Objective To investigate the expressions of LYVE-1 and PROX-1 in human breast carcinoma and the clinical significance of lymphatic vessel density.Methods Immunohistochemistry (SP method)was used to detect the expressions of LYVE-1 and PROX-1 in 80 specimens of breast invasive ductal carcinoma and 35 specimens of breast hyperplasia.Results The density of lymphatic vessels positive for LYVE-1 or PROX-1 was significantly higher in breast carcinoma than in breast hyper-plasia (P<0.01).There was a significant correlation between lymphatic vessel density and lymph node metastasis (P<0.01). A negative correlation was noted between the PROX-1 expression in carcinoma cells and tumor grade (P<0.01)or TNM stage (P < 0.01 ).Conclusion Lymphangiogenesis is increased in breast carcinoma,which is associated with lymph node metastasis.PROX-1 may be involved in tumorigenesis,progression and lymphatic metastasis in breast cancer.

Objective To investigate the expression of CD14/CD16 by monocytes and the anti-inflammatory effects of hypertonic saline plus dextran (HSD) in adult blunt trauma patients in hemonhagic shock. Method A total of 30 adult patients were eligible for inclusion in the study if they sustained blunt trauma from March to October 2007 and had at least one recorded episode of hypotension (systolic blood pressure ≤ 90 mm Hg) with clear evidence of blood loss (external or internal including the thorax, abdomen or retroperitoneum). Patients were excluded if they refused to participate, were admitted ≥ 6 hours after injury, were pregnant, or had chronic disease. The enrolled patients were randomly divided in a double-blinded manner into an HSD group which was administered 7.5% Nad plus 6% dextran - 70, and a control group which was administered 0.9% NaCl. A single 250 ml dose of either HSD or NaO was immediately administered to the patients in each of the two groups while they were in the emergency room. The primary outcomes were to measure the changes in CD4/CD16 expression by monocytes and the levels of anti-inflammatory cytokines, including tumor necrosis factor-alpha (TNF-α), interleukin (IL)-lra and IL-10. Patient demographics, fluid requirements, organ dysfunction, infection and death were recorded. Results A total of 28 patients were enrolled with no significant differences in their clinical measurements. Hyperosmolarity was modest and transient. HSD altered the shock-induced monocyte redistribution pattern by reducing the drop in the "classic" CD14 ++ subset and remarkably affecting the expansion of the "pro-inflammatory" CD14+CD16+ subsets. In parallel, HSD significamly reduced pro-inflammatory TNF-α production while increasing anti-inflammatory IL-lra and IL-10 production. Conclusions This human trial demonstrates that HSD has anti-inflammatory and immunologic properties for trauma patients in hemorrhagic shock. HSD exerts profound immunomodulatory effects, promoting more balanced pro-/anti-inflammatory responses and reducing post-traumatic complications. Therefore, it could be useful in attenuating post-trauma multiorgan dysfunction (MOD).

Objective To explore the value of diffusion tensor imaging (DTI) and diffusion tensor tracography (DTT) in assessment of Corticospinal tract (CST) and medial lemniscus (ML) in tumors involving brainstem.Methods A total of 35 cases with pathologically confirmed tumors involving brainstem were collected,and 35 volunteers matched with genders and ages were recruited as the normal group.DTI scanning was performed on all the patients and controls.The damage degrees of CST and ML were evaluated and graded by DTT,and the dysfunction degrees were evaluated for the patients.Spearman correlation was used to statistically analyze the relationships of limb movement,sensory dysfunction and CST and ML damage.Results According to the rating results,normal findings,shifting,edema or infiltration and damage of CST was found in 9,9,11,and 6 cases respectively.They were 8,9,15,3 cases for ML.Motor function was normal in 20 cases,slightly defective in 11 cases,and moderate defective in 4 cases.Sensory function was normal in 21 cases,slightly defective in 6 cases,and moderate defective in 8 cases.The patients' dyskinesia and CST damage degree,sensory dysfunction and ML damage degree were positively correlated (r was 0.786 and 0.686 respectively,P ＜ 0.01).The position relationship among tumor and CST and ML could be well displayed on images.None of the patients showed new symptoms of dysneuria after surgery.Conclusions DTI and DTT technology can be used to evaluate CST and ML damage degree in tumors involving brainstem.They can display the position relationship between tumor and the brainstem CST and ML,which is important in protecting the brainstem fiber tract during operation and evaluating the recovery after the operation.

