Purpose To explore the expression of Bmi-1, p14ARF and Mdm2 in colorectal carcinoma and to find out their association with clinicopathological features. Methods The expression of Bmi-1, p14ARF and Mdm2 was detected by immunohistochemistry in 125 cases of colorectal carcinoma and 20 cases of normal colorectal tissues. Results ( 1 ) The positive rates of Bmi-1 and Mdm2 were 56. 8% and 62. 4% in colorectal carcinoma, respectively, which were much higher than that in normal colorectal tissues (20. 0% and 15. 0%). The positive rates of p14ARF was 47. 2% in colorectal carcinoma, which was much lower than that 75. 0% in normal colorec-tal tissues ( P<0. 05 ) . ( 2 ) The expression of Bmi-1 was significantly correlated with serosal invasion, lymph node metastasis and Dukes stage. The expression of p14ARF was significantly correlated with serosal invasion and Dukes stage. The expression of Mdm2 was significantly correlated with histologic grade, lymph node metastasis and Dukes stage (P<0. 05). (3) In colorectal carcinoma, the expression of Bmi-1 and Mdm2 was negatively correlated with p14ARF, respectively (P<0. 05). Conclusions Abnormal expression of Bmi-1, p14ARF and Mdm2 is involved in the occurrence, development and metastasis of colorectal carcinoma, which could be as the reference factors in judgement of biological behavior and provide a new target for clinical treatment.

Operation is always thought to be the soul way to cure hepatocelluar carcinoma(HCC),but there are only 30% patients who have the opportunity to receive the operation.Transcatheter hepatic arterial cheomoembolization is the most extensive non-surgery approach to treat hepatocelluar carcinoma which also has a lot of shortcoming and limitation.It is common sense that enhancement of effectiveness of liver cancer therapy largely depends on the combined therapy.

Objective To explore the change of thyroid hormones and leptin at hyperuricemia (HUA)/gout.Methods A total of 96 primary gouts,65 HUAs,and 59 healthy examiners was selected.Height,weight,blood pressure,renal function,serum uric acid(SUA),glucose,lipid profiles,insulin,thyroid hormones were measured after an overnight fast.Results (1) The prevalence of subhypothyriodism at gout and HUA was 7.29％ and 15.38％,respectively.They were higher than that at healthy subjects.(2) Body mass index (BMI),systolic blood pressure (SBP),triglyceride (TG),cholesterol (CHO),thyroid stimulating hormone (TSH),fasting insulin (FINS),homeostasis model assessment of insulin resistance (HOMA-IR),and serum leptin level were increased remarkably at gout/hyperuricemia relative to control group,whereas,free thyroid hormone (FT4) was decreased.(4) In the gout and hyperuricemia groups,TSH was used as the dependent variable for the linear multivariate regression analysis,the results showed that sex,age,BMI,SUA,FT4,HOMA-IR,and Leptin were included in the regression equation of TSH (βwere-0.27,0.832,0.946,0.198,-0.942,0.895,and 0.650,respectively).Conclusions The prevalence of subhypothyroidism in primary gout/hyperuricemia was increased.Female,age,BMI,SUA,FT4,HOMA-IR,and leptin were the independent risk factors.Insulin resistant and leptin played the media roles in the gout/HUA and hypothyroidism.

Objective:To analyze the characteristics of hospital infection of hematological disease, so as to provide reference for clinical therapy. Methods: Bacterial strains and antimicrobial resistance of pa-tients with hospital infection in Department of Hematology, Peking University Third Hospital from Jan. 2011 to Dec. 2013 were identified and analyzed retrospectively. The specimens were from their blood, urine, sputum, throat swabs and etc. Results:Among the total of 168 isolates of bacteria,the majority of the bacteria strains were from sputum (42. 9%);114(67. 9%) bacteria strains were gram negative and 54(32. 1%) bacteria strains were gram positive;the pathogen testing showed that 20. 8% were Pseudo-monas aeruginosa,18. 5% Escherichia coli,17. 9% Staphylococcus aureus, 9. 5% Klebsiellar pneumonia, 5. 9% Staphylococcus epidermis and 27. 4% other bacteria ;The gram negative bacilli to cefepime, ami-kacin and carbapenems showed the lowest antimicrobial resistance rates, and S. aureus showed the lowest antimicrobial resistance rates to vancomycin and linezolid. Conclusion:Patients with hemopathy are the main population of hospital infections, the gram negative bacteria are the most common pathogens. It is very important to promptly know the change in distribution of the pathogens in order to rationally select antibiotics and reduce the incidence of bacterial infections.

