Objective To assess the association between the depth of trophoblastic penetration into the tubal wall with serum concentrations of vascular endothelial growth factor (VEGF) and β-human chorionic gonadotropin (β-HCG). Meth-ods Eighty patients with a diagnosis of tubal pregnancy in the ampullary region underwent radical surgical treatment (sal-pingectomy), were included in this study. The serum levels of VEGF andβ-HCG were detected on the day of surgery. The se-rum level of VEGF was measured by ELISA. The serum level ofβ-HCG was quantified with a two-site immunofluorimetric assay based on the direct sandwichtechnique. Histological material was stained with Masson's trichrome to identify muscular fibers. Immunohistochemical staining was used for human placental lactogen (hPL) to identify intermediate trophoblast and determine the depth of trophoblastic invasion into the tubal wall. The ampullary pregnancies were classified histologically ac-cording to the depth of trophoblastic infiltration into the tubal wall. Results The mean serum values of VEGF andβ-HCG were significantly lower in patients with stage I tubal infiltration than those of stageⅡ, and which were significantly lower in patients with stageⅡthan those in stageⅢ(P<0.05). The threshold serum value of VEGF was 308.6 ng/L, the sensitivity was 100.0%and the specificity was 92.6%for stageⅠand stageⅡ. The threshold serum value of VEGF was 431.9 ng/L, the sensitivity was 79.3%and specificity was 79.2%for stageⅡandⅢ. The threshold serum value ofβ-hCG was 2 509.6 IU/L, the sensitivity was 91.7%and specificity was 81.5%for stageⅠand stageⅡ, and levels of 13 142.6 IU/L, 72.4%and 95.8%for stageⅡand stageⅢ. Conclusion The depth of trophoblastic penetration into the tubal wall is associated with maternal serum concentrations of VEGF andβ-HCG, which can be used as the evaluation index for histological staging of trophoblas-tic tissue infiltration.

Objective: To share the anti-infection experience for the patients with complicated intra-abdominal infection after operation.Methods: The whole course of drug administration participated by clinical pharmacist in one patient with complicated intra-abdominal infection after pancreatoduodenectomy were retrospectively analyzed and discussed.Results: Enterococcus was found in the blood culture and ascites.According to the results of drug sensitive tests, clinical pharmacist provided medication suggestions and performed medication mornitoring.According to the blood concentration, clinical pharmacist adjusted the dose of vancomycin, and changed the therapy regimen according to the changes of conditions.As a result, adverse reactions were controlled timely, and satisfactory treatment effects were obtained.Conclusion: The aetiology of complicated intra-abdominal infection is complex with intractable treatment, and the participation of clinical pharmacists in the treatment can improve the efficiency and safety.

Theinnate immunity system of human body has more and more attention for its antibacterial, antiviral, maintainingimmunehemostasis and promoting tissue damage and repair and other physiological functions.As members of NOD-like receptors(NLRs), NOD1 and NOD2 receptors are identified as intracellular pattern recognition receptors(PRRs), can be identified with molecular damage endogenous(damage-associated molecular patterns, DAMPs)and exogenous injury-molecular pathogen associated molecular(pathogen-associated molecular patterns, PAMPs), and initiation of innate and specific immune response, maintain the steady balance of body.Recently, a bunch of evidence have demonstrated that the importance of NOD1 receptor and NOD2 receptor is not limited in field of anti-infection, and the insulin resistance, kidney and liver damage recovery, cardiovascular disease and tumorigenesis are also closely related with these two receptors.So the aim of this article is to interpret the NOD1 and NOD2 general structure and function, and summarize the link between these two PRRs and tumorigenesis and finally make a clue for cancer immunotherapy.

