Objective To investigate epidermal growth factor receptor(EGFR)expression and tumor residual to the prognostic value in patients with nasopharyngeal cancer(NPC).Methods 200 patients with NPC were examined for EGFR expression by immunohistochemistry analysis,neck cancer and nasopharyngeal residual.Results In 200 cases with NPC,expression of EGFR of positive and negative were 160 cases(80.0%) and 40 cases (20.0%);the rate of overall survival(OS),disease-free survival (DFS),loeoregional relapse-free survival (LRFS) and distant metastasis-free survival(DMFS)in patients with positive EGFR were 72.3%,63.6%,72.2%,63.8% and negative EGFR were 90.0%,90.0%,90.0%,90.0%,respectively in 3-year(X2=3.95,X2=4.12,X2=3.98,X2=4.15,P＜0.05),the rate of local recurrence,distant metastasis rate in residual were 26.6%,32.5% which is significantly higher than 8.1%,18.1% in without residual(X2=4.75,X2=4.94,P＜0.05);the hish expression of EGFR with DFS,OS were significantly correlated(r=6.457,P＜0.05).Conclusion The overexpress of EGFR had the tendency of poor prognosis.tumor residual after radiotherpy can be a prognostic indicator for patients with NPC.

Objective To provide the evidence for the clinical prevention and early treatment for the complication by testing microcirculation of the middle fingertip in renal failure patients with hemodialysis.Methods High-frequency ultrasounds combined with E-flow technique were applied to detect the Doppler velocitg index of middle fingertip's nail bed arteriole and ventral arteriole in 35 renal failure patients with hemodialysis.Peak systolic velocity(PSV),end-diastolic velocity(EDV)and vascular resistance index(RI)were separately measured,and comparison were made with healthy adults and renal failure patients without hemodialysis(sex and age matched).Results Compared with normal control,PSV and EDV of middle fingertip's nail bed arteriole and ventral arteriole were degraded statistically(P＜0.05),while RI was increased statistically(P＜0.05)in renal failure patients with and without hemodialysis.Compared with renal failure patients without hemodialysis,PSV and EDV were degraded(P＜0.05)and RI was increased(P＜0.05)in renal failure patients with hemodialysis.Conclusions High-frequency ultrasound combined with E-flow imaging technique can evaluate the microvascular peripheral resistance in renal failure patients with hemodialysis.

AIM　To find new anticancer drug based on the structure of podophyllotoxin. METHODS AND RESULTS　4-Deoxy-4β-arylmethylenesulfonylamido-4′-demethylpodophyllotoxins were (1-15) synthesized and their antitumour activities against KB cells and L1210 leukemia cells were tested. CONCLUSION　These compounds are new compounds. Among them, compounds 2, 3, 8, 9, 11 and 12 showed antitumour activities. When halides exist on the aryl ring of substituted sulfonyl group, the corresponding compound has relatively higher activities. The stereo factor is important for the activities.

Objective:To investigate the effect of vitamin E, selenium and quercetin on the expression of zf-9 mRNA of hepatic stellate cells (HSC) during early acute liver injury in rats. Methods:90 healthy SD rats were randomly divided into four groups: normal control, pathological control, VE 20 mg/(kg bw﹒d) + Se 16 ?g/(kgbw﹒d) supplement, and quercetin 50 mg/(kg bw﹒d) supplement through intragastric way for 15 d respectively. The normal control group was injected with normal saline, the others were given intraperitonal CCl4 once to induce acute liver injury model. The serum levels of MDA, SOD, ALT and AST were determined at 3 h, 6 h, 12 h and 24 h after CCl4 injection respectively. The pronase-collagenase perfusion of liver was used to isolate HSC, and the expression of zf-9 mRNA was examined by RT-PCR. Results: Serum levels of MDA were lower in VE+Se supplement group and quercetin supplement group than pathological group. Supplementation with VE+Se and quercetin could decrease the level of ALT and AST and down-regulate the expression of zf-9 mRNA. Conclusion:Dietary supplementation of VE,Se and quercetin could effectively down-regulate the expression of zf-9 mRNA in HSC during early acute liver injury in rats.

