Purpose To investigate the expression and significance of MCM5 and p16INK4A in cervical carcinoma and cervical intraepithelial neoplasia (CIN 1,CIN 2 ～ 3) with different degrees of HPV 16 infection.Method RT-PCR and immunohistochemistryof SABC method were used to detect the expression of mRNA and protein in HPV 16 infected normal cervix,CIN 1 tissue,CIN 2 ～3 tissue and cervical squamous cell carcinoma and analyzed the clinical significance.Result The expression of p16INK4A and MCM5 mRNA in cervical cancer tissues were significantly higher than that in normal tissues (x2 =-6.589,P ＜0.001,x2 =-4.349,P ＜0.001).The degree of cervical lesions increased gradually (x2 =57.141,P ＜ 0.001,x2 =47.628,P ＜0.01).Expression of mRNA MCM5 was correlated with pathological grade and clinical stage.Ⅰ a-Ⅰ b period was significantly lower than that of Ⅱ a-Ⅱ b (x2 =-4.93,P ＜0.01),the expression decreased with the decrease of pathological grade (x2 =-4.017,P ＜0.01).The expression of p16INK4A mRNA in cervical cancer decreased with the decrease of pathological grade (x2 =8.560,P ＜ 0.01).The most obvious expression of p16INK4A and p16INK4A mRNA in squamous cell carcinoma.Expression of MCM5 protein and p16INK4A protein in cervical squamous cell carcinoma was positively correlated (r =0.497).Conclusion There is high expression of MCM5 and p16INK4A in cervical carcinoma.MCM5 can be a better reaction of cervical malignant hyperplasia,and p16INK4A joint detection for the improvement of CIN classification and prognosis of the significance of the judgment.

BACKGROUND: It has been reported that human adipose-derived mesenchymal stem cells can be induced to differentiate into hepatocyte-like cells with the function of albumin synthesis and urea secretion in vitro.OBJECTIVE: To investigate the potential of adipose-derived mesenchymal stem cells differentiating into hepatocyte-like cells in vitro.METHODS: Adipose-derived mesenchymal stem cells were isolated from the subcutaneous fat of hepatitis B virus infection patients by collagenase digestion and adherent method. Adipose-derived mesenchymal stem cells were induced by three-phase induction method and observed morphologically. The expression levels of alpha-fetoprotein, albumin and cytokeratin 18 were detected by immunohistochemical staining and glycogen synthesis function was detected by glycogen staining method.RESULTS AND CONCLUSION: Most of adipose-derived mesenchymal stem cells induced by three-phase induction method were differentiated into hepatocyte-like cells with polygonal morphology. Immunohistochemistry staining results showed that hepatocyte-like cells expressed alpha-fetoprotein, albumin and cytokeratin 18, and the expression levels of albumin and cytokeratin 18 increased with the culture time. The induced cells had the function of glycogen synthesis and were positive for periodic acid Schiff staining. These results showed that the subcutaneous adipose-derived mesenchymal stem cells could be induced into functional hepatocyte-like cells in hepatitis B virus infection patients.

BACKGROUNDTo evaluate the clinical significance of predicting post-operative respiratory failure in patients with lung cancer using cardiopulmonary exercise test (CPET).

METHODSBefore operation, 260 patients with lung cancer underwent CPET with incremental protocol. W%, VO₂%P, VO₂/kg, AT, MET, O₂ pulse, VTe, BF and VE were measured in the end of load exercise.

RESULTS(1) In patients after pneumonectomy, the values of the above indexes of CPET in the respiratory failure group were significantly lower than those in the non-respiratory failure group ( P < 0.05 or P < 0.01) except VTe. In patients after lobectomy, the values of 9 indexes of CPET in the respiratory failure group were similar to those in the non-respiratory failure group ( P > 0.05). However, when the patients after lobectomy were further divided into groups of upper and lower lobectomy, W% in the respiratory failure group was remarkably lower than that in the non-respiratory failure group after lower lobectomy ( P < 0.05). (2) Chi-Square test showed that abnormality of CPET indexes in different degrees was related to the morbidity of respiratory failure after pneumonectomy. Logistic regression showed that O₂ pulse < 80% and BF < 30/min correlated with the morbidity of post-operative respiratory failure. (3) For predicting post-operative respiratory failure, the sensitivity and specificity of VO₂%P < 60%, BF < 30/min, VE < 35 L/min were all more than 60% and their negative predictive values were all more than 90%.

CONCLUSIONSCPET is suitable to predict post-pneumonectomy respiratory failure. As a comprehensive index indicating cardiopulmonary function during exercise, VO₂%P < 60% should be selected to predict respiratory failure and evaluate indication of lung resection for patients with lung cancer.

BACKGROUNDTo explore the characteristics of exercise cardio-pulmonary function and its possible influencing factors in patients with lung cancer.

METHODSThe pulmonary function, ECG and exercise cardio-pulmonary function were measured in 198 patients with lung cancer and 20 healthy controls.

RESULTS1. Compared with healthy group, VO₂%P, VO₂/kg, AT, VO₂/HR%, VE and VT/VC significantly decreased in lung cancer patients with normal resting pulmonary ventilation, however, BR remarkably increased (P < 0.05 or P < 0.01). 2. In patients with normal resting pulmonary ventilation, there was no significant difference of exercise cardio-pulmonary function between the central and peripheral lung cancer groups. 3. The exercise cardio-pulmonary function was closely related to the TNM stages (P < 0.05 or P < 0.01). 4. W%, VO₂%P , AT and VO₂/HR% in patients with great vessel invasion were remarkably lower than those without great vessel invasion (P < 0.05 or P < 0.01).

CONCLUSIONSThe results suggest that exercise ventilation is impaired in lung cancer patients with normal resting ventilation. And the decrease of exercise cardio-pulmonary function may be related to TNM stage and to great vessel involvement.