Objective:To investigate the expression of collagen typeⅠ(ColⅠ),collagen typeⅣ(ColⅣ)and fibronectin(Fn)in laryngeal squamous cell carcinomas(LSCC)and their pathobiological relationship with invasion and metastasis of tumor.Method:The expression of ColⅠ,Col Ⅳ and Fn was detected by immunohistochemistry method in normal tissue of latero-carcinoma and tissue of carcinoma in 60 specimens of LSCC.Integral optical density(iOD)was detected by image analysis of computer and was analyzed by SPSS13.O.Result:The expression of ColⅠ was obvious and integrity.The expression of Col Ⅳ and Fn of basal membrane was like intact line-shape appearance and Fn of interstitial substance appeared like a complete network in the normal tissue f latero-carcinoma.Their expression decreased gradually and their integrity was broken and disappeared gradually from well to poorly differentiated LSCC.Their expressions also fell off with the tumor size,clinical stage and cervical lymphatic etastasis gradually and consistently in LSCC.Their variances were statistical significance separately(P＜0.05 or P＜0.01).Conclusion:The expression of ColⅠ,ColⅣand Fn was closely related to tumor invasion,the regional lymph node metastasis and other some pathobiological features in LSCC.A detection of ColⅠ,ColⅣ and Fn as of definite significance on a better comprehension of the possibility of metastasis,choice of surgery and prognosis.

Objective To investigate the correlations of plasma B-type natriuretic peptide (BNP) and carbohydrate antigen 125 (CA125) levels in elderly patients with chronic heart failure (CHF) and to evaluate the clinical value.Methods A total of 124 elderly patients diagnosed as chronic heart failure were recruited.Patients with CHF were divided into the stage Ⅱ group,stage Ⅲ group and stage Ⅳ group according to the New York Heart Association (NYHA) classification.35 health subjects were randomly enrolled as the control group.The plasma levels of BNP and CA125 between different groups were compared.The correlations of the plasma BNP and CA125 levels with chronic heart failure were analyzed.60 cases with clinical improvement by aggressive treatment were followed up and the plasma levels of CA125 and BNP in them were tested.The changes in heart failure indicators were analyzed before and after treatment.Results The plasma BNP and CA125 levels were higher in patients with CHF than in control subjects (all P＜0.01).The plasma BNP and CA125 levels were gradually increased in the stage Ⅱ,Ⅲ and Ⅳ group (all P＜0.01).The plasma levels of BNP and CA125 were negatively correlated with left ventricular ejection fraction and positively correlated with left ventricular end-diastolic diameter (r=-0.75,-0.73,0.72,0.63,respectively,both P＜0.01).There were no significant differences in the plasma levels of BNP and CA125 between patients with or without atrial fibrillation (both P ＞0.05).Conclusions Plasma BNP and CA125 levels are correlated with NYHA classification in CHF,which can be used as indexes for the diagnosis,treatment and prognosis of CHF.

Objective To investigate the condition of inflammation and prethrombotic state (PTS) of the aged patients with coronary heart disease(CHD) complicated with esstential hypertension(EH) and type 2 diabetes mellitns(T2DM). Methods The levds of fasting plasma hs-CRP,D-D and VWF were all measured in 86 CHD patients with EH,84 patients with T2DM,80 patients with EH and T2DM,91 CHD patients and 79 normal cases. Results Compared with normal group,diseases groups had significantly higher hs-CRP,D-D,and VWF,but compared with CHD with EH and T2DM group,other diseases groups had lower hs-CRP,D-D and VWF(P <0.05) ;The concentration of serum hs-CRP was positively correlated with D-D and VWF in CHD group (P < 0. 05). Conclusion The inflammation and hypercoagulable state is more significant in CHD patients with EH and T2DM,thns the levels of plasma hs-CRP,D-D and VWF play an important role in the treatment.

Objective To assess and analyze the current status of clinical guidelines for hypertension in the world by using the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument.Methods The clinical guidelines for hypertension were identified and approved by searching China hownet,WANFANG database,PUBMED database,MEDLINE,Embase and related institutions and authorization web site from 1995 to January 2012,and relevant Web sites of agencies and organizations that produce and/or endorse guidelines.Names of the guidelines,published years and organizations,methodology of development and reference number were descriptively analyzed.AGREE instrument was used to evaluate the qualities of latest edited clinical guidelines for hypertension in countries all over the world.Results Nine guidelines were enrolled.The results showed that the hypertension guidelines scored the highest average of 88.4％ for clarity of presentation and reliability field; for applicability fields,scored an average of 86.1％; the scope and goal field scored an average of 83.8％; participants field scored an average of 71.7％; editorial independence field scored an average of 64.1％ ; rigor of development field scored the lowest average of 62.9％.The overall assessment showed that NICE 2011,Canada 2012,ESC 2009,Australia 2010 editions were the positively recommended guidelines,JNC7,Japan 2009,China Taiwan 2010,China 2010,South Africa 2011 editions were the recommended guidelines (still need to supplement and improve).No recommend or uncertain guide was found.Conclusions The quality of the hypertension guidelines is higher in general,but some common deficiency in the rigor of development and editorial independence in Asian and African guidelines formulated by the states still exists.There still exist certain gaps in evidence-based medical requirement.And the contents and quality are needed for further regulating and enhancing.A set of scientific systemic hypertension clinical guidelines evaluation system should be established.

