Objectives To study the clinical diagnostic value of soluble major histocompatibility complex class Ⅰ-related chain A(sMICA) and analyse the relationship of tumor biologic characteristics and sMICA in lung cancer. Methods The experimental level of sMICA was determined by ELISA in 116 lung cancer patients. The level of serum CEA, NSE, CA-199, CYFRA-211, SCC, ProGRP were determined by ELISA only in 91 lung cancer patients without any therapy. The level of sMICA in 50 normal persons was regarded as control group. Results The level of sMICA in lung cancer patients was significantly higher than that in control group (P<0.001); When sMICA cut-off was set as 240.5 ng/L, the sensitivity for the detection of lung cancer was 90.1%, the speciality was 46.9%. The positive rate of sMICA was significantly higher than that of CEA, NSE, CA-199, CYFRA-211, SCC, ProGRP(P<0.001 respectively); The level of sMICA in lung cancer patients with CR and PR after treatment were lower than that before treatment(P<0.05). The level of sMICA in lung cancer patients with relapse was higher than patients without any treatment (P<0.001). Conclusion SMICA may be a potential marker for diagnosing lung cancer with high sensitivity and speciality. It is associated with tumor progression and distant metastasis and may be helpful in the evaluation of diagnosis for lung cancer.

Objective To investigate the relationship of serum levels of human cartilage glycoprotein 39 (YKL-40) and oxidized low density lipoprotein (ox-LDL) with carotid atherosclerotic plaque in patients with cerebral infarction.Methods The levels of serum YKL-40 and ox-LDL were measured by enzyme immunoassay in 35 normal controls and 130 patients with acute cerebral infarction.Patients with acute cerebral infarction were divided into intima media thickness (IMT) of the common carotid group (30 cases),intima media thickened group (30 cases),plaque group (70 cases) according to their carotid artery sonography.Patients in the plaque group were divided into stable plaque group (33 cases) and unstable plaque group (37 cases).The serum levels of YKL-40 and ox-LDL were determined and compared among different groups.Results Serum levels of YKL-40 and ox-LDL in patients with acute cerebral infarction were (53.61 ± 27.63) ng/ml and (526.58 ± 207.39) mg/L,respectively; which were significantly increased compared to normal control subjects [(25.18 ± 12.69) ng/ml and (301.43 ± 107.53) mg/L,P ＜0.01].Among patients with acute cerebral infarction,the serum levels of YKL-40 and ox-LDL in carotid artery atherosclerosis group were (66.75 ± 28.29) ng/ml and (647.05 ± 198.54) mg/L,respectively;which were significantly increased compared to those of IMT of the common carotid group [(33.23 ±13.06) ng/ml and (366.43 ± 77.51) mg/L,P ＜ 0.01].The serum levels of YKL-40 and ox-LDL in unstable plaque group were (94.87 ± 20.86) ng/ml and (812.47 ± 150.12) mg/L,respectively; which were significantly increased compared to stable plaque group [(59.34 ± 19.17)ng/ml and (609.66 ± 112.96)mg/L,P ＜ 0.01].Serum levels of YKL-40 was significantly linearly correlated with those of ox-LDL (r =0.45,P ＜ 0.05).Conclusions The serum levels of YKL-40 and ox-LDL were significantly increased in patients with cerebral infarction compared to the normal the degree of carotid artery atherosclerosis and instability of atherosclerotic plaque.Patients with serious carotid artery atherosclerosis and instable plaque had higher serum levels of YKL-40 and ox-LDL.The serum levels of YKL-40 were positively correlated with oxLDL.

