Objective To study the content of urokinase-type plasminogen activator receptor(uPAR)in the peripheral blood to investigate its value for the invasion metastasis and prognosis in cervical cancer.Methods The plasma level of suPAR in 30 normal women.94 patients with cervieal cancer was measured by using enzyme linked immunosorbent assay(ELISA).Results The mean level of suPAR was(0.5023±0.1724)ng/ml in plasma of 30 normal women,while that in plasma of 94 cervical cancer patients was (1.0433±0.2736)ng/ml.The plasma suPAR level of cervical cancer patients was increased in comparision with that of normal women (P＜0.01).The suPAR level in the cervieal cancer patients did not show a significant correlation with histological classification,histological grade,style of growth and tumor size(P＞0.05),but was related to clinical stage.lymphnode metastasis and depth of invasion (P＜0.05).Conclusion Plasma suPAR would be a more reliable and convenient indicator in monitoring uPA system,and could be widely used as a new tumor marker in clinic.

Objective To explore the feasibility of local enucleation of pancreatic cystadenoma. Methods From Jan 2001 to Dec 2007, 11 patients with pancreatic cystadenoma underwent operation in Department of General Surgery, first affiliated hospital of China Medical University were enrolled and the clinical features, complications and prognosis were analyzed retrospectively. Results Of the 11 cases, the average age was 47 years old with 2 males and 9 females, the average size of the neoplasm was 4.8cm and 1 located in the pancreatic head, 10 in the body or the tail. Among which 3 cases were serous cystadenoma and 8 were mucinous cystadenoma confirmed by pathological evidence. Three patients developed temporary hyperglycemia and returned to normal after 1~2 weeks; one patient developed incisional infection; two cases developed pancreatic fistula postoperatively. All cases were followed up between 28 and 67 months. No neoplasm re-occurrence or diabetes mellitus occurrence were observed. Conclusions It was safe and feasible to perform enucleation for pancreatic cystadenoma with tumor size less than 6 cm.

Objective To evaluate the significance of suPAR,SCC-Ag in plasma and HPV16,18 in cervical secretion for monitoring pathogenetic condition and prognosis in patients with cervical cancer.Methods 206 cervical cancer patients blood and cervical secretion were collected.Plasma level of suPAR and SCC-Ag were measured by enzyme linked immunosorbent assay (ELISA) in health women and patients with cervical cancer.The expression of HPV16,18 of cervical secretion in control group and patients with cervical cancer were detected by fluorescence quantitative PCR.The correlations of the three indexes were analyzed.Results The plasma level of suPAR and SCC-Ag,the expression of HPV16,18 of cervical secretion in cervical cancer patients were obviously higher than those in health controls with statistical significance ((1.072 5±0.305 2) ng/ml vs (0.501 7±0.179 3) ng/ml,(0.980 6±0.162 7) μg/ml vs (0.261 4± 0.006 3) μg/ml and 53.89 ％ (90/167),46.15 ％ (18/39) vs 6.67 ％ (4/60),P ＜ 0.05).There was a positive correlation between plasma suPAR level and SCC-Ag level in invasive carcinoma of cervix patients (r =0.564,P ＜ 0.05).The plasma level of suPAR between in HPV16,18 positive group and in HPV16,18 negative group did not show difference (P ＞ 0.05).Conclusions In invasive carcinoma of cervix patients,there is a positive correlation between plasma suPAR level and SCC-Ag level.But it's not yet to conclude that plasma suPAR level of cervix invasive carcinoma patients is related to infection of HPV16,18.

Objective To explore the relationship uPAR in tissue and plasma of patients with cervical carcinoma and its clinical pathophysiological characteristics. Methods The preoperative plasma cancer tissue and its adjacent tissue in 42 cases of patient with ⅠB～ⅡA cervical carcinoma and the preoperative plasma and postoperative cervical tissue in 30 cases of patient with hysteromyoma were collected. Their uPAR were detected by ELISA. Results uPAR in the plasma of patients with cervical carcinoma was significantly higher than those in healthy controls and in patients with hysteromyoma. It was related to tumor invasive depth and lymph node metastasis and not related to tumor differentiation, uPAR in cancer tissue of patients with cervical carcinoma was significantly higher than those in normal cervical tissue. It was related to tumor differentiation and not to tumor invasive depth and lymph node metastasis. Conclusion uPAR in the plasma of patients with cervical carcinoma is related to invasion and metastasis, uPAR in the tissue is related to tumor differentiation.

