Matrix metalloproteinase (MMP)plays an important role in the degradation of extracellular matrix components,which is crucial for tumor growth,invasion and metastasis.As one with the largest relative molecular mass in MMP family,MMP-9 takes part in the generation and progression of colorectal cancer. Research shows that MMP-9 can be used for the early diagnosis of colorectal cancer.The expression levels of MMP-9 in tissue and plasma are negatively correlated with prognosis of the postoperative patients with colorectal cancer.In addition,targeted therapy drugs will be designed on the basis of MMP-9 expression increased in colorectal cancer.

Objective To analyze the efficacy and safety of different chemotherapy regimens for treatment of progressive patients with small cell lung cancer (SCLC) brain metastasis after radiotherapy. Methods 96 SCLC brain metastasis patients with progressive intracranial lesions after radiotherapy were divided into four groups: carmustine group (Group A, 28 cases), temozolomide group (Group B, 19 cases), topotecan group (Group C, 24 cases) and no chemotherapy group (Group D, 25 cases). Results In terms of brain metastases, there were no complete response cases in the whole groups. The rates of partial remission (PR), stable disease (SD) and progression of disease (PD) in Group A were 17.8%(5/28), 53.6%(15/28) and 28.6 % (8/28), respectively, the response rate (RR) of intracranial lesions was 17.9 % (5/28), and disease control (CR+PR+SD) rate was 71.4%(20/28). The rates of PR, SD and PD in Group B were 15.8%(3/19), 63.2 % (12/19) and 21.1 % (4/19), respectively, the RR of intracranial lesions was 15.8 % (3/19), and disease control rate was 78.9 % (15/19). The rates of PR, SD and PD in Group D were 8.3 % (2/24), 54.2 %(13/24) and 37.5 % (9/24), respectively, the RR rate of intracranial lesions was 8.3 % (2/24), and disease control rate was 62.5 % (15/24). In Group D, there was no response case, and 20 patients with PD (80.0 %) were found. The median progression-free survivals (PFSs) were (3.64 ±0.43) months, (4.68 ±0.49) months,(3.58 ±0.50) months, (2.60 ±0.31) months in Group A, B, C and D, respectively, and the median overall survivals (OSs) were (18.80±1.74) months, (18.76±1.85) months, (19.10±1.64) months and (9.64±0.84) months, respectively. The median OS of Group A, B or C was longer than that of Group D (P=0.002). The differences of grade Ⅲ-Ⅳhematologic toxicities among the four subgroups were not statistically different. Patients in Group B had better tolerance to nausea and vomit. In Group D, the central nervous system symptoms such as fatigue and headache occurred frequently. Conclusions The response rate and OS of SCLC brain metastasis patients with progressive intracranial lesions after radiotherapy are improved after chemotherapy, however, PFS is not significantly prolonged. The efficacies of carmustine, temozolomide and topotecan are similar in short and long term, besides, temozolomide shows less adverse events and a higher disease control rate. The application of chemotherapy that could penetrate the blood-brain barrier can improve the efficacy on SCLC brain metastasis patients with progressive intracranial lesions after radiotherapy with well tolerance.

In this article we report the results on the synthesis and accumulation of PHAs by Rhodocista pekingensis (strain 3-p), a phototroph that was isolated from wastewater treatment plant. Our results showed that the optimal conditions for PHAs accumulation with strain 3-p were as following: 0.01% Yeast Extract, 0.01% NH 4Cl, Acetate 5 g/L, and medium pH of 7.0～7.2.Under optimized conditions, strain 3-p accumulated PHAs up to 60% of its cellular dry weight. Enzymatic activities of ?-ketothiolase, acetoacetyl-CoA reductase, and PHA polymerase were detected and their activities increased as PHA synthesis initialized. Based on these study, we proposed the metabolic pathway of this strain should be:Acetate (or other fatty acids) - Acetyl-CoA --- thiolase Acetoacetyl-CoA --- reductase D (-)-?-Hydroxybutyryl-CoA ----- PHA polymerase PHAs.

