Objective To study the significance of the expression of β-catenin(β-cat) in Barrett esophagus and esophageal adenocarcinoma (EAC) and the relationship between its expression and clinicopathological factom.Methods By using SP immunohistochemistry technique,β-cat wag detected in the normal esophageal mucosa group (20 cases),Barrett esophagus with dysplasia group (26 cages) and EAC group (50 cases).Results The membranous expression of β-cat appeared in all of nomal esophageal mucosa.The rate of cytoplasmic and/or nuclear expression of β-cat in the Barrett esophagus with dysplasia group and the EAC group was 38.5% (10/26) and 60.0% (30/50) respectively,and compared with the normal esophageal mucosa group,the difference was signfficant (P＜0.01).The rate of cytoplasmic and/or nuclear expression of β-cat in the EAC group with lymphatic metastasis and the EAC group exceeding deep smooth muscle was 90.0% (18/20) and 72.2%(26/36) respectively,and compared with that in the nonlymphatic metastasis and the non-exceeding deep smooth muscle patients [43-3%(13/30) and 28.6% (4/14)],the difference was significant (P＜0.01).Conclusion Cytoplasmic and/or nuclear expression of β-cat might play a role in the carcinogenesis and progression of EAC and might be a predictor indicating the metastatic potential of EAC.

Background The left atrial appendage (LAA) is thought to be the main source of thrombi in patients with atrial fibrillation (AF).The purpose of this study was to describe the LAA orifice diameter,LAA length,and morphologic type of the LAA in Chinese patients with AF as well as to evaluate whether these LAA parameters are associated with a history of stroke in patients with AF from a single center in China.Methods The study population consisted of 219 consecutive patients with drug-refractory,symptomatic paroxysmal,or persistent AF scheduled to undergo radiofrequency catheter ablation in our single center.All patients underwent extensive clinical assessment and multidetector computed tomography to fully explore the anatomy of the LAA.Results Of the 219 patients who underwent catheter ablation procedures,chicken wing LAA morphology was found in 114 patients (52.2％),windsock in 52 (23.9％),cauliflower in 29 (13.0％),and cactus in 24 (10.9％).Compared with the windsock LAA morphology,cactus had a larger left atrial diameter ((42.40±3.68) and (37.91±4.32) mm,P=0.005) and LAA orifice diameter ((27.38±3.70) and (24.14±3.58) mm,P=0.048).The LAA length was significantly larger in the chicken wing morphology than in the windsock ((37.50±6.74) and (31.33±3.92) mm,P=0.015) and cauliflower morphologies ((37.50±6.74) and (31.33±3.92) ram,P=0.015).According to their medical records,26 patients (11.9％) had suffered a prior stroke.Compared with patients who had no history of stroke,the prior-stroke patients were older (62.04±8.07 and 58.24±9.24,P=0.047) and there were fewer patients with chicken wing (23.1％ and 59.1％,P=0.001) and more patients with cauliflower (26.9％ and 9.8％,P=0.046).Multivariate Logistic regression analysis demonstrated that age (odds ratio (OR) 1.26; 95％ confidence interval (CI) 1.08-1.47; P=0.003),non-chicken wing morphology (OR 5.82; 95％ Cl 1.61-21.03; P=0.007),and LAA orifice diameter (OR 1.25; 95％ Cl 1.05-1.49; P=0.014) were independent predictors of stroke after adjusting for all parameters that emerged as potential confounders with univariate analysis.Conclusion lAA analysis can potentially be used to inform guidance on the implication for stroke risk assessment.

