Objective To elucidate the significance of CYFRA21-1 and β2-microglobulin expression in pleural fluid and develop diagnostic application for malignant pleural effusion differentiation. Methods Detected expression of CYFRA21-1 by RIA analysis and β2-MG by immunoturbidimetry assay (ITA), in 40 cases of benign pleural effusion and 40 cases of malignant pleural effusion. Results The mean level of CYFRA21-1 in malignant pleural effusions was (78.80±24.90)μg/L higher than that in benign pleural effusions (26.20±15.60)μg/L (P<0.05) and β2-MG in benign pleural effusions was (6.11±0.87)mg/L, significantly higher than that in malignant pleural effusions which was (3.12±0.91)mg/L respectively (P<0.05). Conclusion Evaluation of CYFRA21-1 and β2-MG in chest fluid can improve the differential diagnosis of malignant pleural effusion from benign pleural effusion and significantly increase the sensitivity of diagnosis.

Objective:To analyze the high risk behaviors of HIV/AIDS and its influencing factors in men who have sex with man(MSM)in a city,so as to provide evidence for the targeted intervention.Methods:Between July 2006 and October 2006,1000 MSM were sampled by snowball sampling and had a face to face interview by well trained investigators with informed consent.Questions on age,education background,and sex orientation were designated and 3 ml blood samples were obtained for examination of HIV and syphilis.?2 test and logistic regression analysis were used for statistical analysis.Results:The average age of the 1 000 MSM was 27.8?9.1 years old.In the past 6 months,43.6% of them had 3 or more male sex partners,53.6% had unprotected anal intercourse with men,8.0% had commercial sex with men,and 24.3% had sex with women.Elder subjects had a higher ratio of unprotected anal intercourse and male-female sex;subjects with lower educational background had more sex partners and male-female sex.Subjects working in the bathhouse had a higher ratio of commercial sex and male-female sex.Subjects with a male-female sex orientation or undetermined sex orientation had a higher ratio of commercial sex.Syphilis was detected in 93(9.3%)subjects and HIV was detected in 104(10.4%)subjects;among them 18 subjects had both syphilis and HIV.Multivariate logistic regression analysis showed that the aged(OR=3.5,95%CI 1.7-7.1),the number of male sex partners(OR=3.8,95%CI 1.9-7.6),the behavior of unprotected anal intercourse(OR=1.9,95%CI 1.0-3.5)and the infection of syphilis(OR=2.1,95%CI 1.4-3.4)were independently associated with the risk of HIV/AIDS prevalence;the knowledge of AIDS was the protective factor of HIV/AIDS prevalence(OR=0.5,95%CI 0.3-0.7).Conclusion:High risk behaviors of HIV exist in MSM population in the researched city;there is local epidemic of HIV.Interventions should be given according to age,educational background,sex orientation,etc.

Objective To survey the high risk behavior and infection of HIV/AIDS among men who have sex with men(MSM)and provide scientific evidence for HIV/AIDS prevention and control.Methods MSM were sampled by snowball sampling method and were interviewed by well trained investigators face to face under the informed consent.Their venous blood samples were collected for HIV seropositivity rate.Results A total of 1000 MSM,averagely aged(27.8?9.1)years,were interviewed,among whom 43.9% perceive AIDS knowledge.78.6% had anal intercourse with male partners,31.8% of whom always used condom in the past 6 months.8.0% participants had commercial sex with men in the past 6 months.The prevalence of HIV in the surveyed subjects was 10.4%.Conclusion Potential risk of HIV epidemic threatens local MSM who spread the risk to general population.High risk behavior is ubiquitous among MSM.It is imperative to carry out targeted interventions among MSM.

