Objective To investigate the β-tubulin Ⅲexpression in locally advanced cervical cancers and its significance in the neoadjuvant chemotherapy of cervical cancer .Methods Immunohistochemistry was used to detect the expression of β-tubulin Ⅲin tissue samples from 62 cases of locally advanced cervical cancer patients .Groups paclitaxel +cisplatin/carboplatin (TP) (34 pa-tients) underwent two cycles of TP chemotherapy ,while group 5-fluorouracil+cisplatin(PF) (28 patients) underwent two cycles of PF chemotherapy .Comprehensive analysis of β-tubulinⅢexpressions of TP and PF neoadjuvant chemotherapies revealed the efficien -cy and operation rate .Results The positive rate ofβ-tubulin Ⅲ was 62.90% in locally advanced cervical cancer .β-tubulin Ⅲ ex-pression was not correlated with clinicopathological features in locally advanced cervical cancer ( P >0.05 ) .β-tubulinⅢexpression was correlated with efficiency and operation rate with TP chemotherapy but not with PF chemotherapy .Conclusions In the neoadju-vant chemotherapy of locally advanced cervical cancers ,β-tubulinⅢexpression can be used as an important index to predict the effec-tive rate of combined chemotherapy containing paclitaxel and guide the patients to individual chemotherapy .

Objective To investigate the association of ERCC1 and BRCA1 gene expression with clinical features and sensitivity to platinum-containing chemotherapy in patients with ovarian epithelial carcinoma. Methods Primary ovarian epithelial carcinoma tissues were harvested from 48 patients receiving staging surgery or cytoreductive surgery. Expression of ERCC1 and BRCA1 in the tumor samples was detected by immunohistochemistry. Results ERCC1 expression was correlated with clinical stage(P﹤0. 05)but not with age,pathological type or degree of differentiation(P﹥0. 05). BRCA1 expression was not correlated with any of the clinicopathological features(P﹥0. 05);ERCC1 expression was significantly higher in drug-resistant tissues than in drug-sensitive samples(P﹤0. 05);The expression of ERCC1 and BRCA1 was positive in 89. 58%and 25. 00%of the samples,respectively. Conclusion ERCC1 gene expression is correlated with clinical stage but not with age,pathological type or degree of differentiation. BRCA1 gene expression is not correlated with clinicopathological features. ERCC1 has high positive expression in epithelial ovarian cancer and is correlated with sensitivity of platinum-containing adjuvant chemotherapy.

Objective To study the effects of propofol exposure during pregnancy on space cognitive and exploration abilities and expression of phosphorylated tau protein ( P-tau) and beta-amyloid protein[ Aβ(1-42) ] in hippocampus of the offspring. Methods Sprague-Dawley female (n=24) and male rats (n=8) of three months old were mated at the same cage at the ratio of 3:1. Pregnant rats were randomly divided into early group (group E), medium group (group M), late group (group L) and control group ( group C) , with 6 rats in each group. Groups E, M and L received propofol 80 mg · kg-1 · d-1 for 7 consecutive days. Propofol was replaced with equal volume of physiological saline in group C. Learning and memory of the 30-day offspring rats were assessed by using Morris water maze test. Then offspring rats were sacrificed to determine the expression of P-tau and Aβ(1-42) in the hippocampus by ELISA and immunohistochemistry. Results The learning and memory abilities were declined significantly in group E (51. 20±8. 11) s, group M (36. 00±6. 44) s and group L (47. 20±12. 30) s, as compared with group C (65. 60± 7. 23) s (all P<0. 05). The result of immunohistochemistry and ELISA showed that expression of Aβ(1-42) and P-tau in hippocampus was significantly higher in group M than in groups E, L and C[(immunohistochemistry: Aβ(1-42), (27. 38±5. 90) vs. (12. 65± 2. 08), (13. 79±3. 37), and (65. 60±7. 23); P-tau, (26. 35±5. 83) vs. (13. 65±3. 46), (14. 56±3. 82), and (8. 49±1. 20);ELISA:Aβ(1-42) , (88. 6±7. 43) vs. (71. 60±6. 79), (13. 79±3. 37), and (65. 80±6. 28);P-tau, (230. 13±8. 22) vs. (210. 42± 2.20), (210.95±1. 75), and (200. 65±1. 57)] (all P<0.05). Conclusion Multiple propofol injections may impair rat offspring’ s space cognitive abilities and exploration abilities, and the impairment is especially obvious in second trimester of pregnancy, which may be associated with over-expression of P-tau and Aβ(1-42) .

