Objective To clone human vacuolar protein sorting 4A gene(hVPS4A)and to construct its eukaryotic expressive plasmid.Methods Primers were designed to amplify the full length hVPS4A by PCR using cDNA of Huh7 cell as a template,then the target DNA was inserted into the eukaryotic vector pRK5.The recombinant plasmid was confirmed by PCR,restriction enzyme digestion and DNA sequencing.Results A 1 300 bp fragment was successfully amplified by PCR from the cDNA of Huh7 cells.Af-ter recycled,purified and ligated with the vector pRK5,the recombinant plasmid was transformed into E.coli DH5α.The positive re-combinant plasmid identified by PCR was selectred and digested by EcoRⅠto get a 5 900 bp fragment;and two fragments including 4 600 bp and 1 350 bp were obtained using EcoRⅠand HindⅢ digestion;the size of these two fragments were consistent with the pRK5 target fragment and the inserted hVPS4A as expected.Moreover,DNA sequencing results confirmed that the inserted frag-ment was in accordance with the hVPS4A reference sequence.Conclusion The eukaryotic expression vector containing hVPS4A gene is constructed successfully,which provides the condition for further study on the hVPS4A biological functions.

Objective To explore the early diagnosis, option of the surgical procedures, preven-tion and treatment of the complications in patients with pancreatic trauma.Methods All patients with pancreatic trauma during the past 20 years were studied retrospectively in respect of sex, age, cause of injury, grade by AAST, style of operation, therapeutic efficacy, complications and factors for death etc.Statistical analysis was made with Chi-square test.Results In all 148 cases of the present series, 132 underwent surgical interventions including simple suture or external drainage alone, distal pancre-atectomy, distal pancreaticojejunostomy or other internal drainage, diverticularization, Whipple's pro-cedure, and Damage Control Surgery (DCS) etc.Postoperative morbidity was 27.83% with a signifi-cant difference of the incidence of pancreatic fistula between pancreas grade Ⅲ-Ⅴ injuries and grade Ⅰ-Ⅱ(P＜0.01).The mortality rate was 11.49%.The cause of the deaths was mainly massive bleed-ing due to severe associated injuries(76.47%).Among various grades, the difference of the mortality was not significant (P＞0.05).Conclusion To improve the survival rate, it is important to control massive hemorrhage from associated injuries precedes dealing with pancreas trauma.Selection of surgi-cal procedures should be based on whether the main duct is injured.The removing of devitalized tis-sue, adequate external and internal drainage are essential for treatment of pancreatic injuries.Early recognition of pancreatic injury and correct choice of surgical procedures may obviously decrease the in-cidence of postoperative complications.

Objective To investigate the expression of Ki-67,Survivin,Livin in dysplasia,colon carcinogenesis and para-carcinoma tissues,and to discuss the variation of cell proliferous capability in colon carcinogenesis and antiapoptosis factors.Methods 219 specimens were composed of mild,moderate and severe atypical hyperplasia,well,moderately,poorly differentiated adenocarcinoma,para-carcinoma tissues of 36,34,18,35,27,35 and 34 cases.Detected the expression of Ki-67,Survivin and Livin with tissue microarray and immunohistochemical methods.All data were statistically analyzed by SPSS 17.0.Results In mild,moderate and severe atypical hyperplasia,well,moderately,poorly differentiated adenocarcinoma and para-carcinoma tissues the expression of Ki-67 were (21.56 ± 19.20)％,(37.44 ± 17.41)％,(36.17 ± 17.41)％,(55.29 ± 16.13)％,(44.89 ± 29.67)％,(45.11 ± 29.24)％,(43.94 ± 28.84)％,Survivin were 13.8 ％,44.1％,77.8 ％,85.7 ％,85.1％,91.4 ％,91.1％,and Livin were 2.7 ％,38.2 ％,55.6 ％,100.0 ％,77.8 ％,80.8 ％,79.4 ％.The differences of Ki-67,Survivin and Livin expression in each group were statistically significant (F =6.796,X2 =81.754,X2 =95.200,all P ＜ 0.05).Ki-67 was significantly correlated with expression of Livin (r =0.360,P ＜ 0.05) and no correlated with expression of Survivin (r =0.044,P ＞ 0.05).Conclusion Colonic epithelium from mild atypical hyperplasia to proliferation of well-differentiated adenocarcinoma cells formed a peak,and gradually down to poorly differentiated adenocarcinoma formed a platform.When the colon epithelial cells to become cancerous,the capability of cell proliferation will significantly enhance,apoptosis inhibition will reach the peak and the tumor cell will happen the changes of malignant biological behavior.Tumor microenvironment may promote the cell proliferation in para-carcinoma tissues and the development of colon cancer.Livin may inhibit apoptosis and promot the progression in synergistic mechanism importing with Survivin,which play a role in the development of colonic adenocarcinoma.

