Objective To study the expression of metastasic suppressor gene( KAI1 / CD82)and cell adhesion molecules(CD44v6)in human laryngeal squamous cell carcinoma(LSCC),precancerous lesion,polyps,and normal mucosa. Methods Immunohistochemical technique( Envision)was used to detect the expression of KAI1 / CD82 protein and CD44v6 protein in 64 cases of LSCC,21 cases of laryngeal precancerous lesion(LPL),15 cases of polyp of larynx(LP)and 15 cases of normal laryngeal mucosa(NLM). Results The result turned out to be as follows:①KAI1 / CD82 protein was highly expressed in NLM and LP,and lowly expressed in LPL and LSCC,the positive rates of KAI1 / CD82 protein expression were 86. 67%(13 / 15),80. 00%(12 / 15),38. 10%(8 / 21)and 37. 50%(24 /64),respectively. There was statistically significant difference in NLM and LSCC. ② CD44v6 protein was lowly ex-pressed in NLM and LP and highly expressed in LPL and LSCC,the positive rates of CD44v6 protein expression were 26. 67%(4 / 15),33. 33%(5 / 15),80. 95%(17 / 21)and 75. 00%(48 / 64),respectively. There was statisti-cally significant difference in NLM and LSCC. Conclusion ① The down-regulation or deletion of KAI1 / CD82 and the up-regulation of CD44v6 are related to carcinogenesis,development of LSCC. ② The combined detection of KAI1 / CD82 and CD44v6 may provide clinical basis for the early diagnosis of LSCC.

Objective To explore the effects of noise exposure on acoustic reflex growth function (ARGF).Methods 106 ears of 57 industrial workers that exposed to high level continuous noise during their work day were divided into three groups according to pure-tone threshold average (PTA): normal hearing group, mild hearing loss group and moderately severe hearing loss group. The control group consisted of 50 ears of 25 young persons with normal hearing. The contralateral acoustic reflex thresholds (ART) were obtained from all individuals.1 000 Hz pure-tone stimuli was wsed to elicit the acoustic reflex at hearing levels from ART to 125 dB in 5 dB steps during ascending intensity level runs. The growth functions were observed as changes in acoustic reactance with increases in activator-signal intensity level.Results The noise exposed groups had smaller acoustic reflex dynamic ranges, smaller acoustic reactance growth magnitudes and shallow slopes compared with those of the control group. Data showed that there were significant differences among the control and the noise exposed groups (P0.05).Conclusion The influence of noise exposure on ARGF is significant. The results of this study suggest that ARGF could be used in the monitoring of the noise-induced hearing loss as an indicator of subtle alterations of the hearing function.

Purpose To study the expression of metastasis suppressor gene (KAI1/CD82) and cell adhesion molecules(CD44v6) in human laryngeal squamous cell carcinoma ( LSCC) and its clinical significance, and to investigate their relationship. Methods EnVi-sion immunohistochemistry was used to detect the expression of KAI1/CD82 and CD44v6 protein in 64 cases of LSCC tissues and 15 ca-ses of normal laryngeal mucosa ( NLM) tissues. Results The positive rate of KAI1/CD82 in LSCC tissues ( 37. 50%) was signifi-cantly lower than that of the NLM tissues(86. 67%) (P=0. 031), and the positive rate of CD44v6 in LSCC tissues(75. 00%) was significantly higher than that of the NLM tissues(26. 67%) (P=0. 011). The expression of KAI1/CD82 was associated with clinical stages, grade of tumor differentiation, neck lymph node metastasis ( P<0. 05 ) while not related with age, sex and prognosis ( P>0. 05). And CD44v6 with grade of tumor differentiation, neck lymph node metastasis and prognosis (P<0. 05), but not with age, sex and clinical stages (P>0. 05). In addition, KAI1/CD82 expression was negatively correlated with CD44v6 expression (rs = -0. 504, P=0. 036). Conclusion KAI1/CD82 and CD44v6 are mutually inhibited in the tumorigenesis, progress, invasion and metastasis, and detection of the expression of KAI1/CD82 and CD44v6 may be helpful for judging the biological behaviors of LSCC.

