Objective To investigate the association of the two single nucleotide polymorphisms(SNPs) rs1386494 and G1463A of tryptophan hydroxylase 2 gene with depression in Yunnan Han population. Methods A case-control study Was designed by collecting 102 patients and 102 controls.Polymerase chain reaction-restriction fragment length polymorphisms(PCR-RFLP)technique Was used to detect the rs1386494 and G1463A polymorphisms.All patients were evaluated with Hamilton Rating Scale for Depression(HAMD),and scores were compared according to different genotype.Results 1.There were differences in genotype and allele frequency of rsl386494 in Yunnan Han population(X~2=4.300,P=0.038;X~2=4.067,P=0.044).The A allele frequency of rsl386494 in controls Was higher than in patients(P=0.044).2.No genotype of G1463A polymorphism was observed in all samples.3.No significant association genotype of rsl386494 with scores of HAMD Was observed(F=2.461,P=0.120).Conclusion The polymorphism of rsl386494 may be associated with the vulnerability of Yunnan Han population,and the A allele maybe the protective gene for depression.

Objective: To screen the differentially expressed proteins in clear cell renal cell carcinoma (ccRCC), and to investigate its clinical significance. Methods: The differentially expressed proteins in 15 cases of ccRCC and their adjacent renal tissues were screened by two-dimensional fluorescence difference in gel electrophoresis combined with mass spectrometry (2-D DIGE-MS). The expression levels of differentially expressed proteins screened by 2-D DIGE-MS in 45 cases of ccRCC and their adjacent tissues were examined by Western blotting. The expression levels of this differentially expressed proteins in 152 specimens of ccRCC and 40 specimens of adjacent tissues were detected by immunohistochemistry. The correlations of this protein expression with the clinicopathologic features and prognosis of ccRCC patients were analyzed. Results: Proteomics screening results showed that the expression level of peroxiredoxin 4 (PRDX4) was significantly different in ccRCC and its adjacent tissues; compared with the adjacent tissues, PRDX4 expression was significantly down-regulated in ccRCC tissues (P < 0.05); and the expression level of PRDX4 in the adjacent tissues was 3.979 times higher than that in ccRCC tisseus. Western blotting showed that the expression level of PRDX4 in ccRCC tissues was significantly lower than that in adjacent tissues (t = 12.810, P < 0.001). Immunohistochemistry showed that the positive expression rate of PRDX4 in ccRCC tissues was significantly lower than that in the adjacent tissues [36.8% (56/152) vs 87.5% (35/40), ?2 = 32.594, P < 0.001]. Furthermore, the expression level of PRDX4 was correlated with tumor grade (?2 = 6.802, P = 0.033) and distant metastasis (?2 = 3.925, P = 0.048), but was not related to gender, age, T stage, lymph node metastasis and recurrence (all P > 0.05). The patients with lower expression of PRDX4 had high grade of ccRCC (? = -0.211, P = 0.009) and distant metastasis (? = -0.161, P = 0.048). The 5-year survival rates of patients with positive and negative expression of PRDX4 were 75.3% and 62.7% (P = 0.862), respectively. Conclusion: PRDX4, as a differentially expressed protein in ccRCC, may be involved in the formation and development of renal cancer, and its down-regulation is correlated with the increased malignancy of ccRCC.

Objective To analyze sleep quality in patients with primary angle-closure glaucoma and its relationship with eyesight, which would provide the basic data for improvement of clinical therapy of primary angle-closure glaucoma.Methods Sleep quality of 49 patients with primary angle-closure glaucoma was evaluated by Pittsburgh Sleep Quality Index(PSQ I) and the relationship between sleep quality and eyesight was analyzed.Results 93.9% primary angle-closure glaucoma patients had sleep disorder.Differences were detected between the scores of PSQI and those in Chinese Norm(P

