OBJECTIVE To study the prevalence,fungal species,therapy and prevention of invasive fungal infections in our Affiliated Hospital.METHODS From Jan 2004 to Dec 2005,all patients with positive results for fungal culture of blood and sterile fluid were reviewed retrospectively.The in vitro activity of antifungal agents against fungal isolates was determined.RESULTS Eighty-eight positive patients were collected in this analysis based on the diagnosis of invasive fungal infection in our hospital for two years,from them the majority were diagnosed as candidal infections(n=72,81.8%),the others were Cryptococcus neoformans(n=8,9.1%),Aspergillus(n=5,5.7%) and other different fungal infections.The most common was C.albicans(n=48,66.7%),C.glabrata(n=12,16.7%),and C.tropicalis(n=8,11.1%),C.parapsilosis and C.krusei were both the same results(n=2,2.8%).CONCLUSIONS Infections caused by Candida are the most common invasive fungal ones in our hospital,and C.albicans is the most common one.Fluconazole remains effective for treament of candidal infections,especially those caused by C.albicans.

Objective To study the correlation of the serum levels of pro-gastrin-releasing peptide (ProGRP) and neuro-specific enolase (NSE) with different treatments in limited-disease small cell lung cancer (L-SCLC) patients.Methods 150 L-SCLC patients were randomly divided into three groups including concurrent chemo-radiotherapy group,sequential chemo-radiotherapy group,and chemotherapy group.The serum levels of ProGRP and NSE were detected by enzyme-linked immunosorbent assay (ELISA) and electrochemiluminescence immunoassay before and after different treatments.The follow-up phase was 12 months.Results The serum levels of ProGRP and NSE were significantly decreased in all 3 groups after treatment (318.96,250.77,226.18 pg/ml and 31.72,23.95,17.89 μg/L),and the lowest level was observed in concurrent chemo-radiotherapy group,then the sequential chemo-radiotherapy group and chemotherapy group.The short term therapeutic effects were in the same sequence,and there was statistical significance between concurrent chemoradiotherapy group and chemotherapy (P ＜ 0.05).The decrease extent of ProGRP and NSE in effective cases (CR+PR) was significantly higher than that in failure cases in all 3 groups.The serum levels of ProGRP and NSE were increased with disease progress (P ＜ 0.05).Conclusion The serum levels of ProGRP and NSE can be used to reflect the patient' s condition and evaluate therapeutic effect in L-SCLC.The concurrent chemo-radiotherapy is more effective than sequential chemo-radiotherapy and chemotherapy only in L-SCLC.

Before and after treatment as well as before metastasis,the combined detection of progastrin-releasing peptide (ProGRP) and neuron-specific enolase (NSE) was performed in 150 patients with small cell lung cancer.The follow-up period was 1 year.Enzyme-linked immunosorbent assay (ELISA) and electrochemiluminescence immunoassay were conducted.The result showed a negative correlation between the serum levels of ProGRP and NSE the curative effect.And a positive correlation existed between the serum levels of ProGRP and NSE and disease development.The difference had statistical significance (P ＜ 0.05).The levels of ProGRP and NSE may be used to indicate the disease development and evaluate the curative effect.

Objective To investigate the factors associated with postoperative metastasis, recurrence, and survival in patients with stage ⅢA ( N2 ) non?small cell lung cancer ( NSCLC ) , and to provide an objective basis for postoperative radiotherapy in patients. Methods Clinical data were collected from 199 patients who underwent complete resection and were diagnosed with stage ⅢA ( N2 ) NSCLC after surgery in our hospital from 2009 to 2013. The Cox regression model was used for the multivariate analyses of metastasis and recurrence. The survival rates were calculated using the Kaplan?Meier method and analyzed using the log?rank test. Results In the 199 patients, 173 had complete follow?up data. The 1?and 2?year metastasis, recurrence, and survival rates were 38?7%/52?6%, 27?8%/39?1%, and 92?5%/51?4%, respectively. The multivariate analysis showed that pathological type and two positive indices among preoperative CEA/CY211/SCC were two risk factors for metastasis ( P=0?013,0?014) . Positive lymph node number, metastatic lymph node number, lymph node metastasis rate, and two positive indices among preoperative CEA/CY211/SCC were risk factors for recurrence ( P=0?046,0?004,0?028,0?001) . All the above indices were risk factors for low survival rates ( P= 0?013 , 0?011 , 0?002,0?026 ) . Conclusions Patients with stage ⅢA ( N2 ) NSCLC who have positive lymph nodes, lymph node metastases, and two positive indices among preoperative CEA/CY211/SCC may benefit from postoperative radiotherapy.

