Objective To know the apolipoprotein E(APOE)genotypes frequency of Chinese old people in the rural area. Methods 2000 Chinese aged 65 years or older from four sites in China were enrolled in this study in 2004-2008.Two sites were from the Sichuan province in southwestern China,and another two sites were from the Shandong province in eastern China.The finger blood samples on filter paper were collected from all the investigated people in the end of the interview.The genotype for apolipoprotein E(gene symbol,APOE)was determined by eluting DNA from a dried blood spot,followed by HhaI digestion of amplified products.Results Through statistical analysis,APOE genotypes frequency of Chinese people aged 65 years or older in the rural area,as for ?/?2,?2/?3,?2/?4,?3/?3,?3/?4,?4/?4,they were 1.1%,13.55%,2.05%,68.80%,13.35% and 1.15% respectively.4 carriers and no 4 carriers were 16.55% and 83.45%.Conclusion The distribution of APOE 4 genotype is more widely in Chinese people aged 65 years or older in the rural area.

OBJECTIVETo investigate the differences in the expressions of E-cadherin and N-cadherin between high-risk prostate cancer and low- and medium-risk prostate cancer, and analyze their correlation with the age, serum PSA level, and Gleason score of the patients.

METHODSWe retrospectively analyzed the clinical data of 42 cases of prostate cancer, which were divided into a low- and medium-risk group (group A, n = 15) and a high-risk group (group B, n = 27). We measured the expressions of E-cadherin and N-cadherin by immunohistochemical staining, compared their differences between the two groups, and analyzed their correlation with the age, serum PSA level, and Gleason score of the patients.

RESULTSImmunohistochemical staining showed that the expression of E-cadherin was significantly higher in group A than in B (6.1 +/- 0.51 vs 4.2 +/- 0.37, P < 0.01), and so was its positive rate (73.3% vs 25.9%, P < 0.05). The positive rate of E-cadherin was also markedly higher in the patients with serum PSA < 20 microg/L than in those with serum PSA > or = 20 microg/L (66.7% vs 29.6%, P < 0.05), and so was it in the patients with the Gleason score 5-7 than in those with 8-10 (60.9% vs 21.1%, P < 0.05). On the contrary, the N-cadherin expression was significantly lower in group A than in B (3.7 +/- 0.32 vs 7.5 +/- 0.58, P < 0.01), and so was its positive rate (13.3% vs 59.3%, P < 0.01). The positive rate of N-cadherin was also remarkably lower in the patients with the Gleason score 5-7 than in those with 8-10 (26.1% vs 63.2%, P < 0.05). However, there were no statistically significant differences in the N-cadherin expression between the patients with serum PSA < 20 microg/L and those with serum PSA > or = 20 microg/L (P > 0.05), nor in the expressions of E-cadherin and N-cadherin between the patients aged > or = 70 years and those aged < 70 years (P > 0.05).

CONCLUSIONThe expressions of E-cadherin and N-cadherin are significantly different between high-risk prostate cancer and low- and medium-risk prostate cancer, which suggests that both may correlate with the invasion and metastasis of prostate cancer as well as with the serum PSA level and Gleason score of the patients.

Age Factors ; Aged ; Aged, 80 and over ; Antigens, CD ; metabolism ; Cadherins ; metabolism ; Epithelial-Mesenchymal Transition ; Humans ; Male ; Middle Aged ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; metabolism ; pathology ; Retrospective Studies

Diagnosis, Differential ; Ependymoma ; metabolism ; pathology ; Female ; Hemangioblastoma ; metabolism ; pathology ; Humans ; Ki-67 Antigen ; metabolism ; Meningeal Neoplasms ; metabolism ; pathology ; surgery ; Meningioma ; metabolism ; pathology ; surgery ; Middle Aged ; Mucin-1 ; metabolism ; Neoplasm Recurrence, Local ; Vimentin ; metabolism

