Objective To investigate the death risk factors of severe cerebrovascular disease.Methods The clinical data of 226 patients with severe cerebrovascular disease were analyzed retrospectively.All of the death risk factors were divided into three types.Type Ⅰ was the uncontrollable factors,including age,gender and family genetic history.Type Ⅱ was morbid risk factors,including hypertension,hyperlipemia,diabetes,valvular heart disease,cardiovascular diseases and history of stroke.Type Ⅲ was life style risk factors,including smoking,drinking,obesity,high salt diet,high protein diet and less movement.The risk factors were evaluated with single factor and multiple factors analysis.Results Single factor analysis showed that age,hypertension,diabetes,history of stroke,smoking,drinking,high salt diet and less movement were the high risk factors (P ＜ 0.01 or ＜ 0.05).Multiple factors analysis showed that age (OR =1.242,P =0.001),history of stroke (OR =2.325,P =0.000),less movement (OR =-1.172,P =0.010) were correlated with the death.Conclusions Severe cerebrovascular disease is associated with multiple factors.Early intervention to the risk factors in patients with severe cerebrovascular disease can effectively decrease the risk of death and reduce the mortality.

Objective To explore memory function affected by chronic insomnia. Methods Fiftyfive patients with primary insomnia (PI), 119 patients with comorbidity of depression and insomnia (CDI)and 50 normal individuals were enrolled. Objective memories, including spatial working memory, spatial reference memory, objective working memory and object reference memory, were detected by nine boxes maze, and subjective memory was assessed by themselves on a 5-point scale ranging from 0 ( extremely severe problem) to 4 (no problem). Results Compared to the controls, the self-evaluated memory ( 1( 1,2 ) ) was worse in the mild PI patients, and the spatial working memory ( 6 ( 2. 5,11 ) ) was also worse in the severe PI patients( ×2 = 4. 526,3. 529, both P ＜ 0. 01 ). For the CDI, the self-evaluated memory ( 2 ( 1,2) ) and spatial working memory (6(3,10)) were worse in the mild patients(×2 =5. 803,4. 155 ,both P ＜0. 01 ). However, the object ( 0. 5 (0,1) ) and spatial reference ( 1.5 ( 1, 3 ) ) memories were also worse in the severe patients ( ×2 =2. 641,3. 955 ,both P ＜0. 01 ). Conclusions PI damages subjective memory and the severe PI also damages spatial working memory. CDI damages various memory functions, especially in severe CDI patients, including subjective memory, object reference memory, spatial reference memory and spatial working memory.

Point of care testing (POCT) is a laboratory-medicine discipline that is evolving rapidly in analytical scope and clinical application.Medical-laboratory tests can be performed at the point of care,shortening the time caused by sample transportation and preparation.At present,POCT contains many items,ranging from blood-glucose measurement to coagulation assays.But,errors in results in POCT practical applications are usually caused by personnel and methodology.Management of POCT detection within the hospital should be strengthened to ensure the quality of POCT in order to provide better services for patients.

Objective To investigate the expression of Vav1 in gastric cancer(GC), and analyze its potential relevance to clinicopathological characteristics and prognostic significance in GC patients. Methods The mRNA expression level of Vav1 was detected by real-time quantitative PCR in GC cell lines (HGC-27,SGC7901 and MGC803) and normal gastric mucosa cell line (GES-1). In addition, the protein expression of Vav1 was analyzed by immunohistochemistry in formalin-fixed samples from 105 GC patients. The associations between clinical pathological features and Vav1 protein expression were evaluated in GC patients. Kaplan-Meier method and Cox regression analysis were used to analyze the related factors influencing the prognosis of GC. Results The mRNA expression levels of Vav1 were significantly higher in GC cell lines (HGC-27, SGC7901, MGC803) than those in normal gastric mucosa cell line (GES-1, P<0.05). The positive expression of Vav1 in GC tissues was correlated with diameter of tumor and lymph node metastasis (P<0.05). The univariate analysis showed that size of tumor, degree of differentiation, serosal invasion, lymph node metastasis and Vav1 expression were significantly related with prognosis of GC (P<0.05). Results of Cox regression showed that tumor invasion depth (HR=2.764, 95%CI 1.316-5.817, P=0.007), lymph node metastasis (HR=1.298, 95%CI 1.098-1.534, P=0.002) and Vav1 expression (HR=2.577, 95%CI 1.066-3.946, P=0.006) were the risk factors affecting prognosis of patients with gastric cancer. Conclusion Vav1 performs important role in the aggressiveness of GC, and Vav1 may serve as a novel prognostic factor in GC.

Objective To study the effect of inhibition of human lung carcinoma-associated antigen gene(ALT04-AG) expression on the growth characteristic and associated gene expression of human lung carcinoma cells(L78).Methods L78 cells were transfected with recombinant plasmid vector expressing(ALT04-AG) antisense RNA mediated by liposome reagent,and treated with DFMO respectively. The growth characteristics were studied by MTT,FCM analysis.The associated gene expression was detected by immunocytochemical staining,Northern blot and gene chip analysis.Results The recombinant plasmid expressing ALT04-AG antisense RNA pALT04-AG as constructed.It was shown that the down-regulation of ALT04-AG gene expression was observed not only in pALT04-AG as transfected L78 cells,but also in DFMO-treated L78 cells,which resulted in growth inhibition of these cells.Gene chip analysis indicated that inhibition of(ALT04AG) gene expression by ALT04-AG antisense RNA regulated some proliferation associated gene expression,while inhibition of polyamine biosynthesis by DFMO regulated proliferation associated genes and also some apoptosis associated genes.Conclusion It is suggested that human lung carcinoma associated antigen gene ALT04-AG plays an essential role in maintaining malignant phenotype of cancer cells.