Objective To evaluate changes in retinal expression of three heat shock proteins(HSPs)HSP27,HSP70 and HSP90 in normal and experimental glaucomatous rats's retina,and to explore the potential relationship between HSPs with glaucoma optic neuropathy.Design Experimental study.Participants 60 Wistar rats.Methods Rats were randomly divided into ocular hypertension group(n=30)and sham control group(n=30).The right eye was designed as the experimental eye,and the left as the control eyes.Intraocular pressure(IOP)was elevated by using underwater bipolar electro coagulation condensate 3 episcleral and limbal veins on the right eye of rats to establish of animal models of glaucoma.IOP were monitored twice weekly with a Tonopen.In treated eyes,IOP ranged from 27 to 35 mmHg throughout the study.Rats were killed with euthanasia at 10,20,or 60 days following the occurrence of ocular hypertension,with retina dissected free and protein isolated.Protein was used for Western blot analysis and probed with specific HSP antibodies,and normalized to ?-actin levels.Main Outcome Measures IOP,Western bolt.Results Western blot analysis demonstrated that HSP27 protein levels in the retinas were elevated as much as 197% at 10,20 and 60 days following the induction of ocular hypertension.No changes in protein levels were observed for HSP70 or HSP90 in retina from ocular hypertensive eyes.Conclusions The stress protein HSP27 is upregulated in retinas from ocular hypertensive rats.No changes in HSP70 or HSP90 were observed.The upregulation in HSP27 appears to be a gene specific event associated with elevated IOP,its expression may be a potential relationship associated with optic neuropathy in glaucoma.

Objective To review the diagnosis and treatment of squamous cell carcinoma of renal pelvis. Methods The clinical data from October 1991 to May 2009 of eight cases of squamous cell carcinoma of renal pelvis were reviewed and analyzed retrospectively. The symptoms of the patients were hematuria (eight cases), pain (seven cases) and abdominal mass (one case). All patients underwent B-ultrasound and IVU examination and four cases underwent CT scan. Three cases were diagnosed as having a tumor before surgery. Five cases were diagnosed as renal calculus, two of the five cases were diagnosed by intraoperative frozen section. Radical nephroureterectomy were performed in four cases, nephrectomy in three cases and palliative resection in one case. Results Histological classification revealed that six cases were moderately differentiated, one case was well differentiated and one case was poorly differentiated. Two cases had stage pT1/pT2 and six cases had stage pT3/pT4. 2 cases had regional lymph nodes metastasis. Seven cases were followed-up. All patients died of tumor recurrence or metastasis. The median tumor specific survive time was six months (range from two months to 42 months). Conclusions Squamous cell carcinoma of renal pelvis is often occurs concurrently with urolithiasis which could lead to difficulty in diagnose before operation. As the most of the patients were diagnosed with advanced stage disease, squamous cell carcinoma of renal pelvis tended to early recurrence and metastasis and the prognosis was very poor.

Objective To detect the patterns of cognitive impairment between patients with paranoid schizophrenia and patients with bipolar mania by using the Cambridge Neuropsychological Test Automated Battery (CANTAB) ,and to explore research clues for finding of cognitive endophenotype in patients with paranoid schizophrenia or bipolar mania. Methods Six CANTAB subtests and the seven subtests of the Wechsler Abbreviated Scale of Intelligence (WAIS short form) were administered to 35 patients with paranoid schizophrenia and 33 patients with bipolar mania who were drug naive experiencing an acute episode, as well as 30 healthy controls. Results Patients with paranoid schizophrenia and bipolar mania demonstrated impairments in 13 of the 15 cognitive indicators in CANTAB. After controlling IQ, both patient groups remained as significantly different from normal controls in terms of search strategy(36. 8 ±3.56,37.24 ±4. 21,30. 33 ±6.24) ,between-search errors(40. 86 ± 19.97,40.24 ± 18.92,15.4 ±17.22) on the SWM test,the proportion of hits(0.54 ±0. 18,0.56 ±0.15,0.78 ± 0.17) on the RVIP test,total errors(45.26 ±36.36,46.61 ±33.32,14 ± 11.7) and EDS errors (12.43 ±9.96, 13.18 ±8.98,4.97 ±6.09)on the IED test. Between search error in the SWM test was positively correlation with YMRS scores ( r=0.38, P=0.039) in bipolar patients. Conclusion Both patient groups demonstrated a comparable profile of cognitive impairments during active periods of their condition. The cognitive impairment index may be a discreet cognitive endophenotype overlapping the disorders.

