Tumor cell invasion and metastasis are associated with the proteolytic activity of various types of proteinases.Among them,cathepsin D,which is a lysosomal proteinase,has received more attention recently.Various studies have shown that the lysosomal aspartic protease cathepsin D is over-expressed and hyper-secreted by numerous cancer cell lines.Indeed it plays an essential role in the multiple steps of tumor progression,in stimulating cancer cell proliferation,tumor invasion and metastasis,fibroblast outgrowth and angiogenesis,as well as in inhibiting tumor apoptosis.In addition,CD is also a key mediator of induced- apoptosis.The aim of this article is to review the current knowledge on Cathepsin D action in cancer progression and metastasis,as well as its dual function in apoptosis.

Researching tissue engineered biliary duct aims to repair,replace and regenerate damaged or diseased bile duct by using the in vitro constructed tissues.In this article,we reviewed the cell sources,and scaffolds and the current status of the construction of the tissue engineered biliary duct in tissue engineering.and discussed the existing obstacles and development trends.Tissue engineered biliary duct has an intriguing perspective for the replacement therapy,but it is still at an early stage,its true value remains to be evaluated.

Objective To evaluate the clinical value of anti-cyclic citrullinated peptide (anti- CCP) anti-body in patients with rheumatoid arthritis(RA) in different agagroup.Methods Anti-CCP antibody was detected by ELISA in 220 cases of RA who were divided into three groups by onset age: juvenile group(n=24) ,adult group (n = 162) and older age group (n = 34).Results The ratio of anti-CCP in three groups were 14.3% (2/14), 81.7% (98/120) and 67.9% (19/28)(χ2 = 42.819, P <0.01).There was good coherence between the of anti-CCP and rheumatic factors (RF), with coherence coefficients of 71.4% (10/14 ), 82.2% (97/118) and 82.1% (23/28).Positive rank correlation was only found between anti-CCP and stages of X-rays(rs=0.243,P=0.002).Patients of juvenile group with anti-CCP were all present in poly-article subtype.There was a linear correlation be-tween anti-CCP and numbers of swollen joint, index of swollen joint in patients of juvenile group (r=0.563, P=0.045;r=0.574,P=0.040).The stage of both hand joints in older patients with anti-CCP positive was poorer than in those with anti-CCP negative[X-ray stage Ⅲ + Ⅳ was 52.2% (12/23), Ⅰ + Ⅱwas 0(0/9),χ2 =2.298,P =0.022].Conclusion The incidences of anti-CCP vary significantly among different age patients with RA.Anti-CCP in patients of juvenile group is related with poly-joint subtype, indicating the worsened swollen of joint.Anti-CCP in older age-onset patients with RA means the more severity of bone erosion.

Parathyroid scanning was performed with 99mTc-MIBI in 10 patients who had clinical and biochemical findings suggesting primary hyperparathyroidism but had no enlarged parathyroid or palpable thyroid. Seven cases were scanned with both 99mTc-MIBI and 99mTc and three cases with 99mTc-MIBI only but perchlorate was administered during the scan. A series of images were acquired for all cases at different time intervals after 99mTc-MIBI was injected intravenously to allow the dynamic studies. The P/T ratios (counts in parathyroid counts in thyroid)were also designed to see whether the agent had different uptakes and metabolic characteristics in parathyroid and thyroid tissues from 99mTc-MIBI. Surgical finding and histological examination were taken as gold standard against which US. CT and scintigraphy were judged. Finally, 10 adenomas found exactly at the sites predicted by scintigraphy and 2 hyperplastic glands were removed from the 10 patients. Ten of 10 99mTc-MIBI scans, two of 9 US scans and three of 8 CT scans were positive for a parathyroid adenoma, but 2 hyperplastic glands were missed by all of the three methods. It was shown that the suitable time for imaging was at 1h-2h or 30min-1h(if perchlorate was used) after 99mTc-MIBI was given, so as to render both adenoma and background clear. Despite the limited number of cases, the preliminary experience thus suggests that 99mTc-MIBI scintigraphy maybecome the technique of choice for the localization of hyperparathyroidism in stead of 21Tl.

