The expressions of survivin,PcNA and Bcl xl were detected in 68 patients with pramary hepatic careinoma(HCC) and adjacent tissues and 12 cases of normal hepatic tissues by immunohistochemical (IHC) EnVision and Tunel method.The relationship between survivin gene expression and apoptosis index(AI),proliferation index(PI) and apoptosis inhibition factors were studied.The positive rate of survivin and Bcl xl expression were 58.8%(40/86) and 48.5%(33/68) in HCC,5.88%(4/68) and 36.8%(25/68) in adjacent tissues,0 (0/12) and 25%(3/12) in normal hepatic tissues.The expression of Survivin and Bcl xl are mainly in cell membrane and cytoplasm.Survivin expression is related to metastasis of HCC ( P

Objective To analyze diagnosis and management of traumatic atlantal fractures complicated with disruption of the transverse atlantal ligament. Methods Twenty-six patients with traumatic atlantal fractures complicated with disruption of the transverse atlantal ligament, 20 acute ones and six old ones, were managed in our department from March 1995 to March 2005. All the patients had the symptom of neck pain and a certain extent of neurological deficits. The radiographic examination showed that there were fractures in the anterior arch or/and lateral mass of the atlas and that the atlanto-dental interval (ADI) in these patients was 4 to 7 mm. Twenty-one cases were operated on with occipitocervical or atlantoaxial fusion immediately after injury. Five cases received conservative treatment. Results All were followed up for 15 (from 6 to 24) months on average. The 21 cases treated operatively reported relieved symptoms. Four of the five conservative treatments succeeded, but one of them underwent a successful atlantoaxial fusion because the original conservative treatment had failed. Conclusions The severity of clinical symptoms mostly depends on the degrees of atlantal displacement and cord compression. Diagnosis should be made on the basis of the ADI change as well as clinical presentations. For patients who have potential risk of atlantoaxial instability, occipitocervical or atlantoaxial,usion should be performed early.

Objective To discuss appropriate strategy about treatment of rotatory fixation or dislocation of atlantoaxial articulation in children. Methods 32 cases of rotatory fixation or dislocation of atlantoaxial articulation in children were analyzed retrospectively from January 2000 to March 2005, 24 males and 8 females; patients' age was from 3 to 12 years old with an average of 5.5 years old. The mean course of diseases was 6.5 weeks (range: 2 days to 50 weeks). According to Fielding-Hawkins clinical classification, typeⅠ17 cases(1 case with os odontoideum), type Ⅱ 12 cases(1 case with os odontoideum and 1 case with congenital absence of the arch of posterior atlas), type Ⅲ 3 cases. 26 cases received conservational treatments which were recommended as 2-3 weeks of cervical traction, traction weight should be controlled to 1.0-1.5 kg. After a successful reduction a proper external fixation was required to maintain reduction. And another 6 serious cases received posterior atlantoaxial or occipitocervical autograft fusion. Indications for posterior atlantoaxial or occipitocervical atuograft fusion includes: 1) have difficulty in reduction even under proper traction; 2) with obvious neurological symptoms; 3) combined with compensatory deformity of atlantoccipital articulation or other occiptocervical deformities. Results All of 32 cases were followed up from 3 to 50 months with an average of 32 months. 26 cases who received cervical traction and external fixation resulted in satisfactory outcome in which all the torticollis were rectified, bilateral masses were symmetrical on AP position, and ADI was less than 4 mm in dynamic extension and flexation lateral view. ROM in rotation and extension and flexion were completely recovered. All the 6 cases surgically treated obtained sound bony fusion and neural symptoms were improved obviously and torticollis were rectified completely in 4 cases and others (2 cases) stopped progressing after operation. Conclusion Conservative treatment including Glission traction, cranial traction, collar, cast or cervicothoracic external fixation has been proved to be very effective in most of rotatory fixation or dislocation of atlantoaxial articulation in children; however, operative treatment should be considered in the following situations: patients with difficulty in reduction, with neural involvement and compensatory deformity of atlantoccipital articulation or other occipitocervical deformities.

Objective: To study the effects of endostatin and doxycycline on microcirculatory patterns in the melanoma transplant model of the chorioallantoic membrane of the chicken embryo and the experimental evidences for melanoma therapy thereof. Methods: Endostatin was dripped on the chorioallantoic membrane after melanoma was transplanted 3 days (A group) and 5 days (B group). Doxycycline was dripped on the chorioallantoic membrane after melanoma was transplanted 3 days (C group) and 5 days (D group). The PBS solution was dripped on the chorioallantoic membrane in control group (E group). The hematoxylin-eosin（HE）staining and immunohistochemical staining were performed to observe microcirculation patterns in sections. Results: Compared with the E group, the area of endothelium-dependent vessels were significantly decreased in A group and B group (P ＜ 0.01). But the areas of vasculogenic mimicry were bigger in the two groups(P ＜ 0.05). Compared with E group, the areas of endothelium-dependent vessels and vasculogenic mimicry were significantly decreased in D group(P ＜ 0.05). Conclusion: Endostatin can inhibit angiogenesis. But it has no effect on vasculogenic mimicry in the transplant melanoma. And Doxycycline can inhibit vasculogenic mimicry and angiogenesis in the transplant melanoma. The results provided experimental evidences for melanoma therapy.

