Objective To investigate the differential expression of annexin A4 (ANXA4)protein in different phenotype of human hepatocellular carcinoma (HCC) tissues, and discuss the correlative clinico-pathologic significance. Methods The mRNA levels of ANXA4 in different liver tissues were validated by using semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR), and the expressions of ANXA4 protein in different liver tissues specimens were observed by immunohistochemistry assay. The relative analysis between the results of immunohistochemistry assay and the clinicopathologic parameters were studied. Results In mRNA level, the results from RT-PCR were significantly increased of ANXA4 in HCC tissues than that in cirrhosis tissues and normal liver tissues. Immunohistochemistry assay of different type liver tissues also confirmed that ANXA4 protein overexpressed in HCC tissues than that in the cirrhosis tissues post hepatitis B and normal liver tissues (49.4% vs 28.0% vs 24.0%), and the higher positive rate could be observed in different phenotype HCC tissues (53.8% in small HCC, 64.5% in large HCC, 28.6% in multiple HCC, respectively),according the positive rate of para-tumorous tissues was 53.8%, 64.5% and 67.9%, respectively. The results of statistics analysis showed that the expression of ANXA4 up-regulated gradually going with the hepatocellular malignant metaplasia and tumorous progression, but the expression of ANXA4 down-regulated when invasion were emerging in HCC. Furthermore, expression of ANXA4 had a negative correlation with the tumor size and maybe responsible for carcinogenesis and progression in human hepatocellular carcinoma. Conclusions The mRNA level of ANXA4 is significantly increased in HCC and cirrhosis tissues compared to the normal liver tissues by semi-quantitative RT-PCR. The same trend can be observed in immunohistochemistry assay. ANXA4 might be concerned with the carcinogenesis of HCC. Unbalance of expression of ANXA4 could be observed in different phenotype HCC tissues. ANXA4 might take part in the process of progression and invasion of HCC.

Objective To evaluate the diagnosis and treatment of malignant rectal gastrointestinal stromal tumor.Methods The clinical and pathological data of 26 patients with malignant rectal gastrointestinal stromal tu- mor were retrospectively analyzed.Results All the patients underwent operation.In 13 cases Miles operation was done and 3 cases Park operation was done.The 10 patients received Dixon resection.The 3-,5-year survival rate were 73% and,54 %,respectively.The median survival time for 26 patients was 52 months.Immunohistochemical analysis displayed positive reactivity for CD117(96%) and CD34(85%).Conclusion For the malignant rectal gas- trointestinal stromal tumor,the most worthwhile diagnostic criterion was the presence of CD117 and CD34 cells and surgical radical resection is the principal treatment.

Objective To explore the influence of parenterai nutrition(PN) on nutritional status and immune function in breast cancer patients undergoing postoperative chemotherapy.Methods 94 patients with breast cancer postoperative patients were randomly divided into the treatment group(47 cases) and the control group(47 cases).All the patients were given chemotherapy with VBP.The treatment group was given glutamine fortified PN,and the control group was given normal nutrition support,respectively.The nutritional status and immune function before and after chemotherapy,and main toxicities were observed.Results Compared with those before chemotherapy,there were no significant decrease on the level of ALB,PA and HB in treatment group(all P ＞ 0.05),while those indicators in control group was significantly decreased (all P ＜ 0.05).After chemotherapy,CD4,CD8,CD4/CD8 and IgA,IgG,IgM levels of the two groups were lower than those before chemotherapy (all P ＜ 0.05),and the levels of immune indicators of the treatment group were significantly higher than those of the control group(all P ＜ 0.05).The main toxicities in two groups were nausea and vomiting,diarrhea and mild bone marrow suppression,and the body weight in control group decreased (0.91 ± 0.53)kg,while it increased (0.45 ± 0.21)kg in treatment group (t =5.53,P ＜0.05).Conclusion PN treatment for breast cancer patients during chemotherapy can improve nutrition status and immune function,enhance the tolerance of chemotherapy,so as to improve curative effect and prognosis.

