Objective To investigate the serum cystatin C(Cys C)levles in different age and sex health physical examination people,and to analyze the correlation between different ages,different genders and Cys C levles. Methods 648 healthy subjects checked with physical examination were selected.611 patients with normal renal function were selected.The serum Cys C and Cr concentrations were determined and statistically analyzed according to different age or gender groups.The serum Cys C and Cr concentrations of other 37 patients with abnormal renal func-tion were detected and compared with normal renal function people in the same ages.Results There were no signifi-cant differences in serum CysC levels between men and women in different ages and normal renal function people(t =2.449,P =0.092;t =0.176,P =0.872;t =2.030,P =0.135;t =2.376,P =0.098;t =1.549,P =0.219;t =1.732,P =0.182;t =1.095,P =0.353;t =1.732,P =0.182;t =2.449,P =0.092;t =2.611;P =0.080).There were significant differences in serum Cys C level between men,women and combined with normal renal function(F =5.662,5.615,7.253,all P <0.05).Taken the linear correlation analysis by age with serum Cys C level among men, women and combined with normal renal function groups,the results showed that had positive correlation(r =0.525, 0.511,0.522,all P <0.05 ).Renal function of different genders in the health physical examination people over 50 years of age appeared serum Cys C positive persons,and the positive rate of each gender group increased alone with the increase of age(F =7.324,7.341,7.452,all P <0.05).The Cys C,Cr content and positive rate of renal function in health physical examination people were significantly lower than abnormal renal function people (t =31.080, 15.472;χ2 =17.043,34.105;all P <0.05).Conclusion There is an evident positive correlation in health physical examination people between serum Cys C level and the ages,and are increased alone with increase of age,which is increasing evidently alone with increase of age,while has no correlation with gender.

Objective To study the role of expressions of vascular endothelial growth factor C (VEGF-C), vascular endothelial growth factor receptor-3 (VEGFR-3) and lymphatic vessel hyaluronan receptor-1(LYVE-1) on the lymphangio-genesis and prognosis in gastric cancer. Methods The tissue microarray technology was used to detect the expressions of VEGF-C, VEGFR-3 and LYVE-1 in 125 gastric cancer specimens, 96 adjacent normal tissues and 20 benign gastric lesion samples. The lymphatic vessel density (LVD) marked by Podoplanin was detected as well. Results The positive rates of VEGF-C, VEGFR-3 and LYVE-1 in gastric cancer tissues were 62.4%, 56.0%and 58.4%, which were significantly higher than those in adjacent normal tissues (10.4%,12.5%and 9.4%) and benign gastric lesion tissues (20%, 30%and 25%, P<0.05). The LVD score was significantly higher in gastric intra-tumoral and peri-tumoral samples (2.98±0.81 and 4.22±1.09) than that in adjacent normal tissues or benign gastric lesion samples (1.82±0.63 or 0.89±0.45, P<0.01). The LVD score was significantly higher in peri-tumoral samples than that of intra-tumoral samples (P<0.01). There was a positive relationship between expression levels of VEGF-C,VEGFR-3 and LYVE-1 with LVD (P<0.05). The positive expressions of the three indexes were the risk factors of lymph node metastasis and distant metastasis (P<0.05). There was a significantly longer 5-year survival rate in patients with negative expression of the three indexes (P<0.05). Conclusion VEGF-C, VEGFR-3 and LYVE-1 proteins were positively highly expressed in gastric cancer tissues, which were risk factors affecting the progno-sis of gastric cancer. The expression levels of the three indexes can be used to predict the prognosis and lymphangiogenesis of gastric cancer.

Objective·To study the hemodynamic parameters of uterine at midluteal phase in patients with early recurrent spontaneous abortion (ERSA) and the effect of aspirin on them. Methods·Transvaginal color Doppler ultrasonography was used to measure the parameters of uterine blood flow and the endometrial thickness at midluteal phase of 271 women with ERSA (ERSA group) and 66 women without a history of recurrent spontaneous abortion (control group). Then ERSA group were administered with aspirin 50 mg/d orally for 2 months and other individualized treatment, and the effect of aspirin on parameters of uterine blood flow and the early pregnancy outcome of them were observed. Results·At midluteal phase, the endometrium was significantly thinner in ERSA group than that in control group. Pulsatility index (PI) of endometrial blood flow and mean PI (mPI), mean resistance index (mRI), and mean systolic/diastolic ratio value (mS/D) of uterine arteries were statistically significantly higher in ERSA group in comparison to control group (P<0.05). Following aspirin treatment, resistance to uterine blood flow reduced significantly in ERSA group (P=0.000), and the endometrial thickness increased in the patients with endometrial thickness less than 7 mm (P=0.000). Only 163 ERSA patients were re-examined by transvaginal color Doppler ultrasonography after aspirin treatment, among whom 136 women was pregnant after individualized treatment. Among these pregnant patients, 97 cases were pregnant for more than or equal to 12 weeks, while 10 cases aborted during the first 12 weeks, and the early pregnancy outcomes of the other 29 cases were still unclear. Conclusion·In comparison with normal fertile women, ERSA patients have significantly higher resistance to uterine blood flow and thinner endometrium. Aspirin can improve uterine blood perfusion, which improves early pregnancy outcome.