Objective To study the microsurgical and anatomic structures of brachial plexus roots and vertebral canal to find the best approaches for reimplantation of avulsed brachial plexus ventral roots into the spinal cord.Methods On nineteen cervicothoracic spine specimens,the brachial plexus nerves were exposed along to intervertebral foramen,and the spinal cord and brachial plexus roots were exposed by excising the vertebral arch and sectioning the spinal dura mater.The anatomy of brachial plexus roots and vertebrae,and the relative positions of spinal cord segments to vertebral discs were measured and observed.Results The relative positions of spinal cord segments to vertebral discs are:C5-7 spinal cord segments face C3,4,C4,5 and C5,6 vertebral discs;and C8 and T1 spinal cord segments face C6 and C7 vertebrae.Based on the anatomic finding,four approaches were found out: the lateroventral approach,the lateral approach by enlarging intervertebral foramen,the laterodorsal approach and the lateral and dorsal combined approach.Conclusions The brachial plexus ventral roots can be best reimplanted into the spinal cord by the lateroventral approach and the lateral approach.Although the laterodorsal approach and the lateral and dorsal combined approach are not the best,they are less difficuh and dangerous.

Objective To investigate work stress state of nursing home staff and to analyze the influential factors affecting work stress.Methods Stratified random sampling method was adopted to investigate 180 nursing assistants by self-designed questionnaire,Work Stress Scale(WSS),Simplified Coping Style Questionnaire and internal-external locus of control scale investigation.Results Totally 174 valid questionnaires were collected.Variance analysis revealed there were significant differences of age and other factors.Stepwise multiple regression analysis showed five variables entered the equation,including workexpenence education level number of the cared ages work scheduline coping stule and explain 56.7％ of the total variable.Conclusion Nurse managers should pay attention to and improve achievement sense and mental adjustment ability of nursing assistants,to build a well-organized support system to reduce the workload.

Objective To know about the influence of quality control based on Gantt chart on work quality and stress,so as to explore effective method of management suitable for them.Methods 52 nurses from the eastern zone of a three A-level hospital in Jiujiang City were randomly selected as the experimental group,they were implemented with Gantt chart management.Another 52 nurses from the western zone of the same hospital were selected as the control group,they were executed traditional experience-based management.The scores of quality of care and nurses stress were compared between the two groups.Results For the score of the quality of care,the experimental group was higher;,for the score of the nurses stress,the experimental group was lower in the overall sides,and the differences were significant except those of the working environment and equipment,which showed no significant difference between two groups.Conclusions Gantt management method can significantly improve the quality of care,moreover,effectively alleviate the nurses'stress.

Objective To investigate the clinical significance of serum transforming growth factor-β( TGF-β),tumor necrosis factor-α( TNF-α) and interferon-γ( IFN-γ) levels in patients with pre-eclampsia. Methods Thirty-two cases of maternal pre-eclampsia( 22 cases were mild pre-eclampsia,10 cases were severe pre-eclampsia),30 cases of gestational hypertension and 30 cases of normal mothers were selected as our subjects. Serum TGF-β,TNF-α IFN-γ levels were detected. Adverse pregnancy outcomes in patients were collected and analyzed. Results Serum TGF-β,TNF-α,IFN-γlevels in patients with severe pre-eclampsia were (90. 4 ± 23. 4)μg/L,(84. 5 ± 13. 6)μg/L and(146. 5 ± 13. 4)μg/L respectively,significantly higher than that in normal mothers((11. 3 ± 3. 7)μg/L,(5. 6 ± 1. 2)μg/L and(82. 5 ± 19. 4)μg/L),the gestational hypertension group(( 35. 3 ± 8. 4 )μg/L,( 10. 4 ± 2. 9 )μg/L and( 96. 4 ± 15. 8 )μg/L ),and mild pre-eclampsia group((76. 5 ± 15. 4)μg/L,(26. 5 ± 3. 2)μg/L and(120. 4 ± 20. 5)μg/L),and the difference were significant(F=11. 363,15. 982,7. 431;P﹤0. 001). Serum TGF-β,TNF-α and IFN-γ levels in mild pre-eclampsia were significantly higher than those in normal mothers and gestational hypertension patients( P﹤0. 05). Incidence of preterm delivery in patients with high TGF-β,TNF-α,IFN-γ expression was significantly higher than patients with low expression(7 cases vs. 2 cases;χ2 =4. 037,P=0. 044). Incidence of in patients with high FGR,TGF-β,TNF-α expression was significantly higher than patients with low expression( 6 cases vs. 1 case;χ2 =4. 969,P =0. 025 ). Conclusion Detection of maternal serum cytokines can evaluate the severity of pre-eclampsia to a certain extent and predicted adverse pregnancy outcomes.