Objective To investigate the clinical significance of brain-derived neurotrophic factor (BDNF) from peripheral serum in patients of vascular cognitive impairment (VCI).Methods Forty VCI subjects (including 10 mild cognitive impairment vascular(MCI-V) and 30 vascular dementia(VD)),and the control group for the same period in 40 healthy persons.Enzyme-linked immunosorbant assay (ELISA) was used to measure the serum levels of BDNF,statistical analysis was performed.Results The peripheral serum levels of BDNF in VCI (0.175 ±0.056) ng/L were lower than those of control group (0.211 ±0.061) ng/L,and there were significant differences (t =-2.752,P ＜ 0.05).The levels of BDNF showed no significant difference between MCI and VD ((0.195 ± 0.067) ng/L vs.(0.168 ± 0.052) ng/L,t =1.310,P ＞ 0.05).But they were both significantly lower than the control group (F =4.590,P =0.013).No significant differences were observed in the levels of BDNF between subcortical small vessel dementia (0.178 ± 0.057) ng/L and big vascular dementia (0.154 ± 0.042) ng/L (t =1.278,P =0.212).Conclusion BDNF participate in pathophysiology of VCI,and the serum levels of BDNF may be a candidate marker for clinical diagnosis of VCI.But serum levels of BDNF could not reflect the severity or the type of the VCI.

OBJECTIVETo observe the long-term outcome of implantable cardioverter-defibrillator (ICD) implantation in Brugada syndrome patients and to explore how to reduce the frequency of ICD nappropriate schocks.

METHODSThis study included 14 symptomatic patients (mean age (44.3 ± 8.3) years old; all males) with Brugada syndrome implanted with ICD in our hospital between 1998 and 2012, and these patients were followed up routinely every 6 months. The initial ICD parameters were set according o conventional experience. The ventricular tachycardia (VT) zone was programmed to ventricular rate 150-188 bpm/cycle length (CL) 400-320 ms and the ventricular fibrillation (VF) zone was programmed to ventricular rate ≥ 188 bpm/CL ≤ 320 ms. The total events were recorded by ICD. The ICD parameters revision was made by electrophysiological (EP) experts in case of inappropriate shocks.

RESULTSPatients were followed up for mean (43.0 ± 28.3) months. A total of 297 VF/VT events were recorded by ICD. Electrophysiological experts found that 90% (178/198) episodes were true VF ( CL 130-250 ms) among of 198 VF episodes and 147 VF episodes were terminated by one shock and 21 VF events were terminated by two or more shocks, and the rest 10 VF terminated spontaneously. Only 9% (9/99) VT events were true VT (CL 320-360 ms) among of 99 VT episodes. Eight VT episodes were converted by antitachycardia pacing therapy (ATP) and the other one terminated spontaneously. The rest 90 VT episodes (91%) were supraventricular arrhythmias (SVT, CL 340-390 ms). About 90% inappropriate shocks can be reduced by Wavelet discrimination function and optimal programming (VF zone ventricular rate ≥ 222 bpm/CL ≤ 270 ms and/or VT zone ventricular rate 167-222 bpm/CL 270-360 ms ) according to the characteristics of arrhythmia of individual patient.

CONCLUSIONICD can effectively prevent sudden cardiac death and syncope in high-risk patients with Brugada syndrome. The most common complication is inappropriate shock due to SVT. Optimal ICD programming with Wavelet discrimination function can effectively reduce the frequency of inappropriate shock rate.

Adult ; Brugada Syndrome ; Cardiac Conduction System Disease ; Death, Sudden, Cardiac ; Defibrillators, Implantable ; Humans ; Male ; Syncope ; Tachycardia, Ventricular ; Treatment Outcome ; Ventricular Fibrillation

Objective To investigate the significance of resistant gene detection combined with adenosine triphosphate-tumor chemosensitivity assay (ATP-TCA) in the second-line chemotherapy of lung squamous cell cancer, and to provide a reference for clinical treatment. Methods 150 patients with lung squamous cell cancer diagnosed by histopathology or cytology and with the disease progressed after NP regime chemotherapy were enrolled. The mRNA expressions of excision repair cross complementation 1 (ERCC1) and ribonucleotide reductase M1 (RRM1) were detected by RT-PCR, and ATP-TCA was carried out. After detected by RT-PCR and ATP-TCA, the patients who were sensitive to gemcitabine plus cisplatin (GP) accepted the second-line systemic chemotherapy with GP regimen, and the others who were not sensitive to GP regimen or whose results of gene detection and ATP-TCA were on the contrary took the second-line chemotherapy regimens with docetaxel plus cisplatin (DP). Both groups accepted 2-4 cycles of systemic chemotherapy. The chest CT was followed up, and the response rate (RR), progression-free survival (PFS) and median survival time (MST) were investigated. Results The RR of GP group was 36.2 % (17/47), while the DP group was 28.1 % (26/92), and the difference was statistically significant (χ2= 4.274, P< 0.05). The media PFS of GP group and DP group were 4.2 months (95%CI 3.485-5.348 months) and 3.6 months (95 %CI 2.685-4.648 months), respectively, and the difference was statistically significant (P<0.05). The MST of GP group and DP group were 9.6 months (95 %CI 8.283-10.637 months) and 8.9 months (95 %CI 7.384-9.648 months), respectively, and there was no statistically significant difference (P> 0.05). Conclusion The resistance gene detection combined with ATP-TCA have certain guiding significance on the second-line chemotherapy for advanced lung squamous cell cancer.

