Small cell lung cancer, most malignant and highly aggressive has a high relapse rate due to drug resistance. Potential strategies as high dose chemotherapy with autologous bone marrow transplantation and analysis on genes of metastases are focused on. In spite of great improvement, methods and clinic significances of bone marrow micrometastases are still to be determinated. Bone micrometastases may be a resort to clarify the mechanism of metastases.

Pseudomonas aeruginosa,a ubiquitous organism,shows a remarkable resistance to antibiotics because of its low permeability of the outer-membrane,over-expression of efflux pumps,inactivation of antibotics,or mutations in targets.These mechanisms are often present simultaneously,and increase the burden on clinical therapy.

Objective To investigate the cerebral protective effect of anti-intercellular adhesion molecule-1 (anti-ICAM-1) antibody (1A29) in rats with global cerebral ischemia/reperfusion (I/R) injury. Methods Forty healthy SD rats weighing 180-200 g were randomly divided into 4 groups ( n = 10 each) : group Ⅰ received isotype-matched control antibody 1 mg/kg iv (control group); group Ⅰ ,Ⅲ ,Ⅳ received 1A29 1 mg/kg iv before cerebral ischemia (group Ⅱ), at the onset of reperfusion (group Ⅲ) and at 4 h of reperfusion (group Ⅳ) respectively. The global cerebral I/R was produced by 30 min four-vessel occlusion followed by 24 h reperfusion. All animals were killed at 24 h of reperfusion. Their brains were removed for microscopic examination and measurement of W/D weight ratio, infarct size and neurological deficits (0 = no deficit,4 = unable to crawl with mental depression) .Results The PMN leukocyte and monocyte infiltration, water content of the brain and infarct size were significantly decreased in group Ⅱ ,Ⅲ and Ⅳ as compared with control group. The neurological deficit scores were significantly lower in group Ⅱ ,Ⅲ, Ⅳ(1.6-1.8) than in control group (2.5).Conclusion 1A29 antibody administered either before ischemia or during the 4 h of reperfusion can protect the brain against global cerebral I/R injury.

Objective To analyze the correlation between Doppler ultrasound parameters, blood biochemical indexes and the severity of esophageal varices (EV), and to explore the values of them in the diagnosis of severe EV.Methods A total of 102 hospitalized patients with liver cirrhosis was consecutively collected.All patients underwent endoscopic examination to determine the presence and severity of EV, then they were divided into moderate/severe EV group (n=78) and non/mild EV group (n=24).Congestion index of the portal vein (PV-CI), damping index of hepatic vein(HV-DI), hepatic vein arrival time(HVAT) and intrahepatic circulatory time (IHCT) were measured by Doppler ultrasound and contrast-enhanced ultrasound.And at same time, the level of yon Willebrand factor antigen (vWF-Ag) and soluble CD163 (sCD163) in peripheral blood were detected by enzyme linked immunosorbent assay (ELISA) method.The differences of these parameters between two groups were compared by independent samples t-test or Mann-Whitney rank sum test.The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy (DA) of related parameters in the prediction of EV were calculated according to receiver operating characteristic(ROC) curve.Results Ultrasound parameters PV-CI, HV-DI and peripheral blood vWF-Ag, sCD163 levels of moderate/severe EV group were all significantly higher than those of none/mild EV group 0.11 (0.05) cm · s vs 0.07(0.03) cm· s;0.72±0.11 vs0.52±0.12;1 824.00(558.00) U/Lvs 1 533.80(311.50) U/L;(72.57±10.94) μg/L vs (57.91±10.40) μg/L;Z=-4.949, t=-7.759, Z=-5.420, t=-5.804, all P＜0.05).However HVAT and IHCT were significantly shorter than those of non/mild EV group (17.00(4.25) s vs 27.78(6.75) s;(6.62±1.85) s vs (9.33±2.26) s, Z=-3.822, t=5.820, both P＜0.05).ROC curve analysis showed that the areas under the ROC curve of HVDI, vWF-Ag and sCD163 predicting moderate/severe EV were all more than 0.8, the appropriate cutoff value of HV-DI, vWF-Ag and sCD163 was 0.64, 1 693.8 U/L and 63.98 μg/L, respectively.The sensitivity were all more than 75％,PPV were all greater than 90％ and DA were all more than 80％.Conclusion HV-DI, peripheral blood vWF-Ag and sCD163 levels can be taken as noninvasive parameters, which can effectively predict the presence of severe EV, facilitate early detection of these high-risk bleeding patients and prevent bleeding.

Objective To observe the impact of Aspergillus fumigatus conidia on the early apoptosis of alveolar epithelial cells.Methods A549 cells was first stimulated with tumor necrosis factor-α(TNF-α)or staurosporine (STS)to induce cell apoptosis,and then co-cultured with Aspergillus fumigatus conidia of three different concentrations (5 × 10 5 ,5 × 10 6 ,5 × 10 7 )simultaneously.The changes of the apoptosis rate of A549 cells were detected by flow cytometry.Results The early apoptosis of A549 cells was increased markedly after stimulated with TNF-α ([14.94 ± 0.82 ]% vs [3.26 ± 0.74]%,χ2 =9.18,P <0.05)and STS ([18.10±1 .00]% vs [3.26±0.74]%,χ2 =12.32,P <0.05). When Aspergillus fumigatus conidia of different concentrations were added,the apoptosis rate was decreased (χ2 =31 .23,P <0.05 ).The early apoptosis of A549 cells was negatively correlated with the concentration of Aspergillus fumigatus conidia (rTNF = - 0.92,r STS = - 0.94,both P < 0.05 ). Conclusion Aspergillus fumigatus conidia inhibits the early apoptosis of A549 cells induced by TNF-αor STS and the inhibit effect increases with the concentration of Aspergillus fumigatus conidia.

