Objective To explore the use of lamivudine alone induced the poor response,especially the related factors of the occurrence of YMDD.Methods Retrospective analysis of 160 cases of the poor answering cases after lamivudine treatment,the baseline parameter values,the time appearing to the poor answering and the HBVDNA load in treatment were analyzed,to study their relationship with poor response.Results The lamivudine prolonged,the poor response to the probability gradually increase.The mutation rate in the 12nd month was 19.67％ and in the 36th month was 49.18％ ( P ＜ 0.05 ).Response to the many reasons,the YMDD mutation is the more common one.The relationship among HBVDNA load,ALT level on baseline and the rate of poor response emergence,the YMDD mutation rate was clear.By comparison in groups,the difference was significant (P＜0.05).Conclusion The lower baselins of ALT level,the higher of HBVDNA load,the greater probability of the poor response and the YMDD mutation.

The paper introduces the ideas of designing hospital information system, including comprehensive cabling, network cover-age, ward calling system, ward monitoring system, queuing management, media teaching, multi -function hall, digital meeting and se-curity system, which would provide reference for the designing and implementation of hospital information system.

Objective To know the relationship between air pollutants and daily hospital visits for respiratory diseases in Guangzhou. Methods The data of daily hospital visits for respiratory diseases in a hospital in Guangzhou during 2006 to 2008, along with the daily meteorological factors, air pollutants concentration (NO2, PM10,PM2.5 and SO2) were collected. The time series analysis auto-regression model was used, considering the potential confounding factors such as seasonal and meteorological factors. Results Daily hospital visits for respiratory diseases presented a significant week effect, the time of higher daily hospital visits for respiratory diseases was the same of higher concentration of pollutants. When SO2 and NO2 increased by 10 ?g/m3, the daily hospital visits increased by 3%(P

BACKGROUND:The dynamic changes of hypoxia inducible factor-1 alpha (HIF-α) and inducible nitric oxide synthase (iNOS) genes in the pulmonary artery wall during the process of hypoxic pulmonary hypertension (HPH) development need to be investigated.OBJECTIVE: This study was to observe the gene expressions of HIF-α and iNOS in the pulmonary artery wall at the different hypoxic time points, and to investigate their effects in HPH development.DESIGN: Controlled observation animal experiment.SETTING: Department of Respiration, Second Hospital Affiliated to Nanhua University.MATERIALS: Forty healthy male Wistar rats of clean grade, aged 6-8 weeks, with body mass of (220±10) g were involved in this study. They were randomized into control group (n =8) and hypoxia group (n =32). Four time points, i.e.3, 7, 14, and 21 days after hypoxia were set for the animals in the hypoxia group, 8 rats at each time point.METHODS: This study was carried out in the Institute of Oncology, Nanhua University between August 2004 and December 2005. Rats in the hypoixa group were treated according to the method reported by Li et al. Hypoxia treatment was omitted for the rats in the control group. At each time point, the rats were anesthetized, and then a micro-catheter was inserted into the right jugular vein and connected to a multichannel physiologic recorder, which was used for detecting the mean pulmonary arterial pressure (mPAP). The heart of each euthanized rat was taken out, and its right ventricle (RV), and left ventricle and septum (LV+S) were weighted. Right ventrical hypertrophy index (RVHI) reflected right ventricle hypertrophy degree. Right upper lung tissue of rat was harvested for haematoxylin & eosin (HE) staining and elastic fiber staining. Pathological image analysis software was used to determine pulmonary arterial wall area/total vascular area, lumina area/total vascular area, smooth muscle cell density in the media of pulmonary arteriole, and media thickness of pulmonary arteriole, which were used as remodeling indexes of pulmonary arteriole. HIF-1α and iNOS in the pulmonary arteriole were performed in situ hybridization and immunohistochemical detection. The mean absorbance of pulmonary arteriole wall was used as the relative content of mRNA expression and protein level.MAIN OUTCOME MEASURES: ①Changes in mPAP, RV hypertrophy degree and remodeling indexes of pulmonary arteriole of rats. ② Expressions of HIF-α and iNOS as well as their correlations with mPAP and remodeling indexes of pulmonary arteriole.RESULTS: All the 40 Wistar rats were involved in the final analysis. ①At hypoxia 7 days, mPAP was significantly higher than that of control group (P ＜ 0.05). mPAP reached to the high level at hypoxia 14 days, and then maintained at this level. ② At hypoxia 14 days, RVHI was higher than that of control group (P ＜ 0.05). ③ At hypoxia 7 days, pulmonary arteriole wall was thickened, and lumina became narrowed. There were significant differences in pulmonary arterial wall area/total vascular area, lumina area/total vascular area between hypoxia group and control group (P ＜ 0.05). At hypoxia 14 days, smooth muscle cell density in the intima-media of pulmonary arteriole, and intima-media thickness of pulmonary arteriole were significantly increased (P ＜ 0.05). At hypoxia 21 days, lumina was further narrowed, and obvious smooth muscle hyperplasy was found. HIF-1α and iNOS mRNA expression presented weak-positive in the control group; The relative content of HIF-1α mRNA did not significantly alter at hypoxia 3 and 7 days, but was obviously increased at hypoxia 14 days ,and after this, it maintained at high level. iNOS mRNA was markedly higher than that in the control group at hypoxia 3 days, reached its peak at hypoxia 7 days, was close to the level in the control group at hypoxia 14 days, and enhanced again at hypoxia 21 days, but it was still lower than that at hypoxia 3 days. ⑤HIF-α was mainly found in the intima and media, while iNOS was found in the whole layer of vessels. iNOS was weakly expressed in the intima and media of pulmonary vessels in the control group. No obvious difference in iNOS existed at hypoxia 3 days as compared with control group. iNOS was obviously expressed in media and intima at hypoxia 7 days. Vascular media was thickened at hypoxia 14 days, and the expression of iNOS was enhanced. iNOS was not found in the vascular adventitia in the control group, but was found in the vascular adventitia in the hypoxia group. ⑥mPAP was positively correlated with pulmonary vascular remodeling (r =0.976, P ＜ 0.01 ), and HIF-1α mRNA was positively correlated with iNOS protein(r =0.927, P ＜ 0.05).CONCLUSION: Both HIF-1α and iNOS exert effects in the process of HPH development of rats, and HIF-1α and iNOS gene expression may be mutually regulated.

