Objective To investigate the expression level of Annexin Ⅱ in bronchial lung cancer tissue,alveolar lavage fluid(BALF) and pleural effusion and its value in the diagnosis of lung cancer.Methods From January 2014 to March 2016 in Jingzhou Infectious Disease Hospital,80 cases of patients with pleural effusion of lung cancer (Lung Cancer Group),40 patients with benign pleural effusion (benign group) were chose.The expression level of Annexin of two groups of patients with pleural effusion,BALF were detected and compared.Sixty specimens of department of pathology past (after lung cancer surgery cancer) and 30 cases of previously collected normal lung tissues (normal lung tissue) were collected,differential expression by immunohistochemical staining were compared between the two groups of Annexin Ⅱ protein.Results The positive expression of Annexin Ⅱ in lung cancer was 61.67％ (37/60),higher than that in normal lung tissue of 23.33％ (7/30),the difference was statistically significant(P＜0.001).The positive expression of Annexin Ⅱ in lung cancer patients was significantly correlated with rate of lymph node metastasis and clinical stage of lung cancer(P =0.039,0.029).Group of patients with pleural effusion,BALF expression of Annexin Ⅱ the level was higher than that in benign group(P＜0.001).When the critical value of Annexin in pleural effusion of lung cancer diagnosis was 10.94 μg/L,the sensitivity of diagnosis of lung cancer was 83.47％,the specificity was 80.66％,AUC value was 0.837.The critical value when BALF Annexin Ⅱ in the diagnosis of lung cancer was 52.08 μg/L,the sensitivity of diagnosis of lung cancer was 86.19％,the specificity was 89.22％,the AUC value was 0.898.Conclusion The expression level of Annexin Ⅱ in the BALF and pleural effusion of patients with bronchial lung cancer and lung cancer is increased,and it has a certain clinical value for the differential diagnosis of lung cancer.

Objective To study the efficiacy and safety of transfacet approach decompression to treat thoracic spinal stenosis caused by anterior compression.Methods Thirty-three patients with thoracic spinal stenosis caused by anterior compression were treated in our institution from April 2005 to April 2009.Nineteen patients with more than 12 months follow-up were included in this study.Among of them,10 were male and 9 were female,with the age ranged from 33 to 77 years(mean,55.9 years).The causes of compression for spinal stenosis included ossification of posterior longitudinal ligament(OPLL)in 5 cases,thoracic disc herniation(TDH)in 11 cases,OPLL with ossification of ligamentum flavum(OLF)in 2 cases and TDH with OLF in 1 case.All patients underwent anterior decompression via a transfacet approach combined with anterior fusion and posterior fixation.The modified Japanese Orthopaedic Association(JOA)score system and Nurick Myelopathy grade were used to evaluate the outcomes.Results The operation time ranged from 180 to 480 min,with an average of 299.5 min and the blood loss was varied from 250 to 2200 ml,with an average of 918.5 ml.Among 7 cases with OPLL(including combined with OLF),2 patients developed neurologic deterioration and 1 patient developed cerebrospinal fluid leakage.There were no neurologic deterioration,cerebrospinal fluid leakage and other complications occurred in 12 cases with TDH(including combined with OLF).The follow-up ranged from 12 to 54 months(mean,28.6 months).The preoperative JOA score ranged from 2 to 11(mean,6.3).The JOA score in the last follow-up ranged from 5 to 11(mean,8.6).According to Nurick Myelopathy grade,the preoperative grade was 0 in 2 cases,1 in 2,2 in 4,3 in 5,4 in 2,and 5 in 4.The number of postoperative grade was 6,6,3,3,1 and 0 respectively.Conclusion Satisfactory decompression could be achieved by using transfacet approach for thoracic spinal stenosis caused by anterior compression.The approach is a safe and promising alternative for thoracic spinal anterior decompression.

A sensitive, rapid and specific liquid chromatographic-tandem mass spectrometric (LC-MS/MS) method for quantification of gabapentin in human plasma has been developed. After a single plasma protein precipitation with methanol, gabapentin and metformin (internal standard) were chromatographed on a Inertsil ODS-3 column (50 mm x 2.1 mm ID, 3 microm) with mobile phase consisting of methanol-0.2% formic acid aqueous solution (80:20, v/v) at a flow-rate of 0.2 mL x min(-1). Electrospray ionization (ESI) source was applied and operated in the positive ion mode. Multiple reaction monitoring (MRM) mode with the transitions of m/z 172 --> m/z 154 and m/z 130 --> m/z 71 were used to quantify gabapentin and metformin, respectively. The run time was 2.2 min. The linear calibration curve was obtained in the concentration range of 40.8-8.16x10(3) ng x mL(-1). The lower limit of quantification was 40.8 ng x mL(-1). The intra- and inter-day precision (RSD) was less than 12%, and the accuracy (RE) was within +/-6.4% calculated from quality control (QC) samples. The method was used to determine the concentration of gabapentin in human plasma after a single oral administration of 600 mg gabapentin capsule to 20 healthy male Chinese volunteers. The method was proved to be selective, sensitive, rapid and suitable for pharmacokinetic study of gabapentin in human plasma.

