Abstract Objective:To study GST-? expression in breast cancer and axillary lymphnodes.Methods: The expression of GST-Tr proteinand mRNA was detected by means of immunohistochemistry and RT- PCR. Results: In normal breast tissue, cancer tissue , HE positive lymph-nodes and HE negative lymphnodes , GST-? protein expression rate is 0,60% ,77% ,43%; GST-? mRNA expression rate is 0,88% ,71%and 39% , respectively. Conclusion; GST-?gene whose expression is upregulated as tumor occurs and develops can be used as a tumor biomar-ker; GST-? expression in HE negative lymphnodes suggests the poor prognosis; drug-resistance response is more sensitive in lymphnode than inprimary cancer. The expression of GST-? gene may be regulated by RNA or before RNA transcription.

objective In the former research work, a differential-expressed gene was cloned from multi-drug resistance lung cancer cell line (SPC-A-1/CDDP) with suppression substractive hybridization, and in this study we further analyze the site of this gene on the chromosome, and appraise its function related to multi-drug resistance in lung cancer cells. Methods The cDNA sequence data of the gene was input to computer and analyzed to ascertain its site on human chromosome by screening the gen bank on the www.ncbi.nlm.nih.gov. With DNA recombination technique, the gene was reversedly inserted to the vector pLXSN to get an antisense expression recombinant vector pLXSN-R, which was then transfected into SPC-A-1/CDDP cells with the aid of electroporation technique. And the semi-quantitative RT-PCR technique was used to quantify the mRNA content of gene in the transfected cells. Finally, the chemosensitivity of the transfected cells was tested with MTT method. Results The gene was located on the human chromosome 19q13.3-19q13.4 locus. The antisense gene recombinant vector was successfully constructed and transfected into SPC-A-1/CDDP cells as shown by its inhibitory activity on the mRNA expression of the gene. The drug-resistance indexes of transfected SPC-A-1/CDDP cells for cisplatin, doxorubicin, 5-fluorouracil, vincristin, hydroxycamptothecine and etoposide were obviously decreased. Conclusion The function of this gene is related to multi-drug resistance in human lung cancer cell, and its locus on the human chromosome is at 19q13.3-1913.4.

OBJECTIVE To investigate mechanisms of sulfamethoxazolel trimethoprim(SMZco) resistance in multi-drug-resistant strains of Shigella.METHODS The strains of multi-resistant Shigella were selected with K-B susceptibility method.The genes(sul1,dfrA1,dfrA5,dfrA12 and dfrA17) of SMZco resistance were detected by polymerase chain reaction(PCR).And using the DNA sequencing determined that bears the genotype.RESULTS In 20 Shigella strains the drug-resistance rate of Shigella to SMZco was 95.0%.Sul1,dfrA1,dfrA12 and dfrA17-positive rate was 15.0%,100.0%,5.0% and 0,DfrA1 positive gene sequencing showed highly homology with the sequence of GenBank.CONCLUSIONS There is a close relation of the SMZco resistance in Shigella to sul1 and dfrA1 existing.

OBJECTIVE To investigate mechanisms of chloramphenicol resistance in multi-drug-resistant strains of Shigella.METHODS The strains of multi-resistant Shigella were detected with K-B susceptibility method.The genes(catB,cmlA)of chloramphenicol resistance were detected by polymerase chain reaction(PCR)and the DNA sequencing.RESULTS In 20 strains,the drug-resistance rate of Shigella to chloramphenicol was 70.0%.Two strains carried cmlA but no catB detected was out.The cmlA gene product sequence showed it was cmlA1.CONCLUSIONS The multiple-drug resistante cmlA1 is detected out.This is the first report in China.

Purpose To investigate the diagnostic value of high-resolution CT reconstruction techniques on the same slice in hypertrophy of transverse process of the fifth lumbar vertebra (HTPL5V), and to provide a basis for clinical diagnosis and treatment. Materials and Methods Twenty-two cases of clinically diagnosed HTPL5V and 20 normal adults were examined with GE LightSpeed 16-slice spiral CT (36 cases) and Philips iCT 256-slice (6 cases). L5 transverse process and the fifth lumber nerve were reconstructed and observed on the workstations. Results In 22 cases of HTPL5V, there were 26 pseudarthrosis formation and 2 sides with L5 transverse process touching the sacral ala. In 28 sides the iffth lumber nerve traveled through false foramina of the HTPL5V including 6 cases of bilateral compression and 16 cases of unilateral compression. In 21 cases, the nerve was compressed by hyperosteogeny on 27 sides (96.4%) and 1 side due to stenosis (3.6%). On 25 sides (89.3%) the compressed nerves were curved in shaper. There was bulging and/or herniated lumbar disc on 9 sides in 7 cases (32.1%). Conclusion High-resolution CT reconstruction techniques can demonstrate the iffth lumbar nerve of HTPL5V and provide evidence for clinical diagnosis and treatment.

