Objective Dysfunction of cell cycle regulation is one of the key factors for cellular carcinogenesis .This paper aimed to study the expression and significance of cell cycle regulation protein Cyclin D 1-CDK4-p21 in scar cancer . Methods The expressions of Cyclin D1, CDK4 and p21 protains were detected in scar cancer group , pathological scar group and normal skin group respectively by using immunohistochemical staining (SP).The mRNA expression levels of Cyclin D1, CDK4 and p21 were detected by the use of nucleic acid-mediated in-situ hybridization .Correlation analysis was made on the indexes , and the average optical density and positive area were analyzed using image analysis . Results The expressions of Cyclin D1, CDK4 and p21 protains and the mRNA ex-pression levels of cyclin D1, CDK4 and p21 were high in scar cancer group, low in pathological scar group , and negative in normal skin group.The mean optical density and positive area in scar cancer group were significantly different from pathological scar group and normal skin group (P<0.01).But no significant difference was found be-tween pathological scar group and normal skin group (P>0.05).In terms of correlation analysis , the expressions of Cyclin D 1 and CDK4 as well as p21 and CDK4 in scar cancer tissue were both in posi-tive correlations. Conclusion The occurrence of scar cancer is related to the abnormal expression of Cyclin D 1 and CDK4.The complex formed by Cyclin D1 and CDK4 may promote the G1/S transition, proliferation and tumorigenesis of scar cancer .In scar canc-er, the inhibition of Cyclin D1-CDK4 complex might be caused by other members of CKI family or even inbibitors of other families apart from CDK family.

OBJECTIVE:To provide suggestions for China in dealing with the drug shortage problem by drawing experiences from USA.METHODS:The study was done by reiviewing literature and cases study.RESULTS:The FDA in USA has established procedures for the Center of Drug Evaluation and Organization of Regulation Affairs to resolve all kinds of drug shortage problems.CONCLUSIONS:A specific department should be set up to be responsible for resolving drug shortage problems in China with an emphasis on the shortage of medical necessary drugs,and it is urgent to get the information of drug shortage.

Objective To investigate prognostic factors in patients with primary central nervous system diffuse large B-cell lymphoma (PCNS-DLCBL).Methods The clinical data of 71 patients with PCNS-DLCBL confirmed by pathology and clinical tests, who were admitted to our hospital from 1991 to 2015, were retrospectively analyzed.All patients received chemotherapy, mainly with high-dose methotrexate (HD-MTX, 66/71), and 59 patients received radiotherapy, mainly with whole brain radiotherapy (WBRT)±local boost.The Kaplan-Meier method was used to calculate survival rates, the log-rank test was used for survival comparison and univariate prognostic analysis, and the Cox model was used for multivariate prognostic analysis.Results Fifty-eight patients achieved a complete response (CR), ten achieved a partial response (PR), and three had progressive disease (PD).The 5-year overall survival (OS) rate was 43%, and the 5-year progression-free survival (PFS) rate was 34%.The univariate analysis showed that the factors associated with OS included the following:age of onset, Karnofsky Performance Scale (KPS) score, single or multiple lesions, whether to receive radiotherapy, evaluation results after radiotherapy and chemotherapy, and the presence or absence of recurrence (P=0.000-0.047);the multivariate analysis showed that the three factors that affected OS were age of onset, KPS score, and the presence or absence of recurrence (P=0.000-0.022).The univariate analysis revealed that chemotherapy regimen, whether to receive radiotherapy, total radiotherapy dose, WBRT dose, evaluation results after radiotherapy and chemotherapy, and the presence or absence of recurrence were the factors associated with PFS (P=0.000-0.028);the multivariate analysis revealed that KPS score and the presence or absence of recurrence were associated with PFS (P=0.000-0.011).Conclusions Among patients with PCNS-DLCBL, younger age, higher KPS score, and no recurrence are associated with better OS, and single lesion, radiotherapy, and better evaluation results after radiotherapy and chemotherapy may be associated with better OS;higher KPS score, better evaluation results after radiotherapy and chemotherapy, and no recurrence are the factors associated with better PFS, and HD-MTX chemotherapy, radiotherapy, higher total radiotherapy dose, and higher WBRT dose may be associated with better PFS.Whether to receive radiotherapy after achieving a CR with chemotherapy and the target area and dose of radiotherapy need to be further studied.