Objective To evaluate the optimized simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) plans in cervical esophageal carcinoma underwent prophylactic lymphatic irradiation.MethodsSix patients with cervical esophageal carcinoma were studied.The gross tumor volume (GTV) and clinical target volume (CTV) (including bilateral mid-lower neck and supraclavicular lymph drainage regions,upper mediastinal lymph drainage regions) were delineated on sim-CT images,GTV and CTV were uniformly expanded by 5 mm to create PGTV and PTV.Five fields(5F) ,7F and 9F SIB-IMRT plans were designed.The prescribed doses to PGTV and PTV were 66 Gy and 60 Gy in 30 fractions respectively.The parameters of dose-volume histograms in three groups planning were compared.Results The values of conformity index(CI) of PGTV were 0.56,0.62 and 0.69 (F =6.22,P ＜0.01 ),the V66 with 88.24% ,95.03% and 94.91% ( F = 4.39,P ＜ 0.05 ) and D95 with 6539.67,6601.83 and 6602.00 cGy (F=4.46,P ＜0.05) in 5F,7F and 9F SIB-IMRT plans.The values of CI,V66 and D95 of PTV were 0.80,0.85 and 0.87 (F=11.29,P＜0.01),with 91.64%,94.05% and 95.06% (F=4.10,P＜0.05) and with 5934.00,5987.17 and 6006.33 cGy (F =4.01,P ＜0.05).The values of maximal dose of spinal cord were 4707.17,4497.83 and 4357.00 cGy( F = 11.26 ,P ＜0.011 ) in 5F ,7F and 9F SIB-IMRT plans.The values of all dosimetic parameters about PGTV and PTV were same in 7F and 9F SIB-IMRT plans ( all P ＞ 0.05 ).Conclusion 7F-SIB-IMRT plan is best one scheme for cervical esophageal carcinoma underwent prophylactic lymphatic irradiation.

Objective To discuss the effect of different methods of dropping the high temperature of the tubercular meningitis patients. Methods 35 cases with tubercular meningitis with high fever were divided into research group(11 cases) and control group(24 cases) ,24 patients in control group were treated by traditional cooling method, 11 patients in research group were rteated by mild hypothermia therapy, The self signs, the intracranial pressure,Glasgow scores, complications and the death rates of patients were assessed and compared. Results The effective rates of the research and control cooling method were 81.8% and 41.7% respectively. The difference between the two groups was significant;After the intervention,compared with the control group, the self scale is superior in research group,and the intracranial pressure and the death rates of patients were lower,and patients'Glasgow scores were higher,but the complications between the two groups had no significant differences. Conclusion Mild hypothermia can effectively control patients'temperature,at the same time, which can improve the patients conscious state and reduce the mortality.

