Objective To observe the effect of improved body turning approach on wound healing after operation of congenital craniovertebral junction abnormity.Methods 82 patients with congenital craniovertebral junction abnormity were performed occipital-cervical bony grafting posteriorly and they were cared with improved or routine body turning approach.Results The incidence of wound healing was 95.1% in routine group and was 100% in improved group.Conclusion The improved body turning approach could improve the wound healing after operation of congenital craniovertebral junction abnormity.

Objective To evaluate the effects of antiviral therapy in prevention of tumor recurrence after curative resection in patients with hepatitis B virus (HBV) related hepatocarcinoma. Methods The data of 78 HBV related hepatocellular carcinoma patients having underwent hepatocarcinoma curative resection were retrospectively analyzed. The patients were divided into 2 groups according to the treatment method and the serum replication level of HBV DNA: 45 patients received antiviral therapy after hepatocarcinoma curative resection (treatment group), including 28 cases of preoperative HBV DNA high replication level (HBV DNA ≥ 107 copies/L), and 17 cases of preoperative HBV DNA low replication level (HBV DNA < 107 copies/L); 33 cases only received hepatocarcinoma curative resection (control group), including 20 cases of preoperative HBV DNA high replication level, and 13 cases of preoperative HBV DNA low replication level. The median follow-up time was 11 months, and the tumor recurrence was observed. The Kaplan-Meier method was used to calculate the tumor-free survival rate, and Cox regression model was used in multi-factor prognostic analysis. Results In the follow-up period, the tumor recurrence rates in treatment group were 84.4%(38/45), in control group were 93.9%(31/33), and there was no statistical difference (P>0.05). The tumor-free survival rates at 6, 12, 18 and 24 months after operation in patients with HBV high replication level of treatment group were 78.6%, 46.4%, 32.1%and 10.7%, and in patients with HBV low replication level of treatment group were 82.4%, 64.7%, 47.1%and 35.3%;these in patients with HBV high replication level of control group were 50.0%, 15.0%, 5.0%and 0, and in patients with HBV low replication level of control group were 92.3%, 46.2%, 30.8%and 15.4%. The tumor-free survival rates in patients with HBV high replication level of control group were significantly lower than those in patients with HBV low replication level of treatment group and patients with HBV low replication level of control group, and there were statistical differences (P<0.05). There were no statistical difference in the tumor-free survival rates between patients with HBV high replication level of treatment group and patients with HBV high replication level of control group, and between patients with HBV low replication level of treatment group and HBV low replication level of control group (P>0.05). Multivariate analysis result showed that preoperative serum HBV DNA ≥ 107 copies/L, lack of antiviral therapy after operation and tumor low differentiation were independent risk factors for tumor recurrence after operations (OR=1.987, 2.119 and 2.539;P<0.05 or<0.01). Conclusions The serum HBV high replication levels and lack of antiviral therapy after operation are independent factors in influencing tumor recurrence in HBV related hepatocarcinoma patients after operation. It might be better that patients with HBV high replication level should receive an antiviral therapy as early as possible after operation.

ObjectiveTo study the treatment and nursing care for intracranial aneurysm in elderly patients. Methods67 patients aged over 60 with intracranial aneurysm were reviewed. ResultsThe outcome was well (Glasgow Outcome Scale scores, 4～5) in 50 cases, and poor in 17 cases(Glasgow Outcome Scale scores, 1～3)．The median of time staying in hospital was 19 d in patients accepted surgery, and 11 d in the patients accepted intervention (P<0.05)． The preoperative Hunt-Hess grade was related with the outcome (P<0.05). ConclusionThe Hunt-Hess grades and the location of aneurysms are related with the outcome, but the treatment of surgery or intervention is not.