Objective To observe the lung protective effect of Tongfu Xiefei method (TFXF) in rats with sepsis, and to discuss its possible mechanism.Methods Forty-two Sprague-Dawley (SD) rats were randomly divided into blank control group (n = 6), model group (n = 18) and TFXF group (n = 18). Sepsis model was reproduced by cecal ligation and puncture (CLP) in rats of model group and TFXF group. After the reproduction of sepsis model, rats in TFXF group received Tongfu Xiefei granules 0.01 mL/g by gavge, while those in model group were given equal dose of normal saline by the same way. The rats in blank control group received no treatment. At 3, 6, 12 hours after CLP, abdominal aorta blood was collected for blood gas analysis and inferior vena cava blood was collected for determination of the concentrations of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6). Bronchoalveolar lavage fluid (BALF) was collected for measurement of concentrations of total protein (TP), total phospholipid (TPL), and desaturated phosphatidyl choline (DSPC). The ratio of wet/dry lung weight ratio (W/D) was measured, and malondialdehyde (MDA) and myeloperoxidase (MPO) in lung tissues were determined. The pathologic changes in their lungs were observed with light microscopy.Results Compared with those in blank control group, the levels of pH value, arterial oxygen partial pressure (PaO2), HCO3-, base excess (BE) were lowered, and partial pressure of carbon dioxide of arterial blood (PaCO2) was increased in model group. The serum concentrations of TNF-α and IL-6 were gradually increased after the reproduction of sepsis model. Compared with those in blank control group, the levels of TP, TPL, and DSPC/TPL in model group were decreased, while the levels of W/D, MDA and MPO were increased. Compared with those in model group, pH value was elevated in TFXF group at 3 hours (7.27±0.04 vs. 7.18±0.07,P < 0.05). PaO2 (mmHg, 1 mmHg = 0.133 kPa) was improved at 3, 6, 12 hours (3 hours: 128.00±16.05 vs. 106.78±10.73, 6 hours: 98.46±15.97 vs. 72.80±16.33, 12 hours: 90.70±9.31 vs. 74.28±12.19, allP < 0.05). The serum concentrations of TNF-α (ng/L) in TFXF group were significantly lower than those in model group at 12 hours (508.20±94.08 vs. 756.60±138.77,P < 0.05), and the serum concentrations of IL-6 (ng/L) in TFXF group were significantly lower than those in model group at 6 hours and 12 hours (6 hours: 687.80±35.00 vs. 849.40±148.28, 12 hours: 728.80±214.41 vs. 917.00±245.96, bothP < 0.05). Compared with those of model group, the levels of TP (g/L) in BALF in TFXF group were significantly decreased at 12 hours (1.01±0.23 vs. 1.60±0.47,P < 0.05), and the levels of TPL (mg/L) in TFXF group were significantly increased at 12 hours (86.40±11.33 vs. 62.40±16.33,P < 0.05). The levels of DSPC/TPL in TFXF group were significantly higher than those in model group at 6 hours and 12 hours (6 hours: 0.58±0.13 vs. 0.38±0.10, 12 hours: 0.45±0.13 vs. 0.24±0.07, bothP < 0.05). The levels of W/D in TFXF group were significantly higher than those in model group at 3 hours (3.84±0.25 vs. 2.99±0.50,P < 0.01), but lower than those in model group at 12 hours (3.21±0.53 vs. 4.89±1.14,P < 0.05). The levels of MDA (nmol/mg) in TFXF group were significantly lower than those in model group at 6 hours and 12 hours (6 hours: 4.04±2.58 vs. 8.89±2.61, 12 hours: 11.31±3.60 vs. 20.60±8.10, bothP < 0.05), while the levels of MPO (U/g) in TFXF group were lower than those in model group at 12 hours (4.79±0.66 vs. 7.22±1.76,P < 0.05). Compared with model group, the lungs in TFXF group showed less morphological changes under light microscopy, such as pulmonary edema, congestion, effusion and fibrosis.Conclusions The method of Tongfu Xiefei may improve hypoxemia and metabolic acidosis, alleviate lung edema and ameliorate pulmonary pathological changes in rat sepsis model. Tongfu Xiefei method shows a protective effect in sepsis by the way of reducing peroxidative damage, inhibiting the release of proinflammatory factors and abating degradation of lung surfactant.

