Purpose:To clarify roles of overexpression of phosphorylated Akt(p-Akt) and loss of phosphatase and tensin homologue deleted on chromosome 10(PTEN) expression in biological behavior of non-small-cell lung cancer(NSCLC). Methods:Immunohistochemical staining was used to determine the expression of p-Akt and PTEN in 20 cases of normal lung tissues and 102 patients with NSCLC.Results:Negative p-Akt expression and positive PTEN expression were found in normal lung tissues, while the positive incidences of p-Akt expresssion and loss of incidences of PTEN expresssion in NSCLC were 41.2% (42/102) and 46.1% (47/102)respectivtly.The overexpression of p-Akt and loss of PTEN expression were correlated to degree of differention of cancer, metastasis(including lymph node), and clinical stages. A significant negative correlation was observed between expression of p-Akt and PTEN(Phi r=-0.425,P

Objective To discuss total vertebrectomy and spine stability and reconstruction by pos-terior ap proach for thoracic vertebra tumor and pedicle screw system fixation and intervertebral fusion.Methods Eighteen patients of 3males and15females of thoracic total vertebral tumor were operated in this group.The age of the group were from14to58years old,with the average of 23years.There were4aneurysmal bone cysts,2hemangiomas,2osteoblastomas,1neurilemomas,5giant cell tumor,1solitary myeloma and3metastatic thoracic vertebra tumors.The locations of the tumors was T 4 in1case,T 5 in1case,T 6 in2cases,T 8 in4cases,T 9 in3cases,T 10 in4cases,T 11 in2cases and T 12 in1case respectively.Pre-operative Frankel classification was grade A in6cases,B in7cases,C in3cases and E in2cases.Cir-cumferential decompression was performed with total spondylectomy through one-stage posterior ap proach.Anterior verte bral reconstruction was provided by autograft(ribs or ilium)bone or metallic cage;Posterior reconstruction was achieved by pedi cle screws system of CD or TSRH,Scofix fixation and auto graft fusion.Results The mean follow-up was8months,ranging from3months to24months.Twelve of 16cases with neu ro logical dysfunction were recovered completely,1case recovered from Frankel grade A to C,2cases from grade A to D,1case from grade B to D.The patient with neurilemmoma recurred and became ma lig nant after20months of operation and died4months later.One case of metastatic tumor of lung cancer sur vived6months after opera tion.One patient with giant cell tumor recurred.The other patients were still alive in the latest follow-up.There were no instruments breakage and spinal instability during the follow-up.Conclusion If the thoracic total vertebral tumor compress spinal cord se riously,the patients should be indi cat-ed for surgical treatment constructively.Total vertebrectomy followed by one-stage posterior approach re con-struction could relieve the com pression caused by tumor and reconstruct the stabilization of spine effectively.

Purpose:To investigate the feasibility of detecting intraoperatively blue sentinel lymph node (BSLN) in patients with cervical cancer and to evaluate the accuracy of predicting pelvic lymph node disease. Methods:Between May 2002 and Jun 2003,29 patients with cervical cancer FIGO stage Ⅰb ( n =3),stage Ⅱa ( n =21),stage Ⅱb ( n =5) underwent BSLNs detection. During operation 4ml of methlene blue or lymphazurin was injected into the cervical tissue around the tumor or 3′,6′,9′,12′ of normal appearance of cervix about 0.5cm deep. Blue lymph duct and BSLNs were observed and located carefully for 10 minutes. Tumor characteristics,surgical findings,and location and number of BSLNs were recorded and correlated with pathologic results to get the accuracy and false-negative rate.Results:Among 29 patients underwent this technique,BSLNs were seen in 24 patients. Total detection rate was 83%(24/29). Location of BSLNs was mainly in obturator and internal iliac group. BSLNs located in left internal iliac group in 11 patients and 13 patients in right internal iliac group,10 patients in left obturator group,and 14 patients in right obturator group. 3 patients had BSLNs in both iliac and internal iliac group. Among 24 patients with BSLNs,there were 6 patients with lymph node metastases. 5 patients had only SLN metastases and one patient had both SLN and other lymph node disease. 18 patients had neither SLNs nor other pelvic lymph nodes metastases. The false-negative rate was 0.Conclusions:Intraoperatively BSLN detection was feasible and safe. Sentinel lymph node was representative of the lymphatic basin.

Objective To determine the relationship between HBeAg and HBV DNA levels and grading of liver inflammation in patients with chronic hepatitis B. Methods Serum HBeAg and HBV DNA were assayed by MEIA and PCR in 74 patients with HBeAg-negative and 73 patients with HBeAg-positive chronic hepatitis B who had undergone liver biopsy and pathological grading. Results The serum HBV DNA levels in 27 patients(36%) HBeAg-negative chronic hepatitis B were higher 10~5 copies/ml.The number of patient at the HBV DNA level increase along with G1～G4 grading ascendant.The correlation between two factors has statistically remarkable significance.Those serum HBeAg quantitative levels are 0～29 PEIU/ml. The number of HBeAg quantitative-positive patients increase also along with G1～G4 grading ascendant and the correlation between two items has statistically significance.However,there are no relationship between serum HBeAg and HBV DNA and G1～G4 grading in 73 patients with HBeAg-positive chronic hepatitis B whose HBV DNA levels are higher than 10~5 copies/ml. Conclusions Serum HBV DNA level is the indicator by which grading of liver inflammation can be judged in the patients with HBeAg-negative chronic hepatitis B and former is positively interrelated with latter significantly.That Serum HBeAg level is low but HBV DNA duplicate actively may indicate that there is C-zone mutation in 36% patients with HBeAgnegative chronic hepatitis B.Serum HBV DNA level cannot reflect grading of liver inflammation in the patients with HBeAg-positive chronic hepatitis B.