Objective To study the relationships among the expression of inhibitors of DNA binding 1 (ID-1) , Ki-67 and Bcl-2 in esophageal squamous cell carcinoma (ESCC) ,and to investigate the potential role of ID-1 in the carcinogenesis of ESCC. Methods One hundred and eighteen cases of surgical resected ESCC specimens and 20 cases of normal tissues ( sampled far from the tumors, as control) were involved. Immunohistochemical technique was applied to detect the expression of ID-1, Ki-67 and Bcl-2. Results The positivity and staining intensity of ID-1 , Ki-67 and Bcl-2 in ESCC were higher than those in normal tissues. Positive immunological reactions of ID-1, Ki-67 and Bcl-2 were found in 86.44% (102/118) , 81.36% (96/118) and 59. 32% (70/118) cases of examined tumor samples, respectively. The expression of ID-1 and Bcl-2 were positively correlated with the histological grades, while the Ki-67 expression showed negative correlation with differentiation degree. No relationship was found among age, sex, lymph node metastasis and the expression of ID-1, Ki-67 and Bcl-2 in ESCC tissues. Conclusion ID-1 expression may be participated in the regulation of apoptosis in ESCC cells, but may not be considered as a biomarker for evaluation of ESCC metastasis.

Objective To investigate the relationship between serum HBeAg level and inflammation grade (G)/fibrosis stage (S) in the liver tissues of chronic hepatitis B (CHB) patients in the immune clearance phase (IC). Methods Both liver biopsy samples and serum samples were consecutively collected from CHB patients in Liver Center,First Affiliated Hospital,Fujian Medical University during March 2007 to June 2010.Electro-chemiluminescence and fluorogenic quantitative polymerase chain reaction (PCR) methods were used to determine HBeAg titer and hepatitis B virus (HBV) DNA level,respectively.The relationships between HBeAg titer and liver pathological stages were analyzed using Spearman rank correlation analysis.Receive operating characteristic (ROC) curve was used to evaluate the diagnostic value of HBeAg for liver pathological stages.Results Totally 249 patients with CHB were enrolled into this study.The serum HBeAg absorbances in patients with liver inflammation G1 to G4 were (2.93±2.85),(2.96±2.74),(2.69±2.67) and (2.30±2.41) lg s/co,respectively,while those in patients with liver fibrosis S1 to S4 were (2.99±2.74),(2.89±2.73),(2.58±2.55) and (2.32±2.44) lg s/co,respectively,which indicated that serum HBeAg titers were significant different in patients with different grading and staging of liver tissues (x2 =47.13,P＜0.01; x2 =74.12,P＜0.01).Spearman rank correlation analysis showed that serum HBeAg titer was negatively correlated with inflammation grades and fibrosis stages of liver tissues (r=-0.418 and-0.532,respectively; both P＜0.01).ROC curve analysis revealed that the areas under the curve (AUC) were 0.74 (G≥≥3) and 0.73 (G≥4),and the HBeAg (s/co) cut-off values were 2.95 and 2.64 lg s/co,respectively.Similarly,ROC curve analysis revealed that the AUC were 0.80 (S≥3) and 0.77 S≥4),and the HBeAg cut-off values were 2.99 and 2.82 lg s/co,respectively.Conclusions The serum HBeAg titer is negatively correlated with the inflammation grades and fibrosis stages m liver tissues of CHB patients in IC phase.The level of HBeAg may be used as an adjunctive noninvasive marker to reflect the inflammation and fibrosis status in the liver.

Objective The aim of this prospective observational study was to analyze the prevalence and the predictive factors of hemorrhagic events after abdominal paracentesis in patients with acute-on-chronic liver failure (ACLF).Methods ACLF patients who received at least one episode of abdominal paracentesis were prospectively enrolled between January 2010 to December 2013. Prevalences of intraperitoneal and abdomen hemorrhage complications were examined. t test was performed for continuous variables and chi-square test was performed for categorical variables.Binary Logistic regression was used to analyze the risk factors of hemorrhage.Results A total of 525 abdominal paracenteses were carried out on 185 ACLF patients within a 4-year period,with 289 (55 .0%)for diagnostic purpose and 236 (45 .0%)for therapeutic purpose.A total of 16 (3.0%)hemorrhagic complications were identified, with 4 cases of abdominal wall hematomas and 12 cases of intraperitoneal hemorrhage.Patients were divided into hemorrhage group and non-hemorrhage group according to this complication.Age,gender, Child-Pugh score,volume of ascitic fluid removed,underlying cirrhosis,platelet count and thrombin time were not significantly different between two groups (all P > 0.05 ).Patients with bleeding events had lower fibrinogen levels and higher prothrombin time,international normalized ratio,activated partial thromboplastin time and model for end-stage liver disease score (all P <0.05).After adjustment of other factors,multivariate regression analysis indicated that low fibrinogen level was the only independent predictor of hemorrhagic complication (OR=0.105,95%CI :0.018-0.608,P =0.012).Conclusion Low fibrinogen level is the independent predictor of severe hemorrhagic complications following paracenteses in patients with ACLF.