Objective: To investigate the influence of TGF-β and IFN-γ on the proliferation, migration and invasion of melanoma cells. Methods: Melanoma cells were cultured in vitro. When tumor cells were confluent about 80% degree, cytokines were added into cell culture media. The concentration of TGF-β and IFN-β was 5ng/mL and 10ng/mL, respectively. Melanoma cells were divided into free-cytokine group, TGF-β group,IFN-γ group, TGF-β and IFN-γ group. Tumor cells in each group were then incubated for 8h, 16h, 24h, 32h,40h and 48h, respectively. After incubation, fixing and staining with SRB, the optical densities and percentage viability were then determined by absorption at 540 nm (A 540). The scarification of tumor cells in each group on the surface was created by a 2001μL pipette tube. The motility of tumor cells in each group was assessed by measuring the distance between scarifications. The speed of the scuffing closure was monitored after 12h.The invasive ability of melanoma cells was observed by transwell cultivation. The tumor cells that invaded through the Matrigel and adhered to the bottom of the outside membrane were determined by absorption at 595 nm (A595). Gelatin zymography assay was used to examine the levels of matrix metalloproteinases-2 (MMP-2) and matrix metalloproteinases-9 (MMP-9) activity when the tumor cells were treated with cytokines after 24h. MMP-2 and MMP-9 activity was demonstrated by gradation in the sodium dodecyl sulfate polyacryl-amide gel electrophoresis (SDS-PAGE) gelatin. MMP-2 and MMP-9 activity was determined by Image analy-sis Software. Results: TGF-β promoted the proliferation, migration and invasion of melanoma cells (P<0.05).However, IFN-γ inhibited the proliferation, migration and invasion of melanoma cells (P<0.05). The effect weakened or disappeared when both of them were used (P>0.05). Conclusion: In vitro, TGF-β may affect the inhibitory effect of IFN-γ on the proliferation, migration and invasion of melanoma cells. This study provided a better understanding of the relationship between tumor and inflammatory factors and established a good ba-sis for future research.

Objective: To build a mouse tumor model with a manufactured surgical wound representing acute inflammation, and to evaluate the relationship between acute inflammation or wound healing and the process of tumor growth. Then to observe the impact of IFN-γ/TGF-β on tumor growth. Methods: Male C57BL mice of six weeks were used and divided into the experiment group and the control group. The B16F10 mela-noma cell suspension was injected into the left groin area of each mouse. A wound measured 1 cm in diame-ter was built on the opposite side of bodies in the experiment group when tumor volume was about 0.5 cm~3.The expression of IFN-γ/TGF-β in blood serum and tumor tissues were examined by ELISA. In order to fur-ther confirm the effect of TGF-β on tumor growth, another 16 mice models with melanoma were established and 8 of them received IFN-γ injection (the experiment group). Results: When acute inflammation had influenc-es on tumor, a two-phase development was presented. In the early phase, the growth of tumor in the mice with wound was slower than that in the control group. In the early phase, the release of IFN-γ was higher and the release of TGF-β was lower in the experiment group. In the later phase, the growth of tumor in the mice with wound was similar to that in the controls and the release of TGF-β was higher. In vivo experiment con- firmed the above results. In the early phase, the release of TGF-β was not significantly different between the experiment group and the control group (P>0.05). In the later phase, the release of TGF-β in the experiment group was higher than that in the control group (P<0.05). Conclusion: In the early phase of acute inflamma-tion, inhibitory effects of IFN-y on tumor growth were presented. In the later phase, the inhibited tumor was re-sistant to IFN-γ through the release of TGF-β to balance the effect of inflammatory factors on tumor cells.

Objective:To explore the diagnostic value of ultrasound-guided fine needle aspiration biopsy(US-FNAB)for thyroid nod-ules.Methods:The clinical characteristics and cytopathological diagnosis of patients with thyroid nodules in Tianjin Medical University General Hospital were analyzed retrospectively;the results of the cytopathological and pathological diagnoses were compared and an-alyzed.Results:Of the 1,241 US-FNAB samples,the ratio of men to women with thyroid nodules was 1:3.83(257/984).The incidence of thyroid nodules gradually increased from the age of 20 years and declined after the age of 60 years.The nodules,which were less than or equal to 1.0 cm in size,accounted for 51.57%(640 cases),and Thyroid Imaging Reporting And Data System(TIRADS)classifica-tion 4 accounted for 86.38%(1 072 cases).Of cyto-pathological diagnoses,22.00%(273 cases)were non-diagnostic,9.75%(121 cases) were benign,30.62%(380 cases)were atypia with undetermined significance,32.15%(399 cases)were suspicious for malignancy,and 5.48%(68 cases)were malignant.In the 302 patients who underwent surgery,the number of cases of clear diagnoses,unavailable di-agnoses,and atypia of undetermined significance were 203,21,and 78,respectively.In the 203 cases of clear diagnoses,the sensitivi-ty,specificity,positive predictive value,negative predictive value,precision,and misdiagnoses following US-FNAB of thyroid nodules were 100.00%(201/201),50.00%(1/2),99.50%(201/202),100.00%(1/1),99.51%(202/203),and 0.49%(1/203),respectively.In the 78 cases that were atypia of undetermined significance,the malignancy rate was 70.51%.Whether the atypia of undetermined signifi-cance was malignant or not was related to the TIRADS classification(P<0.05),and not related to the age,sex,tumor size,or location of the nodules(P>0.05).Conclusions:US-FNAB has high diagnostic value for thyroid nodules and is worthy of being popularized widely.If it replaced some intra-operative frozen sectioning procedures,it may reduce intra-operative waiting time and financial burden of pa-tients.