Objective To investigate the relationship between the expression of estrogen receptor (ER),progesterone receptor(PR)and epidermal growth factor receptor(EGFR)in uterine leiomyoma and the recurrence after myomectomy.Methods Eighty cases underwent myomectomy were enrolled in this study.ER,PR and EGFR expression in uterine leiomyoma tissue and normal myometrium tissue were examined by immunohistochemical technique.All the patients were followed up regularly after myomectomy.Results The positive expression rate of ER,PR and EGFR in uterine leiomyoma tissue were significantly higher than those in normal myometrium tissue[88.8％(71/80)vs.48.8％(39/80),92.5％(74/80)vs.30.0％ (24/80),86.2％(69/80)vs.57.5％(46/80),P ＜ 0.05].The recurrence rates in ER,PR and EGFR positive expression patients were significantly higher than those in negative expression patients[42.3％(30/71)vs.22.2％(2/9),41.9％(31/74)vs.16.7％(1/6),42.0％(29/69)vs.27.3％(3/11),P ＜ 0.05].The recurrence times in ER,PR and EGFR positive expression patients were significantly shorter than those in negative expression patients(P ＜0.05).The expression of EGFR had positive correlation with ER and PR(r =0.837,0.702,P ＜ 0.05).Conclusions The recurrence of uterine leiomyoma may have correlation with high expression of ER,PR and EGFR in uterine leiomyoma.

Objective To investigate the epidemic situation and trend of brucellosis in Jinzhong City of Shanxi Province,and to provide a basis for formulating prevention and control measures.Methods Surveillance datas of human brucellosis in Jinzhong City from 2008 to 2012 were collected throng the national network straight quote system of infectious diseases and the centers for disease control and prevention of counties(districts,cities).Descriptive epidemiological method was used to analyze the distributions of region,time and population of brucellosis.Results A total of 3 627 cases were infected with brucellosis in Jinzhong City from 2008 to 2012,and the incidence of brucellosis was increased from 19.63 per 100 000 to 28.46 per 100 000.All counties(districts or cities) had reported epidemic from 2008 to 2012.The onset time focused on March-July each year,with obvious seasonal periodicity.The ratio of male to female was 5 ∶ 1.The ages were in 35-＜ 65 years old,accounting for 74.00％(2 684/3 627).Brucella infections were given priority to farmers and herdsmen,accounted for 93.63％ (3 396/3 627).Conclusions The epidemic of human brucellosis in Jinzhong City is in a spreading trend.Surveillance,timely analysis and report of the epidemic,health education,and inter-departments cooperation are in need to conduct in order to control the spread of epidemic.

Objective To evaluate the feasibility,safety,post-operative short and long-term outcomes of laparoscopic-assisted D2 radical distal gastrectomy in treating advanced gastric carcinoma without serosal invasion.Method From May 2007 to May 2013,54 cases of advanced gastric antral cancer without serosal invasion underwent laparoscopic-assisted D2 radical distal gastrectomy (laparoscopic group),54 demographically and pathologically-matched cases undergoing open surgery served as control.The surgical risk,post-operative recovery and follow-up results were compared.Result Surgery was successful in all patients.The mean operation time in laparoscopic group and open group was (168 ± 31) mins and (157 ±20) min respectively,the difference was significant (t =2.237,P =0.027) ; Intra-operative blood loss was (151 ± 56) ml and (213 ± 86) ml (t =4.45,P =0) ; Post-operative intestinal function recovery time was (2.7 ± 0.7) d and (3.4 ± 0.5) d (t =5.4,P =0) ; Lymph node dissection number was (26.4 ± 4.2) and (24.8 ±5.2) (t =1.769,P=0.08).Post-operative complication rate was 4％ and 11％ (P =0.142).There was no perioperative mortality in either group.Post-operative pathological stage of Ⅰ B,Ⅱ A,Ⅱ B,ⅢA was 8,17,24,5 cases in laparoscopic group and 9,14,23,8 cases in open surgery group.108 cases were followed up from 7 to 79 months.In laparoscopic group,8 cases had local recurrence or distal mestastasis,and 4 cases died from tumor; In open group,9 cases had local recurrence or distal mestastasis,and 6 cases died from tumor.Conclusions Laparoscopic-assisted D2 radical distal gastrectomy in treating advanced gastric cancer without serosal invasion is feasible,safe and advantageous in minimal invasion and rapid recovery,with good short and long-term outcomes.