Objective To Investigate the important perennial inhaled allergens for children with allergic asthma in Daqing.Method Analyzing the data from 134 patients between 4 and 14 years of age with asthma who have a positive skin test to perennial aeroallergen and also have been carried out Allergen-specific immunotherapy in the last four years.Results The important perennial inhaled allergens for children with allergic asthma in Daqing were house dust,dust mites,polyvalent molds Ⅰ(PMⅠ),animal epithelium and polyvalent molds Ⅱ(PMⅡ).Among them the most important allergens were house dust and dust mites.Conclusion It will have practical significance to prevent and treatment children's asthma by taking measures for these allergens.

Objective To investigate the feasibility of sentinel lymph node (SLN) detection in patients with cervical cancer undergoing radical hysterectomy Methods Twenty patients with cervical cancer at stage Ⅰb ( n =3), stage Ⅱa ( n =12) and stage Ⅱb ( n =5) underwent SLNs detection by using blue dye Four ml of methlene blue or lymphazurin was injected into the cervix at 4 points around the tumor at the time of radical hysterectomy and bilateral pelvic lymphadenectomy Tumor characteristics, surgical findings, and specific locations of lymphatic dye uptake were recorded and correlated with final pathology results Results Among 20 patients underwent this detection, dye uptake was seen in 18 patients Total number of SLNs were 33 Eighteen SLNs identified located in right pelvic and 15 SLNs located in left The SLNs were successfully detected in 78% patients (14/18) Six patients (33%) were diagnosed with lymph node metastases and there were 5 patients with positive nodes in the group of SLN Two patients had both positive SLNs and pelvic lymph nodes Three patients had positive SLNs only The predictive rate was 100% and the false negative rate was zero Conclusion SLN detection undergoing radical hysterectomy is feasible and safe, however, the detection rate of SLN needs improvement

Liver metastasis is the leading cause of death from colorectal cancer (CRC).Multidisciplinary team model has become standard strategy for the diagnosis and treatment of colorectal liver metastases (CRLM),making individualized treatment through precise staging and molecular typing.Preoperative hepatic and regional arterial infusion chemotherapy and portal vein chemotherapy during surgery can reduce the incidence of liver metastases for stage Ⅲ CRC.Surgical resection of CRLM has been accepted by all scholars,and can be performed by minimally invasive surgery.The criteria for hepatic resection of CRLM have been extended including complete tumor resection,negative resection margin and adequate remnant liver volume.Simultaneous resections of primary tumor and liver metastases are safe and feasible.However,neoadjuvant chemotherapy is still controversial.For unresectable liver metastases,conversion therapy should be implemented to make the liver metastases become resectable.For unconvertible and unresectable CRLM,aggressive and comprehensive treatment is required to control the disease progression.

Objective The aim is to inquiring into the diagnosis and discrimination of systemic lupus erythematosus (SLE) complicated with centric nervous system (CNS) infection.Method The retrospective analysis of 14 patients with SLE and CNS infection was made.Results These patients were treated by corticosteroid for a long time before CNS infection.There were 4 patients with cryptococcal meningitis,3 with suppurative meningitis,5 with tuberculosis meningitis,1 with encephalopyosis and 1 with unclear diagnosis.Conclusion Pathogenic microbiological assay of cerebrospinal fluid is a reliable basis for diagnosis of SLE with CNS infection.The diagnosis of patients without pathogenic organism depends on original infection,manifestations,difference of cerebrospinal fluid and head CT.The differentiation of SLE complicated with CNS infection from SLE encepalophathy is important.

Objective To investigate the organ function survival and late effects and secondary malignancy of childhood neuroblastoma (NB) with high intensity comprehensive treatment.Methods A total of 23 children with NB who received comprehensive treatment in Shanghai Children's Medical Center from December 1998 to October 2010 were enrolled.All tests were formulated according to the Children's Oncology Group (COG)'s guidelines with the approval of parents.The late side effects were graded by CTCAE v3.0,and hearing loss related to platinum was graded by Brock and Chang.Results The median follow-up was 96 (65-170) months.All the patients had at least one late side effect.The occurrence rate of 1-2 adverse effects was 100％,and 17.4％ (4/23 cases) of patients had grade 3-4 adverse effects.90.5％ of children (19/21 cases)developed hearing loss on both sides.Eleven children (52.4％,11/21 cases) developed dental abnormities,comprising microdontia,missing teeth,root stunting and enamel hypoplasia.9.5％ of children (2/12 cases) had scoliosis.42.8％ of children (9/12 cases) developed hypogonadism with the approval of parents or delayed growth.47.4％ of children (9/19 cases) had abnormal respiratory function.36.8％ of children (7/19 cases)had abnormal cardiac function.33.4％ of children (7/21 cases)developed renal damage.23.8 ％ of children (5/21 cases) had abnormal liver function.66.7％ of children (14/21 cases) had low level of cortisol,but adrenocorticotrophic hormone was normal.All children had normal function of thyroid.Three children developed secondary malignancy:leukemia,malignant fibroma and liver tumor.Conclusions The incidence of long-term adverse reactions of patients with neuroblastoma treated with high intensity comprehensive treatment is very high and the patients may have adverse effects,like hearing loss,dental abnormality,cardiopulmonary function abnormality,musculoskeletal problems and secondary malignancy.The upmost importance is to establish long-term follow-up program to detect the life quality of children and amend current therapeutic schemes improve life quality.