Objective To prevent the medical personnel from infection during aeromedical evacuation of fulminating respiratory infectious disease patients by exploring the changes of differential pressure between those in and out of the negative-pressure isolation capsule and analyzing the stability of the capsule during aeromedical evacuation.Methods A differential pressure monitor developed by Institute of Medical Equipment was used for real-time recording of the changes the differential pressure in and out of the capsule during five flight phases of the aircraft,and the safety of the capsule during aeromedical evacuation and corresponding considerations were investigated.Results The maximum and minimum values of the negative pressure in the capsule were-60 Pa and-120 Pa respectively during aeromedical evacuation,which were all less than the safety threshold-15 Pa.The negative pressure was is directly proportional to the flying altitude.Conclusion The capsule keeps negative pressure effectively during flight,and thus facilitates patient aeromedial evacuation greatly.

Objective:To observe the influence of parenteral nutrition support on nutritional status and immune function in patients with neoadjuvant chemotherapy for gastric cancer.Methods:60 patients with locally advanced gastric cancer were randomly divided into PN group and control group,30 cases in each group.The nutritional status and immune function were compared.Results:Adverse reaction of chemotherapy in PN group was less than in control group (P ＜ 0.05).ALB,TF.PA and IgA,IgG,IgM,CD4+ and CD4+/CD8+ were all higher in PN group than in control group 7 days after surgery (P ＜ 0.05).Conclusion:Parenteral nutrition support is helpful to improve patients' nutritional state during chemotherapy and operation.

Objective The purpose of this study is to investigate the expression of human epidermal growth factor receptor-2(HER-2)in gastric carcinoma tissue and normal gastric tissue of these patients,and its relationship with the clinical pathological characteristic,the microvessel density( MVD) and early post-operative recurrence,and to analyze the clinical significance of expression of HER-2 in gastric carcinoma,in order to lay the theoretical foundation of effective therapy for gastric carcinoma.Methods The clinical data of 398 cases of gastric cancer and 363 cases of their adjacent non tumorous gastric tissue of Liaoning Cancer Hospital from March 2012 to July 2013 were analyzed retrospectively.The expression of HER-2 gene was detected by IHC method and Fish method.The expressive rate of HER-2 in gastric carcinoma tissue and normal gastric tissue of these pa-tients were compared,and its relationship with the clinical pathological characteristic,MVD and early post opera-tive recurrence were also analyzed.Results (1)Expressive rate of HER-2 in 398 cases of gastric cancer tissue was 14.07%(56/398),which was higher than that in all the adjacent non tumorous gastric tissue presented none expression 0(0/363)(P<0.05);(2)In gastric cancer tissue of 398,the expression of HER-2 was related with Lauren type,tumor site,vessel invasion status,TNM stage,lymph node metastases(P<0.05),and it had no cor-relation with age,sex,tumor size,histological differentiation degree,growth patterns of cancer(P>0.05).Expres-sive rate of HER-2 in T4 stage was higher than( T1 +T2 +T3 ) stage,but the difference was not statistically sig-nificant( P>0.05).(3)The value of MVD in HER-2 expressive group(58.63 ±19.97)was significantly higher than those in HER-2 non expressive group(49.04 ±19.25).A positive significant correlation was found be-tween HER-2 and MVD expression using the rank correlation matrix(P<0.001,r=4.33).(4)1 year and 1.5 year of early post operative recurrence rate in HER-2 expressive group were 16.00%、38.00%,in HER-2 non expressive group were 8.81%,25.53%,the difference was not statistically significant(P>0.05).Conclusion There is excessive expression of HER -2 in gastric cancer tissue,excessive expression of HER -2 patients withgastric cancer is correlated with Lauren type,tumor location,vessel invasion status,TNM stage,lymph node metastases;it displays no correlation with age,sex,tumor size,histological differentiation degree,growth patterns ofcancer.HER -2 expression is positively associated with MVD value.Excessive expression of HER -2 is possibleto be correlative with early post operative recurrence,and it must have further follow up to confirm.

