Objective To evaluate the expression level of cathepsin D protein in nasopharyngeal carcinoma (NPC) and to determine its relationship with clinic pathological characters. Method Immunohistochemistry was performed to detect the expression of cathepsin D in 72 cases of primary NPC and 28 cases of normal nasopharyngal epithelial tissue ( NNET), and the correlation of its expression level with clinicopathologic features and clinical outcomes was evaluated. Results Significant down-regulation of cathepsin D was observed in NPC versus NNET(x2 = 13. 55, P ＜0. 01 ). In addition, cathepsin D down-regulation was significantly correlated with poor histological differentiation ( x2 =41.47, P ＜0. 01 ). Type Ⅰ and Ⅱ (well-moderately differentiated) NPC showed more intense immunoreactivity of cathepsin D compared with type Ⅲ (poorly differentiated) NPC. Cathepsin D up-regulation was significantly correlated with clinical stage, recurrence, and lymph node and distant metastasis (x2 = 13.43,22. 86,21.61,14. 32, P ＜0. 01 ).Tumors with cathepsin D up-regulation tended to have advanced clinical stage, frequent recurrences, and metastasis to lymph node and distant organ. Conclusion The expression of cathepsin D was closely related with the differentiation, clinical stage and pathological grade of NPC. Cathepsin D could be served as an effective differentiation marker for the histopathological grading of NPC and a possible therapy target.

Some problems, such as the differences of intelligence and knowledge basis among the students, ambiguity of teaching goal and lack of proper textbooks for instrumental analysis as well as "double-teacher", should be solved urgently. The authors try to find out some solutions to them.

Objective To know the blood lead level of children in Handan city and the influence factors. Methods In Oct. 2004,211 children aged 2-6 years,living in Handan city for more than one year and without eliminating lead medicine treatment in recent three months,were chosen from a kindergarten. The blood lead was determined by WFC atomic absorption spectrometer. The influence factors were investigated by questionnaire.Results The blood lead level was(89.2?13.6) ?g/L,the prevalence of lead poisoning was 11.85%,no significant difference was seen between boys and girls. As for the blood lead level,the children living in the industrial areas or near traffic road was higher,the children living in the newly decorated house was higher,the children often eat preserved eggs was higher,the children whose parents engaged in the work of lead exposure was higher,the children whose parents smoke heavily at home everyday was higher,the children whose parents had lower education was higher. Conclusion More attention should be paid to prevent and control child lead poisoning in Handan city.

Objective To explore the clinicopathological features of osteofibrous dysplasia (OFD). Methods All the clinicopathological information of 17 cases of OFD were reviewed,including sex,age,course and radiography or histopathology features. The expression of Cytokeratin(CK) was examined by SP. Results Age of the patients ranged from 2-15 years, and the course of the lesion ranged from 1 month to 7 years. The mean age and the mean course was 7.2 years and 2.1 years respectively. Male to female ratio was 1∶1.4. The lesions all occured in tibia, presentating with localized masses. Only one invloved with both tibia and fibula. Radiographs showed there were cystic lesions in the thickened anterior cortex of the tibia with light marginal sclerosis. Histopathology showed a zonal architecture. Abundant osteoblasts in the vicinity of the trabeculae. Only two cases were positive for CK(11.8%). 8 of 10(80%) patients recurred. Conclusion OFD is predominately involved with the tibia in children. The history is long. It has a characteristic histopathologic image and clinical progress. Its a independent entity, not the same of adamantinoma.

Objective To explore the relation among depression,hopelessness and suicide risk,as well as the mediating effect of hopelessness between depression and suicide risk.Methods 1 381 students were recruited from five junior middle schools in Linyi by using cluster random sampling.They were investigated with General Situation Questionnaire,Scale for Suicide Ideation(SSI),Beck Hopelessness Scale (BHS) and Beck Depression Iventory (BDI).Results Suicide risk in junior middle school was significant positively correlated with depression and hopelessness (r=0.43 and 0.64 respectively,P＜0.01).Hopelessness partly mediated the relationship between depression and suicide risk (55.8％).Furthermore,hopelessness showed partial mediating effect on the relationship between depression and suicide risk in boys (42.7％) and in 7th Grade students (29.9％),and also complete mediating effect in girls (74.1％) and in 8th Grade students (95.3％).Conclusion The suicide risk in middle school students increase with the increasing of the severity of depression and hopelessness.The hopelessness plays different mediating effects on relation between depression and suicide risk in students with different gender and grade.

