Objective To investigate the clinical autopsy results of patients died of cardiovascular disease or other disease complicated with cardiac damage. Methods Complete autopsy was performed on 86 cases with uncertain cause of death. Through integrating clinical diagnosis and treatment with gross autopsy findings and microscopic observations, 86 autopsies were determined the major cause of death. Results In 86 autopsies, 69 cases were heart disease. Differences between pathological diagnosis and clinical diagnosis were compared. Twenty-seven cases were cardiac deaths, with diagnosis accrodance rate of 81. 5%. Fortytwo cases died of non-cardiac disease but complicated with heart disease or involving the heart which accelerated the death in patients, with accordance rate of 78.6%. Conclusion Scientific and correct performance of autopsy was important to determine the causes of death, to promote development of related disciplines and to improve the diagnosis and treatment of the diseases.

Objective To investigate the effect of bortezomib on proliferation and apoptosis of pancreatic cancer cell lines BxPC3,SW1990 and explore possible mechanisms of bortezomib's killing effect on cancer cells.Methods BxPC3,SW1990 cells were treated by using 1,10,50,100,500 nmol/L and 1,10 μmol/L of bortezomib,and cells without bortezomib treatment were considered as control group.The cell proliferation was determined by MTF assay,and apoptosis was determined by flow cytometry.Bak,Bax,Bcl2,Bcl-xl,survivin mRNA expressions were measured by RT-PCR,and Western blot was applied to determine the expressions of pro-caspase-3,cleaved-caspase-3,Bax,Bcl-2,surviving protein.Results When bortezomib concentration was higher than 50 nmol/L,it inhibited the proliferation of two cell lines in a dose and time-dependent manner.And with the same treatment the rate of proliferation inhibition of BxPC3 cells by bortezomib was greater than that of SW1990 cells,and the difference between the two cell lines was statistically significant (P ＜0.05).Apoptosis rates in the groups of BxPC-3 and SW1990 cells treated by 100 nmol/L bortezomib were (22.56 ± 4.23) ％ and (12.71 ± 2.23) ％,which were significantly higher than those in control group (2.15 ± 0.47) ％ and (2.32 ± 0.54) ％,P ＜ 0.05).In addition,apoptosis rate of BxPC3 cells was significantly higher than that of SW1990 cells (P＜0.05).Bak mRNA expression of BxPC3 and SW1990 cells after 100 nmol/L bortezomib treatment were not significantly changed,but the expression of Bax mRNA and protein was significantly increased (P ＜0.05).Bcl-2 mRNA and protein,as well as Bcl-xl mRNA expressions was significantly decreased (P ＜0.05).The expression of survivin mRNA and protein in BxPC3 cells were decreased,but were increased in SW1990 cells(P ＜0.05).The expression of pro-caspase-3 protein in the two cell lines was decreased,while the expression of cleaved-caspase-3 protein was increased (P ＜0.05).Conclusions Bortezomib can inhibit the proliferation of pancreatic cancer cell Iines BxPC-3 and SW1990 and induce apoptosis,and the effect on BxPC3 cells is more than that on SW1990 cells.The mechanism may depend on activation of the mitochondrial pathway of apoptosis,and be related to survivin-involved drug-resistance.

Purpose:To evaluate the effects of thymosin ?1 (T?1) in chemotherapy of NSCLC. Methods:We have conducted a prospective randomized controlled clinical trial.40 non-treated cases of stage Ⅲ-Ⅳ NSCLC were randomized into T?1 group ( chemotherapy combined with thymosin ?1) and control group (chemotherapy alone). The number of T cell subgroups, the activity of NK cell and phagocytic index of neutrophilic granulocyte in peripheral blood were detected and quality of life and changes of cancer lesions were evaluated before and after treatment. Results:After treatment,the levels of CD4 in the T?1 group was significantly higher than before treatment(P0.05). There was no significant difference of myelosuppression between the two groups. No infections or severe toxicity occurred in the T?1 group. One severe lung infection was seen in the control group.There was better quality of life for the T?1 group compared with the control group(P

Objective To study the relationship between PDD and the polymorphism of apolipoprotein E(apoE) gene,to inquire the etiological basis of PDD.Methods 11 Patients with PDD 40 patients with PD without dementtia and 52 unrelated controls were collected to detect the genotype of apoE gene by PCR－ RFLP. Results There was no difference in the apoE allele frequencies and genotype distribution in PDD group,PD without dementia group and control group(P >0.05). Conclusion There is no relationship between the polymorphism of apoEgene and the onset of PDD.The pathogenesis of PDD differs from that of AD.