Objective To observe the proportion changes of CD4+CD25+FOXP3+ T cells in peripheral blood of patients with Vogt-Koyanagi-Harada disease(VKH)before and after one month of treatment. Methods The peripheral blood samples from 15 patients with VKH disease before and after one month of treatment by glucocorticoid,and from 15 healthy volunteers were collected,and lymphoeytes were separated from them.CD4+CD25+regulatory T cells were Iabeled by antibodies of cell surface marker CD4、CD25 and transcription factor FOXP3.The proportion of CD4+CD25+FOXP3+ T cells were detected by flow cytometry. Results Before the treatment,the percentage of CD4+ CD25+FOXP3+ T cells in periphery blood was(0.30±0.19)%of CD4+ cell in VKH patients,and(1.41±0.52)%in control group,the difference was statistically significant(t=7.665,P＜0.01);after one month of treatment,the VKH patients group was(1.28±0.54)%which close to the control group.However there were two patients whose CD4+ CD25+ T cells inereased extraordinarily after one month of treatment. Conclusions The proportion of CD4+ CD25+ FOCP3+ T cells in periphery blood in VKH patients were lower than control group obviously before treatment,but were close to eontrol group after treatment.Those results indicated that VKH diseases may be associated with the decreased proportion of CD4+ CD25+ regulatory T cells.

Drug delivery system in tumor targeting research has always been a difficult problem.Apoptosis in vitro experiments and body pharmacokinetic experiments can not reflect the targeting of drug delivery system indirectly.Imaging techniques both in vivo and in vitro solve the problem,researchers can not only observe the drug delivery system in the target organ,the target tissue and target cell directly,but also analyze quantitatively and qualitatively.

Objective To investigate the predictive values of hemostatic activity of platelets on prophylactic transfusion,and determine the threshold of prophylactic platelet transfusion to avoid the bleeding risk caused by thrombocytopenia.Methods One hundred and twenty-seven patients whose platelet count(Plt)

Objective To retrospectively analyze the data of patients with T3N0-1M0 nasopharyngeal carcinoma (NPC) who underwent radiotherapy (RT) alone or concurrent chemoradiotherapy (CCRT), and to investigate the relationship between therapeutic modality and prognosis. Methods From January 2004 to December 2004, 781 patients with biopsy-proven newly diagnosed non-metastatic NPC were analyzed in Sun Yat-Sen University Cancer Center, who had MRI data of nasopharynx and neck. With restaged based on the Chinese 2008 staging system, 82 cases of T3N0-1M0 patients who were treated by RT alone or CCRT were enrolled. They were divided into group A (46 cases, RT) and group B (36 cases, CCRT). Results The clinical data was comparable between the two groups. The 5-year overall survival rate (OS) was 93.5 % (group A) and 100 % (group B)(P =0.046), while the 5-year disease-free survival rate (DFS) was 85.2 % (group A) and 91.7 % (group B) (P =0.498). N-Staging was the factor affecting the DFS. Stratified analysis showed that the 5-year OS of T3N0M0 patients was 94.7 % (group A) and 100 % (group B) (P =0.432), those of T3N1M0 patients were 92.6 %(group A) and 100 %(group B) (P =0.066), while the 5-year DFS was 73.7 % (group A) and 89.3 % (group B) (P =0.244). Multifactor analysis showed that CCRT was not the independent factor affecting the OS(HR =0.019; 95 % CI, 0 to 21.793), and N-stage was not the independent factor affecting the DFS (HR = 0.203; 95 % CI, 0.135 to 1.231×104). Conclusion For T3N0M0, NPC patients, CCRT is not superior to RT alone. Whether CCRT can improve survival of T3N1M0 NPC patients needs further study.