Objective To summarize the experience of diagnosis and treatment of lower gastrointestinal bleeding caused by small intestinal vascular malformation .Methods 12 patients with lower gastrointetinal bleeding caused by small intestinal vascular malformation were retrospectively reviewed.Results ⑴Repeated intermittent hematochezia were the most common cases in our date of lower gastrointestinal bleeding caused by small intestinal vascular malformation.⑵The most common course of disease was 2～3 years.⑶Bleeding was halted after operation in 100% cases and no one relapse.Conclusions ⑴Active bleeding period should be evaluated firstly by angiography and prepare to emergency operation.⑵By treatment combined with enteroscopy during operation could help to diagnose.⑶Surgical operation is the most effective treatment for bleeding of small intestinal vascular malformation.

Resident health card is the golden key for the trans-institutional, trans-regional, interconnected, and intercommunicating medical and health information service , resource sharing and collaboration , the stress was thus laid in this paper on the specific target, design ideas, general design program, implementation of their functions, and measures for their safety for the resident health card operation system on Internet.

Purpose:To investigate the clinical applicati on and curative effect of salvage treatment for primary recurrence after definitiv e radiotherapy in patients with laryngeal cancer. Methods:52 patients with laryngeal cancer receiving definitive radiotherapy in the Cancer Center of Sun Yat-sen University between 1990 and 19 95 were reviewed retrospectively. Among them, 17 patients presented with primary recurrence. Salvage treatment after radiotherapy failure included palliative ch emotherapy (5 cases) and surgical salvage (12 cases). 6 patients were salvaged b y partial laryngectomy and 6 patients by total laryngectomy. SPSS 10.0 software was used to analyze the effects, complications and the differences between diffe rent salvage treatments. Results:The overall 3- and 5-year cumulative survival rates a fter salvage treatment for primary recurrence in patients with laryngeal cancer receiving definitive radiotherapy were 56.3% and 37.5% respectively. The patient s receiving palliative chemotherapy after radiotherapy failure survived between 8 and 26 months. The 3- and 5-year cumulative survival rate in patients receiv ing surgical salvage were 75% and 50% respectively. There was significant differ ence between them analyzed by Kaplan-Meier (Log Rank=8.14, P=0.004 3). More over, the 5-year survival rates in patients salvaged by partial laryngectomy an d total laryngectomy were all 50% and there was no statistical difference betwee n them (Log Rank=0.08, P=0.7782). 5 out of 12 (41.7%) patients salvaged by s urgery presented complication after surgery, mainly infection after surgery (25 %) and pharyngocutaneous fistula (25%). Conclusions:Surgical salvage for primary recurrence in patients with laryngeal cancer receiving definitive radiotherapy could be effective.Part ial laryngectomy could be used for early primary lesion (T 1 and T 2) in patie nts with primary recurrence. The complications after salvage surgery were mainly were infection and pharyngocutaneous fistula.

Objective To study the effect of HCV C gene transfection on expression of hTERT mRNA in human biliary carcinoma cell lines (QBC939) and to elucidate the significance of activation of hTERT mRNA by HCV C gene on the carcinogenesis of bile duct cells. MethodsThe recombinant plasmid(pcDNA3-HCVC) and the vector-alone were co-transfected with enhanced green fluorescent protein( EGFP )into QBC939 and human normal bile duct epithelial cells(HBEC) using liposome. The reverse transcription PCR(RT-PCR) and immunocytochemical stain were used to show the expression of hTERT mRNA and protein. Results The transfection efficiency of pcDNAHCV-C,which was determined by the expression of EGFP,is about 16% and 30% in QBC939 and HBEC respectively. There was no expression of hTERT mRNA assayed in HBECs when transfected blank vector,but a dramatic increase was observed for hTERT mRNA expression in HBEC when transfected with HCV C expressing vector. The expression of hTERT mRNA and protein assayed in QBC939 significantly increased when transfected with HCV C expression vector than that transfected with blank vector. Conclusion HCV C gene transfection up-regulates the transcriptional expression of hTERT mRNA in biliary carcinoma cells,it is suggested that HCV C protein contributes to virus carcinogenesis.

Biliary infection in children includes acute and chronic cholecystitis and cholangitis.The main dinical manifestations of acute cholecystitis are right upper-quadrant abdominal pain which is persistent with nausea and vomiting,Murphy's sign positive.Some of patients have high fever,chills,jaundice,and some severe patients have coma.Acute cholangitis has rapid onset.The most common manifestations are abdominal pain,fever,chills and jaundice which are known as Charcot's triad.A few children's main manifestation is septic shock which has a high mortality.This article described the diagnosis and treatment of biliary inflammation in children.