Objective To develop a reliable scale for evaluating medication compliance among patients with chronic diseases in China.Methods An initial item pool was generated by literature review,based on the definition of compliance generally accepted in China.The items were then subjected to item selections by using item answer distribution and other four methods,which resulted in a primary scale with 16 items.The reliability and validity of this scale was examined.Results Common factors extracted by factor analysis were well explained,there being a close correspondence between the scale construction and the theoretical construction. Convergent validity with the patients' self-ratings on medication compliance ranged from 0.55 to 0.59,and the correlation coefficient with the score of Morisky questionnaire was 0.58.The Cronbach ?,0 and ? coefficients were 0.717,0.751,0.893 respectively,and test-retest reliability was 0.95.Conclusion The newly developed scale appears reliable and may be a useful tool for measuring drug compliance among patients with chronic diseases,but there are still areas where further improvements may be needed.

Aneurysm, Dissecting ; surgery ; Aortic Aneurysm ; surgery ; Blood Vessel Prosthesis Implantation ; Humans ; Postoperative Complications ; Stents

AIM: To study the expression of laminin and survivin in primary gallbladder carcinoma(PGC),and their correlation with clinicopathologic characteristics of PGC.METHODS: Forty-nine specimens with PGC,21 with cholecystoadenoma and 13 with chronic cholecystitis were included in this study.Laminin and survivin expression in gallbladder tissues were detected by immunohistochemistry.The relationship between laminin or survivin expression and clinico-pathologic data were also analyzed.RESULTS: An intact basement membrane(BM) with well-delineated,smooth and continuous line-like laminin staining was identified in the tissues from chronic cholecystitis,adenoma of gallbladder and gallbladder carcinoma in situ.Submucosal BM,which was interrupted in PGC specimens in NevinⅡstage,was almost lost in tumor tissues in Nevin Ⅲ,Ⅳ and Ⅴ stage.Meanwhile,a distinguishing feature of the tumor tissue was broken or discontinuous line-like laminin staining in the matrix to tumor cells.These lines were detected to be weak,or even entirely absent in some neoplastic tissue sections.Sometimes,a faint cytoplasmic staining of laminin was also found in tumor tissues as classified to Nevin Ⅲ,Ⅳ and Ⅴ stage.Expression of survivin in PGC tissues was significantly higher than that in adenoma of gallbladder and chronic cholecystitis.However,survivin expressions had no specificity and positive predictive value for cell differentiation and grade as well as clinic stage of PGC by using statistical analyses.Furthermore,no correlation was confirmed between the staining features of laminin and survivin expression.CONCLUSION: Laminin expression is strongly associated with the malignancy and invasiveness of PGC,and survivin might play an important synergistic role in the development of PGC.

Objective To probe into the content of DNA Topo Ⅱ in osteosarcoma after chemotherapy.Methods 30 patients with osteosarcoma received two courses of chemotherapy treatment before the surgical resection of the tumor tissue.Then immunohistochemistry was used to detect the content of Topo Ⅱ in tissues and detected its relationship in pathology.Results There were 8 out of 30 cases in which Topo Ⅱ was presented positive in osteosarcoma (26.7 ％).The protein content of Topo Ⅱ was unrelated to the patient' s age,gender,degree of tumor malignancy,tumor location and translocation or Enneking staging (P ＞ 0.05),but related to patients survival rate (P ＜ 0.05).Conclusion Patients with lower expression of Topo Ⅱ are more likely to have poor prognosis.

Objective To summarize the treatment experiences and long-term surgical efficacy of spinal hemangioblastomas.Methods The surgical experiences of 46 patients with spinal hemangioblastomas were analyzed retrospectively.All patients underwent microsurgical resection without preoperative embolization, and 52 operations were performed and 58 tumors were resected.McCormick classification was used to evaluate the function of spinal cord.The mean follow-up time was 8 years.Results Total tumor resection was achieved in 55 tumors and subtotal ones in 3.A week later, improvement was obtained in 11 cases, no changes in 29 and aggravation in 6.No patients died.During a follow-up period from 7 to 9 years, the spinal function was improved in 18 patients, remained stable in 21 and deteriorated in 7.No tumor recurrence was found.The subtotal resection affected the prognosis (P =0.08, OR =10.8, 95 ％ CI 2.1-60.8).Conclusions The spinal hemangioblastomas are highly vascularized benign tumors that can be surgically cured under microscope.Subtotal resection is a risk factor of prognosis.