Purpose To explore the role of posterior cingulate cortex (PCC) dysfunction in the pathogenesis of depression and its relationship with the clinical features of depression by analyzing the effective connection among the inner areas of PCC of patients in depression.Materials and Methods The spectral dynamic causal model (spDCM) was used to analyze the resting state functional magnetic resonance imaging (fMRI) data from the PCC inner areas Brodmann area (BA) 23,BA29,BA30,BA31 in the major depressive disorder group (MDD,n=23) and healthy control group (HC,n=36).Results Compared with HC group,the strength of BA30 self-connection of MDD group existed significant difference (t=2.53,P＜0.05).In MDD group,the connection of BA23 toward BA31 had abnormal activation,and the abnormal inhibition occurred in BA23 toward BA30;compared with HC group and after a＜0.05 Hz correction,there were significant differences in the bi-directional connections for BA23 and BA31,BA39 and BA31,BA30 and BA31,and in the unidirectional connections for BA23 to BA31,BA30 to BA23,BA30 to BA29 in MDD group.Conelusion The effective connection and connective nodes and edges in the inner areas of PCC in the depression disorder patients were abnormal.

Objective To study the relationship between expression of matrix metalloproteinases-7 (MMP-7) and clinicopathological characteristics in patients with primary non-smaU cell lung cancer(NSCLC). Methods MMP-7 in 20 normal people and 60 advanced NSCLC patiens were detected with reverse-transcription-polymerase-chain-reaction. Gelatum image analysator analyzed the result. Results The amount of MMP-7 was less in normal people (30.000) than in NSCLC patients(41.231) significantly(P<0.05); the level of MMP-7 was no correlated with gender, age, pathology pattern, tumor size, was inverse correlation with differentiation, and was positive correlation with clinical stages(P <0.05). Conclusion The level of MMP-7 is closely correlated with tissue differentiation and clinical stages of NSCLC, which may serve as a parameter for determining tumor invasion and metastatic.

ObjectivesTo identify the related abnormalities of gray matter in pediatric patients with Tourette syndrome (TS) by using the optimized voxel-based morphometry (VBM).Methods Three dimensional T1WI was acquired in 31 TS children (28 boys,3 girts,mean age 8 years,range 4-15 years) and 50 age- and sex-matched controls on a 1.5 Tesla Philips scanner. Images were pre-processed and analyzed using a version of VBM 2 in SPM 2.The whole brain gray matter volume was compared between the study and control group by using t-test.Multivariate linear regression analysis was used for analyzing the correlation between the change of grey matter volume within each brain region (mm3 ) and YGTSS score and course of disease of TS patients.Statistical analyses were performed by using SPSS 13.0.ResultsUsing VBM,significant increases in gray matter volumes in left superior parietal lobule, right cerebellar hemisphere and left parahippocampal gyrus were detected in TS patients,and the volume changes were 4059,2126 and 84 mm3 ( t =3.93,3.71,3.58,P ＜ 0.05 ) respectively.Compared to the control group,decreased grey matter volumes were found in medulla and left pons,and the volume changes were 213 and 117 mm3( t =3.53,3.48,P ＜ 0.05 )respectively.Tic severity was not correlated with any volume changes of gray matter in brain (P ＞ 0.05,a small volume correction,KE ≥ 10 voxel).Tic course was negatively correlated with the gray matter volume of left parahippocampal gyrus ( Beta =- 0.391,P =0.039 ).ConclusionsUsing VBM technique,the gray matter abnormalities can be revealed in TS patients without obvious lesions on conventional MR imaging.The increasing volume of temporal and parietal lobes and cerebellar may be an adaptive anatomical change in response to experiential demand. The gray matter volume of the parahippocampal gyrus may be used as one potential objective index for evaluating the prognosis of TS.

