Objective To discover the vital role of Rab27B in tumor cells and its potential molecular mechanism by means of quantitative proteomics analysis of Rab27B knockdown in MHCC97H.Methods The expression of Rab27B in MHCC97H cells was knocked down by the combination of Tet-on advanced inducible expression system and RNA interference technology.Then, proteins extracted from the cells were identified by LC-MS/MS system after FASP digestion and iTRAQ 4-plex labeling. Finally, the properties of differentially expressed proteins, including the subcellular localizations, biological processes and molecular functions, were analyzed by the bioinformatics method.Results There were 448 differentially expressed proteins (|Ratio|>1.21, P<0.05) identified in MHCC97H cells after Rab27B knock-down.The expression levels of 229 or 219 proteins were positively or negatively correlated with Rab27B, respectively. These differentially expressed proteins were mainly involved in vesicle transport, macromolecule localization, cellular response to stimulus.Furthermore, there were 26 differentially expressed proteins participating in 8 tumor-related signal pathways, eleven of which were in the focal adhesion signal pathway.Conclusion The analysis of quantitative proteomics in Rab27B-knockdown MHCC97H cell line by iTRAQ suggests that Rab27B not only has an impact on the exosomal secretion of tumor cells, but also regulates master proteins in signal pathways involved in cell proliferation and migration.

Objective To study the pathological and ultramicrostructural characteristics of organ tissues in relation to the clinical course of severe acute respiratory syndrome (SARS). Methods Post-mortem tissue samples of organs (lungs, heart, liver, spleen, kidneys, pancreas, stomach ) were obtained by needle biopsy from four SARS patients who died in middle and late stages 3-5 weeks after the onset of the disease. The pathological samples were studied by light and electron microscope, immunohistochemistry, histochemistry and indirect immuno-fluorescent antibody test. Results The main pathological features were early interstitial pulmonary fibrosis or organizing pneumonia. Fibroblasts were increased in the interalveoli septa and young connective tissue was found to fill the alveoli. Diffuse alveolar damage (DAD) with alveolar pneumocytes proliferation and an increase in macrophages were found. Desquamative alveolitis also existed at the same time. Squamous metaplasia and syncytial giant cells with multinuclei could be seen. CD3 + and CD20 + lymphocytes were markedly decreased and CD68 + macrophages and S-100 + dendritic cells increased in spleen. Proliferation of bone marrow cells became restrained . Hepatocytes were vacuolated with fatty degeneration. Electron microscopy showed the presence of coronavirus-like particles 80-60nm in diameter enveloped in the cytoplasm of the type Ⅱ pneumocytes, endothelial cells and lymphocytes. Conclusions A novel coronavirus is the cause of the newly recognized severe acute respiratory syndrom (SARS). The main target organs are lung and immune system. Different pulmonary pathological features were found in patients dying from the disease in different stages. All of specimens showed positive reaction of SARS-fluorescence antibody.

Objective To identify the key factors triggering medical disputes induced by differences in cognition between doctors and patients in order to control the occurrence and development of medical disputes. Methods From 2002 to 2006,the outpatients,inpatients and medical staff of 3 hospitals in Shanghai(class 3 first level general hospital,n=2;class 3 first level special hospital,n=1) were investigated,and random sampling method was employed for the research analysis. Results There were significant differences between doctors and patients in cognition of influential factors triggering medical disputes such as health law,medical services,rights and obligations. Conclusion The differences in cognition between doctors and patients are important causes for medical disputes,and effective prevention and intervention measures must be taken.

Objective To evaluate the efficacy of thoracic cavity perfusion with cisplatin combined with mannan peptide in nasopharyngeal carcinoma patients with malignant pleural effusion.Methods 47 cases of nasopharyngeal carcinoma patients with malignant pleural effusion with a median age of 50 years old (41-70 years old) were enrolled.Pleural effusion occurred at 38.5 months on average after diagnosis,unilateral effusion was seen in 45 patients (95.7 ％),bilateral effusion was seen in 2 patients (4.2 ％).Cisplatin combined with mannan peptide was administered through pleural puncture by PICC center vein pipe after drainage.Data of survival complications and response to the treatment were reviewed.Results 17 patients (36.1％) had a complete remission (CR),21 patients (44.6 ％) had partial remission (PR),and the total remission rate (CR+ PR) was 80.9 ％.The median survival time was 10.5 months.Patients with pleural fluid pH ≥ 7.2,glucose ≥ 60 mg/L,and lactic dehydrogenase (LDH) ＜ 600 U/L showed association with good efficacy,the efficacy rates were 85.0 ％ (34/40),86.5 ％ (32/37),89.5 ％ (34/38),the median survival time were 11.5,12.0,12.5 months.Pleural fluid pH ＜ 7.2,glucose ＜ 60 mg/L,and LDH ≥ 600 U/L showed association with poor efficacy,the efficacy rates were 42.8 ％ (3/7),50.0 ％ (5/10),44.4 ％ (4/9),the median survival time were 6.5,6.5,6.0 months (P ＜ 0.05).The curative effect of the patients with bone metastasis and (or) pulmonary metastasis without liver metastasis was more similar with that of the patients with liver metastases [(47.0 ％ (16/34) vs 57.1％ (4/7),x2 =0.01,P =0.29].But median survival time had significant difference (11.0 vs 6.0 months,P =0.02).The Cox multi-factor analysis confirmed that the LDH value of effusion was an independent factor as prognosis evaluation.Major side effects of the treatment included fever,chest pain,nausea and vomiting.Conclusion Thoracic cavity perfusion using cisplatin combined with mannan peptide is effective in the treatment of malignant pleural effusion in nasopharyngeal carcinoma patients with pleural effusion,with relatively low toxicity.LDH value is a predictive factor for survival.The patients with liver metastases appeare poor median survival time.