ObjectiveTo examine biochemical characteristics of the frontal lobe and hippocampus in unaffected parentsof schizophreniaprohandsusingprotonmagneticresonancespectroscopy(1H-MRS).Method 19 unaffected fathers of schizophrenia probands with matched 19 male healthy control subjects and 24 unaffected mothers of schizophrenia probands with matched 24 female healthy control subjects were included in the study.1 H-MRS was performed in two sides of the hippocampus and frontal lobes regions.The ratios of N-Acetylaspartate ( NAA ),choline (Cho) to creatine (Cr) were measured.One-sample T test and paired-samples t test were used for statistic process.ResultsUnaffected mothers of schizophrenia probands had a higher Cho/Cr ratio ( left ( 1.10 ± 0.13,right ( 1.08 ± 0.12 ) ) in the frontal white matter compared with matched female health control subjects(left( 1.03 ± 0.10),right( 1.02 ± 0.09 )).The NAA/Cr ratio was significantly reduced in the left frontal white matter of female health control subjects compared to right( 1.64 ± 0.12 vs 1.74 ± 0.13 ),but this difference was not observed in unaffected mothers of schizophrenia probands.There were no significant differences in metabolites for frontal lobe and hippocampus regions between unaffected fathers of schizophrenia probands and male healthy control subjects groups( all P＞0.05 ).ConclusionThe results implicate that the metabolic abnormalities and disappeared asymmetry of NAA/Cr might exist in the frontal white matter among unaffected mothers of schizophrenia probands.

ObjectiveTo identify the metabolic alterations on prefrontal lobes and hippocampus in male patients with the first-episode mania using proton magnetic resonance spectroscopy(H-MRS).Method 18 male patients with the first-episode mania and 27 healthy subjects matched for age,gender,and years of education were included in the study.1 H-MRS was performed in two sides of the hippocampus and frontal lobes regions.The ratios of N-acetylaspartate (NAA),choline (Cho) to creatine (Cr) were measured.One-sample t test and paired-samples t test were used for statistic process.ResultsMale patients with the first-episode mania presented decreased NAA/Cr in left frontal lobe and hippocampus regions when compared to normal controls( left frontal lobe (1.68 ±0.19 vs 1.86 ± 0.19),hippocampus ( 1.32 ± 0.10 vs 1.43 ± 0.16 ),P ＜ 0.01 ),but there were no significant difference in NAA/Cr for right frontal lobe and hippocampus regions between groups ( all P ＞ 0.05 ).Two groups also showcd no significant difference for Cho/Cr in bilateral frontal lobe and hippocampus (P ＞ 0.05 ).Conclusion There is significant difference of manifestation of 1H-MRS between male patients with mania and normal controls,which reflects neuronal dysfunction in the prefrontal lobes and hippocampus.

Medical service pricing system is the basic system of health economics, which has a profound impact on physicians′ medical behavior and the running mode of hospital. Rui′an City, Wenzhou City, Zhejiang Province, freed up the cost space of drug and consumables based on the reasonable diagnosis and treatment behavior of doctors and selection of drug and consumables in the hospital procurement link. 68% of the free space was used to improve the price of medical services. 248 medical service items with obvious cost inversion were selected, such as nursing, traditional Chinese medicine, diagnosis, etc., and the price adjustment range was determined according to the agreed free space limit. Meanwhile, the credit mechanism of Alipay was applied to synchronously implement " vacating space and adjusting structure" , so as to solve the game problem between medical treatment and medical insurance, broaden the path of the " translation compensation method" of medical service price reform, and produce policy superposition and linkage effect with the reform of medical insurance payment mode.