Survivin is the strongest member of the inhibitor of apoptosis protein(IAP)family. Smac is the second mitochondria-derived activator of cysteine proteases,which can promote apoptosis by combining with IAP. Abnormal expression of them is closely related with occurrence,development,treatment tolerance and prognosis of ovarian cancer. It is prompted that Survivin and Smac are expected to play important roles in the early diagnosis and targeted therapy of ovarian cancer.

This guideline was published by the American Institute of Ultrasound in Medicine,which has been developed to assist physicians performing sonographic studies of the brain in neonates and infants.Neurosonography should be performed only when there is a valid medical reason,and gain the necessary diagnostic information.Although it is not possible to detect every abnormality,adherence to the following guideline will maximize the detection of most abnormalities of the brain in neonates and infants that can be imaged with ultrasound.

Objective To investigate the clinical and pathological features of postmenopausal women with thickening endometrial. Methods Totally 187 patients with postmenopausal endometrial thickening by transvaginal B-ultrasound were divided into symptomatic group (n=104)and asymptomatic group (n=83).Their body mass index,age of menarche and menopause,history of menstruation and reproductive,application of estrogen,and hypertension and diabetes were collected.All the patients underwent hysteroscopy and biopsy procedures. Results There was no difference between two groups in body mass index [ (24.3 ± 3.2) kg/m2 vs.(23.3 ± 2.6) kg/m2,t =3.79,P =0.052]. The postmenopausal time of symptomatic patients in the group was shorter than the asymptomatic [ ( 14.6 ± 2.4) years vs.( 16.5 ± 2.9 ) years,t =4.12,P =0.039].The patients in the asymptomatic group were older than the patients in the symptomatic group [(68.1 ±4.8) years vs.(66.1± 5.5) years,F=3.89,P =0.046].The average endometrial thickness of patients in the asymptomatic group showed no difference compared with patients in the symptomatic group [(7.2 ±1.4) mm vs. (7.8 ± 2.0) mm,F=3.21,P=0.065]. There were 5 cases of endometrial adenocarcinoma,1 case of endometrial atypical hyperplasia,38 cases of endometrial polyp,25 cases of submucosal hysteromyoma,14 cases of proliferative phase endometrium in the asymptomatic group;while 8 cases of endometrial adenocarcinoma,1 case of endometrial stromal sarcoma,4 cases of endometrial serous papillary carcinoma,5 cases of endometrial atypical hyperplasia,47 cases of endometrial polyps,21 cases of submucosal hysteromyoma,2 cases of uterine empyema,8 cases of chronic inflammation of the endometrium, 8 cases of proliferative phase endometrium in the symptomatic group,respectively. Conclusions Most of endometrial thickness in postmenopausal women are benign lesions, mainly including endometrial polyps and submucous myoma, but endometrial cancer accounts for a certain percentage. Hysteroscopy is minimally invasive,safe and with specificity for the diagnosis and treatment of endometrial lesions.

ObjectiveTo compare the clinical disease activity index (CDAI) and simplified disease activity index(SDAI) as well as disease activity score 28(DAS28) by assessing the activity of rheumatoid arthritis (RA) and to explore which one is better.MethodsTwo hundred RA patients were enrolled.Swelling joint counts (SJC),tenderness joint counts(TJC ),patient's and doctor's global assessment of disease activity based on visual analogue scale(PGA,PhGA),health assessment questionnaire(HAQ) were recorded and the erythrocyte sedimentation rate(ESR),C reaction protein (CRP) of each patient were tested.DAS28,CDAI,SDAI of all patients were calculated for all patients.Statistical analysiswas carried out by Pearson correlation for the association between DAS28 and the above parameters,as well as CDAI,and SDAI.We created 4 patient groups based on DAS28,CDAI and SDAI ranks and used kappa statistics to assess the level of overall agreement of different disease activity categories between any of the two indices above for individual patients.We assessed the discriminating validity using receiver operating characteristic(ROC) curve analysis to compare the ability of the CDAI and SDAI to discriminate betwecn patients with remission, low and moderate,high disease activity.ResultsOf all the patients,CDAI(17.2±11.1) and SDA[(19.1±11.6) were correlated with DAS28 (4.3±1.5),the correlation coefficients were 0.876,0.861 (P＜0.05) respectively.CDAI and SDAI were correlated with HAQ (0.6±0.7),as well as DAS28.The correlation coefficients were 0.522,0.523,and 0.482(P＜0.05).The Kappa of CDAI and SDAI was 0.777.The Kappa of CDAI and DAS28,SDAI and DAS28 were 0.482,0.394.The areas under ROC of CDAI and SDAI were 0.906,0.888 if DAS28 was used as the gold standard.ConclusionCDAI and SDAI as well as DAS28 can be used to assess the activity of RA and both are better correlated with HAQ than DAS28.Though there is no CRP in CDAI when compared with SDAI,CDAI has very goodoverall agreement with SDAI and the overall agreement of CDAI and DAS28 is better than SDAI and DAS28.In addition, CDAI is better in discriminating between patients with remission/low and moderate/high disease activity.So,CDAI is a simple,convenient,accurate,quick assessment tool and is suitable for daily application.