Objective To investigate the effect of globular adiponectin on the high expression of monocyte chemotactic protein-1 (MCP-1) induced by high glucose in rat renal tubular epithelial cells (NRK52E),and its relationship with adiponectin receptors and p38MAPK.Methods NRK52E cells were cultured in vitro and divided into six groups:normal glucose group (NG,5.6 mmol/L glucose),high glucose group(HG,25 mmol/L glucose),gAd groupl (HG+gAd 2 mg/L),gAd group2 (HG+gAd 5 mg/L),gAd group3 (HG+gAd 10 mg/L),p38MAPK antagonist group:(SB,HG+SB203580 10 μmol/L).The protein expression of phosphorylated p38MAPK (p-p38MAPK),total p38MAPK (t-p38MAPK),MCP-1 and AdipoR1/AdipoR2 were examined by western blotting.The mRNA expression of MCP-1 and AdipoR1/AdipoR2 were detected by RT-PCR and real-time PCR respectively.Results Compared with NG group,the mRNA and protein expression of MCP-1 increased significantly in HG group (all P＜ 0.05).The phosphorylation of p38MAPK increased (P＜ 0.05) with no change in t-p38MAPK protein.The addition of gAd or SB203580 inhibited the unregulation of MCP-1 and p-p38MAPK induced by HG.Two kinds of adipoR,adipoR1 and adipoR2,were all detectable in NG group,and mRNA and protein expression of adipoR1 was higher than that of adipoR2 (P＜ 0.01).Compared with NG group,the expression of adipoR decreased in HG group,but the difference had no statistical significance(P ＞ 0.05).Compared to HG group,the mRNA and protein expression of adipoR1 increased in gAd groups (all P ＜ 0.01).Conclusion The gAd can dose-dependently attenuate the overexpression of MCP-1 induced by high glucose,and this protective effect may be mediated by adipoR1 and p38MAPK.

Objective To investigate the differences between Monte Carlo (MC) calculated doseto-water (Dw) and dose-to-medium (Dm) for lung cancers treated with intensity-modulated radiotherapy (IMRT).Methods A total of 10 lung carcinoma patients with 5-field IMRT treatment plans were stratified sampling randomly selected for this study,which were performed on Monaco treatment planning system (TPS) with MC algorithm.Using the patients' own CT images as quality assurance (QA) phantoms,two kinds of QA plan were calculated,one was the Dm,and another was the Dw plan.Dose volume histogram (DVH) parameters and the subtraction of two plans were used to evaluate the spatial distribution of the difference between the Dm and Dw.Results Differences between dose-volume indices computed with Dm and Dw for the PTV65 and PTV50 doses (D50％,D98％ and D2％) were-0.3％,-0.2％,0.3％ and 0.1％,-0.6％,0.4％,respectively,of which the D50％ of PTV65 and D98％ of PTV50 had statistical difference (t =-2.536,-3.776,P ＜ 0.05).For normal tissues,spinal cord,heart,lung and esophagus,the D50％ differences between Dm and Dw were 0.3％,1.1％,-0.2％ and -0.1％,of which the Dm of spinal cord and heart were slightly lower than the Dw (t =2.535,3.254,P ＜ 0.05).For the D2％ of the normal tissues,the differences were 0.3％,-0.6％,-0.7％ and 0.6％,the differences were statistically significant (t =2.311,-4.105,-3.878,6.214,P＜0.05).All the differences were within 2％.Meanwhile planned subtraction analysis showed the differences between the Dm and Dw varied very much with the other body parts of the patient,especially for bone tissues,and the two doses were significant difference (＞ 5％).Conclusion In the course of clinical application,the relative differences between Dm and Dw for lung cancers MC calculations should be noted when considering the dose limitations of bone tissue.

Objective To study the correlation of blood drug concentration determination of sodium valproate in children with epilepsy by using enzyme-multiplied immunoassay test (EMIT) and high performance liquid chromatography (HPLC), so as to provide basis of selection in clinical determination of sodium valproate ( VPA) .Methods 200 blood samples of epileptic children taking sodium valproate were collected, blood concentration were determined by EMIT and HPLC method, and the correlation was analyzed.Results The following regression equation was obtained by determination results of HPLC (X) and EMIT (Y): Y=1063.517X-331.351(r=0.933), which had significant correlation (P<0.05).The plasma concentration of VPA determined by EMIT was higher than that by HPLC.Conclusion The determination results of VPA concentration in epileptic children by using EMIT and HPLC has significant correlation, and it should choose the suitable method to determine the blood drug concentration of VPA based on the actual situation.

