Objective To analyze the characteristics of diagnosis and therapeutic effect of malignant pleural effusion with lung cancer,and explore the prognostic factors and effective diagnosis and treatment plans.Methods A retrospective analysis in-cludes 728 cases of definite pleural effusion with lung cancer from October 2009 to December 2013 in our hospital,which was fol-lowed-up to September 30,2014,and 438 cases were available analyzed.The main outcome measures were incidence,efficiency,pro-gression-free survival and overall survival.Results The overall median progression-free survival and the median survival of malig-nant pleural effusions with lung cancer was respectively 4 months and 8 months.males,small cell lung cancer,massive pleural effu-sion,and right pleural effusion may be the independent factors of local unmanageable malignant pleural effusion by multivariable Lo-gistic regression.The overall survival of pleural effusion with locally control(less than four weeks )was better than those with un-manageable(mOS:9 month vs.5 month,P<0.001).It was no significant difference of the control rate for overall survival prognosis between pleural effusion with two weeks and those with four weeks.histological type,partial remission time,the number of cycles of chemotherapy and TKI therapy may be the independent development risk by progression with Multivariate Cox regression analysis. the progress risk of patients with squamous cell carcinoma and other histological types were lower than that of adeno carcinoma (P=0.007).The progress risk of development of patients with 4 weeks of pleural effusion was significantly lower than that of the non remission (P=0.004),the progress risk of complete chemotherapy cycle number > 2 cycles and takingTKI treatment were significantly reduced (P<0.001;P=0.026).Gender,histological type,pericardial effusion,partial remission time,cycles of chemo-therapy and TKI were the independent prognostic factors for overall survival.The overall survival prognosis of patients with Fe-male,squamous cell carcinoma,no pericardial effusion,and over three cycles of chemotherapy,TKI therapy,and local controlled in 4 weeks was better.Conclusion Male,massive pleural effusion and right pleural effusion are independent predictive factors of local unmanageable malignant pleural effusion.The overall survival of pleural effusion with locally control was better than the patients with refractory control.Histological type,controllable relief time of pleural effusion,cycles of chemotherapy and TKI therapy were the independent predictive factors of progression and overall survival.

Objective To detect the expression of apurinic/apyrimidinic endonuclease 1 (APEI) and explore its correlation with the expression of mutant p53 in hepatocellular carcinoma (HCC). Methods The expression of APE1 and mutant p53 was detected by SP immunohistochemical method in 10 specimens of normal liver tissue, 40 specimens of liver cirrhosis tissue and 103 specimens of HCC tissue which were collected at the Department of Pathology of Daping Hospital from 1991 to 2004. All data were analyzed by chi-square test, correla-tion analysis and K Independent-Samples Tests. Results The expression rate of APE1 in HCC was 100.0%, which was significantly higher than that in normal liver tissue (40.0%) and liver cirrhosis tissue (82.5%) (χ~2= 47.852, P < 0.01). The expression of APE1 was only detected in the nucleus in normal liver tissue. Ectopic expression of APE1 in cytoplasm was detected in liver cirrhosis tissue and HCC tissue, with the rate of 20.0% and 53.4%, respectively (χ~2=20.757, P <0.01). There was statistical difference in clinical staging and pathological grading of HCC with different combinations of APE1 expression (intranuclear or ectopic expression) and mutant p53 expression (positive or negative expression) (χ~2=12.910, 14.481, P < 0.01), and HCC with ectopic expression of APE1 and positive expression of p53 had high malignant degree. Conclusion Overexpression and ectopic expression of APE1 in cytoplasm may play important roles in the genesis and progression of HCC, and the ectopic expression of APE1 and p53 mutation may have synergistic effect.

Objective To determine if urinary cystatin C (uCys C) level can predict mortality in critically ill neonates.Methods This prospective study included neonates admitted to the intensive care unit within the first 6 hours of life from May.2011 to Oct.2012.Neonates were assigned into survivor and non-survivor groups based on whether they died during the first week of life.The uCys C level was measured on the day of admission.The score for neonatal acute physiology (SNAP) was calculated based on 28 items collected during the first 24 hours of admission.Multivariate Logistic regression analysis was used to determine whether uCys C level was a predictor of mortality.A receiver operating characteristic (ROC) curve was constructed and the area under the ROC curve (AUC) was calculated to assess the predictive strength.Results Of the total 155 neonates,12 cases (7.1％) died during the first week of life.When compared to survivors,the gestational age (t =2.810,P =0.006) and birth weight (t =3.245,P =0.001) in non-survivors were significantly lower; but the uCys C level (z =-3.426,P =0.001),the SNAP score (z =-3.308,P =0.001),and the use of mechanical ventilation (x2 =23.877,P =0.000) were significantly higher.Logistic regression analysis revealed that uCys C remained significantly associated with mortality after adjusting for gestation age,birth weight,or the SNAP score (P =0.024).uCys C achieved AUC of 0.81 (95％ CI:0.71-0.92,P =0.001).When combined with SNAP and mechanical ventilation,the predictive performance of uCys C improved AUC 0.93 (95 ％ CI:0.86-1.00,P =0.000).Conclusion uCys C is significantly associated with adverse outcome of death and independently predictive of mortality in critically ill neonates.