Terpene synthase (TPS) plays important roles in the synthesis of terpenoids which are the main fragrances in Rhododendron flowers. To understand the function of TPS genes in terpenoid metabolism in relation to flower aroma formation, we identified all TPS gene family members in Rhododendron by analyzing its genome database. We then used a transcriptomic approach to analyze the differential gene expression patterns of TPS gene family members in the scented flower Rhododendron fortunei compared to the non-scented flower Rhododendron 'Nova Zembla'. The contents of terpenoid compounds in petals of the above two Rhododendron species at different developmental stages were also measured by using qRT-PCR and head space-solid phase micro-extraction combined with gas chromatography-mass spectrometry. Our results showed that a total of 47 RsTPS members, with individual lengths ranged from 591 to 2 634 bp, were identified in the Rhododendron genome. The number of exons in RsTPS gene ranged from 3 to 12, while the length of each protein encoded ranged from 196 to 877 amino acids. Members of the RsTPS family are mainly distributed in the chloroplast and cytoplasm. Phylogenetic analysis showed that RsTPS genes can be clustered into 5 subgroups. Seven gene family members can be functionally annotated as TPS gene family since they were temporally and spatially expressed as shown in the transcriptome data. Notably, TPS1, TPS10, TPS12 and TPS13 in Rhododendron fortunei were expressed highly in flower buds reached the peak in the full blossoming. Correlation analysis between gene expression levels and terpenoid content indicates that the expression levels of TPS1, TPS4, TPS9, TPS10, TPS12 and TPS13 were positively correlated with the content of terpenoids in the petals of R. fortunei at all flower developmental stages, suggesting that these six genes might be involved in the aroma formation in R. fortunei.
Rhododendron/metabolism* ; Phylogeny ; Terpenes/metabolism* ; Family ; Gene Expression Regulation, Plant

Phenylalaninammo-nialyase (PAL) is a key enzyme in the synthesis of methyl benzoate - a plant aroma compound. In order to understand the function of this enzyme in the formation of fragrance in the scented Rhododendron species-Rhododendron fortunei, we cloned a gene encoding this enzyme and subsequently examined the gene expression patterns and the profile of enzyme activity during development in various tissues. The full length of RhPAL gene was cloned by reverse transcription-PCR (RT-PCR) and rapid amplification of cDNA ends (RACE) techniques. The expression levels of RhPAL gene were measured by real-time quantitative reverse transcription PCR (qRT-PCR) and the amount of phenylalanine and cinnamic acid were assayed with LC-MS. The results showed that the ORF sequence of RhPAL gene amplified from the cDNA templates of flower buds had 2 145 bp, encoding 715 amino acids, and shared 90% homology to the PAL amino acid sequences from other species. qRT-PCR analysis showed that the expression of RhPAL in petals during flowering kept in rising even until the flowers wilted. The expression of RhPAL in pistil was much higher than that in stamen, while the expression in the younger leaves was higher than in old leaves. However, the expression level was relatively lower in petal and stamen compared to that in leaves. We also measured the PAL activity by Enzyme-linked immuno sorbent assay in the petals of flowers at different flowering stages. The results showed that PAL activity reached the highest at the bud stage and then decreased gradually to the lowest when the flowers wilted, which followed a similar trend in the emission of the flower fragrance. The phenylalanine and cinnamic acid contents measured by LC-MS were highly correlated to the expression level of RhPAL in various tissues and at different flowering stages, implying that RhPAL plays an important role in the formation of the flower fragrance. This work may facilitate the breeding and improvement of new fragrant Rhododendron cultivars.
Amino Acid Sequence ; Cloning, Molecular ; DNA, Complementary ; Flowers/genetics* ; Rhododendron/genetics*

In China, with the restructuring of health care system moving forward, private community health facilities have been playing a complementary but increasingly important role in providing public health and basic medical care services in urban areas. However, only limited evidence is available concerning the service functions of private community health facilities in China. The aim of this study was to explore the functions of private community health stations (PCHSs) to provide evidence-based recommendations for policy-making and practice in the development of urban community health services systems. A total of 818 PCHSs and 4320 government-sponsored community health stations (GCHSs) located in 28 cities of China were investigated in 2008. The percentages of stations that provided health services and the annual workload per community health worker (CHW) were compared between the two types of institutions. The results showed that the percentages of PCHSs providing public health services were significantly higher than those of GCHSs (P<0.05); but no significant differences were found in the percentages of basic medical services providing between PCHSs and GCHSs (P>0.05). The annual workloads of all the public health services and basic medical services per CHW in PCHSs were lighter than those in GCHSs (P<0.05), except for resident health records establishment and health education materials distribution (P>0.05). At present, the GCHSs are still the mainstream in urban China, which will last for a long period in future. However, our findings showed that the annual workloads of CHWs in PCHSs were no heavier than those in GCHSs, and the PCHSs were willing to provide public health services. In view of current inadequacy of health resources in China, it is feasible to further develop PCHSs under the guidance of the government, given that PCHSs can perform the basic functions of community health services, which is useful for the formation of public-private partnerships (PPP) and the improvement of community health services.

