Objective To study the correlation of expression of DNA topoisomerase Ⅱ alpha (TOP2A)with expressions of human epidermal growth factor receptor 2 (HER2)and phosphatase and tensin homolog (PTEN)and gene mutation of phosphatidylinositol 3-kinase (PI3K)in breast cancer so as to provide reference for prognosis of the cancer and evaluation of drug efficiency.Methods This study enrolled totally 96 breast cancer patients. Tumor specimens were resected.The gene expressions of TOP2A,HER2 and PTEN were analyzed using branched DNA-liquid-chip,and PI3K gene mutation was detected by xTAG-liquid-chip.Correlations between gene expressions and gene mutation were further explored by Spearman correlation analysis so as to clarify the relationship between TOP2A and HER2 signaling pathway gene.Results Co-expression of TOP2A and HER2 was strong,and TOP2A tended to be highly expressed in the presence of high expression of HER2 (P =0.01).The expression of PTEN was not significantly correlated with the expression of TOP2A,whereas the mutation of PI3K had a positive association with the high expression of TOP2A (P =0.004).Conclusion Anthracycline drug resistance factor TOP2A may be related to the critical factors of HER2 signaling pathway,suggesting that HER2 expression and PI3K mutation may be key factors in regulation of TOP2A expression,which would provide important evidence for chemotherapeutic resistance.

Objective: To compare efficacies and complications of total hip arthroplasty ( THA ) with subtrochanteric osteotomy for treating patients with Hartofilakidis types C1 and C2 developmental dyspla-sia of the hip ( DDH) .Methods:Retrospective analysis was performed in 32 patients with DDH who un-derwent THA.These patients were divided into two groups according to Hartofilakidis classification, 17 patients in type C1 and 15 in type C2.Their HSS and WOMAC scores, leg length discrepancy (LLD), hip joint image data and complications were evaluated.Results:HSS scores in type C1 was changed from preoperative 43.7 ±4.6 to postoperative 87.2 ±7.1 (P<0.001), together with WOMAC scores 43.6 ± 4.3 to 87.5 ±6.7 (P<0.001).HSS scores in type C2 was changed from preoperative 44.4 ±5.4 to postoperative 86.5 ±8.0 (P<0.001), together with WOMAC scores 44.1 ±4.1 to 86.7 ±8.1 (P<0.001).Four cases in type C2 and one case in type C1 presented intraoperative fracture which all healed during the postoperative follow-up.The postoperative X-ray films showed that the joint prosthesis location was satisfactory, the surrounding bone was not dissolved and the bone at femur osteotomy site healed with no infection.Conclusion:For unilateral high dislocation DDH patients, THA with femur osteotomy can be effective and safe.No significant differences were found between types C1 and C2, however intraoper-ative fracture in type C2 should be paid attention to.

Objective To explore the effect of Latexin (Lxn) gene transfection on proliferation of CD13;MIAPaca-2 pancreatic cancer stem-like cells.Methods CD133+ MIAPaca-2 cells were isolated and sorted by magnetic activated cell sorting from pancreatic cancer MIAPaca-2 celt line.CD133+ MIAPaca-2 cells were cultured in serum-free medium and the capacity for proliferation,and tumorigenicity of CD133+ MIAPaca-2 cells was determined by the floating spheres test and tumor xenograft assays.The CD133+ MIAPaca-2 cells were transfected with Lxn plasmid (1,3,5 μg).After transfection,the protein and mRNA expression of Lxn in CD133+ and CD133+-MIAPaca-2 cells were detected by Western blotting and RT-PCR,respectively.Cell proliferation was assayed by CCK-8.Results CD133+ MIAPaca-2 cells were successfully isolated,and it grew into a ball-suspended way,the tumorigenicity rate in nude mice with subcutaneous injection 1 × 105 cancer cells was 100％.After Lxn plasmid transfection,the expression of Lxn in CD133+ MIAPaca-2 cells was increased in a dose dependent manner,the Lxn protein and mRNA expression of tumor cells transfected with 5 μg plasmid was 20.80 ±0.98,16.80± 2.73,which was significantly higher than that in non-transfected cells (1.02 ± 0.01,1.01 ± 0.01),and the difference between the two groups was statistically significant (P ＜ 0.05).After transfection,cellular proliferation activity also showed a transfection dose and culture time-dependent decrease,the inhibition rate of tumor cells transfected with 0.4 μg plasmid was 36.2％,which was significantly different from that in non-transfected cells (P ＜ 0.05).Conclusions CD133+ MIAPaca-2 pancreatic cancer cells have some characteristics of cancer stem cells.Lxn gene transfection can inhibit the proliferation of CD133+ MIAPaca-2 cells.

