Objective To study the expression of p27 gene in endometrial carcinoma and its clinical significance.Methods By using streptavidin-biotin peroxidase(SP) method the expression of p27 gene were examined in 20 normal endometrial tissues and 65 endometrial carcinoma tissues.Results p27 was expressed in 33 of 65(51%) cases of endometrial carcinomas.In contrast,p27 was all expressed in normal endometrial tissues.The expression of p27 was related to the pathological grades,clinical stages and depth of myometrial invasions.Conclusion The level of p27 expression is closely related to the growth,invasion and differentiation of endometrial carcinoma.

Two stage polymerase chain reaction(restricted fragment length polymorphism was used to study K ras mutations and chemiluminescence immunoassay was used to detect CA19 9 in plasma from patients with pancreatic adenocarcinoma, some samples were analyzed by direct seqencing. The results showed 18 (60%) of 30 patients with pancreatic adenocarcinoma had K ras mutations in plasma, and 25 (83 3%) of 30 had elevated CA19 9 in plasma. The former was less sensitive than the latter, but the diagnostic rate of combined analysis was 100%. It is concluded that combined analysis of molecular tumor markers and protein tumor marker is more sensitive than protein tumor markers alone, it might overcome Lewis blood type limitation to protein markers.

Objective To investigate the effect of nalmefene on the cerebral ischemia-reperfusion (I/R) injury in rats.Methods Forty-eight male Sprague-Dawley rats, aged 3-4 months, weighing 220260 g, were randomly allocated to control group (group C), sham operation group (group S), cerebral I/R group (group I/R), or nalmefene group (group N) using a random number table, with 12 rats in each group.Cerebral I/R was induced by occlusion of bilateral common carotid arteries for 20 min followed by reperfusion.Group C received no treatment.Group S underwent 20 min exposure of bilateral common carotid arteries and then received suture.In group N, nalmefene 0.1 mg/kg was injected intraperitoneally immediately after reperfusion.At 6, 24 and 72 h of reperfusion, venous blood samples were collected for determination of the concentrations of S-100β protein and neuron-specific enolase (NSE) in plasma by enzyme-linked immunosorbent assay.After the last blood sampling, the rats were sacrificed, and brains were removed for determination of interleukin-1beta (IL-1β) and tumor necrosis factor-alpha (TNF-α) contents in brain tissues by enzyme-linked immunosorbent assay.Results Compared with group C, the plasma S-100β protein and NSE concentrations at each time point of reperfusion, and TNF-α and IL-1βcontents in brain tissues were significantly increased in S and I/R groups (P＜0.01).Compared with group S, the plasma S-100β protein and NSE concentrations at each time point of reperfusion, and TNF-α and IL-1β contents in brain tissues were significantly increased in group I/R (P＜0.01).Compared with group I/R, the plasma S-100β protein and NSE concentrations at each time point of reperfusion, and TNF-α and IL-1β contents in brain tissues were significantly decreased in group N (P ＜ 0.01).Conclusion Nalmefene can mitigate cerebral I/R injury in rats.

Objective:To compare etomidate in propylene glycol(Eto-PG) with a new galenic preparation of etomidate solved in a lipid emulsion of soya-bean oil(Eto-Lip).Method:Sixty patients were randomly divided into 2 groups:Eto-PG group and Eto-Lip group.The dosage of etomidate was 0.3mg/kg.Hemodynamic change and side effects(pain on iv-injection,involuntary movement, phlebitis, thrombophlebitis etc.) were observed.Result:There were no difference between the two groups in the incidence of involuntary movement.Side effects at the site of injection,both immediate and after operation,were encountered with Eto-PG but were not encountered in the lipid emulsion. Conclusion:Eto-Lip can reduce some undesired side effects without changing its pharmacodynamics.

Objective To evaluate the effect of surgical trauma on the cognitive function and expression of hepcidin and ferroportin 1 (FP1) in hippocampus in aged rats.Methods One hundred male Sprague-Dawley rats,aged 18 months,weighing 400-500 g,were randomly divided into 2 groups with 50 rats in each group:control group (group C) and surgical trauma group (group ST).The rats were anesthetized with chloral hydrate,but underwent no operation in group C.The rats Were anesthetized with chloral hydrate and underwent 30 min of modified exploratory laparotomy in group ST.Ten rats were chosen from each group at 24 h after operation and the cognitive function was assessed using Morris water-maze test for 6 consecutive days.Ten rats were sacrificed on 1st,3rd,5th and 7th days after beginning of Morris water-maze test and brains were removed for determination of hepcidin and FP1 expression in hippocampus by PCR and Western blot.Results Compared with group C,the escape latency was significantly prolonged,the time of staying at the original platform quadrant and frequency of crossing the original platform were decreased on 3rd,4th and 5th days after beginning of Morris water-maze test,and the expression of hepcidin was up-regulated and the expression of FP1 was down-regulated at each time point in group ST (P ＜ 0.05).Conclusion Surgical trauma can decrease the cognitive function in aged rats and the mechanism may be related to up-regulation of hepcidin expression and down-regulation of FP1 expression in hippocampus.