Objective To investigate the pathogens and their drug resistance of neonatal skin infection in Maternal-Neonatal Unit to provide evidence for rational selection of antibiotics.Methods Secretions of skin lesions from newborns with skin infections delivered in Maternal-Neonatal Unit,Department of Obstetrics of Beijing Daxing People's Hospital from Jan.2009 to Dec.2010 were collected,cultured and identified for bacterial serotype.Antibiotic resistances of pathogens were determined.Enumeration data was presented by frequency and rate.The difference between groups was compared with Chi-square test.Results Two hundred and six newborn skin infection cases were diagnosed,which accounted for 2.3％ of all newborns (n=9131) delivered in the hospital during the study period.Two types of skin infection were identified,impetigo (n=192,93.2％) and omphalitis (n=14,6.8％).Totally 154 pathogens were found,including 95 (61.7％) Gram-positive cocci and 59 (38.3 ％) Gram-negative bacilli.The major pathogens among Gram-positive cocci were Staphylococcus aureus (45/154, 29.2％), followed by Staphylococcus epidermidis and Staphylococcus haemolyticus.Staphylococcus was sensitive to Cefazolin,Amoxicillin/clavulanic acid and Piperacillin/tazobactam,while resistant to Penicillin,Ampicillin and Erythromycin.The major pathogens among Gram-negative bacilli were Enterobacter cloacae (19/154,12.3％),followed by Escherichia coli and Klebsiella pneumoniae.Drug resistance rate of Gram-negative bacilli was high in penicillin,aminoglycosides and cephalosporins,while they were sensitive to piperacillin/tazobactam,Ampicillin/sulbactam,carbapenems and Quinolones.Conclusions Gram-positive cocci are the main pathogens of neonatal skin infection in the Maternal-Neonatal Unit,and among which Staphylococcus aureus is the major pathogen.Multi-drug resistance is common in the identified pathogens.Attentions should be paid to use antibiotics reasonably according to drug sensitivity test.

Objective To discuss the features,such as clinical symptoms,pathologic morphologies,immunohistochemical staining of minimal deviation adenocarcinoma and microglandular hyperplasia of the uterine cervix in order to improve the accuracy of pathological diagnosis.Methods s:Histopathologic characteristics of total hysterectomies in 2 cases of minimal deviation adenocarcinoma and 1 case of cervical microglandular hyperplasia based on the formalin-fixed,paralfin-embedded and hematoxylin-eosin stained tissue were analyzed retrospectively.Immunohistochemical staining was used to detect the expression of CEA,p53,PCNA,and Ki-67 in all 3 cases.Results The main clinical symptoms of minimal deviation adenocarcinoma were watery leucorrhea and enlargement of the cervix.The pathological findings of MDA included hyperplasia of the glands with cytological minimal atypia,invasion effects into the stroma could be observed in some glands and abortive glands with desmoplastic changes,or edema and inflammatory infiltration around the glands were also observed.The invasion presented in the deep part of the cervix as well.The patiant of MGH had a history of oval contraceptive use.Histological features of MGH included tightly packed glands in different sizes and shapes,presentation of inflammatory cells in stroma and glandular lumens,and focal epithelial cell pleomorphism and hyperchromatism but without mitosis.CEA was positive in all two MDA cases,but the tissue of MGH was negative for CEA.The expressions of the other four markers had no difference between MDA and MGH.Conclusions For patients with watery discharge and/or hypertrophy of cervix,the deep ( ＞ 5 mm ) biopsies should be performed.The immunohistochemical staining for CEA,p53,CA125 and ER has adjuvant diagnostic values.It is extremely important to recognize that MGH is an entirely benign lesion.

