Objective To study COX-2 expression in bladder transitional cell carcinoma in order to explore the relationship between the immunohistochemical staining and biological behavior of bladder cancer. Methods The expression of COX-2,Ki-67,and VEGF was examined in 50 cases of bladder transitional cell carcinoma and 10 normal bladder mucosa by means of immunohistochemical technique.Results The expression of COX-2 in BTCCs was higher than that in normal bladder mucosa.The positive rate of COX-2 was 80% in BTCCs while it was not detected in normal bladder mucosa.COX-2 was highly positively related to the grade,stage and prognosis of tumors.The expression of COX-2 in poorly differentiated,invasive or re- curring BTCCs was higher than that in well differentiated superficial or nonrecurring ones.But there was not significant difference between the solitary tumour and multiple ones.There were positive correlation both be- tween COX-2 and Ki-67 and between COX-2 and VEGF.Conclusion The high expression of COX-2 may benefit increase in bladder cancer cell proliferative activity.VEGF expression in COX-2 positive tumor was significantly higher than that in COX-2 negative tumor.

Objective To observe the effects of losartan and amlodipine on blood pressure,plasma levels of leptin,adiponectin and norepinephrine (NE) and insulin sensitivity in obese hypertensive patients.Methods The levels of plasma leptin and adiponectin were determined by RIA and the plasma NE level was assayed by high- performance liquid chromatography.Insulin resistance index (HOMA-IR) was evaluated using the homeostasis model.Results Compared with basal levels,after 16-weeks' therapy,plasma leptin,HOMA-IR and body mass index were significantly decreased in losartan group [(35.6?18.5 vs 32.0?17.1)?g/L,P

Objective To construct Fisher discrminant functions with index of ultrasonography. Methods A total of 48 non-neoplastic ovarian cysts, 137 benign and 120 malignant ovarian tumors were enrolled in this study. Taking ultrasonographic parameters and Doppler blood flow signals as differential diagnosis variable, a diagnosis model was developed using stepwise discriminant analysis. Then a projection and territorial map were drew and the diagnostic ability of the model was verified with substitution method and jackknife. Results ①Univariate analysis indicated that ovarian cysts volume, end-diastolic blood flow velocity (V_(ED)), mean blood flow velocity (V_m), resistance index (RI), pulse index (PI), physical property, echo, shape, boundary, ascites and blood flow signal have statistical difference among the three kinds of ovarian cysts. ②Stepwise discriminant analysis showed that volume, resistance index, physical property, shape and boundary are the independent prognostic variables. The two Fisher discriminant functions were as following: Function 1=0.002volume-4.793 RI+0.468physical property+0.862shape+0.901boundary-4.076, Function 2=0.005volume-1.480 RI+0.851physical property-0.291shape+0.443boundary+0.524. ③The projective positions of three kinds of ovarian cysts at 2D coordinates were clear. ④The sensibility and specificity of mode for diagnosis non-neoplastic ovarian cysts, benign and malignant ovarian tumors was 91.67%, 88.32% and 93.33% with substitution method, and was 91.67%, 86.13% and 93.33% with jackknife method. Conclusion Cysts volume, RI, physical property, shape and boundary are the significant differential prognostic variables. Fisher discriminant analysis can provide a reliable prognostic model for ovarian cysts.

Objective To analyze and evaluate neoadjuvant chemotherapy's value and significance in combining with surgical treatment for limited small cell lung cancer(LD-SCLC).Methods A total of 94 LD-SCLC patients underwent complete resections combined with chemotherapy between January 2000 and January 2011 in Shanghai Pulmonary Hospital.Among these cases,initial two cycles of neoadjuvant chemotherapies were performed for all pathologically confirmed patients (Group A),and initial operations followed by adjuvant chemotherapy were administered to patients without pathology (Group B).The survival rate was analyzed by log-rank test and Kaplan-Meier method.Multivariate analysis of the prognostic factors was performed using Cox's regression model.Results Group A included 43 cases and Group B included 51 cases.The mean age was (56.37 ± 10.18) years.According to the 6th edition of Tumor,Node,Metastasis(TNM) classification of lung cancer,54 cases were at stage Ⅰ or Ⅱ,40 cases were at stage Ⅲ.Overall 5-year survival(5-YS) was 27％.The 5-YS for patients with stage Ⅰ-Ⅱ was notably better than that of stage Ⅲ (34％ vs 20％,P =0.033).For patients with stage Ⅲ,the 5-YS of Group A was significantly better than that of Group B(34％ vs 12％,P =0.020),besides median overall survival for Group A and Group B were 46 and 15 months(P =0.009).Furthermore,the results of multivariate analysis showed that neoadjuvant chemotherapy,surgery and histopathology of SCLC were independent factors that strongly affected survival and prognosis.Conclusion In combined surgical treatment for LD-SCLC,neoadjuvant chemotherapy obviously improved the prognosis of patients with stage Ⅲ.Therefore,it was very important and necessary that pre-surgical neoadjuvant chemotherapy was administered to resectable stage Ⅲ LD-SCLC patients.