BACKGROUND:Preliminary studies of our research group have confirmed that the proliferation of preosteoclasts and the differentiation and function of osteoclasts could be inhibited when they were cultured in lower oxygen tension even hypoxia (2%O 2 ), but the gene expression of osteoclasts cultured in vitro have not been reported.
OBJECTIVE:To examine the effect of oxygen tension on specific gene expression of osteoclasts in vitro and explore the mechanism of osteoclast differentiation influenced by oxygen tension.
METHODS:The preosteoclasts were induced with 10μg/L macrophage colony stimulating facto and 10μg/L soluble receptor activator of nuclear factor-κB ligand into mature osteoclasts. Then the osteoclasts were cultured in normoxia, tissue oxygen and hypoxia (20%, 7%, 2%O 2 ) respectively. cells were then stained for tartarate-resistant acid phosphatase to assess osteoclastic formation. cells were col ected at 1, 2, 3, 4, 5, 6, 7 days after culture respectively. The soluble receptor activator of nuclear factor-κB ligand, tumor necrosis factor receptor-associated factor 6, tartarate-resistant acid phosphatase, and cathepsin K mRNA expression levels were determined using real-time quantitative PCR.
RESULTS AND CONCLUSION:The number of osteoclasts positive for tartarate-resistant acid phosphatase in the hypoxia was significantly lower than that in the tissue oxygen and normoxia (P<0.05). Under different oxygen tension, the mRNA expression levels of soluble receptor activator of nuclear factor-κB ligand in osteoclasts maintained unchanged. The mRNA expression levels of tumor necrosis factor receptor-associated factor 6 reached the peak at 5 days after culture in tissue oxygen and normoxia (P<0.05). The mRNA expression time of tartarate-resistant acid phosphatase and Cathepsin K were delayed accompanied by decreased oxygen tension, but the maximum were maintained in tissue oxygen. Compared with normoxia and hypoxia, osteoclasts cultured in tissue oxygen are more prone to differentiate and maintain the activity and functions.

Objective To investigate the exact protocol eliciting the hippocampal CA1 long-term depression (LTD) of rats in vivo and the effect of amyloid β-protein (Aβ) on the LTD.Method By applying test stimulation to Schaffer collateral in hippocampal CA1 region in rats,recorded the in vivo field excitatory postsynaptic potentials (fEPSPs) ;further,observed the induction of LTD with different low frequency stimulation (LFS) and investigated the effect of Aβ25-35 on the LTD.Results Prolonged LFS (1,5 and 10 Hz) but not paired-pulse stimulus (PPS) effectively elicited the LTD in the hippocampal CA1 region,with significantly decreased amplitude of fEPSPs after LFS ; 1 Hz 900 pulses group induced a stronger LTD,being (63.7 ± 3.8) ％ at 120 min post-LFS,lower (P ＜ 0.05) than (75.1 ± 3.2) ％ in 600 pulses group ; different frequencies (1,5 and 10 Hz) of LFS with same pulses induced similar degree of LTD,the amplitude of fEPSPs were (63.7 ± 3.8) ％,(61.2 ± 3.6) ％ and (59.8 ± 3.9) ％ respectively,without significant differences between any two groups (P ＞ 0.05) ; after applying 12.5 nmol and 25 nmol Aβ25-35,the amplitude of fEPSPs decreased to (63.2 ± 3.8) ％ and (46.8 ± 3.9) ％,respectively,and lower and than that in control ((73.9 ± 3.0) ％,P ＜ 0.05).Conclusion Prolonged LFS effectively induced in vivo hippocampal LTD of rats,which provides an important electrophysiological protocol for the study of synaptic plasticity; Aβ25-35 injection dont affect the baseline synaptic transmission,but dose-dependently enhance the in vivo hippocampal LTD of rats,indicating that Aβ-induced LTD facilitation may be involved the early impairment of learning and memory in Alzheimer's disease.

