0.05). Integrin ? 5? 1 was significantly over expressed in lymph node metastatic cancer compared with that in corresponding PGC ( t =2.45, P 0.05) and it showed no correlation with integrin ? 5? 1 expression( r = 0.156, P =0.37).Conclusion Over expression of integrin ? 5? 1 is present in GC and associates with the progression of tumor, implying that it may be viewed as the indicator of invasion and metastasis and the candidate target of gene therapy of gastric cancer. However, integrin ? 5? 1 may not play an important role in the vascularization of GC.

Objective To study the sub chronic toxicity of silver nanoparticles on medaka.Methods Adult fish were divided into silve nenopartides and control group.Animals were collected on 14 days after exposure, and some toxicological endpoints such as death rate, tissue distributed of silver irons, oxidative stress and histopathological damage were measured.Results There were significant difference in death rate of medaka treated with silver nanoparticles and control group.Compared with the control group, the content of silver in gill, intestine and liver of medaka treated with silver nanoparticles were increased significantly.Compared with control group, the activity of LDH in liver and SOD in liver and gill were significantly decreased(P<0.01).The content of MDA in liver of medaka treated with silver nanoparticles was significantly increased(P<0.01).The liver and gill of mekada treated with silver nanoparticles were damaged, compared with control group.Conclusion Nano silver has a certain subchronic toxicity to aquatic life.

Objective To explore the morphological, immunohistochemical characters and prognosis in one case of patients with cutaneous anaplastic large cell lymphoma complicated with acute myeloid leukemia (C-ALCL-AML). Methods The histopathology, immunohistochemical markers and follow-up information of one case of ALCL-AML was analyzed and the correlated literature was reviewed. Results The patient, 69 year-old, female, was initially present with shin lesion on one finger and abnormal myelogram. The histopathology of shin lesion showed that tumor cells were composed of large cells with abundant cytoplasm,the nuclei were large and irregular, and were infiltrated by Neutrophil and eosinophil. The CD30,CD3 and CD43 of tumor cells were positive, but ALK negative by immunohistochemical method. The number of WBC in peripheral blood was 15.5×109/L and 51 archaeocytes were in every 100 karyotes. Bone marrow aspiration detection showed that bone marrow was hyperplasia and the ratio of myeloblast was 78 %. This patient was diagnosed as C-ALCL-AML, partly differentiation type(AML-M2a). Conclusion C-ALCL-AML is very rare. Its diagnosis is dependent on clinical data, histopathology and immunohistochemical markers. The first choice of treatment is chemotherapy, but its prognosis is poor.

Adult ; Altitude ; Case-Control Studies ; Humans ; Immunoglobulins ; blood ; Occupational Exposure ; T-Lymphocyte Subsets ; immunology

Covered herein are the milestones and researches made on healthcare resources integration in China and abroad,focusing on characteristic horizontal and vertical integration of healthcare resources based on medical service value chain.It also analyzed influencing factors on healthcare resources integration,such as health insurance payment and informationization.With reference to global experiences,suggestions are made on the horizontal integration of the resources,in terms of governance,operation mechanism,health insurance payment,informationization and discipline development.

Background and purpose:Now 3-dimensional conformal radiotherapy(3DCRT)and intensitymodulated radiotherapy(IMRT)are widely used in the treatment of head and neck tumor.For the parotid,this target area is located on the side of the head and the tumor has a concave shape.What kind of radiation method can be used more eriectively to achieve dose uniformity and protection organs at risk is the topic of much discussion.The postoperative irradiation of parotid tumor is varied in the techniques used.In this study,3-dimensional conformal radiotherapy (3DCRT),intensity-modulated radiotherapy(IMRT)and simplified forward planned multi-segment radiotherapy (MSRT)were compared to conventional planning techniques in order to investigate the potential advantages of these new treatments.Methods:The conventional planning included the large opposed lateral fields with 2 or 3 weight ratio at the target lateral(2F-2D)and the unilateral field with mixture of 6 MV photon and electron beams(X+E).The 3D techniques included 3DCRT,MSRT and IMRT.Their dose distributions were calculated and compared for 8 patients treated in our center.Different beam arrangements were used for 3D techniques.In each case.the dose of PTV was prescribed to 60 Gy.All plans were compared using dose-volume histogram data.The conformity index(CI)and heterogeneity index(HI)of dose were used to evaluate the dose coverage of the target volume.Dose sparing of brain stem.spinal cord and the contra lateral parotid was also compared.To compare IMRT and MS RT,the timing ofplanning and radiation delivery was recorded.Results:Compared to conventional planning,the 3DCRT,MSRT and IMRT plans produced adequate target coverage,and the CI showed 3DCRT plans(0.78)produced poorer target coverage than MSRT(0.81)and IMRT(0.85).MRST and IMRT plans showed a significant reduction in maximum dose to the spinal cord,brainstem and the contra lateral parotid,compared to the conventional plans,while the 3DCRT plan did not show significant sparing of these structures.MSRT and IMRT plans produced better dose coverage among all the techniques.The efficacy of beam delivery comparing between two modulated planning showed MSRT was better.Conclusion:For postoperative irradiation of parotid cancer,3D planning techniques generated better target dose-coverage,without compromising the dose-sparing advantages of important structures.A satisfactory dose distribution can be obtained using MSRT and such a simple technique may be suitable for replacing IMRT.

