Objective To investigate the function of TRAIUCaspase-3 and NF-κB among the occurrence, development and malignant invasion of bile duct carcinoma. Methods The in-situ hybrization technique and immunochemistry method were adopted to detect expression of TRAIL, Caspase-3 and NF-κB. Results The positive rates of TRAIL expression in carcinoma of bile duct and paracancer tissue were 45.2 % (19/42) and 53.3 %(8/15), respectively. The differences were not significant (P >0.05), and there were no evident difference between expression of TRAIL and every clinic pathology factor(P >0.05). The positive rates of Caspase-3 expression in carcinoma of bile duct were 30.9 %(13/42), which were obviously lower than those in paracancer tissue, 60.0 %(9/15)(P<0.05). However, The positive rates of NF-κB expression in carcinoma of bile duct were 61.9 %(26/42), obviously higher than those in paracancer tissue, 26.7 %(4/15)(P <0.05). The positive rates of Caspase-3, NF-κB expression were relation to metastasis and proliferation, differentiation degree of tissue and survival time (P <0.05), but were independent of sex, ages and position of carcinoma(P > 0.05). Moreover, TRAIL and Caspase-3 manifested positive relationship (P <0.05). On the contrary , NF-κB and Caspase-3 manifested negative relationship (P <0.05). However, there was no relationship between TRAIL and NF-κB(P >0.05). Conclusion Expression of TRAIL has no selectivity of tumour, Its expression is higher or lower which couldn' t absolutely decide tumour' s metastasis and proliferation, and could not decide malignant degree and prognosis of tumour, too. Activation of NF-κB and losing action or absence of Caspase-3 possibly accelerate metastasis and proliferation of tumour, which result in bad prognosis. NF-κB interdicte TRAIL inducing apoptosis approach via control activation of NF-κB, which induce tissue to avoiding apoptosis and multiplication unboundedly, leading to tumour's occurrence, development, metastasis and diffuseness.

Objective To investigate the relationship among Survivin, PTEN and the occurrence, development, soakage and prog-nesis of gastric cancer. Methods The in-situ hybrization technique, immunochemistry and TUNEL method were used to detect the expres-sion of survivin mRNA, PTEN protein and apoptotic cell. Results The positive rate of survivin expression in gastric cancer was obvious higher than that in para-cancer tissue(P <0.01). Moreover, survivin expression rate in advanced clinical stage and low differentiation gastric cancer degree.was higher, compared with para-cancer tissue (P <0.01, P <0.05). The positive rate of PTEN expression in gas-tric cancer was obvious lower than that in pars-cancer tissue (P <0.01). The positive rate of PTEN expression in advanced clinical stage and low differentiation degree of tissue in gastric cancer was lower (P < 0.01). Furthermore, survivin and apoptesis indexes manifested negative relationship in gastric cancer(r =-0.861, P < 0.01), While PTEN and apoptosis indexes manifested positive relationship (r = 0.832, P < 0.01). Conclusions Survivin could be used as a novel marker to detect gastric cancer. PTEN gene lost function, which maybe promote the origin, growth, soakage and metastasis of gastric cancer.

Objective To investigate the effect of the inhalation of nitrous oxide premixed with oxygen (50%∶50%) for analgesia labor on maternal and fetus. Methods A total of 100 cases of pregnant women were provided with nitrous oxide premixed with oxygen (50%∶50%) (control group); Another 100 cases were provided only with oxygen (comparison group). Recording duration of the Labor, way of delivery, bleeding volume, Apgars score, blood gas analysis to maternal radius artery and fetal umbilical blood among all patients. Results The effect for analgesia labor of the premixed gas was much better than that of control group, but there were no significant differences in time of labor, bleeding volume, Apgars score between the two groups. Conclusions The inhalation of nitrous oxide premixed with oxygen (50%∶50%) for analgesia labor benefits pregnant women because of keeping them being a good mental and physical condition. The inhalation of nitrous oxide for analgesia labor is a safe, effective and easy method.

OBJECTIVETo study the relationship between allergic rhinitis and fractional exhaled nitric oxide (FeNO).METHODS FeNO was measured in 66 allergic rhinitis patients before and after treatment. Visual analogue scale (VAS) score was used to describe the patient's symptoms. RESULTSFeNO and VAS score were significantly decreased after treatment (t=4.25,P=0.0000;t=3.34, P=0.0008), and the decrease proportion were (14.56±27.23)% and (8.68±53.17)% respectively. Correlation analysis showed FeNO and VAS score was significantly correlated before (r=0.43,P=0.0003) and after (r=0.45,P=0.0002) treatment. After treatment, the decreased proportion of FeNO and VAS score were significantly correlated (r=0.25,P=0.0437). CONCLUSIONFeNO can provide objective evidence for the treatment efficacy of allergic rhinitis.