Objective To investigate the significance of the mutation of c-kit gene in the development,(clinical) pathology and prognosis of gastrointestinal stromal tumors(GISTs).Methods The technique of(PCR-SSCP) was used to detect ckit gene mutation in 106 cases of GIST,and 57 of the cases were(followed-up).Results The c-kit gene mutation rate in the whole group was 45.3%(48/106),and(3.4)%(2/41) in benign GIST,and 70.8%(46/65) in malignant GIST.The 1-,3 and 5-year survival rates and median survival time of the mutation positive group were all markedlly lower than those of the(mutation) negative group.A comparison of the parameters that can differentiate the benign GISTs from malignant ones such as size,histological necrosis,aggressive grade,nucleus mitotic count and nuclear discrepancy,showed significant difference between the of postive and negative gene mutation(P

Serum Cardiac troponin Ⅰ (cTn Ⅰ) and lactic acid were measured in 128 neonatal patients with hypoxic-ischemic encephalopathy and 38 healthy neonates (control group). Serum cTn Ⅰ and lactic acid levels were higher in neonates with hypoxic-ischemic encephalopathy than those in healthy neonates (P < 0. 05 ); and the differences of these values were also statistically significant between the serious patients and the mild patients (P<0.05). Serum cTn Ⅰ and lactic acid are two sensitive markers for degree of myocardial injury and hypoxia in neonatal patients with hypoxic-ischemic encephalopathy.

Objective To compare the incidence of secondary surgical procedures after cervical disc arthroplasty vs anterior cervical discectomy with fusion in patients treated for symptomatic single level cervical spondylosis.Methods An online search of Pubmed, Medline, Ovid, Embase, Cochrane Library, CBM database, Wanfang data and VIP database were searched for prospective randomized controlled trial of cervical disc arthroplasty versus anterior cervical discectomy with fusion in incidence of secondary surgical procedures.Data were collected and extracted by two reviewers independently.Risk of bias was assessed using the criteria of Cochrane Reviews Handbook 5.1.0.Review Manager 5.2 software system was used to evaluate the data for Meta analysis.Results A total of 12 trials were included.Six of them were short-term follow up (two years).The 6 other trials were mid-and long-term follow up (mean 5.8 years).There are 4 trials with low risk of bias, 7 trials with moderate risk of bias, and 1 trial with high risk of bias.The results of meta-analysis showed there was no statistical difference in reoperation rate of adjacent level between the two groups at two years follow-up;however, the reoperation rate of non-fusion group was significantly lower in the non-fusion group compared with fusion group at mid-and long-term follow-up.The incidence of secondary surgical procedures at index level was higher in fusion group than in non-fusion group.No statistical difference was found between the two groups in using ‘ removal’ for secondary surgical procedure at two years follow-up;however, the rate of non-fusion group was significantly lower than fusion group at mid-and long-term follow-up.Conclusion Cervical disc arthroplasty was partly superior to anterior cervical discectomy with fusion in avoiding secondary surgical procedures of adjacent levels.However, non-fusion surgery doesn't have any advantages in short time (two years) follow up.Reducing the incidence of pseudarthrosis was an effective way to decrease the incidence of secondary surgery procedures in index level.

Objective To evaluate the relationships of the expression of orexin A in hypothalamus with hyperleptinemia, hyperinsulinism, and hyperlipidemia in alimentary obesity rats.Methods The alimentary obesity rat model was induced by high-fat diet in Wistar rats. The levels of leptin, insulin, C-peptide, total cholesterol (TC) and triglyeride (TG) were detected by luminescent immunoassay and biochemistry enzymic method. The gene expression of orexin A in rat hypothalamus was detected by real-time PCR. The correlation between orexin A and leptin was analyzed. Results After 8 weeks of high-fat diet feeding, the body weight, Lee's index, blood glucose, TG and TC significantly increased in obesity rat group (P＜0. 01). The levels of serum leptin, insulin and C-peptide were significantly higher in obesity rats than in controls [( 1.74±0. 36)μg/Lvs. (1.27±0.11) μg/L, (35±5) MIU/L vs. (23±4) MIU/L, (0.21±0.04) μg/L vs.(0. 14±0. 03) μg/L respectively, P＜0.01]. However, the level of orexin A mRNA was lower in obesity rats than in controls (6.8±2.3 vs. 14.5±3.6, t=-8.06, P＜0.01). The correlation coefficient (r) of orexin A mRNA with serum leptin, insulin, and C-peptide in alimentary obesity rat were -0. 726 (P＜0.01), -0. 506 (P＜0.01) and -0. 664 (P＜0.01), respectively. Conclusions High-fat diet can induce leptin-resistance and alimentary obesity in Wistar rat. The down-regulation of orexin A in rat hypothalamus would be correlated closely to the leptin and insulin resistance in alimentary obesity.