Objective To observe the lung protection of Astragalus membranaceus against radiotherapy to intermediate-stage and terminal thoracic neoplasm, and its influence on TNF-α and ET expression.Methods The patients with intermediate-stage and terminal thoracic neoplasm under radiotherapy were divided into a treatment group and a control group.Patients in the treatment group took 10 ml of Asragalus membranaceus twice a day.for consecutive 6 months from the beginning of radio therapy.TNF-α and ET in the plasma were measured before and after the radiotherapy.The clinical symptom,iconographic changes and lung diffusion were observed from the 15th day of radiotherapy.Results The TNF-α and ET in plasma afterthe radiotherapy were(2.48±0.75)as/ml and(69.32±23.03)pg/ml for the treatment group,and(5.12±1.01)ns/ml and(97.87±37.83)pg/ml for the control group with the statistial difference(x2=7.49,6.57,P<0.001).The decrease of CO diffusion 5 and 10 months after the radiotherapy in the treatment group was statistically different compared with that in the control group(x2=3.98,3.78,P<0.05).There was a statistical difference of the incidence of acute radiation pneumonitis and pulmonary fibrosis between these two groups(P<0.05).Conclusions Astragalus membranaceus could inhibit the excess expression of TNF-α and ET in plasma and reduce the deterioration of diffusion after radiotherapy,so that it can be used for intervention of lung injuries from radiotherapy.

Objective To probe timely diagnosis and surgical intervention of traumatic diaphragmatic rupture(TDR). Methods The clinical data of 161 patients with TDR treated surgically in our department during the past 17 years were analyzed retrospectively in respects of diagnostic methods,accuracy of preoperative judgment of TDR,incidence of diaphragmatic hernia,surgical procedures and outcome,etc. Results There were 139 males and 22 females at a mean age of 32.4 years(9-84 years),with average ISS of 27.8 points(13-66 points).Of all patients,65.2%had shock at admission.For these 161 patients,36 suffered from blunt injuries and 125 from penetrating injuries.For diaphragmatic injury.preoperative diagnostic rate was 88.9%for blunt injuries and 78.4%for penetrating injuries (P＞0.01).The incidence of diaphragmatic hernia was 94.4%in blunt injuries and 14.4%in penetrating injuries(P＜0.05).In this series,thoracotomy was performed in 30 patients,laparotomy in 106,thoracotomy plus laparotomy in 18 and combined thoraco-laparotomy in 7,with overall fatality rate of 10.6%and a mean ISS of 41.6 points.The mortality rate was 22.2%in blunt injuries and 7.2%in penetrating injuries(P＜0.01).The main causes for death were hemorrhagic shock and septic complications; Conclusions Blunt diaphragmatic injury can be diagnosed by radiographic signs of diaphragmatic hernia.According to"offside sign",which implies a thoracic wound with positive physical or radiological signs in the abdomen or in the thorax,penetrating diaphragmatic injury can be recognized.To deal with diaphragmatic hernia,it is important to judge the vitality of viscera.Penetrating injury has a relatively good prognosis.

OBJECTIVE:To observe the effect of Qinzao jiufei decoction on radiation-induced lung injury and expression of plasma transforming growth factor beta-1(TGF-?1)and interleukin-1(IL-1).METHODS:Local middle and advanced thoracic tumor patients with radiotherapy were randomized into treatment group and control group. Both groups were given radiotherapy. Treatment group were additionally given Qingzao jiufei decoction (200 mL,b.i.d.) for 6 months. The level of TGF-?1 and IL-1 were determined before and after radiotherapy. After 15 days of radiotherapy,clinical symptoms,lung function and high-resolution CT manifestation of thorax were evaluated. RESULTS:There were statistical significance between two groups in respect of TGF-?1 and IL-1 in serum(P

OBJECTIVE: To elucidate the epidemiological characteristics and to define some preventive strategies for fall injury (FI). METHODS: The medical records of patients admitted following a fall from a certain height between August 1996 and July 1997 were analyzed retrospectively. RESULTS: A total of 138 patients were assessed, with a mortality of 31.2%. The male-to-female ratio was 3.5:1. The persons between 20 and 59 years old were the main victims (81.8%), of which 52.2% were related with their work altitude. The remaining adults fall because of, accidents in daily life, suicide attempts, drug abuse, alcohol, or criminal behavior. There were significant differences between the death group and the survival group in the Revised Trauma Score (RTS) and the Injury Severity Score (ISS) value (P<0.05 and P<0.01, respectively). Six children fall from balconies, open windows or roofs. There were significant differences for the height of fall and RTS value in aged group than those in children, adolescents, and adults (P<0.001, 0.005, 0.05; and P<0.05, 0.01, 0.05, respectively). The mortality of FI was significantly correlated to the height of fall (r=0.897, P<0.005). CONCLUSIONS: Male adults are the main victims, especially the workers at high altitudes. The mortality of FI is significantly correlated to the height of fall. The preventive strategies developed through analyzing the risk factors of fall in different age groups might reduce the injuries and deaths following fall.