Objective To explore the clinical features, imaging and their diagnosis vaule of Baló's concentric sclerosis (BCS). Methods The clinical manifestation, laboratory examination, neuroimaging characteristics, pathology and follow-up of 12 (2 outpatients and 10 inpatients) cases of BCS were analyzed retrospectively. Results The onset age of 12 patients (male 4, female 8) ranged from 8 to 54 years old (mean 36.8 years). Unconcerned and slowness response were common in the disease onset (7 cases).Other symptoms and signs such as hypophrenia ( 10 cases), limitation of limb or hand movement (8 cases),urinary and fecal incontinence (7 cases), hypo-myodynamia (7 cases), positive pyramidal sign (6 cases)were not rare in course of disease. Eight cases underwent the examination of cerebrospinal fluid myelin basic protein, which increased in 7 cases. Demyelinating change and perivascular inflammatory infiltration were shown in 6 brain biopsies. The involvements of multi-lesions were found in 11 cases. Four patients underwent CT scanning and all the cases showed with hypodense lesions and couldn' t be enhanced. On MRI, all cases appeared round or round-like in shape. Enhanced lesions showed ring-like or half-ting-like shape (8 cases) and concentric ring (3 cases). It's easy to be misdiagnosed as brain tumor (8 cases).Conclusions BCS is a kind of demyelinating disease of subacute or chronic onset accompanied with cognitive disorder being the most common initiating symptoms. It's prone to be misdiagnosed. Diagnosis depends on MRI and corticosteroid treatment is effective. BCS has a good prognosis and presents with benign clinical course.

Objective To study the mechanism of oxidative damage in myocardial tissue after limb ischemia reperfusion (IR), and the protective effects of heme oxygenase-1 on myocardial injury in experimental rats. Method The models of bilateral hind limbs ischemia and reperfusion in rats were established by using tourniquets applied to the roots of both hind limbs until palm blanched and pulseless for 4 hours. A total of 56 SD rats were randomly (random number) divided into 7 groups, namely one normal control group ( n = 8) and 6 ischemia-reperfusion groups as per different lengths of reperfusion time, e. g. 2 hrs, 4 hrs, 8 hrs, 16 h rs and 24 hr ( n = 8 each). The experimental rats were sacrificed after different lengths of reperfusion time. Specimens of myocardium and blood were taken for assays of malonaldehyde (MDA), superoxide dismutase (SOD) and myeloperoxidase (MPO), and pathological changes of myocardium were observed, and the expressions of HO-1 mRNA in myocardium were detected. Data were analyzed with ANOVA. Results (1) Compared with the control group, the levels of serum MDA and myocardial MDA of rats were increased in all IR groups and were higher (P < 0.05), and the levels of MDA reached the peak after reperfusion for 4 hours. The levels of serum SOD and myocardial SOD in rats of all IR groups were decreased and lower than those in rats of the control group ( P < 0.05), and the levels of serum SOD dropped away to the lowest point after reperfusion for 4 hours, and the levels of myocardial SOD fell off to the bottom after reperfusion for 8 hours. The levels of serum MPO and myocardial MPO were significantly increased in rats of all IR groups compared with the control group (P < 0.05). The levels of serum MPO reached peak after reperfusion for 4 hours, and the levels of myocardial MPO were increased to the highest spot after reperfusion for 6 hours. (2) The pathological changes in myocardium showed the most severe damage after reperfusionfor 4-6 hours.(3) After reperfusion for 2 hours, there were no significant differences in the expression of HO-1 mRNA between IR groups and control group (P >0.05), and after reperfusion for 4 hours and over, the expressions of HO-1 mRNA were markedly increased in IR groups and reached peak after reperfusion for 16 hours in comparison with the control group (P < 0.05). Conclusions The activation of neutrophils and free radicals may play a primarily adverse role in myocardial injury after limb IR, and the increase in the expression of HO-1 mRNA lessens the harm effects of IR on myocardium.

