Objective To study the changes and its clinical prognostic value of plasma endothelin 1 (ET-1) and P-selectin on early in-stent restenosis after percutanous intervention (PCI) in patients with acute coronary syndrome (ACS). Methods Venous blood samples were drawn from a total of 108 patients who underwent PCI before and right after the operation, as well as at 1 week, 2 weeks, 1 month, 3 months and 6 months post-procedure. Plasma was separated immediately by centrifugation at 4℃ and stored at -70℃ until detection. All patients received coronary angiography after six months and were catagorized into the restenosis and non-restenosis group according to the result. Plasma levels of ET-1 and P-selectin of the two groups were analyzed. Results Four cases received acute PCI died and another 4 cases lost follow-up. The remaining cases were divided into the restenosis (n=16) and non-restenosis (n=84) group according to their coronary angiography result. Plasma levels of ET-1 and P-selectin reached the peak concentration in the two groups right after PCI. In the non-restenosis group, plasma levels of ET-1 and P-selectin resumed to pre-opeation level at 24 hours and resumed to normal level at 2 weeks. In the restenosis group, plasma levels of ET-1 and P-selectin did not resume to normal level at 2 weeks but increased persistently, and showed their second peak value at 3-6 months after PCI. Conclusion The risk of restenosis increased accompanied by the persistent increase of plasma levels of ET-1 and P-selectin in early stages (1-2 weeks) after PCI in ACS patients. ET-1 and P-selectin may be regarded as makers for early recognition of restenosis.

Objective To evaluate the effect and tolerance of late-course three dimensional conformal radiotherapy(LC3DCRT) combined with concurrent chemotherapy for stage Ⅲ non-small cell lung cancer(NSCLC).Methods From May 2000 to May 2003,48 such patients were entered into this study.The patient's characteristics were: 38 male and 10 female,with median age of 62 years(range 40 to 74);Karnovsky performance score ≥70;stage ⅢA 16 and ⅢB 32,squamous cell carcinoma 38 and adenocarcinoma 10.The treatment regimen consisted of conventional radiotherapy first(40Gy/20f/4W),followed by 3DCRT(24-30Gy/4-5f/2W) combined with concurrent chemotherapy.Conventional irradiation field encompassed the primary lesion,ipsilateral hilum and mediastinal lymph drainage region.LC3DCRT focused on the primary lesion only,with the 80%-90% isodose curve covering the planning target volume(PTV) and the target dose was prescribed to PTV.Supraclavicular metastatic lymph node was treated by mixed 6MV X-ray and electron beam to a total dose of 65-70Gy.Chemotherapy treatment regimen consisted of isophosfomide(25mg/m~2,d1、8,iv) and cisplatin(30mg/d,d1-3,iv) in the 1st and 5th week.Results Before the end of the second month after treatment,the complete response(CR)and partial response(PR) rate was 16.7% and 75.0%,respectively,with a CR+PR rate of 91.7%.The 1-,2-and 3-year local control and overall survival rates as monitored by the Kaplan-Meier method was 87.5%,50.0%,35.7% and 87.5%,46.7%,28.6%,respectively.All patients completed the planned treatment without interruption.Hematological toxicity and radiation-induced pneumonitis as shown by the WHO staging system were the most common acute toxicities but they were tolerable,with 8.3% of grade 3 leukopenia and 4.2% of grade 3 radiation-induced pneumonitis.The severity of the other acute toxicities such as nausea,fever,hemoglobin decrease,and radiation-induced esophagitis were mainly grade 1 or grade 2.Conclusions Late course three dimensional radiotherapy combined with concurrent chemotherapy shows a promising results with tolerable acute toxicities.Long-term survival and late toxicities need further observation.

A review of studies on the influence of impurities on protein crystallization is given.The possible sources of impurities and its effect on the protein crystallization are presented.The effects of impurities on protein crystallization,including nucleation,macroscopic morphologies,microscopic surface morphologies,growth rates,kinetics,quality,and repartitioning of impurities are reviewed.

Objective To investigate the clinical efficacy and safety of lyophilized recombinant human brain natriuretic peptide(rhBNP) in the treatment of patients with congestive heart failure (CHF).Methods 120 CHF patients were randomly divided into two groups.58 cases in the observation group were given lyophilized rhBNP,and 62 patients in the control group were given sodium nitroprusside.The clinical effect,changes of echocardiographic indicators and hemodynamic parameters,adverse reactions were observed.Results After treatment,the total effective rate of the observation group was 91.37％,which was significantly higher than that of the control group(x2 =4.23,P ＜ 0.05).The LVEF and NT-proBNP levels in observation group were (59.0 ± 8.2)％ and (535.4 ± 123.8)ng/L,which had higher improvement than control group (P ＜ 0.05).The incidence rate of adverse reactions between the two groups had no significant difference (P＞ 0.05).Conclusion Lyophilized rhBNP in the treatment of CHF has significant effect,and it is worthy of clinical application and promotion.

