The tumor metastasis is the major cause of the death of cancer patients.S-100A4 is a member of the S100 family of calcium-binding proteins and has been categorized as a metastasis-associated protein.S-100A4 is a candidate as a molecular marker for metastatic potential with high prognostic significance.An increase in S-100A4 protein expression has been correlated with poor prognosis of patients with breast,colorectal,gallbladder,bladder,esophageal,nonsmall-cell lung,gastric,medulloblastoma,pancreatic and hepatocellular cancers.The overexpression of S-100A4 protein can induce the increase of invasion and mobility of the tumor cells.It has been considered that S-100A4 is secreted by the tumor and stroma cells as a regulator of tumor metastasis.S-100A4 can regulate the progress of cell cycle,change cell adhesion,cell mobility and increase the survival ability of the tumor cells.

Objective To evaluate the value of lung ultrasound score (LUS) on assessing the severity and extubation opportunity in postoperative patients of general surgery, and to investigate the correlation between LUS and oxygenation index (PaO2/FiO2), acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), sequential organ failure assessment (SOFA), stay length in ICU and stay length in hospital. Methods A prospective double- blind cohort study was conducted. Eighty- nine postoperative patients of general surgery with successful extubation were selected, and the patients were divided into 2 groups:group A ( admission ICU to extubation time less than 48 h, 52 cases) and group B(admission ICU to extubation time more than 48 h, 37 cases). Before extubation, the PaO2/FiO2 was recorded according the blood gas analysis, and APACHE Ⅱ, SOFA and LUS were examined, and the staying time in ICU and staying time in hospital were recorded. The correlation was analyzed. Results The LUS, APACHE Ⅱ, SOFA, staying time in ICU and staying time in hospital in group A were significantly lower than those in group B: (3.98 ± 2.31) scores vs. (13.41 ± 2.82) scores, (7.52 ± 1.96) scores vs. (14.92 ± 3.07) scores, (4.50 ± 2.24) scores vs. (9.70 ± 3.64) scores, (1.77 ± 1.41) d vs. (8.49 ± 4.35) d and (8.49 ± 2.28) d vs. (15.63 ± 6.10) d, and the PaO2/FiO2 was significantly higher than that in group B:(441.57 ± 45.31) mmHg (1 mmHg=0.133 kPa) vs. (305.78 ± 90.72) mmHg, and there were statistical differences (P<0.01). The LUS had negative correlation with the PaO2/FiO2 (r=-0.882, P<0.01), and it had positive correlation with APACHEⅡ, SOFA, staying time in ICU and staying time in hospital (r=0.711, 0.590, 0.930 and 0.709;P<0.01). Conclusions The LUS is simple and easily available. It can evaluate the changes of pulmonary ventilation, and also evaluate its degree of severity and prognosis. It is helpful in the prediction of the extubation time, staying time in ICU and staying time in hospital in patients with general surgery.

Objective To investigate the effect of imaging parameters and postprocessing methods on the quality of MR imaging of short T2 components with 3D ultrashort TE (UTE) double echo pulse sequence. Methods 3D UTE double echo pulse sequence was performed on dry human femoral specimen and the tibial diaphyses, knee joints, and tendons of ankles of a group of healthy volunteers. To investigate the effect of different trajectory delays of the imaging system(-6, -3, -2, - 1,0, 1,2, 3 s), different flip angles(4°, 8°, 12°, 16°, 20°, 24°), different TEs (0. 08, 0. 16, 0. 24, 0. 35 ms)and different postprocessing methods(difference imaging of subtracted volume and non-volume UTE)on the 3D UTE MR imaging quality, the SNR and CNR were calculated and compared, and the artifacts of the images were analysed. Results The cortical bone, periosteum, tendon and meniscus showed high signal intensity on the images of UTE pulse sequence. The best SNR was acquired with 2 s trajectory delay. The best flip angle was 8° to 12° for the human UTE imaging in vivo. The highest CNR was obtained from the TE of 0. 08 ms. The longer the TE was, the more artifacts appeared. The SNR of difference imagewas improved when image subtraction was performed afer multiplanar reconstruction (MPR) of the primary double echo images.Conclusions The short T2 components show high signal intensity on the MRI of 3D UTE double echo pulse sequence. The imaging quality can be improved by shortening TE, using appropriate flip angle and performing subtraction for difference image after MPR of the primary double echo images.

