Malignant pleural effusion is caused by the pleural invasion of malignant tumors such as lung cancer, or by primary pleural tumors. It is a troublesome and debilitating complication of advanced malignancies. If malignant pleural effusion is not treated in time, the average life span of these patients is only several months. An effective treatment can improve the quality of life and prolong the average life spans.

Matrix matalloprotenases-12(MMP-12) is a member of the matrix matalloprotenases family,and it is a main mediator to degradate the extracellular matrix. MMP-12 is composed of an propeptide domain, a catalytic domain and hemopexin-like domain. The function of MMP-12 include the genetic transcription and inhibitor regulation. Overexpress of MMP-12 causes pathological extracellular matrix protein breakdown and excessive airway remodeling,and MMP-12 is impotant in the pathogenesis of the acute and chronic lung injury,which has been implicated in a range of respiratory diseases, including asthma and emphysema.

Phospholipase C(PLC) is a kind of hydrolase for phosphoinositide(PI),which plays a vital role in life activity as a second messenger.It can prohibit hematoblast from aggregating.PLC indwells the prokaryote and eukaryote,especially those existing in bacteria draw great attention since it can simulate the action in eukaryote.In this article,we describe the basic mechanism of cloning,refolding,expressing of PLC,and the purification of recombinant PLC. At the same time,we report our study briefly,and we wish the recombinant PLC will be developed into a new medicine of anti-aggregation to platelet.

BACKGROUND:Unicompartment knee replacement is more popular for smal trauma, rapid recovery, low complication and almost normal knee mechanics, and has been more and more used in clinic to repair single compartment knee disease. At present, there is no report about the influence of the angle of the single condyle prosthesis on the survival rate. OBJECTIVE:To evaluate the effectiveness of unicompartmental knee replacement for medial compartmental osteoarthritis of the knee in 4-6 years of fol ow-up. METHODS:Thirty patients with medial compartmental osteoarthritis of the knee were treated by unicompartmental knee replacement with Oxford system. Complication occurrence was observed. Curative effects were evaluated with Hospital for Special Surgery score before and 3 months, 6 months and 1 year after surgery. On anteroposterior view, the varus/valgus alignments of the tibial components were measured relative to the long axis of the tibia. On lateral view, flexion/extension of the femoral component was measured relative to the posterior femoral cortex. RESULTS AND CONCLUSION:(1) Primary healing of incision was obtained in al patients, and no infection or lower limb deep venous thrombosis occurred. (2) Al of the patients were fol owed up for 48-72 months. There was no prosthetic loosening, dislocation or revision for contralateral compartment and patel ofemoral joint symptoms. (3) Hospital for Special Surgery score was significantly increased to (90.47±4.05) (P=0.00). (4) Tibial placement angle of single condyle prosthesis:The axis of the prosthesis was perpendicular to the axis of the tibia in 21 cases. Varus placement:2° in 1 case, 4° in 3 cases, 5° in 2 cases, 6° in 2 cases, and 10° in 1 case. No valgus occurred in the tibial side. (5) Femoral prosthesis placement angle:The axis of the femoral prosthesis was paral el to the posterior edge of the femoral cortex in 22 cases, on the flexed position:4° in 2 cases, 5° in 1 case, 6° in 1 case and 7° in 1 case;in the extension position:3° in 1 case, 4° in 1 case and 5° in 1 case. (6) Results suggested that the unilateral condylar replacement for the repair of medial compartment osteoarthritis of the knee has a good initial effect. The middle-term and long-term efficacy needs longer fol ow-up study.

Objective To study the association among the color Doppler flow pattern, vascular distribution and the lymph nodes metastasis in breast carcinomas. Methods Sixty-eight patients with infiltrating mammary gland duct carcinoma were divided into the no-lymph-nodes-metastasis group (group I , 37 cases) and the lymph-nodes-metastasis group (group Ⅱ , 31 cases), group Ⅱ were subdivided into group Ⅱa (19 cases): lateral lymph nodes positive of pectoralis minor and group Ⅱ b (12 cases): rear of pectoralis minor and subclavian lymph node positive. Blood flow parameters [peak systoltc velocity (PSV),resistent index ( RI)] and vascular Alder grades were observed and measured with color Doppler ultrasound.The results were compared with the incidence of lymph node metastasis. Results PSV and RI were not significantly different between group Ⅰ and group Ⅱ (t = -0.19,-0.63,P＞ 0.05),and also between group Ⅱ a and group Ⅱ b (t =-1.12,-013,P ＞0.05). By using vascular Alder grades,there were no significant differences between group Ⅰ and group Ⅱ (x2= 0.46, P＞ 0.05 ), but the significant differences were observed between group Ⅱ a [10.5%(2/19) ,63.2%( 12/19) ,26.3%(5/19) in Alder Ⅰ , Ⅱ , Ⅲ grade] and group Ⅱ b [8.3%( 1/12), 16.7%(2/12),75.0%(9/12)in Alder Ⅰ , Ⅱ ,Ⅲ grade](x2 = 7.41,P＜0.05). Conclusion The pattern of blood flow has no correlation with lymph nodes metastasis, vascular Alder grades of carcinoma shows some relevance with the lymph nodes metastasis in the patients with infiltrating mammary gland duct carcinoma.

