Objective:To investigate the expression of multidrug resistance (MDR1) gene and multidrug resistance-associated pro-tein (MRP) gene in patients with non-small-cell lung cancer (NSCLC) and its relation to histopathological type. Methods:The MDRi and MRP genes were determined by reverse transcription-polymerase chain reaction (RT-PCR) in 48 NSCLCspecimens. Results:The positive rates of the MDR1 and MRP gene expression were 62.5％ and 66.7％ respectively in the48 patients. Twenty-one of the 48 NSCLCs (43.8％) expressed both MDR1 and MRP genes. The positive rates of the MRPgene expression in squamous cell carcinoma was significantly higher than those in adenocarcinoma (P＜0.01), and therewas no significant difference in MDR1 gene expression between the two groups (P＞0.05). Conclusion: The MDR1 andMRP gene expressions were both or respectively in the NSCLCs. The incidence of the MRP gene expression in squamous cellcarcinoma was higher than that in adenocarcinoma.

Objective To explore an effective method of repairing the old rupture of patellar tendon. Methods We designed a new 井-shaped apparatus for traction and fixing which was to be used, under the dynamic conditions, to reduce the patella, loosen the quadriceps m. of thigh, repair the tendon of knee cap and facilitate postoperative exercises with the fixing apparatus on. Results We used the apparatus to repair the tendon of knee cap in 6 cases. The follow up of 8 to 56 months (averaging 26 months) showed that their functions of the knee joint were all satisfactory. Conclusions The 井-shaped external fixation device can be used under the dynamic conditions to repair the old rupture of patellar tendon with the advantages of little contracture of the knee cap and quadriceps m. of thigh, easy fixation after repair and suture, and early exercise of the knee joint. This novel method is simple and recommendable.

Objective To investigate the concentration changes of vascular endothelial growth factor(VEGF), nitric oxide(NO) and endothelin (ET) in elderly patients with obstructive sleep apnea syndrome (OSAS) combined with eerebrovascular disease.Methods One hundred and thirty-two subjects were divided into four groups: OSAS with cerebrovaseular disease group (OC group), OSAS without cerebrovascular disease group (O group), cerebrovascular disease without OSAS group (C group) and normal control group (N group).The concentrations of VEGF, NO and ET in the plasma were compared in each subgroup.Results The concentration of VEGF was significantly increased in OC group and O group compared with C group and N group[(195.34±56.7)ng/L, (162.34±48.7)ng/L, (156.4 4±51.8) ng/L, (114.1 ± 54.2) ng/L, F= 21.02, P< 0.05].The concentration of NO was increased gradually in OC group, C group, O group and N group[(62.3±4.9)mmol/L,(64.7±5.1) mmol/L, (66.2± 4.2)retool/L, (77.5 ± 6.8) mmol/L, F= 17.35, P<0.05], and the concentration of ET was decreased gradually in OC group, C group, O group and N group[(59.8±9.6)ng/L, (56.5±4.3)ng/L, (54.7±7.9)ng/L, (37.2±8.5)ng/L, F= 4.27, P<0.05].Conclusions The concentrations of VEGF and ET are increased and the concentration of NO is decreased in patients with OSAS.Patients with OSAS combined with cerebrovascular disease have higher VEGF and ET concentrations and lower NO concentration than in patients with simple OSAS.The results indicate that vascular endothelial dysfunction may play an important role in the development of cerebrovascular disease in patients with OSAS.

Objective: To evaluate the relationship between the change of left ventricular mass and arterial stiffness in the aged patients with diabetes mellitus. Methods: The pulse wave velocity (PWV) and left ventricular mass index(LVMI)were used to estimate the left ventricular mass and arterial stiffness. The relationship between LVMI and PWV and other influencing factors were evaluated with univariate analysis and stepwise regressive analysis in 105 patients with diabetes mellitus. The value of PWV was compared in the subjects of the left ventricular hypertrophy and the non- left ventricular hypertrophy groups. Results: LVMI was positively correlated with PWV, systolic blood pressure, pulse pressure,medical history and body mass index (the values of r were 0.821, 0.792, 0.799, 0.664 and 0.241 respectively,P ＜ 0.01 or P ＜ 0.05). A stepwise regression analysis was used to assess the combined influence of variables on left ventricular hypertrophy. The model included the following variables: PWV, systolic blood pressure and diabetes mellitus medical history. PWV value was significantly higher in patients with left ventricular hypertrophy than that of the patients without left ventricular hypertrophy(t = 9.109,P < 0.01). Conclusion: The increased arterial stiffness is one of the important factors which lead to the increased left ventricular mass index in aged patients with diabetes mellitus.