Objective:To investigate the expression of serum microRNA (miR)-92 in patients with liver cancer and its relationship with poor prognosis.Methods:The clinical data of 70 patients with liver cancer in the First People′s Hospital of Huzhou City, Zhejiang Province and the Central Hospital of Huzhou City, Zhejiang Province from May 2015 to May 2018 were retrospectively analyzed. The miR-92 expression level was detected by real-time quantitative polymerase chain reaction method and compared with that of 80 healthy subjects. Receiver operating characteristic (ROC) curve was drawn to evaluate the efficacy of serum miR-92 in diagnosing liver cancer and early stage (stage Ⅰ to Ⅱ) liver cancer. The relationship between serum miR-92 expression level and clinicopathological characteristic was analyzed. Independent risk factors affecting the prognosis in patients with liver cancer were analyzed by multivariate Cox regression model.Results:The expression level of serum miR-92 in patients with liver cancer was significantly higher than that in healthy subjects (4.10 ± 1.74 vs 1.88 ± 0.78), and there was statistical difference ( P<0.05). ROC curve analysis result showed that the area under curve (AUC) of serum miR-92 for the diagnosis liver cancer was 0.874, the best cut-off value was 2.43, the sensitivity was82.86%, and the specificity was 86.25%; the AUC of serum miR-92 for the diagnosis early liver cancer was 0.755, the best cutoff value was 2.38, the sensitivity was 68.57%, and the specificity was 84.42%. The serum miR-92 expression level was related to TNM stage and lymph node metastasis ( P<0.01), but not related to gender, age, tumor diameter, history of hepatitis, liver cirrhosis, degree of differentiation and portal vein tumor thrombus ( P>0.05). The 5-year overall survival rate in liver cancer patients with high serum miR-92 expression was significantly lower than that in liver cancer patients with low serum miR-92 expression (17.1% vs. 31.5%), and there was statistical difference ( χ2 = 5.561, P<0.05). Multivariate Cox regression analysis result showed that miR-92 was an independent risk factor affecting the prognosis in patients with liver cancer ( HR = 0.282, 95% CI 1.179 to 3.562, P<0.05). Conclusions:The expression level of serum miR-92 in patients with liver cancer is significantly increased, which plays an important role in the progression of the disease. Serum miR-92 can be used as an indicator for early diagnosis and prognosis evaluation of liver cancer.

Objective To investigate the sleep quality state of people who did physical examination,and its correlation with brachial-ankle Pulse Wave Velocity (baPWV).Methods The indexes of Pittsburgh sleep quality index (PSQI) and baPWV were used.The people who did physical examination were divided into sleep disorders group (284 cases) and normal sleep group (608 cases) according to the results of PSQI survey.Results (1) There were 31.84％ of the people who had sleep quality problems.(2) The PSQI total score and the score of subjective sleep quality (SSQ),sleep duration (Sdu),daytime dysfunction (DD) of females were higher than males (t =6.71,3.46,2.45,3.96,P ＜0.05).The PSQI total score and the score of sleep latency (SL),habitual sleep efficiency (HSE),use of sleeping medication (USM) among different age groups were statistically analyzed (F =12.23,8.31,7.50,7.11,P ＜ 0.05).(3) The score of baPWV of sleep disorders group was higher than normal sleep group (t =5.14,P ＜ 0.05).There were significantly positive correlation between baPWV and total PSQI score,subjective sleep quality,sleep time,daytime dysfunction (r =0.28,0.45,0.30,0.36,0.35,P ＜ 0.05).Conclusions 1/3 of the physical examination people have sleep quality problems.Sleep quality of females is worse than males.There are different styles among different age groups.There is significantly positive correlation between sleep quality and baPWV.