Objective To investigate the rates of depression and its risk factors in elderly hypertensive patients and healthy residents in Fuzhou.Methods 882 elderly primary hypertensive patients aged 60 years and over and 1230 healthy elderly residents were assessed by the geriatric depression scale (GDS) and a self-made general information questionnaire, and SPSS 16.0 was used to analyze data.Results The average score of depression and the incidence of depression were higher in elderly hypertensive patients than in healthy elderly residents [(12.43±5.01) vs.(11.53±5.13), 64.4％ vs.55.3％, t=-3.849, x2=16.386, P＜0.01].Compared with healthy controls, scores of depression were higher for all age groups in elderly married male patients, with low levels of education (junior middle school or below), a monthly income less than 2000 yuan, and partial or no medical insurance coverage (P＜ 0.05 for all).Scores of depression were higher in elderly hypertensive patients who had smoking or drinking habits, social activity, hobby, or physical exercise than in healthy controls, (P＜0.05 for all).Scores of depression were also higher in elderly hypertensive patients who had family support, barely enough or adequate family expenses or family support than in healthy controls, regardless of living conditions (P＜0.05 for all).Multiple stepwise regression analysis showed that risk factors for depression in elderly hypertensive patients were family support, age, medical insurance coverage, family expenses, living conditions, hobbies, and gender, while risk factors for depression in healthy elderly residents were family support, interests, medical insurance coverage, and age.Conclusions The incidence of depression is higher in elderly hypertensive patients than in health elderly people in communityin Fuzhou.Family support, hobbies, medical insurance coverage and age are the common risk factors for depression in both elderly hypertensive patients and healthy residents.Family expenses, living conditions and gender are important risk factors for depression in elderly hypertensive patients.

Objective To explore the efficacy of intraductal chilled saline perfusion (ICSP) to reduce the thermal bile duct injury during the treatment of radiofrequency ablation (RFA) associating with occlusion of hepatic blood supply in rabbits.Methods 16 healthy New Zealand white rabbits were divided into 2 groups.Rabbits of the ICSP group were placed tubes in the common bile duct after laparotomy,and ICSP was performed during the RFA procedure accompanied with hepatic blood occlusion.While for rabbits of the non-ICSP group,hepatic blood occlusion and RFA were performed without ICSP.RFA electrodes were placed about 5 mm away from the hilus hepatis approximately.Contrast-enhanced ultrasonography (CEUS) was administrated to evaluate the sizes of the ablative zones after the procedure.On post-procedure 6 week,ultrasonography was prerformed to evaluate the changes of the biliary structure,and liver specimens of rabbits wcrc obtained for histopathologic observation of main bile ducts.Results Post-procedure CEUS examination showed that there was no significant difference in the size of the ablative zone between the groups (P ＞0.05).On post-procedure 6 week,rabbits of the ICSP group appeared with biliary dilatation more frequently by ultrasonography (P ＜0.05),and a higher degree of the injury of main bile duct by histopathologic observation (P ＜0.05).Conclusions In treatment of RFA accompanied with hepatic blood occlusion,RFA-induced bile duct injury may be decreased significantly with ICSP.

Objective To investigate the quality of life (QOL) in elderly patients with chronic diseases living at home and its influencing factors.Methods 1856 elderly patients with chronic diseases living at home were selected by random cluster sampling from two communities.All patients were investigated by SF-36 questionnaire and self-made questionnaire.Results The average QOL scores were (63.8±15.1) in elderly patients with chronic diseases living at home.Scores of SF-36's eight dimensions were respectively (67.8± 22.6) in physiological function,(47.3± 39.4) in role physical,(90.2±14.3) in bodily pain,(52.3±11.9) in general health,(64.1 ± 17.1) in vitality,(74.0 ± 20.9) in social function,(49.7 ± 39.5) in emotional function,(65.0 ± 16.9) in mental health.Scores of SF-36 in each dimension were lower in patients aged 75 years and above than in patients aged 60-74 years (all P＜0.05).Scores of SF-36's dimensions including physical function,bodily pain,vitality,social function and mental health in patients aged 75 years and above were lower in males than females (all P＜0.05).Multiple stepwise regression analysis showed that the major influencing factors for the QOL in elderly patients with chronic diseases living at home were movement,hobbies,age,caregivcr,family support,number of chronic diseases,education status,and alcohol consumption (all P＜0.05).Conclusions The major influencing factors for quality of life in elderly patients with chronic diseases living at home are included demographic,behavior and family factors,etc.Comprehensive community interventions should be taken to improve the quality of life in this elderly population.