Objective To explore the CT and MR features of malignant peripheral nerve sheath tumor (MPNST) of adults.Methods The CT and MRI findings of 20 patients of MPNST confirmed by pathology were analyzed retrospectively.Results Among 20 cases,the lesions were located in the lower extremities (n=4),shoulder and spine (n=4),abdomen (n=3),chest wall (n=2),mediastinum (n=2),breast (n=1),prostate (n=1),scrotum (n=1),scalp (n=1),left maxillary sinus and orbital bottom (n=1).Nineteen cases appeared as solid masses and 1 case appeared as diffuse lesion.The maximum cross section of the lesions were about 1.41 cm× 1.42 cm-17.10 cm× 18.08 cm.Sixteen cases were ill defined margin and 4 cases were well-defined margin.CT scan showed 14 cases were lower density or isodensity and with patchy inhomogeneous density.Multiple calcification were found in 2 cases and osteolytic destruction were found in 7 cases.Enhanced CT of 10 cases showed solid component and gradually delayed enhancement,while cystic lesion and necrosis were not enhancement.The tortuous arteries were displayed in 7 cases.Seven cases were performed MRI and the lesions appeared as hypo-intensity on T1WI and hypo-intensity on T2WI with obviously high intensity of cystic component.Enhanced MRI of 3 cases showed significantly heterogeneous enhancement,cyst and necrosis had no enhancement.MR dynamic enhancement of 1 case showed time-signal intensity curve was platform type.DWI showed high signal.Conclusion MPNST has certain CT and MR characteristics which are helpful to improve the diagnostic accuracy.

Objective To analyze the stroke subtypes and influencing factors in four largest economic regions of China.Methods We analyzed the investigation data of QUEST(Quality Evaluation of Stroke Care and Treatment)study conducted in 2006 which included 62 hospitals in a national scale.According to the concept of four economic regions designed by the Development Research Center of the State Council,we performed the univariate and multivariate analysis for the stroke subtypes and its related risk factors in the different economic regions.Results There were 3362(73.5％)ischemic stroke patients and 1214(26.5％)hemorrhagic stroke patients among the total 4576 first-ever stroke patients.Comparison of stroke subtypes in the four different economic regions was statistically significant(P ＜ 0.001),with a percentage of 80.8％ ischemic stroke patients in the northeastern region,78.9％ in the eastern region,68.3％ in the central region and 67.0％ in the western region.The comparisons of risk factors such as history of hypertension,diabetes,hyperlipidaemia,coronary artery event,atrial fibrillation,and overweight in the four different economic regions were also statistically significant(P ＜0.05).Conclusions The subtypes of first-ever stroke vary in the four largest economic regions with a highest proportion of ischemic stroke in the northeastern region and relatively high proportion of hemorrhagic stroke in the central and western economic regions.There are also discrepancies of stroke risk factors in the different economic regions.

Objective To explore the feasibility of using digital imaging processing (DIP)to extract EUS image parameters for the differential diagnosis of autoimmune pancreatitis (AIP)and chronic pancreati-tis (CP).Methods A total of 81 patients with AIP and 100 patients with CP diagnosed from May 2005 to January 2013 were recruited to this study.A total of 105 parameters of 9 categories were extracted from the region of interest by using computer-based techniques.Then the distance between class algorithm and se-quential forward selection (SFS)algorithm were used for a better combination of features.A support vector machine (SVM)predictive model was built,trained,and validated.Results Overall,25 parameters of 5 categories were selected as a better combination of features when the incidence of accurate category was max (90.08%).A total of 181 sample sets were randomly divided into a training set and a testing set by using two different algorithms and 200 random tests were performed.The average accuracy,sensitivity,specificity, the positive and negative predictive values of AIP based on the half-and-half method were (86.04 ± 3.15)%,(83.66 ±6.57)%,(88.54 ±4.37)%,(85.96 ±4.44)% and (87.12 ±4.39)%,respective-ly.Conclusion Computer-aided diagnosis of EUS images is objective and non-invasive,which can improve the accuracy in differentiating AIP from CP.This technology provides a new valuable diagnostic tool for the clinical determination of AIP.

Objective To optimize primary cultures techniques of isolating neonatal rat cardiomyocytes and to com?pare three different methods of extractingβ3-adrenergic receptor(β3-AR)membrane protein from cultured neonatal rat car?diomyocytes. Methods TypeⅡcollagen and differential velocity adhesion were used to collect primary cardiomyocytes. To?tal protein method, ultracentrifugation method, extract kit method were used to isolate cardiomyocytesβ3-AR membrane pro?teins. The BCA method was applied for protein quantification. Relative content ofβ3-AR membrane protein and GADPH in the sample were examined by western blot. Results Optimizing culture and isolation skills can produce a great quantity of cardiomyocytes in high concentration.The kit method acquired a higher level of protein concentration(8.26±0.29)g/L than to?tal protein method(5.12±0.47)g/L does than ultracentrifugation method(3.20±0.37)g/L does all of which were with signifi?cant difference(P < 0.05). The concentration of β3-AR membrane protein was higher if obtained by kit method(0.22 ± 0.05)than ultracentrifugation method(0.09 ± 0.03)than total protein method (0.01 ± 0.01) with significant difference(P <0.05). Conclusion optimizing methodology can obtain abundant myocardial cells in high concentraion. The kit method of isolating primary culturedβ3-AR membrane proteins result in improved concentration and specificity of membrane protein.

