AIM:To study the relationship between expression of p53 protein and AgNORs count and histological grade in pancreatic adenocarcinoma.METHODS:Fifty-six patients with pancreatic adenocarcinoma and 25 normal pancreatic tissue were examined for mutant P53 protein by immunohistochemistry,silver binding nucleolar organizer regions(AgNORs)were counted in cancer cells,and histological grade was observed in pancreatic adenocarcinoma.RESULTS:P53 protein positive expression was 50% in pancreatic adenocarcinoma,P53 protein expression was negative in all normal pancreatic tissue.There is a significant difference in P53 expression between normal pancreatic tissue and pancreatic adenocarcinoma tissue.The mean AgNORs count was 9.14?2.08 in group with P53 protein positive expression,and 5.99?1.84 in group with P53 protein negative expression group.The P53 expression was associated with AgNORs significantly.The P53 expression was significantly related with histological grade,and AgNORs count was also significantly related with histological grade.CONCLUSION:P53 may be closely related to carcinogenesis and development of pancreatic adenocarcinoma.P53 protein expression and AgNORs count might be a useful prognostic factor in pancreatic adenocarcinoma.

Objective To investigate the implementation of the system of older pregnant women prenatal ultrasound screening for the diagnosis and clinioal significance.Methods Clinical data from March 2004 to April 2009 a total of 10 630 cases of pregnant women receiving prenatal ultrasound examination of fetal malformation data,of which 712 cases of advanced maternal age( expected date of birth aged≥35 years) to implement the system of prenatal ultrasound screening and follow-up of all maternal age pregnancy outcome,the final post-natal diagnosis of fetal malformations in the standard,both young women screened as a control group for comparison to assess the value of prenatal ultrasound diagnosis.Results 712 cases of advanced maternal age,prenatal ultrasound diagnosis of fetal malformations in 32 cases,abnormalities occur in approximately 4.49％,single abnormal in 15 cases,complex deformity in 17 cases,missed 4 cases of malformation detection rate was 88.88％ (36/32).Control group,9918 cases of prenatal ultrasound diagnosis of fetal malformations 243 cases,2.45％ incidence of deformity (243/9 918 ).Conclusion Older pregnant women,prenatal ultrasound screening for malformations occur in approximately 4.49％,higher than the detection rate with screening younger women 2.45％,of older pregnant women according to the results of prenatal diagnostic screening could be effective in reducing the birth rate of deformed children and the rate of misdiagnosis.

Objective To explore the status and influencing factors of sub-health in inpatient caregivers.Methods A total of 432 caregivers met the inclusion criteria were enrolled.Suboptimal health status questionnaire (SHSQ-25) was used to evaluate the status of sub-health.Sub-health was defined as SHSQ-25 score ≥ 35.100 people undertaking routine physical examinations were enrolled as control group.The incidence and influencing factors of sub-health in caregivers were analyzed.Results (1) The caregivers group valued higher in SHSQ-25score significantly (36.9 ± 8.6 vs.27.5 ± 13.0,P ＜ 0.05).The incidence of sub-health was obviously higher in caregiver group than that in control group (69.9％ vs.39.0％,P ＜ 0.05).(2) A significant difference in the SHSQ-25 scores between female caregivers and male caregivers was observed (37.9 ± 9.0 vs.34.6 ± 7.1,P ＜0.05).The SHSQ-25 score was positively related with age (r =0.578,P ＜ 0.05) and accompanying time (r =0.507,P ＜ 0.05).Parents,children,or spouses of patients got higher scores than other types of caregivers (38.1 ±8.1 vs.31.1 ±8.8,P＜0.05).(3) Among the sub-health caregivers,only 10.9％ of them were aware of their sub-health status.Conclusion The incidence of sub-health may be higher in inpatient caregivers than the general population.Gender,age,accompanying time,and the relationship between patients and caregivers may be influencing factors for sub-health.Effective action should be taken to improve the health status of caregivers.

