Objective To investigate the features,prevention and treatment of complications of ultrasound-guided hepatic puncture biopsy.Methods One hundred and seventy-five cases underwent ultrasound-guided hepatic puncture biopsy were retrospectively analyzed.Results The incidence of complications was 16 cases (9.1%),including 5 cases with vasovagal episodes(2.9%),4 cases with ache which needed medicine treatment (2.2%),3 cases with hemorrhage in liver capsule(1.7%),3 cases with hypoglycemia(1.7%),1 case with serve hemorrhage in abdominal cavity(0.6%).Hemorrhage limited in liver capsule,vasovagal episodes,hypoglycemia and ache were relieved with corresponding treatments.One case with hemorrhage in abdominal cavity was handled with percutaneous microwave ablation therapy guided by contrast-enhanced ultrasound.Conclusions Ultrasound-guided hepatic puncture biopsy has good value and low complication.The most severe complication is hemorrhage,which can be handled with percutaneous microwave ablation therapy guided by contrast-enhanced ultrasound.

Objective To explore the relationship between serum uric acid(SUA) levels and metabolic syndrome(MS) in middle-aged and elderly people,and to investigate the impacts of age and gender on the relationship between SUA and MS.Methods A cross-sectional study was carried out in general population aged over 35 years in rural area of Yiling District,Yichang City in 2007.All subjects were investigated by using the standardized questionnaire,physical and biochemical examinations.MS was defined according to the diagnostic criteria of the latest Chinese guidelines.All subjects were divided into different subgroups based on quartiles of SUA levels and age(35-44 years old,45-59 years old,over 60 years old).The relationship of MS with age and SUA levels were investigated.Results 9354 subjects consisted of 3883 males and 5471 females were included in this study.The percentage of subjects aged over 60 years was 21.1％ in men and 17.4％ in women.The prevalence of MS from the first quartile to the fourth quartile were 3.8％,5.5％,7.9％,15.2％ in males,and 3.1％,5.5％,7.9％,16.7％ in females,respectively.The SUA levels was positively correlated with MS in both sexes after adjusting for other confounding factors.By analyzing associated-subgroups based on age and SUA levels,logistic regression analysis showed that the risk of MS was significantly increased with aging and SUA levels in female subjects.The association between age and MS was significantly weaker in men than in women.Conclusions There is a positive correlation between SUA levels and MS.The associations of MS with age and SUA levels are more closely in women than in men.The risk of MS may be highest in middle-aged and elderly women with high level of SUA.

Objective To evaluate the effect of neoadjuvant chemotherapy (NAC) by investigating the expression of cyclin D1 in human breast cancer before and after NAC.Methods Eighty-four cases of breast cancer were diagnosed by core biopsies.The expression level of cyclin D1 in cancer tissues was measured by immunohistochemical envision two-step method before and after NAC (pirarubicin and docetaxel regimen for 3-4 cycles).Results Complete remission (CR) occurred in 4 cases of 84 patients (4.76 ％) with 2 pathological complete response cases,partial response (PR) in 54 cases (64.29 ％),stability (SD) in 26 cases (30.95 ％) and no disease progression (PD) patients.The positive rate of cyclin D1 in cancer tissues [65.48 ％ (55/84)] was significantly decreased after NAC [39.29 ％ (33/84)] (x2 =11.55,P =0.001).In clinical level,the ease rate was significantly improved in patients whose cyclin D1 expression switched from positive [86.36 ％ (19/22)] to negative [45.45 ％ (15/33)] after NAC treatment (x2 =9.359,P =0.002).Conclusion NAC significantly decreases the expression of cyclin D1 in breast cancer tissues.Meanwhile,the ease rate is improved when cyclin D1 expression switched from positive to negative after NAC.Therefore,cyclin D1 expression can be used as an evaluation index for the efficiency of NAC.

Objective:To identify proteins associated with nasopharyngeal carcinoma (NPC) metastasis,and provide scientific basis for the prevention and cure of NPC.Methods:A two-dimensional gel electrophoresis and mass spectrometry were performed to screen for differential proteins between highly metastatic 5-8F and non-metastatic 6-10B NPC cell lines.Western blot was used to confirm the differential proteins.We used siRNA to inhibit the expression of differential protein nm23-H1 to determine the association of nm23-H1 with NPC in vitro invasive ability.Immunohistochemistry and statistics were used to evaluate the correlation of nm23-H1 expression with clinicopathological features and clinical outcomes in paraffin-embedded archival tissues including 93 cases of primary NPC and 20 cases of cervical lymphonode metastatic NPC (LMNPC).Results:A total of 15 differential proteins in the 2 cell lines were identified by a proteomic approach,and 3 differential proteins were selectively confirmed.Downregulation of nm23-H1 by siRNA significantly increased the in vitro invasive ability of 6-10B.Significant nm23-H1 downregulation was observed in LMNPC compared with primary NPC.nm23-H1 downregulation in primary NPC was positively correlated with lymphonode and distant metastasis,advanced clinical stage and recurrence.Survival curves showed that patients with nm23-H1 downregulation in primary NPC had a poor prognosis.Multivariate analysis confirmed that nm23-H1 expression level in primary NPC was an independent prognostic indicator.Conclusion:nm23-H1 behaves as a metastasis suppressor in NPC,and nm23-H1 downregulation is a biomarker for poor NPC prognosis.

