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: To investigate the health-seeking delay in tuberculosis among school students in Yining City, Xinjiang Uygur Autonomous Region from 2009 to 2020, and analyze the influencing factors, so as to provide the evidence for reducing the health-seeking delay in tuberculosis among students in Yining City. Methods: The demographic features and diagnosis of students with tuberculosis in Yining City from 2009 to 2020 were retrieved from the Tuberculosis Management Information System of the Chinese Disease Control and Prevention Information System, and the factors affecting the health-seeking delay in tuberculosis were identified using the multivariable logistic regression analysis. Results: A total of 443 students with tuberculosis were reported in Yining City from 2009 to 2020, including 209 boys and 234 girls, with a male/female ratio of 1∶1.12. There were 29 primary school students ( 6.55% ), 81 junior high school students ( 18.28% ), 187 high school students ( 42.21% ) and 146 college students ( 32.96% ) reporting tuberculosis, and 394 cases ( 88.94% ) had locally registered residence. There were 287 students with health-seeking delay in tuberculosis ( 64.79% ), and the median duration of health-seeking delay was 35 ( interquartile range, 33 ) days. Multivariable logistic regression analysis showed that registered residence ( local, OR=1.899, 95%CI: 1.004-3.591 ) and origin of tuberculosis patients ( clinical consultation, OR=3.448, 95%CI: 1.755-6.775; recommendation for symptoms, OR=3.215, 95%CI: 1.161-8.900; tracking, OR=2.415, 95%CI: 1.269-4.596 ) and diagnostic results ( positive sputum smears, OR=3.081, 95%CI: 1.710-5.551 ) statistically correlated with health-seeking delay among students with tuberculosis. Conclusions The proportion of health-seeking delay in tuberculosis was high among students in Yining City from 2009 to 2020; registered residence, origin of tuberculosis patients and diagnostic results were associated.

Objective To study the clinical features of the variants of benign childhood epilepsy with central temporal spikes (BECT).Methods The clinical data of 12 hospitalized pediatric patients with BECT from Jan 2007 to Jan 2014 were retrospectively reviewed. Results There were 7 boys and 5 girls in 12 patients. The age of onset was from 3 to 9 years old. Two cases were dizygotic twins. The atypical symptoms included atypical absence of 10 cases, negative myoclonic seizure of 8 cases, speech expression disorders and oral-pharynx apraxia of 4 cases. The electroencephalography (EEG) of all 12 patients showed abundance of spike and waves (SW) in rolandic areas during wake-up and sleep. The SW index was 50%-85% during slow sleep in all patients.Conclusions The variants of BECT are often associated with EEG deterioration. Understanding the clinical featuress and EEG characteristics can help the diagnosis of BECT variants.

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.

Objective To analyze the potential etiologies and risk factors of childhood stroke. Methods This study retrospectively reviewed the clinical data of 159 children who were admitted from Jan.2006 to Jan.2014. Results The 159 children were composed of 100 boys and 59 girls , with median onset age of 1.8 years (ranged from 1 day to 12 years old) and median peak age of 0.9 years (ranged from 3 months to 2.8 years old). Their initial symptoms included limb hemiplegia,language dififculties and convulsion. The common causes included infections found in 46 cases (central nervous system infection in 32 cases, respiratory and gastrointestinal tract infection in 14 case), head injury in 42 cases, vitamin K deifciency in 29 cases, Moyamoya disease in 8 cases, heart diseases in 11 cases, spontaneous hemorrhage in 11 cases and 12 cases of unknown reason. Infectious diseases were the most common cause of children acute ischemic stroke in toddler period;and vitamin K1 deifciency were the most common cause of children hemorrhage stroke in infancy. The most common region of infarction is basal ganglia and middle cerebral artery in neuronal imaging. The median age at the time of diagnosis was 1.4 days. The median time of inhospital was 28 days. The median apex time was 4.3 days. Conclusions Among 159 cases, acute ischemic stroke is much more common than hemorrhagic stroke in children stroke, and the major risk factors are infections and head injury;Vitamin K1 deifciency is a major risk factor in infants with hemorrhagic stroke.