BACKGROUND: Many clinical cases have proved that the satisfactory reposition, fusion and internal fixation in the internal fixation for inferior lumbar spondylolisthesis are not consistent with the postoperative symptoms and physical signs, and functional restoration.OBJECTIVE: To investigate the application of somatosensory evoked potential(SEP) in the monitoring during internal fixation for inferior lumbar spondylolisthesis, and the effects of SEP monitoring on the improvement of postoperative symptoms and the spinal functions as well.DESIGN: A randomized controlled trial.SETTING: Inpatient department of spinal surgery, an affiliated hospital of a university. PARTICIPANTS: Fifty-two patients with inferior lumbar spomlylolisthesis including 23 male and 29 female cases aged between 18 and 68 years old were admitted by the Department of Spinal Surgery, Second Affiliated Hospital(Shenzhen People's Hospital) of Jinan University, from June 2000 to December 2003. All cases were randomly divided into control group(n = 20) and monitor group ( n = 32).METHODS: SEP induced by segmental stimulation in cutaneous nerve was used in the control group for preoperative and intraoperative monitoring, and postoperative follow up. The intraoperative potential changes in patients with excellent and good improvement in postoperative functions had been retrospectively investigated to confirm the effective indices for intraoperative monitoring, which thereby provided references for intraoperative monitoring in patients of monitor group.MAIN OUTCOME MEASURES: ① Evaluation of postoperative spinal function; ② SEP latency and amplitude.RESULTS: SEP values after postoperative anesthesia were set as basis.The manifestations of intraoperative potential alterations: ① If the latency reduced 10% -15% or the amplitude increases more than 40% after fixation, it suggested favorable prognosis; ② The potential indices were stable during monitoring, or the reduction of latency was less than 10%,or the increase of amplitude was less than 30%, the fixation could be continued, and partial functions of nerve root and symptoms could be improved after surgery; ③ During the surgery, if potential indices had transient lluctuation, which could be recovered to basic potential within 15 to 20 minutes, fixation should be stopped during the fluctuation. Still partial functions of nerve root and symptoms could be improved after surgery; ④If the intraoperative latency prolonged more than 5%, or amplitude reduced more than 10%, or part of the components disappeared, or the wave shape dispersed, it might suggest postoperative aggravation of pain and dyskinesia. So intraoperative adjustment was necessary. The coincident rate of the improvement of the indices of intraoperative monitoring and the improvement of postoperative spinal function reached 93.75%.CONCLUSION: SEP induced by segrmental stimulation in cutaneous nerve is an objective and effective method in the monitoring and instruction of decompression, reposition, fixation of internal fixation for inferior lumbar spondylolisthesis, which has important merits in the improvement of the function of nerve root and the restoration of spinal function.

Objective To characterize the x-ray image of vertebral artery type of cervical spondylosis and explore its significance in rehabilitation treatment. Methods The X-ray films of 42 cases of vertebral artery type of cervical spondylosis were measured and analyzed. The treatment approaches including restriction of cervical movement,traction,epidural block and surgery were planned and implemented accordingly. Results The X-ray image revealed the following changes in the patients: the straightened physiologic curvature of the cervical spine,cervical vertebral unsteadiness,zygapophyzeal joint hyperplasia. Various treatment approaches are effective to patients with various manifestations. Conclusion Employing treatment approaches on the basis of X-ray images is of great signi-ficance for the effective treatment of patients with cervical spondylosis of vertebral artery type.

Objective:To explore the protective mechanisms of You-gui-wan on hydrocortisone-induced apoptosis of murine thymocytes.Methods:Annexin V/ PI double stain was applied to analyze the apoptotic states of thymocytes after injection with hydrocortisone coupled with or without administration You-gui-wan.The transcriptions of Bcl-2 and Bax were tested by RT-PCR.Results:The apoptotic rate of thymocytes was seriously increased in hydrocortisone-injected mice contrasted to matched control mice(P

Objective To compare the outcome of proximal femoral nail antirotation (PFNA)and third generation of Gamma nail (TGN) in the treatment of femoral intertrochanteric fracture in the elderly. Methods From January 2007 to June 2008, the patients with intertrochanteric fractures were divided into PFNA group ( n = 55 ) and TGN group ( n = 52 ) randomly. The two treatment groups were comparable in aspect of general data. The clinical data of surgical trauma, complications and postoperative function of the two groups were compared in our study. Results The mean operation time was (66.6 ± 15.4) min in PFNA group and (73. 1 ± 20.8 ) min in TGN group (P ＞ 0. 05 ). The mean intraoperative blood loss differed significantly, (219.5 ± 107.5 ) ml in PFNA group compared with (269.0 ±123.9) ml in TGN group ( P ＜ 0. 05 ). The mean fluoroscopy time was ( 2.97 ± 1.14 ) min in PFNA group and (3.43 ± 1.18) min in TGN group (P＜0.05). Unilateral femoral shaft splits at the distal end of the nail was observed intra-operatively in four patients of the PFNA group and in one of the TGN group,with no statistical difference between two groups. Of all, 91 patients ( n =46 in the PFNA group and n =45 in the TGN group) were followed up for a duration of ( 17.5 ±3.69) months. There was one re-fracture and one implant failure during the follow up period in PFNA group, which was not found in TGN group. Fiftyone patients recovered to normal activity status, including 27 in the PFNA group and 24 in the TGN group,with no statistical differences. Conclusions Intertrochanteric fracture can be treated successfully with PFNA and TGN. There is no significant difference in complications and functional outcome between the two groups. However, PFNA takes advantages of less blood loss, less operative time and less fluoroscopy time over TGN.