Objective To construct a questionnaire for patients to participate in hand hygiene promotion in medical institutions,and provide a measuring tool for patients to participate in hand hygiene promotion.Methods A ques-tionnaire was constructed by methods of literature research,expert panel discussion,pre-investigation,and Delphi. Results This questionnaire was designed respectively for patients and health care workers,each contained 20 ques-tions,involving hand hygiene perception,willingness to participate in promoting hand hygiene,and participation method,et al.Conclusion A questionnaire for patients to participate hand hygiene promotion in medical institutions is preliminary constructed,which can be used for evaluating patients’and HCWs’willingness and relevant influen-cing factors of patients’participation in hand hygiene promotion in medical institutions.

Objective To investigate the incidence and etiological factors of hyponatremia following traumatic brain injury (TBI) and analyze the relationship between hyponatremia and the patient’s age, gender, type of injury, Glasgow coma scale (GCS), operation and computerized tomography (CT) scan of head. Methods Clinical data of 136 pa-tients with moderate or severe TBI in our hospital were analyzed retrospectively, including patient’s age, gender, type of injury, GCS, operation, brain edema and basal skull fracture. The relationship between clinical data and hyponatremia were analyzed statistically by Chi-square test and multivariate Logistic regression analysis. Results There were 56 pa-tients with hyponatremia in 136 patients (81 males) with moderate or severe TBI. Multivariate Logistic regression analysis showed that hyponatremia secondary to TBI was not associated with patient’s age, gender, type of injury and operation or not. However, there was a high correlation between hyponatremia following TBI and clinical characteristics of TBI at ear-ly stage, such as GCS, brain edema and basal skull fracture. Conclusions Patients with TBI is more likely to develop hy-ponatremia when they have the following clinical factors, such as GCS≤8, brain edema or basal skull fracture. Preven-tive measures should be given to these patients in advance.

Objective To evaluate the effect of methylprednisolone on endoplasmic reticulum stress in rats with ventilator-induced lung injury ( VILI ) and the relationship with phosphatidylinositol 3-kinase∕serine-threonine protein kinase ( PI3K∕Akt) signaling pathway. Methods One hundred clean-grade male Sprague-Dawley rats, aged 4-5 months, weighing 270-320 g, were divided into 5 groups ( n=20 each) using a random number table method: control group ( C group) , VILI group ( V group) and different doses of methylprednisolone groups ( M1-3 groups) . Group C received no mechanical ventilation and kept spontane-ous breathing for 4 h. Rats were mechanically ventilated ( tidal volume 40 ml∕kg, respiratory rate 15-17 breaths∕min, inspiratory∕expiratory ratio 1 : 1, positive end-expiratory pressure 0, fraction of inspired oxy-gen 21％ during OLV) in group V. Methylprednisolone 2, 10 and 30 mg∕kg were intravenously injected at 20 min before mechanical ventilation in M1-3 groups, respectively, and the equal volume of normal saline was given in group V. Blood samples and lung tissues were taken at 4 h of ventilation for measurement of the lung permeability index ( LPI) and wet∕dry lung weight ratio ( W∕D ratio) , for examination of pathological changes, and for determination of apoptosis index ( AI) in lung tissues ( by TUNEL) , expression of Akt, phosphorylated Akt (p-Akt), glucose-regulated protein 78 (GRP78), CCAAT∕enhancer-binding protein homologous protein (CHOP) and caspase-12 in lung tissues (by Western blot). Injured alveoli rate (IAR) was calculated. Results Compared with group C, the W∕D ratio, LPI, IAR and AI were significantly in-creased, the expression of p-Akt was down-regulated, and the expression of GRP78, CHOP and caspase-12 was up-regulated in V and M1 groups ( P<0. 05) , and no significant change was found in the indexes mentioned above in M2 and M3 groups ( P>0. 05) . Compared with group V, the W∕D ratio, LPI, IAR and AI were significantly decreased, p-Akt expression was up-regulated, and the expression of GRP78, CHOP and caspase-12 was down-regulated in M2 and M3 groups ( P<0. 05) . Conclusion Methylprednisolone in-hibits endoplasmic reticulum stress, thus inhibiting cell apoptosis, and the mechanism is related to activa-ting PI3K∕Akt signaling pathway in rats with VILI.