Adolescent ; Adult ; Chronic Disease ; Female ; Humans ; Laryngeal Diseases ; etiology ; therapy ; Male ; Middle Aged ; Occupational Diseases ; therapy ; Singing ; Young Adult

Objective To determine the free thiols in the chimeric protein PfCP-2. 9 of Plasmodium falciparum expressed by Pichia pastoris. Methods Two experiments of reverse phase HPLC and Ellman' s reaction were applied to the PfCP-2.9 for the determination of its free thiols. For RP-HPLC analysis, three kinds of samples were tested: PfCP-2. 9, dithiothreitol-reduced PfCP-2.9 and indoacetic acid-alkylated PfCP-2.9. Results Both experiments showed that there were no any free thiols present in the PfCP-2. 9. Conclution The disulfide bonds between cysteine residues of PfCP-2. 9 were formed completely.

Objective:To express MSP1-31 gene of Plasmodium falciparum in Salmonella typhi CVD908 vaccine strain using a tetracycline-controlled P LtetO promoter. Methods:The MSP1-31 gene was cloned into the plasmid of pZE11 and transformed into the CVD908/tetR strain by electroporation. Expression of MSP1-31 in CVD908/tetR strain was detected using the method of Western blot. Results: The recombinant plasmid of pZE11/MSP1-31 was constructed, there was effective expression of MSP1-31 protein in CVD908/tetR strain in presence of tetracycline, and no expression of gene in absence of tetracycline. Conclusion: The recombinant Salmonella typhi strain in which the expression of Plasmodium falciparum MSP1-31 fragment induced by tetracycline is established successfully.

Objective To analyze the clinical characteristics of liver metastases of neuroendocrine tumors (NET) and its treatment outcome,so as to further cognition of NET.Methods The clinical data of patients with liver metastases of NET diagnosed by Peking Union Medical College Hospital during January 1996 to July 2010 were analyzed retrospectively.Results The ratio of male to female was 1∶1.15 (20∶ 23).The median age at onset of the patients with liver metastases of NET was 47.5 (26-70) years.The median duration from onset to diagnosis was 4 (0-120) months.The liver metastases were the first manifestation in 69.8％ (30/43) cases.The detection rate of primary lesions with routine abdominal imaging (B-type ultrasonography,CT,MRI) was 65.1％ (28/43),while increased to 90.7％ (39/43) when combined the following one or more special examinations including somatostatin receptor scintigraphy ( SRS),PET-CT,endoscopic ultrasound (EUS) (P =0.004).The definite diagnosis methods mainly depended on surgical specimens (69.8％,30/43).The ratio of nonfunctional to functional NET with liver metastases was 1.87∶1(28∶ 15).The primary tumors were most commonly located in pancreas [39.3％ (11/28) and 73.3％( 11/15 ) ],followed by stomach [ 21.4％ (6/28) and 13.3％ ( 2/15 ) ].Totally 88.4％ ( 38/43 ) patients received operation,and 9.3％ (4/43) patients had reoperation due to missed diagnosis of the primary tumors on earlier operation.Non-surgical treatments included octreotide acetate long-acting release,interventional therapy,chemotherapy and radiotherapy,which were difficult to be evaluated due to less follow-uped cases.Conclusions Liver metastases of NET are common and even the first manifestated symptom.Primary NET with liver metastases is the most commonly nonfunctional and located in digestive system.The detection rates of primary lesions are increased by special examinations including SRS,PET-CT and EUS. Surgical specimens are helpful to the final diagnosis,but it is necessary to improve the preoperative diagnostic rate of primary tumors to avoid repeat surgeries.

Lumbar fusion is currently the major treatment of lumbar degenerative disease, spinal instability and discogenic disease etc. Transforaminal lumbar interbody fusion (TLIF) is a novel lumbar fusion technique in recent years, and with the progress of minimally invasive spinal surgery, minimally invasive TLIF (mini-TLIF) technique has also got access to rapid development, which has more advantages compared with traditional open TLIF. The authors review the indications and contraindications, surgical method, development and advantages and minimally invasive surgical assistant instruments of mini -TLIF.

