Objective: To detect the expression of fragile histidine triad (FHIT) protein and aberrant methylation of its gene in lung carcinoma tissue and discuss their significance in tumorigenesis of lung cancer. Methods: The expression of FHIT protein was determined by immunohistochemical SP staining and its aberrant methylation was detected by methylation-specific PCR (MSP) in lung cancer and adjacent lung tissues (n = 60). The sequencing of the amplified products of MSP was performed. The 60 patients were followed up. Results: The expression of FHIT protein in adjacent lung tissues was obviously higher than that in lung cancer tissues. There was significant difference between them (76.7% vs 50%, P < 0.05). The aberrant methylation of FHIT gene was significantly higher in lung cancer tissues than that in adjacent lung tissues (68.3% vs 35.0%, P <0.001). And the aberrant methylation of FHIT gene occurred frequently in FHIT-negative patients compared with FHIT-positive patients (83.3% vs 53.5%, P <0. 05). The expression of FHIT protein and the aberrant methylation of FHIT gene had no correlation with clinicopathological parameters (age, sex, smoking status, histological type, general classification, TNM staging, and lymph node metastasis) in the patients with lung cancer (P > 0.05). The survival time was longer in FHIT-positive patients than FHIT-negative patients (P <0.05). The FHIT protein was the risk factor associated with the disease-free survival time of patients (P <0.01). Conclusion: The aberrant methylation of FHIT gene occurrs frequently and the expression of FHIT protein is significantly down-regulated in lung cancer. FHIT may play an important role in the tumorigenesis and development of lung cancer. FHIT protein could be used as an important factor for predicting the prognosis of patients.

Objective: To investigate the expression of fragile histidine triad (FHIT) protein in lung carcinoma tissues and its relationship with multidrug resistance protein 1 (MDR1), and to discuss the clinical significance of the changes of FHIT expression. Methods: The expression of FHIT protein was detected in the lung cancerous tissues and the adjacent tissues (n = 60) using S-P staining method. The expression of MDR1 in lung carcinoma tissues was also detected. The expression of FHIT was analyzed in lung cancerous tissues with different clinicopathological parameters and its relationship with MDR1 was analyzed at the same time. Results: The expression of FHIT protein in the adjacent tissues was obviously higher than that in the lung cancerous tissues(76.7% vs 50%, P<0.01). No correlation was found between FHIT expression and the age, sex, smoking, general type, TNM staging, histological type, and lymph node metastasis in the patients with lung cancer. The expression of MDR1 protein in lung cancerous tissues positive for FHIT was obviously higher than those negative for FHIT(83.3% vs 60%, P<0.01). Conclusion: The expression of FHIT protein in lung cancer is evidently down regulated and is correlated with the expression of MDR1. Potential multiple drug resistance should be considered in FHIT gene therapy.

Objective To investigate the relation between positive fluid balance and the prognosis in severe sepsis patients with acute kidney injury (AKI).Methods A retrospective analysis of clinical data of 90 patients in our department was carried out.According to the final outcome,patients were divided into survival group (n =26) and non-survival group (n =64),in which the relation between patients' positive fluid balance and the prognosis was evaluated.Results (1) There was no statistically significant difference in the age and severity between survival group and non-survival group of patients with severe sepsis and consequent AKI,but the patients in non-survival group had greater volume overload.Compared with the survival group,higher mean fluid balance [(1 112.12±546.85) mLvs.(644.69±474.93) mL,P=0.00],and less urine output [(1 224.07 ± 708.79) mL vs.(2 032.36 ± 723.53) mL,P =0.00) in non-survival group.(2) There was no significant difference in mortality between early and late continuous renal replacement therapy (CRRT) during ICU care.However,the average daily fluid load in late CRRT patients was significantly greater than that in early CRRT patients [(1178.81 ±397.03) mLvs.(287.22 ± ± 433.53) mL,P =0.00] and the lung oxygenation index in late CRRT patients was significantly worse thanthat in early CRRT patients [(211.22±42.56) vs.(169.46±57.40),P=0.04] (3) The relevant variables to 28-day mortality in AKI patients with severe sepsis included CRRT treatment,oxygenation index and the average daily fluid balance ＞ 500 mL.Among them,fluid balance ＞ 500mL was an independent risk factor for AKI patients with severe sepsis.Their prognosis was worse if they had greater positive fluid balance.CRRT was the protective factor which could affect the prognosis of patients with severe sepsis complicated by AKI.Conclusions Patients with severe sepsis complicated by AKI has a high mortality.Persistent fluid overload can lead to increased mortality in patients with severe sepsis complicated by AKI.Early CRRT can reduce fluid retention in patients with renal failure and improve oxygenation index.

