Objectives To investigate HPV infection and its correlati on with the expression of matrix metalloproteinase-9 (MMP-9) and tissue inhibito r of metalloproteinase-1 (TIMP-1) in vulvar squamous cell carcinoma (VSCC). Meth ods HPV6/11 and 16/18 DNA were detected using in situ hybridization in 26 case s of VSCC, 21 cases of vulvar intraepithelial neoplasia (VIN) and 10 specimens o f normal skin. The expression of MMP-9 and TIMP-1 was measured by immunohistoche mical method in these three groups. Results The infection rates of HPV6/11 and 16/18 in VSCC and VIN were 69.23% (18/26) and 38.46% (10/26), 42.86% (9/21) and 28.57% (6/21) respectively, and no HPV6/11 or 16/18 DNA was discovered in norma l skin epidermis. The expression rates of MMP-9 and TIMP-1 in VSCC, VIN and norm al skin epidermis were 92.31%(24/26) and 76.92% (20/26), 90.45% (19/21) and 80.9 5% (17/21), and 80.00% (8/10) and 50.00% (5/10) respectively. MMP-9 expression in HPV positive lesions was higher than that in HPV negative lesions, but no sig nificant difference of TIMP-1 expression was observed in HPV positive and negati ve lesions. Conclusions HPV infection may play a role in the development of VS CC. The higher expression of MMP-9 comparing with that of TIMP-1 may be an early marker of tumor progression in VSCC, and HPV infection may facilitate the invas ion and metastasis of VSCC.

Objective To investigate the expression of occludin in the intestinal epithelial cells of neonatal rats with necrotizing enterocolitis ( NEC) . The influence of vitamin D on NEC and the expression of occludin was also explored. Methods Sixty neonatal Wistar rats from different litters were divided into four groups 48 hours after birth:10 in the breast-fed+ control group,10 in the breast-fed +vitamin D group,20 in the NEC+ control group and 20 in the NEC+ vitamin D group. In groups with NEC,neonatal rats were sep-arated from their mothers and treated with rat milk substitute+hypoxia+hypothermia. In groups with vitamin D treatment,paricalcitol was given through intraperitoneal injection 30 minutes before,one day and two days after the induction of NEC. The tissue was harvested from the ileum of the rats 72 hours after induction of NEC. Microscopically,the tissue was assessed according to the Nadler scoring system. The expression and location of occludin was observed after immunofluorescence staining. Western blotting was performed and quantified to compare the expression of occludin among groups. Results In NEC rats,the intestinal structure was destructed. Separation of the submucosal or muscular layer,discharge or disappearance of the villa was accompanied by necrosis of the intestinal cells. Vitamin D treatment could significantly alleviate those chan-ges,with the Nadler score 1. 70 ± 0. 21 compared to 2. 90 ± 0. 23 without vitamin D treatment ( P<0. 01 ) . The expression of occludin was decreased in NEC rats and vitamin D could partly rescue this decrease (P<0. 01). The distribution of occludin was sparse and discontinuous in NEC rats while after vitamin D treatment,the distribution was maintained even and continuous. Conclusion The expression of occludin in intestinal epithelial cells is significantly reduced in NEC rat. Vitamin D treatment may inhibit the development of NEC by maintaining the expression of occludin.

Objective To observe the effects of psychological supportive therapy on the activities of daily living (ADL) and depression after cerebral hemorrhage. Methods 60 cases with mild or medium depression according to 17 items Hamilton Rating Scale for Depression (HAMD-17) after cerebral hemorrhage were divided into treatment group (n=30) and control group (n=30). All of them accepted physical exercise, and those in the treatment group accepted psychological supportive therapy in addition. They were assessed with Functional Independence Measure (FIM) and HAMD-17 before and after the treatment. Results After 2 months of treatment, the score of FIM increased more in the treatment group than in the control group (P<0.001), and the score of HAMD-17 decreased (P<0.001). Conclusion Psychological supportive therapy may promote the recovery of ADL and depression for patients post cerebral hemorrhage.