Objective To explore the hierarchical chain management model of type 2 diabetes and determine its evaluation.Method Based on the hierarchical chain management of the three community health service institutions and Dahua hospital in Shanghai Xuhui district,215 cases of type 2 diabetes had been involved in the study.Results Compared with the baseline before management,lasting blood glucose (FBG),2 h postprandial glucose (2hPBG),glycosylated hemoglobin (HbA1c),low density lipoprotein cholesterol (LDL-C),systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the diabetes after 12 months' management declined [(8.50 ±2.81) mmol/L,(11.09 ±4.01) mmol/L,(8.56 ±2.41)% ,(3.31 ± 1.06) mmol/L,(139.06 ±20.68) mm Hg (1 mm Hg = 0.133 kPa),(78.20 ± 12.11) mm Hg vs.(7.41 ±2.04) mmol/L,(9.03 ±2.46) mmol/L,(7.34 ± 1.59)% ,(3.00 ± 1.06) mmol/L,(135.48 ± 17.82) mm Hg,(77.27 ±11.83) mm Hg],and the differences were statistically significant(P＜0.01 );control rate of FBG,2hPBG,HbA1c,LDLC,SBP,DBP had improved significantly [19.5% (42/215),20.9% (45/215),24.7%(53/215),20.0%(43/215),27.4%(59/215),30.2%(65/215) vs.50.7%(109/215),53.0% (114/215),54.0%(ll6/215),42.3%(91/215),47.0%(101/215),45.6%(98/215)](P＜0.01).Conclusion Primary and secondary-care hospital based hierarchical chain management model is valid and can be implemented for type 2 diabetes.

Objective To explore the effects of upper limb robot-assisted therapy on motor function and activities of daily living in con-valescent stroke patients. Methods From June to September, 2016, 12 chronic stroke patients at their first-ever stroke were enrolled and ran-domized into experimental group (n=6) and control group (n=6). Both groups received routine rehabilitation. Additional robot-assisted thera-py was provided to the experimental group, and additional repetitive movement training was provided to the control group, 20 minutes a day, five days a week for four weeks. Fugl-Meyer Assessment-Upper Extremities (FMA-UE), modified Ashworth Scale (MAS) and Func-tional Independent Measure (FIM) were used to assess the motor function of the upper limbs and hands, the muscular tension of shoulder and elbow, and activities of daily living (ADL) before and after treatment. Results After treatment, the scores of FMA-UE and FIM were bet-ter in both groups (Z>2.032, P<0.05), and no significant difference was found between two groups (t<0.723, P>0.05), however, the scores were a little bit higher in the experimental group than in the control group. After treatment, for the experimental group, the MAS scores of shoulder abduction/adduction and elbow flexion/extension improved (Z>2.121, P<0.05);for the control group, the MAS scores of shoulder abduction/adduction improved (Z>2.000, P<0.05), but the MAS scores of elbow flexion/extension were not significantly different (Z<1.890,P>0.05). There was no significant difference in the MAS scores of shoulder abduction/adduction and elbow flexion/extension between two group (Z<1.734, P>0.05). The moving trail recorded by the computer, gradually became a regular pattern from the mass, saying the motor control ability became better. Conclusion Upper limb robot-assisted therapy can promote the recovery of the motor function of upper limbs and ADL in convalescent stroke patient, similar to the repetitive movement training.

Objective To evaluate the efficacy of port catheter system(PCS)placement in pulmonary artery via percutaneous subclavicle vein treatment for multiple metastatic tumor in the two lungs and discuss the PCS technique.Methods Fifteen multiple metastatic tumor patients(13 hepatocellular carcinomas,one mandible grand adenocarcinoma,one oral bottom squamous carcinoma)were carried out with pulmonary artery PCS placement by way of percutaneous subclavicle vein.FPA/FPM/GP chemotherapy scheme were introduced every 4～6 weeks.Results The success rate of PCS placement technique was 93.3%(14/15).One case failed.Percutaneous subclavicle veins were performed 14 cases in right side and 1 in left one.Following up 2～43 months,2～7 chemotherapy cycles(mean 5 cycles)were accomplished,and the clinical CR and PR were achieved in 1 and 3 cases respectively with clinical efficacy rate 28.6%(4/14).Major side reaction was late wound healing in 1 case.Conclusion PCS placement in pulmonary artery treatment for multiple metastatic tumor in the two lungs is effective,and mastering operation technique is the key for increasing operation suc- cess rate.