Objective To explore the long-term effects of physical exercise on learning,memory and the expression of plasticity-related gene-1 (PRG-1) in the cerebral cortex of rats with penicillin-induced developmental seizures.Methods Twenty-four 21-day Sprague-Dawley rats were randomly divided into a control group (CONT1),an exercised control group (CONT2),a seizure group (EXP1) and a seizure plus exercises group (EXP2),each of 6 using a random number table.Penicillin was injected intraperitoneally to the rats in the EXP1 and EXP2 groups to induce seizures,while those in the CONT1 and CONT2 groups received saline injections.Morris water-maze tests were performed to evaluate spatial learning and memory capacity.The rats in the CONT2 and EXP2 groups were administered an aerobic exercise program 30 min per day for 6 consecutive days.The other groups were maintained on the treadmill for the same time but without exercising.Real-time polymerase chain reactions were used to quantify the expression of PRG-1 mRNA in the cerebral cortex.Results There was a decreasing trend in marginal searching and increasing taxis and linear searching in all four groups.Ridit analysis showed that in the watermaze tests on days 2 and 4 the average scores of the control groups were significantly higher than those of the EXP1 and EXP2 groups.However,significant increases in the average scores were observed in the maze tests of the EXP1 group after day 2 and with the EXP2 group from day 4 on.The average scores of the control group were significantly lower than those of the other 3 groups.In the first maze test,the average memory scores of the two seizure groups were significantly lower than those of the controls.In the second maze test,however,only the EXP1 group's average score was significantly worse than those of the other groups.That of the EXP2 group had improved significantly,and was not significantly different from that of the CONT2 group.The expression of PRG-1 was much higher in the CONT2,EXP1 and EXP2 groups than in the CONT1 group.The average expression of PRG-1 in the EXP2 group was not significantly different from that in the EXP1 group.Conclusions Physical exercise can significantly relieve the cognitive deficits induced by long-term seizures,which may be associated with the regulation of PRG-1 expression in the cerebral cortex.

Objective To observe the clinical effect of modified laryngeal mask airway combining fiberoptic bronchoscope intubation in difficult airways.Methods Forty patients,21 males and 1 9 females,aged 30-55 years,ASA physical status Ⅰ or Ⅱ,scheduled for elective general anes-thesia surgery after failure to direct laryngoscope two attempts were randomly divided into two groups,20 cases in each group.Patients in group LMA-FOB underwent intubation with modified la-ryngeal mask airway combining fiberoptic bronchoscope,and patients in group FOB underwent intu-bation with fiberoptic bronchoscope.The fiberoptic bronchoscope score,the intubation time and the rate of successful intubation at first attempt were recorded.All the patients were followed up postop-eratively for adverse effects.Results The fiberoptic bronchoscope scores (Ⅰ/Ⅱ/Ⅲ/Ⅳ:1 5/4/1/0 vs. 8/4/5/3,P <0.05)and the rate of once successful intubation (90% vs.60%,P <0.05)was signifi-cantly higher,and the intubation time [(75 ± 20)s vs.(105 ± 25 )s,P < 0.05 ]was significantly shorter in group LMA-FOB than that in group FOB.In group LMA-FOB,one patient had blood stain in the LMA and one patient felt slight sore throat.There were no significant adverse effects in the two groups.Conclusion Modified Laryngeal mask airway combining fiberoptic bronchoscope intubation in difficult airways was effective to improve the grade of the view of the larynn and the success rate of intubation and shorten the intubation time.No significant adverse effect postoperatively was reported. It is relatively safe,effective and promising in patients with difficult airway.

