Objective To investigate the expression and distribution of COX-2 in benign and malignant breast disease,and the relationship among COX-2 expression and the clinicopathologic factors,hormone receptors.Methods Immunohistochemistry Was used to investigate the expression and distribution of COX-2 in 8 accessory.breasts,31 BPBDs(15 in adnosis,16 in fibroadnoma),70 IDCs(35 of them accompany with DCIS);The relationships between the expression of COX-2 and hormone receptor(ER and PR),C-erbB-2.and the clinicopathologic factors were studied respectively.Results①The expression of COX-2 in various kinds mammary diseases:8 accessory breasts were all negative;the positive rate of COX-2 in BPBD was 96.5%(30/31),among these,the positive rate of COX-2 in adnosis was 93.3%(14/15),and in fibroadnonm was 100%(16/16).The positive rate of COX-2 in DCIS was 85.7%(30/35).The intensity of COX-2 expression in DCIS of periph-IDC was higher than that in corresponding carcinoma.The positive rate of COX-2 in IDC Was 84.3%(59/70),the expression of COX-2 Was different among non-cancer gland.②COX-2 expression in BPBD was obviously higher compared with COX-2 in IDC,the difference was significant in statistics(χ2=9.39,P＜0.025).③The expression of COX-2 in DCIS was correlative with low histological differentiation(χ2=10.98,P＜0.005),PR negative(P=0.019,Fisher exact probability),and C-erbB-2 positive(P=0.0008,Fisher exact probability).The expression of COX-2 in IDC was correlative with lymph node metastasis(χ2=4.09,P＜0.05),tissue poorly differentiated(P=0.004,Fisher exact probability),PR negative(χ2=6.91,P＜0.01)and C-erbB-2 positive(χ2=5.94,P＜0.025).Conclusion COX-2 does not express in normal mammary gland.It is high-expressed in BPBD,DCIS and IDC;These indicate the up-regulation of COX-2 expression not only participates in breast carcinogenesis,but also promotes its metastasis and progression,and suggests COX-2 may down-regulate reactivity of endocrine thempy by participating in therapy resistance of PR negative breast cancer.

Objective To study factors influencing injury severity of expressway traffic acci- dents. Methods Data of expressway traffic accidents involving casualties in areas around Hangzhou during 2005-2006 were collected and analyzed by non-conditional simple and multiple logistic regression analysis. Results (1) During 2005-2006, there were 220 traffic crashes involving 327 eases, of which there were 64 deaths (19.6%), 121 severe injuries (37.0%, ISS≥16 points) and 142 slight and mod- erate injuries (43.4%, 1 point≤ ISS≤15 points). (2) Non-conditional simple logistic regression analy- sis showed that risk factors significantly influencing the injury outcomes of traffic accidents included gen- der, weekday, weather, type of collision, vehicle type, driver category, purpose of vehicle use, purpose of travel and crash responsibility. (3) Non-conditional multiple logistic regression analysis manifested that influential factors were gender, type of collision, driver category and crash respensibihty. Conclu- sion Analysis of expressway traffic accidents data helps identify factors influencing injury severity of ex- pressway traffic accidents may provide suggestions for prevention or decrease of expressway traffic acci- dents.

Objective To explore the relationship between self-efficacy and self-management behaviors of patients with chronic obstructive pulmonary disease (COPD).Methods A total of 350 COPD patients form 5 residents' committees in shanghai were recruited by using a convenient sampling method and were scored using Chinese Self-efficacy Scale (CSES)and the self-management behaviors scale.Spearman's correlation analysis was performed to detect the relation of self-efficacy with self-management behaviors.Results Three hundred and twenty adults were included in this investigation,and their average FEV1/FVC was (57.86 ± 7.06)％,average score of self-efficacy was 74.2 ± 9.5.In self-management behaviors,time spent on physical exercise was (16.2 ± 33.9) minutes per week,and endurance exercises accounted for (109.0±49.0) minutes per week.The score of cognitive symptom management practice was 0.9 ± 1.0 and communication with physicians was 0.7 ± 0.8.Total score of self-efficacy was positively correlated with self-management behavior in each dimension (r values were 0.522,0.407,0.330 and 0.044,respectively ; all P ＜ 0.01).Conclusions Self-efficacy and self-management behaviors of COPD patients need to be improved,and self-efficacy may be related to self-management behaviors.