Objective To establish an animal model of severe blast lung injury in baby rabbits,and to provide a way to study the char-acteristic and treatment of blast lung injury in minors.Methods Randomly selected sixteen 4-weeks old New Zealand white rabbits,and the blast lung injuries were made by BST-Ⅰ biological shock tube with different drive pressure (4.0 MPa and 4.5 MPa)respectively.Then compared the injury severity of the 4.0 Mpa group and the 4.5 MPa group.Selected forty-eight 4-weeks old New Zealand white rabbits and di-vided them into the control group (8 rabbits)and the blast lung injury group (40 rabbits)Rabbits in the blast lung injury group were injured with 4.5 MPa drive pressure.Observed the vital signs,physiological index,gross anatomy of the lung,pathology,and pulmonary water content at the time of injury immediately (0 hour),2 hours,4 hours,6 hours,12 hours,24 hours,48 hours and 72 hours after the injury.Results Rabbits inthe 4.0 Mpa group and the 4.5 MPa group were all alive.The overpressure of blast wave of the 4.0Mpa group was (328.16 ± 4.78)kPa,rate of severe pulmonary defense was 12.5%,and the AIS score was (3.38 ±0.52)points.In the 4.5 MPa group,the overpressure of blast wave was (395.04 ±11.74)kPa,rate of severe pulmonary defense was 87.5%,and the AIS score was (4.13 ±0.64) points.Rabbits in the control group and the blast lung injury group were all alive.The spirits of rabbits were drooping immediately after inju-ry,and it last about 0.5 hour.Then the breathing and heart rate was accelerated,pulmonary water content was increased significantly,and there were extensive hemorrhage and edema in the lung.Most of the rabbits suffered severe lung injury,and the AIS score was (3.98 ±0.55) points.Lung tissue rupture,hemorrhage,edema,and inflammatory cells infiltration were the main pathological manifestations under light microscopy. Conclusion The model of severe blast lung injury in baby rabbits could be established with BST-Ⅰbiological shock tube and drive pressure of 4.5 MPa.It is relatively simple,easily controllable and highly repeatable,which can be used as a feasible model for the study of blast lung injury.

Objective To evaluate the effects of multiple exposures to sevoflurane anesthesia on the expression of apolipoprotein E (ApoE) in the hippocampus of neonatal rats.Methods Twenty-four pathogen-free Sprague-Dawley rats (12 males,12 females),aged 7 days,weighing 15-20 g,were randomly divided into 2 groups (n=12 each) using a random number table:control group (group Con) and multiple exposures to sevoflurane anesthesia group (group Sev).On postnatal day 7,14 and 21,2.6％ sevoflurane was inhaled for 2 h in group Sev,while the mixed gas of oxygen and air was inhaled instead of sevoflurane in group Con.Morris water maze test was carried out on postnatal day 31-37 to assess cognitive function.The rats were then sacrificed,and the hippocampus was removed to determine the expression of ApoE protein in hippocampal CA1,CA3 and DG regions (by immunohistochemistry) and the expression of ApoE mRNA (by fluorescent quantitative real-time reverse transcriptase polymerase chain reaction).Results There was no significant difference between the two groups in cognitive function (P＞0.05).Compared with group Con,the expression of ApoE protein in hippocampal CA1 and CA3 regions and ApoE mRNA was significantly up-regulated in group Sev (P＜0.05),and no statistically significant change was found in the expression of ApoE protein in hippocampal DG region in group Sev (P＞0.05).Conclusion Multipie exposures to sevoflurane anesthesia can up-regulate the expression of hippocampal ApoE and produce mild neurotoxicity without causing changes in cognitive function in neonatal rats.

