Objective To explore the expression of mismatch repair gene (MMR) (MLH1,MSH2,PMS2 and MSH6) in endometrioid adenocarcinoma,and to analyze its clinical pathological significance.Methods Inmunohistochemical EnVision method was used to detect the expressions of DNA mismatch repair proteins (MLH1,MSH2,PMS2 and MSH6) in 101 cases of endometrial adenocarcinoma.The phenotypes of tumor microsatellite instability (MSI) and microsatellite stable were determined,and its relationship with onset age,differentiation,depth of myometrial invasion,lymphatic metastasis and prognosis of tumor were analyzed.Results There were 67 cases of hysterectomy and 34 cases of endometrial biopsy in 101 cases of endometrial adenocarcinoma.52 cases of surgical specimens and 14 cases of biopsy specimens were included in 66 cases that had complete follow-up data.Rates of negative expression were as follows:MLH1 31.6 ％ (32/101),MSH228.7 ％ (29/101),PMS2 16.8 ％ (17/101),MSH6 8.9 ％ (9/101).MSI phenotype 53.5 ％ (54/101),MSS phenotype 46.5 ％ (47/101).Univariate analysis showed that prognoses of MSI-L&MSS group (34 cases) were better than those of MSI-H group (18 cases) in hysterectomy organization (P =0.041).The differences between depth of myometrial invasion,degree of differentiation,age and prognosis of endometrial adenocarcinoma were statistically significant (P ＜0.05).Cox multivariate analysis showed that differences between depth of myometrial invasion,age and prognosis of endometrial adenocarcinoma were statistically significant (P =0.034,P =0.009),while there was no significant difference between MSI-L&MSS group and MSI-H group in prognosis (P ＞ 0.05).Conclusions MSI is one of the molecular events that occur in the endometrioid adenocarcinoma.Age and depth of tumor invasion are independent prognostic factors of endometrioid adenocarcinoma.In view of inconsistency between univariate analysis and multivariate analysis,whether MSI can be used as deterministic accordance for endometrioid adenocarcinoma prognostic evaluation requires further verification.

Objective To evaluate the effects of a single IV lidocaine bolus dose on the minimal alveolar concentration (MAC)of sevoflurane. Methods Patients (n=90), aged 25-65 years whose Anesthesiologists (ASA) classification wasⅠorⅡand underwent elective surgery on trunk under general anesthesia, were randomly divided into 3 groups with 30 cases in each group:high-dose lidocaine group (group H), low-dose lidocaine group (group L) and control group (group C). They were induced by sevoflurane inhalation, and ventilated by LMA (laryngeal mask airway). After a 15 minutes equilibration period with the above sevoflurane concentration , the medication to be studied (2%lidocaine 1.5 mg/kg for group H , 2%lidocaine 0.75 mg/kg for group L, 0.9%saline 5mL for group C) was administered for 3 minutes before the skin incision. The response to skin incision (movement versus no movement) was recorded in the first minute after skin incision. The MAC for sevoflu?rane was determined using the Dixon′s up and down method. Values of mean arterial pressure (MAP), heart rate (HR), and BIS were recorded at 1 minute and 5 minutes after being monitored (average values were noted as T0), immediately before the administration of medication (T1), immediately before the skin incision (T2) and 1 minute after the skin incision(T3). Results MAC in group H (2.00%± 0.17%) was lower than that in group C (2.22%± 0.18%) by approximately 0.22%,and which was lower than that of group L ( 2.21%± 0.14%) by approximately 0.21%(F=7.054,P<0.05). No significant differ?ence in the MAC of sevoflurane was noted between group L and group C. The values of HR, MAP and BIS all decreased at T 2 and increased at T3 in all 3 groups (all P<0.05). No significant difference in HR, MAP or BIS was observed between T0 and T1 in all three groups. The values of HR and BIS were lower in group H than those in group C and group L at T2 and T3. The values of MAP were lower in group L and group H than those in group C at T2 and T3. The value of MAP were lower in group H than that in group L at T2(all P<0.05). Conclusion A singleⅣ1.5 mg/kg lidocaine decreases MAC of sevoflurane, but the decreased amplitude (11%) does not reach expectation.

Objective To establish a safety culture evaluation model to conduct empirical research with regard to the assessment of both the radiation safety culture and management at different levels of health institutions.Methods Delphi method is used to develop a model to define the effectiveness and operational practice of safety culture system in hospitals.Results The research had achieved good reliability assessment,with Cronbach coefficient α of all indicators higher than 0.60.There were 16 hospitals with scores less than 75 (61.54％),at the primary stage of radiation safety culture,and 9 hospitals among 75-95 (34.62％),at the middle stage,only 1 hospital with score of 95.48 (3.85％),at the high grade stage.Conclusions At present,the level of radiation safety culture in medical institutions is lower as a whole.The evaluation model established in the present research is practicable to some extent and can provide reference for strengthening radiation safety management.