Gastrointestinal stromal tumors (GISTs) are relatively common mesenchymal tumors of the digestive tract characterized by c-kit mutations and the stomach is the commonly involved site.Clinical and pathological diagnosis of GISTs can be achieved by B sonography,computed tomography and immunohistochemical detection of marker CD117.Surgical resection of GISTs has been the most effective therapy.Target therapy with tyrosine kinase inhibitors may reduce the development of recurrence or progression of GISTs.The optimized method of diagnosis and treatment of huge GISTs is still controversial.In this paper,the diagnosis and treatment for huge GIST combined with large right inguinal hernia were discussed.

Objective To explore the clinical implication of serum Dectin-1 level in the non-agranulocytic patients with pulmonary aspergillosis. Methods Serum specimen were collected from the non-agranulocytic patients with pulmonary aspergillosis to determine the serum level of Dectin-1 with ELISA.The relationship between serum Dectin-1 level,the results of G test and galactomannan (GM)test of Aspergillus,and white blood cell count was analyzed.Results The serum Dectin-1 level was (427.2 ± 42.6)pg/mL in the patients with Aspergillus infection,and (280.8 ± 39.4)pg/mL in the control patients (P<0.05 ).Dectin-1 level was not correlated to white blood cell count,or the result of G test,or GM test. Conclusions Serum Dectin-1 level increases significantly in the non-agranulocytic patients with pulmonary aspergillosis, suggesting that Dectin-1 is an important anti-Aspergillus immune molecule.

Objective To investigate the relationship between the expression of MIF mRNA and TNF-α in the lung tissue of rats with acute necrotizing pancreatitis (ANP) and explore their mechanism of action in acute lung injury during the course of ANP. Methods A total of 40 Sprague-Dawley rats were randomly divided into four groups (n = 10 in each group) : the sham operation (SO) group, ANP 3h group, 6h group, 12h group. The model of ANP was induced by retrograde injection of 5% sodium tanrocholate (0. 1 ml/100 g) into the biliary and pancreatic duct. The level of serum amylase was determined;pancreatic and lung tissues were harvested for pathological examination, and wet/dry weight ratios were estimated. Intrapulmonary expression of MIF mRNA was assayed by semi-quantitative RT-PCR. TNF-α in pulmonary homogenate was measured by immunoradiometric assay. Results Serum amylase, wet/dry weight ratios of pancreatic and lung tissues all significantly increased, and pathological injuries aggravated with time in ANP groups. Levels of TNF-α in ANP 3h, 6h, 12h group were (0.69 ± 0. 107) ng/ml, (1.64 ± 0. 10) ng/ml and (0.92 ± 0.11) ng/ml, and expression of MIF mRNA were 1.97±0.09, 2.55±0.23, 3.29±0.26, which were significantly higher than those in control group [(0. 19±0.06)ng/ml, 1.21±0.34, P<0.01]. lntrapulmonary expression of MIF mRNA was positively associated with lung pathological injuries, wet/dry weight ratio, and TNF-α(r = 0. 637, r = 0.684, r = 0.858, P < 0.01). Intrapulmonary levels of TNF-α was positively associated with lung pathological injuries, wet/dry weight ratio (r=0.540, r=0.421, P<0.01). Conclusions MIF mRNA was over- expressed and level of TNF-α was significantly increased in pulmonary tissue in rats with ANP, and this may be one of the mechanisms in the pathogenesis of lung injury in ANP.

Objective To explore the changing levels of serumIL-17 and Dectin-1 and their implication in non-neutropenic pa-tients with invasive pulmonary aspergillosis (IPA).Methods The clinical data were reviewed for 23 non-neutropenic patients with clinical diagnosis of IPA (IPA group),31 patients with clinical diagnosis of pneumonia (pneumonia group)and 51 healthy subjects(control group).The peripheral serum was collected to analyze IL-17 level by ELISA.Serum Dectin-1 level was also determined at the same time.Serum G test,GM test,WBC and CRP level were also assayed for the patients in IPA group.Pa-tient outcome was followed up and analyzed in terms of serum IL-17.Results The serum IL-17 level of the patients in IPA group was significantly higher than that in the control group (P <0.05).The serum IL-17 level in the pneumonia group was not significantly different from that in the control group (P >0.05).The serum Dectin-1 level in IPA group was significantly higher than that in the control group (P <0.05).For the patients in IPA group,serum IL-17 level was positively correlated to serum Dectin-1 level (r=0.81 ,P <0.05),while serum IL-17 and Dectin-1 levels were not correlated to the results of G test, GM test, WBC,CRP or patient outcome (P > 0.05 ). Conclusions Dectin-1 may be produced and Th17 cell immunity activated in response to Aspergillus fumigatus in-fection in non-neutropenic patients.And,serum Dectin-1 level is correlated with Th17 response.