Objective To observe the effects of seawater immersion at different temperatures on survival time and mortality and physiological state of non-anesthetized rats.Methods Totally 100 SD male rats(The abdominal cavity was implanted with a temperature sensor in advance)were randomly divided into five groups which were immersed in 20 ℃,17 ℃,15 ℃,13 ℃ and 10 ℃ seawater,respectively.Each group contains 20 rats.The changes of respiration,heart rate and muscle fibrillation within 2 hours were observed and the survival time and mortality of each group were counted in 24 hours.The decrease trend of intraperitoneal temperature in rats was analyzed retrospectively within 2 hours.Results Soaking for 10 minutes,the respiratory and heart rate of each group were significantly increased,but there was no significant difference among groups(P>0.05).The respiratory and heart rate decreased rapidly between 10 and 40 minutes,and the decline was slower relatively between 40 and 80 minutes.Soaking for 80 minutes,the respiration rate of rats among groups had significant difference(P<0.05).Immersing for 100 minutes,the heart rates of rats in each group were significantly different(P<0.05).Soaking for 20 minutes,the muscle fibrillation of 15 ℃,13 ℃ and 10 ℃ group reached the peak,and there were significant differences among groups(P<0.05),then disappeared.However the rats in 20 ℃ and 17 ℃ group reached the peak at 30 minutes,but there was no significant difference between two groups(P>0.05),hereafter the muscle fibrillation was maintained at a certain level.The mean survival time of 20 ℃ group,17 ℃ group,15 ℃ group,13 ℃ group and 10 ℃ group in 24 hours were(23.6±1.23)hours,(15.0±4.16)hours,(7.7±3.21)hours,(2.4±0.91)hours and (1.1±0.39)hours,respectively,and the survival curve of each group was statistically significant(P<0.05).The intraperitoneal temperature of rats showed a decline in the cliff,the lower the water temperature,the faster the descending.Soaking for 40 minutes,the difference of intraperitoneal temperature of each group was statistically significant(P<0.05).Conclusion The effects of seawater immersion at different temperatures on the physiological state and survival time and mortality of rats are significantly different.With the decrease of water temperature,the physiological state changes more obviously,the survival time is shorter and the mortality rate is higher.