Objective To investigate the result and side effect of late course accelerated three-di-mensional conformal radiotherapy (3DCRT) for esophageal carcinoma. Methods From July 2003 to March 2006, 55 patients with esophageal carcinoma receiving 3DCRT were randomly divided into late course accel-erated radiation group (group A, 27 patients) and conventional fractionation group (group B, 28 patients). The prescribed dose in group B was 64 -66 Gy, 2 Gy per fraction, 1 fraction per day, 5 fractions per week for about 6.5 weeks. Patients in group A received conventional fractionation irradiation for the first 4 weeks. Then the dose was increased to 3 Gy per fraction to a total dose of 67 -70 Gy. The treatment course in group A was about 6 weeks. The treatment response, acute site effects, 1-, 3-and 5-year local control rates and o-verall survival rates of the two groups were observed. Results In group A, 23 patients (85%) achievedcomplete response (CR) and 4(15%) achieved partial response (PR). While in group B, 16 patients (57%) achieved CR and 12(43%) achieved PR. The CR rate was significant higher in group A (χ~2 = 5.24,P=0.022). The 1-, 3-, 5-year local control rates were 85%, 54%, 54% in group A, and 70%, 56%, 33 % in group B (χ~2 = 0.68, P = 0.409), respectively. The 1 -,3-,5-year overall survival rates of the two groups were 81%, 37%, 29% and 61%, 39%, 23% (χ~2 = 0.06, P = O. 804), respectively. Both lo-cal control and overall survival were similar between the two groups. The incidences of acute radiation esoph-agitis in the two groups were similar (85% vs. 89% ;χ~2 =0. 00,P=0. 959), and the incidence of radiation pneumonitis was slightly higher in group A than in group B (67% vs 43% ;χ~2 =3.14,P =0.076). By the last follow up, 19 patients in group A and 21 in group B died. Among them, 10 in group A and 15 in group B died of local failure, while 7 in group A and 5 in group B died of metastasis. Conclusions When com-pared with conventional fractionation 3DCRT, late course accelerated 3DCRT for esophageal carcinoma can achieve better results in clinical response, though not in long-term local control or survival. The incidence of acute radiation esophagitis and pneumonitis is clinically acceptable.

Objective To observe the incidence of RP in NSCLC and esophageal carcinoma treated with 3DCRT and investigate the relationship between acute RP and lung function and dosimetric parameters.Methods From October 2006 to August 2008, 3DCRT plus concurrent chemotherapy of NP or LFP were applied to 64 patients with locally advanced NSCLC or esophageal carcinoma. twenty-three patients suffered form NSCLC and 41 patients from esophageal carcinoma, the prescription doses were 60 Gy/30fx and 58 -64 Gy/29 -32fx, respectively. Results For patients with esophageal carcinoma, 34% developed RP(9 grade 1,3 grade 2 and 2 grade 3). For patients with NSCLC, 96% developed RP(9 grade 1, 8 grade 2 and 5 grade 3). There was significant difference between the two groups(t =5. 55,P=0. 000). The FEV1.0/FVC and DLCO of patients with NSCLC were significantly lower than those of esophageal carcinoma, the ratio were 75.6%:82.7%(t=2.75,P=0.008)and 71.7%:81.0%(t=2.50, P=0.015),respectively. For patients whose FEV1.0, FEV1.0/FVC%, DLCO ＜80% and ≥80% before irradiation,the incidence of ≥2grade ARP were 35% vs 25% ,31% vs 26% and 35% vs 19%, respectively(x2 = 1.81,0.15,2. 13,P =0.179,0.697,0.144). While for patients whose FEV1.0 ＜ 70% and ≥70%, the incidence of severe ARP were 67% and 22% ,respectively(x2 =5.64, P =0.018). Spearman correlated analysis indicated that all the dosimetric parameters had relation with ≥ 2 grade ARP . The V20 of lung and MLD were found independently associated with RP according to multivariate analysis(x2 = 4.61,6.97, P = 0.032,0.008).Conclusions Parameters of basic lung function can predict the incidence of ≥2 grade RP to some extent,especially when the value of FEV1.0, FEV1.0/FVC%, and DLCO was lower. However, the V20 of lung and MLD may be the most valuable predictors.