Purpose: To investigate the expression of Survivin gene and its relationship with expression of Caspase-3, B-cell lymphoma-2( Bcl-2) in human non-small-cell lung carcinoma( NSCLC) . Methods: Expression of the Survivin mRNA was evaluated by in situ hybridization (ISH) in 13 normal bronchial epithelium, 11 dysplasia, 54 NSCLC and 12 lymph node metastasis. Immunohistochemical assay was used to detect the expression of Caspase-3 and Bcl-2 proteins. Results: Expression of Survivin was detected in a significantly greater proportion in NSCLC (74. 07%) and lymph node metastasis (91. 67%) than normal bronchial epithelium (7. 69%) and dysplasia ( 27. 27%) (P

Objective To analyze the surgical operation and prognosis of gastric stump carcinoma in elderly patients. Methods The clinical data of 25 cases of elderly gastric stump carcinoma in our department from 1993 to 2003 were analyzed retrospectively. Results In this group of cases, TNM stages Ⅰ, Ⅱ, Ⅲ and Ⅳ was 3, 5, 8 and 7 cases, respectively. Among them, radical resection was performed in 12 cases(48.0%), palliative operation in 9 cases(36.0%), exploratory laparotomy in 2 cases, and 2 cases lost the chance of resection due to extensive tumor dissemination. Nutritional jejunostomy was performed in all the cases received resection operation. 1, 3 and 5 years survival rates in the patients who underwent radical dissection were 81.2%, 41.5% and 28.6%, respectively. Conclusion Endoscopy examination plus gastric mucosa biopsy were major means for diagnosis of gastric stump carcinoma in elderly patients. Perioperative managements should be emphasized. Radical resection was a reasonable therapeutic procedure of elderly gastric stump cancer, and was also an important factor affecting prognosis.

Objective To investigate the causes of hernia recurrence after tension free inguinal hernioplasty and its prevention and treatment Methods The clinical data of 10 hernia recurrence cases were retrospectively analyzed Results There were 6 recurrent cases after mesh plug tension free hernioplasty and 4 cases after Lichtenstein repair The causes of recurrence included too small for size of the mesh, mesh was coiled and migrated, too large holes of mesh left for spermatic cord, mesh plugs not properly fixed, internal rings too large miss matching the mesh plug, two mesh plugs not mounted together, etc Conclusion The main causes of recurrent hernia after tension free inguinal hernioplasty were related with failure in applying correct operative techniques, the recurrence needs open mesh repair, especially mesh plug tension free hernioplasty

Objective To investigate the value of endoscopy in the diagnosis and treatment of biliary obstructions on different sites with variable causes. Methods The clinical records of biliary drainages under duodenoscope in 104 patients with biliary obstruction from October 1998 to November 2002 was reviewed retrospectively. Results Drainage was successfully completed in 97 patients, with a success rate of 93.3%(97/104). The patients were relieved of their symptoms of biliary obstruction (abdominal pain, jaundice and fever), and the effective rates of ENBD and ERBD were 93.0% (66/71) and 93.3% (28/30), respectively. Conclusions Endoscopic drainage for biliary obstruction has advantages of minimal invasion, rapid recovery, short hospital stay and apparent efficacy. Emphasis should be placed on the site of drainage and proper selection of operative method to further elevate its success rate.

Objective To evaluate the value and limitation of MRI in the diagnosis of meningovascular neurosyphilis. Methods Five cases of neurosyphilis confirmed by clinical history/laboratory were examined with MRI (3 plain MRI, 2 enhanced MRI). The results of blood and CSF TPPA/RPR were positive and HIV was negative. Results Abnormal signals were demonstrated in the temporal lobe in 3 cases, and infarction was revealed in the basal ganglion and periventricular white matter in another 2 cases. There was no marked contrast enhancement in the 2 cases. Conclusion Meningovascular neurosyphilis has no characteristic features on MRI, but MRI is an effective method in delineating the size, range, and characters of neurosyphilis, and it is also an useful modality to follow-up after antibiotic therapy.