Objective To explore the effect of bronchoalveolar lavage combined with mechanical ventilation on the clinical symptoms and pulmonary function of elderly patients with severe asthma.Methods A total of 70 patients with severe asthma were selected and randomly divided into observation group and control group.The observation group was given routine treatment,bronchoalveolar lavage and mechanical ventilation,while the control group was given routine treatment and mechanical ventilation.Clinical symptoms,airway function,inflammatory mediators and effect were compared between two groups.Results The effective rate of observation group was 94.29%,which was significantly higher than 77.14% of control group (P<0.05).Clinical symptoms,duration of mechanical ventilation and ICU stay of observation group were significantly shorter than the control group (P<0.05).In the observation group,FEV1,FVC and FEV1/FVC% were significantly higher than the control group (P<0.05),and CRP,TNF-α and IL-6 were significantly lower than the control group (P<0.05).Conclusion Bronchoalveolar lavage combined with mechanical ventilation can improve the clinical symptoms and pulmonary function,alleviate the inflammatory reaction and improve the therapeutic effect.

Objective To explore the effect of bronchoalveolar lavage combined with mechanical ventilation on the clinical symptoms and pulmonary function of elderly patients with severe asthma.Methods A total of 70 patients with severe asthma were selected and randomly divided into observation group and control group.The observation group was given routine treatment,bronchoalveolar lavage and mechanical ventilation,while the control group was given routine treatment and mechanical ventilation.Clinical symptoms,airway function,inflammatory mediators and effect were compared between two groups.Results The effective rate of observation group was 94.29%,which was significantly higher than 77.14% of control group (P<0.05).Clinical symptoms,duration of mechanical ventilation and ICU stay of observation group were significantly shorter than the control group (P<0.05).In the observation group,FEV1,FVC and FEV1/FVC% were significantly higher than the control group (P<0.05),and CRP,TNF-α and IL-6 were significantly lower than the control group (P<0.05).Conclusion Bronchoalveolar lavage combined with mechanical ventilation can improve the clinical symptoms and pulmonary function,alleviate the inflammatory reaction and improve the therapeutic effect.

OBJECTIVETo observe the curative effects of platelet-rich plasma (PRP) combined with negative-pressure wound therapy (NPWT) on patients with sternal osteomyelitis and sinus tract after thoracotomy.

METHODSSixty-two patients with sternal osteomyelitis and sinus tract after thoracotomy, hospitalized from March 2011 to June 2015, were retrospectively analyzed. Based on whether receiving PRP or not, patients were divided into two groups, group NPWT ( 22 patients hospitalized from March 2011 to December 2012) and combination treatment group (CT, 40 patients hospitalized from January 2013 to June 2015). After debridement, patients in group NPWT were treated with continuous NPWT (negative pressure values from -15.96 to -13.30 kPa), while those in group CT were treated with PRP gel (blood platelet counts in PRP ranged from 1 450×10(9)/L to 1 800×10(9)/L, with 10-15 mL in each dosage) made on the surgery day to fill the sinus tract and wound, followed by NPWT. Negative pressure materials were changed every 5 days until 20 days after surgery in patients of both groups. PRP gel was replenished before changing of negative pressure materials in patients of group CT. The sinus tract sealing time, wound healing time, number of patients who had secondary repair surgery, number of patients who had recurrence of sinus tract within three months after wound healing, and length of hospital stay were recorded. Data were processed with t test, Fisher's exact test, and chi-square test.

