Objective To study the expression and clinicopathological significance of Paxillin and CAⅨ in the benign and malignant lesions of gallbladder.Methods The surgical resected specimens of 108 cases of gallbladder adenocarcinoma, 46 cases of peritumoral tissue, 15 cases of adenomatous polyp and 35 cases of chronic cholecystitis were routinely made paraffin embedded sections.The expressions of Paxillin and CAⅨ were stained with Envision immunohistochemistry.Results The positive rates of Paxillin and CAⅨ expression was significantly higher in gallbladder adenocarcinoma (60.2% and 49.1%) than those in peritumoral tissues (26.1%, x2 =15.00, P ＜0.01 and 23.9%,x2=8.41,P ＜0.01), adenomatous polyp (20.0%,x2=8.60,P＜0.01 and 20.0%,x2 =4.49,P＜0.05) and chronic cholecystitis(14.3% ,x2 =22.89, P＜0.01 and 11.4%,x2 =15.63,P ＜0.01).All the gallbladder epithelia of the benign cases with Paxillin and CA Ⅸ positive expression showed moderate to severe atypical hyperplasia.The positive expression rates of Paxillin and CA Ⅸ were significanctly lower in the cases of well-differentiated, maximal diameter of mass less than 2 cm, no lymph nodes metastasis and no surrounding tissues invasion than those of the cases with poorly differentiated, maximal diameter of mass over 2 cm, lymph nodes metastasis and surrounding tissues invasion.With Kaplan-Meier analysis, it suggested that the survival period after the surgery in Paxillin and CAⅨ positive expression cases was shorter than that of negative expression cases (x2 = 5.65,P＜0.05,5.65=5.92, P＜0.01).With multivariate Cox regression analysis, it indicated that both Paxillin and CAⅨ positive expression was an important indicator of the poor prognosis in gallbladder adenocarcinoma.Conclusion The expression of Paxillin and CA Ⅸ may be closely related to the carcinogenesis, tumor biological behaviors, and prognosis of gallbladder adenocarcinoma.The positive expression of Paxillin and/or CAⅨ is associated with poor prognosis.

AIM: To evaluate the clinical effect and the rotational stability of AcrySof Toric intraocular lens ( IOL ) implantation to correct preexisting corneal astigmatism in cataract surgery.
METHODS: Twenty-three patients ( 28 eyes ) were enrolled from the department of ophthalmology in the first Affiliated Hospital of Nanjing Medical University. All patients underwent similar phacoemulsification procedure combined with AcrySof Toric IOL implantation from June 2012 to December 2013. The uncorrected visual acuity ( UCVA ) , best corrected visual acuity ( BCVA ) , anticipated residual astigmatism, postoperative residual astigmatism, and Toric IOL axis were detected and measured.
RESULTS:Three months after operation, the UCVA of all eyes were 0. 75±0. 16 and the BCVA were 0. 84±0. 15, there was no significant difference between UCVA and BCVA ( t = 1. 036, P>0. 05 ). The anticipated residual astigmatism was ( 0. 28±0. 12 ) D. The actual residual astigmatism after 3mo of the operation was (0. 42±0. 17) D. There was no significant difference between anticipated and actual residual astigmatism (t=1. 259, P>0. 05). The mean axis rotation of Toric IOL was 3. 02o±1.56o (0o-7o) after 1d of operation and 3. 28o±1. 85o (0o-7o) after 3mo. Among all the eyes, 25 eyes ( 89%) rotated <5o, in 3 eyes (11%) rotated 5o-7o.
CONCLUSION: The AcrySof Toric IOL implantation shows good effectiveness, predictability and stability in correcting pre-existing astigmatism in cataract patients.

Family resilience explores the positive resources of a family under adversity. This paper expounded the origin, concept, related factors, framework and implications of family resilience, especially the family resilience in families with a cancer patient.

ObjectiveTo study the expression of ABCG2, SFRP2, BRMS1 and HPA and detect their clinicopathologicalsignificancesinthebenignandmalignatntlesionsofthegallbladder.MethodsEnVisiom immunohistochemical method for determining the expressions of ABCG2, SFRP2,BRMS1 and HPA was used in paraffin-embedded sections of surgical resected specimens from gallbladder adenocarcinoma (n =108), peritumoral tissues (n =46 ), adenomatous polyp (n =15 ), and chronic cholecystitis ( n =35 ).ResultsThe positive rates of ABCG2 and HPA expression were significantly higher in gallbladder adenocarcinoma than that in peritumoral tissues, adenomatous polyp and chronic cholecystitis (P ＜ 0. 05 or P ＜ 0. 01 ) ; The positive rates of SFRP2 and BRMS1 expression were significantly lower in gallbladder adenocarcinoma than that in peritumoral tissues, adenomatous polyp and chronic cholecystitis(P ＜0. 05 or P ＜0. 01 ). The positive cases of ABCG2 and/or HPA as well as negative ones of SFRP2 and/or BRMS1in the benign lesions showed moderately-or severely-atypical hyperplasia of gallbladder epithelium. The frequency of samples with positive staining for ABCG2 and/or HPA in cases with small tumor volume (diameter ＜ 2 cm), no lymph node metastasis, and no invasion into surrounding tissues was significantly lower than that in cases with larger tumor volume (diameter＞ 2 cm ), lymph node metastasis, and invasion into surrounding tissues ( P ＜ 0.05 or P ＜ 0. 01 ). However, compared with ABCG2 and/or HPA, the expression of SFRP2 and/or BRMS1 showed an opposite correlation in these cases ( P ＜ 0. 05 or P ＜0. 01 ). Unitivariate Kaplan-Meier analysis showed that increased expressions of ABCG2 (P =0. 019) and HPA ( P =0. 016) or decreased expression of SFRP2 ( P =0. 019) and BRMS1 ( P =0. 008 )were associated with poorer overall survival, respectively. Multivariate Cox regression analysis showed that increased expression of ABCG2 (P =0. 018 ) and HPA ( P =0. 019) and/or decreased expression of SFRP2 (P =0. 015 ) and BRMS1 ( P =0. 011 ) were independently poor-prognostic predictors in gallbladder adenocarcinoma.ConclusionsThe expression of ABCG2, SFRP2, BRMS1 or HPA might be closely related to the carcinogenesis, clinical biological behaviors, and prognosis of gallbladder adenocarcinoma.