Objective To analyze the correlation between the positive rate of autoantibody and hepatitis C virus load and the relationship between the positive incidence and the status of liver function in patients infected HCV.Methods 168 patients infected hepatitis C virus were included,to detect serum autoantibody,HCV loads and liver function file.And 129 healthy controls were collected to test the serum autoantibody.Using the Chi-square test to analyze the count data,and performing student test or Nonparametric test to study measurement data,compared the positive rate of autoantibody in patients with HCV and that in healthy controls.Analyzed the correlation among the positive incidence of autoantibody,HCV load and the status of liver function in patients infected HCV,and studied the relationship of the positive rate of autoantibody with age and also with gender of the patients.Results The positive rate of autoantibody in patients with HCV was 35.12%(59/168),in which ANA accounted for 33.93%,SMA took up 2.98%,AMA-M2 made up 1.80% and anti-LKM1 1.20%.No patient existed LC-1 or SLA/LP in his/her serum.The total positive rate of autoantibody and ANA both were higher in pa-tients than in healthy controls (χ2=23.179,P=0.000;χ2=21.360,P=0.000).There existed no significant difference in the levels of HCV load,total bilirubin (TBil),ALT and AST between the patients whose autoantibody examinations were positive and those who were negative in autoantibody test (χ2=0.113,P=0.945;Z=-1.087,P=0.277;Z=-1.356,P=0.175;Z=-0.153,P=0.878).The positive rate of autoantibody not correlated with the gender (χ2=2.897,P=0.089), but related to the age (t=3.274,P=0.001)of the patients.There existed significant difference in the levels of ALT,AST and the age between the patients HCV RNA negative and those HCV RNA positive (Z=-6.430,P=0.000;Z=-6.123, P=0.000;t=-3.152,P=0.002),and the patients whose HCV RNA were negative younger than those who with HCV RNA positive (44.17 vs 55.27 years).Conclusion It is easy for autoimmunity to occur on persons infected HCV.The posi-tive rate of autoantibody is related to patients’age,but not to the HCV amount in patients.Besides,it cannot predict the sta-tus of the patients’liver injury that weather the autoimmunity appears.But HCV load correlated with patients'age and liver inj ury,which older group patients bring higher virus load and had more serious liver damage.

Objective High frequency microsatellite instability(MSI-H)was considered to be the phenotype of DNA mismatch repair(MMR)deficiency.However,a contradiction was noticed that p53 mutation is reposed to be extremely rare in MSI-H tumors.The aim of the current study was to confirm and try to explain this a phenomenon.We have demonstrated a direct link between MMR model and"modification"type MSI,and suggested the new categorization system of MSI by quantification of MSI profile.Based on this categorization system we studied the relationship between MSI and mutation of p53 oncogene in colorectal cancer.Methods A series of 180 sporadic colorectal cancer cases were investigated for their microsatellite status and p53 mutations.High resolution fluorescent microsatellite instability analysis assay and direct sequencing were employed in this study.Results Two definite patterns of microsatellite instability were confirmed,i.e."modification" type and "jumping" type MSI. In colorectal cancer,low frequency microsatellite instability (MSI-L)cases all showed pure"modification"type,while"jumping"type MSI changes were confirmed in all MSI-H cases.MSI-H was related with proximal tumor location and poorly differentiated.p53 mutation rate was more frequent in well differentiated tumors.Interestingly.MSI-L tumor showed a 40% mutation rate which is similar with MSS tumor 41%,however,in MSI-H tumors no p53 mutation was confirmed.Conclusions We confirm in human colorectal cancers,the"modification"type MSI might be connected with MMR defection.The mechanism underlying MSI-H phenotype was supposed to be other than MMR deficiency.

Microsatellite instability(MSI)was defined according to the frequency of positive findings in a panel of MSI markers.High frequency MSI(MSI-H)was the phenotype in which repeat sequences were extraordinarily unstable, and was considered to be the bona fide phenotype of DNA mismatch repair defection. However base substitutions in some well studied oncogenes or tumor suppressors were reported to be uncommon in MSI-H tumors. To explore this obvious contradiction, the relationship between MSI and KRAS gene mutations were studied in a panel of 76 human colorectal carcinomas, the whole exon of MLH1 and MSH2 were sequenced for MSI-H tumors. KRAS gene mutation was confirmed by similar frequencies in tumors of different MSI status. Intriguingly, all of the KRAS mutant MSI-H tumors harbored sequence alterations in MLH1gene, which was a key player in DNA mismatch repair system. This implied that in MSI-H tumors carrying MMR mutations, KRAS mutation were frequently and almost exclusively occurred. Furthermore, these MMR mutants were uniformly carrying a unique modification + jumping type MSI, which was different to MSI-H tumors without MLH1 or MSH2 gene mutations. This study shaded lights on the heterogeneity of MSI-H tumors, and implied the connection between modification type MSI and DNA mismatch defection.

Objective To investigate the activity of recombinant Vibrio vulnificus hemolysin (rVvhA) on the apoptosis of J774A.1 cells and the related mechanism. Methods The cytotoxic effect of rVvhA on the growth of J774A.1 cells was identified by MTT, celluar and mitochondrial morphology were observed by transmission electron microscopy, apoptosis or necrosis and mitochondrial membrane potential in J774A.1 cells were measured by flow cytometry, activities of caspase-3 ,-8,-9 were detected by spectrophotometry. Results The viability of J774A.1 cells exposed to rVvhA was inhibited, and it is dependent on dose. Celluar and mitochondrial uhrastructure both occurred to change obviously observed by transmission electron microscopy in J774A.1 treated by 2.0 HU/ml and 3.0 HU/ml rVvhA after 8 hours; and 3.0 HU/ml rVvhA group had a better cytotoxic effect on J774A.1 than that of 3.0 HU/ml rVvhA group. The percentage of apoptosis is (7.80±0.62)%, (12.33±0.12)%, respectively. Besides, the mitochondriai membrane potential also reduced, because the rate of fluorescence which is green increase 1.0% (normal) to 9.8% (2.0 HU/ml rVvhA) and 39.2% (3.0 HU/ml rVvhA). At the same time, the caspase-3, -9 activity increased gradually, but caspase-8 remained unchanging. In J774A.1 cells treated by 3.0 HU/ml rV-vhA + caspase-3 inhibitor(Ac-DEVD-FMK) or caspase-9 inhibitor(Ac-LEHD-FMK), The apoptosis of was reduced to(6.23±3.95)% ,(9.60±3.14)%, and the activity of caspase-3, -9 reduced, too. Conclusion The rVvhA has cytotoxic effect on J774A.1. Mitochondria-mediated apoptosis pathway which is dependent on caspase may be related to apoptosis induced by rVvhA in J774A.1.

