Background and purpose:Brain is one of the most common sites for distant metastasis in patients with non-small cell lung cancer,and the prognosis of patients with brain metastasis is usually dismal.The purpose of this retrospective study is to document the relationship between the prognosis of lung cancer patients with brain metastasis and the expressions of p53,nm23 and VEGF in resected lung cancer tissues.Methods:Ninety-two patients who were definitively treated with surgery for non-small cell lung cancer but lately developed brain metastasis between 1997 and 2005 were identified in our institution.Their clinical data were retrieved and retrospectively reviewed.All pathological specimens of their resected lung cancer were examined for the expressions of p53,nm23 and VEGF by immunohistochemical staining.The association between the treatment outcome and the expression of the above mentioned biomarkers were analyzed.Results:The median survival time(MST) of patients with p53(+) versus p53(-) was 11.0 versus 11.9 month,respectively.The 1,2,and 3-year overall survival rates were 45.71%,22.86%,and 18.29% respectively for p53(+) patients,and 49.55%,16.12%,and 8.89% respectively for p53(-) patients(P=0.5179);The MST of patients with nm23(+) versus nm23(-) was 13.0 versus 10.1 month,respectively.The 1,2,and 3-year overall survival rates were 54.20%,21.51%,and 16.45% respectively for nm23(+) patients,and 32.0%,12.0%,and 4.0% respectively for nm23(-) patients(P=0.1075);The MST of patients with VEGF(+) versus VEGF(-) was 10.5 versus 12.2 months,respectively.The 1,2,and 3 year overall survival rates were 42.20%,0,and 0 respectively for VEGF(+) patients,and 50.0%,25.41%,and 16.57% respectively for VEGF(-) patients(P=0.0231).Conclusions:VEGF was a significant adverse prognostic factor for patients with non-small cell lung cancer who developed brain metastasis.Lung cancer patients whose tumor tissue demonstrated positive VEGF expression had reduced overall survival rates at 1,2,and 3 years after surgery.The expression of p53 and nm23 are not significantly associated to the prognosis of this group of patients.

Objective To study the safety and efficacy of laparoscopic splenectomy for splenic diseases.Method We retrospectively studied the outcomes of 55 patients who underwent laparoscopic splenectomy from May 2007 to December 2009.Splenic diseases included idiopathic thrombocytopenia purpura (n=11),autoimmune hemolytic anemia (n=6),hereditary spherocytosis (n=1),splenic lymphoma (n =1),splenic cyst (n=10),splenic angioma (n=5),vascular tumor of spleen (n=2),cirrhosis,portal hypertension and hypersplenism (n=9),cirrhosis and hyperplenism (n=9),and idiopathic splenomegaly (n=1).Results All patients underwent laparoscopic splenectomy,and there was no conversion to open surgery.The operation time (mean±S.D.) was (119.7±33.0) min.The intraoperative blood loss (mean± S.D.) was (83.8± 65.2) ml,and the postoperative hospital stay (mean±S.D.) was (5.7±1.1) days.One patient developed postoperative ascites,and 7 patients had drain fluid rich in amylase.There was no perioperatively death.Conclusion Laparoscopic splenectomy was safe and efficacious for splenic diseases.

AIM: To evaluate the effect of endothelial Rho and Rho kinase in extravasation migration of sarcoma cell. METHODS: We used an in vitro model of sarcoma cell transmigration across a monolayer of HUVEC cultured on collagen gel to observe extravasation migration of sarcoma cells and calculated the electrical resistance of HUVEC monolayer in extravasation migration of sarcoma cells. RESULTS: Sarcoma cells migrated through endothelial cells into collagen gel, the electrical resistance of a HUVEC monolayer reduced in extravasation migration of sarcoma cells.Endothelial Rho inhibitor(C3 transferase) and Rho kinase inhibitor(Y-27632) inhibited extravasation migration of sarcoma cells and inhibited reduction of electrical resistance of a HUVEC monolayer in extravasation migration of sarcoma cells. CONCLUSION: Endothelial Rho and Rho kinase regulates sarcoma cell transendothelial migration through modification of endothelial cytoskeleton.