Objective To evaluate the relationship between liver cell type A receptor (EphA) expression and androgen receptor (AR) signaling in androgen-dependent prostate cancer cells. Methods RT-PCR and Western blot assay were used to determine mRNA and protein levels of EphA3 and AR in prostate cancer LNCaP and 22Rv1 cells, respectively. The variations of EphA3, AR and prostate specific antigen (PSA) expressions were also measured in these cells after dihydrotes?tosterone (DHT) treatment for 48 h. The constructed EphA3-Luc (-789-+146) luciferase reporter plasmid was co-transfect?ed with pcDNA3.1(+)-AR or siAR in 22Rv1 cells to analyze the effects of different AR expression levels on EphA3 tran?scription activity. Results The expression pattern of EphA3 was similar to AR, showing a lower level in prostate stromal cell line WPMY-1 and a higher level in prostate cancer cell lines LNCaP and 22Rv1. When stimulated with 10 nmol/L DHT, the expression levels of AR, PSA and EphA3 were significantly increased in 22Rv1 cells, and the protein levels of these genes were also increased in LNCaP cells. Moreover, AR expression levels markedly influenced the activity of EphA 3 pro?moter. Conclusion AR up-regulates EphA3 expression by increasing the activity of EphA3 promoter.

Objective To investigate the relationship between levels of ceruloplasmin (CP) and inflammation grade,fibrosis stages in liver of patients with chronic hepatitis B (CHB),and to establish liver fibrosis non-invasive model and evaluate its diagnostic value for liver pathological stages.Methods Both liver biopsy samples and sera were collected from 148 consecutive CHB patients in Liver Center,First Affiliated Hospital,Fujian Medical University during January 2009 to June 2011.The relationships between CP and liver pathological stages were analyzed using Spearman rank correlation analysis.Receiver operator characteristic (ROC) curve was used to evaluate the diagnostic value of CP for liver pathological stages.The diagnostic values of relevant indicators were analyzed by Logistic regression.The liver pathology-predicting model was built and the diagnostic value of the model was analyzed by ROC curve.Results The mean values of CP in 148 CHB patients with liver inflammation grades of G1 to G4 were (212.5 ± 34.9),(205.5± 32.0),(201.4 ± 37.7) and (172.8 ± 20.4) mg/L,respectively,which were significantly different by ANOVA test (F=6.309,P＜0.01).Similarly,the mean values of CP in patients with liver fibrosis stages of S1 to S4 were (217.4±32.3),(206.0±37.7),(194.2±29.8) and (179.7±30.4) mg/L,respectively,which were significantly different by ANOVA test (F =8.608,P ＜ 0.01).Spearman rank correlation analysis showed that CP was negatively correlated with liver inflammation grades (r=-0.316,P＜0.01) and fibrosis stages (r=-0.404,P＜0.01).ROC curve analysis revealed that the area under the curves (AUC) were 0.71 (S≥2),0.70 (S≥3) and 0.72 (S=4).Multiple Logistic regression analysis showed that CP,α-fetoprotein,cholesterol,platelet and age were independent predictors for liver fibrosis.ROC curve analysis revealed that AUC were 0.84 in model-1 (S≥2),0.83 in model-2 (S≥3) and 0.87 in model-3 (S=4).The accuracy rates were 71.8％,80.3％ and 79.2％,respectively.Conclusions The CP levels are negatively correlated with inflammation grades and fibrosis stages in the liver of CHB patients.CP could be an important non-invasive indicator for liver fibrosis and the model including CP can be used to predict liver fibrosis in CHB.

