1375 cases of autopsy in our university from 1950～1989 were analysed in this paper. The results showed that the consistency between clinical and pathological diagnosis reached 79.3%. The clinical misdiagnosis were found to be 20.7%. The statistcal figures indicated that the infectious diseases occupied a dominant position in 1950s, while malignant tumors and cardiovascular diseases have become the major diseases in 1980s. Reasons of the lowering down of autopsy rate and clinical misdiagnoses are discussed. It demonstrates that autopsy is still of extreme importance in investigations of modern medical sciences.

Objective To study the expression of N-myc downstream regulated gene 1 (NDRG1) in renal cell carcinoma and its relationship with microvessel density (MVD) and clinicopathologic parameters.Methods Immunohistochemical study for NDRG1 and CD34 was performed on paraffin sections of cases of renal cell carcinoma and adjacent non-neoplastic renal parenchymal tissue. MVD was analyzed by CD34immunostaining.Results Immunohistochemical study showed that non-neoplastic proximal convoluted tubule, distal convoluted tubule and collecting ducts was positive for NDRG1 (membranous and cytoplasmic). The expression rate of NDRG1 in renal cell cancer was 51%, which was significantly lower than that in normal renal tissues of 100 % (P ＜0.05).Clinicpathologically, the result also showed a close relation between lower NDRG1 expression and higher pathologic grade (χ2 =9.968, P =0.007), later clinic stage (χ2= 6.437,P =0.011), lymph node metastases (χ2=5.800, P =0.016) and higher MVD of cancer (t =2.235, P =0.030)whereas no relation with other factors. Conclusion NDRG1 might play as a cancer suppressor gene in renal cell carcinoma in that it could be correlated with tumor invasion and metastasis.It might also suppress tumor growth and metastasis by regulation of tumor angiogenesis.

0.05);While the differences of the levels of p53,Bcl2,Bax between all D_1+D_2 groups and sham-irradiated group were significant(P

Objective To analyze utilization of antibiotic drugs and resistance rate of gram negative bacteria in the 3rd People's Hospital of Bengbu during 2011-2013,to provide references for clinical rational use of antimicrobial drugs and reduce bacterial resistance.Methods Retrospective investigation method was used to statistically analyze the pathogenic bacteria culture results,antimicrobial cumulative frequency of each categories and results of drug resistance test.Results The total DDDs of antibacterial drugs reduced year by year,down from 255 456 DDD in 2011 to 155 024 DDD in 2013,cephalosporin and enzyme inhibitors and macrolide consumption ranked increased year by year,the three or four generation cephalosporins and quinolones such amount was reduced year by year,antifungal fungi and carbapenem ranking had no obvious change,cefoperazone shubatan,cefuroxime and etimicin ranking and the dosage ratio did not change significantly,the cefathiamidine,cefepime and aztreonam ranking and the dosage ratio was reduced.Bauman acinetobacter and Pseudomonas aeruginosa to piperacillin-tazobactam resistant rate increased year by year,Bauman acinetobacter to beta lactam antibiotics drugs showed a gradual trend of drug resistance.Conclusion The frequency of antimicrobial drug use showed a declining trend in our hospital,and drug-resistant bacteria rate increased,in order to reduce the resistance present form,we need to more rational use antimicrobial agents.

For making a improving of cytological study doctors in the short term in the basic operated techniques and the level of diagnosis of cytology,the experience of teaching practice in the past fifteen years were reviewed.Flexible teaching ways were appearanced that such as,the reasonable teaching plan and target were maked,promotting self-learning strategies in the work,and special topic lectures and difficult cases discussion were performed with multi-media teaching,and so on.Finally, the activeness and initiative of study doctors were mobilized,and may be passably has the obtaineding in the satisfactory teaching effect.