Objective To summarize the pattern and main characteristics of fatal cases related to medical disputes in Yancheng area. Methods Sixty fatal cases of medical disputes were retrospectively analyzed to elucidate the annual incidence, characters of distribution of hospitals, gender and age of the decedents, types of diseases, and cause of death. Results Among 60 fatal cases, most cases happened in health clinics of county, township and village. There were more males than females. The major medical specialties in-volved included internal medicine, surgery, gynecology and pediatrics, with the internal medicine specialty having the highest incidence. Conclusion Police institutions have advantages in investigation of these cas-es in their jurisdictions, which could enhance the ability of local medicolegal examination.

Objective To explore the role of coping styles and personalities in the etiology of Graves' disease (GD). Methods All participants (581 patients and 800 normal controls) completed the general information questionnaires,trait coping style questionnaires(TCSQ) and eysenck personality questionnaires revised,short scale for Chinese(EPQ-RSC). Basic characteristics of all subjects were documented, and logistic regression analysis was used to analyze the role of coping styles and personality in etiology of GD. Results The negative coping style(OR = 1.068,P=0.000) ,concealing character(OR = 1. 121, P=0.000) and internal and external personality (OR = 1.089, P = 0.005) neurotic personality (OR > 1.000, P< 0.05) were risk factors of GD( OR = 1. 162, P = 0.000) ,positive coping style was protective factor of GD( OR < 1.000, P<0.05). Conclusion Positive coping style and specific personality adjustment can prevent effectively onset of GD.

It is very common that the number of neurons in the brain is progressively decreasing in the neurodegen-erative diseases such as Alzheimer’s disease, Parkinson’s disease and Huntington’s disease, etc.Moreover, it is much more important that there is a decline in the neurogenesis of adult brain in such neurodegenerative diseases. In treating neurodegenerative diseases, it is a potential therapeutic modality to promote endogenous neurogenesis in the brain.

Objective To establish and apply the procedure of survey on quality indicator in clinical laboratory and to analyze the status in quo of the 15 quality indicators in Zhejiang province .Methods A network platform for the survey on quality indicator in clinical laboratory was designed and developed by our center.The online questionnaires that should be reported back within one month were assigned to 473 laboratories.The developed software and SPSS 13.0 were used for statistical analysis .13 indicators expressed in rate were further evaluated with sigma scales .The 25th percentile, 50th percentile, and 75th percentile of the distribution of each quality indicator were regarded as the minimum , appropriate and optimum quality specifications, respectively.Results Totally 444 laboratories submitted the survey results.The overall sigma levels of 10/13 indicators were all >3, of which the inappropriate CV of internal quality control and unacceptable performances in EQA were still less than 3σin 15.8%and 9.2%of the laboratories.The rates of quality indicators in different scales of laboratories and diverse disciplines were significantly different .Pre-analytical TAT in routine examination for clinical chemistry and immunology was 50 min, on average.And the time for routine examination of blood , urine and stool was 30 min.Pre-analytical TAT in emergency examination for all four disciplines were all between 10 and 15 min. Intra-analytical TAT for clinical immunology was the longest , which was 154 min for routine examination and 40 min for emergency examination, respectively.The optimum quality specifications for 8 indicators were 6σ, while the minimum quality specifications were less than 1σfor 4 indicators.Conclusions According to the results of our survey, the pre-analytical quality indicator perform better than that of Intra-analytical and post-analytical phase.The laboratory should strengthen the laboratory information system technology construction to ensure the reliable data collection and long-time monitoring.