Objective To analyse CT signs of lumbar spinal degenerative diseases.Methods CT findings of lumbar spine in 1180 cases with degenerative disease lumbocrural pain were analysed.CT classification of degenerative disease of lumbar spine was carried out according to the lumbar structures in combination with clinical sign.Results Lumbar spinal degenerative disease could be classified into 6 types:intervertebral disc degeneration(degenerative rate 65.3%);lumbar vertebra degeneration(degenerative rate 48.1%);vertebra facet joint degeneration(degenerative rate 36.0%);ligment degeneration(degenerative rate 25.4%) ;degenerative stenosis of lumbar spinal canal(degenerative rate 44.0%);and degenerative lumbar spine unstability(degenerative rate 25.0%).The former 4 types were belonged to primary degeneration of lumbar spine,the latter 2 types were belonged to secondary degeneration of lumbar spine.Conclusion CT classification of lumbar spinal degenerative disease is helpful to clinic in diagnosis and therapy.

Objective To study the Value of low dose CT scanning with gas-contrasted and low window level in diagnosing gastro-colon lesions.Methods 126 cases suspected with gastro-colon lesions were randomly devided into two groups,group A(69 cases) were scanned with conventional water-contrast or non-contrast and conventional expose dose,and with conventional window level,group B(57 cases) were scanned with gas-contrasted and low expose dose,and using low window level.The images were evaluated by 2 experienced radiologists,the results including doctor's self-confidence and diagnostic accurate rate in both group A and group B were compared based on the endoscopic results.Results The diagnostic self-confidence of radiologists and the accurate rate in evaluating the lesions in group B were obviously superior to group A.Conclusion CT scanning of gastro-colon with gas-contrasted,low expose dose and low window level is markedly superior to conventional one.

Objective To explore the risk factors for clinical anastomotic leakage after resection of rectal cancer in China. Methods By meta-analysis we made a comprehensive analysis of the risk factors for clinical anastomotic leakage after resection of rectal cancer based on 19 articles published in China between January 1999 and January 2009. Results The anastomotic leakage rate was higher in the patients aged 60 years old and above than in those younger, with the combined odds ratio (OR) value being 0.50 (95% CI: 0.33-0.76) (P<0.01). The incidence rate was higher in the male patients than in the female ones, with the combined OR value being 2.17 (95% CI: 1.38-3.42) (P<0.01). The incidence rate in the patients with the distance of tumor from the lower margin to anal verge being 7cm and shorter was higher than that with longer distance, with the combined OR value being 1.79 (95% CI: 1.37-2.35) (P<0.01). The incidence rate in the patients who had received radiotherapy preoperatively was higher than that in those who had not, with the combined OR value of 3.66 (95% CI: 2.19-6.09) (P<0.01). The incidence rate in the patients who had received stapler anastomosis was higher than that in the patients who had received manual anastomosis, with the combined OR value being 0.70 (95% CI: 0.47-1.05), but there was no significant difference between them (P>0.05). The incidence rate was higher in the patients with diabetes mellitus than in the healthy ones, with the combined OR value being 3.16 (95% CI: 2.27-4.39) (P<0.01). The incidence rate was lower in the patients with Dukes A and B stages than in those with Dukes C and D stages, with the combined OR value being 0.61 (95% CI: 0.45-0.83) (P<0.01). The incidence rate in the patients with high malignance degree in clinicopathological types was higher than that with low malignance degree, with the combined OR value being 2.17 (95% CI: 1.38-3.42) (P<0.01). The incidence rate was lower in the patients who had received preventive colostomy than in those who had not, with the combined OR value being 0.39 (95% CI: 0.14-1.05), but there was no significant difference between them (P>0.05). The incidence rate was higher in the patients who had got selective operation than in those who had got emergency operation, with the combined OR value being 0.27 (95% CI: 0.13-0.56). Conclusion The risk factors of anastomotic leakage after resection of rectal cancer are as follows: 60 years old and above, male patients, diabetes mellitus, preoperative neo-adjuvant radiotherapy, the distance of tumor from the lower margin to the anal verge being shorter than 7cm, Dukes C and D stages, high malignance degree in clinicopathological types, and emergency operation.