Objective To explore the effect of the expressive psychotherapy on the feeling of inadequacy and loneliness of inpatients with chronic schizophrenia.MethodsTotally 120 chronic schizophrenia inpatients met recruited criteria were randomly divided into study group(n=60) and control group(n=60) according to random number table.57 patients in each group finished all the follow-ups finally.The patients in two groups were received normal medications while the patients in intervention group also attended expressive psychotherapy.All the patients were assessed at baseline,6 weeks and 12 weeks of treatment with the feeling of inadequacy scale (FIS) and the status and trait loneliness scale (STLS).Results(1) The FIS score(F=225.19,P<0.01),STLS total score(F=225.20,P<0.01),STLS status score(F=240.40,P<0.01) and STLS trait score(F=106.75,P<0.01) decreased significantly in both groups after intervention.(2) The FIS score of study group was much lower than those of control group at the at 6-week-follow-up(4.93±20.86,57.89±20.48,t=-2.250,P<0.01) and 12-week-follow-up(38.43±17.50,57.21±22.98,t=-4.900,P<0.01).(3) After 6 weeks treatment and 12 weeks treatment,STLS total score(6 weeks:(54.32±12.30) vs (68.46±15.53),t=-5.425,P<0.01,12 weeks:(44.16±10.81) vs (65.75±16.26),t=-8.386,P<0.01),STLS status score (6 weeks:(25.95±6.41) vs (34.31±7.91),t=-6.239,P<0.01,12 weeks:(19.15±5.49) vs (32.58±8.45),t=-10.103,P<0.01) and STLS trait score (6 weeks:(28.37±6.73) vs (34.15±8.45),t=-4.138,P<0.01,12 weeks:(25.00±6.18) vs (33.15±8.22),t=-6.019,P<0.01) in study group were lower than those in control group,and the difference was statistically significant.ConclusionExpressive psychotherapy can effectively improve the loneliness and inadequacy of patients with chronic schizophrenia.

Objective:To investigate the relationship between the distance from the upper and lower resection margin and the gastric cancer patients with R0 resection and no distant metastasis.Methods:Retrospective analysis of 281 patients with gastric cancer in our hospital,the relationship between the age,sex,tumor size,tumor size,vascular invasion,lymph node metastasis,TNM stage,type of gastric cancer,tumor location and operation mode was analyzed.To compare the survival time of patients with different upper and lower margins.Results:The increase of the distance from upper resection margin was significantly related to the tumor size＞5 cm,TNM stage,type of gastric cancer,tumor location,and the difference was statistically significant(P＜0.05);The distance of lower resection margin was significantly correlated with tumor size＞5cm,vascular invasion,lymph node metastasis and TNM stage,type of gastric cancer,and the difference was statistically significant (P＜0.05);Themedian survival timein patientsof upper resection marginr□3cm with 48 months of the 5-year follow-up period was significantly higher than that in patients of the resection margin＞3cmwith 46 months (P＜0.001).Themedian survival timein patientsof lower resection margin□3cm with 45 months of the 5-year follow-up period was significantly higher than that in patients of the resection margin＞3cm with 44 months (P＜0.001).Conclusion:Gastric cancer postoperative upper and lower resection margin was significantly related with tumor size,TNM staging factors,and the median survival time of upper and lower resection margin＞5 cm was significantly lower than that of the resection margin3 cm.

Objective To reform practice in the pharmacy administration courses for cultivating student′s comprehensive qual-ity.Method Reform practice was tried in the aspects of teaching methods , teaching contents , teaching means and evaluations based on theoretical teaching in the pharmacy administration courses .Results A teaching system was formed to enhance pharmacy under-graduate′s comprehensive abilities , including self-learning ability , language skills , communication and social skills , information pro-cessing skills , solving problem skills and ability to cooperate with others .Conclusion It is a workable and valuable teaching system which should be improved and innovated and kept up with the times in future .