Objective To evaluate the reproducibility of quality intima-media thickness(QIMT) and quality arterial stiffness (QAS) technique in assessment of carotid under different measuring methods.Methods Between December 2012 and January 2014,carotid QIMT and QAS examinations were carried out in 30 health volunteers.QIMT and QAS indicators included IMT in QIMT and distensibility coefficient (DC),compliance coefficient(CC),stiffness index α(α),stiffness index β(β),pulse wave velocity(PWV) in QAS.The measurement employed unilateral/once,bilateral/twice,and unilateral/twice methods.Using intra observer and inter-observer variability,the reproducibility was compared between different QIMT and QAS indicators and measuring methods.Results Extremely high level of intra-observer reproducibility was found for both QIMT and QAS technique (ICC＞0.8).QIMT also showed an excellent inter observer reproducibility (ICC＞0.8).In contrast,the reproducibility of QAS technique varied in different indicators (PWV ＞ β ≈ α ＞ CC ＞ DC) and method ( unilateral/once ＞ bilateral/twice ＞ unilateral/twice).Conclusions QIMT measurement was highly reproducible.Whereas the reproducibility of QAS technique varied in different indicators and methods.Due to low reproducibility,the study result did not support the clinical application of DC indicator and unilateral/once method.

Objective To summarize the sonographic features and pathological features of ovarian tumor during pregnancy. Methods One hundred and five women with 114 pathologically proved ovarian tumors during pregnancy in Peking Union Medical College Hospital were retrospectively recruited. According to pathological diagnosis, the clinical treatment, the result of the pregnancy and sonographic examinations were reviewed and analyzed. The sonographic features of benign tumors were compared with low-grade malignant tumors. Results Among the 105 pregnant women with a total of 114 ovarian tumors, 65 tumors were found by ultrasound exam. The other 49 tumors were found during cesarean section. The sonographic features of pathologically proved ovarian tumors include regular shape and well-deifned margins, with 58 of benign tumors and 7 of borderline or low-grade malignant tumors. Compared with borderline or low-grade malignant tumors, benign tumors manifested as strong echoes or high echogenic mass without papillae in the tumors (50/58). As for borderline or low-grade malignant group, tumors manifested as papillae within the tumors (5/7). Pathological classiifcation of the 114 ovarian tumors included 84 germ cell tumors, 19 epithelial tumors, 9 sex cord-stromal tumors, and 2 germ cell tumors combined epithelial tumors. Surgical treatments were performed in 7 cases during the ifrst trimester, while 11 cases during the second trimester, and 87 cases during the third trimester. Pregnancy outcome of the 105 pregnant women included term delivery in 82 cases, premature delivery in 18 cases, artiifcial abortion during ifrst trimester in 4 cases, and induced abortion during second trimester in 1 case. Conclusions Most ovarian tumors treated in pregnancy are benign. The sonographic features of benign tumors include regular shape with well-deifned margins, strong echoes or high echogenic mass within the tumors. While the sonographic features of borderline or malignant tumors include papillae within the tumors. Ultrasound assessment of ovarian tumors can help to determine the risk of malignancy and guide the surgical management.

Objective To evaluate the contrast enhanced perfusion pattern of PTC micro-vascular imaging (MVI) quantitatively.Investigate the correlation between PTC MVI features and CD34 micro-vascular density (MVD).Methods Thirty-nine pathological and clinical confirmed sporadic PTCs were evaluated with real-time gray-scale contrast-ernhanced micro-vascular imaging under a low mechanical index.The micro-bubble agent was SoneVue.Of the 39 PTCs,33 were classical PTCs,6 were PTC with follicular variant (FVPTC).The △ ROI,which is the subtraction of peak echo intensity between the lesion region of interest (ROI) and normal thyroid parenchyma ROI,was used to evaluate the perfusion characteristics of PTC MVI quantitatively.The paraffined specimens were selected for immunohistochemical (IHC) staining for CD3,and the correlation between △ ROI and the CD34 were evaluated.Results △ ROI was strongly correlated with the CD34 expression (P=0.000),significant differences were detected in the distribution pattern of △ ROI value among different CD34 expression levels,no overlapping of the mean △ ROI values and the 95％ confidence intervals was found among the 3 CD34 expression levels.The PTC MVI perfusion was classified into 3 patterns,low perfusion,focal perfiusion and high perfusion,on the basis of combining△ ROI values with the peak ehco pattem in time-intensity curve.Conclusions The △ ROI is strongly correlated with the CD34 expression in papillary thyroid cancer.It can be used for the quantitative evaluation ofPTC MVI pattem and intensity as an objective indicator.