Objective To investigate the rehabilitation prognoses of children with traumatic brain injury (TBI).MethodsA retrospective analysis was made in 64 children who had been admitted for rehabilitation.Their clinical information,rehabilitation protocols,recovery of consciousness and ability in the activities of daily living (ADL) were analyzed. ResultsThe children's injuries were severe-42.19％ had consciousness disorders,but 80％ of them recovered consciousness after rehabilitation.Their limb motor dysfunction was dominated by hemiplegia (51.67％).For 65.63％ of the patients rehabilitation was initiated within one month after injury.The average length of stay in rehabilitation was 33.09 ± 25.96 days.Those with consciousness disorders stayed significantly longer than those without.The main treatments were hyperbaric oxygen therapy,exercise and neurotrophic drugs (the ratios were 95.31％,89.06％ and 82.81％ respectively).After the first course of inpatient rehabilitation,the conscious ness recovery rate was 81.48％ and ADL ability improved significantly.The total effectiveness rate was 90.63％.Univariate and multivariate analyses showed that the factors most strongly correlated with effective rehabilitation were age at injury and the rehabilitation intervention time.ConclusionThe results suggest that a general hospital should focus on early (acute and subacute phase) rehabilitation.So developing the rehabilitation network system is necessary and urgent.Rehabilitative therapy is very helpful in TBI cases.Being older at the time of injury and earlier rehabilitation intervention predict better short term outcomes.It is necessary to build and improve on a more standardized and systemic rehabilitation and assessment system for pediatric TBI.

The study aims to establish a method for simultaneous determination of repaglinide and pravastatin sodium in rat plasma by LC-MS/MS and to study its pharmacokinetic interactions. Eighteen male SD rats were divided into repaglinide group, pravastatin sodium group and co-administration group. Blood samples were collected at different times after oral administration. Repaglinide and pravastatin sodium in rat plasma were separated by Agilent HC-C18 with the mobile phase consisting of methanol-0.1% formic acid (80 : 20). Detection and quantification were performed by using ESI-MS. The detector was operated in selected Reaction-monitoring mode at m/z 453.3-->230.1 for repaglinide, m/z 447.2-->327.4 for pravastatin sodium and m/z 285.1-->192.9 for diazepam as the internal standard. The calibration curve obtained was linear (R2>0.99) over the concentration range of 9.77-10,000 ng.mL-1 for repaglinide and 4.88-625 ng.mL-1 for pravastatin sodium. Compared with the single administration group, Cmax and AUC0-6h of repaglinide increased significantly (P<0.05) and tmax of pravastatin sodium prolonged (P<0.05) in co-administration group. The method is found to be simple, sensitive and accurate for determining the concentration of repaglinide and pravastatin sodium in rat plasma. There exists pharmacokinetic interactions in the co-administration of repaglinide and pravastatin sodium.

Objective To evaluate the nephrotoxicity induced by radiographic contrast media with different osmolality in rats with hypercholesterolemia, and to explore the protective effect of pentoxifylline. Methods Forty-eight healthy SD male rats were randomly divided into normal dietary group (NN, n =8) and high cholesterol supplemented dietary group (H, 4% cholesterol and 1% cholic acid, n=40). At the end of 8th week, the rats with high cholesterol diet were randomly divided into five subgroups (n=8, respectively): high cholesterol diet group(HN), high cholesterol plus iso-osmolar contrast media (iodixanol, IOCM) group (HI), high cholesterol plus low-osmolar contrast media (iohexle, LOCM) group (HL), high cholesterol diet plus high-osmolar contrast media (diatrizoate, HOCM) group (HH) and high cholesterol plus HOCM plus pentoxifylline group (HHP). Forty-eight hours after contrast media injection, the rats were executed and blood samples were prepared to determine total cholesterol, triglyceride, serum creatinine, creatinine clearance(Ccr), fractional excretion of sodium and potassium(FeNa, FeK), and angtension Ⅱ (Ang Ⅱ) levels. The renal injury was assessed by HE staining and TUNEL staining, respectively. The expression of NF-κB protein in the renal tissue was detected by using immunohistocbemical method. Results An increase of cholesterol was observed in all the rats with high cholesterol diet. Scr, FeNa%, FeK% and Ang Ⅱ levels of rats in HH group were obviously higher than those in HL and HI groups respectively. Ccr in HH group [(0.11±0.02) ml·min-1·(100 g)-1] was significantly lower than that in HHP group [(0.43±0.03) ml·min-1·(100 g)-1], HL group [(0.25±0.02) ml·min-1·(100 g)-1] or HI group [(0.27±0.03) ml·min-1,(100 g)-1] (P<0.05). TUNEL staining showed that the pewentage of apoptotic cells in HH group [(89.60±6.40)% ] was higher than that of the other groups [NN (2.40±0.77)%, HN (5.60±1.08)%, HHP (8.91±1.44)%, HL (63.34±11.97)% and HI (61.50±9.40)%]. Immunohistochemistry staining showed that the average gray value of NF-κB positive cells in HH group decreased (P<0.05). There were no significant differences of all indices between HL and HI groups (P0.05). Conclusions Contrast media can cause kidney injuries in the rats with hypercholesterolemia. PTX can protect the renal tissue from nephrotoxicity induced by HOCM in hypercholesterolemia.