-34a transfected group appeared a smaller tumor volume compared to the other two groups at the beginning of 21th day( P<0.05).The eventual average tumor volumes in miR-34a group,Scrambled miRNA group and blank control group were(351.37±98.19)mm3,(798.75±91.04)mm3 and
(849.62±101.32) mm3 ,respectively,and the eventual average tumor weights in miR-34a group,Scrambled miRNA group and blank control group were(0.81±0.13)g,(1.47±0.21)g and(1.58±0.37)g,respectively.Both the eventual average tumor volumes and weights in miR-34a group were lower compared to the other two groups(P<0.05).qRT-PCR results revealed that the expression of miR-34a in miR-34a transfected group was significantly higher than in the other two groups,while the mRNA and protein expression of CDK6 and Bcl-2 were lower than the other two groups ( P<0.05 ) .Conclusion: miR-34a may inhibit the growth of human nasopharyngeal carcinoma CNE-2 cell line subcutaneous xenograft tumor in nude mice by down-regulating CDK6 and Bcl-2.

Objective To explore clinical features and misdiagnosis reasons in mitochondrial encephalomyopathy,lactic acidosis,and stroke-like episodes (MELAS) syndrome.Methods The results of clinical data,brain magnetic resonance imaging (MRI),and the course of diagnosis were analyzed in 6 patients with MELAS.Results (1) Clinical features:headache and vomiting were the starting symptoms in 4 of 6 cases,and developmental delay was initial symptoms in 2 of 6 cases.Marasmus occurred in 6 cases,seizure in 5 cases,fever in 3 cases,and hirsutism and visual impairment in 2 cases.(2) Experimental results:blood lactic acid was higher in 6 (4.28 ～ 10.3 mmol/L).(3) Brain MRI:6 patients had abnormal signals in parietal,occipital,temporal lobe,which were not in accordance with vascular distribution.(4) Molecular genetics:All the 6 patients had A3243G gene mutation.(5) Three patients were misdiagnosed for viral encephalitis,and 2 developmental retardation.Conclusions MELAS is characterized with developmental retardation,and repeated encephalitis attack.It is also misdiagnosed because of its variety of clinical features.If patients have high level of lactic acid and multiple MRI signal abnormalities of brain which are not in accordance with vascular distribution,MELAS should be suspected of.Genetic examination and muscle biopsy are especially important in the diagnosis of MELAS.

In order to sum up the antineoplasmic active components of Holothuria, we studied the literatures in recent years. The results showed that Holothuria contained a variety of anti-tumor active ingredient, such as Holothurian Glycosaminoglycan and Holothurin. These anti-tumor active components played important roles in different stages of tumor developmment, progression and metastasis. The discovery of new anti-tumor active ingredients may be helpful for the application of Holothuria in clinical tumor treatment.

OBJECTIVE:To explore the feature and regularity of ADR induced by animal bone polypeptide medicine,so as to provide reference for rational use of these drugs in clinical practice. METHODS:In retrospective analysis,96 cases of ADR oc-curred in our hospital during Jan. 2009-Jun. 2016 were analyzed statistically in terms of patients'gender and age,drugs involved, occurrence time,route of administration,organs and systems involved,association,prognosis,etc. RESULTS:Among 96 cases (including 17 serious ADR),the ratio of male to female was 1.34 : 1,and 56.25% of them were above 40 years old. ADR mainly occurred within 15 minutes after medication(39.58%)dominated by intravenous drip. Organs/systems involved in ADR were main-ly lesion of skin and its appendants(34.81%),followed by respiratory system damage(18.35%)and systemic damage(16.46%). In aspect of ADR association,41 were probable(42.71%)and 55 were possible(57.29%). After suffering from ADR,43 patients (44.79%)were cured after drug withdrawal or corresponding treatment,and 53 patients(55.21%)were recovered. CONCLU-SIONS:Medical staff should master the regularity and characteristics of ADR induced by animal bone polypeptide medicine,while strengthen rational drug use management and monitoring to ensure the safety and effectiveness of clinical drug use.

