Objective:To investigate the expression and correlation of EHD2 and E-cadherin in hepatocellular carcinoma (HCC). Meth-ods:Western blot and immunohistochemistry were used to detect the expression of EHD2 and E-cadherin in HCC specimens and adja-cent noncancerous tissues. The correlations of EHD2 and E-cadherin with the clinicopathological characteristics and prognosis of pa-tients were further analyzed using Pearsonχ2 test and Kaplan-Meier method. Results:EHD2 expression, along with E-cadherin, was markedly reduced in HCC tissues than in adjacent noncancerous tissues. Moreover, EHD2 and E-cadherin expression were correlated with histological grade, microvascular invasion, and lymph node metastasis (P<0.05). Kaplan-Meier survival analysis showed that HCC patients with decreased EHD2 and E-cadherin expression had shorter overall survival time than those with higher expression. Conclu-sion:The abnormal expression of EHD2 and E-cadherin possibly promote HCC. Detection of EHD2 and E-cadherin may be valuable for diagnosing HCC and evaluating malignancy extent and prognosis.

Objective To evaluate the efficacy of continuous stellate ganglion block (SGB) for prevention of cerebral vasospasm (CVS) following interventional treatment of intracranial aneurysms.Methods Forty patients of both sexes with ruptured intracranial aneurysm,aged 20-60 yr,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,with Hunt-Hess grade Ⅰ-Ⅲ,scheduled for elective interventional treatment of intracranial aneurysms,were divided into 2 groups (n =20 each) using a random number table:control group (C group) and continuous SGB group (SGB group).After induction of anesthesia,patients received ipsilateral continuous SGB with 0.25％ ropivacaine 6-8 ml followed by continuous infusion of 0.2％ ropivacaine 2 ml/h for 3 days in group SGB.Transcranial Doppler ultrasound was used to measure the blood flow in bilateral middle cerebral arteries and internal carotid arteries within 3 days after operation,and the development of CVS was assessed.Before operation and at 2 and 6 h and 1 and 3 days after operation,blood samples were collected from the internal jugular vein for determination of plasma melatonin (MT) and endothelin-1 (ET-1) concentrations by enzyme-linked immunosorbent assay.Results Compared with group C,the incidence of CVS (5％) was significantly decreased,and the plasma ET-1 concentration was decreased at 2 and 6 h and 1 and 3 days after operation (P ＜ 0.05),and no significant change was found in plasma MT concentrations at each time point in group SGB (P＞0.05).Conclusion Continuous SGB can effectively prevent the development of CVS following interventional treatment of intracranial aneurysms,and the mechanism may be related to inhibited release of ET-1 from vascular endothelial cells,but not related to MT.

Objective To investigate the prevalence and main genotypes of carbapenemases in carbepenem‐resistant Enterobacteriaceae (CRE) .Methods A total of 114 strains of CRE were isolated in Shanghai Ruijin Hospital from May 2011 to June 2013 .The diameter of inhibition zone of imipemen or meropenem for these strains was not larger than 22 mm .PCR method was used to screen for the main carbapenemase genes (blaKPC ,blaIMP ,blaVIM ,blaOXA‐48 and blaNDM ) with previously described primers followed by nucleotide sequencing analysis . Conjugation experiments were performed to examine the transferability of plasmids .Pulsed‐field gel electrophoresis (PFGE) was used to show the relatedness of KPC‐2‐producing Enterobacteriaceae .Results Most of the 114 isolates were K lebsiella pneumoniae and Escherichia coli .Of the 114 isolates ,98 was positive for carbapenemases ,specifically ,78 blaKPC‐2‐positive ,15 blaIMP‐4‐positive ,2 blaIMP‐8‐positive ,1 positive for both blaKPC‐2 and blaIMP‐4 and 4 blaNDM‐1‐positive .None of the strains was positive for blaOXA‐48 or blaVIM .About 21 .4% (21/98) of the isolates were conjugated successfully .The 49 blaKPC‐2‐positive K .pneumoniae isolates were grouped into 12 types according to PFGE patterns .Majority (34/49) of these isolates belonged to the same type A .Conclusions BlaKPC‐2 was the primary epidemic genotype of Enterobacteriaceae in Ruijin Hospital ,followed by blaIMP‐4 .NDM‐1 carbapenemase was produced in 4 strains of CRE . Meanwhile , clonal spread of KPC‐2‐producing K . pneumoniae was observed in some departments of our hospital , such as surgical ICU , respiratory medicine and thoracic surgery . Appropriate measures should be taken timely and effectively to prevent the in‐hospital spread of resistant genes .