Objective To evaluate the application value of three-dimensional power Doppler imaging(3D-PDI) in diagnosis of carotid artery stenosis in the elderly. Methods A total of 72 elderly patients with history of hypertension, coronary atheroselerosis, diabetes mellitus or hyperlipidemia were included in the study. The condition of carotid artery stenosis was examined by colour doppler flow imaging (CDFI), 3D-PDI in free-hand mode, and measured by digital subtraction angiography (DSA) as a golden standard in 24 hours. The sensitivity, specificity, positive and negative predictive values were calculated, and all the results were compared with CDFI. Results 3D-PDI directly showed the stereo image, including surface character and exact position of plaque,volume of vessel lumen and spatial distribution of blood flow. Seventy two patients had 85 stenosis of carotid arteries. There was no statistical difference in diameter stenosis rate between CDFI and 3D-PDI [(49.2±0.7)% vs. (52.3±0.3)%,P>0.05], and the area stenosis rate measured by 3D-PDI was significantly lower than by CDFI[(53.24±0.7)% vs. (59.3±0.4)%, P<0.01]. In the diagnosis of stenosis classification, the diagnostic sensitivities of light, mild and severe stenosis were significantly different between CDFI(88.9%,100.0%,100.0%) and 3D-PDI(100.0%,70.4%,58.1%) all(P<0.01). The 3D-PDI was better in diagnostic sensitivity of mild and severe stenosis, but specificity was not better than CDFI. Conclusions 3D-PDI is an easy, convenient method with no-wound and good reproducibility in the diagnosis of carotid artery stenosis. It is more accurate than CDFI and similar to DSA.

Objectives To study the value of CT and MRI in diagnosing focal nodular hyperplasia (FNH).Methods The CT and MRI findings of 16 patients with FNH confirmed histopathologically were analyzed retrospectively.Both plain and dynamic enhanced CT scannings were performed in all the patients.Plain and dynamic enhanced MRI were carried out in 9 patients.Results (1) There were 16 patients with 19 lesions,and 8 lesions were in the left lobe,5 lesions in the right lobe,4 lesions between the left/right lobes and 2 lesions in the caudate lobe.The morphology of the lesions showed 15 lesions to have clear boundaries and 4 lesions to have fuzzy boundaries.The tumor diameters varied from 2.2 to 9.6 cm,(average 4.3 cm).(2) Sixteen patients underwent CT examination.On plain CT,the lesions were isotonic (n＝ 5),or slightly low-density (n=11).In 7 lesions,there was a slit-like,stellate-shaped low density central scar.Nine patients underwent MRI examination.On T2WI,6 lesions showed slightly higher signal while the remaining 3 lesions showed iso-signal.On T1WI,4 lesions showed slightly lower signal,3 lesions showed iso-signal and 2 lesions showed slightly higher signal while in 1 lesion the local signal showed reduction in anti-phase 1.A central scar was seen in 6 lesions which showed high signal on T2WI,and low signal on T1WI.(3) Enhanced CT: 15 lesions were significantly enhanced and 1 lesion showed mild enhancement at the arterial phase.For the patients with mild enhancement,the scar in the center of the lesion showed no enhancement.In all lesions,the central scar did not enhance.In 5 lesions,enhancements of thickened and torturous arteries were seen.In all the lesions with enhancement,the enhancement was reduced at the portal venous phase,with 12 lesions showing slightly higher density,3 lesions isodensity and 1 lesion low-density.Three lesions showed mild enhancement of the central scar.All the substantial parts of the lesions with enhancement declined at the delay phase,with 3 lesions showing slightly higher density,9 lesions of isodensity and 4 lesions slightly low density.In 7 lesions with central scar delayed enhancement,they showed slightly higher density.Nine patients underwent MRI enhancement and the enhancement characteristics were similar to CT,but the arterial phase magnitude was higher than that of CT.In 4 lesions,the central scar began to enhance at the portal venous phase,while 6 lesions continued to enhance,thus showing slightly higher signal at the delay phase.In a large lesion,there was persistent delayed enhancement in the capsule.(4) On DWI,6 lesions showed inhomogeneous,slightly hyperintensity with the center showing a slit-like low signal area.Three lesions showed iso-signal.The ADC values of the lesions were (1.31±0.08)× 10-3 mm2/s,and the normal liver parenchyma were (1.22± 0.14)× 10-3 mm2/s,(difference not statistically significant).Conclusions CT and MRI using plain and dynamic enhanced scans could show fully and accurately the pathological features and the characteristics of blood supply of FNH.The characteristic signs on both CT and MRI make an accurate diagnosis of FNH.MRI when compared with CT was slightly better.A combined use of both CT and MRI has an important value in the diagnosis of FNH.