Objective To compare the clinical manifestations,renal histological lesions,and the levels of urinary protein markers between the children with IgA nephropathy (IgAN) and those with IgM nephropathy (IgMN), and to determine whether urinary protein markers could predict the severity of renal histological lesions in children with IgAN and IgMN.Methods Seventy-four children with renal biopsy-proven IgAN and IgMN from January 2002 to October 2014 were enrolled in the study.The levels of IgG, albumin (Alb), transferrin (TRF), α1-microglobulin (α1-MG) ,β2-microglobulin (β2-MG) and N-acetyl-β-glucosaminidase (NAG) in morning urine samples before biopsy were measured.The semi-quantitative scores of mesangial hypercellularity (MC), glomerulosclerosis (GS), and tubule-interstitial damage (TID) were used to assess renal histological lesions.Multivariate Logistic regression analysis was used to determine whether urinary protein levels were independently associated with renal histological lesions.The area under the receiver-operating-characteristic curve (AUC) was calculated to assess the predictive ability of urinary protein markers.Results Seventy-four children (44 cases with IgAN,30 cases with IgMN) were included.The urinary levels of α1-MG and Alb were significantly higher in children with IgAN as compared to those with IgMN.The differences, however, did not remain significant after adjustment for age.The urine protein, as an independent factor associated with severe MC(＞ 5 mesangial cells per mesangial area) was TRF(B =0.010), and severe GS (≥ 10％ glomeruli showing segmental adhesion or sclerosis) was significantly correlated with Alb(B =0.001) ,and severe TID (focal or diffuse tubular and interstitial lesions) was significantly correlated with NAG(B =0.038).Urinary β2-MG was not significantly associated with severe MC, GS and TID.Urinary TRF, Alb and NAG achieved the best AUC of 0.85 (P ＜ 0.001) ,0.78 (P =0.002), and 0.78 (P =0.003), respectively, for predicting severe MC, GS, and TID.Conclusions Urinary proteins are useful to predict the severity of renal histological lesions in children with IgAN and IgMN.Urinary TRF, Alb and NAG have better predictive value.

Objective To investigate the role and molecular mechanism of epithelial‐mesenchymal transition (EM T ) in che‐moresistance to oxaliplatin in colorectal cancer cells .Methods Oxaliplatin resistant LOVO/L‐OHP cells were established by gradu‐ally increasing the concentration of oxaliplatin and intermittent treatment with high‐dose concentration on parental cells (LOVO) . The expression of E‐cadherin and Vimentin was detected by indirect immunofluorescence and Western blot analysis .The expression of Snail and Twist was detected by Western blot analysis .cell proliferation was detected by MTT .Results Compared with LOVO cells ,the epithelial phenotype of LOVO/L‐OHP cell line was lost ,and the expression of E‐cadherin was decreased (22 .63 ± 3 .25)% (P<0 .01) ,an increase in the mesenchymal marker Vimentin (475 .42 ± 58 .36)% (P< 0 .01) .LOVO/L‐OHP cell line Twist expression was slightly increased (116 .42 ± 18 .36)% (P> 0 .05) ,Snail expression was significantly increased (382 .18 ± 41 .33)% (P<0 .01) .The expression of siSnail increased E‐cadherin (246 .82 ± 31 .57)% (P<0 .01) .The expression of Vimentin (28 .75 ± 3 .96)% (P< 0 .01);siSnail significantly enhanced sensitivity to oxaliplatin based chemotherapy in LOVO/L‐OHP cell line ,IC50 control group and siSnail group were 23 .75 μg/mL and 12 .42 μg/mL .Conclusion EM T may play an important role in chemoresistance to oxaliplatin in colorectal cancer cells ,inhibition of EM T can restore chemosensitivity of resistant colorectal cancer cells.

Aim To investigate the protective effect of Panax Notoginseng Saponins ( PNS ) on Aβ25-35-in-duced apoptosis in PC12 cells and molecular mecha-nism. Methods The cell viability of PC12 cells was detected by MTT assay. The levels of LDH leakage, ROS,MDA,Caspase-3 activity and antioxidant enzyme activities of SOD, CAT, and GSH-Px activity were de-termined by respective kits. The apoptosis of cells was decteced by Western blot. Results PNS could signifi-cantly inhibit the decrease of cell viability and LDH leakage, reduce the production of MDA and ROS( P<0. 01), increase the activity of SOD,CAT and GSH-Px ( P <0. 01 ) , and the mitochondrial membrane poten-tial, inhibit the activation of caspase-3 ( P <0. 01 ) in PC12 cells which were induced by Aβ25-35 . PNS could incrase nuclear Nrf2 and up-regulate HO-1 . The neu-roprotective of PNS could be inhibited by HO-1 inhibi-tor ZnPP. Conclusion PNS may inhibit Aβ25-35-in-duced oxidative stress and apoptosis in PC12 cells by activating Nrf2/HO-1 signaling pathway.

