Objective To analyze the effect of combined detection of serum tumor markers, Ki-67 and P-glycoprotein (PGP) in lymph node metastasis and postoperative recurrence of colorectal cancerpatients. Methods The clinical data of 517 colorectal cancer patients who had underwent surgicaltreatment were retrospectively analyzed. Among them, lymph node metastasis was found in 165 cases(lymph metastasis group), and 352 cases did not have lymph node metastasis (non lymphoid metastasis);postoperative recurrence was found in 224 cases (postoperative recurrence group), and 293 cases did havepostoperative recurrence (non postoperative recurrence group). The serum tumor markers levels of cancerantigen 19- 9 (CA19- 9), carcinoembryonic antigen (CEA), cancer antigen 125 (CA125) and theexpressions of Ki-67, PGP were compared. The correlation between the serum tumor markers levels andthe expressions of Ki-67, PGP was analyzed. Results The serum levels of CEA, CA19-9 and CA125 and the positive expression rates of Ki-67 and PGP in lymph metastasis group were significantly higher than those in non lymph metastasis group:(21.39 ± 3.15)μg/L vs. (10.12 ± 2.48)μg/L, (68.48 ± 5.82) U/L vs. (35.26 ± 3.51) U/L, (82.16 ± 7.53) U/L vs. (32.46 ± 6.24) U/L, 69.70% (115/165) vs. 13.64% (48/352) and 72.73%(120/165) vs. 14.77%(52/352), and there were statistical differences (P<0.01). The serum levels of CEA, CA19-9 and CA125 and the positive expression rates of Ki-67 and PGP in postoperative recurrence group were significantly higher than those in non postoperative recurrence group:(18.26 ± 2.34)μg/L vs. (9.18 ± 1.26)μg/L, (47.52 ± 4.85) U/L vs. (21.43 ± 2.18) U/L, (59.16 ± 4.25) U/L vs. (33.17 ± 3.46) U/L, 60.27% (135/224) vs. 9.56% (28/293) and 6.70% (15/224) vs. 7.51% (22/293), and there were statistical differences (P<0.01). The correlation analysis results showed that the positive expression rates of Ki-67 and PGP were positive correlated with the serum levels of CEA, CA19-9 and CA125 (P<0.05). Conclusions The levels of serum tumor markers and the positive expression rates of PGP and Ki-67 in colorectal cancer patients with lymph metastasis and postoperative recurrence are high. The levels of tumor markers are closely related to the positive expression rates of Ki-67 and PGP, which indicates that the combined detection of these indexes has a good effect on evaluating lymph metastasis and postoperative recurrence of colorectal cancer patients.

Objective To study the risk factor of postoperative acute lung injury(ALI)after liver transplantation.Methods The clinical data of I00 patients with end-stage liver diseases who re- ceived liver transplantations were retrospectively reviewed.The risk factors of postoperative ALI after liver transplantation were analyzed by using single variance analysis and multiple variance regression analysis.Results Thirteen patients(13 %,13/11t0)altogether were diagnosed as ALI after liver transplantation.Binary logistic analysis revealed that massive transfusion during operation(more than 5000 ml)and severity of reperfusion injury(ALT above 600 U/L)were two independent risk factors of postoperative ALI following liver transplantation.Massive transfusion significantly increased the risk of ALI by 12.7 times,whereas the severe reperfusion significantly increased the risk of ALI by 7.0 times.Conclusions ALl is a serious multifactoral complication after liver transplantation with high mortality and fatality.Massive transfusion and the severe reperfusion injury are two independent risk factors with high morbidity and mortality.

· AIM: To investigate the role of intercellular adhesion molecule-1 (ICAM-1) in the graft rejection of rabbit penetrating keratoplasty (PKP).· METHODS: Sutures were used to produce corneal neovascularization (CNV) on New Zealand white rabbits to make PKP model. Graft mean survival time and rejection index were determined. The levels of sICAM-1 in serum and aqueous humor were dynamically determined by enzyme-linked immunosorbent assay (ELISA).Immunohistochemical technique was used on cornea to get the evidence of expression and distribution of ICAM-1.· RESULTS: Graft mean survival time is (12.4±1.3) days.The mean sICAM-1 levels in aqueous humor and serum in the control animals that did not undergo surgery were (16.6±3.6)ng/L and (95.2±6.3) ng/L respectively. Levels in aqueous humor and serum for the graft rejection group increased postoperatively, continued to increase to (53.9±19.2)ng/Land (378.8±30.6)ng/L, compared to those in the other group (P ＜0.01). ICAM-1 positive cells were found in the graft rejection group.· CONCLUSION: ICAM-1 plays a critical role in initiating and maintaining corneal graft rejection. Sequential determination of serum sICAM-1 after operation may be of value in the prediction and diagnosis of acute rejection.