Objective To explore the effects of amisulpride on the cognitive function in first-episode schizophrenia patients.Methods 64 patients in first-episode schizophrenia were divided into two groups randomly according to the method of tossing a coin,then treated with amisulpride or risperidone respectively for 12 weeks.The efficacy and adverse effect were evaluated with positive and negative scale (PANSS) and treatment emergent side effect scale (TESS) before treatment and after treatment for 2 weeks,4 weeks,8 weeks,12 weeks.Before and after treatment for 12 weeks,cognitive function of all the patients was blindly evaluated with Wechsler Scale-revised China (WMS-RC),Wisconsin Card Sorting Test(WCST) and Trail Making test A and B.Results After 12-week treatment,statistical difference was found in amisulpride(44.7 ± 6.7) and risperidone (45.2 ± 7.4) groups (P ＜ 0.01).But no statistical difference was found between the two groups (P ＞ 0.05).The cognitive function in firstepisode schizophrenia was damaged obviously.In two groups,the scores in recognize,association,comprehend,back a few and MQ of WMS and TAT-A,TAT-B were improved significantly after treatment for 12 weeks (P ＞ 0.05).These items of WCST were improved more remarkably than baseline (amisulpride (20.63 ± 13.06),(28.75 ± 15.72),(43.17 ±22.13),(3.62 ±2.21),P＜0.05; risperidone(20.41 ±13.82),(29.31 ± 16.12),(42.78 ± 21.42),(3.67 ± 2.32),P ＜ 0.05).The improvement in the scores of WCST were statistical difference compared with control group(P ＜ 0.05).But statistical difference was no found between the two groups (P ＞ 0.05).Conclusion The study shows that the cognitive dysfunction in first-episode schizophrenia can be improved by amisulpride,and the efficacy was similar with risperidone.

Objective:To explore the epidemiological characteristics and clinical outcomes of patients diagnosed with novel coronavirus (COVID-19) pneumonia (NCP), and to provide clinical reference for subsequent epidemic prevention and control.Methods:The pathogenesis, clinical characteristics and clinical outcomes of 62 patients with imported novel coronavirus COVID-19 pneumonia in Qingdao area from January 21, 2020 to April 6, 2020 were analyzed.Results:There were 24 males and 38 females, aged from 5 to 91 (52.5±15.7)years. Among them, 31 cases (31/62, 50%) were family cluster disease, 11 cases (17.74%) were nosocomial cross infection, 14 cases (22.58%) came back from Wuhan to Qingdao and community contact infection, and 6 cases (9.68%) were imported from abroad. The longest time from fever to diagnosis was 26 days. Clinical classification: 40 cases were mild, 13 were general, 7 were severe, 2 were critically ill. 61 cases were discharged from hospital, and 1 was dead. The clinical cure rate was 98.39%. The average stay was (18.5±4.8)days. All patients were treated combined with Chinese medicine on the basis of symptomatic treatment.Conclusions:The clinical symptoms of imported NCP are relatively mild, and mild cases were more, the recovery rate was higher. The intervention strategy of traditional Chinese medicine is conducive to rehabilitation. The external input cases and symptomless infected patients are important for epidemic situation in the future.

