Purpose To study clinical pathological significance of the expression of PTEN, p53 and epidermal growth factor receptor ( EGFR) in breast carcinoma and their correlation. Methods Immunohistochemical MaxVision method was used to detect the expres-sion of PTEN, p53, EGFR in 209 cases of infiltrating ductal carcinoma of breast and 40 cases of benign breast diseases. Results The over-expression rate of PTEN, p53 and EGFR protein in breast carcinoma was 57. 9%, 55. 0% and 38. 3% respectively, which was significantly different from those in benign breast diseases (P<0. 05). The expression of PTEN, p53 and EGFR in breast cancer was correlated with tumor size, histological grade, lymph node metastasis, ER status, PR status and molecular subtype (P<0. 05). There was an association between PTEN or p53 and TNM stage, PTEN or EGFR and HER-2 status. There was a negative correlation in the protein expression of PTEN vs EGFR or PTEN vs p53 (P<0. 01). There was a positive correlation between EGFR and p53 protein ex-pression (P=0. 000). The expression of PTEN or EGFR was correlated with the prognosis of breast cancer, but not independent prog-nostic factors. The survival rate of patients with PTEN- /p53 + /EGFR+ was lower than those with other combined expression of PTEN/p53/EGFR (P=0. 008). Conclusions Low or loss expression of PTEN, p53 mutation and EGFR over-expression may be coordinate-ly involved in the pathogenesis and progression of breast cancer. The combined detection of these markers may play an important role in making treatment and indicating prognosis for breast cancer patients.

Islet β cell secretion deficiency and( or) the decreased insulin sensitivity of target tissue are the important pathophysiological mechanisms of diabetes. So,detection and assessment of isletβcell function in the early stages,could be of great significance for disease severity evaluation,early intervention and prognosis of the disease. At present,the main methods of the testing and assessment ofβcell function includeβcell function evaluating indexes,pulsatile insulin secretion,insulin secretion by glucose or non-glucose secretagogues and func-tion testing by other secretions of isletβcells. Among of them,βcell functional assessment methods by detecting C-peptide( especially aspects such as 90 minutes of C-peptide testing in mixed-meal tolerance test,urinary C-pep-tide creatinine ratio) have experienced some progress in recent years.

Objective To analyze the factors related to glare occurred after the phakic intraocular lens (P-IOL) implantation,and to raise the standard for the P-IOL selection.Design Retrospective case series.Participants 104 patients with high myopia underwent P-IOL implantation in Beijing Tongren Hospital.Methods In 104 cases,22 cases (22 eyes) were implanted angle supported Phakic6 designed accord with corneal symmetry,54 cases (54 eyes) were implanted iris fixed Verisyse,and 28 cases (28 eyes) were implanted posterior chamber PRL.Selection of the diameter of P-IOL optics depended on P-IOL diopters.The pupil diameter,the P-IOL optic center position,the pupil and corneal center position were measured with anterior segment optical coherence tomography (OCT).The contrast sensitivity (CS) under different condition (day,day and glare,night,night and glare) and in different space frequency (1.5,3,6, 12,18c/d)were examined with Optec6500 system.Main Outcome Measures Glare incidence,CS,and the influence of pupil diameter and P-IOL location to glare.Results None of the 104 P-IOL eyes occurred glare in day time.59 eyes (56.73%) complained of glare in dime condition.The glare incidence was 63.18% (14/22) in Phakic6 eyes,55.56% (30/54) in Verisyse eyes,and 53.27% (15/28) in PRL eyes (P=0.691).CS of all surgical eyes were improved in day time with or without glare luminous environment (P=0.000).And the CS of halo-complaining eyes was lower than of no halo eyes in night time with or without glare luminous environment (P=0.000).Glare oc- curred more frequently in eyes with the pupil diameter larger than P-IOL diameter in clime condition after surgery (10 in Phakic6 eyes, 20 in Verisyse eyes,12 in PRL eyes,all P

