The mechanism and interaction among Rb/p16, Rb/E2F1 and HDAC1 proteins in gallbladder carcinoma were investigated. By using the immunoprecipitation method, the interactions among Rb, p16, E2F1, HDAC1 proteins in gallbladder carcinoma cell line (Mz-ChA-1) were studied. It was found that there were Rb and E2F1 proteins in the precipitates with anti-HDAC1, and there were HDAC1 and E2F1 proteins in the precipitate with anti-Rb. It was concluded that there are specific interactions among Rb, HDAC1 and E2F1 proteins in gallbladder carcinoma, indicating the existence of the direct Rb/E2F1/HDAC1 signal transduction pathway. There is no direct relationship between p16 proteins with Rb, HDAC1, and E2F1 proteins.

The glucose-regulated protein78 (GRP78) is a member of the heat-shock protein 70 (HSP70) family and responsible for cellular homeostasis. GRP78 is highly expressed in various tumors. It plays an im-portant role in tumor proliferation, survival, metastasis, and drug resistance. Suppression of GRP78 in tumors could enhance cancer treatment. Inhibition of GRP78 in tumors may provide a noval approach toward cancer therapy.

Objective To investigate whether emergency rooms in major general public hospitals are reasonably designed and convenient for patients. Methods 78 major public hospitals were selected from all over China, except Hong Kong, Macau and Taiwan, for emergency room convenience analysis. The standards in use were the "Standards of Hospitals" of Joint commission International Accreditation. Results The investigation found in such hospitals the following: poor road conditions outside the clinic and insufficient guides in the clinic; long-than-expected distance (normally over 50 meters) from ER to imaging departments (such as X-ray and CT scan service); ERs in provincial capital cities are significantly more convenient than those in non-capital cities; distance from ERs to CT service is significantly shorter in hospitals in eastern China than those middle and western China. Conclusions Parameters on ER's service quality from "Standards of Hospitals" could serve as a guideline to emergency medicine in China. ERs in China need to improve with conspicuous ER signs, unblocked passageways, and convenient access to inspection departments.

Objective To investigate the expression and polymorphism of lipoprotein lipase (LPL) gene and their association with acute hyperlipidemic pancreatitis(HLP). Methods A total of 120 patients Were assigned to HLP group (n=20), acute pancreatitis (AP) group (n=50) and control group (n= 50). Serum levels of triglyceride (TG), cholesterol (Ch), free fatty acid (FFA), lipoprotein and apolipoprotein and serum LPL/HL activities were determined. The mRNA expressions of LPL/HL and LPL gene intron 8 polymorphisms were detected by RT-PCR and PCR-RFLP, respectively. Results The serum levels of TG, Ch, FFA and ApoE were significantly higher in HLP group than those in AP group and control group (P<0.05). The serum level of HDL was lower in HLP group than that in AP group and control group(P<0.05). The serum LPL/HL activities were significantly higher in HLP group than that in AP and control groups. The expression of LPL mRNA was up-regulated and intron 8 Hind Ⅲ H2 allele frequency was significantly inereased in the HLP group compared to control group(0.90/0.72, P<0.05). H1 allele frequency was significantly decreased in the HLP and AP groups compared to control group(0.10/0.28 and 0.14/0.28, respectively). Conclusions The high allele frequency of LPL gene intron 8 Hind H2 result in the increase of activities and expression of LPL mRNA, which exacerbate the development of HLP through changing TG metabolism such as FFA accumulation.