Objective： To study the changes of water molecular diffusion in the ischemic region by using MR dephase technique and discuss the potential mechanism of the diffusion changes at early stage. Methods: Totally 43 cases were studied retrospectively. There were 10 cases whose MRI examinations were performed within 6 hours，12 cases from 7－24 hours，7 cases from 2－7 days, 8 cases from 8－14 days, 6 cases from 15 days to 2 months. The apparent diffusion coefficients in the ischemic region were calculated. Results: The ADCav in the grey matter was 8.61×10－4mm2*s－1. The ADCav decreased to (4.72×10－4±1.51×10－4) mm2*s－1 in ischemic region at superacute stage, ADCav ratio to contralateral corresponding region was 0.55±0.18, and ADCav increased to (5.68×10－4±1.22×10－4) mm2*s－1 during the time range of 2-7 days, （9.22×10－4±2.07×10－4） during the time range of 8－14 days, and approaching （26.42×10－4+9.65×10－4） mm2*s－1 during the time range of 2 months. The pearson product- moment correlation between the changes of diffusion value and time was sighificent (r=0.95, P<0.001). ADCv increased at superacute stage and decreased over time. Conclusion: The diffusion of water molecules in ischemic region decreased at superacute stage, and the ADC increased over time. The anisotropy increased at superacute stage and decreased as the course developed. DWI could detect ischemic lesion much earlier than CT and routine MR examination. DWI has great value in the diagnosis of superacute stroke. The mechanism of the diffusion changes at early stage may be the intracellular toxicity edema.

Objective:To observe the effects of isobavachalcone (IBC)on the proliferation and apoptosis of tongue squamous cell carcinoma Tca-8113 cells,and to explore their mechanisms. Methods:The Tca8113 cells cultured in vitro were divided into control group and different doses (0, 10, 20,40, 80 μmol · L-1 )of IBC groups.The inhibitory rates of cell proliferation were detected by MTT method.The apoptosis was detected by flow cytometry.Western blotting method was used to detect the expressions of Akt,p-Akt,Erk,p-Erk,Bax, Bcl-2 and Caspase-3 proteins in the Tca8113 cells in various groups.Results:The MTT results showed that the inhibitory rates of proliferation of Tca8113 cells were increased in a concentration-and time-dependent manner;the IC50 at 12,24 and 48 h were (285.13±8.97), (132.40±7.76),and (58.56±5.93)μmol·L-1 ,respectively;and there were significant differences between different time points (P <0.05).The FCM results showed that the apoptotic rates of Tca8113 cells in 20 and 40 μmol·L-1 IBC groups at 48 h were (8.21 ±2.32)% and (22.45 ± 1.18)%, respectively; compared with control group (1.69% ± 0.65%), the differences were statistically significant (P <0.05).The Western blotting results showed that the expression levels of Bcl-2,p-Akt,and p-Erk, in 20 and 40 μmol·L-1 IBC groups were decreased and the expression levels of Bax were increased compared with control group (P < 0.05);the expression levels of Akt and Erk had no significant changes (P > 0.05 ).The expression levels of Caspase-3 in Tca8113 cells in 40 μmol·L-1 IBC group at 48 h were increased compared with control group (P <0.05).Conclusion:IBC could inhibit the proliferation and induce the apoptosis of Tca8113 cells;Akt and Erk signaling pathway may be the pathway of IBC to induce the apoptosis of tumor cells.