Objective To explore the relationship between hypothyroidism and myocardial injury in patients with idiopathic dilated cardiomyopathy (IDC) by 99Tcm-MIBI SPECT/18 F-FDG PET and late-gadolinium enhancement cardiac magnetic resonance imaging (cMRI-LGE).Methods Sixty-three consecutive patients (42 males and 21 females,(52±11) years) with IDC were enrolled from October 2010 to December 2012.Serum TT3,TT4,FT3,FT4 and TSH were determined using a fully automated chemiluminescence immunoassay.All patients underwent 99Tcm-MIBI myocardial perfusion SPECT/18F-FDG myocardial metabolism PET imaging and cMRI-LGE.Seventeen segments model was used for segmental analysis.Patterns of perfusion/metabolism were classified as normal,mismatch,mild-to-moderate match and complete match.cMRI-LGE was classified into 3 categories (non-LGE,mid-wall LGE and transmural LGE).x2 test was used for data analysis.Results All patients were divided into euthyroid group (n =53) and hypothyroidism group (n =10) according to the levels of serum thyroid hormones.The percentage of normal perfusion/metabolism segments in the euthyroid group was apparently higher than that in the hypothyroidism group:71.8％ (647/901) vs 57.6％ (98/170),x2 =13.50,P＜0.001 ; whereas the percentage of perfusion/metabolism mismatch segments in the euthyroid group was significantly lower than that in the hypothyroidism group:17.8％ (160/901) vs 31.2％ (53/170),x2=16.20,P＜0.001.The euthyroid group had a higher percentage of non-LGE segments (88.0％ (793/901) vs 69.4％ (118/170),x2 =35.70,P＜0.001) and a lower percentage of mid-wall LGE segments (4.8 ％ (43/901) vs 24.1％ (41 / 170),x2 =74.70,P＜ 0.001) compared to hypothyroidism group.Conclusions Hypothyroidism has a detrimental effect on myocardium.99Tcm-MIBI SPECT/18F-FDG PET imaging is sensitive in detecting viable/ischemia myocardium,and cMRI-LGE is good at detecting moderate fibrosis.Combining SPECT/PET imaging and cMRI-LGE for assessing myocardial injury would provide more comprehensive information.

Objective: To analyze the basic thyroid hormone level on long term prognosis and peri-operative recovery in patients after heart transplantation (HT) at the terminal stage of heart failure (HF).
Methods: A total of 270 consecutive patients who received HT at the terminal stage of HF in our hospital from 2009-09 to 2014-07 were retrospectively studied. According to serum levels of thyroid stimulating hormone (TSH), the patients were divided into 3 groups: TSH < 0.55 mIU/L group, TSH (0.55-2.5) mIU/L group and TSH > 2.5 mIU/L group. The peri-operative recovery condition and long term prognosis were observed and compared among 3 groups.
Result: The average age of patients was at (44.58 ± 13.30) years including 228 (84.4%) male and 42 (15.6%) female. The average post-operative follow-up period was (31.88 ± 17.48) months with 100% follow-up rate. There were 41.8% of patients with hypothyroidism, and 46 (17.0%) patients with low T3 syndrome, 56 (20.7%) with subclinical hypothyroidism and 11 (4.1%) with clinical hypothyroidism. The ratio of low level thyroid hormone in HT patients was much higher than general population. For peri-operative recovery, the ICU stay time and mechanical ventilation time were similar among 3 groups,P>0.05, while TSH (0.55-2.50) mIU/L group had the shortest times and TSH > 2.50 mIU/L group had longest times. For long term prognosis, no matter uni-/multi- aviate regression analysis or Kaplan-Meier surviving curve all suggested that TSH > 2.50 mIU/L was the independent risk factor inlfuencing the prognosis of HT patients at the terminal stage of HF. Upon TSH increasing, the patients would have worse prognosis accordingly.
Conclusion: Serum level of TSH > 2.50 mIU/L was the independent risk factor in HT patients at the terminal stage of HF.

OBJECTIVE: To investigate the effect of balloon kyphoplasty combined with bone cement on the treatment osteoporotic vertebral fracture.METHODS: A total of 58 aged patients with single osteoporotic vertebral compression fracture (58 vertebral bodies) were treated with balloon kyphoplasty. The fracture always occurred at T_8-L_4 segment of vertebral body in particular at T_(10)-L_2 segment of thoracic waist. By local anesthesia, lateral or bilateral pedicle of vertebral arch was punctured to injection bone cement under C-arm fluoroscopy.RESULTS: Bone cement leakage occurred in 8 cases, including leakage along posterior longitudinal ligament into adjacent posterior margin of vertebral body (n=1), external edge of vertebral body (n=6), and subcutaneous tissue (n=1); however, all the patients did not have clinical symptoms. C-arm fluoroscopy showed that height of vertebral body was increased, and rachiokyphosis was improved after treatment. Pain was obviously improved, and the easement rate of pain was 100%. There was significant difference in visual simulation score, angle degree of rachiokyphosis, and living activity scale before and 6 months after treatment (P < 0.05), but there was no significant difference between 6 months after treatment and following up stopping (P>0.05).CONCLUSION: Balloon kyphoplasty can significantly ease pain caused by osteoporotic spinal fractures and tumor metastatic spinal fractures and can partially restore vertebral body height and kyphosis deformity, there is conducive to improving spinal function and improving the quality of life.

