Objective To analyze expression of angiopoietin-2 (Ang-2) protein in human esophageal squamous cell carcinoma (ESCC),and to investigate the relationship between Ang-2 protein and clinicopathologic factors.Methods 60 cases of ESCC,5 cases of latero-carcinoma tissues and 30 cases of normal tissue were immunohistochemically stained using Ang-2 monoclonal antibodies with PV-9000 non-biotin detection system.The positive expression rate and expression level of Ang-2 were evaluated.Results Ang-2 was mainly expressed in cytoplasm.The positive expression rates in normal epithelium,latero-carcinoma tissues and ESCC were respectively 3.33 ％ (1/30),40.00 ％ (2/5),53.33 ％ (32/60).Compared ESCC with normal epithelium and latero-carcinoma tissues,Ang-2 positive expression rate was significantly higher (P ＜ 0.05).Among ESCC,expression of Ang-2 was positively correlated with the tumor infiltration depth (rs =0.621,P =0.002),and inversely correlated with tumor differentiation status (rs =-0.309,P =0.018).Conclusions Ang-2 may play an important role in the carcinogenesis and development of ESCC.Tumor differentiation degree,infiltration depth and TNM staging are the independent prognostic indicators for ESCC patients.Combinative detecting the expression of Ang-2 may provide more accurate information in early diagnosis and predicting the prognosis of ESCC.

Objective To investigate the expression and significance of activating transcription factor 4 (ATF4) in the hepatocyte steatosis models induced by oleic acid,and to explore the relationship between the expression of ATF4 and nonalcoholic fatty liver disease (NAFLD). Methods L02 cells were treated by 20 mg/ml oleic acid for 0,24,48 and 72 h respectively to induce the hepatocytes steatosis,and then the cells were collected and the total RNA and protein were extracted. Reverse transcriptional polymerase chain reaction (RT-PCR) and Western blot analysis were used to detect the expressions of ATF4 gene at different time points. Results With the development of deterioration of steatosis,the expression levels of ATF4 mRNA were 1.01?0.12,1.87?0.24,2.01?0.13,and 1.79?0.19 respectively correspondingly from 0 h to 72 h. The peak of ATF4 mRNA expression was reached at the 48th hour,and then showed the tendency of down-regulation. At the same time points,the protein expression of ATF4 were 0.31?0.16,0.57?0.14,0.91?0.20,and 0.89?0.17 separately,and the protein expression was maintained at a high level up to the 72nd hour. There were significantly differences compared with the control group(P

Objective The changes of peripheral T cell subgroup in patients with rectal cancer preoperatively and postoperatively were studied dynamicly.Method Peripheral T cell subgroup of 46 patients with rectal cancer was measured dynamicly by the monoclonar antibody enzyme labelling techniques during the preoperative and postoperative period.Result (1)CD3 cell and CD4 cell decreased markedly,the CD4/CD8 rate increased apparently in patients with rectal cancer.(2)Depressed immunity was related to the term of cancer.(3)The immunity of patients treated by radical rectal resection may recover gradually,the immunity of patients treated by palliative rectal resection,colostomy and laparotomy was depressed constantly.Conclusion The depressed immunity of patient with rectal cancer was related to the tumour preponderance.T cell subgroup dynamic surveillance was important to juide the possibility of recurrence and prognosis in patient with rectal cancer.

OBJECTIVE:To study the analgesic effect of total flavonoids of propolis(TFP)and its mechanism.METH?ODS:The analgesic effect test is performed by formaldehyde method,hot-plate method,warm bath method and writhing method.The mice were randomly divided into normal saline(NS)control group,morphine positive control group and different dosage of TFP group,each pain index under each experiment condition was determined after intragastric administration of each group of mice.RESULTS:Compared with the NS control group,TFP group showed a decreased scoring in pain reaction(15min later),reduced writhing response(50,100mg/kg),prolonged latent phases of foot licking(50,100mg/kg)and tail-shrinking(50mg/kg),significant decrease of the content of malonaldehyde,prostaglandin-2and NO in mice'blood serum and brain tissue.CONCLUSION:TFP have notable analgesic effect,the mechanism may be related to its function on inhibiting prostaglandin-2and lipid peroxidation and reducing the release of NO releasing of brain tissue.

Objective To study the clinical feature of 26 cases which were diagnosed pathologically as cerebral amyloid angiopathy ( CAA ) and to improve the level of diagnosis.Methods The clinical characteristics of the 26 cases with CAA in our hospital from 1983 to 1999 were retrospectively reviewed and analyzed,including previous history,clinical manifestation,and laboratory examination.Results Of the 26 CAA patients,there were 17 men and 9 women with age ranging from 45 to 78 years.Eight patients (30.7％ ) had the history of hypertension; 6 cases (23.1％ ) suffered from diabetes; 2 patients(7.6％ ) were taking anticoagulant or antiplatelet agents in whom serious CAA and multiple hemorrhages were histopathologically confirmed by autopsy.There were 20 cases diagnosed as cerebral hemorrhage,including 2 patients with single lobe hemorrhage,8 patients with multiple lobe hemorrhage,5 patients with putamen hemorrhage,2 patients with cerebral ganglion hemorrhage,2 patients with cerebellar hemorrhage,and 1 patient with brain stem hemorrhage.Of the 26 CAA patients,there were 2 patients with subaracchnoid hemorrhage,1 patient with hemorrhagic cerebral infarction,1 patient with basal ganglia infarction,1 patient with basilar artery occlusion,1 patient with subdural hematoma.The clinical manifestation of the 20 cases diagnosed as cerebral hemorrhage included headache,limb palsy,coma,and hyperspasmia.Conclusions CAA always begin as cerebrovascular disease symptoms with or without hypertension.The most common manifestation of CAA is lobe hemorrhage,while the CAA-related hemorrhage seldom occurs in basal ganglia,cerebellum and brainstem.CAA can also manifest cerebral infarction and subarachnoid hemorrhage.Anticoagulant (warfarin) or antiplatelet agents (aspirin) maybe a contributing factor for CAA-related hemorrhage.