Students generally felt difficult in studying during clinical practice and the orthopedics teaching quality was unsatisfactory due to the discrepancies existed among teaching of anatomy,imagie and orthopedics clinical practice concerning the time,content,requirement and method.Students' understandings of anatomy and image knowledge were improved through launching theoretical study by means of lectures and case discussion.Students' understandings of orthopedics diseases were promoted through preoperative diagnosis and intraoperative conformation using anatomy and image knowledge for the patients they were responsible for.In all,orthopedics clinical teaching quality was promoted through applying these measures.

Objective To detect and analyze the expression of ER and PR in endometrial benign and malignant tumor,and to study its correlation of ER and PR with the establishment and development of endometrial carcinoma.Methods The expressions of ER and PR were examined by immunohistochemical method in 58 eases of endometrial carcinoma,37 cases of atypism endometrial hyperplasia,25 cases of simple endometrial carcinoma.and 25 eases of normal endometrium.Results The expressions of ER and PR were higher in normal endometrium,atypism endometrial hyperplasia and endometrial carcinoma.They were lower in endometrial carcinoma than in atypism endometrial hyperplasia,both were higher than that in normal endometrium(P＜0.05).The rates of expression in ER and PR increased gradually from histological grade Ⅰ,Ⅱto Ⅲ.The expressions of ER and PR in histological grade Ⅰ were significantly different from that in histologic grade Ⅲ(P＜0.05).There were no correlation between expressions and ages,which expression rates less than 50 years were higher than those above 50 years.Its expression W88 not related to different clinic grade(P＞0.10).Conclusion The expressions of ER and PR increased gradually from normal endometrium,atypism endometrial hyperplasia to endometrial carcinoma.ER and PR expressions were obviously related to histologic degree.It maybe related to establishment and development of endometrial carcinoma.

Objective To develop a questionnaire suitable for China's cultural background on nurses' attitudes towards the causes of aggressive behavior in patients with schizophrenia,and to test its reliability and validity.Methods By literature review,semi-structured interview and combining with the China's conditions,the draft of the questionnaire item pool was formed,which was evaluated by the experts.Then the reliability and validity of the questionnaire were tested by investigating 340 nurses.Results The effective questionnaires were 312 copies.The questionnaire included 4 dimensions and 29 items.Exploratory factor analysis extracted 4 factors,the total explained variance was 56.175％.The Cronbach alpha coefficient of the questionnaire was 0.909,and the dimensions' Cronbach alpha coefficient was 0.812-0.896.The testretest reliability of the questionnaire was 0.897,and the dimensions' test-retest reliability was 0.742-0.886.The average of total questionnaire's content validity index was 0.968 and the average of the dimensions'content validity index was 0.943-0.978.Conclusions The questionnaire has good reliability and validity,which can be used to investigate nurses' attitudes towards the reasons of the aggressive behavior in patients with schizophrenia.

Objective To analyze the clinical features and laboratory data of 10 patients with macrophage activation syndrome (MAS) complicating systemic onset juvenile idiopathic arthritis (soJIA),which were characterized by acute severe liver injury.Methods Data of 10 patients with soJIA/MAS from Nanjing Children's Hospital were collected retrospectively.The clinical features,laboratory findings,treatment,outcomes and prognosis were analyzed.Results In the total 10 patients,female (6/10) outnumbered male.Their age ranged from 1.5 to 9.5 years old (average 5.2±2.6).The most remarkable clinical manifestations were severe liver injury without systemic features,representing as hepatomegaly (10/10),splenomegaly (2/10) and strikingly increased transaminase (10/10,median:ALT 1 445 U/L,AST 885 U/L).Central nervous system dysfunction and hemorrhages were recorded in 20％ of the patients.Two patients had pulmonary infection.Laboratory data showed that platelet count was less than normal or precaution value (10/10,≤262×10g/L).Hyperferritinaemia (10/10,median:17 329 mg/ml) and soluble CD25 elevation (median:3 140 U/ml) were common in the soJIA/MAS patients.Evidence of macrophage hemophagocytosis was found in 90％ of the patients (9/10) who underwent bone marrow aspiration.Pathological findings of liver biopsy from 1 patient revealed massive infiltration of mononuclear cells in the portal tracts.Nearly all patients (9/10) received intravenous pulse methylprednisolone therapy,combined with cyclosporine A and high-dose intravenous immunoglobulin.Eight patients had good outcome.Only 2 patients were complicated with severe interstitial lung disease during 12-months follow-up.Conclusion MAS should be considered when patients with soJIA represents acute severeliver injury without systemic features combined with other laboratory data.Intravenous pulse methylprednisolone and cyclosporine A therapy may improve the prognosis of soJIA/MAS.