BACKGROUND AND PURPOSE: Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is the most common type of autoimmune encephalitis. This study aimed to explore the possible factors affecting the response to first-line treatments in patients with anti-NMDAR encephalitis. METHODS: We enrolled 29 patients who were diagnosed as anti-NMDAR encephalitis between January 1, 2015, and June 30, 2018. They were divided into the remission and nonremission groups according to their response to first-line treatments. The demographics, clinical manifestations, main ancillary examinations, follow-up treatments, and prognosis of patients were recorded. The symptoms reported on in this study occurred before treatments or during the course of first-line treatments. RESULTS: There were 18 patients (62.07%) in the remission group and 11 patients (37.93%) in the nonremission group. Compared to the remission group, a higher proportion of the patients in the nonremission group exhibited involuntary movements, decreased consciousness, central hypoventilation, lung infection, and hypoalbuminemia. The nonremission group had a high incidence of increased intracranial pressure and significant elevations of the neutrophil-to-lymphocyte ratio in peripheral blood (NLR), aspartate aminotransferase, and fibrinogen. Six patients (54.55%) in the nonremission group received second-line immunotherapy. Only one patient (3.45%) died, which was due to multiple-organ failure. CONCLUSIONS: Anti-NMDAR-encephalitis patients with more symptoms—especially involuntary movements, disturbance of consciousness, central hypoventilation, and accompanying hypoalbuminemia and pulmonary infection—may respond poorly to first-line treatments. Positive second-line immunotherapy therefore needs to be considered. Admission to an intensive-care unit, increased cerebrospinal fluid pressure, and increased NLR might be the significant factors affecting the response to first-line treatments.
Anti-N-Methyl-D-Aspartate Receptor Encephalitis ; Aspartate Aminotransferases ; Cerebrospinal Fluid Pressure ; Consciousness ; Demography ; Dyskinesias ; Encephalitis ; Fibrinogen ; Follow-Up Studies ; Humans ; Hypoalbuminemia ; Hypoventilation ; Immunotherapy ; Incidence ; Intracranial Pressure ; Lung ; Prognosis

Objective: To explore the correlation between antithrombotic strategy and its prognostic value in coronary artery disease (CAD) patients combining with atrial ifbrillation (AF) after percutaneous coronary intervention (PCI).
Methods: A total of 570 CAD patients with AF received PCI in our hospital from 2012-01 to 2013-12 were retrospectively analyzed by CHADS2 and HAS-BLED Score system. According to CHADS2 < 2 and CHADS2 ≥ 2 or with/without warfarin medication, the patients were divided into 2 groups:①CHADS2 < 2 (Low risk of stroke) group,n=339 including 309 patients without warfarin and 30 with warfarin medication;②CHADS2 ≥ 2 (High risk of stroke) group,n=231 including 200 patients without warfarin and 31 with warfarin medication. All patients were followed-up for 15 months to compare the different anti-platelet/ anti-coagulation strategies for the occurrence rate of MACCE, ischemic and bleeding events.
Results: Compared with Low risk of stroke group, the patients in High risk of stroke group had the worse prognosis and higher rate of MACCE occurrence,P<0.001, HR=2.677, 95% CI (1.535-4.635), more ischemic events,P=0.013, HR=2.080, 95% CI (1.167-3.709). Multi-factor Cox surving analysis indicated that compared with low risk patients without warfarin medication, the high risk patients without warfarin had the higher rate of MACCE occurrence,P=0.001, HR=2.985, 95% CI (1.532-5.816), more ischemic events,P=0.026, HR=2.068, 95% CI (1.090-3.925). Whereas, the occurrence rates of MACCE and ischemic events in high risk, low risk patients with warfarin and low risk patients without warfarin were similar, all P>0.05. The major bleeding events in patients with warfarin were a little higher than those without warfarin,P>0.05. The minor bleeding events were increased in both Low risk stroke group asP<0.001, OR=4.458, 95% CI (1.934-10.277) and High risk stroke group asP=0.002, OR=4.155, 95% CI (1.717-10.055).
Conclusion: Warfarin medication may obviously decrease the occurrence rates of MACCE and ischemic events in high risk of stroke patients, while in low risk patients, warfarin could not further decrease the occurrence of MACCE and ischemic events. Warfarin could increase the risk for minor bleeding in both low risk and high risk of stroke in CAD patients combining with AF after PCI.