Background: Acute mastitis is an acute infectious disease of breast. Antibiotic treatment is often unable to obtain a good effect, and we should actively look for a safe and effective non-drug therapy. Objective: To validate the clinical efficacy of kneading and dispersing manipulation in treatment of early-stage acute mastitis. Design, setting, participants and interventions: According to the multicenter randomized controlled trial design, 198 cases of acute mastitis from Yueyang Hospital of Integrated Traditional Chinese Medicine, Longhua Hospital, and Shanghai Yangpu Maternity and Child Health Hospital were randomly divided into treatment group and control group. There were 99 cases in each group. Patients in the treatment group were only treated with manipulation, and cefradine was orally administered to patients in the control group. Main outcome measures: The local breast lump size, clinical symptoms and the adverse reactions in the two groups were observed before and after the treatment. Results: The total response rates in the treatment and control group were 95.92% (94/98) and 80% (76/95) respectively. There was a significant difference in the total response rate between the two groups (P<0.05). There were significant differences in the score of breast lump size, and the score of signs and symptoms between the two groups (P<0.05). Conclusion: Kneading and dispersing manipulation has certain effects on early-stage acute mastitis, and the therapy is safe and repeatable.

Objective To evaluate effect of clinical study combined with short-term intensive simulation on training of hysteroscopy technology. Methods Trainees receiving training of hystero-scopy technology from the January to December 2012 in Gynecology Minimally Invasive Center, Bei-jing Gynecology and Obstetrics Hospital Affiliated to Capital Medical University were enrolled and di-vided into two groups depending on the different training modes. Twenty-four trainees in group1 par-tic-ipated in three-month hysteroscopic clinical study program. Twenty-two trainees in group2 partici-pated in three-month clinical study program including one-week short term intensive simulation. After the training, the effect was evaluated by the rating scale and the Rank sum test was used for statisti-cal analysis. P<0.05 signifies statistically significant difference. Results The operation time(P=0.03), forward planning (P=0.02), instrument handing (P=0.00) and knowledge of specific procedure (P=0.04) were improved significantly in group 2 compared with those in group 1. Conclusions The training mode of clinical study combined with the short-term intensive simulation can improve hys-teroscopy technology effectively and should be widely applied.

Objective Obesity is one of the risk factors for gout.The aim of the present study was to evaluate clinical characteristics of gout patients with different BMI.Methods A total of 5 104 patients with gout were enrolled and divided into three groups according to the BMI.The clinical information was collected and relevant biochemical indices were detected.SPSS software was applied for the statistical analyses.Results There were significant differences in the ratios of gender,regular exercise,hypertension,tophus,renal insufficiency,hyperlipidemia,impaired glucose metabolism,liver dysfunction among the three groups (all P＜0.01).The onset age in overweight [45(36,55) years] and obese subjects [40(31,50)years] were earlier than that of the normal weight subjects [50 (38,61) years].Moreover,waist circumstances [103(99,108) cm and 94 (90,98) cm vs 87 (82,91) cm],systolic pressure [130 (120,145) mmHg (1 mmHg =0.133 kPa) and 130 (120,140) mmHg vs 128 (115,140) mmHg],diastolic pressure [90 (80,100) mmHg and 85 (80,92) mmHg vs 80 (79,90) mmHg],fasting blood glucose [5.77 (5.30,6.44) mmol/L and 5.65 (5.19,6.26) mmol/L vs 5.55 (5.10,6.15) mmol/L],TG [2.10 (1.46,3.04) mmol/L and1.88 (1.35,2.78) mmol/L vs 1.52 (1.07,2.39) mmol/L],TC [5.20 (4.55,5.93) mmol/L and 5.07 (4.46,5.75) mmol/L vs 4.95 (4.27,5.65) mmol/L],serum uric acid [483(418,552) μmol/L and461(395,524) μmol/L vs440 (368,517) μmol/L],ALT [30 (21,46) U/L and25 (18,36) U/L vs 21 (14,29) U/L],AST [21(17,28) U/L and 20 (17,26) U/L vs 20 (6,25) U/L],the number of joints involved [2 (1,3) joints and 2 (1,2) joints vs 1 (1,2) joints] in the overweight and obese groups were higher than those in the normal weight group (all P ＜ 0.01).There were no statistical differences in family history,involvement of upper limb joints,kidney stones and coronary heart disease among the three groups (all P ＞ 0.05).Conclusions Obesity is associated with an earlier age of gout onset.With the increase of BMI,the blood pressures,glucose,lipid,serum uric acid,liver transaminase levels and the number of involved joints increased gradually.Cautions should be taken in treating patients with different BMI.