Objective To compare the efficacy of intralesional glucocorticoid injection with a needle-free injector versus an ordinary injector for the treatment of keloid. Methods A total of 60 patients with keloid were enrolled and randomly divided into two groups by using a random number table to receive intralesional injection of compound betamethasone with a needle-free injector(n=31)or an ordinary injector(n=29). The injection was given at a dose of 0.2 ml/cm3 once every 3 weeks for 3 sessions. Parameters for therapeutic efficacy were assessed, adverse reactions were recorded, and clinical pictures were taken before and after each treatment. Statistical analysis was carried out by the Mann-Whitney U test and chi-square test with the SPSS 19.0 software. Results Compared with the ordinary injector group, the needle-free injector group showed significantly different injection time during the first and second treatment (U=299.000, 773.500, respectively, both P=0.000), as well as duration of pain after the first injection(U=730.000, P=0.003). After three sessions of treatment, there was a significant difference in the volume, height, hardness of keloid, scores for pain, itching and appearance, and number of injection points between the needle-free injector group and ordinary injector group (U=295.000, 336.500, 264.000, 464.000, 451.500, 308.000, 233.500, P=0.001, 0.007, 0.000, 0.041, 0.043, 0.003, 0.001, respectively). No significant differences were observed in the incidence of adverse reactions between the two groups(all P>0.05). Moreover, the interval for lesion recurrence was significantly shorter in the needle-free injector group(11.8 days, 95%CI:10.96-12.6 days)than in the ordinary injector group(21.2 days, 95%CI:13.96-28.45 days). Conclusion Compared with the ordinary injector, the needle-free injector shows better efficiency for the treatment of keloid with decreased difficulty in injection and improved compliance in patients.

Objective To evaluate the role of autologous septal cartilage in the rhinoplasty of the wide and bulbous nasal tip. Methods A big piece of autologous nasal septal cartilage was removed and transplanted to the front of nasal septum, acting as a septal extender to fix the nasal alar cartilage,and then the shape of nasal tip was reconstructed by middle crus suture technique, excessive soft tissue under skin of tip and a part of lateral crura cartilage were removed to stand out the shape of the nasal tip. Results After one year follow-up, 118 of 126 cases achieved satisfied effects, but 8 cases dissatisfied because of their undue thick skin. Conclusions This method is reliable in the correction of the wide and bulbous nasal tip.

Objective To retrospectively analyze the therapeutic effect of wide surgical excision combined with low-dose adjuvant interferon-alpha 2b on cutaneous malignant melanoma.Methods A total of 32 patients with cutaneous malignant melanoma received wide surgical excision after preoperative examination and staging.The excisions were performed with a margin measuring 1-2 cm from the visible lesions or biopsy scars.Surgical modalities included direct suture after excision(4 patients),dactylolysis or toe amputation(6 patients),free skin grafting(15 patients),random skin flap transfer(3 patients)and pedicle skin flap transfer(4 patients).Lymph nodes were selectively dissected in 9 patients with regional transfer of lymph nodes,and inguinal lymph nodes were cleared away in 2 patients.One week after the operation,patients received adjuvant therapy with subcutaneous injection of interferon-alpha 2b(3 million IU,thrice per week)for one to three years.Results Preoperative tumor staging revealed 21 cases of cutaneous malignant melanoma at stage Ⅱ,and 11 cases at stage Ⅲ.The excisions healed by the first stage in all the patients.Up to June 2011,2 patients had been lost to follow up,5 patients with stage Ⅲ melanoma had died.Survival was observed in all of the 4 patients receiving 1-year follow up,12 of 13 patients receiving 1-3 year follow up,5 of 7 patients receiving 3-5 year follow up,and 4 of 6 receiving 5-year follow up.Of the 25 surviving patients,regional lymph node metastasis was observed in 8 patients,which developed within 2 years after the operation in 2 patients.The adjuvant therapy with interferon-alpha 2b lasted 3 years in 8 patients,and more than 1 year in 11 patients.Side effects were mild.Conclusion Wide surgical excision plus low-dose interferon-alpha 2b is effective for the treatment of stage Ⅱ and Ⅲ cutaneous malignant melanoma with lower local recurrence and higher survival rate.