Objective To investigate the antitumor activity of the procaspase-3 activator SM-1 in BGC-823 cells in vivo and in vitro and the mechanisms.Methods The inhibitory effects of SM-1 on proliferation of BGC-823 cells were evaluated using MTT method, the cell apoptosis rate was detected by flow cytometry, and the expression of caspase-3 protein and procaspase-3 mRNA was detected by Western blotting and RT-PCR, respectively.SM-1 Antitumor activity was evaluated using the xenograft of BGC-823 cells in nude mice.Results SM-1 effectively inhibited the proliferation in vitro and in-duced apoptosis of BGC-823 cells in a dose-dependent manner.After treatment with SM-1 for 48 h, the protein expression levels of caspase-3 and mRNA expression levels of procaspase-3 were increased.SM-1 significantly inhibited growth of BGC-823 xenograft tumor at the 300 mg/kg dose and the inhibition rate was 56.3%(P<0.05).Conclusion SM-1 can significantly inhibit the tumor growth of BGC-823 cells in vivo and in vitro.The mechanism is possibly related to the activation of procaspase-3 and induced apoptosis of tumor cells.

Objective To explore the feasibility of patient health questionnaire-9 (PHQ-9) in a general hospital outpatients and analyze the risk factors of depressive syndromes.Methods Two hundred fifty-eight outpatients filled out PHQ-9 and the World Health Questionnaire Quality of Life Brief Questionnaire(WHOQOL-BREF) by themselves.Then they were evaluated by professionals with Hamilton Depression Rating Scale (HAMD-17).Ninety-seven of them were further interviewed with the Structured Clinical Interview for DSM-Ⅳ Disorders(SCID) for the diagnosis of major depression which in order to analyze the validity of the PHQ-9.All patients were divided into the depressive group and non-depressive group according the score of PHQ-9,and then analyzed the risk factors of depression.Results ①The sensitivity of PHQ-9 was 98％,the specificity was 67％ and Kappa was 0.664.The total score of PHQ-9 was high correlated with the total score of HAMD,the coefficient was 0.75(P＜0.01).②The Univariate analysis showed that the depressive symptom was associated with age,monthly income,health status,the quality of life.Logistic regression analysis showed that age,health status,the quality of life were the main factors of depression.Conclusion PHQ-9 may svere as a screening tool to increase the recognition of depression and age,health status,the quality of life were the main factors of depression.

Objective To study the effect of Tacrolimus on blood lipid after renal transplantation,and the relationship between C825T polymorphism in G protein beta 3 subunit (GNB3) gene and serum lipid levels.Method Eighty-one cases of recipients patients after renal transplantation were divided into two groups in terms of Tacrolimus concentration:normal blood concentration group (group A) and low blood concentration group (group B).The serum lipid levels at 1st,3rd,6th,and 12th month after renal transplantation were measured.Genotype was determined by the simple sequence-specific primer polymerase chain reaction (SSP-PCR).Result The percentage of patients with hypertriglyceride in group A was significantly higher than in group B during the one-year follow-up period.There was significant difference between the two groups in the serum triglyceride levels but no difference in the serum cholesterol levels.The 825C/T polymorphism in the GNB3 gene was not associated with hypertriglyceride in renal transplantations in Wenzhou.Conclusion The serum triglyceride levels in renal transplantations in Wenzhou was associated with the Tacrolimus concentration,and the incidence of hypertriglyceride is not associated with the 825C/T polymorphism in the GNB3 gene.