Objective To investigate the characteristics of spinal injury caused by earthquake as well as to improve its therapeutic ability by comparatively studying the medical records of the inpatients with spinal injuries caused by Wenchuan earthquake and the inpatients with spinal injuries in peace time.Methods Medical records of inpatients with spinal injuries were extracted from 5.12 earthquake injury database(earthquake group) and medical records of the patients with spinal injuries firstly admitted to Daping Hospital between 2001 and 2007 were extracted from Chinese trauma database systems (control group).The epidemiological characteristics of the two groups were comparatively studied,including gender,age,injury causes,injury severity,treatments and outcomes.Results (1) The incidence of spinal injuries in the earthquake group was 16.7％ (524/3145),which was significantly higher than that (6.4％,682/10644) in control group (P＜0.01).(2) The female ratio in the earthquake group was significantly higher than that in the control group (57.4％:31.8％) (P＜0.01).(3) The age range of the earthquake group was (47.9 ±20.9) years.The wounded number presented an undulately rising trend in the earthquake group as the growth of age,while it showed a parabolic distribution in the control group.(4)The main causes for spinal injuries were crush injury (69.3％) and multi-factor injury (2.8％) in the earthquake group,while slipping up/fall (56.0％) and traffic accidents (23.6％) were the main causes in the control group.(5) There were 82.3％ of the earthquake group that were combined with multiple injuries and 48.1％ combined with at least two injuries,while the control group accounted for only 28.9％ and 12.0％ respectively.The NISS (new injury severity score) in the earthquake group was significantly higher than that in the control group [(11.6±8.8) points vs (7.5±4.8)points](P＜0.01).Meanwhile,the proportion of NISS≥16 in earthquake group was significantly higher than that in the control group as well (P＜0.01).(6) The length of hospital stay of the wounded in the earthquake group was significantly longer than that in control group [(40.5±24.5)d VS (23.9±26.7)d](P＜0.01).The treatment inefficiency rate in the earthquake group was higher than that in the control group (9.2％ vs 4.8％) (P＜0.01).Conclusions The earthquake group has a higher proportion of spinal injuries,female and elder cases,and combined injuries,a much severer injury,a longer length of hospital stay,and a higher treatment inefficiency rate,as compared with the control group.In the earthquake relief,more importance should be attached to salvage,diagnosis,transfer regulation and missed diagnosis,misdiagnosis and secondary injury should be avoided so as to improve the treatment level of the spinal injuries in earthquake.

ObjectiveTo study the characteristics and risk factors of traffic injuries among the adolescents (0-19 years old) in the urban and rural areas of Chongqing and discuss the preventive strategy. MethodsData of road traffic crashes and injuries involving 0-19 years old adolescents over a seven-year period (2000-2006) in three districts of Chongqing was picked up from Road _Traffic Crashes and Injuries Database. Epidemiological characteristics of the traffic crashes and injuries among 0-19 years old adolescents were analyzed and differences between rural and urban areas were studied. ResultsFrom 2000 to 2006, both incidence rate and mortality rate peaked in the urban fringe area were 95.43/100 000 and 3.44/100 000 respectively. Traffic accidents in the suburbs and counties had the highest injury extent, with mortality rate of 9.06％ and severe injury rate of 17.33％. Brain injuries were the primary cause of death. Among the victims, 62.7％ were the pedestrians, of which 20.72％ bore equal responsibility because of disobeying traffic signals, suddenly walking across roads and not walking along the sidewalk. Ninety percentage of the traffic accidents occurred in the sections with no traffic signals or traffic control system. ConclusionIt is important to enhance the traffic safety consciousness of teenagers and children, strengthen preventive measures in fringe areas and rural areas and improve the emergency medical system in rural areas to provide the teenagers and children with a safety traffic environment.

Objective To explore the correlation of total IgE and childhood atopic dermatitis (AD) in maternal serum and newborn cord blood, as well as its clinical significance of allergen testing. Methods Thirty-five cases diagnosed as AD (AD group) were selected, and other 35 children who were not diagnosed as AD (control group) were randomly selected from a birth cohort established in 2009—2011. The total IgE levels were detected by ELISA in maternal serum and newborn cord blood. The serum specific IgE antibody level was detected by quantitative immunoblotting method. Results The serum total IgE level was significantly higher in mother and newborn cord blood in AD group than that in control group (χ2=16.568 and 14.933, P<0.01). Compared to control group, there was a significantly higher positive rate of mother serum allergen includ?ing dust mites, house dust, ragweed pollen, song kind of pollen, poplar, surname and elm pollen, mould, shrimp, marine fish, in AD group (P<0.05). There was a significantly higher positive rate of artemisia pollen and fungi IgE in newborn cord blood in AD group (P<0.05). Conclusion The increased total IgE in maternal serum may play a predictive effect on infants suf?fering from AD. There is no obvious consistency in allergic state between mothers and infants.