Objective To explore the epidemiology, clinical and pathological characteristics,treatment and prognosis of Richter's syndrome (RS). Methods The clinical and laboratory feature,treatment, prognosis of two cases were reported, and the related literature was reviewed. Results The major symptom of two cases suffered with enlarged lymph nodes, and pathological examination indicated a diffuse large B cell lymphoma. A large number of mature small lymphocytes were found in peripheral blood and bone marrow, and the immune phenotype was consistent with chronic lymphocytic leukemia. CHOP regiment was used on two cases. One obtained complete remission, and the other cases partial remission. Conclusion RS may occur at early stage after CLL diagnosis. In some cases, the diagnosis of RS and CLL are concomitant.Prognosis of some patients of RS is unfavourable. It was important to take biopsy at early stage.

Objective To investigate the effect of pretreatment with parecoxib for postoperative analgesia in patients undergoing laparoscopic hernia repair. Methods Sixty patients undergoing laparoscopic hernia repair were assigned in two groups by random digits table with 30 cases each. The patients in pretreating group received parecoxib 40 mg intravenously before anesthesia, and in control group with the same capacity of normal saline. All patients were anesthetized with combined spinal epidural blockage and tranquilized with pethidine, droperidol and diazepam. Postoperative pain of the abdomen incision was assessed by visual analogue scale (VAS) and the pain of shoulder or back was judged by a 4 grade scale. Side-effects, supplement analgesic, passage of gas by anus 24 h after surgery were observed as well. Results The abdomen incision VAS at 4,8,12,24 h after surgery in pretreating group were lower than those in control group (P ＜ 0.05). And the incidence of pain of shoulder or back was lower in pretreating group (13.3% ,4/30) than that in control group (33.3% ,10/30)(P ＜0.05). While the cases needing supplement analgesic also decreased in pretreating group (13.3% ,4/30) compared with control group (40.0%, 12/30)(P ＜ 0.05). And the side effects and passage of gas by anus 24 h after surgery had no significant difference in two groups. Conclusion Pretreatment with parecoxib in patients undergoing laparoscopic hernia repair may relieve the postoperative incision pain and the pain of shoulder or back while reducing the analgesic supplement without side effects.

The objectives of this study are as follows:1) to explore the expression level of alpha hydroxybutyric acid dehydrogenase (α-HBDH) in patients with non-Hodgkin's lymphoma (NHL) and its prognostic significance;and 2) to analyze the relationship amongα-HBDH, lactate dehydrogenase (LDH), and beta 2-microglobulin (β2-MG), so as to evaluate their diagnostic and prognostic sig-nificance. Methods:The expression levels of serumα-HBDH, LDH, andβ2-MG were examined in 104 patients with NHL before and after treatment. The relations among the levels of serum LDH,α-HBDH, andβ2-MG, as well as their connection with the patients' age, gender, disease stage, and pathological type, were explored. Results:Serumα-HBDH level increased in 35%of the patients and showed a significant correlation with LDH andβ2-MG. Significant differences were observed forα-HBDH andβ2-MG at different stages but not for LDH. Significant differences were observed betweenα-HBDH and LDH for different pathological types, but none was found inβ2-MG. The three serum enzymes did not exhibit any significant difference for different ages and genders. Levels of serum LDH andα-HBDH showed considerable difference between pre-treatment and post-treatment of patients. Serumβ2-MG level did not show any significant change after two or three cycles of chemotherapy. Conclusion:The expression level of serumα-HBDH increases in patients with NHL, is positively correlated with the levels of LDH andβ2-MG, and is highly relevant to disease stage and pathological type, regardless of the patients' age and gender. Serumα-HBDH is expected to be a new NHL indicator for tumor load, disease severity, and prognosis.

Objective To investigate the significance of serum interleukin-1β,interleukin-2,interleukin-6,TNF-α,erythrocyte sedimentation rate(ESR),c-reactive protein(CRP),IgA,IgG and IgM in patients with ankylosing spondylitis(AS),and to analyze their relationship with the Bath ankylosing spondylitis disease activity index (BASDAI). Methods Participants of this study included 45 AS patients(patient group)and 30 healthy subjects (control group).The patient group was further divided into an active subgroup and an inactive subgroup based on the disease activity assessed by using BASDAI.Then serum levels of IL-1β,IL-2,IL-6,TNF-α,ESR,CRP,IgA,IgC and IgM were tested in all the subjects,and the values were compared between different groups.In addition,the relationship between various parameters and those with BASDAI were also evaluated. Results The serum levels of ESR,CRP,IgA,lgM,IgG,IL-1β,IL-2,IL-6 and TNF-α in patients with AS were significantly higher than those in the healthy controls(P<0.05).The serum level of CRP,IL-2 and IL-6 were significantly different between the active and inactive subgroups(P<0.05).There was a positive correlation between CRP and IL-6,IL-6 and IL-2,as well as IgA and IgG levels.The IL-2,IL-6 and CRP levels were positive correlated with BASDAI.Conclusion It was suggested that the serum levels of IL-2,IL-6 and CRP can be used to assess the disease activity in patients with AS.