Objective To investigate the relationship between ambulatory arterial stiffness index (AASI) derived from blood pressure monitoring and early signs of renal damage in patients with primary hypertension． Methods 74 primary hypertensive outpatients were divided into two groups according to their AASI values: normal AASI group (AASI≤0.51, n=40) and high AASI group (AASI>0.51, n=32). The urinary micro-albumin, glomerular filtration rates (GFR) were measured and compared. The relationship between AASI and micro-albumin, GFR were tested with Pearson correlation and multiple Logistic regression. Results Compared with those in the normal AASI group, the patients in high AASI group showed a higher level of urinary microalbumin (P<0.05) and a reduction in GFR (P<0.01). AASI was positively correlated with urinary microalbumin （r=0.32, P<0.001）, and negatively correlated with GFR （r=0.44, P<0.001）. After adjusting the potentially confounding variables, the odd ratio (OR) of AASI to renal damage was 2.18 （P=0.008，95%CI：1.76～4.34）. Conclusion The increase of AASI is associated with early signs of renal damage in patients with primary hypertension.

Objective To observe the clinical efficacy and adverse reactions of high-dose methylprednisolone pulse treatment on peritumoral edema induced by supratentorial brain tumors.Methods Thirty-five patients with supratentorial brain tumors and peritumoral edema were treated with methylprednisolone pulse therapy before surgery and the edema index of every patient was calculated by MRI examinations before and after methylprednisolone treatment.Results After methylprednisolone pulse therapy, the edema indexes of the light, medium and severe edema patients reduced by 1.79%, 8.81% and 12.02% respectively. The edema indexes of the medium and serious patients were significantly lower than that before treatment ( P<0.01). But the edema index of the light edema patients was not significantly different with that before treatment ( P>0.05).Conclusion High-dose methylprednisolone pulse therapy has an obvious effect on medium and serious peritumoral edema induced by supratentorial brain tumors and has no serious adverse reactions.

Cell Line, Tumor ; Humans ; Matrix Metalloproteinase 2 ; analysis ; Matrix Metalloproteinase 9 ; analysis ; Melanoma ; enzymology ; Skin Neoplasms ; enzymology

Adult ; Aged ; Alveolar Ridge Augmentation ; methods ; Dental Implantation ; methods ; Female ; Humans ; Male ; Maxillary Sinus ; surgery ; Middle Aged

Objective To discuss the difference of myopia prevalence and spherical equivalent among normal,exophoria and intermittent exotropia children.Methods The children aged between 6 years old to14 years old were divided into 3 groups of orthophoria (n =151),exophoria (n =180) and intermittent exotropia (n =168) based on the result of cover-uncover test.Intermittent exotropia group was divided into three types of basic,convergence insufficiency and divergence excess.Diopter values were retrospectively reviewed,and results were recorded with the average data after the objective optometry of cycloplegia.Results Myopia prevalence of intermittent exotropia of different ages was higher than normal and exophoria (all P ＜ 0.05),but no difference between exophoria and normal (all P ＞ 0.05).There were statistical significant differences in overall prevalence among three groups (intermittent exotropia and orthophoria:P =0.000,intermittent exotropia and exophoria:P =0.000,orthophoria and exophoria:P =0.034).Average spherical equivalent was (0.08 ± 0.99) D in orthophoric group,(-0.16 ± 1.16)D in exophoric group and (-1.23 ± 1.57)D in intermittent exotropic group,there was statistical difference among three groups (P =0.000).The differences were also statistical significant between orthophoria group and exophoria group (P =0.015),intermittent exotropia group and orthophoria group (P =0.000),exophoria group and intermittent exotropia group (P =0.000).In the group of intermittent exotropia,average spherical equivalent was (-1.68 ± 1.61) D in convergence insufficient group,(-1.14 ± 1.44) D in basic group and (-0.85 ± 1.50) D in divergence excessive group,there was statistical difference among three groups (P =0.000).The spherical equivalent in convergence insufficient group was lower than the basic group (P =0.000)and divergence excessive group (P =0.041).Conclusion The myopia prevalence and degree of intermittent exotropia are all higher than normal and exophoria in children.

Objective To evaluate the ability of multi-slice spiral CT angiography(MSCTA)in showing the celiac trunk and its degree branches,and the value of MSCTA in preoperative evaluation of laparoscopic-assisted gastrectomy for advanced gastric carcinoma.Methods A total of 25 consecutive patients scheduled for laparoscopic-assisted gastrectomy with D2 lymph node dissection were evaluated by MSCT,CT angiography(CTA)were reconstructed separately using a volume rendering algorithm(VR).The space anatomy characteristics of celiac artery and its degree branches were evaluated according to the CTA results,and with anatomy information,laparoscopic-assisted gastrectomy with D2 lymph node dissection was processed with references to anatomy.Results In all the 25 cases,the left gastric artery and gastroduodenal artery were accurately identified on MSCTA.In 12 of them,the right gastric artery was accurately identified.The origin of the spleen artery is relatively constant.Laparoscopic-assisted gastrectomy with D2 lymph node dissection was successfully completed without conversion to open surgery in all the cases.The reconstructed celiac trunk and branches are identical with anatomy.Conclusions Three-dimensional CTA using MSCT clearly reveals the anatomy of celiac artery and their space structure.It plays an important role in guiding lymph node dissection during laparoscopic-assisted gastrectomy for advanced gastric carcinoma.

0.05). Metastasis of the liver of colorectal cancer occurred higher in the patients with serum CEA concentration ≥15ng/ml than that in those with serum CEA