Objective To evaluate the preventive effect of auricular therapy in schizophrenia pa-tients with constipation. Methods 200 psychotic inpatients with anti-psychotic medication were random-ly divided into the intervention group and the control group with 100 cases in each group. The intervention group received conventional therapy combined with auricular therapy while the control group adopted only conventional therapy. The incidence of constipation was observed in the two groups. Results The rate of constipation was 11.34% and 36.73% in the intervention group and the control group, respectively. Auricu-lar therapy showed various effect in constipation caused by different drugs, especially for constipation caused by clozapine, chlorpromazine and pentiapine. Conclusions Auricular therapy showed good effect in preventing constipation induced by antipsychotic drags with less pain and adverse effect, easy and safe to operate, besides, it can improve the medication compliance of patients and promote their rehabilitation.

Objective To observe the iffectiveness of comprehensive rehabilitationinterventions on stroke patients with unilateral spatial neglect (USN). Methods A total of 245 cases if strijd were examined to diagnose USN. Of the 245 patients,86 cases were diagnosed as being with USN, and divided into a control group(n=43 cases) and a treatment group (n=43 cases) randomly. The control group was treated with Bobath and Rood techniques in addition to routine clinical medical interventions, while the treatment group was treated with a comprehensive rehabilitation protocol for USN in addition to the same interventions for the control group. Both groups were assessed with regard to motor, balance function, walking performance, and USN severity as well as the activities of daily living (ADL) performance. Results After 8 weeks of treatment,both groups improved, but there showed a significantly statistical difference between the 2 groups in terms of Fugl-Meyer motor function scores (P＜0.01), balance function scores (P＜0.01) Holden walding function classifications (P＜0.01), Barthel index(P＜0.001) and USN severity scores(P＜0.01). Conclusion Comprehensive USN rehabilitation intervention could improve motor, balance, walking functions and ADL performance and alleviate the USN severity in stroke patients with USN.

Objective To investigate the incidence and risk factors of surgical site infection(SSI)in neurosurgical patients in a tertiary first-class hospital,and provide reference for the prevention and control of SSI.Methods 47 neurological patients with SSI (49 patients developed SSI,2 were excluded from study due to the lack of appropriate control subject)from December 31 ,2011 to December 31 ,2012 were as infected group,and 94 patients without SSI (1 ∶2 matching)were as non-infected group,risk factors for SSI were analyzed retrospectively.Results There was no significant difference in general condition of two groups of patients (all P >0.05 );among 3 708 patients,49 (1 .32%)developed SSI;intracranial infection was the main type of SSI (89.80%);27 patients were performed ce-rebrospinal fluid (CSF)bacteriological detection,6 (22.22%)of whom were positive for CSF bacteriological detec-tion.Univariate conditional logistic regression analysis showed that risk factors for SSI in neurosurgical patients were operational risk assessment score (OR =2.04),frequency of preoperative antimicrobial use(OR =3.15 ),fre-quency of intraoperative antimicrobial use(OR=2.58),duration of operation(OR=2.70),surgical blood loss(OR=1 .72),indwelling drainage tube(OR=4.30),duration of indwelling drainage tube after operation(OR=2.06),and time for initial dressing change(OR=1 .66);Multivariate conditional logistic regression analysis showed that the in-dependent risk factors for SSI were frequency of preoperative antimicrobial use(P =0.03,OR =4.86),duration of operation(P =0.05,OR = 2.89 ),and time for initial dressing change after operation (P = 0.01 ,OR = 1 .92 ). Conclusion Risk factors for SSI in department of neurosurgery are multiple,duration of operation,duration of in-dwelling drainage tube after operation,and time for initial dressing change after operation are major risk factors.