Objective · To investigate the status of depression and anxiety in patients with recurrent spontaneous abortion (RSA) and the possible influence factors and to provide theoretical support for further psychological intervention. Methods · RSA patients and women with no history of RSA were invited to complete a questionnaire, including basic information, Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS). All data were analyzed by SPSS. Results · Of all 1064 cases included in this study, 725 were RSA cases, 217 cases with one spontaneous abortion and 122 in control group with no history of spontaneous abortion. Our results showed that both RSA patients and patients with one spontaneous abortion have significantly higher SDS and SAS scores than control group. Furthermore, non-pregnant RSA patients with lower education level, lower household income and 3-5 years of marriage have significantly higher levels of depression and anxiety. Patients with multiple miscarriages (≥4), history of induced abortion and no live birth, score significantly higher in SDS. Conclusion · Whether pregnant or not, RSA patients are much easier to become depressive and anxious, which may be associated with education level, household income, length of marriage, numbers of pregnancy losses and previous live birth. Women with one spontaneous abortion also show a significant higher tendency of depression and anxiety. These patients should be given proper psychological intervention if necessary.

Objective To analyze the mammographic features of invasive lobular carcinoma (ILC)compared to those of invasive ductal carcinoma (IDC).Methods Twenty cases with ILC and 95 cases with IDC were retrospectively evaluated by two breast radi-ologists according to the Breast Imaging Reporting and Data System (BI-RADS)lexicon.The mammographic findings were com-pared between ILC and IDC with the independent samples chi-square test or Fisher’s exact test,as appropriate.Results Mass was the most common finding in both ILCs and IDCs,but less frequent in ILCs (36.4% vs 63.9%,P =0.008).Mass in ILCs was more frequently lobular or irregular shape with spiculated margin.Architectural distortion and focal asymmetry were more frequent in ILCs than in IDCs,however,the differences were no significant.The frequency of calcifications was not significantly different between the two groups.The distributions of calcifications were more regional in ILCs,and more segmental or linear in IDCs (P =0.01).Conclu-sion ILCs are more usually shown as non-mass appearances on mammography.ILCs that appeared as mass are more frequently ir-regular in shape with spiculated margins.

Objective To explore a reasonable,accuracy and effectual proposition model for medical imaging examination.Methods Mean scores and their standard deviation and distribution as well as the difficulty,discrimination,reliability and validity of the test paper were analyzed for the 2005 grade 7-year program students by using SPSS 13.0 statistic software.Results The scores of the 67 copies of test paper displayed a normal distribution,with the mean score of 73.76 and standard deviation of 11.88.The difficulty,reliability and validity indexes of the test paper were 0.74,0.78 and 0.25 respectively.The difficulty,discrimination,reliability and validity indexes of subjective items were higher than those of objective items(0.76 vs.0.73,0.94 vs.0.90,0.71 vs.0.68,0.32 vs.0.22,respectively).Conclusions We should keep quite high proportion of subjective items and make detailed scoring standard in medical imaging examination.Furthermore,as a supplement,objectively items such as multiple choice questions can expand the scope of knowledge examined.

Objective To evaluate the value of diffusion.weighted imaging(DWI)in the differential diagnosis of benign and malignant breast lesions with Meta.analysis.Methods English and Chinese articles published from 1997 to 2007 were searched in Cochrane library,Pubmed,Ovid.Elsevier.Springer databases and Chinese National Knowledge Infrastructure(CNKI),and selected according to the criteria for diagnostic research recommended by Cochrane Method Group.The characteristics of selected articles including the study background,design,results and diagnostic indicators were analyzed.Statistical analysis was performed with Meta-test version 0.9.Results Six articles were included with a total of 479 lesions.The sensitivity and specificity of DWI for breast 1esions ranged from 64.0% to 92.8% and from 45.8% to 96.7% respectively. All groups had homogeneity.and a fixation effects regression Was developed.The pooled weighted sensitivity and specificity with 95% CI and Az Was 86%(76%-92%).80%(61%-91%)and 92.19% respectively.Sensitivity analysis demonstrated no remarkable change on heterogeneity.Condnsion The value of ADC in DWI can help to differentiate the benign breast lesions from the malignant with good sensitivity and specificity.The further study is needed to assess the clinical aplication of the b-value and diagnostic threshold.