Objective To explore the expression of methyl CpG binding protein 2 (MeCP2) in gastric cancer tissues and its role in multi-drug resistance (MDR) in gastric cancer cells.Methods The expression of MeCP2 in 90 gastric cancer tissues and the adjacent normal tissues was detected by immunohistochemistry,and the relationship between MeCP2 expression level and clinicopathological parameters was analyzed.The expression level of MeCP2 in gastric cancer cell line SGC7901,MDR cell variants SGC7901/doxorubicin hydrochloride(ADR) and SGC7901/vincristine(VCR)was determined by Western blot.After the expression of MeCP2 was silenced by short interference RNA (siRNA),half inhibitory concentration (IC50) of 5-fluorouraeil and cisplatin in gastric cancer cell was tested by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide(MTT) assay.The t test or chi square test was performed for statistical analysis.Results The positive rate of MeCP2 expression in gastric cancer tissues was 72.2％ (65/90),which was significantly lower than that in adjacent normal tissues (93.3％,84/ 90),and the difference was statistically significant (x2 =14.068,P＜0.01).MeCP2 expression was not correlated with age,tumor maximum diameter and lymph node metastasis (all P＞0.05),however which was related to gender,clinical TNM stages and distant metastasis (x2=4.680,4.186 and 4.327;aH P＜ 0.05).The gray scale ratios of MeCP2/β-actin in SGC7901/ADR and SGC7901/VCR were 0.593 7 ± 0.030 5 and 0.651 2 ± 0.018 6,which were lower than that of parental SGC7901 cells (1),and the differences were statistically significant (t =23.080,17.360;both P ＜ 0.01).After the expression of MeCP2 was silenced by siRNA,the IC50 of 5-fluorouracil and cisplatin in SGC7901 transfected with MeCP2 specific siRNA were (11.540 0±0.469 3) μg/mL and (2.273 0±0.265 4) μg/mL,which were higher than the IC50 of 5-fluorouracil and cisplatin in SGC7901 transfected with non-related oligonucleotide sequence ((8.663 0±0.160 1) μg/mL and (0.884 0 ±0.038 6) μg/mL),respectively.The differences were statistically significant (t =15.380 and 8.153;both P ＜ 0.01).Conclusions The expression of MeCP2 in gastric cancer tissues significantly decreased,which was correlated with clinical stages,distant metastasis.MeCP2 can inhibit the MDR of gastric cancer cell,which indicated the dysregulated expression of MeCP2 might participate in the genesis and development of gastric cancer.

Objective To study the disease trend of Keshan in Hubei Province and provide a basis for scientifically making control and prevention strategy.Methods According to Chinese Surveillance Plan of Keshan Disease,physical examination and electrocardiogram were done for surveillance subjects and suspected patients were filmed chest X-ray in Keshan disease areas.Results Totally 4 822 people were monitored from 2007-2014.The numbers of females (2 589,53.69％) were more than those of the males (2 233,46.31％).The group of people under the age of 15 accounted for 52.47％ (2 530/4 822) which was higher than that of the group over the age of 55 (19.14％,923/4 822).The rate of electrocardiographic abnormality was the highest in 2011 (61.33％,268/ 437) and the lowest in 2014 (5.61％,23/410).In the eight years,only potential type of Keshan disease patients were detected,and the incidences from 2007 to 2014 were all lower than 3％ and had a decreasing trend yearly.No Keshan patient was detected in 2012-2014.Ninety-one suspected cases were taken chest X-ray.Most of the suspected cases (63.74％,58/91) had normal cardiothoracic ratio.The cardiothoracic ratio increased,excepting one,other 32 were all potential type Keshan disease patients.Conclusions The disease trend of Keshan disease in Hubei Province is weak.Nevertheless,surveillance and health education are indispensable,in case the disease relapses.