Objective To investigate the diagnostic value of serum proadrenomedullin( pro-ADM)in catheter related blood stream infection( CRBSI). Methods Prospective diagnostic test was performed with 76 cases patients with clinically suspected diagnosis of CRBSI,and the patients were divided into CRBSI group( n=25)and non-CRBSI group. Serum pro-ADM,procalcitonin( PCT),C-reactive protein( CRP)and white blood cell( WBC)levels were measured at the study entry and on the day of CRBSI suspicion. Results On the day of CRBSI suspicion,the levels of pro-ADM,PCT,CRP and WBC in the CRBSI group were(5. 17 ± 1. 28)nmol/L, 2. 29(1. 47-4. 28)μg/L,(102. 04 ± 51. 00)μg/L and(14. 66 ± 5. 09)× 109/L respectively,significantly higher than those in the non-CRBSI group((2. 83 ± 1. 25)nmol/L,2. 29(1. 4-4. 28)μg/L,(61. 43 ± 53. 52) mg/L and(11. 78 ± 3. 52)× 109/L respectively;t or Z=7. 636,-4. 777,3. 156,2. 882;P﹤0. 05). For the diagnosis of CRBSI,the area under the curve(AUC)of pro-ADM,PCT,CRP and WBC were 0. 89(95%CI 0. 82-0. 97),0. 84(95%CI 0. 75-0. 93),76(95%CI 0. 65-0. 86)and 0. 68(0. 54-0. 81)respectively. Taking pro-ADM with 4. 31 nmol/L as the cutoff value,the sensitivity,specificity,positive predictive value and negative predictive value were 76. 0%,84. 3%,70. 4% and 87. 8% respectively. Simultaneously,taking procalcitonin with 1. 52 μg/L as the cutoff value, the sensitivity and specificity was 81. 8% and 87. 0%respectively. Conclusion Serum level of pro-ADM in the diagnosis of CRBSI has good specificity. Simultaneous surveillance of serum pro-ADM and PCT may be helpful for the diagnosis of CRBSI in the early stage.

AIM: To investigate the effect of homocysteine (HCY) on the induction of macrophage inflammatory protein-1? (MIP-1?) expression in cultured human umbilical vein endothelial cells (HUVECs). METHODS: After exposure of the cultured HUVECs to HCY at increasing concentrations (0.1, 0.5 and 1 mmol/L) for 8 h, the MIP-1? mRNA expression was determined by in situ hybridization using a MIP-1? cDNA probe, and the MIP-1? protein expression was measured by cell enzyme-linked immunosorbent assay (ELISA) using a goat anti-human MIP-1? monoclonal antibody. RESULTS: The in situ hybridization showed that cultured HUVECs were able to express MIP-1? mRNA at a low level that was purplish blue granules in cytoplasm. After exposure to HCY at the concentrations mentioned above, the expression of MIP-1? mRNA was significantly increased in a dose-dependent manner. Analysis of variance showed that there was significant difference between groups ( F= 606.38, P

OBJECTIVE: To study the chemical constituents of Zhishi Xiebai Guizhi decoction and its single agent by high performance liquid chromatography-mass spectrometry to provide a scientific basis for the quality evaluation and control. METHODS: Agilent XDB-C18(4.6 mm×250 mm, 5 μm) column was used for HPLC analysis with acetonitrile-water as mobile phase by gradient elution. Using liquid chromatography-mass spectrometry technology to collect data in positive and negative ion mode, combined with literature reports, the main chemical components of Zhishi Xiebai Guizhi decoction were analyzed and identified. RESULTS: A total of 19 compounds were identified from Zhishi Xiebai Guizhi decoction. The main components are naringin, neohesperidin, etc. The main component types include alkaloids, steroidal saponins, glycosides, flavonoids, etc. CONCLUSION: This study comprehensively clarified the chemical composition of Zhishi Xiebai Guizhi decoction, and it has important reference value for the identification and quality evaluation of Zhishi Xiebai Guizhi decoction.

Objective To understand the immigrants' recognition of schistosomiasis and their relevant behaviors in the South-North Water-Diversion Middle-line Project areas in Hubei Province.Methods The investigation objects were selected by the method of stratified sampling among immigrants in the project areas and were surveyed through oral interview and questionnaire.Results A total of 1 010 immigrants were investigated and 1 005 questionnaires were indentified as effective ones.The awareness rates of schistosomiasis and the correct rates of related behaviors among the immigrants were still not satisfying.Conclusions The immigrants' recognition of schistosomiasis and their relevant behaviors in South-North Water-Diversion Middle-line Project areas in Hubei Province still need to be improved through health education and other measures.

