Objective To investigate the clinical value of CA125, CA153, HE4 joint detection in diagnosis of gynecological malignancies.Methods 70 cases of gynecological malignancies were selected from our hospital in 2013, 72 cases of benign gynecological diseases selected in the same period, and 70 healthy controls were selected. The expression levels of CA125, CA153 and HE4 were detected and statistically analyzed.Results The positive rate of serum CA125 in the gynecological malignancies group was higher than that in the benign gynecological disease group (p <0.05).The positive rate of serum HE4 in the gynecological malignancies group was higher than that in the benign gynecological disease group (p <0.01).The positive rate of CA125, CA153, HE4 joint detection in the gy-necological malignancies group (up to 72.9%) was also significantly higher than that in the benign gynecological dis-ease group (p <0.01).Conclusion is a single tumor marker with the highest sensitivity and specificity for diagno-sis of gynecological malignancies.CA125, CA153, HE4 joint detection can improve the positive rate of diagnosis of gynecological malignancies.

Objective To investigate the effectiveness of early minimal enteral feeding′s prevention and cure of feeding intolerance of very low birth weight infants (VLBWs).Methods A total of 45 VLBWs from the neonatal intensive care unit(NICU) of the second people′s hospital of Shantou,were included,from 2011 Jan to 2012 Dec. 23 infants in the intervention group which were hospitalized in 2012,received early minimal enteral feeding (MEF), while 22 infants in the control group which were hospitalized in 2011,received routine feeding .The incidence of feed-ing intolerance of the two groups was observed .Results The incidence rate of feeding intolerance was 21.74%(5 cases) in the intervention group and 72.73%(16 cases) in the control group.The incidence rate of feeding intol-erance of the intervention group was lower than that of the control group obviously and the difference was statistical significance(P<0.05).The time to achieve full enteral feeding of the intervention group [(28.22 ±1.97)days] was significantly shorter than that of the control group [(34.23 ±3.10)days](P<0.05).Conclusion An early MEF is beneficial to reduce the occurrence rate of feeding intolerance ,achieve full enteral feeding sooner ,decrease the length of hospital stay and improve the life quality of VLBWs .

Objective To evaluate the effects of different head-down tilt (HDT) angles on respiratory mechanics and cerebral circulation during laparoscopic radical resection of rectal carcinoma in the patients.Methods Thirty patients of both sexes,aged 40-64 yr,of ASA physical status Ⅰ or Ⅱ,with body mass index ＜ 30 kg/m2,scheduled for elective laparoscopic radical resection of rectal carcinoma,were included in the study.Anesthesia was induced with midazolam,fentanyl,propofol and cis-atracurium and maintained with targetcontrolled infusion of propofol and remifentanil and cis-atracurium when needed.At 5 min after supine position,5 min after 30° HDT,5 min after 35° HDT,5 min after 40° HDT,and 30 min after pneumoperitoneum (T1-5),airway pressure (Paw),peak airway pressure (PIP),lung compliance (Cpat) and jugular bulb blood pressure (JBP) were recorded.Blood samples were taken from the radial artery and jugular bulb for blood gas analysis and arterial partial pressure of oxygen (PaO2),partial pressure of carbon dioxide in artery (PaCO2),arterial oxygen saturation (SaO2),jugular bulb oxygen partial pressure (PjvO2),and jugular bulb venous saturation (SjvO2) were recorded at each time point mentioned above.Results Paw,PIP,MAP,PaCO2,JBP,PjvO2 and SjvO2 were significantly increased as compared with those obtained when the patients were in supine position,increased gradually with the increasing HDT angles,and decreased to the level obtained when the patients were in supine position at 30 min after pneumoperitoneum.Cpat and PaO2 were significantly decreased as compared with those obtained when the patients were in supine position decreased gradually with the decreasing HDT angles,and increased to the level obtained when the patients were in supine position at 30 min after pneumoperitoneum.Conclusion HDT-induced effects on respiratory mechanics and cerebral circulation increase with increasing angles during laparoscopic radical resection of rectal carcinoma; thus the optimum HDT angle is smaller than 40° for the patients undergoing this kind of surgery.