Objective To explore the clinical significance of serum concentrations of Cystatin C (CysC) in children with kidney disease in different disease courses. Methods The serum concentrations of CysC, creatinine(Cr) and endogenous creatinine clearance rate(Ccr) were determined in 182 children with kidney disease. They were divided into five study groups:normal renal function group (73 cases), compensatory renal disfunction group (44 cases), non-compensatory renal disfunction group (35 cases), renal failure group(22 cases) and end stage of renal failure group(8 cases). Meanwhile 70 healthy children were involved in control group. Relationships among CysC, Cr and Ccr were calculated and the diagnostic efficiency was assessed by comparing the areas under the ROC curves. Results The serum concentrations of CysC increased in different courses of renal function impairment in children and were significantly related to the severity of impairment. CysC was positively correlated to Cr and negatively correlated to Ccr. The areas under the ROC curves of Cr and CysC were 0.764 and 0.725. Conclusions The serum concentrations of CysC can accurately identify different impairment grades of renal function and the function of glomerular filtration. As an indicator of early reduction of renal function, its sensitivities and specificities are superior to Cr and Ccr. CysC can be a sensitive endogenous marker for glomerular filtration rate determination. With simple, convenient and applicable assays methods, CysC is essential for early diagnosis of children kidney diseases.

Anemia, Hemolytic, Congenital ; etiology ; Female ; Hepatitis ; complications ; Humans ; Infant ; Syndrome

Objective To understand the situation of procrastination and its influencing factors in medical students.Methods The general procrastination scale (GPS),general self-efficacy scale (GSES),achievement motivation scale(AMS),self-esteem scale (SES),self-rating depression scale (SDS) and self-rating anxiety scale (SAS) were applied to 531 medical students,and the influence factors were analyzed with correlation analyses,hierarchical regression and path analysis of SPSS 16.0 and Amos 5.0.Results (1) The scale score of procrastination was between 31-93 and the average score was 55.54±9.68.96.1％ students showed different degree procrastination,with the moderate-severe degree ones accounted for 45.3％.(2)Procrastination was positively correlated to anxiety(r=0.331) and depression(r=0.415),but negatively correlated with self-efficacy(r=-0.247) and selfesteem(r=-0.328).(3)The hierarchical regression revealed that self-efficacy,self-esteem,and depression could significantly predict procrastination,which increased the explained variance 6.1％,6.1％ and 6.3％ respectively.(4) Path analysis showed that the self-esteem had direct effect on procrastination (path coefficient 0.12);self-efficacy had indirect effect on procrastination through self-esteem (path coefficient 0.21).Depression had direct effect on procrastination (path coefficient 0.34) and indirect effect to the procrastination through the self-esteem (path coefficient 0.50).All the fitting indices reached statistical standards.Conclusion Procrastination was common in medical students and self-efficacy,self-esteem,depression had direct or indirect effect on it.

Objective To observe the effect of intra-articular injection of dehydroepiandrosterone (DHEA)on the experimental osteoarthritis in rabbits and study the mechanism.Methods Forty rabbits un derwent unilateral anterior cruciate ligament transection(ACLT)and then divided into two groups randomly. 100?mol/L DHEA resolved in the dimethylsulphoxide were injected into the knees of experimental rabbits 4 weeks after transection,once a week for five weeks.Rabbits in the control group were treated under the same schedule using dimethylsulphoxide.All rabbits were killed 9 weeks after ACLT and the knee joints were evalu- ated by gross morphology and histology.The mRNA expression of metalloproteinases-3(MMP-3),tissue in- hibitor of metalloproteinases-1(TIMP-1)and interleukin-lbeta(IL-1?)in the cartilage and synovium was analyzed using reverse transcription polymerase chain reaction(RT-PCR).Results Gross morphologic in- spection and histological evaluation showed that the extent and grade of cartilage and synovium damage in the experimental group were less severe than the control group.The mRNA expression of MMP-3 in cartilage and synovium decreased significantly in the experimental group(both P＜0.05).The mRNA expression of TIMP-1 in cartilage and synovium increased significantly in the experimental group compared with that in the control group(both P＜0.05).No significant difference of IL-1?mRNA expression in cartilage was found between the experimental and the control groups(P＞0.05).The mRNA expression of IL-1?in the synovium was signifi- cantly suppressed in the experimental group compared with that in the control group(P＜0.01).Conclusion DHEA protects against cartilage degradation,alleviates synovium inflammation and inhibits the progression of osteoarthritis in the experimental model.Down-regulation of MMP-3 and up-regulation of TIMP-1 in cartilage and synovium and IL-1?in the synovium may be the mechanism of the protective effect of DHEA on os- teoarthritis.

Objective To study the possible relationships between expression of matrix metalloproteinase(MMP)2,9 and the pathogenesis of preeclampsia in which trophoblast invasion is impaired. Methods MMP-2,9 expression were detected by immunohistochemistry streptavidin-biotin complex (SABC)method in 20 normal term placentae and 20 preeclampsia placentae,respectively.In addition, mRNAs for MMP-2,9 were analyzed by real time PCR in both groups.Results The intensities of both MMP-2 and MMP-9 immunostaining in preeclampsia placentae were significantly declined compared to those of normal term placentae(P