Objective To investigate the self-efficacy levels and its influencing factors of community-based patients with chronic obstructive pulmonary diseases (COPD).Methods From October 2008 to March 2009,320 community COPD patients were recruited from a Shanghai community.They undertook questionnaires,scale survey and pulmonary function testing so as to investigate the influencing factors of self-efficacy.Results The total scale of self-efficacy was 74.24 ± 9.50 and the level of selfefficacy in 286 cases( 89.4％ )was intermediate.The knowledge of COPD,social supports,forced expiratory volume at 1 second (FEV1)/forced vital capacity (FVC) and self-management level were entered into regression equation and could explain 57.1％ of the total variance of independent variables.Conclusions The knowledge of COPD,social supports,FEV1/FVC and self-management level are the major influencing factors of self-efficacy in the COPD patients.We should improve the knowledge of disease and strengthen the psychological care and social supports so as to improve their quality of life.

Objective To assess the significance of urethral sphincter electromyography (US-EMG) and external anal sphincter electromyography (EAS-EMG) for the diagnosis of multiple system atrophy (MSA).Methods US-EMG and EAS-EMG were performed in 9 patients who were diagnosed as MSA.Duration,motor unit action potentials amplitude,polyphasicity,as well as recruited pattern and amplitude during powerful contraction were recorded and analyzed.Results Among 9 patients who were diagnosed as MSA,7 cases showed neural injury by both US-EMG and EAS-EMG.There was significant difference of electromyographic findings between US-EMG group and EAS-EMG group (average volatility (μV):1063.44 ±499.92 vs 634.89 ±265.07; polyphasic wave:0(0,20％ ) vs 57％ (28％,63％ ) ; t =2.567,P=0.033;t =2.833,P=0.012).Conclusions Although US-EMG may be difficult to perform,US-EMG may have the same specificity as EAS-EMG for the diagnosis of MSA,especially for the diagnosis of MSA patients only with urination disorders,who are involved in Onuf neclear according to some of the abnormal indexes.

Objective To evaluate the clinical,neuroimaging and electrophysiology features of 62 patients with multiple system atrophy(MSA).Methods Sixty-two cases with diagnosis of probable MSA were recruited in a retrospective studied.Clinical,neuroimage and external anal sphincter electromyography (EAS-EMG)data was retrospectively analyzed.Results In 62 cases(44 male and 18 female),the onset age was between 37 and 76.Among them,29 cases(46.8 % )were MSA-A,with orthostatie hypotension as the main clinical manifestation;24 cases(38.7 % )were MSA-C,with cerebellar ataxia ag the main chnical manifestation;9 cases(14.5 % )were MSA-P,with extrapyramidal symptoms as the main clinical manifestation.MRI showed that main lesion of MSA-A was in the cerebellum:that of MSA-C was in the cerebellum,pons and medulla;and that of MSA-P was in the putamen.Fifty-one cases did EAS-EMG and 46 cases showed neurogenie impairments.Nineteen cases were initially misdiagnosed with other diseases.Conclusions MSA is easy to be omitted or misdiagnosed at early stage.The diagnostie rate of MSA can be increased by the combination of clinical expressions,neuroimage,EAS-EMG and other necessary examinations.