Objective To investigate the expression of nuclear factor erythroid-2 related factor 2 (Nrf2) gene in chronic myeloid leukemia (CML) and explore its relationship with clinical characteristics and thioredoxin reductase (TrxR).Methods The expressions of Nrf2 and TrxR genes in bone marrow cells and K562 cells were analyzed in 30 bone marrow preparations of CML patients in different phases,including 20 in chronic phase,3 in accelerated phase,7 in blastic phase by real-time quantitative polymerase chain reaction.Ten health subjects were served as normal controls.Results The relative quantitation expression of Nrf2 and TrxR mRNA were 5.601±1.069 and 9.017±2.398 in chronic phase,1.698±0.349 and 5.590±1.015 in accelerated phase,1.252±0.807 and 5.050±1.469 in blastic phase,1.377± 0.344 and 1.867±0.977 in normal controls.The expressions of both Nrf2 and TrxR mRNA in CML had significant differences from those of the normal controls (x2 =14.680,P =0.002,x2 =8.271,P =0.041).The expression of Nrf2 mRNA in accelerated phase,blastic phase group showed no significant difference (Z =0.011,P =0.496),but lower than that in chronic phase group (Z =2.155,P =0.016,Z =2.534,P =0.006).The difference between the first visit and post-treated group was significant (Z =2.015,P =0.022).The expression in K562 cells and normal controls had significant difference (Z =1.898,P =0.029).In CML patients,the expression of Nrf2 was positively correlated with that of TrxR (r =0.738,P =0.037).Conclusion The expression of Nrf2 gene is higher in the first visit group of CML than that in the other groups,and is decreased after therapy,which may be the molecular marker predicting the progress of CML.Nrf2 mRNA expression level is correlated with TrxR.

Objective It is important to precisely determinate the single nucleotide polymorphisms (SNPs) in many genes in‐cluding genes related with base excision repair (BER) pathway .This research is conducted to evaluate the role of polymerase chain reaction with confronting two‐pair primers (PCR‐CTPP) in analyzing the SNPs of BER pathway .Methods Four common SNPs of BER pathway (OGG1 Ser326Cys ,XRCC1 Arg399Gln ,APE1 Asp148Glu and‐141T/G in the promoter region) was detected with PCR‐CTPP .10 of the products were sent for genotype sequencing .Compare the results of PCR and sequencing to evaluate the accu‐racy of PCR‐CTPP .Results The genotypes were exactly the same as the sequencing .Conclusion The PCR‐CTPP was a reliable and rapid detective technology for SNPs genotyping .Its broadest application would be great help for gene variant analysis .

Objective To develop a new risk scoring model based on cuproptosis-related lncRNAs (CRLs) to predict the prognosis of lung squamous cell carcinoma (LUSC). Methods Data were obtained mainly from TCGA and GTEx databases. Univariate Cox, Lasso, and multivariate Cox regression analyses were conducted to determine CRLs that affect the prognosis of LUSC and establish a risk scoring model. The ability of risk score characteristics to independently predict LUSC survival was compared with that of clinical characteristics by calculating the area under the ROC curve (AUC). Immune-related functions and immune checkpoint differences were compared between high- and low-risk groups. Results Nine CRLs were selected as independent prognostic lncRNAs for LUSC, and a risk scoring model was developed. Risk score was the influence factor for the prognosis of LUSC. The AUC values predicted by the risk score model for 1-, 3-, and 5-year survival rates of patients with LUSC were 0.710, 0.718, and 0.743, respectively. The high- and low-risk groups were partly statistically different in terms of immune-related functional assays and immune checkpoint assays (P < 0.05). Conclusion The risk scoring model developed based on nine CRLs could predict the prognosis and immune therapy response of patients with LUSC in clinical practice.

Objective To discuss the methods, advantages and indications of multipoint puncturing in performing endovascular therapy for complex lower extremity arterial occlusive diseases. Methods During the period from Oct. 2011 to Oct. 2013, a total of 46 patients with complex lower extremity arterial occlusive diseases were treated with endovascular therapy by using multipoint puncturing technique. The puncturing type, the advantages of multipoint puncturing technique and the success rate of this technique were analyzed. Results The multipoint puncturing was divided into three types: type Ⅰ : puncturing from the opposite direction to deal with the same target vessel; type Ⅱ: direct puncturing of the target vessel; and type Ⅲ:using the same puncturing direction to deal with different target vessels. The success rate of endovascular treatment was 80.4%. Conclusion Multipoint puncturing technique helps improve endovascular treatment success rate for lower extremity arterial occlusive diseases. Full understanding of the advantages of multipoint puncturing technique, perfect preoperative planning, precise puncturing technique and proper interventional equipments are helpful to ensure a successful treatment.