Objective To investigate expression level of sphingosine kinase 1 (SPHK1) and nuclear factor-κB (NF-κB) in non-small cell lung cancer (NSCLC) and their relationships with invasion, metastasis and prognosis of NSCLC. Meth-ods Ninety-three NSCLC specimens and paraneoplastic normal lung tissue from conventional surgery were confirmed by histology. Expression of SPHK1 and NF-κB were detected by Immunohistochemistry on paraffin sections. Primary antibody were Rabbit Anti-Human SPHK1 and Rabbit Anti-Human NF-κB p65, which were incubated 1 hour in water bath. The secondary antibody was HRP-Polymer anti Mouse IgG, which was incubated 20 minutes in water bath. Results SPHK1 ex-pression was positive in 96.8% (90/93) of NSCLC specimen which is higher than in paraneoplastic normal lung tissue in which the positive rate is 18.3%(17/93);NF-κB expression was positive in 89.2%(83/93) NSCLC which is higher than the in paraneoplastic normal lung tissue in which the positive rate is 12.9%(12/93). The expression of SPHK1 and NF-κB in NSCLC was positively correlated (r=0.464, P＜0.01). TThe expression levels of SPHK1 and NF-κB p65 in NSCLC patients with were positively related to TNM staging and lymph node metastasis. SPHK1 expression and NF-κB p65 expression lev-el were higher in the deads than in survivals. There was no statistical significance in different expression intensity of SPHK 1 and NF-κB p65 in patients with NSCLC who had differences in gender, age, tumor size, tumor location, histological type. Survival analysis showed that survival time of patients of NSCLC with high expression of SPHK1 was shorter than those in the group with low SPHK1 expression, and the difference was statistically significant (χ2=14.025, P ＜ 0.01). Conclusion In the process of NSCLC invasion and metastasis,SPHK1 may play an important role through NF-κB, and it can predict prognosis of NSCLC patient. Moreover, it will become a potential target for NSCLC target.

Objective The objective of this study was to explore the construction of a comprehensive and systematic quality management system for pharmacy intravenous admixture service (PIVAS) and form quality management method and model reflecting distinct gradations,specific responsibility and all staff participation,so that we can provide safe and effective intravenous solutions for the patients and guarantee the quality and safety of intravenous infusion and improve management quality.Methods According to Quality Management Standards of PIVAS published by Ministry of Public Health and JCI Standard,with the theory and methods of feed forward control and delicacy management,by establishing and completing three-grade-quality management organization,defining the quality control indicators,selecting and demonstrating with the application of expert meeting method and Delphi method,a scientific quality control system was formed.Statistics on unreasonable prescriptions,adverse drug reaction of intravenous infusion,defect of pharmacy intravenous admixture and satisfaction of medical staff and patients were compiled and evaluated throughout the implementation of the practice changes in 38 wards.Results Significant differences were observed in various indicators,comparing statistics collected during 6 months of the same season throughout the implementation of the practice changes.x2 value was 160.54,21.39 and 10.29 by comparison of unreasonable prescriptions,adverse drug reaction and number of drug preparation errors.The satisfaction degree of medical staff and patients improved evidently,x2 value was 14.34 and 26.76.Conclusions The construction and implementation of three-grade-quality management system adapt to high-risk,high strength,high sense of responsibility,process-oriented and intensive management of PIVAS.The impact on the continuous improvement PIVAS quality and assurance in safety of intravenous infusion is remarkable.

Objective To compare the influence of tracheotomy after two wet fluid on airway and provide the basis for clinical treatment and care. Methods A total of 30 patients with severe brain injury stay neurosurgery tracheotomy were divided into 0.45% sodium chloride group and ambroxol hydrochloride group with 15 cases each by random digits table method, two airway humidification liquid (0.45%sodium chloride,0.9% sodium chloride + ambroxol hydrochloride) were each instilled in the trachea inner sleeve. Blood gas analysis was performed and the levels of serum lung surface active substances related protein-A (SP-A protein), interleukin-6, interleukin-8, tumor necrosis factor-alpha(TNF-α) were measured by enzyme linked immunosorbent assay (ELISA) before 1 d and after 3,7,14 d of tracheotomy. Results There were significant differences in arterial blood oxygen partial pressure, arterial carbon dioxide partial pressure, oxygenation index after 14 d of tracheotomy between ambroxol hydrochloride group and 0.45% sodium chloride group:(110.72±26.75) mmHg(1 mmHg=0.133 kPa) vs.(89.39±21.98) mmHg, (30.44±6.75) mmHg vs. (35.12±7.28) mmHg, 333.23±80.56 vs. 270.93±77.21, t=29.49,-8.63,7.44, P<0.01.There were significant differences in the levels of serum SP-A protein, interleukin -6, interleukin -8, TNF-α after 14 d of tracheotomy between ambroxol hydrochloride group and 0.45% sodium chloride group:(191.34 ±1.21) ng/L vs. (61.92 ±12.0) ng/L, (2.62 ±0.23) ng/L vs. (5.42 ±0.16) ng/L, (124.56 ±2.10) ng/L vs. (185.91 ±1.48) ng/L, (31.32±1.38) ng/L vs.(69.13±1.16) ng/L, t=75.72,-13.51,-23.89,-20.97, P<0.01. Conclusions The airway humidification effect of ambroxol hydrochloride group is better than 0.45%sodium chloride group, it can improve the wetting effect, and better protect the lung tissue, reduce the incidence of lung infection, make it an ideal airway humidification liquid.