Objective To construct a hexon-chimeric human adenovirus type 3 ( HAd3 ) vector expressing two neutralizing epitopes of hepatitis B surface antigen preS 1 (HBsAg-preS1) and to analyze the antigenicity of the chimeric epitopes .Methods Two neutralizing epitopes of HBsAg-preS1 including KR359 and KR127 were inserted into hypervariable region 1 ( HVR1) and hypervariable region 2 ( HVR2) of HAd3 hexon .Chimeric hexon gene encoding the two epitopes was amplified by overlap PCR and then subcloned in -to shuttle plasmid pBR322-L/R containing the homologous recombination regions .The digested shuttle plas-mid containing chimeric hexon gene was co-transfected into Escherichia coli BJ5183 cells together with back-bone plasmid pBRAdΔE3GFP to construct pBRAdΔE3GFP-preS1 vector.Then pBRAdΔE3GFP-preS1 vector was digested with AsiSⅠand transfected into AD293 cells to construct recombinant virus (rAD3E-preS1). CsCl gradient centrifugation was used for purification .Glutathione S-transferase ( GST ) fusion protein KR359KR127 ( GST-KR359KR127 ) was expressed in Escherichia coli BL21 by using expression vector pGEX-4T3.Female BALB/c mice at age 6-8 weeks were intraperitoneally injected with 1010 virus particles or 80 μg GST fusion protein .Serum samples were collected to analyze the antigenicity of two epitopes by ELISA and Western blot .Results ELISA showed that KR 359 and KR127 were successfully exposed on viral sur-faces by using hexon-chimeric HAd3 vector .The induced polyclonal antibodies in serum samples could rec-ognize GST fusion protein and native HBsAg from patients infected with hepatitis B virus .Conclusion The antigen capsid-incorporation strategy could be used to display epitopes on viral surface .Enhanced antigen-specific responses could be achieved through inserting multiple foreign epitopes into hexon HVRs .This study provided evidence for further application of hexon -chimeric human adenovirus type 3 vector in the developmentof vaccine, especially for the development of multivalent hepatitis B vaccine .

Objective To discuss the related factors of early pathological fracture after curettage of benign bone tumors in femoral shaft.Methods The clinical data of 47 patients with benign bone tumors in femoral shaft,treated by curettage with bone graft via the vastus lateralis approach from March 2004 to March 2011,were retrospectively analyzed.Thirteen patients of them presented with early pathological fracture after the curettage.In fracture group,there were 13 cases,11 males and 2 females,and the time from finishing curettage to fracture occurring ranged from 21 to 36 days.In non-fracture group,there were 34 cases,23 males and 11 females.The following data of fracture group and non-fracture group were compared and analyzed,such as specific value of absolute width of tumor and transverse diameter of bone shaft,specific value of defect width of bone window and sagittal diameter of bone shaft,defect length-width ratio of bone window,defect morphology of bone window,classification of bone tumor,violence of causing injury and compliance to medical advice.Results The average defect length-width ratio of bone window in fracture group was 3.72±3.58,in non-fracture group was 2.67±6.35.For classification of tumor,in fracture group 1 case was in incubation period,6 in active period,6 in invasion period; in non fracture group 21 cases were in incubation period,10 in active period,and 3 in invasion period.Four cases in fracture group had poor compliance to medical advice,and 9 in non-fracture group had good compliance.Between two groups,there were no statistical differences in specific value of absolute width of tumor and transverse diameter of bone shaft,specific value of defect width of bone window and sagittal diameter of bone shaft,and defect morphology of bone window.Conclusion When defect length-width ratio of bone window is larger than 4,the classification of tumor causes expanded incisal edge,and the cortical bone was damaged extensively,there are more possibilities for pathological fracture.

Objective To assess the characteristics of magnetic resonance imaging (MRI) for spinal cavernous angiomas.Methods The examinations of plain scan and contrast enhanced scan of magnetic resonance (MR) were performed in three patients with spinal cavernous angiomas.Results The focus of two cases was located in thorax segment of the spinal cord and one in lower cervical segment.All focuses were single and the shape of spinal cord was normal or slightly thick. MRI characteristic of spinal cavernous angiomas was just like popcorn or mulberry with a jumbled gobbet signal. Low and short T2 signal appeared around the focus. In all cases, there were no obvious contrast enhanced signal in 2 cases and one case with moderate contrast enhanced signal. The diameter of hemorrhage was smaller than that of the spinal cord.Conclusion MRI has higher sensitivity and specificity in the diagnosis of spinal cavernous angioma.