Forty three patients with L5-S1 spondylolisthesis undergoing surgical treatment from April 2012 to November 2014 were included for analysis,including 20 cases received transforaminal lumbar interbody fusion (TLIF group) and 23 cased received posterior lumbar interbody fusion (PLIF group).The incision length,operative time were shorter and blood loss was less in TLIF group than those in PLIF group [(9.6±0.9) vs.(16.1±1.5) cm,(125.6±13.0) vs.(156.4±11.8) minand (218.7±22.5)ml vs.(326.5 ±20.1) ml,respectively,all P =0.000].There was no statistical difference in the S1 pedicle screw (S1PS) insertion point between two approaches[(29.4 ± 1.9) vs.(28.5 ± 1.0) mm,P =0.069],but the distance from the midline to the lateral edge of the screw (12.9 ±3.6) mm,S1PS angle (23.3 ±2.1) ° and length of S1PS length with the sacral body (40.9 ± 2.6) mm in the TLIF group were better than those in PLIF group (P =0.000).Our results demonstrate that the paraspinal muscle approach for the treatment of L5-S1 spondylolisthesis may be superior with less trauma,better functional recovery and stable screw placement.

ObjectiveTo study the efficacy of transcatheter arterial chemoembolization (TACE) after liver resection for hepatocellular carcinoma (HCC) with tumor thrombus in the main trunk and/or first branch of portal vein,and to clarify prognostic factors affecting survival.Methods From 2005 to 2009,there were 358 consecutive patients with HCC who underwent surgical resection in our Department.In 55 patients (15 ％),portal vein tumor thrombus (PVTT) was found intraoperatively or postoperatively during histopathological examinations to involve the first portal branch,main portal trunk,or contralateral portal branch.In this retrospective study,these 55 patients were divided into two groups:Group A,29 patients received postoperative TACE,and Group B,26 patients who did not receive TACE.The clinical data and survivals were compared between the two groups.Prognostic factors were indentified using univariate analysis,followed by multivariate regression analysis using the Cox proportional hazards model.ResultsThere were no significant differences in the demographic clinical data between Group A and Group B.The overall 1-,2- and 3-year survivals for the 55 patients were 63.3 ％,51.4 ％ and 43.5 ％,respectively.The accumulative 1-,2- and 3-year survivals for group A were 71.4 ％,60.1 ％ and 50.1 ％,respectively.The corresponding figures for group B were 56.7％,21.7％ and 10.4％,respectively.Multiple tumors,intrahepatic metastases,hepatic vein thrombus,and invasive type of tumor thrombus were found to be risk factors for short-term survival on univariate analysis,while the latter 3 factors were further found to be significant prognostic factors in the Cox proportional hazards model.Postoperative TACE was shown to be a significant factor in both univariate and multivariate analyses.ConclusionLiver resection was beneficial for some patients with portal vein tumor thrombus.Postoperative TACE further improved the prognosis and prolonged survivals in these patients.

Objective:To identify anti-dipeptidyl-peptidase-like protein 6 (DPPX) antibody in patients with encephalitis of unknown etiology and describe the clinical features of anti-DPPX antibody-associated encephalitis in Chinese patients.Methods:For patients registered in the Peking Union Medical College Hospital Encephalitis and Paraneoplastic Syndrome Registration Project from 2016 to 2019 with negative findings in autoimmune encephalitis routine antibody profile and paraneoplastic antibody profile, but with positive tissue-based assay (TBA) results, further tests for rare antibodies, including cell-based assay (CBA) of anti-DPPX antibody, were performed. Patients positive for anti-DPPX antibody were enrolled and the clinical data were collected.Results:Two patients with anti-DPPX antibody-associated encephalitis were found from 2016 to 2019 among about 15 000 patients. Both were females, aged 46 and 75 years. One patient had diarrhea, cachexia, cognitive dysfunction, agitation, myoclonus, tremor, and seizures. The other had cognitive impairment, restlessness, memory loss, disorientation, and sleep disturbance. The second patient had medical history of systemic lupus erythematosus and secondary Sj?gren′s syndrome.Conclusions:TBA should be combined with CBA in identification of anti-DPPX antibody to confirm the diagnosis. Anti-DPPX antibody-associated encephalitis has clinical manifestations of encephalopathy with diarrhea and cachexia, and can coexist with systemic lupus erythematosus.