Objective To inhibit the expression of transcription factor special protein 1(Sp1) through RNA interference (RNAi) technique and to investigate its impact on the proliferation ability of colorectal cancer cell line SW620. Methods The recombinant plasmid of Sp1 RNAi (pGenesil-1-Sp1) was constructed and transfected into SW620 cells by Lipofectamine. The transfcction efficiency was observed under fluorescence confocal microscopy. Expression levels of Sp1 mRNA and protein from SW620 after transfection were examined by real time PCR and Western blot respectively, after transduction of the recombinant plasmid into the SW620. The proliferation ability of SW620 cell line was evaluated by MTT assay. Results The expression plasmid (pGenesil-1-Sp1) against Sp1 was successfully constructed, recombinant vectors could reduce the expressions of Sp1 mRNA and protein in SW620, the ratio of inhibition of the expression of Sp1 mRNA and protein was 68.47 % and 73.82 % in 48th hour respectively. Compared with the control group, the difference was significant (P <0.05). MTT showed that the proliferation ability of SW620 cell was degraded. Conclusion Silencing Sp1 gene by the RNAi technology can actively inhibit the proliferation of SW620 cell. The successful application of Spl SiRNA extends the list of available therapeutic modalitics in the treatment of human colon cancer.

Objective To study inhibitory effects of transcription factor activator protein-2α(AP-2α)on proliferation of colon cancer cells in vitro and its mechanism. Methods The peDNA3.1 (+)-AP-2α recombinant plasmid was constructed. Plasmid pcDNA3.1(+)- AP-2α and pcDNA3.1(+)was transfected into SW620 cell by liposome mediation for transient expression, and proliferative activities of SW620 cell were evaluated by MTT assay. The change in the mRNA and protein expression level of ER-β before and after transfection was detected using the methods of Real-Time PCR and Western blotting respectively. Results The mRNA and protein expressions of AP-2α could be enhanced by transfecting of AP-2α gene in SW620 cell. MTT assay indicated: the proliferation velocity of SW620 cell for transfection of the pcDNA3.1(+)-AP-2α plasmid was apparently inhibited. The expression of ER-β in SW620 cell increased significantly after AP-2α gene transfection. Compared with control group, the difference was significant (P＜0.05). Conclusion Overexpression of AP-2α inhibits the proliferation of SW620 cell in vitro, which is probably related with activation of ER-β.

Objective: To systematically evaluate the incidence and influencing factors of depression in family caregivers of Alzheimer's disease (AD) patients, so as to provide the basis for the prevention and treatment of depression among the family caregivers of AD patients. Methods: Publications pertaining to depression in family caregivers of AD patients were retrieved from CNKI, Wanfang Data, PubMed and other databases from the time of their establishment to June 15, 2023. The evaluation criteria recommended by the Agency for Healthcare Research and Quality (AHRQ) and the Newcastle-Ottawa Scale were used to assess the quality of cross-sectional and cohort studies, respectively. Stata 16.0 and Revman 5.4 softwares were used to conduct a meta-analysis on the incidence and influencing factors of depression in family caregivers of AD patients. Sensitivity analysis and publication bias assessment were also performed on the results. Results: A total of 2 324 articles were retrieved, and ultimately 14 articles were included, with a total sample size of 8 313 individuals. There were 6 high-quality articles and 8 moderate-quality articles. Meta-analysis showed that the incidence of depression in family caregivers of AD patients was 37.5% (95%CI: 30.2%-45.1%). Factors associated with depression included patients' high degree of dementia (OR=1.718, 95%CI: 1.059-2.789), patients' low scores on Activities of Daily Living Scale (OR=1.344, 95%CI: 1.059-1.706), patients' psychobehavioral abnormalities (OR=1.248, 95%CI: 1.155-1.348), long duration of caregiving (OR=1.998, 95%CI: 1.637-2.437), less involvement of other family members in caregiving (OR=1.597, 95%CI: 1.237-2.061), low educational level (OR=1.191, 95%CI: 1.044-1.359), poor caregiving skills (OR=3.060, 95%CI: 2.257-4.149), poor self-rated health (OR=2.536, 95%CI: 1.114-5.771) and social support (OR=0.424, 95%CI: 0.232-0.774). The results of depression incidence demonstrated good stability with no significant publication bias. However, publication bias was observed in the influencing factors for depression, which were patients' high degree of dementia and patients' low scores on Activities of Daily Living Scale. Conclusions The incidence of depression in family caregivers of AD patients ranges from 30.2% to 45.1%. It is primarily influenced by the severity of patients' symptoms and ability to perform daily activities, and caregivers' educational level, caregiving skills, health status, caregiving duration and social support.