Objective To summarize the clinical efficacy of suture anchors in repairing the delayed Achilles tendon rupture.Methods From January 2010 to December 2013,23 patients with delayed Achilles tendon rupture were treated using the suture anchors.There were 19 males and 4 females,at mean age of 43 years (range,35-53 years).Injury on the left side occurred in 5 patients and right side in 18 patients.Mean time from injury to operation was 26.3 days (range,21-40 days).Ten patients were diaguosed by ultrasound and the other by MRI.All patients underwent suture anchor fixation without external support.Functional training started at the early stage.Incision complications were detected.Ankle flextiou-extension range,American Orthopedic Foot and Ankle Society (AOFAS) score,maximum bilateral leg circumference,tendon rerupture and walking posture were recorded at postoperative 6,12,18 and 24 months.Achilles tendon muscular strength was measured with the Lunsford-Perry heelrise test.Results Follow-up was 24 months.All incisions healed by first intention without sural nerve injury,adherence with skin and deep infection.Six months after operation,the ankle range of motion was dorsiflexion 10.8° (range,9-15°) and plantar flexion 43.8° (range,40-48°),with no significant difference in comparison to the health side (P ＞ 0.05).AOFAS score differed significantly before and after operation (P ＜ 0.01).Maximal leg circumference was 38.2 cm in the health side versus 35.8 cm in the injury side (P ＜ 0.05),but the difference was no more than 3 cm.All patients completed 25 times heel raising without difficulty.Four patients walked with a slight limp and recovered from the limp 12 months after operation.No Achilles tendon ruptured again during the follow-up time.Conclusions Repairing the old Achilles tendon rupture with suture anchors can supply strongly strain between broken ends of the tendon,and the outer cast is not needed after operation.Complications are less and functional practice can be commenced in the early postoperative period for better function restoration.

Objective To study the significance of expression of Cyclin E in hepatocellular carcinoma (HCC). Methods Cyclin E expressions were examined in 45 specimens of HCC and 30 specimens of paracancer tissues, and the relationship between Cyclin E with the clinico-pathological parameters was determined.Among the 45 patients ,19 were poor encapsulatic; 12 patients had portal vein thrombus; 11 had extrahepatic metastasis;12 had intrahepatic metastasis.Any patient had one or more of 4 conditions mentioned above was considered as invasion and metastasis. Results The overexpression of Cyclin E in HCC tissues was seen in 16 cases (35.6%) ,but not seen in paracancer tissues. Cyclin E overexpression occurred more frequently in HCC patients with poor differentiation and portal vein thrombus ( P 0.05). Conclusions Expression of Cyclin E is related with HCC carcinogenesis; differentiation , invasion and metastasis, detection of expression of Cyclin E may be helpful in the diagnosis, treatment and prediction of the prognosis of patients with HCC.

Objective To investigate the effects of levocarnitine on pregnancy outcome of the patients with obstructive azoospermia treated with intracytoplasmic sperm injection ( ICSI ) . Methods A total of 74 patients with obstructive azoospermatism treated with ICSI randomly divided into 2 groups:treatment group( n=38) , taking levocarnitine before treatment with ICSI 1 g twice a day for three months;control group( n=36) , taking vitamine E before treatment with ICSI 0.1 g twice a day time for three months.tumor necrosis factor-α(TNF-α), reactive oxygen species(ROS) level, epididymal sperm motility and morphology in epididymal fluid of the two groups were determined before and after treatments. The number of matured oocytes, fertilization, and embryos of adequate quality, the rate of fertilization and embryo of adequate quality, and pregnancy rates after PESA-ICSI were compared between the two groups. Results TNF-α in epididymal fluid before and after the treatment was (5.39±2.28)and(4.05±2.14)ng.mL-1 in the treatment group(P<0.05), and(4.97±2.13)and(4.83±2.35)ng.mL-1 in the control group.ROS in epididymal fluid before and after the treatment was(62.72±8.51),(56.28±8.70)RLU.s-1(P<0.05)in the treatment group( P<0. 05 ) , and ( 62. 61 ± 7. 55 ) and ( 61. 05 ± 6. 77 ) RLU . s-1 in the control group. After treatment with levocarnitine, epididymal sperm motility was significantly increased(P<0.05).There were no significant differences in all the indexes in the control group before and after the treatment(P>0.05).After PESA-ICSI, the number and percentage of high quality embryo in the treatment group were significantly higher than those of the control group(P<0.05). Conclusion Levocarnitine can down-regulate epididymal TNF-α and ROS in patients with obstructive azoospermatism, thereby improve the environment of the epididymis and elevate the quality of sperm and ICSI pregnancy outcome.