Objective To explore the hierarchical chain management model in blood glucose control and its influence factors in patients with diabetes mellitus.Methods Health management database of diabetic patients was established in 2007 and managed by hierarchical chain management.The number of the patients reached to 1010 till 2011.The blood glucose control of diabetic patients was analyzed and its influence factors were analyzed by multivariate unconditional Logistic regression method.Results The concentration of glycosylated hemoglobin( HbA1c ) of 1010 patients with type 2 diabetes was (8.21 ±:2.70)％.Four hundred and eighty-seven cases (48.22％) reached the blood glucose standard,303 cases (30.00％)reached the blood pressure standard,245 cases (24.26％) reached the blood lipids standard,and 76 cases (7.52％) reached all three standards.Multivariate analysis showed that occupation (OR =2.521,95％ CI:1.871 - 3.397),education level (OR =1.890,95％ CI:1.642 - 2.174),disease course (OR =1.035,95％CI:1.016 -1.055),systolic pressure (OR =1.016,95％ CI:1.007 -1.025) and triglyceride (OR =1.204,95％CI:1.063 - 1.365) were the risk factors of blood glucose control (P ＜0.01).Conclusions Hierarchical chain management model is helpful for the blood glucose control in patients with type 2 diabetes.The comprehensive control and treatment of type 2 diabetes should be taken combined with related risk factors,such as blood pressure,blood lipids and diabetes disease course.

Objective To analysis the influence factors of standardization in the hierarchical chain management of type 2 diabetes and to enhance the hierarchical chain management of type 2 diabetes.Methods ( 1 ) Six hundred and ninty patients with type 2 diabetes completed 1 years management were divided into well-controlled glycosylated hemoglobin ( HbAlc ) group (＜7.0％ ) and bad-controlled glycosylated hemoglobin (HbAlc) group ( ≥ 7.0％ ).The conditions of diet,physical activity,medication,self-blood sugar monitoring and participation in health seminars were investigated and analyzed.(2) The patients were divided into standardized management group and not standardized management group.Their age,sex,educational background,occupation,monthly income per person,medical security,the course,cognition for glycuresis,two-way transfer,and chronic complications were investigated and statistically analyzed.Results ( 1 ) The proportions of physical activity (70.1％ vs 54.2％,x2=6.163,P=0.018),self-blood sugar monitoring(60.4％ vs 43.8％,x2=6.268,P=0.016) and participation in health seminars (56.0％ vs 41.7％,x2=4.577,P=0.045) in the well-controlled HbAlc group were significantly higher than those in the bad-controlled HbAlc group.(2) Their age [(61.08 ±10.04) years old vs ( 57.75 ± 9.89 ) years old,t=2.539,P=0.012],educational background ( ratio of low educational attainment:8.3 ％ vs 17.2％,x2=6.426,P=0.041 ),medical security (own expense ratios:4.6％ vs 11.5％,x2=3.543,P=0.048 ),awareness of diabetes ( ratio of poor awareness of diabetes:19.4％ vs 41.0％,x2=17.518,P=0.000 ),two-way transfer ( ratio of not transfer treatment:4.6％ vs 14.8％,x2=7.662,P=0.022) and chronic complications ( ratio of chronic complication:41.7 ％ vs 26.2％,x2=6.130,P=0.017) were significantly different between the standardized management group and not standardized management group.(3) Logistic regression analyses indicated that the age ( OR=0.954,P=0.006),monthly income per person ( OR=4.101,P=0.018 ),medical security ( OR=7.617,P=0.003 ),cognition for glycuresis ( OR=0.030,P=0.000),two-way transfer ( OR=9.079,P=0.000) and chronic complications ( OR=0.456,P=0.031 ) were the risk factors of standardized management.Conclusion We should focus on the impact factors affecting the standardized management of patients including age,monthly income per person,medical security,awareness of diabetes,ratio of not transfer treatment,positive strategies for chronic complications,improve the hierarchical chain management of type 2 diabetes,and then make the diabetic patients to early participate in standardization management of diabetes mellitus and delay the appearance of complications.