Objective:To observe the relationship between non -dipper heart rate and morbidity of coronary heart disease (CHD) in patients with hypertension .Methods :According to Holter monitored results ,a total of 130 pa‐tients with essential hypertension were divided into dipper heart rate group (n= 77 ) and non -dipper heart rate group (n=53) .Ambulatory blood pressure and dynamic ECG were monitored in two groups ,and CHD was diag‐nosed according to coronary angiography results .Ambulatory blood pressure ,ambulatory heart rate and incidence rate of CHD were compared and analyzed between two groups .Results:Compared with dipper heart rate group , there was significant reduction in daytime mean heart rate [ (73.45 ± 9.57) beats/min vs .(68.77 ± 12.61) beats/min] ,but significant rise in nighttime mean heart rate [ (61.30 ± 7.62) beats/min vs .(65.49 ± 12.97) beats/min] , P<0.05 both ;there were significant reductions in 24h mean diastolic blood pressure (DBP) [ (75.77 ± 10.91) mm‐Hg vs .(71.92 ± 9.30) mmHg] and daytime mean DBP [ (77.16 ± 11.11) mmHg vs .(72.81 ± 9.61) mmHg] , P<0.05 both in non -dipper heart rate group ,there were no significant difference in other blood pressure indexes be‐tween two groups (P>0.05);.Morbidity rate of CHD in non -dipper heart rate group was significantly higher than that of dipper heart rate group (71.70% vs .29.87% ,P=0.001) .Conclusion:Compared with dipper heart rate pa‐tients ,morbidity rate of CHD significantly rises in patients with hypertension and non -dipper heart rate .It may help to reduce occurrence of CHD by monitoring circadian changes of heart rate and recover circadian heart rate rhythm while treating hypertension .

Aim To investigate endoplasmic reticulum stress ( ERS)-mediated high-fat diet and palmitic acid-induced insulin resistance ( IR) in skeletal muscle and interventional effects of fenofibrate both in vivo and in vitro tests. Methods Female SD rats were randomly subjected to a standard control diet ( SCD) or high-fat diet ( HFD) for 20 weeks, then the HFD group was di-vided into high-fat-diet group and high-fat-diet group treated with fenofibrate ( HFD +FF, 30 mg · kg-1 · d-1 ) for another 8 weeks. The changes of IR and ex-pression of peroxisome proliferator-activated receptor α( PPARα) , glucose regulated protein 78 ( GRP78 ) and transcription factors GADD153 ( CHOP ) were as-sessed respectively. C2C12 myotubes were divided into normal control group ( NC ) , model group ( palmitic acid, PA) , postive control drug group ( tunicamycin, TM) and treatment group ( fenofibric acid, FA+PA) , the expressions of GRP78 and CHOP were assessed re-spectively. Insulin-stimulated phosphorylation of Akt was also analyzed to detect changes of insulin sensitivi-ty in C2 C12 . Results The high-fat diet induced obvi-ous IR and upregulated ERS markers GRP78 and CHOP in skeletal muscle of rats, and these responses were attenuated by treatment with fenofibrate. Incuba-tion of myotubes with palmitic acid or tunicamycin sig-nificantly increased expression of ERS markers GRP78 and CHOP. Meanwhile, insulin-stimulated phosphoryl-ation of Akt was inhibited obviously. Pre-incubation with FA markedly inverted PA-induced ERS and insu-lin-stimulated phosphorylation of Akt. Conclusion Fenofibrate ( fenofibric acid) has obvious effects of IR on skeletal muscle tissues and cells, which may be re-lated with reduced expression of GRP78 and CHOP in ERS.

