Objective:To explore relation of TCM syndrome types in patient with sexual hormones of hyperplasia of mammary glands,so as to establish objective indexes of TCM syndrome types of hyperplasia of mammary glands.Methods:112 cases of hyperplasia of mammary glands were divided into 3 types:stagnation of liver-Qi,intermingled phlegm and blood stasis,disharmany of thoroughfare vessel and conception vessel.Level of estradiol(E_2),progestin(PT),testosterone(TT),prolactin(PRL),follicle- stimulating hormone(FSH)and luteotropic hormone(LH)during ovulatory period in the patients were determined.The relation of hormone level with TCM syndrome types was analyzed.Results:Level of LH and E_2 decreased,PRL and PT increased and level of TT and FSH did not significantly change during ovulatory period in the patient of hyperplasia of mammary glands.LH and E_2 level in the patients with stagnation of liver-Qi or intermingled phlegm and blood stasis was significantly lower than normal values,and the level of PRL and PT was significantly higher than that of normal values.The level of LH and E_2 was also lower than the normal value in the patient with disharmany of thoroughfare vessel and conception vessel,but the level of FSH was significantly higher than normal value.Conclusion:The patient of hyperplasia of mammary glands during ovulatory period manifests endocrine dysfunction,and the patients with different TCM syndrome are different in secretion of sexual hormones; Changes of sexual hormones can be used as objective indexes of TCM syndrome types and basis of clinical medicinal application.

Objective To evaluate the application value of circulating tumor cell ( CTC ) in the differential diagnosis of solitary pulmonary nodule ( SPN ) . Methods Peripheral blood samples were collected from 134 patients with solitary pulmonary nodule in Shanghai Chest Hospital from September 2013 to January 2015, including 80 patients with malignant nodule and 54 with benign nodule.CTC levels of the above subjects were detected by ligand-targeted polymerase chain reaction ( LT-PCR ) assay, and serum carcinoembryonic antigen ( CEA ) and cytokeratin 19 fragment ( CYFRA21-1 ) were detected by flow fluorescence assay.Results By Mann-Whitney U Test, the CTC levels of malignant SPN patients [11.06 (8.77-14.41)units/3 ml] were significantly higher than those of benign SPN patients [6.65(4.49 -7.84)units/3 ml] (Z=-6.217,P<0.001).The sensitivity and specificity of differential diagnosis of SPN for CTC were 80%(64/80) and 85%(46/54) respectively.According to the diameter of SPN, the patients were divided into three groups to evaluate the diagnostic value of CTC in SPN with different size .For SPN with diameter less than 8 mm, the sensitivity and specificity of CTC were 6/9 and 4/5 respectively .For SPN with diameter between 8 mm and 20 mm, the sensitivity and specificity of CTC were 83%(35/42) and 85%(29/34).For SPN with diameter greater than 20 mm, the sensitivity and specificity of CTC were 79%(23/29) and 13/15.Conclusion Comparing with the traditional tumor markers, CTC could provide more clinical value in the differential diagnosis of solitary pulmonary nodule .

Objective]Through judging the constitutional types of traditional Chinese medicine(TCM) of acute mastitis patients, do statistics and analysis of the distribution of the acute mastitis patients’constitutional types of TCM, and study their laws, in order to provide guiding basis of constitutional theory of TCM for preventing and early treating mastitis. [Method] By means of questionnaire method, judge the constitutional types of TCM of 77 acute mastitis patients according to the classification and judgment of constitution of TCM ,and analyze the results by statistical methods. [Results] The number of the constitutional types of TCM of 77 acute mastitis patients from high to low is as follows: dampness-heat constitution is 65 cases, energy-stagnant constitution is 52 cases, yang-deficiency constitution is 51 cases, qi-deficiency constitution is 37 cases, yin-deficiency constitution is 34 cases, phlegm-dampness constitution is 32 cases, blood-stasis constitution is 29 cases, normal constitution is 12 cases, and special-natural constitution is 7 cases. Individuality constitution has 9 cases, two and three mixed constitution each has 12 cases, four and five mixed constitution each has 9 cases, six mixed constitution has 14 cases, seven mixed constitution has 11 cases, eight mixed constitution has 1 case. In the main constitutional types of TCM of 77 acute mastitis patients, dampness-heat constitution(54 cases, 70.13%) is most, followed by normal constitution(12 cases, 15.58%) and yang-deficiency constitution(5 cases, 6.49%). In the individuality constitution and two mixed constitution, the proportion of dampness-heat constitution(60 cases, 39.47%) is highest, and that of yang-deficiency constitution(34 cases, 22.37%) is also higher. This shows that: 1. Dampness-heat constitution is the most common constitutional type related with the occurrence of acute mastitis, and yang-deficiency constitution is the second. 2. The acute mastitis patients have a variety of constitutional types such as dampness-heat constitution, energy-stagnant constitution etc. Mixed constitution is common and complex. May be it is associated with the particular period of postpartum lactation period. [Conclusion] Constitution as internal factors of disease has an important influence on occurrence and development of acute mastitis. It has great meaning to adjust prejudiced constitutional types of TCM as dampness-heat constitution and yang-deficiency constitution for preventing and early treating acute mastitis. This reflects the TCM thought of“treat unoccurred disease”.