Kennedy disease,a motor neuron disease,is an adult onset form of spinal and bulbar amyotrophy characterized by the damage of low motor neuron and uncompleted androgen insensitivity syndrome.So far,there is no effective treatment.This article is intended to provide neurologist with information about Kennedy disease in epidemiology,etiology,pathogenesis,clinical feature,treatment and so on.

Objective To define the correlation between the proliferating cell nuclear antigen (PCNA) and metastasis-related gene nm-23-H 1, and to correlate their espressions with clinical features,radiosensitivity and prognostic variables in exophageal squamous cell carcinoma (ESCC), to establish some biological parameters obtained prior to therapy though which we can predict radiosensitivity and outcome.Methods PCNA and nm-23-H 1 expression protein were determined by immunohistochemical technique with formalin-fixed paraffin-embedded specimens from 59 patients with ESCC who had received definitive radical radiation and had been followed up for more than 3 years. The values were assessed by distributions of patients , disease factors, including age,sex,lesion site,legth ,histological grade and prognosis.Results The findings showed that the mean labelling indices of PCNA and nm-23-H 1 were significantly higher in ESCC than in the normal esophageal tissue (P0.05).Conclusions PCNA and nm-23-H 1 indices can be taken as biological endpoints to predicting therapeutic response, local and systemic control of disease.

Objective To explore the expression of plasminogen activator inhibitor-3 (PAI-3) in normal adult skin. Methods Immunohistochemistry and RT-PCR were used to detect the expressions of PAI-3 and uPA. Results mRNA of PAI-3 and uPA were detected. PAI-3 was mainly expressed in stratum basale, stratum spinosum and stratum granulosum, and its expression enhanced in the well differentiated keratinocytes of the epidermis. uPA was located in basal layer. Conclusion PAI-3 exists in normal adult skin and is related with the differentiation of epidermal keratinocytes.

Objective To analyze the risk factors for ventilator-associated pneumonia(VAP) in the intensive care unit(ICU) of a hospital,and provide theoretical reference for preventing and controlling VAP.Methods ICU patients receiving mechanical ventilation for more than 48 hours between October 2013 and December 2014 were monitored by targeted monitoring method,risk factors for the occurrence of VAP were analyzed.Results A total of 483 patients received mechanical ventilation for more than 48 hours,76 (15.73％) of whom developed VAP;the overall ventilator days were 5 347 days,incidence of VAP was 14.21 per 1 000 ventilator days.Univariate analysis showed that groups of gender,age,length of hospital stay,and duration of artificial airway were all significantly different,VAP rate in male patients was higher than that in female patients(x2 =9.838,P＜0.01);VAP rate was highest in patients aged 41-70 years(x2 =10.242,P＜0.01),followed by patients aged≥71 years;VAP rate were relatively higher in patients with longer length of hospital stay and longer duration of artificial airway(x2 =59.533,P＜0.01;x2 =74.215,P＜0.01,respectively).Conclusion Incidence of VAP in the ICU of this hospital is higher,especially in male patients,patients aged 41-70 years,as well as patients with long length of hospital stay and long duration of artificial airway.

To retrospective analyze the clinical profiles of 80 patients undergoing thoracotomy with protection of intercostal nerve versus traditional method.The doses of narcotics of two groups were (12 ± 5)and (43 ± 11) mg respectively.The postoperative levels of visual analogue score (VAS) and such potential complications as pneumonia,atelectasis and paraesthesia were examined (P ＜ 0.01).Protective technique of intercostal nerve during thoracotomy could effectively relieve postoperative chest pain,reduce the dosage of narcotics and lower the occurrence of lung complications.