Adolescent ; Classical Lissencephalies and Subcortical Band Heterotopias ; diagnosis ; Female ; Humans

Objective To find out the status of prevention and control of iodine deficiency disorders and evaluate the iodine nutritional status of Jinan residents,to explore appropriate iodine level in drinking water,and to provide a scientific basis for adjustment of intervention strategies.MethodsAccording to the Monitoring Program of the National Iodine Deficiency Disorders (Trial),qualified iodized salt consumption rate,drinking water iodine content and urinary iodine levels of women of childbearing age were determined in iodine deficiency areas from 2003 to 2010.Salt iodine was detected by direct titrimetry,urinary iodine by As-Ce catalytic spectrophotometric assay and iodine in drinking water by cerous sulfate catalytic spectrophotometric method.Results Intake rate of qualified iodized salt was up to 90％ and above from 2003 to 2010,median water iodine was 13.65 μg/L in the 10 counties(cities,districts),of which less than 100 μg/L accounted for 79.82％(4560/5713 ) and ＞ 150 μg/L accounted for 12.73％(727/5713).With the increase of water iodine(0 ～ ＜ 10,10 ～ ＜ 50,50 ～ ＜ 100,100 ～ ＜ 150,150 ～ ＜ 300 and ≥300 μg/L),urinary iodine levels of women of childbearing age increased successively(median 156.56,175.81,267.04,349.00,524.22,583.20 μg/L,respectively,x2 =121.20,P ＜ 0.05),while the ratio of urinary iodine ＜ 100 μg/L was significantly lower.The ratio of urinary iodine between 100 and 300 μg/L was decreased gradually,but the ratio of great than 300 μg/L was gradually increased.ConclusionsIodine deficiency areas in Jinan have reached the standard of elimination of iodine deficiency disorders.We should insist to carry out our measures to suit local conditions,classified guidances and scientific principals of iodine supplementation.

Objective To investigate the diagnosis and treatment of primary hyperparathyroidism ( PHPT) initially with urinary calculus .Methods The clinical data of 26 patients who diagnosed as PHPT ini-tially with urinary calculus were retrospectively reviewed .Results There were 22 cases with bilateral urinary calculus and 4 cases with unilateral relapsed urinary calculus .Ultrasonography , CT and radionuclide were helpful to determine the location of the neoplasia .24 cases underwent percutaneous nephroscope or ureteroscopy pneu-matic ballistic lithotripsy , 2 cases discharged ureteral calculi by themselves .All patients were performed surgical treatment of PHPT , which was confirmed by intraoperative frozen pathology and postoperative pathological exami -nation.There was great improvement of clinical symptoms after surgical procedures .The preoperative serum calci-um, urine calcium and parathyroid hormone elevated , while serum phosphate decreased .The postoperative indi-cators were just the opposite .The difference had statistical significance ( P<0.05 ) .Conclusions Laboratory investigations and imaging studies are very important to diagnose PHPT initially with urinary calculus .The para-thyroid surgery can remarkably reduce the calculus recurrence and improve renal function .

Objective To retrospectively analyze the clinical results of peroneal tendon insertion and reconstruction with suture anchors in the treatment of avulsion fractures of the fifth metatarsal base.Methods Five patients (three males and two females) with the fifth metatarsal base fractures were in zone 1, with average seven days of duration before surgery. The result of radiological examination confirmed that all fractures were in zone 1 of the fifth metatarsal base, with some small, comminuted and obviously displaced pieces. After removal of the small comminuted fracture pieces, the peroneal tendon insertion was dissociated and sutured to the fifth metatarsal base by suture anchors (5 mm in diameter) with line. The feet were immobilized by plaster in the vagus position. The patients began to walk with weightbearing six weeks after operation. Results All patients were followed up for at least six months, which showed no deformity of the feet. The function of forefoot valgus and abduction restored to normal. There was no any loss in muscle force compared with the normal side. Conclusions Peroneal tendon insertion and reconstruction by suture anchors is very helpful to solve the problem in the fixation of the small fracture fragments. The function of the peroneal tendon recovers very well. The surgery has the advantages of easy manipulation and small area of dissection, without requirement of secondary surgery.

Acetaminophen (APAP, also known as paracetamol)-induced liver injury is the leading cause of drug-induced liver injury in the world. Wuzhi Tablet (WZ, an ethanol extract of Schisandra sphenanthera) is widely used in clinical practice to protect liver function. Our previous studies have shown that pretreatment with WZ for 3 days can significantly protect against APAP-induced liver injury; however, the effect of different intervals between APAP and WZ treatment on APAP-induced liver injury remains unclear. In this study, the change in liver injury indexes, APAP metabolites, and the activity of cytochrome P450 (CYP450) enzymes after treatment with WZ and APAP at different intervals were determined. The animal experiment was reviewed and approved by the Animal Ethics Committee of Sun Yat-sen University. The results show that 0 h, 0.5 h, and 2 h pretreatment with WZ significantly protected against APAP-induced liver injury in mice, as evidenced by a significant decrease in biochemical parameters such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), and malonaldehyde (MDA). WZ inhibited the metabolic activation of APAP mediated by CYP450 enzymes and reduced the formation of APAP metabolites. This study further demonstrates that pretreatment with WZ at different intervals (0 h, 0.5 h, and 2 h before APAP dosing) exerts a significant hepatoprotective effect against APAP-induced liver injury, and a single-dose of WZ inhibits the activity of CYP450 enzymes related to APAP metabolic activation, thereby protecting against APAP-induced hepatotoxicity.

Dioxin, a persistent organic pollutant, is also a typical environmental endocrine disruptor.With its strong toxicity, it can persist in the environment and be enriched through the food chain.Therefore, it has attracted wide attention in recent years.In this paper, the pollution status of dioxins in the atmosphere is summarized, the risk of respiratory exposure to dioxins is introduced, the possible health effects of human exposure to dioxins are summarized, and suggestions for future control are put forward.In cities and functional areas with high dioxin concentration, long-term inhalation of pollutants has potential risks for people′s health and life span.It is suggested to carry out orderly classification of waste, track and monitor the health status of residents around the waste incinerator, and to establish relevant emission standards and limits, so as to gradually standardize and make the dioxin emission harmless.