RESULTSThe sinus tract sealing time, wound healing time, and length of hospital stay in patients of group CT were (16±8), (27±13), and (43±13) d respectively, which were all significantly shorter than those in group NPWT [(29±14), (41±17), and (60±20) d, with t values from 3.88 to 4.67, P values below 0.01]. The number of patients who had secondary repair surgery in group CT was less than that in group NPWT (P<0.01). There was no statistically significant difference in the number of patients who had recurrence of sinus tract between two groups (P>0.05).

CONCLUSIONSCompared with NPWT only, PRP combined with NPWT has great curative effects on patients with sternal osteomyelitis and sinus tract after thoracotomy, for it shortens sinus tract sealing time, wound healing time, and length of hospital stay, and avoids the secondary repair surgery. This method is simple and safe with little injury.

Debridement ; Humans ; Length of Stay ; Negative-Pressure Wound Therapy ; Osteomyelitis ; surgery ; therapy ; Paranasal Sinuses ; pathology ; Platelet-Rich Plasma ; Retrospective Studies ; Sternum ; surgery ; Thoracotomy ; Wound Healing

In China,with the restructuring of health care system moving forward,private community health facilities have been playing a complementary but increasingly important role in providing public health and basic medical care services in urban areas.However,only limited evidence is available concerning the service functions of private community health facilities in China.The aim of this study was to explore the functions of private community health stations (PCHSs) to provide evidence-based recommendations for policy-making and practice in the development of urban community health services systems.A total of 818 PCHSs and 4320 government-sponsored community health stations (GCHSs)located in 28 cities of China were investigated in 2008.The percentages of stations that provided health services and the annual workload per community health worker (CHW) were compared between the two types of institutions.The results showed that the percentages of PCHSs providing public health services were significantly higher than those of GCHSs (P＜0.05); but no significant differences were found in the percentages of basic medical services providing between PCHSs and GCHSs (P＞0.05).The annual workloads of all the public health services and basic medical services per CHW in PCHSs were lighter than those in GCHSs (P＜0.05),except for resident health records establishment and health education materials distribution (P＞0.05).At present,the GCHSs are still the mainstream in urban China,which will last for a long period in future.However,our findings showed that the annual workloads of CHWs in PCHSs were no heavier than those in GCHSs,and the PCHSs were willing to provide public health services.In view of current inadequacy of health resources in China,it is feasible to further develop PCHSs under the guidance of the government,given that PCHSs can perform the basic functions of community health services,which is useful for the formation of public-private partnerships (PPP) and the improvement of community health services.

Objective To explore the predictive value of the expression of CD44v6 and EGFR on the efficacy of neoadjuvant chemotherapy (NACT) in stageⅡ-Ⅲ cervical cancer. Methods A total of 53 patients with stageⅡ-Ⅲ cervical cancer diagnosed by pathology were selected. All patients received two cycles of paclitaxel+platinum NACT. The pathological tissue samples of cervical tumors before NACT treatment were collected. The expression of CD44v6 and EGFR were detected by the immunohistochemical SP method, and we analyzed their predictive value of NACT in stageⅡ-Ⅲ cervical cancer. Results Among the 53 patients, 38 were in the NACT effective group (CR+PR), and 15 were in the NACT ineffective group (SD+PD). The expression of CD44v6 in the ineffective group was significantly higher than that in the effective group (P < 0.05). The expression of CD44v6 was significantly different in patients with CR, PR, and SD (P < 0.05). The AUC of CD44v6 to NACT effect on stage Ⅱ-Ⅲ cervical cancer was 0.74 (P < 0.05). The patients in the high expression group of CD44v6 had worse efficacy in NACT than those in the low expression group of CD44v6 (P < 0.05). Pearson test showed that CD44v6 and EGFR expression were correlated (R=0.34, P < 0.05). Conclusion High expression of CD44v6 may reduce the efficacy of NACT in stageⅡ-Ⅲ cervical cancer, suggesting that the expression of CD44v6 has a certain predictive value and clinical significance in the efficacy of paclitaxel+platinum NACT on cervical cancer. Moreover, CD44v6 is positively correlated with EGFR expression.