Objective To explore the clinicopathological features and renal outcomes of primary IgA nephropathy (IgAN) patients with chronic tonsillitis.Methods Patients with biopsyproven primary IgAN admitted to The First Affiliated Hospital,Sun Yat-sen University from January 2006 to December 2011 were enrolled.The clinicopathological features and renal outcomes of patients with and without chronic tonsillitis were retrospectively compared.The primary outcome was progression to end stage renal diseases and/or doubling of serum creatinine.Results A total of 981 primary IgAN patients were enrolled and 98 patients (9.99％) had a history of chronic tonsillitis.Compared with patients without chronic tonsillitis,IgAN patients with chronic tonsillitis exhibited significantly higher prevalence of acute episodes of tonsillitis as a predisposition (P ＜ 0.001),higher serum IgA levels (P=0.012),and higher prevalence of macrohematuria (P=0.006).No significant difference in renal pathological features was observed in patients with and without chronic tonsillitis.Moreover,the renal outcomes were similar as regards IgAN patients with and without chronic tonsillitis.Conclusion IgAN patients with chronic tonsillitis had higher prevalence of acute episodes of tonsillitis and macrohematuria as well as higher serum IgA levels.However,IgAN patients with and without chronic tonsillitis showed no significant difference in renal pathological features and renal outcomes.

Objective:To investigate the expression and clinical significance of serum response factor (SRF) and myosin heavy chain 9 (MYH9) in esophageal squamous cell carcinoma(ESCC).Methods:The clinical data of 113 patients with esophageal squamous cell carcinoma treated in Tangshan people′s Hospital from January 2014 to December 2016 were retrospectively analyzed.Immunohistochemical staining was used to detect the expression of SRF and MYH9 in esophageal squamous cell carcinoma and corresponding adjacent tissues, and the correlation between the differential expression of SRF and MYH9 and clinicopathological features was analyzed.Results:Immunohistochemical staining showed that the positive expression rate of SRF in esophageal squamous cell carcinoma was 42.48% (48/113), which was significantly higher than that of 6.25% (2/32) in adjacent tissues (χ 2=14.487, P<0.05). The positive expression rate of MYH9 was 57.52% (65/113), which was significantly higher than that of 25.00% (8/32) in adjacent tissues (χ 2=10.551, P<0.05). The expression levels of SRF and MYH9 were closely related to the differentiation, lymph node metastasis and TMN stage of ESCC (all P<0.05). The positive expression of SRF had a correlation with positive expression of MYH9( r=0.521, P<0.05). The median survival time of SRF and MYH9 double negative expression group, SRF and MYH9 single positive expression group, SRF and MYH9 double positive expression group were 30, 20 and 12 months respectively.There were significant differences between the double negative, single positive expression groups and double positive expression groups (χ 2 values were 43.855, 17.799, all P<0.001), but there was no significant difference between the double negative and single positive expression groups (χ 2=2.787, P=0.095). Conclusion:SRF and MYH9 may be one of potential targets for diagnosis and treatment of esophagus cancer.

Objective To investigate the expression and significance of PDCD4 and MMP-7 in human gastric carcinoma (GC) tissues and to analyze their association with clinical pathological characteristics in GC patients.Methods Immunohistochemical staining SP was used to detect the expression of PDCD4 and MMP-7 protein in gastric cancer specimens and para-carcinoma tissue in 70 cases,and the relationship with clinical pathological characteristics were analyzed.Results The expression rate of MMP-7 in GC tissues in the study group was high and significantly higher than that in the control group (78.6％ vs.22.9％,P ＜ 0.05),while the expression rate of PDCD4 protein was low and significantly lower than that in the control group (31.4％ vs.75.7％,P ＜0.05).Both the expressions of PDCD4 and MMP-7 were significantly associated with tumor lymph node metastasis,peritoneal metastasis,the depth of invasion and late clinical stage of GC (P(0.05).The correlation analysis indicated that there was a negative correlation between the expressions of PDCD4 and MMP-7 (r =-0.526,P =0.000).Conclusion The expression of PDCD4 and MMP-7 might be correlated to the carcinogenesis and invasion,and might be involved in the GC regulation.