In order to explore the value of p63, smoothmuscle actin (alpha-SMA) and cytokeratin 5/6 (CK5/6) in the differential diagnosis of ductal lesions of breast, 88 tissue specimens of ductal lesions of breast were collected and examined histologically by HE staining. By using immunohistochemistry, the expression of p63, alpha-SMA and CK5/6 was detected. The results showed that in 38 cases of benign breast lesions, the proliferating cells were all positive for p63 and alpha-SMA. In 19 cases of ductal carcinoma in situ (DCIS) and 7 cases of intraductal papillary carcinoma, alpha-SMA positive cells formed a layer of continuous embroider-shaped structure and the p63 positive cells formed a layer of evenly separated embroider-shaped structure around the ducts. There was no cross-reaction between p63 and interstitial myofibroblasts and vascular smooth muscle cells. In 38 cases of benign breast lesions, the positive rate of CK5/6 expression was 100%. In 5 cases of atypical ductal hyperplasia, there were few positive cells in the ducts. In 19 cases of CDIS, no tumor cells expressed CK5/6. In 19 cases of invasive ductal carcinoma, almost no CK5/6 was detectable. It was suggested that p63 could serve as a novel specific marker for the identification of breast myoepithelial cells. CK5/6 is of value in differentiating ductal proliferation of varying degrees, especially in the differentiation between cancerous and non-cancerous changes. Simultaneous detection of p63, CK5/6 and alpha-SMA can help increase the diagnostic accuracy of breast diseases.

OBJECTIVE To evaluate the risk factors for postoperative nosocomial infection(NI) among inpatients with cervical carcinoma.METHODS A prospective and retrospective study was carried out to investigate the clinical data of patients with cervical carcinoma in department of gynecology during the period from Jan 1 to Dec 31,2003.RESULTS The incidence and case incidence of NI were 22.88% and 23.99%,urinary tract infection((52.3%)) was the most common infection,followed by vaginal margin infection and pelvic infection.NI was closely related with diabetes mellitus,the duration of catheter reservation,and different operators.CONCLUSIONS NI is high in postoperative patients with cervical carcinoma,which should be paid attention during the course of clinical treatment.

OBJECTIVE To explore the risk factors of infection in patients with chemotherapy-induced neutropenia in order to offer scientific references for clinical treatment.METHODS With case-control study,two hundred and fifty-six cancer patients with chemotherapy-induced neutropenia were compared between the infection group and non-infection group.The data were analyzed on risk factors by univariate analysis(Chi-square test) and multivariate analysis(non-conditional Logistic regression models).RESULTS Multivariate analysis showed that early lymphopenia after chemotherapy(OR=3.347),the depth of the Absolute neutrophil count nadir(

Objective To investigate the distribution and drug resistance of pathogens in cancer patients with nosocomial infections. Methods Pathogens isolated from cancer patients with nosocomial infections in Zhejiang Cancer Hospital from 2004 to 2008 were analyzed. Results Totally 3454 strains of pathogens were isolated, including 1900 strains of Gram-negative bacilli (55.0%), 838 strains of fungi (24.3%), and 716 strains of Gram-positive bacteria (20.7%). Pathogenic bacteria Escherichia coli and Candida albicans were isolated mainly from surgical wound, urinary tract, respiratory tract and oral cavity. The drug resistant rates for Gram-negative Escherichia coli and Gram-positive staphylococci were high, and Candida albicans was sensitive to all antifungal drugs. Conclusion Opportunistic pathogens account for most nosocomial infections in cancer patients, and some of them are of high-level resistance to antimicrobial agents.

Objective To explore the relationship between ULI43 sequence variability and clini-cal disease. Methods UL143 from samples obtained from suspected congenitally human cytomegalovirus (HCMV) infected symptomatic infants were PCR amplified and sequenced. Results There were not too much sequence variability of UL143 compared with Toledo. But no one was completely identical to Toledo, and all UL143 ORFs were shorter than Toledo for frame-shift. Conclusion HCMV-UL143 existed in moat of low passage isolates and sequences were variable. No obvious linkage was observed between UL143 poly-morphisms and outcome of suspected congenital HCMV infection.

Objective To explore the clinical application value of transparent cap gastroscope in the Billroth Ⅱ procedure after subtotal gastrectomy in patients with bile duct diseases by endoscopic retrograde cholangiopancreatography(ERCP).Methods 20 patients underwent ERCP with Billroth Ⅱ gastrectomy postoperation with biliary diseases were selected as the research subjects,selected the transparent cap gastroscope ERCP,successful intubation received endoscopic sphincterotomy(EST) and(or) endoscopic nasobiliary drainage(ENBD),endoscopic papillary balloon dilatation(EPBD),endoscopic biliary metal stent drainage(EMBE),endoscopic biliary drainage(ERBD) treatment.Results 20 patients with Billroth Ⅱ gastrectomy after angiography were successful,the successful rate was 100.00%,14 cases of EST patients,4 patients underwent EPBD surgery,common bile duct stones all took the net,took the net rate of 100.00%;1 case of bile duct cancer underwent EMRE resection,1 case of bile duct stenosis after biliary tract surgery ERBD operation,hyperamylasemia occurred in 1 case,no serious complications such as bleeding and perforation of digestive tract.Conclusion Billroth Ⅱ gastrectomy postoperative patients with bile duct disease receiving ERCP,endoscopic transparent cap can provide good operative field for jejunal loop inside the mirror,improve the success rate of bile duct intubation,conducive to the removal of stones,improve the success rate of surgery,reduce complications security,safety of operation,and can be used in clinical application.