Objective To explore the correlation between the TCM syndromes of mammary hyperplasia patients and their sex hormones,molybdenum target radiography image to establish the objective indexes for its syndrome differentiation.Methods According to the TCM syndrome differentiation,the 346 patients with mammary hyperplasia were diagnosed liver qi stagnation syndrome,phlegm and blood-stasis syndrome,and chong and ren dysfunction syndrome.Their pituitary gonad stimulating hormones,including estradiol(E2),progesterone(PP),testosterone(PT),prolactin releasing hormone(PRL),follicle-stimulating hormone(FSH),and luteotropic hormone(LH) were measured during ovulatory period.At the same time,the molybdenum target radiography examination was given.Results The level of FSH,LH and E2 in mammary hyperplasia patients during ovulatory period was obviously lower,the level of PRL and PP was obviously higher,and the level of PT was not obviously changed.The comparison among groups showed that the level of FSH in chong and ren dysfunction patients was higher than that in liver qi stagnation patients,but the level of LH of the two was just opposite;the level of E2 was lower in an order of liver qi stagnation,phlegm and blood-stasis,and chong and ren dysfunction patients;the molybdenum target radiography image showed that there was mainly the lobular hyperplasia in liver qi stagnation and phlegm and blood-stasis patients and then the nodular type;but there was mainly nodular hyperplasia in chong and ren dysfunction patients and then the lobular type.Conclusion The pituitary gonad stimulating hormones of mammary hyperplasia patients were disordered in the duration of ovulatory period.The level of sex hormones and change of molybdenum target radiography image were different in different TCM syndromes and they can be used as one of the objective indices in TCM syndrome differentiation for diagnosis.

The blood and urine estrogen (E2) and progesterone (P) were measured in 133 patients with fibrocystic disease (FCD) of breast and 17 healthy subsjects during menstrual cycle phases. According to the characteristics of the secretion, the patients were divided into five types. Type A (54 patients): The secretion peak of E2 and P appeared beforehand and secretion of P was prolonged and E2 decreased significantly in ovulatory phase. Type B (16 patients): The secretion peak of E2 disappeared in ovulatory phase although the secretion of P was normal. Type C (16 patients): The secretion peak of P deferred its disappearance and maintained at higher level till pre-menstrual period and sc did E2: the secretion of E2 decreased in ovulatory phase. Type D (41 patients): The secretion peak of E2 in ovulatory phase was normal but could not return to normal level in pre-menstrual period, in the mean time the secretion of P also deferred its disappearance. Type E (6 patients): There was no secretion of P and the blood and urine concentrations of E2 deccreased in all phases. The average value of E2 in the patients with FCD was compared with that of healthy subjects. The concentration of E2 in all the patients increased in follicular and pre-menstrual phases. However, the concentration of E2 in ovulatory phase was much lower in the patients than in healthy subjects.