Objective: To explore the impact of insulin resistance (IR) and adiponectin (APN) lacking on myocardial remodeling in experimental mice. Methods:16 normal C57 mice were divided into 2 groups: Control group and IR group; in addition, 16 APN gene knockout(APNKO) mice were divided into another 2 groups: APNKO group and APNKO+IR group.n=8 in each group. The mice in Control group and APNKO group were fed with normal diet, in IR group and APNKO+IR group were fed with high fat diet to create the IR model. All animals were treated for 12 weeks. Blood levels of total cholesterol(TC), triglycerides(TG),fasting plasma glucose(FPG) and fasting insulin(FINS) were examined; heart weight and left ventricular weight were measured; left ventricular myocardial morphological changes and the degree of ifbrosis were assessed by HE staining and Masson staining; protein expressions of myocardial matrix metalloproteinase-9 (MMP-9) and APN were detected by immunehistochemistry and Western blot analysis. Results: Compared with Control group, IR group, APNKO group and APNKO+IR group showed elevated blood levels of TC, TG, FPG and FINS; increased heart weight and left ventricular weight, allP<0.05; IR group, APNKO group and APNKO+IR group presented more myocardial hypertrophy, decreased protein expression of APN and increased protein expression of MMP-9, allP<0.05.Conclusion: IR and APN lacking could incur myocardial remodeling in experimental mice and they had synergistically facilitated effect.

ObjectiveTo investigate the effects of lipopolysaccharide (LPS) on mRNA expression of iron metabolism related genes. Methods Ten male mice (2 months) were injected intraperitoneally with lipopolysaccharide(0.5 μg/g). After 6 hours, mice were sacrificed and then sera, liver and spleen were collected. The mice blood routine was measured. The serum iron and total iron binding capacity (TIBC) were determined with reagent kit. The quasi-quantitative reverse transcription polymerase chain reaction (RT-PCR) was performed for mRNA of hepatic hepcidin(HP), ferroportin1(Fpn1), transferrin receptor 1(TfR1) and spleenic HP, Fpn1 and interleukin-6(IL-6). Results The serum iron and TIBC were reduced in mice injected LPS, which exhibited mild anemia(P＜0.05) . LPS can increase the expression of hepatic hepcidin and decrease Fpn1 and TfR1 in liver after LPS administration 6 hours(P＜0.05). In spleen, IL-6 was upregulated and Fpn1 downregulated(P＜0.05). Conclusion LPS can influence serum iron through regulating the mRNA expression of hepatic and spleenic iron metabolism related genes, such as HP, Fpn1 and TfR1.

Objective Through the detections of the heterozygote frequencies tests of fetal specific genes PLAC4 and COL6A2 mRNA alleles in plasma of pregnant women, to explore its possibility of application in the noninvasive prenatal screenings of trisomy-21. Methods A toltal of 500 cases (males and females 250 cases respectively)of Han ethnic groups with Henan Provice of China who were subject to the physical checkup clinic of the Third Affiliated Hospital,Zhengzhou University from June to December, 2013 were selected as the healthy physical checkup group, and such techniques as DNA sequencing and PCR-restriction fragment length polymorphism (RFLP) were adopted to the determinations of the heterozygote frequencies of the single nucleotide polymorphism(SNP)of the PLAC4 and COL6A2 genes in the maternal peripheral blood in the healthy physical checkup group, and the differential comparisons of the determination results of the SNP heterozygote frequencies and the corresponding heterozygote frequencies in the National Center for Biotechnology Information (NCBI) database;30 cases of healthy pregnant women who spontaneously underwent pregnancy checkups at the maternity clinic were randomly selected as the healthy pregnancy group, and real-time fluorescence quantitative reverse transcription-PCR technique was adopted for determining the expression levels of PLAC4 and COL6A2 mRNA in the peripheral blood of pregnant women of 8 weeks, 10 weeks, 12 weeks, 14 weeks and 16 weeks;40 cases of the same phase were selected for acting as the specimens for the karyotype analyses of the amniotic fluid cells, among which 20 cases were trisomy-21, and the 20 cases of the negative control group, and reverse transcription-multiplex ligation dependent probe amplification (RT-MLPA) technique was adopted for screening the fetal trisomy-21. Results (1) The allele heterozygote frequencies of the SNP of the healthy physical checkup group:determinations of the genotypes and hybrid rates of the 10 SNP sites of the PLAC4 and COL6A2 genes indicated that those with higher heterozygote frequencies were respectively rs7717, rs559, rs1044598, rs59066201 and rs1042917, with population coverage of 98%. Among them, the allele hybrid rates of rs59066201 were never seen in the NCBI database;in the respective comparisons of the allele hybrid rates of rs8130833, rs9977003 and rs7844 with the hybrid rates of the NCBI database, the variations had statistical significance (P<0.05). (2) The expression levels of PLAC4 and COL6A2 mRNA of the different pregnancy weeks of the healthy pregnancy group: the levels of PLAC4 mRNA in the peripheral blood of women of 8 weeks, 10 weeks, 12 weeks, 14 weeks and 16 weeks of pregnancy were respectively 7.22 ± 1.05, 8.02±1.41,9.51±1.69,11.33±2.11 and 13.31±2.58, with their expression levels rising along with the increase of the pregnancy weeks; among them, the comparison of pregnancy 8 weeks and pregnancy 10 weeks, the variations had no statistical significance (P>0.05);in the mutual comparisons among the expression levels of the various pregnancy weeks, the variations had statistical significance (P<0.05). The expression levels of COL6A2 mRNA in 8 weeks, 10 weeks, 12 weeks, 14 weeks and 16 weeks were respectively 8.95 ± 1.28, 11.19 ± 1.36,15.00 ± 1.58,16.87 ± 1.72 and 18.96 ± 2.79, with their expression levels rising along with the increase of the pregnancy weeks, and in the mutual comparisons between the expression levels of the various pregnancy weeks, the variations all had statistical significance (P<0.05). (3) Prenatal screenings of trisomy-21 in the validation group of the trisome:a total of 5 sites of rs7717, rs559, rs1044598, rs59066201 and rs1042917 were selected from the allele heterozygote frequencies of SNP sites were selected from the subjects of the healthy physical checkup group, and 10 cases of trisomy-21 specimens and 10 cases of negative CTR specimens were accurately determined, with the sensitivity reached 80%(17/20), and the specificity reached 90%(18/20). One case of the trisomy-21 and two negative cases were both homozygotes, and among the trisomy-21 specimens of two cases, only one SNP was a heterozygote, and it was impossible to conduct screenings on these 5 cases, with the screening accuracy reaching 100%(35/35). Conclusions Fetal specific genes PLAC4 and COL6A2 mRNA are expressed in the peripheral blood of pregnant women in different gestational age;its expression level increases with the increase of gestational age. Among them, five SNP including rs7717, rs559, rs1044598, rs59066201 and rs1042917 show highest heterogeneity rate, which is different from the corresponding heterogeneity rate in NCBI database. RT-MLPA technology is a rapid, effective, noninvasive and low cost method of prenatal screening 21 trisomy.