A total of 127 type 2 diabetic patients were divided into low glycemic index meal replacements (intervention) group and standard food-based diet (reference) group in an experiment for 12 weeks.The results showed that fasting plasma glucose,postprandial 2 h plasma glucose,fasting insulin,and homeostasis model assessment insulin resistance(HOMA-IR) in the intervention group decreased significantly after 12 weeks trial ( P＜0.05 or P＜0.01 ).However,there were no significant changes in lipid profile and HbA1C in intervention group.In addition,percentage of body fatty,visceral fatty area,and waist-hip ratio also decreased in intervention group( all P＜0.01 ).Superoxide dismutase and glutathione levels increased significantly in intervention group by the end of trial (both P＜0.01 ),while malondialdehyde was decreased (P＜0.01 ).There were no significant changes in the aforementioned indices in the reference group.Weight,body mass index,and waist circumferences were decreased in both groups,but without significant difference between the two groups.

Objective To explore the possible correlation between HbA1c level and nutritional status in community.based patients with type 2 diabetes.Methods A totaI of 219 type 2 diabetes patients were assigned into 2 groups:one with HbAIc<6.5%(n:108)and HbA1f≥6.5%(n=111).Metabolic parameters,food components.and nutritional status were compared between 2 groups.Results (1)49.32% of the participants attained HbA1c<6.5%.(2)HbA1c level was positively correlated with fasting plasma glucose,postprandial plasma glucose,and homeostasis assessment for insulin resistance(HOMA-IR)(r were 0.56,0.49,and 0.20,respectively,P<0.05 or P<0.01),but negatively correlated with high-density lipoprotein-cholesterol(HDL-C)(r=0.16,P<0.05).(3)Linear regression analysis showed that energy,carbohydrate,protein,and fat were the independent risk factors of HbA1c(all P<0.05).(4)Patients with HbA1c<6.5%consumed more fruits.The intake of pure energy-providing foods and protein-,fat-,or saturated fatty acid-rich foods were more frequent in patients with HbA1c≥6.5%(P<0.05).(5)The linear regression revealed that HbA1c level were decreased 0.36%(P<0.10)or 0.46%(P<0.01)by intake of more fruits,roughage and beans,and HbA1c levels were also decreased 0.42%(P<0.05)or 0.37%(P<0.10)by intake of less meat or oils.Conclusions In communitybased patients with type 2 diabetes mellitus,the incidence of HbA1c<6.5% remains low,There exists great difference in nutritional status between the groups with high and low HbA1c levels.The impact of diet OB HbA1c level is great.It's necessary to emphasize the importance of diet therapy far better diabetes control.

Objective To evaluate the safety of heparin used in plasma exchange (PE) and molecular absorbent recirculating system (MARS) for hepatic failure. Methods 8 databases were electronically searched including CNKI,CBM,WANFANG,VIP,PubMed,Web of Science,Cochrane and EMBASE.Two researchers individually performed the literature screening,data extraction and evaluation of risk of bias.Random or fixed effect model based on the result of the test of heterogeneity were chosento synthesize the datausing RevMan 5.3 software. Results 6 eligible studies with 863 patientswere included. Compared to omitting of heparin, the heparin PE could increase the probability of circuit clotting, hemorrhage in puncture point, puncture hematoma (RR = 6.05, 95% CI:2.00-18.30, P=0.001;RR=10.80,95% CI:4.78-24.37,P<0.05;RR=6.34,95% CI:1.13-35.53,P=0.04),but the probability of circuit blocking and other adverse reactions are not influenced(RR=5.61,95% CI:0.99-31.89,P=0.05;RR = 1.17,95% CI: 0.73-1.86, P=0.51). As for the treatment with MARS, heparin could increase the chance bleeding death (RR =12.04, 95% CI:1.69-85.66, P=0.01), but had no obvious effect on circuit clotting. Conclusion When curing the hepatic failure,heparin PE can increase the probability of circuit clotting, hemorrhage in puncture point and puncture hematoma, and heparin MARSE can increase the probability of bleeding death. On the contrary, no-heparin PE and MARSE will be safer in treatment of hepatic failure.