Objective To investigate the influence of Lipoprotein lipase (LPL)/Hepatic lipase (HL) on hyperlipidemie acute necrotizing pancreatitis (HLANP) in rats. Methods The rats were fed with hyperlipidemic feed for 4 weeks, then the rats were injected with 5% sodium taurocholate into pancreatic duct to induce HLANP model. Seventy-two rats were randomly assigned to HLANP and control groups, and then each group was subdivided into 6 subgroups (n = 6) at 0, 3, 6, 12, 24 and 48 h. Serum amylase, cholesterol, triglyeride (TG), free fatty acid (FFA) levels and serum LPL, HI. activities were determined. Under the light-microscopy and electron microscopy, the histopathologic and uhrastructure changes of pancreas were observed; the HL mRNA expressions were detected by RT-PCR; HL protein expressions HL were assessed by immunohistoehemical staining. Results The serum amylase levels reached peak values at 12 h after ANP induction in the two groups, the mean values were 7 176U/L and 6 366U/L, which were significantly higher than those of baseline values (P <0.05) ; serum levels of cholesterol in HLANP group at 0 ～ 12 h were higher than those of control group, however, only at 0 h the difference (1.19±0.49 vs 0. 32±0.14 mmol/L) was significant (P < 0.05) ; serum levels of FFA in HLANP group were not significantly different when compared with those of control group; serum levels of LPL and HL at 3 h were (17.5±7) U/L and (18.6±3.9) U/L, which were significantly higher than those of control group (8.9±3.4 U/L and 9.5±2. 1 U/L, P < 0.05). The pancreatic tissues necrosis levels were significantly increased in HLANP groups (3, 6, 24 and 48 h) than those of control group at corresponding time points (P < 0.05). lipid droplet deposition, rough endoplasmic reticulum distension, zymogen granule reduction, and chondriosome swelling in acinar cells of pancreatic tissues in HLANP group were found. The HI, mRNA expressions at 3 h and 6 h in HLANP group were 1.1±0.09 and 0.89±0.08, which were significantly higher than those in control group (0. 11 ± 0.01 and 0.15±0. 03, P <0.05). HL proteins were positively expressed in pancreatic tissues of two groups before ANP was induced, and HL proteins were strongly positively expressed after ANP induction. Conclusions Lipase (LPL/HL) expression increased in HLANP rats, and the content of serum protein increased, which resulted in lipids decomposition and increased the severity of ANP. LPL/HL may be one of the key lipids metabolic enzymes aggravating HLANP.

Objective To explore the functional impairment characteristics of acute stroke patients and cor- relate them to the functional independence after rehabilitation therapy. Methods Seventy-nine inpatients with stroke were divided into hemorrhage group and infarct group according to their condition.They are assessed by using measures of ESS,MBI,MMSE,Sheikh,Fugl-Meyer Balance and Fugl-Meyer motor assessment before rehabilitation treatment.After 1 month of treatment,all the patients were evaluated again using FIM.Correlation analysis was con- ducted with all the parameters. Results It was found that patients in the hemorrhage group scored lower with MBI, Sheikh,Fugl-Meyer Balance and FIM than those in the infarct group (P

Objective To investigate the clinic diagnosis value of CT scan and the determination of serum NSE, Cyfra21-1 for SCLC. Methods ① The CT findings and pathologic basis of 220 cases with SCLC were analyzed retrospectively.② Between February 2000 and December 2001, 120 consecutive patients with pulmonary lesions by CT scan, which suspiciously suffered lung cancer, were studied prospectively. Serum samples were obtained by venous puncture from all patients 1 week prior to surgery or puncture biopsy. The serum concentration of NSE, Cyfra21-1 were determinated using ELISA. According to the pathologic result, the diagnostic value of CT scan, NSE and Cyfra21-1 were evaluated.Results ① Most CT findings of SCLC were central and spindly or eggplant-shape mass, hilar and/or mediastinal lymph nodes enlargement.The obstructive pulmonary lesions were found rarely.② Using CT scan, NSE and Cyfra21-1 alone, the sensitivity were 75%,72.5% and 32.5%,the specificity were 73.75%, 83.75% and 48.75%,the accuracy were 74.16%, 81.67% and 43.33% respectively. With combination of CT scan and NSE, the diagnostic accuracy was 78.3%, and the sensitivity was 87.5%. However, CT scan combined with Cyfra21-1 can not be improve the diagnostic value. Conclusion SCLC has specific CT findings. The sensitivity of CT scan was 75%, combinated with NSE, its accuracy was higher(78.3%), and the sensitivity was 87.5%.

Objective To investigate stem cell factor(SCF)expression in activated pancreatic stellate cell(PSC)and the effect of SCF on adhesion between PSC and mast cell(MC).Methods PSC of SD rat was separated and activated by pancreatic tissue culture;the expression of SCF mRNA and protein was detected bv RT-PCR and immunachemistry.SCF was blocked with different dose of anti-SCF antibody,the rate of adhesion between PSC and MC was determined by thiomn blue stain and β-hexasaminidase assay.PSC was stimulated by 10 μg/ml mitomycin-C and was co-cultured with MC,then the growth of MC was observed at 2,3,5 day,respectively.Results Activated PSC expressed SCF mRNA and protein,the number of adhered MC in the control,1mg/ml and 10 mg/ml antibody groups was 48±10,28±8,and 23±9,respectively;the difference between antibody and control group was statistically significant(P＜0.05).One day after PSC and MC was co-cultured without serum.there were MC adhesion;3 days later the rate of adhesion increased;5 days later the adhesion appeared bulk-like and lots of colonies were present,while PSC basically disappeared.Conclusions Activated PSC may synthesize,express SCF and induced adhesion and growth of MC.