Objective To investigate the analgesic efficacy of intrathecal injection of RC-13,a competitive kinesin superfamily protein 17 antagonist,in a mouse model of bone cancer pain.Methods Forty male C3H/HeJ mice,aged 6-8 weeks,weighing 20-25 g,were randomly divided into 5 groups (n=8 each): sham operation group (group S); bone cancer pain + 5 μl dimethyl sulfoxide (DMSO) group (group R0); bone cancer pain + 2.5 μg RC-13 group (group R1); bone cancer pain + 5 μg RC-13 group (group R2) and bone cancer pain + 10 μg RC-13 group (group R3).In groups R0-3,bone cancer pain was induced by implantation of α-min-imal essence medium (α-MEM) containing osteosarcomaNCTC 2472 cells into the intramedullary space of right femur.In group S,culture medium α-MEM containing no cancer cell was injected instead.10％ DMSO 5 μl and RC-13 2.5 μg/5 μl,5μg/5μ1 and 10 μg/5 μ1 dissolved in 10％ DMSO were injected intrathecally in groups R0-3,respectively,once a day for 3 consecutive days starting from 14th day after inoculation of the tumor cells.Pain behavior was assessed by the paw withdrawal mechanical threshold (PWMT) and spontaneous lifting times (SLTs) measured at 1 day before inoculation and at 3,5,7,10,14 days after inoculation.The same tests were also performed at 1,3,5 and 7 days after administration in groups R0-3.Results Compared with group S,PWMT was significantly decreased and SLTs were increased at 7-14 days after inoculation in the other groups (P ＜ 0.05).Compared with group R0,PWMT was significantly increased and SLTs were reduced at 1 day after administration in group R1,at 1and 3 days after administration in group R2,and at 1,3 and 5 days after administration in group R3 (P ＜ 0.05).Compared with group R1,PWMT was significantly increased and SLTs were reduced at 3 days after administration in group R2,and at 1,3 and 5 days after administration in group R3 (P ＜ 0.05).Compared with group R2,PWMT was significantly increased and SLTs were reduced at 1 and 3 days after administration in group Rs (P ＜ 0.05).Conclusion Intrathecal RC-13,a competitive kinesin superfamily protein 17 antagonist,has a good analgesic efficacy in a mouse model of bone cancer pain and the efficacy is dose-dependent.

Myeloproliferative neoplasm (MPN) is a kind of clone hematopoietic stem cell disease characterized by one or more myeloid cell lines hyperproliferation, including bcr-abl gene positive chronic myeloid leukemia (CML) and bcr-abl negative MPN, the later representing polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF). A big stride has been made since the discovery of JAK2 and MPL gene mutations. However, the exact genetic basis of JAK2/MPL mutation double negative in MPN patients is still unclear. It has been reported recently that a new CALR mutation is discovered in the JAK2/MPL unmutated MPN patients who show unique clinical presentations, which provides a new diagnostic and prognosis-accessing criteria. The paper reviews CALR mutation and genetic mechanism mediating MPN.

Objective To evaluate the effect of verapamil on the expression of K+-Cl-cotransporter 2 (KCC2) in spinal dorsal horns during remifentanil-induced hyperalgesia in a rat model of incisional pain.Methods Thirty-two pathogen-free healthy adult male Sprague-Dawley rats,aged 6-7 weeks,weighing 250-300 g,were divided into 4 groups (n=8 each) using a random number table:control group (group C),incisional pain group (group Ⅰ),incisional pain plus remifentanil plus verapamil group (group I+R+ V) and incisional pain plus remifentanil group (group I+R).Normal saline was subcutaneously infused in group C.A 1 cm long incision was made in the plantar surface of the right hindpaw in anesthetized rats in group Ⅰ.Verapamil 5 mg/kg was intraperitoneally injected at 10 min before establishment of the incisional pain model in group I+R+V.In I+R and I+R+V groups,the model of incisional pain was established,and remifentanil was subcutaneously infused for 30 min at a rate of 80 μg · kg-1 · h-1 simultaneously.The mechanical paw withdrawal threshold (MWT) to yon Frey filament stimulation was measured at 1 day before establishment of the model (T0) and 2,6,24 and 48 h after establishment of the model (T1-4).The rats were sacrificed after measurement of MWT at T4,and the lumbar enlargement segments of the spinal cord were harvested for determination of the expression of KCC2 by immunofluorescence.Results Compared with group C,the MWT was significantly decreased at T1-4,and the expression of KCC2 was down-regulated in the other groups (P＜0.05).Compared with group Ⅰ,the MWT was significantly decreased at T1-4,and the expression of KCC2 was down-regulated in group I+R (P＜0.05).Compared with group I+R,the MWT was significantly increased at T1-4,and the expression of KCC2 was up-regulated in group I+R+V (P＜0.05).Conclusion The mechanism by which verapamil reduces remifentanil-induced hyperalgesia is related to up-regulation of the expression of KCC2 in spinal dorsal horns in a rat mnodel of incisional pain.