AIM:To investigate the protective effects of astrocyte protein phosphatase 2A (PP2A) up-regula-tion on APP/PS1 double transgenic mice.METHODS:An eGFP-wtPP2A lentivirus with glial fiber acidic protein promoter was constructed to specifically increase PP2A expression in the astrocytes.The mice were divided into wild -type mice +vector virus group (Con), APP/PS1 transgenic mice +vector virus group (APP/PS1) and APP/PS1 transgenic mice +eGFP-wtPP2A lentivirus group (PP2A) by lateral ventricular injection of the lentivirus.Four weeks after injection of the vi-rus, the immunofluorescence of brain slices were used to detect the level of β-amyloid protein ( Aβ) .Golgi staining was used to detect the changes of dendritic spine density and morphology.Electron microscopy was applied to detect the thickness of postsynaptic density (PSD).The Morris water maze test was applied to examine the learning and memory abilities of the mice.RESULTS: Up-regulation of PP2A in the astrocytes attenuated Aβlevel increasing in APP/PS1 group.Up-regulation of PP2A in the astrocytes significantly attenuated both decreases in the dendritic spine density and the percentage of mushroom-like dendritic spines in the hippocampal CA3 region of APP/PS1 mice.Up-regulation of PP2A in the astrocytes significantly attenuated the reduced thickness of PSD in APP/PS1 group.Up-regulation of PP2A in the astro-cytes attenuated the escape latency extending in APP/PS1 group .CONCLUSION: Up-regulation of PP2A in the astro-cytes reduces AD-like pathological changes, and attenuates synaptic impairment, synaptic plasticity deficits and cognitive impairment in the APP/PS1 double transgenic mice.

Objective To estimate the diagnostic value of circulating tumor cell detection for non-small cell lung cancer.Methods A Non-intervention clinical study was conducted in this research.From October 2014 to April 2015, totally 162 NSCLC who presented at Thoracic Surgery Department, 119 benign pulmonary disease and 52 healthy individuals were collected from Shanghai Chest Hospital.Folate receptor ( FR) based polymerase chain reaction ( PCR) method was used to detect the circulating tumor cell ( CTC) level, CEA and CYFRA21-1 was detected by the flowcytometry fluorescence luminance method, SCC was detected with Chemiluminescent microparticle immunoassay.The differences among groups were analyzed by the Kruskal-Wallis test( multi group comparison) and the Mann-Whitney U test( two group comparison) , and the chi-square test was used in the positive rate comparison;the Receiver Operating Characteristics ( ROC) curve was established.Results The median level of CTC in NSCLC patients was 11.90 Units/3 ml, which was significantly higher than those of benign pulmonary disease ( 6.72 CTC Units/3 ml ) and healthy individuals (5.82 CTC Units/3 ml,χ2 =125.990, P<0.01).Areas Under Curve ( AUCs) of ROC curve for NSCLC was 0.853 2(95% CI: 0.809 5,0.896 9).The cut-off value for discriminating NSCLC with benign pulmonary disease/healthy people was 8.74 CTC Units/3 ml with sensitivity being 77.16% and specificity being 90.06%.The positive rate of CTC in Stage I NSCLC patients was 68.7%, which was much higher than that of the combination of tumor markers(χ2 =32.98,P<0.01).Conclusion With relatively high sensitivity and specificity, the detection of circulating tumor cell may has a clinical value of application and extension.

Objective To develop a method of simultaneous detection and Gram classification for pathogens causing sepsis with gram-specific probes based real-time PCR. Methods A pair of universal primers and a set of probes including Gram-positive probe and Gram-negative probe were designed based on the bacterial highly conserved region of 16SrRNA gene. With the gram-specific probes based real-time PCR, 35 clinical frequently-isolated strains including 17 gram-positive and 18 gram-negative bacteria were identified correctly with the corresponding gram probe. The blood samples from 512 cases of suspected septicemia, who were hospitalized in our neonatal ward and the NICU and developed clinical signs suggestive of infection, were tested with routine culture and bacterial gram-specific probes based real-time PCR separately. Results The detection limit of the gram-specific probes based real-time PCR assay was 10 CFU of the bacteria. The 35 isolates could be detected and classified correctly by gram-specific probes based real-time PCR. The PCR results were all negative for Cytomegalo virus, EB virus, hepatitis B virus, Cryptococcns neoformans, candida albican, human genomic DNA and negative control. The gram-specific probes based real-time PCR appeared to be quite specific. For 512 blood specimens from the patients with suspicious neonatal sepsis, the positive rate of the gram-specific probes based real-time PCR array was 8.20% (42/512,), which is significantly higher than that of blood culture (32/512, 6.25%) (χ2=8.10, P<0.01). When blood culture was used as a standard, the sensitivity of the gram-specific probes based real-time PCR was 100%. The specificity was 97.92% and the accuracy was 98.05%. Canclusions Cram-specific probes based real-time PCR with universal primers and gram-specific probes are developed. This study suggests that the bacterial gram-specific probes based real-time PCR are very useful for the rapid and accurate diagnosis of bacterial infection.