Objective To observe the pathological change of visceral pleura in patients with chronic obstructive pulmonary disease (COPD), and to discuss the relationship between the changes and COPD airflow limitation. Methods A total of 70 patients received the pulmonary lobectomy or partial resection because of lung tumor in Tianjin Chest Hospital from May 2014 to August 2015 were selected in this study. According to the results of pulmonary function test, the patients were divided into COPD group [forced expiratory volume in one second (FEV1)/ forced vital capacity (FVC) <70%,n=40] and control group (FEV1/FVC≥70%,n=30). The lung tissues, which was not the lesion areas, were used to make tissue sections. The Elastica Van Gieson (EVG) method was used to stain the sections. The thickness of visceral pleural and the proportion of elastic fibers in visceral pleural were observed and calculated under a microscope in the two groups. Results The specimens were derived from upper and middle lobes in 22 cases of COPD group, and from lower lobe in 18 cases. Specimens were derived from upper and middle lobes in 17 cases of control group, and from lower lobe in 13 cases. There were no statistical differences in sampling sites between two groups (χ2=0.019,P>0.05). The visceral pleural thickness and the proportion of elastic fibers in visceral pleural were significantly thinner in COPD group than those of control group ( P<0.01). In both COPD group and control group, visceral pleural thickness was significantly thinner in upper and middle lobes than that of lower lobe (P<0.05), but the proportion of elastic fibers in visceral pleural of upper, middle lobes showed no statistical difference compared with that of the lower lobe (P>0.05). Conclusion The thinner visceral pleural and the reduction of elastic fibers in visceral pleural are one of the causes of expiratory airflow limitation in COPD patients.

Objective To investigate the expressions of RhoB and E-cadherin in non-small-cell lung cancer (NSCLC), and their clinical significances thereof. Methods Immunohistochemical staining was applied to detect expres-sions of RhoB and E-cadherin in 116 samples of NSCLC (NSCLC group) and 116 samples of normal lung tissues (control group). Correlations of expressions of RhoB and E-cadherin to clinical pathological parameters and prognosis were analyzed in two groups. Results The expression intensities of RhoB and E-cadherin were significantly lower in NSCLC group than those in control group (57.76%vs 87.07%,54.31%vs 85.34%,P＜0.01). There were significant differences in the expres-sion of RhoB between different pathological types, differentiation and lymph node metastasis in NSCLC group. There were significant differences in the expression of E-cadherin between different TNM stages, differentiation and lymph node metas-tasis in NSCLC group. The expression of RhoB was positively correlated with the expression of E-cadherin ( r=0.503,P＜0.01). The 3-year survival rates were significantly higher in patients with high expression of RhoB (83.93%) than those in pa-tients with low expression of RhoB (40.00%, Log-rank χ2=18.992,P＜0.01). The 3-year survival rates were significantly higher in patients with high expression of E-cadherin (85.11%) than those in patients with low expression of E-cadherin (44.93%, Log-rankχ2=16.680,P＜0.01). Further multivariate analysis suggested that both lower expressions of RhoB and E-cadherin and lymph node metastasis were prognostic indicators for NSCLC (P＜0.001). Conclusion The expressions of RhoB and E-cadherin showed a good correlation in NSCLC. Detecting the expression of RhoB combined with E-cadherin may give a clue on clinicopathological features and prognosis in patients with NSCLC.

Objective To investigate the effects of ERK1/2 signaling pathway on coronary atherosclerosis-associated inflammatory reaction in autopsy cases. Methods Forty-five autopsy cases were divided into three groups:coronary arterydisease (CHD)-associated death group, CHD group and control group (n=15 for each group). The inflammatory cell infiltration in myocardial tissues was observed through staining leucocyte common antigen (CD45) by HE and immunohistochemistry method. The protein expression level and distribution in extracellular signal-regulated kinase 1/2 (t-ERK1/2) and phosphorylated extracellular signal-regulated kinase 1/2 (p-ERK1/2) of myocardial tissues were detected by immunohistochemistry and Western-blot assay. The expression level of tumor necrosis factor α (TNF-α) was determined using semiquantitative RT-PCR analysis. The activity of nuclear factor (NF)-κB was assessed using electrophoretic mobility shift assay (EMSA). Results Compared with CHD and control groups, myocardial inflammatory cell counts, phosphorylation of ERK1/2, TNF-α mRNA expression and NF-κB activation were significantly increased in CHD-associated death group (P < 0.05). Western blot analysis showed that the phosphorylation of ERK1/2 was positively correlated with expression of TNF-αmRNA and the number of inflammatory cells in CHD-associated death group (r=0.675, P<0.01;r=0.893, P<0.01). Conclusion Results reveal that the activation of ERK1/2 signaling pathway is considered as an important mechanism for coronary atherosclerosis caused myocardial inflammatory reaction, which indicates that the inhibition of ERK1/2 signal transduction pathway may become a potential new target for prevention and treatment of atherosclerotic coronary infarction.