Objective To investigate the EUS elastographic patterns of normal pancreas and focal pancreatic lesions, and its value for characterizing and differentiating between benign and malignant pancreatic tissues. Methods Between January and June 2009, 6 patients with normal pancreas and 9 patients with focal pancreatic lesions were enrolled. Real-time elastography was carried out during the conventional EUS examination. The elastographic images were scored with 1 to 5 based on the elastographic pattern. Results Nine focal pancreatic lesions were finally diagnosed as pancreatic cancer (n = 4), cyst-adenocarcinoma (n =1), cyst-adenoma (n = 2) and focal pancreatitis (n = 2), respectively. Pancreatic cancers were scored as 3(n = 1) and 4 (n = 3). Cyst-adenocarcinoma was scored as 5 and cyst-adenomas were scored both as 2,while focal pancreatitis were scored as 2 and 3, respectively. Elastographic pattern was scored as 1 (n = 5)and 2 (n = 1) in 6 normal pancreas. When scores 1 and 2 were assigned to benign lesion and 3 to 5 to malignancy, the overall diagnostic accuracy of EUS elastography for focal pancreatic lesions was 88. 9%(8/9). Conclusion There are apparent differences in elastographic patterns between benign and malignant pancreatic tissues. EUS elastography is a promising method that allows characterization and differentiation of benignancy and malignancy.

Phosphoinositide 3-kinase/serine-threonine kinase (PI3K/AKT)has been found playing an important role in the pathogenesis of severe acute pancreatitis (SAP)in recent years,but the underlying mechanism has not been clarified.Aims:To investigate the role of PI3K/AKT in regulating the inflammatory response in SAP by evaluating the effect of insulin-like growth factor-Ⅰ (IGF-Ⅰ)and wortmannin,the agonist and inhibitor of PI3K/AKT on Toll-like receptor 4 (TLR4)signaling pathway in macrophage cell line RAW264.7.Methods:RAW264.7 cells were treated with different concentrations of lipopolysaccharide (LPS ), IGF-Ⅰ and wortmannin, respectively, and cell viability was determined by CCK-8 assay.RAW264.7 cells were divided into blank control group (no treatment),LPS group (LPS 1 μg/mL),IGF-Ⅰ group (IGF-Ⅰ 100 ng/mL +LPS 1 μg/mL),wortmannin group (wortmannin 100 nmol/L +LPS 1 μg/mL)and IGF-Ⅰ +wortmannin group (wortmannin 100 nmol/L +IGF-Ⅰ 100 ng/mL +LPS 1 μg/mL).Protein expressions of tumor necrosis factor-α(TNF-α)and interleukin-6 (IL-6)were detected by ELISA;mRNA expressions of TLR4,myeloid differentiation factor 88 (MyD88),AKT,PI3K,p38 mitogen-activated protein kinase (p38MAPK)and nuclear factor-κB (NF-κB)were determined by real-time PCR.Results:After treated with LPS,IGF-Ⅰand wortmannin, respectively,no differences in cell viability of RAW264.7 cells were found between different concentrations groups (P>0.05).Protein expressions of TNF-αand IL-6 in LPS,IGF-Ⅰ,wortmannin and IGF-Ⅰ +wortmannin groups were significantly higher than those in blank control group (P<0.05 ).Protein expressions of TNF-αand IL-6 in wortmannin group were significantly lower than those in LPS and IGF-Ⅰ groups (P<0.05),and those in IGF-Ⅰ+wortmannin group were significantly lower than those in IGF-Ⅰ group (P<0.05).In LPS group,mRNA expressions of AKT and PI3K as well as TLR4 and its downstream molecules MyD88,p38MAPK and NF-κB were significantly higher than those in blank control group (P <0.05 ).Expressions of all above-mentioned mRNAs in IGF-Ⅰ group were further increased and significantly higher than those in LPS group (P<0.05).Expressions of all above-mentioned mRNAs in wortmannin group were significantly lower than those in LPS and IGF-Ⅰ groups (P<0.05 ),and those in IGF-Ⅰ+wortmannin group were significantly higher than those in wortmannin group (P<0.05),but significantly lower than those in IGF-Ⅰ group (P<0.05).Conclusions:PI3K/AKT might regulate TLR4 signaling pathway and its downstream molecules in macrophages, thereby affects the expressions of inflammatory cytokines and being involved in the pathogenesis of inflammatory response in SAP.