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 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 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 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.

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 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.

Background:To date,clinical studies on intravenous rabeprazole sodium for treatment of duodenobulbar ulcer bleeding are still lacking.Aims:To evaluate the efficacy and safety of intravenous rabeprazole sodium with different doses and times of administration in treating patients with duodenobulbar ulcer bleeding.Methods:A multicenter,randomized, double-blind,positive drug parallel-group controlled trial was performed.One hundred and five patients with duodenobulbar ulcer bleeding proved by gastroscopy were randomly divided into four groups.Patients in group A,B and C were treated with intravenous rabeprazole sodium 20 mg qd,40 mg qd and 20 mg bid for 5 days,respectively.Patients in control group received intravenous omeprazole sodium 40 mg bid for 5 days.Hemostatic rate was the primary endpoint,hemostatic time and amount of blood transfusion were the secondary endpoints.Results:Hemostatic rates in group A,B,C and control group were 96.2% (25 /26),92.6% (25 /27),100.0% (26 /26)and 100.0% (26 /26),respectively,no significant difference was seen between the four groups (P >0.05).Median hemostatic time in group A,B,C and control group were 24 (24,72)h,24 (24,72)h,24 (24,48)h and 24 (24,48)h,respectively,no significant difference was seen between the four groups (P >0.05).No patient need blood transfusion during the treatment course.Slight leucopenia was the exclusive adverse effect seen in one case in group C after accomplishment of treatment.Conclusions:Three intravenous rabeprazole sodium regimens with different doses and times of administration were all effective and safe for treatment of mild to moderate duodenobulbar ulcer bleeding.Administration with 20 mg bid seems more effective among the three regimens.

Objective To analyze the correlation between the levels of urinary ptasminogen activator receptor (uPAR) and the clinicopathological characteristics of patients with cervical carcinoma and it's clinical significance. Methods SABC immunohistochemistry was employed to detect the expression of uPAR in 50 cases of cervical carcinoma tissue and 50 cases of normal cervical tissue. ELISA method was used to determine the serum uPAR levels for the patients with cervical carcinoma. Results There was no expressionfor uPAR in normal tissues, The positive expression rate of uPAR was 66 % (33/50). The uPAR level of cervix cancer tissues [(70.92±28.55) ng/100 mg protein]was significantly higher than those in normal tissues [(11.01±5.40) ng/100 mg protein], (P ＜0.001). and uPAR levels were closely related to clinical stages,lymphatic metastasis and differentiation degree (P ＜0.05), but not related to deep myometrial invasion and vascular embolization (P ＞0.05) (however, they were not related to patient's age, tumor growth type and the size of tumor. Significant difference of uPAR level was observed between the patients with cervical carcinoma [(2.38±0.29) ng/ml]and in healthy controls [(0.50±0.16) ng/ml](P ＜0.001). Single factor analysis indicated that, before the treatment, the serum uPAR levels were closely related to clinical stages, lymphatic metastasis, vascular embolization, and deep myometrial invasion (P ＜0.05-P ＜0.01). However, they were not related to differentiation degree (P ＞0.05). Multifactor regression analysis showed that the pretreatment serum uPAR levels of patients were related to clinical stages (P =0.000), cavum pelvis lymphatic metastasis (P =0.000) and deep myometrial invasion. Patients with cervical carcinoma showed a dramatic drop in serum uPAR levels after treatment, which were significantly different compared to their pretreatment uPAR levels (P ＜0.001). Linear correlation analysis showed that there was a positive correlation between serum and tissue uPAR levels, (r =0.801, P ＜0.001). Conclusion There were high expression of uPAR in serum and tissues with cervical carcinoma. Pretreatment serum uPAR levels were closely related to patients' clinical stages,cavum pelvis lymphatic metastasis and deep myometrial invasion, serum uPAR levels may be an important tmnor marker for the diagnosis, detection, prognosis of cervical carcinoma.

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 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.