Objective To investigate the impact of obstructive sleep apnea hypopnea syndrome (OSAHS) on development of nonalcoholic fatty liver disease (NAFLD) in the non-obese elderly.Methods A total of 91 non-obese elderly patients were divided into 3 groups,29 cases with mild to moderate SAHS (mild-to-moderate OSAHS group),31 cases with severe OSAHS (severe OSAHS group),30 cases without OSAHS and matched with age,sex and BMI (control group).The changes in NAFLD severity index including serum liver enzyme levels,Type Ⅲ procollagen peptide (PⅢ P)and liver/spleen CT ratio were observed,and the influence factors for the changes were analyzed.Results Serum alanine aminotransferase (ALT),aspartate aminotransferase (AST)ALT/AST ratio and serum PⅢ P levels were significantly higher in severe OSAHS group than in mild-to-moderate OSAHS and the control group(F=25.71,15.15,18.64,respectively,all P＜0.01).There was no significant differences in serum liver enzyme ALT,AST and P Ⅲ P levels between mild-to-moderate OSAHS and the control groups(all P＞0.05),and the ALT/AST ratio was significantly higher in mild-to-moderate OSAHS group than in the control group(P＜0.01).The Liver/spleen CT ratio was significantly lower in OSAHS groups than in control group,while the ratio was lower in severe OSAHS group than in mild-to-moderate OSAHS group(all P＜0.01 or 0.001).Serum PⅢ P level was significantly higher in OSAHS groups than in control group(F=31.46,P＜0.01),while PlⅢ P levels were not significantly different between the mild-to-moderate OSAHS group and the control group(P ＞ 0.05).The correlation analysis showed that the liver/spleen CT ratio in OSAHS group was negatively correlated with AHI(r=-0.785,P＜0.001),but was positively correlated with the lowest oxygen saturation(r=0.517,P=0.001).The ALT/AST ratio and serum P Ⅲ P level in OSAHS patients were positively correlated with AHI (r=0.463,0.770,both P＜0.001),but were negatively correlated with the lowest oxygen saturation (r=-0.395,-0.514,P＜0.01 or 0.001).The multiple regression analysis showed that AHI was the only variable that affected liver/spleen CT ratio and serum P Ⅲ P level in OSAHS patients.Conclusions OSAHS patients in the non-obese elderly are always complicated with NAFLD,characterized by abnormal liver enzymes,hepatic steatosis and fibrosis.The severity of lesion is increased with the deterioration of OSAHS.AHI may play an important role in the development of NAFLD in the non-obese elderly with OSAHS.

Objective To explore the variation of engine exhausts and its secondary pollutant in the daytime. Methods The concentration of engine exhausts(NOx) and its secondary pollutant(O3) were determined during 7:00-17:00, Apr 10th and 12th, 2005. The ratio of air pollutants to vehicle flow (KNOx, KO3) was analyzed to reflect the variation of air pollutants concentration in the daytime. Results The values of KNOx, and KO3 showed the same trend during 7:00-9:00 and 17:00-18:00, the opposite trend during 11:00-15:00. The peak value was observed at 12:00 for KNOx with the lowest level, at 13:00 for KO3 with the highest level. Conclusion Air pollution by secondary pollutant from engine exhausts is associated with sunlight.

Objective To provide an comprehensive evaluation of the correlation between sleep apnea hypopnea syn?drome (SAHS) and nonalcoholic fatty liver disease (NAFLD). Methods The various case-control studies on the relation?ship between SAHS and NAFLD were retrieved from all kinds of large-scale databases at home and abroad (including Web of science, EMbase, Pubmed, Springer Link, EBSCO Databases, CNKI, CQVIP, Wanfang Data). The quality evaluation of in?cluded studies was made by two independent researchers. RevMan 5.1 and stata 12.0 software were used for meta-analysis. Results A total of 11 qualified documents were included in this study. Meta analysis showed that the relative risk of NAFLD was increased in SAHS patients than non-SAHS patients (RR=2.82, 95%CI:2.03-3.92, P<0.01). The serum ala?nine aminotransferase (ALT) increased in SAHS patients (SMD=0.53, 95% CI:0.02-1.05, P < 0.05). Compared with non-SAHS patients, the apnea-hypopnea index (AHI) was significantly higher in SAHS patients combined with severe NAFLD than those combined with mild NAFLD (SMD=1.42, 95%CI:0.12-2.72, P < 0.05). Conclusion The risk of NAFLD in?creases in SAHS patients. The severity of NAFLD is relatively higher with the severity of intermittent hypoxia.