Objective The study was conducted to investigate the acute phase of convulsion related problem on the clinical manifestations,imaging and electroencephalograph (EEG) examination of purulent meningitis.Methods Cluster sampling method was employed to select children in our hospital,a total of 301 cases with purulent meningitis was analyzed retrospectively.Among them,62 cases had convulsion.The incidence of convulsion in the acute phase of the purulent meningitis,risk factors,and prognosis were analyzed.Results The convulsion incidence rate of acute purulent meningitis was 20.60％.The partial seizure was eight cases (12.90％).The secondarily generalized seizure following partial seizure was 15 cases (24.19％).The generalized seizure was 32 cases (51.61％).The convulsive status was 7 cases (11.29％).The EEG abnormality was significantly different between the convulsion group and the no convulsion group (P ＜ 0.05).The incidence of brain organic damage was significantly different between two groups (P ＜0.05).The multivariate unconditional logistic regression analysis showed,cause of disease,first symptom,disturbance of consciousness,obvious signs,and cerebrospinal fluid culture with convulsion were the relevant factors (P ＜ 0.01).Conclusions The most common seizure of purulent meningitis was the generalized seizure.Brain organic damage easily resulted in convulsion of purulent meningitis.The days of hospitalization,cause of disease,first symptom,disturbance of consciousness,obvious signs,and cerebrospinal fluid culture with convulsion were the positively relevant factors.Those positively relevant factors in combination of the clinical manifestations,imaging,and EEG examination in children would play an important role in diagnosis,treatment,and prognosis evaluation of convulsion derived from purulent meningitis.Moreover,convulsion affects the disease recovery in children with purulent meningitis.

Objective To investigate the interseed dose attenuation for multiple 125I seeds.Methods Monte Carlo simulation was done by Geant 4 to investigate the dose distribution of single seed and multiple seeds.The results were compared with the dose calculation method from TG43-U1 and examined by experiments.Results The difference of single seed dose distribution between Monte Carlo method and line source model was ± 3％.The difference between Monte Carlo method and experiment result was ± 5％.The interseed dose attenuation of multiple seeds at the interesting points was 3.8％ to 13.2％ and the average interseed dose attenuation was 7.2％.The difference of experiment result and Monte Carlo result was less than 6％.Conclusions The interseed attenuation is about 7％ and the maximum value may be larger than 13％ for multiple seeds.The interseed dose attenuation may be larger in tissue.So it is not accurate to calculate the dose distribution by using TG43-U1.

Objective To evaluate the renal cortical blood perfusion changes in rabbits with acute renal failure (ARF) with gray scale contrast-enhanced ultrasound, and to explore the relationship between these changes and the blood creatinine (SCr), as well as the blood urea nitrogen (BUN). Methods Rabbit ARF models were established with 50% glycerin injected into the rabbits' thighs. Gray scale contrast-enhanced ultrasound was performed on the day before injection (T_0) and 1, 4, 8, 12 days (T_1, T_4, T_8, T_(12)) after injection. The renal cortex perfusion time-intensity curve (TIC) was analyzed, including parameters like arrival time (AT), time to peak intensity (TTP), amplitude of peak intensity (A) and slope rate of TIC (β) of renal cortex. Meanwhile the SCr and BUN were measured, the correlation between SCr, BUN and parameters were analyzed. Results Compared with the value of T_0, the value of TTP, A, β after injection (T_1, T_4, T_8) were statistically different, respectively (P<0.05), but the differences among T_1, T_4 and T_8 were various. No linear correlation between above parameters and SCr, BUN was found. Conclusion The renal cortical blood perfusion changes can be early observed with gray scale contrast-enhanced ultrasound, but there is no linear correlation between the changes of parameters and SCr, BUN.

Objective To assess the application of contrast-enhanced ultrasound (CEUS) in evaluation of the renal cortical and medullary perfusion changes before and after acute renal failure (ARF) in rabbits. Methods Rabbit ARF models were established with intramuscular 50% glycerin (12-15 ml/kg) injection into rabbits' thighs. One day before and after ARF models establishment, CEUS was performed on each rabbit. The renal perfusion time-intensity curve (TIC) was analyzed, including parameters like AT (arrival time), TTP (time to peak intensity), A (amplitude of peak intensity), AUC (area under the curve), β (slope rate of TIC) of renal cortex and medulla. Results The value of A and β before model establishment was (17.36±13.73) dB and (5.38±2.08) dB/s, respectively, both was significantly higher than those after glycerin injection ([6.59±4.25] dB and [1.58±1.41] dB/s, respectively) (P<0.05). The value of TTP and AUC before model establishment was (2.46±1.76) s and (329.31±171.70) dBs, both was significantly lower than those after injection ([5.93±4.80] s and [722.28±354.14] dBs, respectively) (P<0.05). No significant difference was found in AT of renal cortex and AT, A, TTP, AUC, β of renal medulla, nor in SCr or BUN. Conclusion CEUS can display the changes of perfusion image of the renal cortex of the ARF earlier than SCr and BUN.