BACKGROUND: Studies have shown that after bone marrow stem cell transplantation, there are juvenile cells with the episode of myocardial cells around the infarct areas, which was recognized as deriving from bone marrow stem cells.OBJECTIVE: To explore the homing situation of bone marrow stem cells by autologous mobilization around the infarct areas aftar myocardial infarction.DESIGN, TIME AND SETTING: The cytological in vitro study was performed at the China-Japan Clinical Pathology Center, Daliar Medical University from February 2005 to April 2006.MATERIALS: A total of 30 myocardial samples from the autopsy at the Department of Pathology and Forensic Medicine, Dalian Medical University between 2000 and 2005. Fifteen normal samples dyed from the mechanical injuries or craniocerebral injury,without abnormity following autopsy. Fifteen samples in the myocardial infarction group suffered from coronary atherosclerosis and coronary tube stenosis, and died within 10 days after myocardial infarction.METHODS: The autopsy was performed within 48 hours after the death and the tissues were obtained from antedor wall, lateral wall and posterior wall of the left ventricle, and made into tissue sections. We checked the expression of CD34, CD133 and transforming growth factor-β, in the normal area, infarct area and around the infarct area by immunohistochemistry.MAIN OUTCOME MEASURES: The expression of CD34, CD133 and transforming growth factor-β in different areas and the relationship between them.RESULTS: The positive expression of CD34 in infarct area was significantly stronger than that around the infarct area and in normal area (P < 0.01). The positive expression of transforming growth factor-β in infarct area was significantly stronger than that around the infarct area (P < 0.01), and the expression of transforming growth factor-β showed negative reactJon in normal area. The expression of CD34, CD133 and transforming growth factor-β, in infarct areas and around the infarct area was closely related (P < 0.01).CONCLUSION: There are the homing of bone marrow hemopoietic stem cells in infarct area and around the infarct ares after myocardial infarction. The increase in transforming growth factor-β in infarct area provides the possibility for the differentiation of the homing stem cells, the following angiogenesis and the regeneration of cardiomyocytes.

Objective To investigate the effects of thoracic epidural anesthesia and analgesia on cellular immune function and erythrocytes glycometabolism in the patients undergoing thoracic surgery.Methods Forty esophageal carcinoma patients,classified as ASA Ⅰ or Ⅱ,scheduled for elective thoracic surgery were randomly divided into two groups with 20 cases each：group A underwent general anesthesia plus thoracic epidural anesthesia （TEA） during thoracic surgery and received patient-controlled epidural analgesia （PCEA） with fentanyl and ropivacaine postoperatively;group B received general anesthesia during thoracic surgery and patient-controlled intravenous analgesia （PCIA） postoperatively. Venous blood samples were collected for the measurement of Th1,Th2 and the activities of PFK,G-6PD and AR before the induction（T0）,2 h after the initiation of the incision（T1）,and 4 h（T2）,24 h（T3）and 48 h（T4）after surgery. Results The Th1/Th2 ratio in both groups were decreased significantly after completion of surgery compared with baseline levels （P0.05）. At T2,T3 and T4 the Th1/Th2 ratio in group A were higher than group B. Compared with these before operation,the activity of PFK was decreased significantly and the activities of G-6PD and AR in erythrocytes were increased markedly at T3 in group B（P0.05）.But erythrocytes PFK,G-6PD and AR activity slightly changed in group A.Conclusion These findings show that thoracic epidural anesthesia and PCEA may inhibit Th0 cells to differentiate into Th2 cells,protect cellular immune function and moderate erythrocyte glucose metabolism changes.