Objective To find out the health status and community health care requirement of the elderly in urban Fuzhou and to provide suggestions on how to develop and consummate the community health care for elderly. Methods With the method of stratified random sampling, 3285 elderly people aged 60 years and over were surveyed by a questionnaire. Results The average quality of life of elderly people in urban Fuzhou was above the moderate level. But education level of the elderly was low. And the prevalence rate of chronic diseases was high. There were 2134 elderly people (65.0%) who had more than one chronic disease. The older the people, the higher proportion the coincidence of multiple diseases (P＜0.01). The first five chronic diseases in the elderly were hypertension, diabetes, coronary heart disease, arthropathy and stroke. The incidence rate of depression was high up to 60%. The requirement rate of community health care was 75.2%, and the older the people, the more items they needed(P＜0.05). The requirement of community health care at the first 5 rank position were regular physical examination, health education, regular home visiting, health direction and diet direction. Conclusions Elderly people have many health problems and requirements of community health care.We should provide more and more community health care, in order to improve the quality of life of elderly people.

ObjectiveTo investigate the status of depression and its relationship with quality of life in Fuzhou city community Methods With stratified random sampling method,3285 elderly people (age≥ 60 years) in 12 communities of Fuzhou city were investigated by SF-36 health survey questionnaire and Geriatric Depression Scale (GDS)Results The number of the elderly with depression was 1981 ( 60.3％).The incidence of depression in the female elderly was statistically higher than male(x2 =7.561,P＜0.01).The incidence of depression increased with age(P＜0.01),and declined with higher education ( P ＜ 0.01 ) and income ( P ＜ 0.05).The higher incidence of depression appeared in the elderly with no spouse,paying for medical expenses themselves,living alone(all P＜0.01).The scores of physiological functions (PF),physiological role (RP),body pain (BP),general health (GH),vigor (VT),social function (SF),emotional role (RE),mental health (MH) and quality of life in the elderly without depression (78.0± 19.2,62.7 ± 39.7,94.1 ± 12.3,57.9± 12.0,74.3 ± 14.9,83.0 ± 20.1,64.3 ± 39.1,73.8 ± 14.8,and 73.5 ± 13.6,respectively) were higher than in the elderly with depression (65.9±22.6,45.3±37.8,89.5±15.2,50.8±11.4,59.8 ± 15.9,70.5± 20.9,44.7 ± 37.8,60.6 ± 15.6 and 60.9 ± 14.0,respectively) (P＜0.01 ).All scores had significant differences among different levels of depression (P＜ 0.01 )and the dimension scores decreasedwithserious depression.Depression was negatively correlated with various dimensions of quality of life and total score(P＜0.01).ConclusionsThe incidence of depression of the elderly in Fuzhou city is high.There are negative correlations of depression with quality of life scores and total score of various dimensions.The community nursing service should emphasize on the elderly who are female,advanced age,no spouse,poor-education,low-income,no medical insurance and live alone,then take appropriate measures to reduce depression and improve quality of life of the elderly.

Objective To investigate the clinical efficacy and safety of hybrid artificial kidney in the treatment of patients with uremia.Methods 30 maintenance hemodialysis patients who were altered to be treated by hybrid artificial kidney(treatment group)were compared with 29 patients who were treated by hemodialysis only(control group).The amelioration of clinical symptom,remove of urea nitrogen(BUN),creatinine(Cr).Middle Molecular Substance(MMS)and variation of blood regular test were observed.Results BUN,Cr,haemoglobin level,leucocyte count and blood platelets count improved between after and before treatment(P ＜0.05),but there was no significant difference between the two groups(P ＞ 0.05).Clearance rate ofMMS(25.6%)and improvement of clinical symptoms in treatment group were better than those of control group(5.9%)and difference was statistically significant(P ＜0.05,P＜0.01).There was no serious adverse events in two groups.Conclusion Hybrid artificial kidney could remove molecular substances better and markedly improv clinical symptoms.It can make up for the shortcomings of conventional hemodialysis.

Objective To evaluate serum C-reactive protein (CRP) level and its correlation with malnutri-tion,anemia. Methods Thirty-eight elderly and 42 young maintenance hemodialysis patients were studied. Blood samples were collected at the day on hemodialysis for the determination of red blood cell(RBC), hemoglobin(Hgb), hematocrit (Hct), transferrin (TF), serum albumin (Alb), serum creatinine (SCr), blood urea nitrogen (BUN) and CRP; and triceps skinfold (TSF), arm circumference (AC), arm muscle circumference (AMC) were measured. Results The levels of TSF、AC、AMC、RBC、Hgb、Hct、TF、BUN、SCr、Alb in elderly maintenance hemodialysis pa-tients were lower than those of young patients; but serum CRP was higher( P < 0.05 or P < 0.01), The serum-CRP is negatively correlated with hemoglobin(Hgh), hematocrit (Hct) and serum albumin(P <0.01, P <0.01, P <0.05) in elderly maintenance hemodialysis patients. Conclusion Serum CRP is the sensitive index which reflecting early malnutrition and micro-inflammation.