Objective To study the characteristic findings of computer tomography (CT) and magnetic resonance imaging (MRI) in hepatobiliary cystadenocarcinoma.Methods CT,MRI and clinical data were analysed retrospectively.Plain,dynamic CT and MRI were performed in all patients.Results There were 8 patients,7 female,1 male,aged 48-74 years,with a median age of 58.Five lesions were in the left liver,and 3 lesions were in the right liver.One lesion was multilocular cysts with septations.Seven lesions were solitary.The lesions showed low or mixed density on plain CT.Two cysts showed evidence of hemorrhage,while 3 cysts showed fluid levels.There were different signal intensities in the cystic wall nodules which could appear as slightly low intensity on T1WI or slightly high intensities on T2WI.The cyst wall and septations appeared as slightly low intensity on T1WI and T2WI.The cystic fluid signal intensity changed with liquid ingredients.The nodularities showed obviously high signal intensity on DWI,and the fluid showed slightly high signal,while the cystic wall and separations showed slightly low signal intensity.On CT and MRI dynamic enhancement scanning,the nodularities showed obvious enhancement on the arterial phase,while the cystic wall and separations showed no enhancement.The nodularities showed persistent enhancement on the portal venous and delayed phases while the cystic wall and separation showed slight enhancement.Conclusions Hepatobiliary cystadenocarcinoma showed characteristic features on MSCT and MRI.MSCT combined with MR is an important method in the diagnosis and differential diagnosis of hepatobiliary cystadenocarcinoma.

Objective To analyze the related records of acupuncture and moxibustion in the treatment of urticaria in ancient medical books,and to select valuable data as a reference for clinical optimization of acupuncture and moxibustion treatment.Methods With the keywords of "Yin Zhen" and "Feng Sao Yin Zhen",the ancient medical records of acupuncture and moxibustion were retrieved from Encyclopaedia of Traditional Chinese Medicine (5th edition) as the research object,to build database including books,publish year,records,number of selected acupoints,acupuncture and moxibustion methods,acupuncture points,and analyze according to the frequency.Results The earliest records were from the Jin Dynasty (A.D.266-420) "A-B classic of acupuncture and moxibustion",the most documented book was the Ming Dynasty Pu Ji Fang (22);63.64％ of the records did not describe the urticaria syndrome classification,while 36.35％ only briefly described the cold and heat.There were 117 single point prescription,4 pair points prescription,11 multi-point prescription.The commonly used interventions were acupuncture combined with moxibustion (41),moxibustion (31) and needling (22).Commonly used acupoints were Quchi (43),Hegu (18),Jianyu (17).The acupoints were mainly from Hand Yangming large intestine meridian (84),as the specific points of five (105) and from upper limb (120).Conclusions Chinese acupuncture treatment of urticaria has a long history.Prescription was usually single prescription,and the lack of the principle of syndrome differentiation,acupoints from the Hand Yangming large intestine meridian were Quchi,Hegu,etc.as the main points.Ancient medical acupuncture treatment program might be suitable for acute urticaria and grassroots units.