Objective To evaluate the diagnostic value of clinical laboratory indexes on judgment of hypovolemia in the patients with nephrotic syndrome (NS).Methods The blood volume of each 50 cases of healthy adult men and women was assessed with indocyanine green-pulse dye densitometry (ICG-PDD).The normal range of blood volume and the cut-off value of hypovolemia were determined.The blood volume of 81 patients with NS was also measured with ICG-PDD and then these patients were divided into the hypovolemic group (21 cases) and the non-hypovolemic group (60 cases) according to the cut-off value of hypovolemia.The test data of clinical laboratory indexes of the patients in the two groups were compared,and the indexes with statistic difference were screened out.Their diagnostic values on judgment of hypovolemia were evaluated by receiver operating characteristic (ROC) curve analysis,and finally the indexes with high judgment accuracy were selected.Results ①The cut-off values of hypovolemia are ＜ 52.9 ml/kg for the male and ＜ 52.5 ml/kg for the women,which were determined with ICG-PDD.②The five clinical laboratory indexes,including orthostatic heart rate (OHR) increase ＞ 10 bit per minute,fractional excretion of sodium (FENa) ＜ 1,transtubular potassium gradient (TTKG) ＞ 60％,blood urea nitrogen/serum creatinine ratio (BUN/Scr) ＞ 20,and urine specific gravity (SG) ＞ 1.020,were used to judge the hypovolemia in NS patients in this study.ROC curve analysis showed that the diagnostic accuracy in judgment of hypovolemia by one index or two indexes combination only belonged to medium level.However,the diagnostic accuracy in judgment of hypovolemia by the following three indexes combination,i.e.OHR increase+FeNa+BUN/Scr,FeNa+ BUN/Scr+SG,OHR increase+TFKG+BUN/Scr,or ORG increase+FeNa+TTTKG,reached high level.Conclusion This study obtained the cutoff value of Chinese adults hypovolemia are ＜ 52.9 ml/kg for the male and ＜ 52.5 ml/kg for the women,which are determined with ICG-PDD,through evaluation we recommend applying the above four specific combinations of three indexes for diagnosis of hypovolemia in NS patients.

Objective To analyze the reasons for accidental extubation in infants during mechanical ventilation and to explore effective intervention countermeasures.Methods A total of 148 infants with accidental extubation from May 2013 to February 2014 who given routine nursing care were selected as control group.Another 152 infants with accidental extubation in pediatric intensive care unit (PICU) who given optimization nursing care from March to December 2014 were selected as observation group.Retrospective analysis of accidental extubation,artificial airway way and intervention care were conducted.Results The total intratracheal tube time was 283 d in control group and 253 d in observation group.Nineteen cases (6.7％) suffered accidental exudation in control group and that of 8 cases(3.2％) in observation group,and there was significant difference between two groups,x2=5.25,P＜0.05.The primary reason of unplanned extubation was that infants with unconsciousness,the second cause was the improper catheter fixed.The third cause was the patient's comfort level and so on the improper nursing operation leading to accidental extubation too short or too shallow.Conclusion Infants given mechanical ventilation should pay more attention to the intervention of accidental extubation,appropriate calm,physical constraints and correct fixed pipeline.

Objective To explore whether LDL and oxLDL may induce kidney tubular epithelial-mesenchymal transition (EMT) and its mechanism. Methods The second generation human kidney tubular epithelial cells (TECs) were cultured for 24 hours in different conditions as (1) serum free as control, (2) treated with LDL (50 ?g/ml) , (3) treated with oxLDL(50 ?g/ml), (4) treated with LDL(50 ?g/ml) plus PD98059(5 ?mlo/L) , (5) treated with oxLDL(50 ?g/ml) plus PD98059 (5 ?mol/L). The expression of cytokeratin, E-cadherin, ?-SMA and vimentin was assessed by immunofluorescence and Western-blot. Western-blot was also performed to test the expression of collagen I and phospho-ERKl/2MAPK and phospho-GSK-3?. Results oxLDL was more potently in inducing tubular EMT than LDL at 24 hours as demonstrated by de novo a-SMA expression, increased expression of vimentin, partial loss of cytokeratin and reduction of E-cadherin expression by TECs. The expression of collagen I and phospho-ERKl/2MAPK and phospho-GSK-3? was increased in TECs stimulated by LDL or oxLDL. MAPK inhibitor (PD98059) inhibited the phosphorylation of GSK-3P and almost completely blocked oxLDL-induced tubular EMT. However, PD98059 alone was able to inhibit LDL-induced tubular EMT partially. Conclusions oxLDL is more potently in inducing tubular EMT than LDL. The ERKl/2MAPK-GSK-3? signaling pathway mediates the LDL or oxLDL-induced tubular EMT.