Objective To evaluate the effects of propofol and sevoflurane anesthesia on cognitive function and amyloid beta protein ( Aβ) deposition in hippocampi of aged mice. Methods Thirty?six SAMP8 mice, aged 6 months, weighing 29-32 g, were randomly assigned into 4 groups ( n=9 each) using a random number table: control group ( group C ) , propofol anesthesia group ( group P ) , sevoflurane anesthesia group (group S) and propofol plus sevoflurane anesthesia group (group PS). In group P, propofol 140 mg∕kg was injected intraperitoneally, when righting reflex occurred, additional propofol 70 mg∕kg was given, and when it occurred again, additional propofol 40 mg∕kg was given. Group S continuously inhaled 1% sevoflurane for 120 min. Group PS continuously inhaled 2% sevoflurane for 120 min, and when righting reflex occurred, additional propofol 40 mg∕kg was given. Anesthesia was maintained for 120 min in P, S and PS groups. Before anesthesia and at 7, 14 and 28 days after anesthesia, Morris water maze test was performed, and the escape latency was recorded. Hippocampi were obtained to determine the expression of Aβ using immuno?histochemistry. Results Compared with group C, the escape latency was significantly prolonged at 7 days after anesthesia, and the expression of Aβwas up?regulated at 7, 14 and 28 days after anesthesia in group S, and no significant change was found in the parameters mentioned above in P and PS groups. Compared with the value at 7 days after anesthesia, the expression of Aβ was significantly down?regulated at 14 and 28 days after anesthesia in group S, and no significant change was found in the expression of Aβ at 14 and 28 days after anesthesia in C, P and PS groups. Conclusion Although sevoflurane anesthesia promotes Aβ deposition in hippocampi, it only causes short?term cognitive dysfunction, however, anesthesia with propofol or with propofol in combination with sevoflurane produces no influence in aged mice.

Objective To evaluate the imaging features of acute necrotizing encephalopathy caused by children A H1N1 influenza.Methods CT and MRI brain imaging data of three children acute necrotizing encephalopathy caused by A H1N1 influenza virus and proved by clinical and laboratory investigation were analyzed.All the three children got CT and MRI scan because of coma while in hospital.Results All cases represented multifocal damage,and some were symmetrical.Bilateral thalamencephalons were involved in the all cases.Bilateral grey and white matters of frontal lobe,temporal lobe,parietal lobe and occipital lobe,and hippocampi,putamina,external capsule,brain stem,bilateral cerebellum,could be seen multifocal damage,and some were symmetrical.All the cases showed brain swelling in varying degrees.These region presented low density in CT,hypointensity on T1 weighted series and hyperintensity on T2 weighted series and FLAIR series in MRI.Conclusion The imaging features of acute necrotizing encephalopathy caused by children A H1N1 influenza represented multifocal and symmetrical damage and brain swelling.It may be characteristic that bilateral thalamencephaloas were involved.The patient was serious,and fatality rate was high.So we should pay much attention to acute necrotizing encephalopathy caused by children A H1 N1 influenza.

Objective To investigate the protective effects of creatine phosphate pretreatment on circulato ry function in prone position in elder patients with general anesthesia.Methods Forty patients in ASA physical status Ⅰ or Ⅱ of male and female,aged 60 to 75 years undergoing percutaneous nephrolithotripsy in prone position,were randomly divided into two groups (n =20 each):the control group (gToup N) and the creatine phosphate group (group P).In the group P,creatine phosphate sodium (30 mg·kg-1 in 50 mL normal saline) was continuous infused at a speed of 100 mL· h-1,while only normal saline 50 mL in the group N at the same time.HR,MAP,CO,SV,CVP,Pulse Pressure Variation (PVV) and Systemic Circulation Resistance (SVR) were monitored and recorded at 1 min before prone position (T0) and 1 min (T1),3 min (T2),5 min (T3),10 min (T4) after prone position.The requirement for vasoactive agents were also recorded.Results Compared with T0,HR began to increase significantly at T1 in the group N(P ＜ 0.05),while MAP,CO and SV began to decrease at T1 to T3,and CVP,PVV and SVR began to increase significantly at the same time in the group N (P ＜ 0.05).Compared with the group N,MAP,CO and SV were decreased,PPV,CVP and SVR were increased significantly at T1 to T2 in the group P (P ＜ 0.05).The requirement for vasoactive agents in the group P was obviously lower than that in the group N (P ＜ 0.05).Conclusion Creatine phosphate pretreatment can stabilize the hemodynamic change effectively,and prevent the adverse cardiovascular events caused by prone position in elder patients with general anesthesia.

[ABSTRACT]OBJECTIVETo investigate the morbidity rate and the epidemiological characteristics of snoring among the elderly in Yangpu District of Shanghai City.METHODSOne thousand six hundred and thirty persons(≥60 years) were investigated through questionnaires in Yangpu District of Shanghai City by a method of cluster sampling.The prevalence and risk factors of snoring were estimated. The relationship between snoring and the common clinical complications was observed by correlation factor analysis.RESULTS1630 questionnaires were provided, among which 1489 questionnaires(91.35%) were effective for evaluation.Of 1489 subjects, 213(14.3%) subjects had habitual snoring. Multivariate analysis revealed that obesity as a significant risk factor of snoring. The prevalence rate of snoring in the elderly with hypertension and poor quality of sleep was higher than that in the normal elderly.CONCLUSIONThe prevalence of snoring in the elder persons (≥60 years) in Yangpu District of Shanghai City is high. Obesity is a significant risk factor of snoring. The main clinical presentations of snoring in the elderly are atypical by the performance of poor sleep quality and the complication of hypertension.