ObjectiveTo evaluate the protective effect of Xuebijing injection against renal injury in patients with sepsis, and to explore its possible mechanism.Methods A prospective randomized controlled trial (RCT) was conducted in which 62 severe patients with sepsis and septic shock admitted in Department of Critical Care Medicine of Jiangsu Province Traditional Chinese Medicine Hospital from June 2013 to December 2013 were randomly divided into control group and Xuebijing group, with 31 patients in each group. The patients in both groups received basic treatment for sepsis, and the patients in Xuebijing group were additionally given intravenous injection of Xuebijing 100 mL once a day for 7 days. In both groups, the changes in acute physiology and chronic health evaluationⅡ (APACHEⅡ) score were observed before treatment and 1, 3, 7 days after treatment, and the changes in the levels of interleukins (IL-6, IL-10), prothrombin time (PT), fibrinogen (Fib), activated partial thromboplastin time (APTT), serum creatinine (SCr), and Cystain C (Cys C) were determined before treatment and 1 day and 3 days after treatment.Results There was no statistically significant difference in APACHEⅡ score before treatment between two groups, however, the APACHEⅡ scores were significantly decreased in both groups 3 days and 7 days after treatment compared with those before treatment, and the degree of decrease in Xuebijing group was more obvious 7 days after treatment (13.61±7.62 vs. 16.34±8.70,P< 0.05). Serum concentrations of Cys C, SCr, IL-6, IL-10, PT, APTT, and Fib showed no difference between two groups before treatment (allP> 0.05), while after treatment the degrees of improvement of above indexes in Xuebijing group were obviously superior to those in control group, especially 3 days after treatment[Cys C (mg/L):1.12±0.11 vs. 1.35±0.14, SCr (μmol/L): 115.0±31.0 vs. 135.0±24.0, IL-6 (ng/L): 54.27±28.79 vs. 73.35±31.01,PT (s): 13.50±0.11 vs. 15.71±0.11, APTT (s): 43.66±0.31 vs. 48.03±0.55, Fib (g/L): 1.91±0.51 vs. 1.51±0.52, P< 0.05 orP< 0.01].ConclusionXuebijing injection has certain renal protective effect in patients with sepsis, and its mechanism is possibly related to the regulation and improvement of uncontrolled inflammatory response and coagulation function in sepsis.

Objective: To deepen the knowledge of HIV-negative plasmablastic lymphoma (PBL) . Methods: Medical records from 8 HIV-negative PBL patients diagnosed in Peking Union Medical College Hospital from January 1997 to May 2015 were collected, and the clinical features and prognosis of these patients were analyzed. Results: All of these 8 patients were diagnosed as HIV-negative PBL, 3 of 8 patients were males, and others were female. The median age was 60 (43-80) year. Among these patients, 4 cases had underlying immunosuppressive state. These patients all had extra-nodular involvement, and 6 cases of them were at stage Ⅳ according to Ann Arbor Staging, 5 patients had bone marrow involvement. CD38 and CD138 were diffusely positive for all patients, while the positive rate of B cell marker including PAX-5 and Bcl-6 were relative low. 5 of 8 patients had been detected for EBV-DNA, and all of them were negative. The median follow-up for the 7 patients receiving chemotherapy and regular follow-ups was 36 (11-57) months, the median progression-free survival (PFS) was 15 (6-52) months, and the median overall survival was 36 (2-52) months. Among these patients, 4 cases had received chemotherapy combined with Bortezomib, showing 3 cases of effective, but it seems to be difficult to keep the long term efficacy, and disease progression occurred in 2, 9, and 21 months after treatment. 2 patients at stageⅠ-Ⅱ were treated effectively, without disease progression and survival, 5 patients at stage Ⅳacquired the efficacy unsustainably, with a median PFS of 10 (2-21) months and a median overall survival of 12 (6-52) months. Conclusion HIV-negative PBL is relatively prevalent in elderly patients, and presenting with high invasiveness in clinical, extremely prone to extra-nodular involvement, especially the bone marrow. The immunophenotype of PBL is more resemble to that of plasmacytoma. Patients who were in late stage at diagnosis show poor prognosis.