Objective To analyze diagnostic evaluation of urethral sphincter electromyography (US-EMGs) for patients with multiple system atrophy (MSA).Methods Totally 15 patients who were diagnosed as MSA were examined as treatment group while 17 non-MSA patients were examined as controls.US-EMGs were performed in the both groups.Spontaneous activities when relax,parameters of motor unit potentials(MUPs) mean duration and amplitude,percentage of polyphasic ware,satellite potential,recruitment potentials and amplitude when strong contraction were recorded and analyzed.Results USEMGs changes of various abnormalities were found in 13 cases (86.7％) in MSA group.There were significant differences of electromyographic findings between the MSA group and control group including MUPs mean duration[(12.79 ±3.18)ms vs (9.49 ± 1.51)ms] and amplitude[(828.53 ±459.89) μV vs (378.76 ± 152.26) μV] as well as recruitment potentials [(11.47 ± 21.55) ％ vs (8.23 ± 10.74) ％] and amplitude [(2.19 ± 1.24) mV vs (0.75 ± 0.42) mV] when strong contraction (all P values ＜ 0.05).Conclusions There is certain value of US-EMGs for the diagnosis of MSA.It could be used as a routine electrophysiological method for the patients who are suspected of MSA.It could be a supplement of externalanal sphincter electromyography.

Objective To reduce birthrate of severe thalassemia children of this area and improve population diathesis.Methods The red blood cell indices analysis was carried out on all of the samples of 2 218 couples.GapPCR and RDB method were used for α-thalassemia genotyping and β-thalassemia genotyping.Results 277 cases of thalassemia (12.49％) were identified among the total cases.220 cases were with α-thalassemia(9.92％),which including 198 cases of--SEA/αα,11 cases of-α37/,7 cases of-α4.2/αα,57 cases were with β-thalassemia(2.57％),the types of mutation were CD41/42 (-TTCT),IVS2nt-654 (C→T),CD17 (A→T),-28 (A→G),TATAbox29 (A→G),CD71/72(+ A).42 carrier couples were detected for thalassemia and the fetuses were subjected prenatal diagnosis:3cases of Bart's edema,7 cases of β-thalassemia homozygote.Conclusions Neonates with major thalassemia can be clarified and even avoided by screening the incidence and types of genicmutations.Thus setting up the system of prenatal screening-prenatal diagnosis-selective abortion is effective to avoid the birth of neonates.And it is vital to improve the quality of human being.

Objective To study the effects of matrine on proliferation, cell cycle and apoptosis of human hepatocarcinoma cell line HepG2 and probe into the mechanisms of its anti-hepatocarcinoma effects.Methods The HepG2 cells were treated with different concentration of matrine (0.0125, 0.02, 0.05, 0.1, 0.2,0.4, 0.8, 1.6 g/L) for different time (24, 48, 72 h), then investigate the effects of matrine on cell proliferation by MTT, and the effects on cell cycle and apoptosis by flow cytometry. Results Matrine can inhibit the HepG2 cells proliferation at the concentration of 0.1 g/L and above in a concentration-dependent and timedependent manner(P ＜0.01). The result of FCM showed that the cell cycle of HepG2 was retarded at G1 phase treated with matrine for 48 h at the concentration of 0.8 g/L [(75.3±6.5)% vs (64.1±6.3)%, P ＜0.05], whereas was retarded at G2 phase treated with matrine for 48 h at the concentration of 1.6 g/L [(29.1 ±9.1)% vs (11.6±2.1)%, P ＜0.01]. The apoptosis of HepG2 cells can be induced by matrine for 12, 24 h or 48 h at the concentration of 0.4, 0.8, 1.6 g/L. Conclusion Matrine can inhibit cell proliferation, interfere cell cycle and inducing apoptosis of hepatocarcinoma cells, which may be involved in the mechanisms of matrine's antihepatocarcinoma effects.

Objective To discuss the clinical and X-ray representations and to improve the knowledge of primary alveolar sarcoma of the bone . Methods The manifestaion of 4 patients with primary alveolar sarcoma of the bone comfirmed by operation and pathology were analyzed retrospectively and relevant literature were reviewed.Results The tumors often located in the long tubular bone and most of them were occurred at the lower limb, The main X-ray features were osteolytic and expansive bone destruction, periosteal reaction was usually absent but soft tissue mass commonly occurred. Pathological characteristics were of typical tumor cell of the aggregating to form solid hest-like or alveolar structure. Conclusion The tumors is rare, this neoplasm is lack of characteristic X-ray features and the finial diagnosis depends on pathology.