Objective The study the effect on cardiac remodeling induced by low level adiponectin(APN)and insulin resistance(IR).Methods 16 wild-type C57 mice were randomly divided into control and IR groups.16 APN gene knockout mice were randomly divided into APNKO and APNKO+IR groups.The IR and APNKO+IR groups were a high-fat feed to induce insulin resistance.After 12 weeks,cholesterol(TC),triglycerides(TG),fasting plasma glucose(FPG), fasting insulin(FINS) were measured.HOMA-IR,HWI and LVWI were calculated.The left ventricular myocardial were examined by microscopy to observe the degree of myocardial fibrosis,and the protein expression of matrix metalloproteinase-9(MMP-9) and APN in myocardial were detected with western blot.ResultsLow level APN and IR increased heart weight, left ventricular weight, HWI, LVWI(P<0.05).There were interaction between IR and low level APN on the TC,TG, FPG, FINS, and the index related myocardial fibrosis(P<0.05), and they were positive effect.There was also interaction effect between IR and low level APN on myocardial APN expression, but it was the negative effects (P<0.05).Conclusions Both low level adiponectin and insulin resistance could lead to cardiac remodeling synergistically.

Objective To make certain about the phase of time from the culminated point of instantaneous accelerating wave intensity (W1) to that of instantaneous decelerating wave intensity (W2) wave intensity(WI) technique. Methods The ejection time of the curve of Doppler rate of flow in aortic opens and W1～W2 of common carotid arteries of both sides were detected in 66 healthy adults by Prosound α10 color Doppler ultrasound and the data were contrasted and analyzed. Results There were no statistical significances in the standardized value difference of ejection time of aorta and of time from starting point of W1 to culminated point of W2 in common carotid arteries of both sides (P>0.05). And there were all statistical significances in the standardized value difference of ejection time of aorta and of time in other groups (P<0. 001). Conclusions The ejection time is the time from starting point of W1 to culminated point of W2. The beginning of cardiac ejection should be the starting point of W1 curve,and the culminated point of W2 is the terminal time of ejection.

BACKGROUNDTo study the expression and clinicopathological significance of CD44V6 in non-small cell lung cancer (NSCLC).

METHODSCD44V6 expression in lung cancer tissues was detected in 90 patients with lung cancer by immunohistohemistry SABC method.

RESULTSThe positive rate of CD44V6 expression in NSCLC was 51.1% (46/90), which was related to TNM stage, but not to cell differention, age and sex of the patients (P > 0.05). The positive rate of CD44V6 expression was 32.2% (10/31) in stage I+II patients and 61.0% (36/59) in stage III+IV disease. A highly significant difference was existed between the two groups (P < 0.01). The positive rate of CD44V6 expression was significantly higher in NSCLC with lymph node metastasis (61.0%, 36/59) than that without lymph node metastasis (32.2%, 10/31) (P < 0.01). The 3-year survival rate (65.5%, 19/29) in patients with low CD44V6 expression was significantly higher than that (35.0%, 7/20) with high CD44V6 expression (P < 0.05).

CONCLUSIONSOverexpression of CD44V6 may be involved in the progression and metastasis of the cancer and prognosis of the patients with lung cancer. It might be helpful to evaluate the progression of the cancer, and to predict the metastasis and progression of lung cancer.