Objective To summarize our experiences in the diagnosis and treatment of giant colonic lipoma,and enhance awareness of the disease and avoid misdiagnosis.Methods We retrospectively analyzed the clinical data of 5 cases of giant colonic lipoma that were mistaken for colon cancer,and evaluate the possible reasons of misdiagnosis.Results Colonic lipoma is an uncommon benign tumor.Most cases with larger tumor size were misdiagnosed as colon cancer when they suffered from the symptoms of abdominal pain,bloody stool,abdominal mass,even bowel obstruction and intussusception.Barium enema and colonoscopy are important diagnostic means.Contrast enhanced CT scan can provide definitive topographical information identifying a colonic lipoma.Surgical resection was performed in all the 5 cases.Conclusion Giant colonic lipoma with intussusception can mimic a colonic carcinoma leading to misdiagnosis.

Using the high efficient copper-adsorbing yeast strain Y17 as absorbing material, the major affect factors including pH, original concentration of Cu2+, cell biomass, adsorption time and temperature were examined, and then the absorbing sites of the Y17 was determined. The results showed that the solution pH was the most dominate factor which affected the biosorption of Cu2+, the other affecting factors were the ini- tial concentration of Cu2+, the cell biomass added, and adsorption time, respectively; the temperature had lit- tle effect on the rate of biosorption. The orthogonal experiment showed that the optimal absorption condition was as follow: the solution pH was 5.0, the absorption time was 40 min, the cell biomass of Y17 added was 5.0 g/L, and the concentration of Cu2+ was 8 mmol/L; the highest adsorbing rate was up to 82.7% at this condition. Based on the results of different pretreatments and the desorption of Cu2+, the cell wall of Y17 was identified as the main place occurring boisorption process, and the -NH2 group, -COOH group on the surface of the yeast cells played an important role on the boisorption process.

· AIM: To discuss the cause and management of complications during the manual small incision cataract surgery (MSICS).combined with intraocular lens implant (MSICS-IOL) were done in 160 patietns with cataract. In this paper, we reviewed the clinical data of the intraoperative complications.injury, posterior capsule rupture, iris prolapse and hyphema, were mainly caused by inexpert skill and lacking of experience.techniques, careful operation could decrease the incidence of complications during MSICS operation. By proper management, the intraoperative complications could be solved satisfactorily.

The silent cerebral infarct is an clinic symptom that is so slight or transitory as to be easily neglected. There are only neural symptoms and signs,but irresponsible infarct focus can be seen on image. The risk factors of silent cerebral infarct may be the same as those of symptomatic cerebral infarct. Such infarct is likely to influence the course, clinic symptom and prognosis of acute cerebral infarct and may foretell symptomatic cerebral infarct and deteriorate into pseudo-global paralysis or multi-infarcted dementia. Therefore elder who suffer from hypertension or diabetes and experience vertigo, headache, language barrier but without apparent signs and symptoms should receive cerebral CT or MRI. Minor or third-degree precautionary measures can be taken as a chief therapy for cerebral infarct. Alternatively vitamines B_6,B_(12) and folic acid can be supplied to reduce the chance of hyperhomocysteinemia. Headache is the initial symptom in silent brain infarct. Magnesium is effective when dehydration does not work.

Otjective To study whether there is the apoptosis of neural cells and the expressionof Bcl-2 protein in intracerebral hemorrhage (ICH) in model of rats, for the further understanding the mechanism of the delayed damage of the neural cells around the hematoma after ICH. Methods Fifty SD rats were randomly divided into 5 groups, ten in each. With the Group A as the control, the rest 40 were used to set up intracerebral hemorrhage model. The brains were taken out at 12th, 24th, 48th and 72th hours, respectively. Apoptosis cells were detected with terminal deoxynucleotidyl transferase mediated dUTP nick end labeling (TUNEL), and the expression of Bcl-2 protein was detected with immunochemical stainging methed (SP). Results In the control group, no apoptosis cells and Bcl-2protein were detected. In rest groups, the apoptosis cells and Bcl-2 protein were expressed in different degree.Apoptosis rates verified and corresponded with the time after ICH, with the peak at 48th -72th hour after hemorrhage.The peak rate of apoptosis cells was (24. 50± 2.69)% and Bcl-2 protein expression was (20. 76 ± 1.97)% . There was significant difference between the experimental groups and control (P＜0.05), and no linear relationship between the apoptosis rate and the expression of Bcl-2 protein. Conclusion Apoptosis may be an important factor in the secondary trauma of ICH. There is a time leg after hemorrhage. All this is instructive to clinical treatment in time. Bcl-2 protein keeps increasing in a certain time after hemorrhage, but not synchronize with the cell apoptosis. This indicates that bcl-2 has the effect to reduce the apoptosis of neural cells.

Objective To study the protective effect of(-)clausenamide on the damage of PC12 cells induced by serum deprivation and to explore its related mechanism. Methods The cell viability was detected by MTT assay and morphological observation. The effect of(-)clausenamide on the PC12 cell apoptosis was analyzed by flow cytometry. Then western blotting and confocal microscope was used for the further study of effect of(-)clausenamide on the protein expression of GSK-3?,Bax and Bcl-2. Results(-)Clausenamide remarkably increased PC12 cell survival rate through inhibiting the PC12 cell apoptosis induced by serum deprivation at the concentration of 1 or 10 ? mol/L(P