Objective To investigate the dynamic expression from gene and protein levels of hypoxia inducible factor-1α(HIF-1α) during the development of hypoxic pulmonary hypertension (HPH) in neonatal rats.Methods A neonatal rat model of HPH was established,normal neonatal rats were enrolled as the control group.At the 3th 、7th、10th and 14th days,we measured the mRVSP through catheterization of right ventricule,collected hearts to figure out the right ventricular hypertrophy index(RVHI),evaluated vascular remodeling by the percentage of medial thickness to outer diameter of the small pulmonary arteries (MT％) and the percentage of medial cross section on area to the total cross section area of the pulmonary small arteries (MA％),observed the expression of HIF-1α by immunochemistry,and measured the expression of HIF-1α in mRNA and protein by RT-PCR and Western blot respectively.Results The mRVSP increased at the 3th day,and sustained until the 14th day (P ＜ 0.01).RVHI MT％ and MA％ increased at the 7th day,and sustained until the 14th day (P ＜0.01).HIF-1α mainly expressed in endothelium and smooth muscle cells in the CHPH group and the HIF-1αmRNA increased significantly on the 3th and 7th days (P ＜ 0.05),and the HIF-1α protein increased significantly on the 7th、10th and 14th days in the CHPH group compared with the control group(P ＜ 0.01).Conclusion The mRVSP increased at the early stage after hypoxic exposure in neonatal rats,followed by vascular remodeling and right ventricular hypertrophy.Both mRNA and protein levels of HIF-1α sustained higher than control group during the vascular remodeling stage,indicating that HIF-1α might be a important factor contributing to the vascular remodeling.

Objective To understand the diagnostic value of blink reflex (BR) in central neuropathy by observing the variations of blink reflex in diabetic patients. Methods Electrical pulse was used to stimulate the supraorbital nerve at the supraorbital notch. The responses of bilateral orbicular muscles of the eye were recorded, the variations of the latency and amplitude of R 1 and R 2 recorded on the side of stimulation and of R′ 2 recorded on the contralateral side were measured. Results There was significant prolongation in the latency and lowering of the amplitude of R 1, R 2 and R′ 2 in the diabetic patients compared with the control group. The abnormality rate of BR increased gradually with the prolongation of diabetic duration. Conclusion BR examination might provide an objective index for nervous damage in diabetic patients and it is helpful in early diagnosis of diabetic neuropathy.

Objective To observe the clinical efficacy of acupoint sticking with Chan Wu gel in managing cancer pain.Method A hundred patients were randomized into a treatment group of 50 cases and a control group of 50 cases. The treatment group was intervened by thethree-step analgesic ladder plus acupoint sticking with Chan Wu gel; the control group was by the three-step analgesic ladder alone. The decrease of the pain degree, action and lasting time of analgesia, and adverse reactions in the two groups were observed.Result The treatment group was superior to the control group in comparing the release of pain, action and lasting time of analgesia; the occurrence rate of adverse reactions in the treatment group was obviously lower than that in the control group(P<0.05).Conclusion The conventional three-step analgesic ladder plus acupoint sticking with Chan Wu gel is effective in mitigating cancer pain, and it can reduce the dose of the three-step analgesics and the adverse reactions.

Objective To explore the feasibility of using clinical whole body MR scanners to investigate the intravital visibility of central nervous system (CNS) lesions in rats of multiple sclerosis (MS). Methods Ten Lewis rats were injected with the peptide 35-55 of myelin oligodendrocyte glycoprotein to make the model of MS. On a Siemens Sonata 1.5T MR scanner equipped with a flexible surface coil, rats brain and spinal cord were examined using T2-weighted and T1-weighted imaging with slice thickness of 1-2 mm. On a Siemens Trio Tim 3.0T MR-scanner equipped with a quadrature wrist coil, rats were examined using T2WI, T1WI and Gd-DTPA enhanced T1WI 3-dimensional imaging with voxel size up to 0.06-0.08 mm~3. Rat brain and spinal cord images in multiple orientations were reconstituted with special software in workstation. Results T2WI and T1WI of the lesions in MS rat brain with high spatial and contrast resolution could be obtained with clinical 3.0T MR scanner, though the image resolution of spinal cord was relatively low. The resolution of 1.5T MR was lower than that of 3.0T. Plaques in CNS of MS rats presented as hyperintense areas on T2WI and hypointense areas on T1WI. Contrast enhancement was observed as hyperintense on T1WI. Conclusion High quality images of CNS lesions canbe obtained with clinical 3.0T MR-scanner in MS rat, which offers a noninvasive access for studying CNS diseases in the rats.