Objective To investigate the influence of previous abdominopelvic surgery on gynecological laparoscopic operation.Methods A retrospective analysis of 3 283 cases of gynecological diseases by laparoscopic operation patients in Peking University First Hospital from 2007 January to 2012 December,among them,719(21.90％) patients with previous abdominopelvic surgery history (study Group),2 564 (78.10％) patients have no history of abdominopelvic surgery (control group).Study group 719 patients,previous operation times:one time in 525 cases,194 cases were multiple; previous operation:185 cases of gynecological surgery,305 cases of obstetric surgery,108 cases of general surgery,and 121 complex surgery (include at least two kinds of surgery) ;previous operative approach:650 cases laparotomy and 69 cases laparoscopy.Compared two groups of patients with abdominopelvic adhesion and the gynecologic laparoscopic operation situation,analyzed the influence of previous abdominopelvic surgery on abdominopelvic adhesionon and gynecological laparoscopic operation.Results The incidence of abdominopelvic adhesion in the patients with previous abdominopelvic surgery was 51.2％ (368/719),which was significantly higher than that of 8.2％ (211/2 564) in patients without previous abdominopelvic surgery (P＜0.01).But the study group score (median 3) and the degree of abdominopelvic adhesion [mild 49.7％ (183/368),moderate 36.1％ (133/368),severe 14.1％ (52/368)] compared with the control group score (median 2) and degree [mild 55.0％(116/211),moderate 25.6％(54/211),and severe 19.4％(41/211)] were no statistical difference (P=0.930,P=0.684).Super-umbilical primary trocar site were chosen more common in patients with previous abdominopelvic surgery (23.1％,166/719) was significantly higher than that in the control group (3.3％,85/2 564; P＜0.01).And the rate of conversion to laparotomy was 0.6％ (4/719)significantly more than the control groups(0.l％,2/2 564; P=0.023).Compared with other groups,patients with gynecological or complex surgery or multiple operation history presented more severe abdominopelvic adhesion both in the score and degree (P＜0.01).The rate of super-umbilical primary trocar site,hospitalization time,operation time and bleeding during operation in patients with multiple operation history were significantly higher than those with single operation history (P＜0.05) ; the rate of blood transfusion,postoperative complication and conversion to laparotomy showed no statistical difference between the two groups (P＞0.05).Conclusion The laparoscopic operation could be carried out successfully and safely in patients with a history of various abdominopelvic operations,but the conversion rate increases,for patients with a history of multiple operation because of pelvic adhesion increases the difficulty of the laparoscopic operatio

Objective To establish a multi-drug resistant model of temporal lobe epilepsy,and to observe the changes of γ-aminobutyric acid (GABA) receptor expression in the hippocampal tissues so as to explore its effects in pharmacoresistant epileptogenesis.Methods One hundred rats were selected to prepare the amygdaloid kindled model of epilepsy by chronic stimulation of amygaloid basal lateral nucleus.After the kindled model of epilepsy was prepared successfully(n =52),pharmacoresistant epileptic rats were selected according to their response to the phenobabital and phenytoin.The selected pharmacoresistant epileptic rats (n =8)were sacrificed and the hippocampus was removed to determine the GABA receptor expression,and the same number of pharmacosensitive epileptic rats was used as control.Results The pharmacoresistant epileptic rats displayed degenerative and necrotic hippocampal neurons.The arrangement of hippocampal neurons was disordered,and the structural characteristics of the arrangement of the hippocampal neurons disappeared.The gray values of GABAA-positive neurons in the hippocampal tissues (141.15 ± 14.72) increased significantly compared with the pharmacosensitive epileptic rats (92.56 ± 5.17; t =3.380,P =0.006).Western blot method demonstrated that the band of GABAA became narrowed and thin.The relative quantity of GABAA in the hippocampal tissues (0.38 ± 0.08) decreased significantly as compared with the pharmacosensitive epileptic rats (0.88 ± 0.18).A significant difference was observed (t =5.420,P =0.002).Conclusions GABA receptor expression might be decreased in the hippocampal tissues of pharmacoresistant epileptic rats.It might play a certain role in the formation of pharnmacoresistant epilepsy.