Objective To construct short hairpin RNA (shRNA) expression plasmids against the inhibitor of differentiation 2 (Id2) gene and establish a suitable cell model for the role of Id2 in proliferation and differentiation of human Ewing sarcoma cell.Methods Three shRNA sequences targeting Id2 gene were designed and inserted into the pGPU6/GFP/Neo (-shRNA-Id2) expression vectors.The recombinant pGPU6/GFP/Neo-shRNA-Id2 plasmids were introduced into Ewing sarcoma RD-ES cells by liposome-mediated transfection.The knock-down efficiency of Id2 in infected RD-ES cells was verified by Western blot assay.The cell growth and cell cycle changes were evaluated by cell counting and flow cytometry between transfected cells and control cells.Results The Id2 expression decreased 54 ％ and 57 ％,respectively,in RD-ES cell line which were transfected with the shRNA-Id2-543 and shRNA-Id2-593 plasmids compared with the control group cells by Western blot analysis.The cell growth assay demonstrated that the cell number in transfected cells was significantly decreased during 6-7 d compared with the control group (P ＜ 0.05).The cells at the S-phase of cell cycle were increased [(36.60±1.53) ％ and (44.89E2.46) ％ vs (29.73±2.03) ％,P ＜ 0.05],and no significant changes at the G2 phase or even reduction in the transfected cells.Conclusions Id2 stable knock-down cell lines are successfully established.The reduced expression of Id2 is related with decreased cell growth and cell cycle arrest in the S-phase.Id2 maybe plays an important role in proliferation of Ewing sarcoma cell.

Purpose To explore the role of cell blocks combined with immunohistochemical examination in the diagnosis and differential diagnosis of malignant pleural effusion,and to explore the role of pleural effusion cell blocks in lung adenocarcinoma molecular pathology examination.Methods 142 cases of malignant pleural effusion based cytology,cell blocks of HE staining and immunohistochemical staining by EnVision twostep were retrospectively analysed,the tumor classification was made through analyzing the characteristics of the cells combined with antibody expression.The detection of epidermal growth factor receptor (EGFR) gene mutation of 40 cases of lung adenocarcinoma diagnosed after immunohistochemical staining were used by ARMS-PCR method.Results Among 142 cases of malignant pleural effusion,there were 99 cases caused by lung adenocarcinoma,4 cases of lung small cell carcinoma,3 cases of lung squamous cell carcinoma,13 cases of breast carcinoma,9 cases of ovarian carcinoma,2 cases of gastric carcinoma,1 case of thyroid carcinoma,1 case of endometrial carcinoma,5 cases of mesothelioma,3 cases of lymphoma,1 case of malignant melanoma,1 case of synovial sarcoma.In 40 cases of lung adenocarcinoma pleural effusion cell block,there were 20 cases with EGFR mutations,9 cases of 19del mutations and 11 cases L858R mutations.Conclusion The pleural effusion cell blocks combined immunohistochemistry are useful to improve the accuracy of diagnosis of patients with pleural effusion,and helpful for the determination of classification and the primary site of tumor,assessment of prognosis.Pleural dffusion cell block may used to detect EGFR mutations of lung adenocarcinoma,which provide new source of specimen for the gene detection of lung adenocarcinoma.

Objective: To explore correlation between QRS complex duration and left ventricular ejection fraction (LVEF) in patients with complete left bundle branch block (CLBBB).Methods: A total of 213 patients, who were diagnosed as left bundle branch block by ECG in our hospital from Feb 2012 to Jun 2013, were selected.According to QRS complex duration, patients were divided into CLBBB group (n=182) and incomplete left bundle branch block (ICLBBB) group (n=31).Linear correlation analysis was used to analyze the correlation between QRS complex duration and LVEF, and receiver operating characteristic curve (ROC) was used to analyze optimal cutoff point of QRS complex duration for predicting LVEF<50%.Results: Compared with ICLBBB group, there was significant rise in QRS complex duration [(104.61±8.85) ms vs.(149.36±17.25) ms] and significant reduction in LVEF [(54.26±4.96)% vs.(45.22±12.57)%] in CLBBB group, P<0.01 both.Linear correlation analysis indicated that QRS complex duration was significant inversely correlated with LVEF (r=-0.55, P=0.001) in CLBBB patients.ROC analysis indicated that optimal cutoff point of QRS complex duration for predicting LVEF<50% was 151ms, the area under the curve was 0.79 (P=0.001),its sensitivity was 68.1% and specificity was 83.5%.Conclusion: QRS complex duration is significant inversely correlated with LVEF in CLBBB patients, which can be used as a simple index predicting reduced LVEF.