Objective:To explore the relationship between arterial plasma levels of von Willebrand factor (vWF) and cardiovascular events in patients with stable coronary heart disease (CHD) .Methods :A total of 88 stable CHD pa‐tients from Aug 2007 to Dec 2008 , were enrolled ,their clinical ,coronary angiography (CAG) and percutaneous coronary intervention (PCI) data were collected .Enzyme linked immunosorbent assay was used to measure arterial (aortic root) plasma vWF level before PCI .Except two lost cases ,according to baseline vWF level ,other patients were divided into high vWF level group (vWF≥13.5 ng/ml ,n=43) and low vWF level group (vWF <13.5 ng/ml , n=43) .Incidence rate of major adverse cardiovascular events (MACE) ,including mortality rate ,non-fatal acute myocardial infarction (AMI) , CAG+PCI etc .after six years were followed up .Results:After a mean 74.7 months follow-up ,there were no significant difference in mortality rate (9% vs . 9% ) ,person‐time of non‐fatal AMI (12% vs .7% ) ,arrhythmia (9% vs .16% ) ,CAG+ PCI (53% vs .67% ) ,heart failure (30% vs .23% ) ,cere‐brovascular incident (14% vs .26% ) between low vWF level group and high vWF level group ,P>0.05 all .Conclu‐sion:In patients with stable coronary heart disease ,level of von Willebrand factor is not significantly related to long-term cardiovascular events .

OBJECTIVETo investigate the molecular epidemiological characteristics and antibiotic resistance profiles of Vibrio cholerae O139 in Shandong province.

METHODSA total of 13 strains of V. cholerae O139 (9 clinical strains and 4 environmental strains) isolated from cholera epidemics in Shandong province since 1997 were recovered and confirmed with serum agglutination and biochemical reaction. Pulsed-field gel electrophoresis (PFGE) was carried out for molecular subtyping. Virulence genes and drug resistance related genes were detected by PCR. Antibiotic susceptibility tests were performed using micro-broth dilution method.

RESULTSThirteen strains of V. cholerae O139 were differentiated into seven pulsetypes. One clinical strain and two environmental strains isolated from Jining in 2013 were clustered into the pulsetype namely KZGN11O139. CN0077, and an identical PFGE pattern of KZGN11O139. CN0002 was found among three clinical strains from Jinan in 2005, Jining in 2005 and Heze in 2009. Other pulsotypes were unique in China and found only in Shandong province. Because of deletion of ctxAB and tcpI, the PFGE patterns of two strains isolated from Yantai in 2000 and 2004 were different from other 11 strains which harbored ctxAB, tcpA, tcpI, rtxA, hlyA and toxR. All strains contained one or more drug resistance related genes such as intI 1, intI 4 and sxt, and were resistant to two kinds of antibiotics at least. Among the 12 kinds of antibiotics, the resistant ratioes to kamamycin, trimethoprim-sulfamethoxazole, ampicillin and gentamicin were 11/13, 9/13, 7/13 and 7/13, respectively.

CONCLUSIONMolecular subtyping indicates possible epidemiological links among V.cholerae O139 in Shandong province, and almost all strains were toxigenic and drug resistant.

China ; Cholera ; Cholera Toxin ; Drug Resistance, Bacterial ; Electrophoresis, Gel, Pulsed-Field ; Epidemics ; Humans ; Molecular Epidemiology ; Polymerase Chain Reaction ; Vibrio cholerae O139 ; Virulence

Objective To investigate the patent technological domain distribution of shanghai health system,and comparative analysis of patent technological hotspots between shanghai health system and enterprises.Methods The study used IPC classification method to conduct quantitative analysis of the distribution of patent technology,co-words analysis and visualization of social network establishment method were adopted to analyze patent technological hot spots.Results Within the A61 category,numbers of authorized patents of shanghai health system in orders are A61B、A61K、A61M and A61F.Further analysis of the highest authorized A61B17 group patent in the highest class A61B found that,compare to enterprises,the degree of coincidence with the high-frequency keywords of the technology hotspots is small,the technical hotspots are scattered,and lack of overall technical arrangement.Conclusions Shanghai health system mainly focused on medical device development.It is lower than that of enterprises regarding to the patent technology market demand matching,technical arrangement of the enterprise is relatively better than the health system,thus,the study suggested enhancing market demand survey,adjusting patent distribution,and broadening the scope of market promotion.