Recent study demonstrated that insulin-like growth factor-1(IGF-1) could have benefits to improve the learning memory.Exercise can increase IGF-1 level in hippocampus.IGF-1 may mediate exercise inducing learning memory;one of the possible mechanism is that the IGF-1 and brain derived neurotrophic factor(BDNF) has a common regulatory capacity over calcium/calmodulin-dependent protein kinase Ⅱ(CAMKⅡ),mitogen-activated protein kinase Ⅱ(MAPKⅡ) and synapsin-1,and the convergence of multiple signaling pathways mediate synaptic plasticity and improve learning memory.

Objective To investigate the characteristics of health related quality of life(HR-QOL) in Chinese patients with early Parkinson' s disease(PD), to identify the motor and non-motor factors that are associated with a poorer quality of life in patients with early PD. Methods All 391 patients with early PD were identified in a clinical-based study. Motor functions were measured by Unified Parkinson' s Disease Rating Scale (UPDRS) and Hoehn-Yabr Scale. Non-motor variables were assessed by Center of Epidemiological Survey Depression Scale (CES-D) for depressive symptoms, Pittsburg Sleep Quality Index (PSQI) for sleep disturbance, Fatigue Severity Scale (FSS) for fatigue, Alzheimer' s Disease Assessment Scale-Cognitive Sections (ADAS-Cng) for cognitive function, and Constipation Severity Scale for constipation. HR-QOL was measured by SF-36. Motor and non-motor variables were collected at the baseline assessment of a clinical trial and determined during a structured interview and by clinical examination by movement disorder specialists. The results were compared with those in healthy elderly people. Multiple regression analyses were used to determine which variables were strongly associated with lower levels of quality of life. Results Patients with early PD had a lower score on all dimensions of SF-36, except bodily pain dimension. Motor factors, particular physical disability and disease severity, contributed to decreased HR-QOL, but to a lesser extent. The motor score of the UPDRS (23. 8±11.8), Hoehn-Yahr stage(2. 0± 0.7), together with the rigidity score (4.4 ± 3.1), only accounted for 18.9 % (R2=0. 189) of the variance of SF-36 total score. The variables that most strongly predicted a low total SF-36 score were non-motor factors, particularly depressive symptoms, sleep disorders and fatigue. When the CES-D, FSS, and PSQI score were included in the model, the R2 increased from 0. 189 to 0.617, indicating that 61.7% of the variance in HR-QOL could be explained if additional CES-D, FSS and PSQI scores were known. Depressive symptoms, as measured by CES-D, had an overwhelming impact on HR-QOL. When CES-D score was included, the R2 change was 0.433, which indicated that additional 43.3% of the variability in HR-QOL could be explained by adding depressive symptoms. Conclusions PD has a substantial impact on HR-QOL, even if in its early stage. Depressive symptoms, sleep disorders and fatigue correlated strongly with lower quality of life. Depressive symptoms appeared to be the strongest determinant of HR-QOL in early PD patients. Every effort should be made to recognize and treat these conditions, thus improving all aspects of PD and giving these patients as good a quality of life as possible.

A continuing professional development program was implemented in Shanghai Weifang Community Health Center for general practitioners (GPs) who completed residency training.The program consisted of four aspects: clinical ability, scientific research ability, teaching ability, and management ability.Clinical ability-building included the re-practice of specialty skills, expert mentoring in clinics, continuing education courses and clinic skills competitions.The scientific research ability was built from participating in research projects and talent cultivation programs.GPs were encouraged to be clinical mentors, and teaching ability was developed through attending teacher-training class and teaching practice.For those who were interested in management, the administrative positions related to medical, teaching and research would be provided.The implementation of the program received strong policy support from the health administrations at various levels.

Objective To apply the optical coherence tomography(OCT) to detect the characteristics of coronary artery plaque and to investigate its correlation with levels of serum matrix metalloproteinase 7(MMP 7),MMP9 and MMP12.Methods The patients undergoing coronary arterial angiography for diagnosing coronary arterial lesions in the cardiology department of our hospital from October 2014 to March 2016 were collected and included into the research subjects.The subjects were divided into the stable plaque group and unstable plaque group based on the results of OCT scanning.The neovascularization characteristics such as the fibrous cap thickness of plaque,angle of lipid pool,macrophage infiltration and plaque cracks were detected by using OCT.ELISA was used to measure serum MMP7,MMP9 and MMP12 levels.Results (1) The fibrous cap thickness in the stable plaque group was more than that in the unstable plaque group(P＜0.01);the lipid pool angle,microphage infiltration,intima erosion and plaque cracks in the unstable plaque group were more than those in the stable plaque group(P＜0.05).(2) The MMP7 and MMP9 levels in the unstable plaque group were higher than those in the stable plaque group and control group(P＜0.05).(3) The fibrous cap thickness had significantly negative correlation with serum MMP9 level(r=-0.336,P=0.034);the MMP7 and MMP9 levels in the microphage infiltration group were higher than those in the non-microphage infiltration group(P＜0.05);the MMP9 level in the intima erosion group was higher than that in the non-intima erosion group(P＜0.01).Conclusion OCT can detect and find unstable plaque and the serum levels of MMP7 and MMP9 are significantly elevated in the patients with unstable plaque,which can be used as an important basis for predicting unstable plaque and guiding the treatment decisions.