Objective To evaluate the effect of bone marrow stem cells (BMSCs) transplantation in the treatment of hepatolenticular degeneration of liver fibrosis. Methods Sixty cases with confirmed hepatolenticular degeneration of liver fibrosis were randomly divided into 3 groups: penicillamine group [40 mg/(kg·d)], BMSCs group and BMSCs + penicillamine group. Autologous BMSCs (2 mL) were injected into vein with normal saline (100 mL). Liver tissue pathology biopsy was inspected and the changes in HA, PCⅢ, LN, CⅣ, TIMP-1 and MMP-1 were observed at 0, 4th, 8th and 12th week during the therapeutic process. Results The level of serum fibrotic markers were reduced in every group , while the changes in BMSCs + penicillamine group were especially obvious (P < 0.05). Conclusion Penicillamine combined with BMSCs was effective in the therapy of hepatolenticular degeneration of liver fibrosis.

Objective:To evaluate the influence of bone marrow stem cells ( BMSCs ) in the serological indicators of hepatolenticular degeneration combined liver fibrosis.Methods:60 cases were randomly divided into 3 groups: penicillamine group, BMSCs group and BMSCs+penicillamine group.BMSCs(2 ml)were injected into vein with normal saline(100 ml) every 10 days ( 3 times for a period of treatment).Liver tissue pathology biopsy was inspected and TBIL, ALT, ALB, CHE, PDGF-BB, TGF-β1, IL-6 and TNF-αwere detected at 0,4 ,8 and 12 weeks.Results: The level of serological indicators about liver functions were reduced in every group, while the changes in BMSCs+penicillamine group were especially obvious ( P<0.05 ).Conclusion: Penicillamine combined with BMSCs was effective in the improvement of liver functions of hepatolenticular degeneration combined liver fibrosis.

The PBL was adopted by the author in training medic in the department of digestion.The method has shown that it can improve the capability of independent study,spirit of team cooperation,clinical practice ability and improve comprehensive qualities.In the meanwhile,it can improve the tutor's all-around caliber.To guarantee the teaching effect,the tutor should especially comprehend the theory and skills of PBL,to design masterly clinical questions,to ensure the practice time and assistant facilities thoroughly.

The head injury patients is very common in clinic and it is complicated to cure them.Furthermore,many ethical questions are involved during the treatment,which are discussed in the article.The aim is to be helpful to protect both patients'and medical staff's right,reduce medical disputes and form a good relationship between doctors and patients from the view of ethics.Accordingly,the patients of head injury will acquire better treatment.

Background and purpose:Medulloblastoma(MB),which is a primitive neuroectodermal tumor(PNET),is the most common malignant brain tumor of childhood.The mean age at diagnosis is 6 years.Due to the tremendous improvements in techniques of radiotherapy and chemotherapy,the 5-year overall survival(OS) is increased to 70% now,compared with 20% in the 1970s.Factors which include local relapse,whether or not there has occurred metastases before resection,residual tumor and age etc.are mostly considered to have significant effects on prognosis.We studied the effects and side effects of the three dimensional conformal radiation therapy(3D-CRT) for the children with medulloblastoma,and summarized the reasons of failure of the therapy.Methods:From August 2001 to August 2007,34 children with medulloblastoma were treated in our hospital.Among all the patients(3-16 years,mean age was 9.5 years) there were 16 cases in high-risk group,and 18 cases in low-risk group.All of them underwent total or subtotal resection before radiation therapy.Patients were not given radiotherapy and chemotherapy before surgery.The interval between surgery and radiotherapy was less than 3 weeks.The 3D-CRT was done for all the patients with the same techniques:30 Gy to the whole cranialspinal axis followed by a boost of 20-25 Gy to the posterior fossa,witha median fraction dose of 180 cGy.Chemotherapy was given according to the protocol which consisted of lomustine,cisplatinum and vincristine after radiotherapy,but the patients were not given intrathecal chemotherapy.Blood counts and chemistries and renal and hepatic evaluations were performed regularly before every course.Results:5-year OS and 5-year event free survival(EFS) were 71% and 62% respectively.The mean follow-up was 36.5 months.The 5-year OS of the high risk group and low risk group were 88.9% and 50.0% respectively.There was significant difference between them(P=0.01).13 patients were failures.Of all failure patients,3 had recurrence in the region of the cribriform plate.The complete remission was 70.5%,and the partial remission was 14%.If metastases were found before surgery,the 5-year OS was 12.5%(1/8),and if the residual tumor was more than 1.5 cm3,the 5-year OS was 0%(0/5).Whether or not the metastases were found before surgery,and the presence of residual tumor,both had significant impacts on the prognosis of the children with medulloblastoma(P