Objective To explore the role of Foxp3+ T cells (Tregs) in liver injury induced by chronic intermittent hypoxia. Methods Thirty-two male Wister rats were divided into four groups:control group (A), high-fat diet group (B), intermittent hypoxia group (C), and high-fat diet and intermittent hypoxia group (D). After 4 weeks, blood samples were collected and livers were surgically removed. Using the standard automatic clinical analyzer to test serum levels of total cholesterol (TC), low density lipoprotein cholesterol (LDL- C), alanina aminotransferase (ALT) and aspartato aminotransferase (AST). The MDA content of liver tissue was measured by colorimetrc method. The levels of TNF-αand IL-1βwere measured by radiommunoassay, and the expression of Foxp3 protein was measured by Western blotting technique. Results Serum levels of TC and LDL-C were significantly higher in B group than those of A, C and D groups, and which were higher in D group than those of A and C groups (P<0.05). There were no significant differences in serum levels of TC and LDL-C between A group and C group. Serum levels of ALT, AST, MDA, TNF-αand IL-1βwere significantly higher in C group than those of A group, and which were significantly higher in D group than those of A, B and C groups (P<0.05). There were no significant differences in these indicators between A group and B group, and between B group and C group. Foxp3 protein expression in liver was significantly lower in D group than that of other groups (P<0.05). Conclusion Foxp3+T regulatory cells involve in the regulation of hepatic injury induced by chronic intermittent hypoxia on the basis of a high-fat diet, and which may play an important role in this process of protective immune response.

Clinical data of one patient diagnosed as IgG4-related retroperitoneal fibrosis was analyzed.IgG4 and retroperitoneal fibrosis were used as the key words to search literatures from PubMed and Wanfang Database.Clinical data of 27 cases with IgG4 retroperitoneal fibrosis,including clinical manifestation,diagnostic basis,therapeutic method and prognosis,which were retrieved through literatures,were analyzed.A 82-year-old male patient presented with urinary tract obstruction and renal insufficiency.Imaging examination revealed a retroperitoneal irregular lump shadow,and showed chronic inflammation of soft tissues in posterior peritoneum with fibrosis by biopsy pathology.The IgG4-positive plasmocyte infiltration was found by immunohistochemical method.The serum level of IgG4 was significantly increased,which was in accord with IgG4-related retroperitoneal fibrosis.After treatment with methylprednisolone,retroperitoneal lump shadow was obviously dissipated.The serum level of IgG4 became normal.27 cases with IgG4-related retroperitoneal fibrosis were searched through literature retrieval,with 19 confirmed cases,3 suspected cases,and 5 suspicious cases.Male accounted for 92.6％ (25/27),and the average age was 67.6 years old.The cases with the involvement of extraperitoneal organs accounted for 37.0％ (10/27).The misdiagnosis rate was 55.6％ (15/27).23 cases took effective therapy with glucocorticoids.IgG4-related retroperitoneal fibrosis is an orphan disease,which can be misdiagnosed easily.The diagnosis is made with histopathological examination and determination on the serum level of IgG4.The therapy with glucocorticoids is effective.

Objective To investigate the effect of chronic intermittent hypoxia (CIH) on myocardial tissue pathology,oxidative stress and apoptosis in rat fed a high-fat diet,and to explore the possible mechanism of CIH induced cardiomyocyte injury.Methods A total of 24 male Wistar rats were randomly divided into 3 groups (n=8 each).The control group was fed common rat forage,the high-fat group was fed high-fat forage,and the high-fat plus intermittent hypoxia group was fed high-fat forage combined with a 7h/d intermittent hypoxia treatment.The changes of myocardial tissue pathology and ultrastructure of cardiomyocyte,and the activities of apoptosis regulating factor cysteine-containing aspartate-specific proteases-3 (caspase-3) and oxidative stress marker myeloperoxidase (MPO) were observed in the 3 groups after 4 weeks of treatment.Results There were significant differences in the activities of caspase-3 and MPO among the three group (F=89.94,71.24,both P＝0.001).The activities of caspase-3 and MPO were lower in the control group than in the high-fat group and in high fat plus intermittent hypoxia group [(0.21±0.06) vs.(0.80±0.11),(1.15±0.21),(3.20±0.58) vs.(10.87±1.96),(13.17±2.22),P＜0.01].The activities of caspase-3 and MPO were higher in the high-fat plus intermittent hypoxia group than in the high fat group[(1.15±0.21) vs.(0.80±0.11),(13.17±2.22) vs.(10.87±1.96),P＜0.01].No abnormal findings in the structure of cardiomyocyte were observed in the control group,while multiple pathologic damages in cardiomyocyte were detected in the high-fat group,and more obvious injuries in the high-fat plus intermittent hypoxia group.Conclusions The pathologic damages to cardiomyocyte are more serious in high fat and intermittent hypoxia group than in the high-fat group.Apoptosis induced by oxidative stress may play an important role in the pathogenesis of these injuries.