Objective To investigate the effect of infection on the expression of substance P(SP) and Th1 cytokine on colonic mucosa in patients with irritable bowel syndrome(IBS).Methods Mucosa biopsy samples were obtained in descending colon and rectum from 77 patients(20 post-infective-IBS cases)and 30 controls by colonoscopy.The expressions of SP,interleukin(IL)-2,interferon(IFN)-?were determined by immunohistochemical staining.Results Compared with controls,expressions of SP,IL-2 and IFN-?were significantly increased in IBS patients with diarrhea-predominant(P＜0.05),and expression of SP in post-infective-IBS patients with cytokines positive(IL-2 and IFN-?)were also signifi- cantly increased(P＜0.05).There were no significant differences between non post-infective-IBS and controls.Conclusions Expression of SP was significantly increased in post-infective-IBS.SP upregulated the expression of Thl cytokines(IL-2 and IFN-?).Gastrointestinal infection may involve in the patho- genesis of IBS through neuroimmune mechanism.

Objective To investigate the effect of exogenous interleukin-10 (IL-10) on STAT3 protein activation in rats with allergic rhinitis (AR).Methods60 SD rats were randomLy divided into AR model group, IL-10 group and control group, with 20 in each group.AR group and IL-10 group were treated with conventional ovalbumin (OVA) combined with aluminum hydroxide sensitization method.The negative control group was treated with saline instead of 48 h after the last challenge.The levels of IL-6, TGF-β and P-STAT3 in nasal mucosa and serum IgE were measured by ELISA kit.The expression of IL-6, TGF-β and P-STAT3 in nasal mucosa was detected by Western-blot Detection.ResultsAR group exhibited severe clinical manifestations of AR, such as friction around, tears flowing, the signs of which in IL-10 group were significantly lower than that in the control group (P<0.05).Compared with the control group, the levels of serum IgE and IL-6, TGF-β and P-STAT3 in the nasal mucosa were significantly higher than those in the control group (P<0.05).After treatment with IL-10, the levels of TGF-β and P-STAT3 were significantly increased (P<0.05).Western-blot showed that compared with the control group IL-6, TGF-β and P-STAT3 in nasal tissues of AR group and IL-10 group were significantly increased, while the expression level of IL-10 group was lower than that of AR group.ConclusionTreatment of AR with exogenous IL-10 can significantly relieve the clinical manifestation of AR, inhibit STAT3 activation immune response, and achieve the purpose of treatment of AR in some extent.

Objective To evaluate the efficacy of stereotactic body radiation therapy (SBRT) for hepatic metastases from colorectal cancer,and to collect data for the application of this technique.Methods A total of 28 patients from No.306 Hospital of PLA,including 17 male and 11 female with median age of 63.8 (range from 31 to 86),were treated with SBRT for colorectal cancer with liver metastases with 54 lesions in total.The GTV,CTV and PTV were delineated above the enhanced CT scans acquired during normal quiet respiration.CTV was obtained by adding 5 mm isotropic margin from GTV,and PTV was obtained by adding 5 to 10 mm isotropic margin from CTV.Prescription dose line covered 50％-60％ of isodose curve at 3-6 Gy/fraction.The total dose was 39-45 Gy and the biologically equivalent doses(BED)was 50.7-65.3 Gy.The patients were followed-up beginning at 3 months after SBRT.The change in size of the lesion based on enhanced CT or MR scans was evaluated.Toxicity was evaluated and scored according to the RTOG criteria.Local control rate and survival rate were analysed.Results All patients completed the treatment.With median follow-up of 15.1 months (range frome 3 to 30 months),7 patients survived at the end of follow-up.The local control rate (LC) was 79.2％,and 1-and 2-year overall survival rate(OS) were 82.7％ and 48.6％,respectively.There was a close corelation between the size of lesion and the LC.The LC (PR + CR) was much better at the size of lesion less than 14 cm3 than that at the size more than 65 cm3(x2 =4.17,P＜0.05).When the size was more than 180 cm3,the LC was zero.Toxicity included fatigue (60.7％),grade 1 and 2 digestive system toxicity (28.6％),a transient grade 1 and 2 bone marrow suppression (46.4％) and a transient increase in transaminase(17.8％).No grade 3 toxicity and above and late toxicity were observed.Conclusions Stereotactic body radiation therapy could be suggested as the first choice for the selected patients who suffer form colorectal liver metastases,especially for those who cannot undergo surgery.