Objective To assess the clinical utility of measurement of plasma heparin-binding protein (HBP) in diagnosis and prognosis of sepsis.Methods This is a retrospective study on the performance of plasma heparin-binding protein, procalcitonin and C-reaction protein in the early diagnosis of sepsis. Thirty-one patients with sepsis, 16 patients with severe sepsis, 12 patients with septic shock and 37 control patients without confirmed sepsis, all admitted to the Intensive Care Units (ICU) of the Third Hospital Affiliated to Wenzhou Medical University and Wenzhou Central Hospital from August 2014 to November 2016, were enrolled in the study. The plasma level of HBP, procalcitonin (PCT) and C-reactive protein (CRP) were measured, and the detailed clinical data were retrieved from the patient chart records for all patients described above. Comparison of each laboratory and clinical parameters between groups was carried out by Non-parameter Test. The efficiency of each parameter was calculated by receiver operating characteristics curves (ROC) analysis. The correlation between HBP, PCT or CRP and clinical or other laboratory parameters was explored using Spearman correlation analysis.Results HBP was significantly elevated in patients with severe sepsis[(100.65±58.82)ng/ml and(31.86±36.87)ng/ml,Z=-3.856,P<0.05;(100.65±58.82)ng/ml and(24.96±17.49)ng/ml,Z=-3.556,P<0.05]and in patients with septic shock[(148.28±99.73)ng/ml and(31.86±36.87)ng/ml,Z=-4.432,P<0.05;(148.28±99.73)ng/ml and(24.96±17.49)ng/ml,Z=-4.157,P<0.05], respectively, while CRP[(154.64±62.90)mg/L and(92.56±67.49)mg/L,Z=-2.749,P<0.05;(154.64±62.90)mg/L and (79.21±51.80)mg/L,Z=-3.218,P<0.05]and PCT[(32.86±39.93)ng/ml and(2.70±6.24)ng/ml,Z=-3.395,P<0.05;(32.86±39.93)ng/ml and(4.21±14.94)ng/ml,Z=-4.092,P<0.05]were increased only in patients with septic shock (P<0.05).For HBP, the area of under the ROC curves (AUC) was the biggest (AUC=0.687), indicating the clinical significance(P<0.05) with excellent sensitivity(0.729) at the optimal cut-off value(18.58 ng/ml). In addition, HBP(APTT: r=0.244, P=0.016;PT: r=0.351, P<0.001;INR: r=0.314, P=0.002;D-Dimer: r=0.334, P=0.001;lactic acid: r=0.394, P<0.001), CRP(APTT: r=0.271, P=0.008;PT: r=0.348, P=0.001;INR: r=0.264, P=0.009;D-Dimer: r=0.257, P=0.012;lactic acid: r=0.329, P=0.001) and PCT(APTT: r=0.375, P<0.001;PT: r=0.523, P<0.001;INR: r=0.535, P<0.001;D-Dimer: r=0.254, P=0.013;lactic acid: r=0.422, P<0.001)were positively correlated to coagulation function and to lactate.Conclusion HBP could probably be acted as an important biomarker for diagnosis and prognosis for patients with sepsis, esp., for patients with severe sepsis and septic shock.

Objective The objective of this study was to study the dosimetric characteristics and advantages of Non-coplanar IMRT techniques stereotactic body radiation therapy(SBRT)in the early stage of NSCLC.Methods Ten patients were selected with early stage of NSCLC.Treatment planning designed 9 fields coplanar IMRT and 9 fields Non-coplanar IMRT,respectively.Non-coplanar plans include five coplanar fields and four non-coplanar fields.Two group patients' plans compared V2.5,V5,V20,V25 of the whole lung,the average exposure doses of the whole lung,and the average exposure doses of the contralateral lung.The comparison of the other OARs include:spinal cord Dmax,heart Dmax,esophagus Dmax,trachea Dmax,chest wall Dmax and V30 of chest wall.At the meantime,we compared the conformal index of PTV(CI)and the homogenization index of PTV(HI).Results Non-coplanar plans reduced V20 of the whole lung(P=0.001),the average exposure dose of the contralateral lung(P=0.001),but V5 of the whole lung non-coplanar plans were increased than that in coplanar plans(P=0.002).Non-coplanar technology reduce max dose of spinal cord,esophagus,trachea,chest wall and V30 of chest wall(P=0.026,0.001,0.026,0.008,0.016).Heart Dmax of the non-coplanar plans was high in coplanar plans with no statistical significance difference(P=0.296).The conformal index of PTV of the non-coplanar plans was better(P=0.036),there was no difference in the homogenization index of PTV(P=0.254).Conclusion The stereotactic body radiation therapy of the early stage of NSCLC,the non-coplanar technology can effectively reduce exposure doses of the lung tissue and the other most OARs,also improve the conformal index of the PTV.The non-coplanar technology have possibility in reducing complications when compared with the coplanar technology and therefore has certain dosimetry advantage.

Objective:To evaluate the reliability of localization of the impacted teeth by assessing various conventional radiographies. Methods:32 patients with impacted teeth were included. The impacted teeth were localized by conventional roentgenographic techniques including panoramic radiography (PR) and linear tomography (LT).Results:Dentomaxillary orthopantomographic solution (PR,LT and PR combined with LT) clearly presented the position of the impacted teeth. Serial cross-section linear tomography also ensured the shape and axis of the impacted teeth captured on the radiograph. The accuracy of the localization was further verified by the surgical exposure in 5 cases. Conclusion:Orthopantomographic assessing can directly and precisely localize the buccal and lingual position of the impacted teeth.