Objective To investigate the value of macrophage activity imaging (MAI) in the diagnosis of brain and spinal cord lesions in rat model of multiple sclerosis(MS). Methods Twenty LEW rats were divided into 15 model rats and 5 control rats. MS animal model, experimental autoimmune encephalomyelitis (EAE) was induced by the injection of peptide 35-55 of myelin oligodendrocyte glycoprotein ( MOG35-55 ). MRI was performed on the third day of the acute stage of disease. The brain and spinal cord of rats were scanned by 3.0 T MR scanner( Siemens Trio Tim) with quadrature wrist joint coil.The T2W and T1 W images, Gadolinium enhanced T1 W images in 3D volume were obtained respectively. The MAI were obtained at 24 hours after intravenous injection of ultra small superparamagnetic iron oxide (USPIO) as contrast medium on T2WI. The workstation with special software was used for the reconstruction images of brain and spinal cord of rat in multiple orientations. Results Fifteen MOG35-55-EAE rats model of MS were successfully induced. The great majority lesions of central nervous system in acute stage were located in the brain( 58/63 ) and less in the spinal cord (5/63). The main manifestation of EAE lesions presented was hyperintensity on T2 WI and hypointensity on T1 WI, and some lesions had enhancement after Gd-DTPA injection. The EAE lesions presented as hypointensity on MAI images, but some of them were found to be isointensity on T2 WI. The enhancement pattern was discrepant between USPIO and Gd-DTPA.The sensitivity of depicting lesions of MOG35-55-EAE rat at acute stage were higher on T2WI ( 14/15 ) and MAI ( 13/15 ), and the detection rate was 100% ( 15/15 ) if they were combined. Gd-DTPA enhanced T1 WI had a lower sensitivity (7/15). All the MAI findings were negative in the control rats. Conclusions MAI can complement the drawback of conventional MRI techniques by continuously monitoring the inflammatory activity of EAE lesions, and it could raise the detection rate of EAE lesions by combining with T2WI. Gd-DTPA enhanced T1 WI monitors the breakdown of the blood brain barrier. MAI and Gd-DTPA enhanced MR imaging are complementary in the diagnosis and monitoring of EAE lesions.

BACKGROUND: Cognitive impairments are often accompanied in patients with silent cerebral infarction (SCI) and depression, and there is still no reliable objective assessing method for the evaluation.OBJECTIVE: The purpose of this study was to probe into the value of auditory P300 in detecting the cognitive impairment in SCI patients with depression.DESIGN: A golden standard control study.SETTING: Department of Neurology, Xi 'an Central Hospital; Department of Neurology, the Second Hospital of Xi' an Jiao Tong University.PARTICIPANTS: Thirty-eight SCI patients were selected from the Outpatient Department of Neurology, the Second Hospital of Xi' an Jiao Tong University between January 2002 to May 2003, including 10 got dizziness,11 got poor concentration, 8 got headache, 5 got numbness of extremities and 4 got syncope. Among them, 26 were detected by CT and 12 by MRI.The patients'aged 45 to 63 years with mean age of (57.3±5.1) years, including 20 males and 18 females.METHODS: The existence of depressive symptoms was measured with the 17-item Hamilton depression scale (HAMD). In this scale, the total score ranged from 0 to 52, with higher score indicating more severe depressive symptoms, and the patient was considered as having depression if the HAMD score was ≥ 9. HAMD tests were administered by two psychiatrists,who were experienced in psychiatric disorders in stroke and other somatic diseases, and the two psychiatrists had a better coincidence (Kappa=0.86 -0.91). The auditory event related potential was detected with MYTO serial cerebra induced potential meter, while lying in a bed placed in a sound-attenuated room. Auditory stimuli were delivered binaurally through headphones. The subject was required to distinguish between the tones by noting the occurrence of the target and not to respond to the standard. All patients underwent a routine experimental test at first, and then a normal test was performed to obtain a better coincidence. Mini-mental state examination (MMSE) was conducted for the 38 patients by specialized training neurologist to assess the cognitive impairment, in which the total score ranged from 0 to 30, with lower score indicating greater impairment. The criteria of intellectual deterioration was defined on the basis of educational level:MMSE score of 17 for illiterate, 20 for primary school and 24 for middle school and above.MAIN OUTCOME MEASURES: The score of MMSE, latent period of P300 wave and amplitude of P300 wave were mainly observed.RESULTS: All the 38 cases were involved in the final statistical analyhave depressive symptoms (47%, depression group) and 20 had no depresindexes and score of MMSE between the SCI patients with and without depression: As compared with the SCI patients without depression, the P300 latent period was obviously prolonged, the P300 amplitude and MMSE score were markedly decreased in the SCI patients with depression [(383.3±31.1), (347.2±37.3) ms; (5.6±0.7), (9.9±1.6) μV; (15.2±1.1),and P300 indexes: In the SCI patients with depression, the P300 latent period had significant negative correlation with the MMSE score (r=-0.549, P ＜ 0.05), the P300 amplitude had significant positive correlation with the MMSE score (r =0.525, P ＜ 0.05). However, there was no correlation between the latent period and amplitude of P300 and the MMSE score in the SCI patients without depression (r=-0.349 to 0.065, P ＞ 0.05).CONCLUSION: Depression and cognitive impairments may have the same pathophysiological basis in SCI patients. P300 can be used as a referential and objective method to analyze the cognitive function in SCI patients with depression.