BACKGROUND:A short-peptide small molecule hydrogel (SMH) developed in the previous study has more obvious advantages than other hydrogels to improve local microenvironment, carry bioactive substances and interfere with stem cell signal transduction pathways. OBJECTIVE:To explore the effect of SMHs on bone marrow mesenchymal stem cells (BMSCs) proliferation, apoptosis and differentiation into myocardial cells. METHODS: (1) Passage 9 rat BMSCs in vitro were divided into control group and experimental group, followed by routine culture and culture in SMHs, respectively. At 7 days of culture, cell proliferation and apoptosis were detected. Cells in the two groups were exposed to anaerobic environment for 12 hours, and expression levels of Bcl-2, Bax and Caspase-3 in BMSCs were detected. (2) Passage 9 BMSCs were divided into four groups and then cultured in 5-azacytidine, SMHs, SMHs+5-azacytidine, and L-DMEM (normal control), respectively. After 4 weeks of induction, expression of CTnT, desmin and Cx-43 proteins was detected and expression levels of early cardiac transcription factors, NKX2.5 and GATA-4, were also measured. RESULTS AND CONCLUSION: (1) Compared with the control group, better proliferation and lower apoptosis of BMSCs were found in the experimental group. Under anaerobic conditions, the number of survival cells was reduced in both groups, but less apoptosis or necrosis was found in the experimental group than the control group (P < 0.05). Moreover, the level of Bcl-2 was higher in the experimental group than the control group (P < 0.01), while the levels of Bax and Caspases-3 protiens were lower in the experimental group than the control group (P < 0.01). (2) NKx2.5 and GATA-4 mRNA expression was found in both 5-azacytidine and SMHs+5-azacytidine groups, and moreover, the mRNA levels of early cardiac transcription factors were significantly higher in the SMHs+5-azacytidine group than in the 5-azacytidine group (P < 0.05). In the normal control group, cTnT expressed negatively, and desmin and Cx-43 expressed weakly. The expression of cTnT, desmin and Cx-43 proteins was higher in the SMHs+5-azacytidine group than in the 5-azacytidine and SMHs groups, while there was no significant difference between the latter two groups. To conclude, SMHs as a culture medium is conducive to the proliferation of BMSCs, reduces cell apoptosis, and promotes myocardial differentiation of BMSCs.

Objective To evaluate the high?risk factors for brain metastases after prophylactic cranial irradiation ( PCI), and to provide a basis for personalized treatment. Methods A retrospective analysis was performed in 188 patients with limited?stage small?cell lung cancer who received PCI in our hospital from 2005 to 2010. The Kaplan?Meier method was used to calculate the cumulative rate of brain metastases. The log?rank test and the Cox model were used for the univariate and multivariate analyses of the potential factors for the cumulative incidence of brain metastases, respectively. Results In the 188 patients, 31 ( 16?5%) had brain metastases. The 1?, 2?, and 3?year cumulative incidence rates of brain metastases were 4%, 15%, and 20%, respectively. The univariate analysis showed that staged Ⅲ disease before treatment, elevated levels of tumor markers, incomplete remission after chemoradiotherapy, and local?regional relapse were risk factors for high incidence of brain metastases ( P= 0?044, 0?037, 0?005, 0?007) . The multivariate analysis revealed that incomplete remission after chemoradiotherapy and local?regional relapse after chemoradiotherapy were risk factors for high incidence of brain metastases after PCI ( P= 0?003, 0?040 ) . Conclusions Patients with incomplete remission or local?regional relapse after chemoradiotherapy have high incidence of brain metastases after PCI. For those patients, a frequent follow?up of the central nervous system plus salvage cranial irradiation might provide an alternative to PCI.