Objective To investigate the hepatoprotective effect of silybin-phosphatidylcholine complex(SPC) in sepsis rats.Me-(thods) Fifty Wistar immature rats were randomly divided into 3 groups:normal control(10 cases),septic group(30 cases) and interfe-(rence) group(10 cases).In septic group and interference group,rats were treated by cecal ligation and puncture(CLP).Meanwhile,the interference group was given SPC before 2 hours of CLP and after 2 hours of CLP.Blood of rats was taken from all groups to determine the levels of serum tumor necrosis factor-?(TNF-?),interleukin-1(IL-1),alanine aminotransferase(ALT) and aspartate aminotransferase(AST) at varying intervals.Results The levels of serum TNF-?,IL-1,ALT and AST after CLP were significantly elevated in septic group compared with the normal control group(P

Objective To measure the levels of monocyte chemoattractant protein-1 (MCP-1) in the aqueous humor of patients with acute primary angle-closure glaucoma (APACG),and its correlation with the patients' prognosis after trabeculectomy.Methods This retrospective case-control study included 19 patients with APACG who experienced a failed trabeculectomy (case group) and 57 age-and sex-matched patients with APAGG who underwent successful trabeculectomy (control group).Aqueous humor was collected before trabeculectomy for the detection of MCP-1 levels in the both groups by enzyme-linked immunosorbent assay.And finally,logistic regression analysis was applied to assess the risk factors for failed trabeculectomy.Results The MCP-1 concentration in aqueous humor was (5688.04 ± 2099.99)ng · L-1 in the case group and (2077.57 ± 568.44)ng · L-1 in the control group,and the difference between both groups were significant (P ＜ 0.001).Logistic regression analysis revealed MCP-1 level (OR =1.005;95％ CI =1.001-1.008) and a shallow anterior chamber after surgery (OR =31.430;95％ CI =1.577-57.350) were the independent risk factors for failed trabeculectomy procedures.Conclusion MCP-1 levels in aqueous humor are higher in APACG eyes with failed trabeculectomy than those with successful one during 1-year follow-up,so MCP-1 level is considered as an independent risk factor for failed trabeculectomy.

Objective To observe and evaluate the clinical value of presepsin level in cirrhosis-associated bacterial infections. Methods 30 cirrhosis patients with bacterial infections were enrolled as study group.At admission,60 cirrhosis patients without bacterial infections were enrolled as control group.The difference of blood presepsin level between two groups were analyszed and compared the relationship between level of presepsin patients.The level of presepsin of survival and death group were compared and analyszed risk factors for the prognosis of bacterial infection by COX multi-factor analysis.The sensitivity and specificity were compared by PCT,CRP and presepsin detection.Results The blood presepsin level of study group was 1 002.3(575.1 2~149.5)pg/ml,the blood presepsin level of control group was 475.0(332.7~680.2)pg/ml. The presepsin of study group was significantly higher than control group,the difference was statistically significant(t=1.865,P<0.05).The presepsin level of death patients was significantly higher than survival patients(t=5.875,P<0.05). COX multi-factor analysis showed that presepsin levels were independent risk factors affecting the prognosis of bacterial in-fection in patients with liver cirrhosis.There were statistically significant of sensitivity and specific degrees between presep-sin and CRP(P<0.05).Conclusion Presepsin level is a valuable new biomarker for defining severe infections in cirrhosis. The increase of Presepsin level can be used as a judgment is an important index indicator of liver cirrhosis bacterial infection. It was worthy of clinical attention.

The opening of laboratories in universities is one of important parts in teaching reform and it is necessary for bringing up high-qualified students.Combined with the practical teaching,we have a primary discussion with the problems of the laborato- ry opening and put forward some suggestions and measures.