A differential diagnosis between primary and metastatic cancers is required in lung cancer patients with a history of breast cancer, However, the limited morphological findings are not enough to differentiate many atypical cases. Essential immunohistochemical and molecular markers are helpful for differential diagnosis. Combined markers currently specific and sensitive to lung or breast carcinomas can improve the efficacy of differential diagnosis between primary lung cancers and metastatic breast cancers.

Objective To investigate the expression of CD40 protein in bladder urothelium cancer and to explore its correlation with clinical stage, pathological grades, cell apoptosis. Methods Expression of CD4o protein was evaluated by immunohistochemistry in paracancerous tissues (20 cases) and bladder urothelium cancer tissues (78 cases). Apoptosis of bladder urothelium cancer tissues was detected by Hoechst to determine the apoptotic rate (AR). Results The expression rate of CD40 protein was 2/20(10 %) in the cases of paracancerous tissues, 55/78(70.5%) in the cases of bladder urothelium cancer tissues, a statistically significant differences of CD40 staining was observed between paracancerous tissues and bladder urothelium cancer tissues (P ＜0.01). Overexpression of CD40 was strongly inversely related to the tumor grade and clinical stage; the positive group of CD40 protein was (12.60±0.38)%, the negative group of CD40 protein was (6.77±0.53)%, a statistically significant differences of apoptosis were observed between CD40 protein positive group and CD40 protein negative group (P ＜0.01). It showed CD40 protein might induce cell apoptosis. Conclusion Expression of CD40 protein is closely related with clinical stage, pathological grade and cell apoptotic rate and may offer reliable evidence for diagnosis, treatment and prognosis in bladder urothelium cancer.

Objective To investigate the changes in BIS values induced by TCI of sufentanil at different target concentrations (Cr) during propofol anesthesia. Methods Fifty ASA Ⅰ or Ⅱ patients aged 18-57 yr undergoing elective surgery under general anesthesia were randomly divided into 5 groups (n = 10 each) based on CTof sufentanil: 0.07, 0.10, 0.14, 0.20 and 0.28 ng/ml. BIS, ECG, HR, MAP, SpO2, PET CO2 were continuously monitored. Anesthesia was induced with propofol TCI. The initial target plasma concentration (Cp) was set at 3.0 μg/ml. If the patient remained conscious 5 rain after the equilibrium between Cp and target effect-site concentration (Ce) was achieved, the Cp of propofol was increasing in increments of 0.3 μg/ml until consciousness was lost (LOC). Propofoi TCI was maintained at this level and Cp and Ce were recorded. TCI of safentanil was then started at the different Cp set in the 5 groups. When the equilibrium between Cp and Ce of safentanil was achieved, tracheal intubation was facilitated with succinyl choline 1.5 mg/kg and the patients were mechanically ventilated (VT= 8-10 mi/kg, RR = 8-12 bpm, PETCO2 = 30-35 mm Hg). BIS value, HR, MAP, SP and DP were recorded before induction of anesthesia at LOC (T0) and 1,2, 3, 4, 5 and 6 min after sufentanil TCI was started. Results There was no significant difference in Cp and Ce of propofol at LOC (T0) among the 5 groups. BIS value was decreasing after the beginning of TCI of sufentanil and was significantly lower than the BIS value at T0. The changes in BIS value was negatively correlated with the Cp and Ce of sufentanil. Conclusion TCI of sufentanil can decrease BIS value further during propofol anesthesia.

Objective To investigate the coagulation and fibrinolytie system changes in liver cirrhosis (LC) patients with and without portal vein thrombosis (PVT). Method Twenty-six cases of LC with PVT (PVT group) and 61 eases of LC without PVT (control group) were chosen. Platelet(Pt), prothrpmbin time (PT), activated partial thromboplastin time (APTT), fibrin (Fib), D-dimer, tissue plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-l) were determined. SPSS 11.5software was used for statistic analysis. Results In PVT group, the average level of D-dimer was (0.97±0.53 ) mg/L,signifieantly higher than that in control group (0.61±0.40) mg/L. No significant difference was found between the two groups in Pt PT, APTT, Fib, t-PA and PAI-1. PT and APTT were progressively prolonged from Child-Pugh grade A to B and then to C. Fib was progressively decreased from Child-Pugh grade A to B and then to C. Decreased Pt and increased t-PA, PAI-1 were found in LC patients, but had no sighifieant difference. Conclusions The changes determined of coagulation and fibrinolytie system in patients with LC are abnormal. The average level of D-dimer is higher in LC patients with PVT than that in LC patients without PVT. D-dimer may be a helpful tool to rule out the presence of an underlying PVT in LC patients.

Objective To observe the effect of acupuncture plus rehabilitation on the development quotient in patients with mental retardation (MR) and its therapeutic efficacy by using the Neural and Mental Development Check List for Children Aged 0-6. Method Sixty MR patients were divided into a treatment group and a control group by the random number table, 30 cases in each group. The treatment group was intervened by acupuncture plus rehabilitation training, while the control group was by rehabilitation alone. The improvement of development quotient and therapeutic efficacy were evaluated after 3 treatment courses. Result The improvement of development quotient in the treatment group was more significant than that in the control group; the total effective rate was 83.3% in the treatment group versus 73.3% in the control group, and the difference was statistically significant (P<0.05). Conclusion Acupuncture plus rehabilitation training can produce a more significant efficacy than rehabilitation alone in treating MR.