Objective To compare the diagnostic value of sound velocity(SV) and real-time ultrasonic elastography in differentiating benign or malignant of breast lesions.Methods 75 patients with 99 lesions were examined with the zone speed index technique and real-time ultrasonic elastography respectively.Then the SVs of the lesions were calculated and elastography of the lesions were scored with 5-scoring method.The ROC curves were constructed with histology as the golden standard.Results There was significant difference between the SVs of benign and malignant breast lesions(P =0.0001).1561 m/s was the best cufoff point.And the areas under the curves (AUC) of SV and real-time ultrasonic elastography were 0.842 and 0.968,respectively.There was significant difference between the two methods of AUC (P =0.023).The sensitivity,specificity and accuracy for SV were 81.5％,91.7％,88.9％,respectively.There was no significant difference between sensitivity,specificity and accuracy of the two methods(P =1.0,P =0.125,P =0.146).Conclusions Both SV method and real-time ultrasonic elastography are helpful in the evaluation of benign or malignant of breast lesions.

Objective To explore the application of contrast-enhanced scoring system in the diagnosis of breast tumor.Methods 249 patients with 260 lesions were examined by elastography and contrastenhanced ultrasound before surgery.All the lesions were scored according to the two different methods.Pathological results were made the golden criteria.The diagnosis accuracy of the two methods were compared.Results There were 145 benign and 115 malignant tumors.The diagnosis accuracy,specificity and sensibility of elastography were 85.0％,88.3％,80.1 ％ respectively.The critical value of contrastenhanced ultrasound was between 3 and 4.The diagnosis accuracy,specificity and sensibility of contrastenhanced ultrasound were 88.9％,87.6％,90.4％ respectively.Area under ROC curve of the two methods were 0.901 and 0.910,the difference was not statistically significant.Conclusions Contrast-enhanced ultrasound 5-point scoring system was an initial quantitative criterion for breast tumor diagnosis.The diagnosis accuracy was parallel to that of elastography.

BACKGROUND: It has been proved that interleukin-18 (IL-18) involves in the development of acute cerebral infarction (ACI) and is positively correlated with the time of brain stroke onset, erythrocyte sedimentation rate (ESR), as well as neurological deficit and low-density value of brain CT.OBJECTIVE: To investigate the dynamic changes of serum IL-18 in the course of ACI.DESIGN: Verification analysis with patients as subjects and healthy volunteers as controls.SETTING: Department of neurology of a municipal hospital.PARTICIPANTS: Totally 46 inpatients (29 males and 17 females) with ACI were randomly selected from the Department of Neurology of People's Hospital, Maoming City, between December 2002 and January 2004.Meanwhile, 40 healthy controls (27 males and 13 females) were recruited from those who came to the hospital for routine physical examination. All the participants signed informed consent.METHODS: Fasting peripheral vein blood of 2 mL was collected from the patients on the 1st, 7rh, 14th and 21st days of ACI onset, and from healthy controls on the day of routine examination. The blood samples were centrifuged at 3 000 r/minute for 15 minutes at 4 ℃, and then the supernatant was collected for detecting IL-18 level by ELISA.MAIN OUTCOME MEASURES: The serum IL-18 level of patients on the 1st, 7th 14th and 21st days of ACI onset and that of healthy controls on the day of routine examination.RFSULTS: Totally 46 patients and 40 healthy controls were enrolled in this study and all data were statistically analyzed. The level of serum IL-18 was significantly higher in the patients with ACI than in normal controls on the 1st and 7th days of onset [(178±41) ng/L, (104±34) ng/L, (65±14) ng/L, P ＜ 0.01],but was similar on the 14th and 21st days [(88±36) ng/L, (72±33) ng/L,(65±14) ng/L, P＞ 0.05]. The level of serum IL-18 in ACI patients was significantly higher on the 1st day than on the 7th, 14th and 21 st days of the onset (P ＜ 0.05-0.01); moreover, it was also significantly higher on the 7th day than on the 21st day of the onset (P ＜ 0.05).CONCLUSION: The level of IL-18 increases obviously on the 1st day of ACI onset, and gradually decreases with the extended course of disease and time of treatment.