Objective To explore the influence of plasma matrix metalloproteinase-7 ( MMP-7 ) levels and genetic polymorphism of MMP-7 - 181 A/G on the stability of carotid plaque.Method According to carotid ultrasound examination, 503 patients with carotid atherosclerotic lesions were consecutively recruited and divided into vulnerable plaque group (n = 118) and stable plaque group (n = 385).Plasma MMP-7 levels were measured by enzyme-linked immunosorbent assay (ELISA), and MMP-7 -181 A/G genotypes were determined by polymerase chain reaction-restiction fragment length polymorphism (PCR-RFLP).Results Plasma MMP-7 levels in carotid vulnerable plaque group were significantly enhanced as compared to stable plaque group (t =5.49, P =0.00).The frequency of MMP-7 -181G allele in vulnerable plaque group was significantly higher than that in stable plaque group (11.4% vs 7.0% ,χ2 = 4.78, P= 0.029).Compared to AA genotype, the genotypes with - 181G allele (AG + GG) significantly increased susceptibility to carotid vulnerable plaque ( χ2 = 5.01, OR = 1.81, P = 0.025 ) .When further analyzing the relationship between genotype and plasma MMP-7 levels, no significant differences of plasma MMP-7 levels were observed between AA genotype and AG + GG genotype in stable plaque group.However, in vulnerable plaque group, plasma MMP-7 levels of AG + GG genotype were significantly higher than that of AA genotype( t = 2.62, P = 0.01).Conclusion The present findings suggest that plasma MMP-7 level may be a biomarker for carotid vulnerable plaque.Genetic polymorphism of - 181 A/G in MMP-7 promoter may affect the expression of MMP-7, and seems to be implicated in susceptibility to carotid vulnerable plaque.

Objective To identify the risk factors for in-hospital cardio-cerebrovascular events and 1-year mortality following lower extremity fracture surgery in elderly patients. Methods Four hundred and thirty patients, aged ≥ 65 yr, undergoing elective lower extremity fracture surgery from January 2010 to December 2014, were selected. Age, gender, American Society of Anesthesiologists (ASA) physical sta-tus, preoperative comorbidities (diabetes mellitus, cardio-cerebrovascular events and hemiplegia), preop-erative anemia, surgical site (hip and femur, knee joint and the site below the knee), anesthesia method (general anesthesia, neuraxial anesthesia), surgery time, intraoperative hypertension and hypotension, intraoperative blood loss, postoperative Hb≤90 g∕L in hospital and volume of postoperative drainage, post-operative pneumonia and admission to the intensive care unit after operation were recorded. The patients were divided into either cardio-cerebrovascular event group or non-cardio-cerebrovascular event group ac-cording to whether the patients developed cardio-cerebrovascular events after surgery in hospital. The pa-tients were divided into either survival group or dead group according to the living status 1 yr after surgery. The risk factors of which P values were less than 0. 05 would enter the multi-factor logistic regression analy-sis to stratify the risk factors for in-hospital cardio-cerebrovascular events and 1-year mortality following low-er extremity fracture surgery. Results Three hundred and seventy-two patients completed the study. A-mong the 372 patients, 35 patients developed postoperative cardio-cerebrovascular events in hospital, and the incidence was 9. 4％, logistic regression analysis showed that the preoperative cardio-cerebrovascular diseases and ASA physical status ≥ Ⅲ were risk factors for in-hospital postoperative cardio-cerebrovascular events. Thirty-three patients died within 1 yr after surgery, the mortality rate was 8. 9％, and logistic re-gression analysis showed that age≥75 yr, preoperative hemiplegia and development of cardio-cerebrovascu-lar events after surgery in hospital were postoperative 1-year mortality-related risk factors. Conclusion Preoperative cardio-cerebrovascular diseases and ASA physical status ≥ Ⅲ are the independent risk factors for in-hospital cardio-cerebrovascular events following lower extremity fracture surgery in elderly patients;age≥75 yr, preoperative hemiplegia and in-hospital postoperative cardio-cerebrovascular events are the in-dependent risk factors for 1-year mortality after surgery.