BACKGROUND:During artificial knee replacement for al kinds of severe knee disease or conservative treatment for end-stage knee disease, Deluxe-PS knee prosthesis and PFC Sigma RP knee prosthesis have their advantages.
OBJECTIVE: To compare and analyze the matching of the Deluxe-PS and PFC Sigma RP knee prostheses with bone cross section.
METHODS:According to the use of the knee prosthesis, 87 gonarthritis patients undergoing bilateral knee replacement were divided into two groups. 46 cases in the test group received Deluxe-PS knee prosthesis replacement. 41 cases in the control group received PFC Sigma RP knee prosthesis replacement. Operation time and intraoperative blood loss were compared between the two groups. American Knee Society score, knee score of American Special Surgical Hospital and knee joint range of motion were used to evaluate knee joint function before replacement, 3 months after replacement and during final folow-up. Anteroposterior X-ray films were obtained after replacement to measure valgus angle and flexion angle of femoral prosthesis.
RESULTS AND CONCLUSION: (1) Operation time and intraoperative blood loss were significantly better in the test group than in the control group (P< 0.05). (2) No significant difference in American Knee Society score, knee score of American Special Surgical Hospital and knee joint motion was detected between the two groups before replacement and 3 months after replacement (P > 0.05). Above indexes were significantly improved in both groups at 3 months after replacement and during final follow-up (P < 0.05). (3) No significant difference in valgus angle and flexion angle of femoral prosthesis was identified between test and control groups during final follow-up (P > 0.05). (4) These findings indicate that effect of Deluxe-PS type artificial knee prosthesis was identical to that of PFC Sigma RP knee prosthesis in knee osteoarthritis patients receiving bilateral knee joint replacement. Deluxe-PS type artificial knee prosthesis can perfectly realize high-accuracy combination of the prosthesis and the bone cross section, and enhance the fusion suitability of the prosthesis and the bone surface. Deluxe-PS type artificial knee prosthesis has the advantage of operation. This advantage is possibly because Deluxe-PS type artificial knee prosthesis is more in line with the anatomical structure of the knee joint of Chinese.

Objective To discuss the video-urodynamic characteristics and management in infra-sacral cord injured patients. Methods The video-urodynamic finding and managements in 169 patients was reviewed. They were followed up for 2 years. Results Detrusor areflexia was found in 76.33% (129/169) patients, among them there were 27.22% (46/169) patients appeared hyper-compliance, and 7.10% (12/169) patients appeared reflux. The video-urodynamic characteristics showed over activity and low-compliance in 12.43% (21/169) patients, including reflux in 5 cases. Different management was chosen according to the video-urodynamic examination. No special complication was observed after 2 years follow-up. Conclusion The majority patients with infra-sacral cord injury appeared detrusor areflexia and hyper-compliance. Special management according to the video-urodynamic characteristics is important for protecting upper urinary tract and preventing urinary system infection.

Objective To evaluate the effects of propofol on the expression of hippocampal γ-aminobutyric acid (GABAA) and NMDA receptor in a rat model of inflammatory pain (IP).Methods A total of 32 female Sprague-Dawley rats,weighing 180-220 g,were randomly divided into 4 groups (n =8 each):control group (group C),group IP,and different doses of propofol groups (P1,2 groups).IP was induced by injection of formalin.In group C,normal saline and dimethyl sulfoxide (DMSO) 0.1 ml/kg were injected intraperitoneally.In group IP,normal saline and DMSO 0.1 ml/kg were injected intraperitoneally,and 5 min later formalin was injected.In P1,2 groups,propofol 30 and 100 mg/kg were intraperitoneally injected,respectively,and 5 min later formalin was injected.The pain behavior of rats was observed within 1 h after injection of formalin and pain intensity scoring (PIS) value was calculated.The animals were sacrificed at 1 h after injection of formalin and the hippocampi were isolated for determination of GABAA and NMDA receptor expression by immunohistochemisty.Results Compared with group C,PIS value was significantly increased,GABAA and NMDA receptor expression was up-regulated in IP and P1.2 groups.Compared with group IP,PIS value was significantly decreased,GABAA receptor expression was up-regulated,and NMDA receptor expression was down-regulated in P1,2 groups.PIS value was significantly lower,GABAA receptor expression was higher,and NMDA receptor expression was lower in group P2 than in group P1.Conclusion Intraperitoneal propofol can down-regulate NMDA receptor expression in hippocampi of rats with IP,thus inhibiting responses to pain sensitivity; intraperitoneal propofol can up-regulate hippocampal GABAA receptor expression,thus enhancing endogenous mechanism of analgesia.