Abstract: Objective　To investigate the composition and diversity of midgut microbial community of Haemaphysalis longicornis infected with severe fever with thrombocytopenia syndrome virus (SFTSV)． Methods　The midgut DNA of three group Haemaphysalis longicornis infected with SFTSV was extracted, and the 16S rDNA gene of the sample was sequenced by HiSeq platform. The composition and diversity of endosymbiotic microbial community were clarified by OTU cluster analysis and alpha diversity analysis. Results　The midgut microbial clusters of the three groups infected with SFTSV were 143, 113, 163 OTUs respectively; the sparsity curve and abundance grade curve showed that the data had sufficient sequencing depth, and the midgut of Haemaphysalis longicornis infected with SFTSV was rich in microbial composition, but the species distribution was uneven. The analysis of microbial community composition showed that Proteobacteria, Firmicutes and Actinobacteria were the main dominant bacteria at the phyla level. At the class level, Gammaproteobacteria, Bacilli, Betaproteobacteria and Actinomycetia were the main dominant bacteria. At the order level, Legionellales, Bacillales, Burkholderiales and Actinomycetales were the main dominant orders. At the family level, Coxiellaceae, Bacillaceae, Moraxellaceae and Rhodococcaceae were the main dominant families. At the genus level, the relative abundance of Coxiella was the highest, followed by Aeribaillus and Azonexus. Alpha diversity analysis showed that the average Shannon index was 139.67, the average Simpson index was 0.48, the average Chao index was 145.06, and the average ACE index was 147.11. Conclusions　The species diversity of intestinal microorganisms in Haemaphysalis longicornis infected with SFTSV is rich. The results provide a basis for further exploring the interaction between intestinal microbes of Haemaphysalis longicornis and SFTSV and developing new ideas for the prevention and control of ticks and tick-borne diseases.

Objective To assess the nutritional risk of patients with inflammatory bowel disease (IBD).Methods The nutritional status of 112 IBD patients from PUMC Hospital were evaluated by Nutritional Risk Screening 2002 (NRS 2002).Using Chinese standard,a body mass index (BMI) that was lowered than 18.5 kg/m~2 according to clinical material was regarded as malnutrition,and the score was recorded as 3.The se-verity of ulcerative colitis (UC) was evaluated using True-Love criteria as mild,moderate,and severe.Crohn's disease (CD) was evaluated using Harvey-Bradshaw Index as in remission stage (≤4),moderately active stage (4-8),and severely actively stage (≥9).Results All these 112 patients,including 70 UC cases and 42 CD cases,were evaluated by NRS2002.Forty-five patients (40.2%) were judged as at the risk of malnutrition.The incidence of malnutrition was significantly higher in CD patients than in UC patients (52.4% vs.32.9%,P<0.05).It was also significantly correlated with the severity of disease.In patients with severe IBD,the rate of mal-nutrition evaluated by BMI according to clinical material was significantly lower than the rate of nutritional risk.Con-clusions The risk of malnutrition is high in IBD patients.NRS 2002 can be used for nutritional risk screening.

Objective To study the character of cervical lymph nodes metastasis in nasopharyngeal carcinoma(NPC) by contrast-enhanced uhrasonography(CEUS) and time-intensity curve. Methods Forty-one lymph nodes of metastasis from 32 patients were studied by CEUS. The enhancement of echogenicity was evaluated,and the time-intensity curve was analyzed. Results Of the 41 lymph nodes examined, 10 (24.4%) showed intense homogeneous enhancement by CEUS, 23 (56.1%) showed inhomogeneous enhancement and 8 (19.5 %) showed scarce intranodal enhancement. There were 20 (48.8%) lymph nodes showed necrosis. Most of the lymph nodes (92.7%) showed peripheral type blood flow, 3 (7.3) % showed mixed type blood flow. There were significant differences in them(P < 0.01). The time-intensity curve displayed steeply in upslope, and gently in decent. The arrival time(AT), time to peak(TTP), peak intensity (PI) ,area and gradient were (7.2±2.5)s,(7.6±2.3)s,(9.5±3.3)dB,(203.4±45.7)dB· s,1.2±0.5 respectively. Between the lymph nodes with envelope infringed and not, there were significant differences in PI and area, while there were not significant differences in AT, TTP and gradient. Conclusions The metastasis cervical lymph nodes of NPC had specific character by CEUS and time-intensity curve. In this way,it may help us to diagnosis cervical lymph nodes metastasis of NPC,and provide more information for the therapy and prognosis judgement.

Objective: To study the infectious state of 3 kinds of viruses (CVB, CMV and EBV) in respiratory tract infection and its significance. Methods: Among 290 patients studied, there were 158 boys and 132 girls, aged from 6 months to 12 years. The antigen of coxsackievirus B (CVB-Ag) and antibody of coxsackievirus B (CVB-IgM), antibody of cytomegalovirus (CMV-IgM) and antibody of EB virus (EBV- IgM) were detected by ELISA method. Results: (1) The positive incidence of upper respiratory tract infection, bronchitis, pneumonia was higher than that of noninfectious disease group (P<0.01). The positive incidence of CVB was higher than that of CMV and EBV(P＜0.01). (2)There were cross viruses positive, especially in pneumonia group (P<0.05), usually CVB cross other virus infection. (3) The course of pneumonia was long in single CVB (P<0.01) and longer in cross infection of viruses (P<0.01). Conclusion: CVB infection is the most common one in the 3 viruses. Attention should be paid to multiple viruses infections in pneumonia children.