Objective To evaluate the effect of the single energy metal artifact reduction (SEMAR) algorithm with a 320 multi-slice computed tomography (MSCT) volume scanner in patients with knee tumor prostheses.Methods From November 2015 to March 2016,23 consecutive patients with knee tumor prostheses who underwent a 320-MSCT scan were collected.And the raw data were reconstructed using two different methods:conventional iterative reconstruction (IR) alone and IR associated with SEMAR.The ROI were objectively and subjectively assessed at osteotomy level and articular level,and the Wilcoxon signed rank test was used for them.Results Compared with IR,objectively,artifact index (AI) values of the osteotomy level decreased 44.8％ to 74.1％ and that of the articular level decreased 73.2％ to 93.2％;subjectively,the scores of image quality of two levels were increased 0.5 to 2.0 scores and 1.0 to 4.0 scores by SEMAR respectively.The objective and subject image quality of periprosthetic structures were all significantly improved by the SEMAR algorithm (P＜0.05).Conclusion The SEMAR algorithm significantly reduced the metal artifact of knee tumor prostheses,improved the image quality of periprosthetic structures and may increase diagnostic confidence of prosthetic complications in patients with modular knee tumor prostheses,especially at the osteotomy level.

Objective To evaluate the relationship between the blood flow values generated from MR arterial spin labeling (ASL) perfusion imaging and pathologic indicators of angiogenesis including microvascular density (MVD) counts and vascular endothelial growth factor (VEGF) expression levels of VX2 carcinoma in rabbit soft tissue. Methods VX2 tumor was inoculated in the muscular tissue of right posterior limbs of 18 healthy New Zealand white rabbits ,on which arterial spin labeling perfusion imaging was performed by using flow sensitive alternating inversion recovery pulse sequence 3 to 4 weeks later. Arterial spin labeling images were transferred to an independent computer for post-processing and blood flow (BF) maps were generated from them. BF values were measured in 2-4 regions of interest (ROIs) for each tumor. The rabbits were sacrificed after MR imaging. The gross specimens of tumors were obtained and tumor tissues were taken from the non-necrotic regions corresponding to ROIs on BF maps. Immunohistochemical staining of the specimens was performed by using CD31 monoclonal antibody to calculate MVD counts, using VEGF antibody to calculate VEGF expression levels. Correlation between BF values and MVD counts as well as between BF values and VEGF expression levels was evaluated using Spearman correlative analysis.Results On BF maps, viable tumor tissues showed high BF values compared with muscle, but there were areas without blood perfusion in some tumors. Under microscope, the microvessels positively stained by CD31 appeared as light brown areas, and the cells positively staied by VEGF showed reddish brown areas within their cytoplasm. Totally 39 pieces of VX2 tumor tissue were analyzeed There was a significant positive correlation between the BF values(M =6. 4 ml · 100 g-1 · min-1 ) and MVD counts(M =6. 8) (r = 0. 906,P ＜ 0. 01 ), and no significant correlation between BF values and VEGF expression levels ( M = 8％ ) ( r =0. 116, P=0.483). Conclusion BF value can be used in evaluating angiogenesis of soft tissue tumor through its reflection of MVD counts, and thus may be helpful in evaluating the prognosis of soft tissue tumor and making plan for their treatment.

This article was aimed to study the effect of geniposide in hyperuricemia mice. Different doses (50, 100, 200 mg·kg-1) of geniposide were administrated to hyperuricemia mice induced by potassium oxonate by gavage for seven consecutive days. Then, serum uric acid (SUA), urinary uric acid (UUA) and the hepatic xanthine oxidase ac-tivities (XOD) of mice were detected. The results showed that the middle- and high-dose groups of geniposide re-duced the level of SUA significantly (P<0.01). It was concluded that geniposide can reduce the level of SUA in hy-peruricemia mice by promoting UUA excretion.