Objective To investigate the effects of the expressions of thymidine kinase 1 (TK1) and Ki67 alone or their combination on the recurrence and metastasis of breast cancer.Methods Sixty-five samples were selected from the Second Affiliated Hospital of Guangzhou Medical University from March 2005 to June 2007,which were resected by surgical operation and confirmed as breast carcinoma by pathology.They were individed into two groups including 37 cases with recurrence or metastasis in 5 years (group A),28 cases without recurrence or metastasis in 5 years (group B).The expressions of TK1 and Ki67 in the two groups were detected by immunohistochemical staining assay.Then,Kaplan-Meier assay was used to describe survival curve.Results The positive expression rate of TK1 in group A was 91.8％,which was dramatically higher than that in group B 67.8％ (x2 =6.116,P =0.013).The positive expression rates of Ki67 in group A and B were 78.4％ and 42.9％ (x2 =8.635,P =0.003).The positive expression rates of TK1 combined with Ki67 in group A and B were 67.6％ and 39.3％ (x2 =5.159,P =0.023).Moreover,disease free survival of patients with positive expression of TK1 combined with Ki67 decreased significantly,compared with patients with positive expression of TK1 or Ki67 alone (x2 =6.137,P =0.046).Conclusion Positive expression of TK1 combined with Ki67 is the high risk factor of the reccurence or metastasis of breast carcinoma,and indicates poorer prognosis compared with positive expression alone.

Objective To investigate the expressions of Sema4D and HER-2 in breast cancers and their relationship with microlymphtic vessel density (MLVD).Methods MLVD and expressions of Sema4D and HER-2 were detected in 110 cases of breast cancer tissues by immunohistochemistry.The relationship of Sema4D and HER-2 expressions with clinicopathologic parameters was analyzed.Results The positive expression rate of Sema4D and HER-2 was 71.82％ (79/110) and 33.64％ (37/110),respectively,with a statistically significant differences compared to those in the control group ( P ＜0.01 ).The positive expression rates of Sema4D and MLVD in cases with lymphatic metastasis were higher than that without lymphatic metastasis ( P ＜ 0.01 ).The expressions of Sema4D and HER-2 were closely correlated with the histological grade,TNM stage,lymph node metastasis,and expression of ER of breast cancers ( P ＜0.05),but were not related to tumor size and expression of PR (P ＞ 0.05 ).On univariate analysis,the disease-free survival rate of patients with Sema4D positive expression was better than those with its negative expression ( P ＜ 0.05).Sema4D expression was positively correlated with the HER-2 expression ( r =0.535,P ＜ 0.01 ).Conclusions Sema4D may play important roles in the carcinogenesis and development of a breast cancer.