Objective To explore the clinical effect of arthrolysis and a hinged external fixator for treatment of posttraumatic elbow stiffness.Methods From April 2007 to April 2012,26 cases of posttraumatic elbow stiffness patients were treated with arthr o lysis and a hinged external fixator after operation,and the effect was observed.Results After operation,26 patients were followed up for 15(8-24) months,the ranges of elbow joint motion increased from (42 ± 17) ° to (119 ± 17) ° after operation.There was significant difference (t =152.85,P＜ 0.05).The MEPS scores increased from (36 ± 13) points to (82 ± 14) points after operation,15 cases were excellent,5 cases were good,3 cases were fair and 3 cases were poor,the rate of excellent and good cases was 76.9％ (20/26).Twenty-three cases (88.5％,23/26)elbow function improved.Postoperative infective complication occurred in 1 case,postponed incision healing occurred in 1 case and 1 patient had cubital nerve paralysis,the symptom disappeared after 3 months and the patient showed no instability in elbow joint.Conclusion Arthrolysis and a hinged external fixator can deep stabe the elbow and its specific position,allowing early rehabilitation to promote functional recover of the elbow.

Immunohistochemical method was used to investigate the morphology and distribution of the oxytocin immunoreactive (OXT-ir) neurons and their dendrites in the subependymal plexus (SEP) around the third ventricle (OXT-SEP). The OXT-ir neurons were of magnocellular neurosecretory type which often intercalated between the ependymal cells, their dendrites were generally long and straight and mostly paralleled to or traveled within the ependyma,some of them could protrude into the ventricle, and most of them appeared heavily vacuous and have a strong tendency of grouping into fascicles. The plexus was composed of dorsal and ventral parts, the former corresponding to the extent of the magnocellular paraventricular nuclei and was extensive and dense, the dendrites were well organized; the latter was more sparse. The cell bodies and dendrites within and between different parts might mix or contact with each other. The functional significance of the plexus is discussed.

Using immunohistochemical method in the present study we examined the changes of the CGRP-LI nerve fibers in the anterior pituitary (AP) of the rat after adrenalectomy. 60 male adult rats were divided into 5 groups at random, i.e., normal, sham-operated, adrenalectomized (AdX) plus hydrocortisone, normal plus hydrocortisone and AdX groups. There were some of CGRP-LI nerve fibers sparsely and unevenly distributed in the normal rat AP. The fibers which had some varicosities and varied in their thickness could occurred either individually or in plexus. The quantity of CGRP-LI nerve fibers increased in number, length, branches and the density of the varicosities. The extent of their distribution was also enlarged. With a Leitz computer-assisted image analyzer the quantity of the CGRP-LI nerve fibers in the 5 groups was measured and the results showed that the amount of CGRP-LI nerve fibers in AdX group was significantly higher than those in all the other groups (P

Objective To investigate the Cardioprotective effects of sevoflurane postconditioning on surgery patients undergoing cardiopulmonary bypass with diabetes mellitus ,in order to provide theoretic basic for clinical practic. Methods 180 patients of undergoing cardiopulmonary bypass sugery were divided into 3 groups:A group:64 patients undergoing heart valve replacement with Type II diabetes. B group:64 patients Pa-tients undergoing heart valve replacement without diabetes ,the group A and B were treated by sevoflurane post-conditionging for 10 minutes before the end of cardiopulmonary bypass. C group:60 patients undergoing heart valve replacement without diabetes,no sevoflurane postconditionging;Three groups of patients detect perioperative tro-ponin T and Creatine Kinase Isoenzyme-MB ,observed and following up the occurrence of postoperative com-plications. Results CK-MB and cTnT were compared at 8 and 24 hours after operation:two biochemical indi-cators of group A and C at different time points after operation were significantly higher than those in group B (P < 0.05),With significant statistical difference , The number of patients with heart failure and malignant arrhythmia in group A and C was higher than group B(P < 0.05),Differences in 30 day mortality and other clinical data between the three groups were not statistically significant. Conclusion Sevoflurane postconditionging has significant myocardial protection effect for patients undergoing valve replacement surgery without diabetes , however ,the myocardial protective effect of patients who undergoing valve replacement surgery with diabetes was weakened.

Objective:To establish a Crownpak CR( +)-HPLC method for the determination of the content and related substance of valacyclovir hydrochloride dispersible tablets. Methods: A Crownpak CR( +) [4. 0 mm × 150 mm,5 μm,DAICEL CROWNPAK CR( +)] column was used,and the mobile phase was 0. 1% perchloric acid in water. The flow rate was 0. 75 ml·min-1 and the de-tection wavelength was 255 nm. Results: A good linear range of valacyclovir hydrochloride was 11. 25-180. 00 μg · ml-1 ( r =1. 000 0), and the average recovery was 99. 0%(RSD=0. 8%, n=9). A good linear range of alacyclovir was 0. 2-50μg·ml-1(r=1. 000 0), and the average recovery was 99. 3%(RSD=0. 6%, n=9). The content of the tablets from two pharmaceutical companies was 92. 7% and 97. 4%, respectively, that of acyclovir calculated by an external standard method was 0. 5% and 0. 4%, respectively, and that of D-valacyclovir calculated by a self-control method was 0. 9%. Conclusion:The method can effectively separate valacyclovir and D-valacyclovir, which is simple, accurate and reliable, and suitable for the quantity control of valacyclovir hydrochloride.

Objective: To construct the antheraea pernyi lysozyme(ApLZ) expression system using the methylotrophic yeast Pichia pastoris, to assay the antibacterial activity of the recombinant ApLZ against Streptococcus mutans. Methods:The ApLZ expression system was used in the expression and purity of Ap-lysozyme. The antibacterial activity of the recombinant ApLZ against Streptococcus mutans were assayed by using agar diffusion method. Results:Expression system of ApLZ was constructed using the methylotrophic yeast Pichia pastoris as a host. ApLZ was expressed correctly and secreted efficiently when the native signal sequence of ApLZ was used as secretion signal. The level of ApLZ expression in Pichia pastoris peaks at 96 h after the induction of sustaining 5 ml/L methanol. The molecular weight of the recombinant ApLZ is about 20 000. Conclusion:The recombinant ApLZ is active in inhibiting the growth of Streptococcus mutans.