[ ABSTRACT] AIM:To construct a conditionally replicating adenovirus vector activated by CXCR4 promoter and to evaluate its ability of lysing the lung cancer cells specifically.METHODS:Human CXCR4-E1A gene amplified by PCR was cloned into the shuttle plasmid pDC316-GFP to construct the recombinant shuttle plasmid pDC316-CXCR4-GFP.The recombinat shuttle plasmid and adenovirus genomic plasmid pBHG-lox-E1, 3Cre were transfected into 293 cells to construct the recombinant adenovirus CRAd-CXCR4-GFP.PCR was used to detect the target gene fragments, and the viral titer was determined.A549 cells with the highest mRNA expression of CXCR4 were screened out from 5 kinds of lung cancer cell lines by real-time PCR.CXCR4 promoter activity and adenovirus replication numbers were detected in A549 cells after transfection of CRAd-CXCR4-GFP and Ad-NULL.CRAd-CXCR4-GFP and Ad-NULL were transfected into A549 cells and 16HBE cells, the apoptotic rates were detected by flow cytometry and the viability was analyzed by CCK-8 assay.RE-SULTS:The recombinant plasmid pDC316-CXCR4-GFP was constructed successfully.Green fluorescence was observed in 293 cells under fluorescent microscope after co-transfection of pDC316-CXCR4-GFP and pBHG-lox-E1, 3Cre at 11 d. Green fluorescence was observed in 293 cells after infection of amplified 3rd generational adenovirus.PCR showed that the purpose gene was successfully integrated in recombinant adenovirus genome.The virus in the supernatant reached a titer of 1 ×1013 PFU/L.The mRNA expression of E1A and E4 in the A549 cells after transfection of CRAd-CXCR4-GFP was markedly increased compared with Ad-NULL group.Compared with Ad-NULL group and empty control group, the apoptotic rate and the viability of A549 cells in CRAd-CXCR4-GFP group had no significant difference in the first 4 d, the apoptotic rate increased significantly at 5 d, and the cell viability declined significantly at 5 d, but the apoptotic rate and the viability of 16HBE cells in each group had no significant difference within 5 days.CONCLUSION: The conditionally replicating adenovirus vector CRAd-CXCR4-GFP has been successfully constructed, which has the ability of lysing lung cancer cells specifically.

The aim of this study is to investigate the anti-inflammatory effect of the adenosine derivative N6-(3-hydroxylaniline) adenosine (WS070117M1) on cigarette smoke plus LPS (lipopolysaccharide)-induced chronic obstructive pulmonary disease (COPD) in mice and its mechanism. COPD model was established by exposing male BALB/c mice to cigarette smoke and challenged with LPS inhalation. Supernatants of bronchoalveolar lavage fluid (BALF) were harvested and IL-1β, IL-6, IL-8 and TGF-β1 levels were measured by ELISA (enzyme-linked immunesorbent assay). The number of total white blood cells and neutrophils in bronchoalveolar lavage fluid was counted separately. Lung tissue was stained with Mayer 's hematoxylin and eosin for histopathologic examination. pAMPKa protein expression and distribution of lung tissue were analyzed by immunohistochemistry method. In vitro, levels of AMPKα phosphorylation in phorbol-12- myristate-13-acetate (PMA) differentiated THP-1 cells was detected by immunohistochemistry, IL-8 level in supernatants of cigarette smoke condensate stimulating PMA differentiated THP-1 cells was measured by ELISA. The results showed that WS070117M1 treatment significantly activated AMPKa in the lung tissue. It also resulted in down regulation of IL-1β, IL-6, IL-8 and TGF-β1 levels in bronchoalveolar lavage fluid and IL-8 level in cigarette smoke condensate stimulating PMA differentiated THP-1 cells. In addition, WS070117M1 could inhibit the recruitment of total white blood cells and neutrophils. These results suggest that WS070117M1 may alleviate the airway inflammation by activating AMPK in the lung tissue.

Purpose To explore the effect of Levothyroxine on spatial working memory in patients with subclinical hypothyroidism (SCH) using blood oxygenation level dependent-functional MRI (BOLD-fMRI). Materials and Methods Sixteen patients with SCH before and after 6 months levothyroxine (LT4) treatment and 16 matched euthyroid volunteers underwent n-back task fMRI scanning. AFNI software was used for localization and quantification. Results All the subjects demonstrated activated areas including bilateral dorsolateral prefrontal cortex (DLPFC), bilateral premotor area (PreMA), supplementary motor area/anterior cingulate cortex, bilateral parietal area (PA) and right caudate nucleus/thalamus, with right hemisphere dominance. Quantitative analysis of regions of interests showed that all these regions had load effect related to memory load in the control group (P<0.001), whereas only left DLPFC, left PA, bilateral PreMA and right caudate nucleus/thalamus showed the same effect in SCH group. After 6-month treatment with LT4, BOLD signal change was observed in SCH patients within the right DLPFC, right PA and anterior cingulate/supplementary motor cortex (P<0.001). The activation intensity of working memory related brain regions was lower in SCH group compared with that of the control group. Conclusion Spatial working memory impairments in SCH patients are likely related to decreased right DLPFC and right posterior parietal function. LT4 replacement therapy is important to improve and reverse the memory impairment.