Objective To determine the median effective dose (ED50) of hemocoagulase agkistrodon (HCA) inhibiting the bleeding after trans-bronchial lung biopsy (TBLB).Methods ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 45-75 yr,body mass index 19-24 kg/m2,scheduled for elective TBLB,were enrolled in this study.TBLB was performed after routine anesthesia.HCA diluted in normal saline 5 ml was locally injected into the biopsy site at 2 min before surgery.The initial dose of HCA was 1.4 U.The dose of HCA was determined by up and down sequential method.Each time the dose of HCA increased/decreased in the next patient depending on whether nor not the bleeding was observed in the biopsy wound under fiberoptic bronchoscope.The ratio between the two successive concentrations was 1.2.The ED50 and 95 ％ confidence interval of HCA were calculated by Dixon's up-and-down method.Results ED50 of HCA inhibiting the bleeding after TBLB was 0.9 U,and 95 ％ confidence interval was 0.7-1.1 U.Conclusion ED50 of HCA inhibiting the bleeding after TBLB is 0.9 U.

Objective:To study the influence of r-tPA and urokinase in curative effect and thrombolysis time on patients with acute and severe pulmonary embolism after interventional thrombectomy .Methods:After reviewing and analyzing the clinical data of 19 acute and severe pulmonary embolism patients , we classified them into two groups in accordance with the application of r-tPA and urokinase to compare the changes of their heart rate , blood pressure , pulmonary arterial pressure , arterial partial pressure of oxygen and hemachrome before and after thrombolysis , as well as the thrombolysis effect time the two groups took.Results: The heart rate, blood pressure, pulmonary arterial pressure , arterial partial pressure of oxygen of the patients in both groups gained remarkable improvement after operation ( P<0 .05 );the pulmonary arterial pressure of the r-tPA patient group dropped but not significantly compared with that before operation ( P>0.05); the pulmonary arterial pressure of the urokinase patient group dropped significantly compared with that study before operation ( P<0.05 ); the hemachrome of both patient groups did not significantly drop after operation ( P>0 .05 );the thrombolysis effect time by adop-ting r-tPA was remarkably shorter than that caused in thrombolysis by adopting urokinase ( P<0 .05 ) . Conclusion: Both r-tPA and urokinase are effective in interventional thrombolysis for acute and severe pulmonary embolism .However , r-tPA could significantly shorten the time caused in thrombolysis without increasing any bleeding risk.

Objective To explore the relationship between peripheral differential blood count and ATP value in Cell CD4 + T tested by ImmuKnow method in liver transplants. Methods In this study 49recipients after classic orthotopic liver transplantation (OLT) were enrolled. In a period from two weeks to two months after transplantation when all were free of glucocorticoid. Blood were sent for WBC differential samples count and ATP value in Cell-CD4 + T tested by ImmuKnow method via SPSS17. 0 software. Five more samples were selected randomly for duplicated testing of the indices in Week2, 3, 4,6 and 8 after the transplanting operation to further verify the relativity. Results White blood cell count has the highest relativity with ImmuKnow ATP value at 0. 821. The 5 recipients were repeatedly tested for ImmuKnow ATP values that were found positively correlated to cell count with a coefficient of over 0. 5. Conclusions The peripheral leukocyte count in early stage after liver transplantation is in positive correlation with ATP value in Cell CD4 + T, and the changes of numeration of leukocyte reflect changes of ATP value.

Objective To explore the relationship between obese children with benign acanthosis ni-gricans and insulin-resistant and type 2 diabetes mellitus. Methods Levels of glucose, insulin, and glucose/ insulin ratio were measured on fasting blood specimens, and anthropometric parameters including waist/hip ratio, fat mass, body fat percentage and body mass index were examined in 42 obese children with benign acanthosis nigricans, 60 cases of simple obesity and 20 healthy children controls. Glucose tolerance tests were performed in groups of obese children with benign acanthosis nigricans and simple obesity, respectively. Results Two of 42 obese children with benign acanthosis nigricans were diagnosed as type 2 diabetes mellitus. The rate of abnormal glucose tolerance and levels of blood sugar during 60 min and 120 min after glucose tolerance were significantly higher in acanthosis nigricans children than those in simple obesity (P