Objective To observe the clinical effect of the club exercise designed ourselves on the prevention of should-hand syndromeafter stroke. Methods 100 stroke patients in early stage, whose motor function of upper limb were lower than Grade Ⅲ evaluated byBrunnstrom assessment and without shoulder pain and swelling of hand, were randomly divided into control group (n=50) and observationgroup (n=50). All of them received routine rehabilitation therapy, and the observation group received club exercise in addition. The incidenceof shoulder pain, the active range of motion of shoulder, the motor function of upper limb and activities of daily living (ADL) of 2groups were evaluated before and 2 courses (60 d) after treatment. Results There was no statistical difference between 2 groups before thetreatment (P>0.05). After 2-course treatment, the incidence of shoulder pain was significantly lower in the observation group than in the controlgroup (P<0.001), the active range of motion of shoulder, motor function of upper limb and ADL were significantly better in the observationgroup than in the control group (P<0.001). Conclusion The club exercise can prevent the pain of shoulder joint, increase the activerange of motion of shoulder joint and improve the motor function of upper limb and ADL in patients after stroke.

Objective To study the safety and efficacy of fast track program in anorectal surgery perioperative period. Methods One hundred and sixty-nine cases of rectal cancer were divided into the study group of 86 patients with fast track program, and the control group of 83 patients with traditional programs by random digits table. Both groups were compared from the time out of bed, the first intestinal discharge time,intravenous fluids stopping time,length of hospital stay,total cost of treatment and the incidence of postoperative complications. Results The study group compared with the control group: the first intestinal discharge time [(33.6 ± 12.9) h vs. (81.7 ± 20.1) h], intravenous fluids stopping time [(4.5 ±1.3) d vs.(7.4 ± 1.6) d],and length of hospital stay [(5.6 ± 1.2) d vs.(8.9 ±2.7) d],the total cost of treatment [(15 000 ± 3000) yuan vs. (16 000 ± 4000) yuan], the differences were statistically significant (P ＜ 0.01 or ＜ 0.05),and had less incidence of postoperative complications in study group than that in control group [5.8% (5/86) vs. 16.9% (14/83)], the difference was statistically significant (P ＜ 0.05).Conclusions Fast track program in anorectal surgery perioperative period is safe and effective, beneficial,conducive to rehabilitation of patients.

Objective To investigate the anti carcinoma role of integrin targeted photodynamic therapy (PDT) on pancreatic carcinoma cells in vitro.Methods Pancreatic carcinoma cells SW1990 were divided into four groups:cells without quantum dots (QDs) and light-treated as blank control group,pure light-treated group,photosensitizer group and PDT group.The targeting of QDs-arginine,glycine,aspartic acid (RGD) and integrin probe was confirmed by laser confocal microscopy.And as a photosensitizer for photodynamic therapy,after treated for 48 hours the morphology changes of pancreatic carcinoma cells of each group were observed.After 48 hours,the cell proliferation,apoptosis and cell cycle changes were detected by methyl thiazolyl tetrazolium (MTT) assay and flow cytometry (FCM).The expressions of myeloid cell leukemia-1 (Mcl-1),protein kinase B(Akt) and tumor necrosis factor-related apoptosis inducing ligand (TRAIL) were detected by reverse transcriptase polymerase chain reaction(RT-PCR).The amount of reactive oxygen species (ROS) of each group were evaluated by fluorescence probe.One-way ANOVA was performed for comparison between groups to analyze the treatment effects of PDT group.Results The QDs RGD probe could effectively targeting pancreatic carcinoma cells.The MTT results indicated that the relative inhibition rate of pancreatic carcinoma cells proliferation of PDT group was statistically higher than that of the other groups at 24,48,72 h (F=73.00,85.10,126.58; all P＜0.01).The FCM results revealed that the cell apoptosis rate of PDT group (17.860％ ±1.230％) was higher than that of the other groups (F=130.617,P＜0.01) and cell cycle G0/G1 phase (69.14％±2.63％) and S phase (24.41％ ± 2.67 ％) retardance was also significant (all P＜0.05).The expression of proliferation and apoptosis related gene Mcl-1 and Akt at mRNA level was lower than that of the other groups however the expression of apoptosis-inducing ligand TRAIL at mRNA level was higher than that of the other groups (F=567.456,446.817,145.238; all P＜0.05).The ROS level of PDT group was higher than that of the other groups (F=3262.559,P＜0.01).Conclusion PDT with a QDs-RGD probe could significantly inhibit pancreatic carcinoma cell proliferation and promote cell apoptosis.