Objective To evaluate five years results of laser in situ keratomileusis(LASIK)for correction of myopia.Design Ret- rospective case series.Participant 64 patients(126 eyes)with myopia received operation of LASIK.Method 126 myopic eyes were treated with LASIK.Based on the preoperative spherical equivalent refraction(SER),the patients were divided into Group A,B and C(-3.00D～6.00D,-6.25D～-10.00D and -10.38D～-19.88D).Before and after operation,the visual acuity,refraction,anterior seg- ment,funduscopy,intraocular pressures of patients were measured,and the patients were followed-up five years.Main Outcome Measure Visual acuity,intraocular pressure,refraction and complication.Result At five years,in Group A,B,C,uncorrected visual acuity was≥1.0 in 87.2%,69.1%,31.3% patients,and 100%,98.2%,75% had vision of≥0.5.After five years of operation,the re- fraction was -0.70D?0.52D,-1.06?0.13D,-2.46?2.14D in three groups respectively,there was no significant difference between Group A and B(P=0.23);But there was significant statistical difference between Gruop A and C(P=0.008),Group B and C(P=0.021)respec- tively.At the fifth-year,68.3%,45.0% and 23.5% of refraction in Group A,B,C were within?1.00D.Intraocular pressure at the fifth year was 11.91?2.35mmHg,11.31?2.20 mmHg and 9.24?2.20 mmHg respectively.In Gruop B and C,one patient complained glare re- spectively.In Gruop B,one patient's intraecular pressure was elevated after using glueocorticoid.In Group C,one eye was complicated with rbegmatogenous retinal detachment at the second year after LASIK.Conclusion In the follow-up of five years,LASIK is effective and safe.The results in middle and high myopia are better than that in extreme high myopia.(Ophthalmol CHN,2006,15:312-314)

Objective To synthesize 16α-[18F]fluoro-17β-estrogen(18F-FES) with high chemical and radiochemical purity using multifunctional radiolabeling module of Explora GN and separation module of Explora LC (Explora GN/LC dual module). Methods Explora GN/LC dual module and one-pot radiochemical process were applied for fully automated synthesis and separation of 18F-FES. The radiochemical purity of 18F-FES was analyzed by HPLC. The saturation binding test of 18F-FES with ER (ER-positive MCF-7 cell line) was applied to examine the biological activity of 18F-FES. Results 18F-FES synthesis procedure took 60 min, with radiochemical yield about 45% and radiochemical purity higher than 98%. The Kd and Bmax of MCF-7 cells with 18F-FES were (2.922±0.619) nmol/L and (4.193±0.360) nmol/L respectively. Conclusions 18F-FES can be automatically synthesized by Explora GN/LC dual module with high chemical purity and radiochemical purity. It would be a potential PET tracer to be used in estrogen-related molecular imaging.

Objective To propose a new suggestion for the clinical downstaging of nasopharyngeal carcinoma (NPC) in the era of intensity-modulated radiotherapy (IMRT) without changing the current T,N,and M staging system.Methods We reviewed the records of 536 NPC patients treated in Sun Yat-Sen University Cancer Center from January 2002 to December 2006.The Kaplan-Meier method was used to calculate the disease-specific survival (DSS) rate,and the log-rank test was used for survival difference analysis.The Cox regression model was used to calculate the hazard ratio (HR) of each subset.ResultsAccording to the 7th edition of UICC/AJCC staging system,the 5-year DSS rates of stage Ⅰ-Ⅲ patients (except T3N2M0) were all more than 85%(P>0.05),those of stage ⅣA and ⅣB patients were 71.8% and 46.2%,respectively (P=0.171),and that of stage ⅠVC patients was only 24.0%.In stage Ⅲ,the 5-year DSS rate of non-T3N2M0 patients (91.5%) was significantly higher than that of T3N2M0 patients (78.6%)(P=0.042),but there was no significant difference in DSS between T3N2M0 patients and stage ⅣA and ⅣB patients.Based on the above results,new stage Ⅰ included T1-3N0-1M0 and T1-2N2M0,new stage Ⅱ included T3N2M0,T4N0-2M0,and TxN3M0,and new stage Ⅲ included TxNxM1.The 5-year DSS rates of new stage Ⅰ,Ⅱ,and Ⅲ patients were 93.3%,72.7%,and 24.0%,respectively (P=0.000).Compared with new stage Ⅰ patients,new stage Ⅱ and Ⅲ patients had HRs of 4.01 and 16.76,respectively,for 5-year DSS.Conclusions In the era of IMRT,the new clinical staging system (stages Ⅰ,Ⅱ,and Ⅲ) helps with prognostic evaluation and clinical treatment.