Objective To study the application value of modified urine nucleoside's detection in prognosis of patients with bladder cancer. Methods We enrolled 85 patients with bladder transitional cell carcinoma confirmed by pathological examination.The 85 patients fulfilled one-year follow-up visit after TUR-BT and were reviewed every three months.The 85 patients did not relapse in the first third month after operation.At the sixth month after operation,20 cases relapsed.18 cases and 19 cases relapsed at the ninth month and the twelfth month after operation.Patients with recurrence added up to 57 cases as the recurrent group.The remaining 28 cases did not relapse at one year after operation as the no recurrent group.Of the 85 cases,55 cases were in T(is) - T1,while 30 cases were in T2 - T4.Of the 85 cases,27 cases were with G1,40 cases were with G2 and 18 cases were with G3.In T(is) -T1,there were 35 cases in recurrent group,while there were 20 cases in the no recurrent group.In T2 -T4,there were 22 cases in recurrent group,while there were 8 cases in the no recurrent group.There were 50 normal people in the control group.Highperformance liquid chromatography/electrospray ionization-quadrupole-time-of-flight mass spectromerry was used to measure the levels of change of two urine modified nucleosides (M1A,1-MeI) which the patients with bladder cancer had different pathology grades,clinical stages,before or after operation and recurrence or no recurrence. Results The levels at third month after operation in no recurrent group ( M1A:3.24 ± 0.40,1 -MeI:5.73 ± 0.67 ) were significantly lower than that before operation ( M 1A:4.34 ± 0.98,1-MeI:14.22 ± 4.05,P ＜ 0.005 ),and remained in low status at another time points after operation.The levels at the third month after operation in recurrent group (M1A:3.31 ±0.33,1-MeI:5.67 ±0.55) were significantly lower than that before operation ( M1A:4.32 ± 1.19,1-MeI:14.31 ± 4.12,P ＜ 0.005 ),which was on the rise and indicating a high level approaching the condition before operation.According to the time point before the operation,recurrent group and no recurrent group were higher than control group (M1A:2.91 ±0.84,1-MeI:5.56 ± 1.25,P ＜ 0.01 ).The levels at the sixth month,ninth month and twelfth month after operation in recurrent group ( M 1A referring to 4.04 ± 0.48,4.11 ± 0.47,4.09 ± 0.53 ;1-MeI referring to1 1.46 ± 1.34,12.14 ± 1.22,12.33 ± 1.27) were the highest (P ＜ 0.01 ).The levels of change of two urine modified nucleosides between pathology grade and clinical stage had no statistical difference ( P ＞ 0.01 ).The levels in recurrence group in T(is) - T1 ( M1 A:5.92 ± 1.28,1-MeI:20.01 ± 8.53 )were higher than the levels in no recurrent group ( M1A:4.02 ±1.22,1 -MeI:11.21 ± 6.45,P ＜ 0.05 ),which was the same in T2 - T4. Conclusion Urine modified nucleosides detection offer a certain clinical value the prognostic of operated bladder cancer patients.

Objective:To construct GJB2 gene mutaitons common in Chinese EGFP fusion protein vectors, and to search for better way to study the mechanism of deletion mutaitons in GJB2 gene. Method: Non-fusion protein vectors of 235delC, 299-300 del AT and 176 del 16 bp were first made by point mutaiton methods in vitro. Then expression part of the upper 3 mutations were amplified by PCR and the PCR products were cloned into TA cloning vector. After cutting by restriction enzymes EcoRI/BamHI, three deletion mutaions were inserted into pEG-FP-N1 vector. Sequencing was used to verify the validity of the fusion protein vectors. HEK293 cells were trans-fected with the recombinant DNA samples by the liposome complex method. Results The recombined plasmids were highly expressed in HEK293 cells. Green fluorescence singals were distributed uniformly in cytoplasm. Conclusion; GJB2 mutations common in Chinese EGFP fusion protein vectors were constructed successfully. It may provide a better way to explore the reasons of nonsyndromic hearing loss common in Chinese.