Objective To investigate the clinical features of subarachnoid hemorrhagic moyamoya disease and the therapeutic effect of encephalo-duro-arterio-synangiosis (EDAS). Methods The clinical and imaging data of 38 patients with subarachnoid hemorrhagic moyamoya disease admitted to the Department of Neurosurgery,the 307th Hospital of PLA from January 2002 to April 2013 were analyzed retrospectively. Thirty-five patients underwent unilateral or bilateral EDAS (64-sides underwent EDAS,4 patients with aneurysms underwent endovascular embolization first),and 3 patients did not undergo any surgery. Results (1)Subarachnoid hemorrhagic moyamoya disease accounted for 10. 8%(38/353)of all the hemorrhagic moyamoya disease admitted in hospital over the same period,including 37 adults and 1 child. The male to female ratio was 1∶3. 22 (9/29),and the age of onset was 12 to 59 years. The mean age of patients was 39 ± 11 years. Four patients were combined with aneurysms. There were no significant differences in the distribution of Suzuki stage,anterior choroidal artery dilatation and posterior communicating artery dilatation in the remaining 34 patients without aneurysms between the bleeding sides and non-bleeding sides (P>0.05). (2 ) The patients were followed up for 13 -125 months (mean 51 ± 27 months ),two patients had rebleeding,one of them was intraventricular hemorrhage,the other was parenchymal hemorrhage. The postoperative modified Rankin score (mRS)was significantly lower in 35 patients whom were treated with EDAS. Compared with before surgery,there was significant difference (P<0. 05). The re-examination of positron emission tomography (PET)for 16 patients at 3 to 19 months after surgery showed that among the 23 surgically treated hemispheres,the cerebral metabolisms of 17 hemispheres were improved after surgery, and 6 did not have any change after surgery. The re-examination of whole brain digital subtraction angiography (DSA)at 5 to 30 months after surgery in 13 patients showed that revascularizations in 19 of 23 surgical hemispheres were effective. Conclusion Subarachnoid hemorrhagic moyamoya disease often occurs in adults,and women are more common. EDAS can achieve good revascularization effect and improve brain metabolism of patients,and thus relieve the symptoms of cerebral ischemia.

Objective To summarize the clinical experience of surgical intervention for cardiac neoplasm in a fetus . Methods A 32-year-old pregnant woman was admitted to our hospital for complaint of fetal cardiac neoplasm .A separated het-erogenic cardiac occupying lesion was identigied at right atrium of the fetus by echocardiography , whose size is 2.85 cm ×2.25 cm, but the pathogenic origin still remained uncertain, maybe originate from ether pericardium or atrium.The annulus of tri-cuspid valve was compressed nearly 50% with the presence of amount of pericardial effusion.The fetal heart rate decreased at some fetal position resulting in the compression to the heart.So an Ex-utero Intrapartum Therapy(EXIT) procedure was per-formed under the supply of placenta at the 32 weeks of pregnancy.Cesarean section was performed with intact umbilicus and fe-tal circulation by obstetricians.Consequently, the median sternotomy of this fetus and pericardiotomy were performed , with 30 ml clear pericardial effusion drained .The tumor was confirmed to be giant right atrial neoplasm after the intraoperative explora-tion.Considering on the high risk of the cardiopulmonary bypass and limited time for EXIT , the giant atrial neoplasm was left alone with delayed sternum closure after the effectively decompression of the heart .The omphalotomy was successfully per-formed after the EXIT surgery.The neoplasm resection and the repair for its defect on right atrium were performed with cardiop-ulmonary bypass 2 days later.Results Convalesce of this mother was quite good after cesarean resetion .Hemodynamics of the premature baby was satisfatory after the resection of right atrial neoplasm which pathological report was benign hemangioma . Conclusion Via multiple disciplines collaboration , EXIT intervention for fetus is feasible and safe under adequate prepara-tion.

Objective To screen down regulated genes and find down regulated novel genes in gastric cancer. Methods Genes mRNA expression were detected between gastric cancer and normal gastric mucous membrane of five patients using cDNA microarray. Genes mRNA expression signals on hybridization membranes were analysized with computer software. Down regulated genes in gastric cancer were screened. cDNA suppression subtraction library was established by counterpart normal gastric mucous membrane mRNA(Tester) subtracting gastric cancer tissues mRNA(Driver) of five patients. After identification of the subtraction library, positive clones choosen randomly were sequenced , and down regulated novel genes in gastric cancer were screened. Some of the genes were identified by RT PCR.Results Down regulated genes in gastric cancer consist of 60 genes including tumor suppressing genes, apoptosis related genes, DNA replication and transcript or translate related genes, cell cycle related genes, cell migration related genes, etc. Two unknown gene fragments in gastric cancer were cloned. Conclusions Sixty down regulated genes in gastric cancer are confirmed. They are involved in gastric tumorigenicity and metastasis. cDNA subtraction library of gastric cancer was constructed successfully. Two down regulated novel gene fragments in gastric cancer was found.