ObjectiveTo assess negative risk factors associate with short-term and long-term poor outcome of acute heart failure syndromes(AHFS) and provide evidence to emergently proceed to AHFS low risk stratification.Methods A retrospective cohort study was conducted. 125 AHFS patients who met research criterion were enrolled from Guangxi Baise People's Hospital and Youjiang District People's Hospital of Baise City. The patients were divided into poor outcome and relatively low-risk groups by the results of short- and long-term follow-up of their outcomes. The patient's vital signs and disease history were collected at the first time after admission, and auxillary examination parameters were recorded. The poor outcomes occurring in the follow-up periods from the admission to after discharge for 30 days(short-term) and 1 year(long-term)were recorded, and Cox hazard regression was used to analyze the negative risk factor in the short- and long-term.Results There were 58 cases(46.4%)with poor outcome and 30 cases(24.0%)dead in short-term, and there were 111 cases(88.8%) with poor outcome and 39 cases(31.2%) dead in the long-term follow up. Seven negative risk factors were identified by Cox regression. They were no previous or de novo myocardial infarction〔short-term: hazard ratio(HR)=0.36, 95% confidence interval (95%CI)=0.20-0.65,P=0.001〕, lymphocyte ratio 0.20-0.40(short-term:HR=0.13, 95%CI=0.04-0.47, P=0.002; long-term:HR=0.42, 95%CI=0.26-0.68,P=0.001),oxygenation index(PaO2/FiO2)>300 mmHg (1 mmHg=0.133 kPa,short-term:HR=0.23, 95%CI=0.09-0.54,P=0.001),estimated glomerular filtration rate (eGFR)>60 mL·min-1·1.73 m-2(short-term:HR=0.31, 95%CI=0.16-0.64,P=0.002;long-term:HR=0.54, 95%CI=0.36-0.83,P=0.004),left ventricular ejection fraction(LVEF)>0.50(short-term:HR=0.29, 95%CI= 0.10-0.85,P=0.024), P wave terminal force in lead V1(PtfV1)>-0.04 mm·s(short-term:HR=0.29, 95%CI= 0.14-0.60,P=0.001), planar QRS-T angle<90°(long-term:HR=0.46, 95%CI=0.27-0.77,P=0.003). ConclusionsOur patients with AHFS cohort have very poor outcomes both in short-term and long-term follow up. Those with the following characteristics: no previous or de novo myocardial fraction, lymphocyte ratio 0.20-0.40, PaO2/FiO2>300 mmHg, eGFR>60 mL·min-1·1.73 m-2, PtfV1>-0.04 mm·s, LVEF>0.50 and planar QRS-T angle<90°are more likely to have optimal short-term and long-term outcome.

BACKGROUND:Repair of extrahepatic biliary tract injury is a difficult problem in the abdominal surgery. Tissue-engineered extrahepatic biliary tract is an ideal selection for this problem. Construction of tissue-engineered extrahepatic biliary tract with excelent performance is a key to related studies. OBJECTIVE:To investigate the biocompatibility of bile duct endothelial cels differentiated by porcine bone marrow mesenchymal stem cels with electrospun nanofibers. METHODS:Porcine bone marrow mesenchymal stem cels were induced toward biliary tract endothelial cels, which were then identified by morphology and RT-PCR. Polylactic-co-glycolic acid (PLGA) nanofiber membranes were prepared by electrospinning. The morphology was determined by scanning electron microscopy and the short-term (2-week)in vitro degradation rate was determined. Adhesion and proliferation of biliary tract endothelial cels on the nanofiber surface was analyzed by calculating the cel adhesion rate and MTT assay, respectively. Cel growth, morphology and distribution on the material surface were observed by fluorescence staining and scanning electron microscopy, respectively. RESULTS AND CONCLUSION: After 4 weeks of directed differentiation of bone marrow mesenchymal stem celsin vitro, cels showed typical morphology of dendritic bile duct endothelial cels and had the expression of CK19. Scanning electron micrographs showed that electrospun materials were continuous nanofibers with diameters between 200 and 500 nm. No significant degradation of the PLGA nanofibers was observed within 2 weeks. Based on the measured cel adhesion rate, MTT assay, fluorescence staining, and scanning electron microscopy, the differentiated cels possessed a good proliferative capacity on PLGA nanofibers. Bone marrow mesenchymal stem cels differentiated into bile duct endothelial cels in vitro. Materials prepared by the electrospinning method had a nanofiber structure, which did not significantly degrade within 2 weeks. Differentiated cels exhibit good biocompatibility with the nanofibers.