Objective To evaluate the clinical significance of expression of mitogen-activated protein kinase/extracellular signal-regulated kinase kinase kinase 3 (MEKK3) in the early-stage cervical cancer. Methods Seventy-one patients with cervical intraepithelial neoplasia (CIN) and 92 patients with early-stage cervical cancer who underwent surgery in Shanxi Provincial Cancer Hospital from March to October 2010 were enrolled. In the same period, 30 normal cervical specimens from hysterectomy due to uterine fibroids were collected as normal controls. The expression of MEKK3 in all specimens was detected by immunohistochemistry and its clinical significance was analyzed. Theχ2 test was performed on the comparison of count data. Results The positive expression rate of MEKK3 was 13.33％ (4/30) in the normal control group, 28.57％(6/21) in the CINⅠgroup, 38.89％(7/18) in the CINⅡgroup, 56.25％(18/32) in the CIN Ⅲgroup and 70.65％(65/92) in the early-stage cervical cancer group. The differences of positive expression rates of MEKK3 in the normal control group, CIN group and early-stage cervical cancer group had statistical significance (χ2=36.870, P<0.05). Compared with the normal control group, the positive rates of MEKK3 in the CINⅢ group and early-stage cervical cancer group increased significantly (χ2 values were 12.458 and 30.251, both P<0.005). The positive rate of MEKK3 in the early-stage cervical cancer group was higher than that in the CIN Ⅰ group (χ2=12.964, P<0.005). The expression of MEKK3 in early-stage cervical cancer were related to histopathological differentiation and lymphatic metastasis (χ2 values were 6.832 and 4.404, both P< 0.05) rather than age, International Federation of Gynecology and Obstetrics (FIGO) stage, histopathological type, tumor diameter and infiltration depth (all P>0.05). Conclusion MEKK3 plays a role in the occurrence, development and prognosis of early-stage cervical cancer, and the detection of MEKK3 may help to assess the degree of early-stage cervical cancer.

Objective:To collect the imaging data and related materials of the patients with in-stent restenosis (ISR)after coronary artery stent operation with intravascular ultrasound (IVUS),and to analyze the risk factors of ISR,and to propose the reasonable intervention strategies.Methods:Fifty patients with ISR were divided into ISR ≤ 50% drug group (n = 14 )and ISR > 50% drug group (n = 36),including drug-coated balloon therapy group (n=16)and stent treatment group (n=20);IVUS virtual organization technology was used to compare the plaque area,location,tissue composition,thrombus and other factors of the patients in various groups after treatment;the data changes after 6 months of follow-up were analyzed.Results:The IVUS results showed the plaque areas and plaque loads of the ISR patients treated with intervention were significantly reduced compared with before operation (P <0.05);the plaque compression degree of the patients in drug-coated balloon therapy group was lower than that in stent treatment group (P <0.05),but the differences were not found between drug-coated balloon therapy group and stent treatment group in fibrous tissue components and calcified tissue proportion (P >0.05).Conclusion:The ISR rate is higher in the patients with high degree of fiber components,plaque composition heterogeneity and distribution of diffuse tortuous and calcified lesions.ISR has no significant correlation with the plaque wall thickness and lipid content and plaque instability and necrotic tissue proportion.