Objective To evaluate left ventricular myocardial function of rabbit after ischemiareperfusion using speckle tracking imaging (STI),and to explore the myocardial protect effects of ischemia postconditioning (I-PostC) on reperfusion injury.Methods 24 Japanese rabbits were divided into ischemiareperfusion group (group Ⅰ) and I-PostC group (group Ⅱ) randomly.The characteristic changes of left ventricular global and regional myocardial strain and twist function of two groups were evaluated quantitatively by STI and compared with pathological results.Results ① Global longitudinal systolic strain rate(GLSrsys),global longitudinal systolic strain (GLSsys) and global longitudinal peak strain(GLSp) decreased in both groups,longitudinal systolic strain rate(SrLsys),longitudinal systolic strain(SLsys) and longitudinal peak strain(SLp) in the lateral wall of left ventricle decreased significantly and negative peak of SrLivr and PSI increased after the left ventricular branch of coronary artery was occluded;The values of Ptw and untwR of left ventricle were smaller.② After the artery was released,GLSp recovered in group Ⅱ,which was not seen in group Ⅰ.The values of SrLsys,SLsys and SLp increased significantly and negative peak of SrLivr and PSI decreased in group Ⅱ.However,only Slsys and SLp rebounded in group Ⅰ.Between the 2 groups,SrLsys andSLp in group Ⅱ were higher than that of group Ⅰ (P＜0.05 or 0.01),and SrLivr was lower compared with group Ⅰ (P ＜0.05).In group Ⅱ,Ptw and untwR changed back to a normal range (P ＜0.05 or 0.01),and no index has changed in group Ⅰ ;Between the 2 groups,Ptw and untwR in group Ⅱ were higher than that of group Ⅰ (P ＜0.05).③ The sensitivity and specificity of GLSrsys,GLSsys,SrLsys,SLsys and Ptw to detect rabbit myocardial infarction were 81.3 ％ and 75.0 ％,62.5 ％ and 81.2％,87.5％ and 87.5％,93.8％ and 75.0％,81.3％ and 68.7％ respectively.Conclusions STI may provide a promising approach to evaluate the global and regional myocardial function.It also can observe the protect effects of I-PostC on myocardial reperfusion injury accurately.

Objective To compare the effects of preload with intravenous infusion of 6％ hydroxyethyl starch combined with phenylephrine or dopamine to prevent the hypotension after combined epiduralspinal anesthesia in parturient undergoing caesarean section.Methods Eighty patients with ASA class Ⅰ or Ⅱ[,were randomly divided into Dopamine group and Phenylephrine group,40 cases in each group.The 6％hydroxyethyl starch 500 ml was infused at the tate of 20 ml/(kg · h) after the intravenous catheterization was established and after the finishing of the infusion of 250 ml,the dopamine 5 mg (Dopamine group) or 200 ug phenylephrine (Phenylephrine group) were added respectively in residual liquid.After the bupivacaine was injected into the subarachnoid space,the intravenous infusion was continued at the same rate until the fetus was taken out and the blood pressure and heart rate were measured at intervals of 1 min.The blood sample of fetal cord was taken to measure ther troponin Ⅰ concentration.Results The incidence of hypotension after combined epidural-spinal anesthesia anesthesia in dopamine group (2/40) and in phenylephrine group (3/40) was with no statistical difference (P ＞ 0.05) ;The incidence of bradycardia in dopamine group (0/40) was significantly lower than that in phenylephrine group (6/40)) (P ＜0.05) ; The incidence of tachycardia in dopamine group (8/40) was significantly higher than that in phenylephrine group (1/40) (P ＜0.05) ; The troponin Ⅰ concentration of fetal cord blood in dopamine group [(0.21 ±0.07) ng/ml] and in phenylephrine group [(0.18 ±0.09)ng/ml]was with no statistical difference (P ＞0.05).Conclusion Preload with intravenous infusion of 6％ hydroxyethyl starch combined with phenylephrine or dopamine can effectively prevent the hypotension after combined epidural-spinal anesthesia in parturient undergoing caesarean section with no significant effect on the fetus and both can be chosen in terms of the heart rate of parturient before anesthesia.