Objective To explore the value of improved elasticity scores in differentiating malignant and benign breast lesions. Methods A prospective study was done in 394 patients with 508 breast lesions confirmed by pathology and the elastographic images of the lesions were evaluated by using old and improved elasticity scores respectively. Results The elastographic images of the lesions could be evaluated and classified in all patients by improved elasticity scores but could not be evaluated and classified in 82 lesions by old elasticity scores. The accuracy of ultrasonic elastography for diagnosing benign and malignant breast lesions was 88.8% and 78.1%, respectively by old elasticity scores and improved elasticity scores. Conclusions The elastographic images of breast lesions were accurately evaluated by using improved elasticity scores, and the use of improved elasticity scores is helpful to reduce the biopsy which is not necessary.

Objective To evaluate the application of the binary Logistic regression model to analyze ultrasonographie indexes of the solid breast tumors. Methods The indexes of two dimensional gray scale ultrasonography,two dimensional color Doppler flow imaging,three dimensional gray scale ultrasonography, three dimensional color Doppler flow imaging and ultrasonic elastography were evaluated in 151 breast lesions confirmed by surgical pathology. A Logistic regression model for predicting breast rnalignaney on the basis of ultrasonographic indexes was obtained. A receiver operating characteristic (ROC) curve was used to assess the performance of the Logistic regression model. Results Six ultrasonic indexes were finally entering the Logistic regression model. They were elasticity score, shape,internal echo, RI, enhancement of posterior acoustic alteration and the converging pattern in the coronal plane. The area under the ROC curve was 0. 996. The percentage correct of prediction was 97.35 %. Conclusions The multivariate analysis model of binary Logistic regression can describe and analyze the process of differential diagnosis of malignant and benign solid breast tumors by ultrasonography and can select out the valuable indexes of differential diagnosis.

Objective To analyze the value of color Doppler ultrasound in the diagnosis of lower extremity arterial disease in patients with type 2 diabetes mellitus.Methods A total of 800 patients with type 2 diabetes mellitus underwent color Doppler ultrasonography to examine anterior tibial artery (ATA),dorsalis pedis artery (DPA) and posterior tibial artery (PTA).Ultrasonic findings including vascular diameter,stenosis ratio and hemodynamics of lower extremity arterial disease were analyzed retrospectively.Results ATA and DPA had more plaques and stenosis than PTA.There was no statistical difference of vascular diameter,stenosis ratio and hemodynamics between left and right lower extremity artery in patients with type 2 diabetes mellitus including diabetic foot.Conclusion Color Doppler ultrasound is a useful method in the diagnosis of lower extremity arterial disease in patients with type 2 diabetes mellitus,providing information of stenosis ratio and hemodynamics of lower extremity artery,so as contributing to the clinical therapy of this disease.

Aim To evaluate the effect and mechanism of vascular endothelial growth factor(VEGF) and Cysteine protease aspartic acid-3(Caspase-3) inhibition of human hepatocellular carcinoma(HCC)implants in nude mice by nanometer magnetic interferon-?2b liposome targeting therapy.Methods Thirty nude mices bearing human HCC were divided into 5 groups of 6 mice:group 1,saline(NS);group 2,free interferon-?2b group(IFN);group 3,interfe-ron-?2b liposome group(IL);group 4,magnetic liposome group(ML);group 5,nanometer magnetic interferon-?2b liposome group(MIL).Above dosage of 200 ?l/nude mice was respectively injected through the caudal vein in these 6 groups.Meantime,magnetic field with the strength of 5000 GS was added to the tumor surface about 30 min,and this therapy was done three times.After 30 days,the mices were killed and the tumors were taken out.The difference at the mRNA expression level of VEGF and Caspase-3 was observed by RT-PCR between the experimental group and control group.The protein expression level of VEGF and Caspase-3 was detected by western blot between the experimental group and control group.Results Targeting therapy study in nude mice bearing human HCC displayed that the growth speed of tumor in the MIL group significantly slowed down than other groups.The tumor inhibition rate of MIL group was 62.50%,which was remarkably higher than those of the IFN group(27.61%) and IL group(28.17%).RT-PCR showed that the mRNA expression of VEGF of MIL group is the lowest of all groups(P