Objective: To investigate the risk factors of ventricular arrhythmias in patients with Brugada syndrome. Methods: Clinical data of 60 Brugada syndrome patients admitted in the department of cardiology of the First Affiliated Hospital of Nanjing Medical University from March 2003 to December 2016 were collected and retrospectively analyzed. The age at diagnosis was (43.2±13.1) years (0.6-83.0 years), 98.3% were males (n=59), and the patients were followed up to (92±41) months (12-169 months). The 12-lead surface electrocardiogram (ECG) recorded at the time of diagnosis and showing the highest type 1 ST elevation, either spontaneously or after provocative drug test, was used for the analysis. Patients were divided into ventricular arrhythmia (VA, n=12) group and non-ventricular arrhythmia (non-VA, n=48) group depending on the presence or absence of clinical VA event. The demographic data and ECG data of the 2 groups were compared, and the independent risk factors of VA events were analyzed by stepwise logistic regression. Results: Incidence of family history of sudden death (7/12 vs. 22.9% (11/48)) and percentage of type 1 ST elevation in the peripheral ECG leads (6/12 vs. 16.67% (8/48)) were significantly higher in VA group than in non-VA group (both P<0.05). Max Tpeak-Tend (Max-Tpe) interval ((144±53)ms vs. (110±16)ms) and dispersion of Tpe ((74±50)ms vs. (43±17)ms) were significantly higher in VA group than in non-VA group (both P<0.05). The area under receiver operating characteristic (ROC) curves for the Max-Tpe interval was 0.693 and Max-Tpe interval ≥140 ms was determined as an optimized cutoff point with increased risk of VA event, which had a sensitivity of 50.0%, a specificity of 98.0%, a positive predictive value of 85.7%, and a negative predictive value of 88.7% for predicting VA event. The ROC curves for the dispersion of Tpe was 0.775 and dispersion of Tpe ≥45 ms was determined as an optimized cutoff point for predicting VA event, which had a sensitivity of 91.7%, a specificity of 64.6%, a positive predictive value of 39.3%, and a negative predictive value of 96.9% for predicting VA event. In multivariate analysis, Max-Tpe interval ≥140 ms (OR=27.53, 95%CI 1.07-706.77, P=0.045) and family history of sudden death (OR=24.63, 95%CI 2.05-295.38, P=0.011) were found to be the independent risk factors of arrhythmic events. Conclusions Max-Tpe interval ≥140 ms and family history of sudden death are risk factors of VA event in included patients with Brugada syndrome.

OBJECTIVETo compare gene expression profile of human hepatocellular carcinoma (HCC) cell lines with different metastatic potentials, so as to screen for metastasis-related genes.

METHODSGene expression profile of MHCC97-L and HCCLM3, two HCC cell lines with similar genetic background but different in spontaneous metastatic potentials, were studied by cDNA microarray.

RESULTSFrom 1,626 screened genes, 25 differentially expressed genes were found, 18 showed decreased expression including the decreased expression of cell cycle control genes Rb2, mismatch repair gene hMSH2, and signal transduction gene protein kinase C beta 2 and 7 increased expression including signal transduction gene MAP kinase kinase 6, cell proliferation gene E25, immunity related gene SP40, 40, etc in HCCLM3.

CONCLUSIONThe genes, being closely associated with cancer metastasis, could be considered as potential markers to predict metastasis and targets for anti-metastasis intervention.

Blotting, Northern ; Carcinoma, Hepatocellular ; genetics ; pathology ; Gene Expression ; Gene Expression Profiling ; Humans ; Liver Neoplasms ; genetics ; pathology ; Neoplasm Metastasis ; genetics ; Oligonucleotide Array Sequence Analysis ; RNA, Neoplasm ; analysis ; Tumor Cells, Cultured