Objective To investigate the effects of cold preservation and reperfusion injury on the regen-eration of donor liver and to study the mechanisms. Methods Male SD rats were divided in to sham group (6 rats), UW 1 h group (48 rats) and UW 12 h group (48 rats). Liver tissue specimens were collected at different time points after orthotopic liver transplantation or sham operation. The morphology of liver tissue was observed via light microscope and transmission electron microscope. Proliferation of hepatocytes and sinusoidal endothelial cells (SECs) were assessed by a double immunostaining technique using antibodies against rat endothelial cell antigen-1 and bromodeoxyuridine (BrdU). Expression of vascular endothelial growth factor (VEGF) and its receptors, fins-like tyrosine kinase-1 (flt-1) and fetal liver kinase-1 (flk-1) was evaluated by immunohistochemistry. The mRNA expression of flt-1 was detected by a RT-PCR method. Mean comparison in groups was conducted by one-way ANOVA or t test. Results BrdU labeling indexes of hepatocytes and SECs in UW 12 h group was significantly higher than those in UW 1 h group (F = 61.45,41.4, P < 0.05). The proliferation of hepatocytes peaked at 48 h after operation in both UW 1 h group and UW 12 h group. However, the proliferation of SECs was fallen behind compared to hepatocytes, with a peak appeared at 72 h in UW 1 h group and at 96 h in UW 12 h group, respec-tively. The expression of VEGF was up-regulated in both UW 1 h group and UW 12 h group compared to sham group. Furthermore, expression of flt-1 and flk-1 was found to be mainly limited in SECs, with a peak in expres-sion occurring between 72 h and 96 h, coinciding with the peak in SECs proliferation in UW 1 h group. Conversely, flt-1 was found to be reduced significantly on mRNA level at any time throughout the experiment in UW 12 h group compared to sham group (F = 141.67, P < 0.05). Conclusion Reduced expression of flt-1 results in a retarded regeneration of SECs, and then the recovery of rat donor liver function is delayed after cold-preserved transplantation.

Objective To evaluate the two-dimensional strain by speckle tracking echocardiography in healthy piglets.Methods 9 small Guizhou-Panama pigs were used.High frame rate two-dimensional images were recorded from the left ventricular short-axis views at the levels of mitral annulus,papillary muscle and apex.Radial strain,circumferential strain and rotation were measured in the left ventricular short-axis views using two-dimensional strain software.Results Left ventricular two-dimensional radial strain gradually increased from the base to apex.As seenfromthe apex.LV performs a wringing motion with a clockwise rotation at the base and counterclockwise rotation at the apex.Conclusion 2DS technique is a rapid,accurate,easy,repeatable and no angle reliant method to quantitatively estimate the left ventrlcle function.

Objective To investigate the existence of epithelial-mesenchymal transition(EMT)and its relation to the expression of HBx protein in hepatocellular carcinoma(HCC).Methods The expression of HBx protein,E-cadherin,β-catenin,N-cadherin and fibronectin were detected by immumnohistochemistry technique in 76 cases of HCC.Results Among 76 HCC samples,the loss of expressions of E-cadherin and β-catenin were 34%(26/76)and 20%(15/76),respectively.The positive expressions of HBx protein,N-cadherin and frbronectin were observed in 68%(52/76),55%(42/76),46%(35/76)of HCC samples,respectively.The loss of expression of E-cadherin significantly correlated with the positive expression of N-cadherin and HBx protein (P＜0.01).The positive expression of N-cadherin and fibronectin significantly correlated with the loss of expression of β-catenin and the positive expression of HBx protein(P＜0.05).Conclusions EMT exists in hepatocellular carcinoma,and the expression of HBx is significantly associated with EMT.

Objective To study the value of two-dimensional Echocardiography(2DE)and doppler tissue synchronization imaging (TSI) during early diagnosis of close myocardial contusion.Methods 9 small Guizhou-Panama pigs were used.The close myocardial contusion animal model was successfully established by using the serf made small impactor.Echocardiography wag applied before and after injury for 0.5,2,4,8 and 12h respectively,these data were analyzed together with the TYC pathological results.Results After the strike for 0.5h,the location and area of the damage call be directly and rapidly shown by 2DE and TSI,which showed that after myocardial contusion (MC),main damaged areas are anterior and lateral myocardial walls.After myocardial contusion MC,three echocardiography techniques were used to observe the scale of the abnormal segment,the movement of the myocardial wall,Time tO Peak of Systolic Velocity and wall motion segmental inter(WMSI),Time to Peak of Systolic Velocity index(TPI),which all were increased than that pre-injury.Conclusion 2DE and TSI can be used for accurately early diagnosis of the location of myocardial contusion.TSI is more specific for the diagnosis of myocardial contusion.