Objective To study the relationship between cognitive dysfunction and depression and event-related potential(ERP) in patients with silent brain infarction(SBI).Methods 68 SBI patients were tested by the Hamilton Depression Rating Scale for Depression(HAMD),scale of mini mental state examination(MMSE)and ERP;and the results were compared with those in 55 patients without cerebral infarction(control group).Results In the SBI group,the HAMD score was ≥17 in 31(45.6%)cases(depression subgroup)and

Chronic pancreatitis (CP) with mass and pancreatic cancer are difficult to identify from the Clinical performance. Imaging methods in the diagnosis of the CP with mass play an important role, which is very helpful for the indications for surgery of the hands, of resectable pancreatic head tumor, and surgical options, as well as estimates of the difficulty of the surgery. At present, we have taken the CP with mass as a precancerous lesion of pancreatic cancer. Surgical strategy in CP with mass has been directed at the pancreatic head with a variety of tactics including pancreatoduodenectomy ( Whipple procedure with or without pylorus preservation) and partial resection of the pancreatic duct drainage( Frey operation, Beger operation ). Once the diagnosis of the CP with mass was confirmed surgical treatment should be performed by pancreatoduodenectomy, which by not only the pancreatic head mass was resected, the bile ducts and pancreatic ducts and obstruction of the duodenum were lifted, but also the potential causes of pancreatic cancer were ruled out. Pancreatoduodenectomy has great risk for the big mass of pancreatic head, but the partial head resection can be accomplished with relative safety.

Objective To evaluate the efficacy of laparoscopic management for bile duct and gastrointestinal injuries during laparoscopic cholecystectomy. Methods Laparoscopic cholecystectomy with or without laparoscopic bile duct exploration was attempted in 9 016 consecutive patients between October 1991 and December 2002. We experienced 14 cases of bile duct injuries (0.15%) and 3 cases of gastrointestinal injuries (0.03%). One patient with circumferential injury and 10 patients with partial laceration injuries of the bile duct underwent a laparoscopic simple closure. One gastric and two duodenal injuries were successfully repaired under laparoscope. Results Expect 1 patient suffered postoperative biliary leakage and bile duct stricture 1 year after the surgery, all the patients were cured and discharged from the hospital. Conclusions Partial laceration injuries of the bile duct or gastrointestinal injuries could be treated with a laparoscopic technique. Concerning laparoscopic management of circumferential bile duct injuries, further study should be taken.

Objective To explore the expressions of livin and Smac in condyloma acuminatum (CA) tissue and their roles. Methods The expressions of Livin and Smac were analyzed by immunocytochemical staining with streptavidin-peroxidase (SP) in tissue specimens from the lesions of 58 patients with CA and foreskin of 20 normal human controls. Results The detection rates of Livin and Smac were 81.03% (47/58) and 77.59% (45/58) in CA lesions, respectively, compared to 25.00% (5/20) and 35.00% (7/20) in the controls, respectively. The expressions of Livin and Smac varied from positive (++) to strongly positive (+++) in CA lesions, and from negative (-) to positive (++) in the controls (both P< 0.05). A positive correlation was found between the expression of Livin and Smac in CA lesions (r = 0.373, P < 0.01). Conclusion There is an over- expression of Livin and Smac in CA tissue, which may be involved in the occurrence and development of CA.

Objective To observe the effects of cigarette smoke extract (CSE) on the proliferation and secretion of hydrogen peroxide (H2O2) in human lung fibroblasts (HLFs) induced by transforming growth faetor-β1(TGF-β1).Methods Cultured HLFs were divided into a normal group and a model group induced by TGF-β1 (5 ng/mL),then intervened with CSE at different concentrations (0% ,2.5% ,5%, 10%, respectively).Brdu ELISA assay was used to detect cell proliferation.H2O2release from cultured cells was assayed using a fluorimetric method.Cellular localization of H2O2 and expression of α-SMA were performed using a fluorescent-labeling strategy.Results TGF-β1 stimulated group showed positive expression of α-SMA, implying TGF-β1 had induced fibroblasts to differentiate into myofibroblasts.In TGF-β1 stimulated group,2.5% and 5% CSE promoted cell proliferation (P < 0.01 or 0.05), while 10% CSE inhibited cell proliferation (P < 0.01).In the normal group, both low and high concentration of CSE inhibited cell proliferation (P < 0.01 or P < 0.05), and the inhibition effect was dose-dependent.HLF induced by TGF-β1 generated low constitutive levels of extracellular H2O2 that was markedly enhanced by CSE treatment (P < 0.01).Pretreatment with DPI, an inhibitor of NADPH oxidase, abolished secretion of H2O2.Cellular localization of H2O2 by a fluorescent-labeling strategy demonstrated that extracellular secretion of H2O2 is specific to the myofibroblast.Conclusions Low concentration of CSE can promote myofibroblast proliferation, and markedly increase extracellular secretion of H2O2.CSE possibly take part in the development and progress of idiopathic pulmonary fibrosis by increasing oxidative stress.