Objective To study the radiographic findings of anomalies of thoracic skeletion in patients with congenital heart disease.Methods Frontal and lateral chest films of 252 cases with congenital heart disease proved by operation were reviewed.Results The skeletal anomalies in 8 cases including generalized sternal prominence,sternal bowing,pouter pigeon breast,hemivertebrae and butterfly vertebrae of thoracic spine,and deformities of ribs were discovered.Conclusion The skeleton anomalies which are divided into primary and secondary types often occur in patients with congenital heart disease.

Objective To explore the effect of chlamydia pneumoniae(CP)infection on T lymphocyte subsets in patients with chronic obstructive pulmonary disease(COPD).Methods A total of 176 patients with acute exacerbations of COPD who were admitted to hospital from Jan.2001 to Jan.2005,and 46 healthy subjects were selected.Chlamydia pneumoniae-specific serum IgG,IgA,IgM antibodies were measured by microimmunofluorescence(MIF)test;the flow cytometer was used to analyze the frequency of CD+_3,CD+_4 and CD+_8 lymphocytes in patients with COPD and controls.Results The rate of acute chlamydia pneumoniae infection in COPD patients with acute exacerbations was 27.3% and that of chronic CP infection was 19.3%.They were all significantly higher than that in healthy subjects(P﹤0.01).The frequency of the CD+_3 and CD+_4 lymphocytes showed no difference in each group.The frequency of CD+_8 lymphocyte in COPD patients of chronic CP infection rose and the CD+_4/CD+_8 ratio was decreased in comparison with controls.On the other hand,the CD+_8 lymphocytes and the CD+_4/CD+_8 ratio showed no difference between chronic CP infection group,no CP infection group and controls.Conclusion The chlamydia pneumoniae infection is a rather frequent event in acute exacerbations of COPD,and it is an important reason to cause the disorder of cell-mediated immunity in COPD patients.The disorder of cell-mediated immunity may be involved in pathogenesis of COPD.

AIM: To identify the key factors responsible for drug resistance in different ovarian cancer cell lines using protein microarray system. METHODS: Six ovarian cancer cell lines were employed. The sensitivity of ovarian cancer cell line to common chemotherapeutic drugs was determined by using MTT assays. The expression of 78 cytokines and other factors was examined by using cytokine antibody array technology. RESULTS: Different ovarian cancer cell line responded to chemotherapeutic agents differently. The drug resistance was correlated with certain cytokine expression. Cell line SKOV3 was less sensitive to first line chemotherapeutic drug (ADM, CBPDA) and accumulated high amounts of GRO and TIMP-2 compared with other 5 cell lines. OVCAR4 cells were more resistant to second line chemotherapeutic drug (TAXOL, VP16) and had higher levers of IL-6 and IL-8 than IGROV1, OVCAR3 and OVCAR5. CONCLUSIONS: Among the most common excretive cytokines, increasing of GRO, IL-6, IL-8 and TIMP-2 might be related to drug-resistance of ADM and CBPDA in ovarian cancer cell, while IL-6 and IL-8 might also be related with drug resistance of TAXOL and VP16. The different types of ovarian cancer cell might have roughly similar excretive cytokines-induced mechanism of drug resistance.

Variants of gene loci on susceptibility genes are the major individual susceptibility factors of esophageal squamous cell carcinoma (ESCC) in China.Some of the gene loci participate in the DNA damage and repair,and some are related with cancer suppressor genes,metabolism enzymes,trace elements and smoking.The single nucleotide polymorphisms of these susceptibility genes are closely correlated with the genesis of ESCC.

The external treatmen of traditional Chinese medicine, the enema and the acupuncture is the current methods of external treatment of traditional Chinese medicine treatment for cirrhosis ascites. In the field of external application and enema, most literature reported specific herbal formular for specific disease, while little literature reported combination of oral administration of herb and external application, or external application based on TCM pattern differentiation, or external application on the acupoints. Acupuncture can reduce drug use and avoid their damage on the liver. This paper summarized the current researches of Chinese medicine external treatment, and points out the direction of the research on the external treatment of traditional Chinese medicine.

Objective To analyze the changes in platelet parameters and their influential factors in cirrhotic patients with hepatocellular car-cinoma (HCC).Methods The clinical data of 602 cirrhotic patients with HCC who were admitted to the First Hospital of Jilin University from January 201 1 to December 2012,as well as 200 cirrhotic patients hospitalized during the same period,were collected.Statistical analy-sis was performed using SPSS 19.0.Normally distributed continuous data were expressed as mean ± standard deviation;comparison be-tween two groups was made by t test,and comparison between multiple groups was made by analysis of variance.Non-normally distributed data were expressed as median and interquartile range (P25 -P75 );comparison between groups was made by rank sum test.Results Com-pared with the cirrhotic group,the HCC group had significantly higher platelet count (PLT)and plateletcrit (PCT)(t=5.019,P=0.000;t=5.017,P=0.000)and a significantly lower mean platelet volume (MPV)/PLT (t=5.877,P=0.000);there were no significant differences in MPV and platelet distribution width between the two groups (t=-0.942,P=0.347;t=-1.040,P=0.298).The receiv-er operating characteristic (ROC)analysis showed that the area under the ROC curve was 0.636 for PLT,0.633 for PCT,and 0.639 for MPV/PLT in the diagnosis of HCC in cirrhotic patients.Decreases in PLT and PCT were closely related to hepatitis C virus (HCV)infec-tion.Patients with Child-Pugh class A cirrhosis had significantly higher PLT and PCT than those with Child-Pugh class B and C cirrhosis (P<0.01);patients with a maximum tumor diameter of≥5 cm had significantly higher PLT and PCT than those with maximum tumor di-ameters of2-5 cm and≤2 cm (P<0.01).Patients with Child-Pugh class A cirrhosis had a significantly lower MPV/PLT than those with Child-Pugh class B and C cirrhosis (P<0.01);patients with a maximum tumor diameter of≥5 cm had a significantly lower MPV/PLT than those with maximum tumor diameters of2-5 cm and≤2 cm (P<0.01).Conclusion PLT,PCT,and MPV/PLT can be used in the auxiliary diagnosis of HCC in cirrhotic patients,which are related to HCV,Child-Pugh classification,and tumor size.