Objective To establish a stable animal model for sequentially dynamic and direct monitoring of the skin wound infection. Methods The mice with full-thickness skin incisions were replicated. After immediate subcutaneous suture,the mice were randomly divided into four groups,ie,Group A was inoculated with 50 μl sterile PBS solution),Groups B,C and D were inoculated with 50 μl suspension containing 1 × 106,1 × 108 and 1 × 1010 colony forming unit (CFU)/ml bioluminescent methicillin-resistant staphylococcus aureus (MRSA) respectively.Then,the diet behavior of each group was observed and the mean weight and mortality of each group were also recorded at different time points.The bioluminescent intensity of fluoresce in the wounds was recorded at different time points by using the charge-coupled device (CCD) based imaging system.Local wound tissues were incised at 24 hours after inoculation for HE staining so as to observe wound inflammatory reaction in each group.Wound healing time of each group was also recorded. Results ( 1 ) Average weight:Groups A and B showed unobvious changes in weight; Group C lightened until day 3 after inoculation and then recovered gradually to the preinoculation level at day 14; Group D lightened gradually until death.(2)Mortality:Groups A and B had no death; Group C had 10％ deaths at day 14; Group D had 100％ deaths.(3) Bioluminescent intensity of wounds:Groups A and B showed a gradual weakened luminescence since the day of inoculation and had almost complete disappearance at days 5 and 7 respectively; there was no sign of obvious increase or decrease in Group C from the day of inoculation till day 14 ; Group D had a gradual increase since the day of inoculation and the luminous area expanded until the death.(4) HE staining at 24 hours after inoculation:all the four groups showed inflammatory cell infiltration,especially in Groups C and D.(5) Wound healing time:wound healed at days 5 and 7 after inoculation in Groups A and B; the wounds showed no healing even at day 14 in the Group C,but the wounds length and area did not show obvious enlargement or diminishment ; the wounds extended gradually until the death in the Group D,since the day of inoculation. Conclusions The inoculation of 50 μl suspension with 1 × 108 CFU/ml bioluminescent MRSA to full-thickness skin incision rats allows direct,real-time dynamic and continuous detection of the occurrence and development of the wound infections.The infection model is easy to make and has stability and high repeatability.

OBJECTIVETo observe microvessel density(MVD), epithelial stromal vascular cuffing(VC) and expression of vascular endothelial growth factor(VEGF) in human cervical carcinomas and to clarify their significance in the invasion and metastasis of cervical carcinoma.

METHODSVEGF and CD34 were stained immunohistochemically (SP) in 57 cases of cervical carcinoma (30 cases of squamous cell carcinoma, 20 of adenocarcinoma 7 of glandular and squamous cell carcinoma), 29 cases of cervical intraepithelial neoplasia (CIN) and 16 cases of normal cervices, meanwhile, MVD and VC were also assayed.

RESULTSThere were significant differences among the above 5 groups for MVD P<0.01 . The VC pattern showed a significant difference between cervical carcinoma and CIN or control group P<0.01). The positive rates of VEGF in normal cervical epithelium, CIN, squamous cell carcinoma, adenocarcinoma, glandular and squamous cell carcinoma were 18.8% 3/16, 82.8% 24/29), 93.3% 28/30), 100% 20/20 and 7/7(100%), respectively. There were significant differences between these cervical lesion groups and the control group(P<0.001). The MVD showed significant differences between the positive pelvic node metastasis and negative pelvic node metastasis P<0.05). There was no significant correlation between the expression of VEGF and the tumor diameter, clinical stage, pathologic grade and pelvic node metastasis.

CONCLUSIONThe expression of VEGF may play an important role in the angiogenesis of cervical carcinoma. Degree of malignancy of cervical carcinoma has a close association with microvessel density.

Adult ; Aged ; Aged, 80 and over ; Endothelial Growth Factors ; analysis ; Female ; Humans ; Intercellular Signaling Peptides and Proteins ; analysis ; Lymphatic Metastasis ; Lymphokines ; analysis ; Microcirculation ; Middle Aged ; Uterine Cervical Neoplasms ; blood supply ; chemistry ; pathology ; Vascular Endothelial Growth Factor A ; Vascular Endothelial Growth Factors