Objective To explore the findings of diaphysial osteosarcoma in long bone on X-ray,CT and MRI, and discuss their clinical features and manifestations for differential diagnosis. Methods Twenty-eight cases with diaphysial osteosarcoma in long bone proved by surgery and pathology were reviewed retrospectively. Eighteen tumors were located in the femur, 4 in fibula, 4 in humerus and 2 in tibia. All of the patients were examined by X-ray, CT and MRI. The imaging manifestations on X-ray, CT and MRI were analyzed, and the relationship of the imaging features with the pathological types was also observed. The imaging signs were correlated with the pathologic findings with a double blind method. Results Of the 28 cases, there were 16 cases with large bone destruction, 22 cases with periosteal reaction on X-ray and CT. On X-ray, 18 cases showed soft tissue mass and 12 cases with neoplastic bone and tumor calcification.While on CT, 22 cases showed soft tissue mass on plain scan and 2 more cases displayed soft tissue mass after the injection of contrast mediun. Sixteen cases showed neoplastic bone and tumor calcification on CT.On MRI, there were 10 cases with bone destruction and periosteal reaction with iso- and hypo-intense on T1WI and iso- signals on T2WI. Twenty-six cases showed soft tissue edema and bone marrow on MRI. The soft mass were iso-signals on T1 WI and iso-hyperintense signals on T2 WI or STIR. The soft tissue edema was found hyperintense signals on T2WI or STIR. The lesions had heterogeneous enhancement especially in bone marrow with edema and adjcent soft tissue. Conclusion The X-ray, CT and MRI can reflect the pathological changes of diaphysial osteosarcoma in long bone from different aspects. Lower incidence, large bone destruction and no pathological fracture were the features of diaphysial osteosarcoma. The osteogenic type is diagnosed easily, but the osteolytic lesion should be differentiated from Ewing sarcoma, malignant giant cell tumor of bone and so on.

Objective To investigate the clinical significance of serum anti-Saccharomyces cerevisias antibody (ASCA),anti-outer membrane porin C (anti-OmpC),antibody to Pseudomonas fluorescens-associated sequence I2 (anti-I2 )and antibody to bacterial flagellin (anti-CBirl )in the diagnosis and treatment of inflammatory bowel disease (IBD).Methods From 2011 to 2013,87 patients with IBD were enrolled and divided into Crohn′s disease (CD)group (66 cases)and ulcerative colitis (UC)group (21 cases).A total of 62 age and gender matched healthy individuals were enrolled as the control group. Fasting blood samples (2 mL)of the subjects were collected.The expression of ASCA,anti-OmpC,anti-I2 and anti-Cbirl antibodies was detected with enzyme-linked immunosorbent assay (ELISA)kits.The diagnosis value of each antibody in IBD and the differential diagnostic value of in UC and CD were compared by receiver operating characteristic (ROC)curve.Results The area under the curve (AUC)of ASCA between IBD and the healthy control group,between CD group and UC group was 0.580 and 0.512, respectively;the accuracy in diagnosis was low.The AUC of anti-CBirl between IBD and the healthy control group was 0.617.There was no differential diagnosis significance of the other antibodies.The positive rate of ASCA in IBD group was 62.1 % (54/87),which was significantly higher than that in the control group (38.7%,24/62).The positive rates of anti-OmpC and anti-I2 in IBD group was significantly lower than those in the control group and the differences were statistically significant (both P <0.05).No difference was observed in positive rates of serum antibodies among the others groups (all P >0.05).The specificity,sensitivity,positive predictive value (PPV)and negative predictive value (NPV)of ASCA in differential diagnosis of CD and UC was 52.4%,66.7%,81 .48% and 33.33%,respectively.The specificity and sensitivity of anti-OmpC,anti-I2 and anti-CBirl in differential diagnosis of CD and UC was 81 .0% to 100.0% and 9.1 % to 37.9%,respectively.The specificity,sensitivity,PPV and NPV of double-positive ASCA and anti-I2 in the diagnosis of CD was 57.1 %,86.4%,82.6% and 50.0%, respectively.The positive rate of ASCA and anti-I2 in CD group was significantly higher than that in UC group (84.8%(56/66)vs 57.1 % (12/21 );χ2 =5 .633,P =0.018 ).Conclusions Positive ASCA has some significance in the diagnosis of patients with IBD in our country.The detection of anti-I2 can help to diagnose ASCA negative CD.Because of low sensitivity and positive rate,anti-OmpC and anti-CBirl have limited value in the diagnosis of IBD and the differential diagnosis of UC and CD in our country.