Objective To explore the prevalence of parenteral nutrition-associated liver disease (PNALD) and its risk factors in elderly people after gastrointestinal operation. Methods Seventy-five patients received parenteral nutrition (PN) after gastrointestinal operation were retrospectively analyzed. Age, height, body mass index, suftering diseases, history of diseases, time of therapy, total calorie, nonprotein calorie, the kind and amount of fat emulsion and amino acid, the amount of glucose, non-protein energy to nitrogen ratio, ratio of glucose to lipid, liver function, renal function and blood routine were collected. Results The prevalence of PNALD was 25.3% (19/75). The total calorie, nonprotein calorie, the amount of protein, the amount of glucose and ratio of glucose to lipid were obviously higher in PNALD group than in non-PNALD group [(24.0±6.5) vs. (20.7±5.4)kcal·kg-1·d-1, (20.5±5.5)vs. (17.2±4.8)kcal·kg-1·d-1, (1.0±0.3)vs. (0.9±0.2)g ·kg-1·d-1, (2.9±0.9)vs.(2.3±0.9)g·kg-1·d-1, 1.5±0.7 vs. 1.1±0.5; all P<0.05], while the hemoglobin was lower in PNALD group [(97.4±15.1)vs. (110.1±19.1)g/L, P<0.05]. The kind of fat emulsion and amino acid, gender, history of diseases, suftering diseases, body mass index, serum albumin, leukocyte levels and renal function were comparable between the two groups (χ2=0.114,0.843,0.116,0.531,0.344,1.588,0.006,0.063 and 0.549, all P>0.05). Conclusions The prevalence of PNALD is 25.3% in 75 elderly patients after gastrointestinal operation. Total calorie, the amount of glucose and the ratio of glucose to lipid should be reduced in these patients for preventing PNALD.

Objective To identify the peptide that have strong ability binding to HCMV-UL149 encoded protein,and to analyze the characteristics of the amino acid sequence of UL149-binding peptides.Methods Expressed UL149 proteins of three genotypes were used to screen the binding peptide in the random peptide display library,then the encoding sequence of binding peptides in the selected clones were sequenced.The amino acid sequences of the binding peptides were analyzed for their homology,and were com pared with those of the known protein in protein banks.Results The homologous amino acid sequence W/A/F/V-D/E-D/E-G-W/F/I/L were found within the binding peptides selected by proteins of all the three UL149 genotypes proteins,and no difference between three groups was found.The alignment with amino acid sequences of the known proteins in protein banks showed that the binding peptides of UL149 putative protein have homologous amino acid sequences with immunoglobulin heavy chain variable region(IgHV),the serine/threonine protein kinases,compliment factor H,zinc finger protein,MHC Ⅰ molecule,eukaryotic translation initiation factor,nuclear factor and so on.Conclusion The UL149 encoding proteins have binding ability to proteins mentioned above,and might interfere with the immunity responds to HCMV infection through multiple mechanisms.

Objective Using yeast two-hybrid system to screen the proteins which can interact with the human cytomegalovirus (HCMV) UL128 which have two difference transcription structure from human fetus brain cDNA library, and compare the difference with structure and function of interacting proteins. Methods Two fragments of UL128 were amplified by 3'RACE and 5'RACE technology, the length are 519 bp and 642 bp, respectively. The "bait plasmid" (named as pGBKT7-UL128-519 bp and pGBKT7-UL128-642 bp) was constructed successfully. Using pGBKT7-UL128-519 bp and pGBKT7-UL128-642 bp as a bait, a human fetus brain cDNA was screened and the proteins interacting with UL128-519 bp and UL128-642 bp encoded protein were searched, and the positive clones were sequenced and analyzed by bioinformatic methods. Results EFEMP2 interacting with HCMV UL128-519 bp were identified, THY-1 interacting with HCMV UL128-642 bp were identified. Conclusion EFEMP2 and THY-1 proteins interacting with HCMV UL128-519 bp and UL128-642 bp in human fetus brain cDNA library were successfully screened, but same proteins weren't found from the proteins interacting with UL128-519 bp and UL128-642 bp protein, UL128-519 bp and UL128-642 bp protein may be play an different effect in the process of infect by HCMV.

In order to explore the value of p63, smooth muscle actin (α-SMA) and cytokeratin 5/6(CK5/6) in the differential diagnosis of ductal lesions of breast, 88 tissue specimens of ductal lesions of breast were collected and examined histologically by HE staining. By using immunohistochemistry,the expression of p63, α-SMA and CK5/6 was detected. The results showed that in 38 cases of benign breast lesions, the proliferating cells were all positive for p63 and α-SMA. In 19 cases of ductal carcinoma in situ (DCIS) and 7 cases of intraductal papillary carcinoma, α-SMA positive cells formed a layer of continuous embroider-shaped structure and the p63 positive cells formed a layer of evenly separated embroider-shaped structure around the ducts. There was no cross-reaction between p63 and interstitial myofibroblasts and vascular smooth muscle cells. In 38 cases of benign breast lesions, the positive rate of CK5/6 expression was 100 %. In 5 cases of atypical ductal hyperplasia, there were few positive cells in the ducts. In 19 cases of CDIS, no tumor cells expressed CK5/6. In 19 cases of invasive ductal carcinoma, almost no CK5/6 was detectable. It was suggested that p63 could serve as a novel specific marker for the identification of breast myoepithelial cells. CK5/6 is of value in differentiating ductal proliferation of varying degrees, especially in the differentiation between cancerous and non-cancerous changes. Simultaneous detection of p63, CK5/6 and α-SMA can help increase the diagnostic accuracy of breast diseases.