Objective To investigate the levels and clinical significance of serum 25 -hydroxy vitamin D[25 (OH)D]in patients with chronic liver disease.Methods A total of 153 hospitalized patients with chronic liver disease in the First Affiliated Hospital of Jilin Univer-sity from June 2012 to September 2013 were enrolled in the study group.The levels of serum 25(OH)D were measured by liquid chromatog-raphy tandem mass spectrometry.The serum samples from 300 healthy volunteers who underwent physical examination in our hospital were used as controls.The study group was divided into three subgroups:non -cirrhosis,liver cirrhosis [Child -Pugh (CP)grades A,B,and C],and primary biliary cirrhosis.Comparison of continuous data between groups was made by t test and analysis of variance,and compari-son of categorical data was made by chi -square test.Correlation between different variables was investigated by Pearson linear regression a-nalysis.Results Of the 153 patients with chronic liver disease,the percentages of those who had vitamin D adequacy (≥30 ng/ml),in-sufficiency (20 -30 ng/ml),deficiency (10 -20 ng/ml),and severe deficiency (<10 ng/ml)were 20.3%,22.9%,35.9%,and 20.9%,respectively.The percentages of patients with vitamin D deficiency and severe deficiency were significantly higher in the cirrhosis subgroup than in the non -cirrhosis and primary biliary cirrhosis subgroups (41.7%,25.0% vs 27.5%,12.5% and 23.5%,17.6%,re-spectively;χ2 =6.261 -18.474,P =0.001 -0.012).The serum 25(OH)D levels in patients with cirrhosis were significantly lower com-pared with those in patients without cirrhosis and in controls (18.58 ±12.48 vs 23.78 ±11.81 and 25.69 ±12.39 ng/ml,P =0.029 and 0.001).CP class C cirrhotic patients had significantly lower serum levels of 25(OH)D compared with CP class A patients (P =0.009). Conclusion Serum 25(OH)D deficiency is common in patients with chronic liver disease.25(OH)D levels in cirrhotic patients,especial-ly in CP class C patients,are markedly lower than those in non -cirrhotic patients.

Objective To study the clinical features and therapeutic effects of pituitary adenomas in elderly patients. Methods The clinical materials including main clinical manifestations, diagnostic methods and outcome of treatments of 49 elderly patients with the pituitary adenomas from 1987 to1998 were analyzed retrospectively. Results It was showed from the data that the average duration of illness was 4 4 years; and 46(93 8%) cases were with visual deterioration, 20 (40 8%) with headache, and 16(32 7%) with endocrine abnormality. The diameter of tumors was more than 3 cm in 25 (51 0%), and the non functioning adenomas were found in 27 (55 1%). Operation was undergone through trans sphenoidal (61 2%), subfrontal (32 7%) and extensive subfrontal extradural approaches(6 1%), respectively. Among the 49 cases, tumor was totally or subtotally removed in 38 cases (77 6%), large partially or partially removed in 11 cases (22 4%). The results of operation through the trans sphenoidal approach were superior to other routes All patients were long term followed up for an average of 50 5 months. Visual disturbances were improved in 27 of 46(58 7%). A total of 43 patients could live by themselves Tumor disappearance was observed in 30 cases and recurrence in five cases. Five cases showed no changes in tumor size. 28 cases underwent radiotherapy after surgery and the occurrence rate of hypopituitarism after radiotherapy turned to be 50%. Total tumor control rate was calculated as 93%. Conclusions Macroadenomas and non functional pituitary adenomas happened most frequently in elderly patients and the main clinical symptoms was visual deterioration. Trans sphenoidal route for microsurgery was believed to be the first choice of operation. Tumor recurrence can be controlled or delayed by postoperative radiotherapy, but severe complication of the visual injury and pituitary dysfunction should be paid much attention.

Objective To evaluate different operative procedures for renal cell carcinoma. Methods 81 cases of renal cell carcinoma operated were reviewed.Radical nephrectomy was carried out for 73 case of which renal artery embolism was conducted for 38 before operation.Simple nephrectomy was carried out for 6 cases and enucleation of the tumor for 2. Results The pathological stu dies showed that 52 cases were clear cell carcinoma,19 cases of granular cell carcinoma,6 cases being a combination of the above two varieties,4 cases being cystic renal cell carcinoma.65 of 81 cases have been successfully followed up for 12～110 months.The 5 year survival rate for stage Ⅰ,Ⅱ,Ⅲ and Ⅳ tumors were 83.9%,78.9%,33.3% and 16.7% respectively. Conclusions Renal artery embolism before radial nephrectomy is essential for a successful operation to achieve a long term survival.Nephron sparing surgery for a small,localized low stage renal tumor is safe and effective.

Objective To study the relationship of expr ession of PTEN and vascular endothelial growth factor (VEGF) with angiogenesis i n bladder cancers. Methods Using immunohistochemical S- P method,the expression of PTEN and VEGF was examined in 62 bladder cancer sampl es and 18 chronic cystitis samples (control group);and the microvessel density ( MVD) was compared among different expression states of PTEN and VEGF in bladder cancer tissues. Results The positive rates of PTEN in bl adder cancer and control groups were 53.2% (33/62) and 100.0% (18/18),respective ly.The difference between the 2 groups was significant ( P