Programmed cell death(PCD)of human leukemic HL 60 cell and human poorly differentiated gastric adenocarcinoma cell BGS 180 induced by efoposid(VP 16) was preliminarily observed comparatively in the same experimental condition through rate of cell death, DNA agarose gels electrophoresis and terminal deoxynucleotidyl transferase(TdT) mediated biotin 11 dUTP nickend labeling(TUNEL).It was found that apoptosis is the main pattern of HL 60 cell death induced by low does VP 16 in a short time, and it can be suppressed when protein kinase C(PKC) is activated. The main pattern of BGS 180 cell death induced by VP 16 is necrosis, and PCK activation does not affect its necrosis rate. Extracellular Ca 2+ reduction do not affect BGS 180 and HL 60 cell death rate. The mechanism of VP 16 action on BGS 180 and HL 60 cell is different, apoptosis is not the main pattern of cell BGS 180 death induced by VP 16.

Programmed cell death(PCD)of human leukemic HL-60 cell and human poorly differentiated gastric adenocarcinoma cell BGS-180 induced by efoposid(VP-16) was preliminarily observed comparatively in the same experimental condition through rate of cell death, DNA agarose gels electrophoresis and terminal deoxynucleotidyl transferase(TdT) mediated biotin-11-dUTP nickend labeling(TUNEL).It was found that apoptosis is the main pattern of HL-60 cell death induced by low does VP-16 in a short time, and it can be suppressed when protein kinase C(PKC) is activated. The main pattern of BGS-180 cell death induced by VP-16 is necrosis, and PCK activation does not affect its necrosis rate. Extracellular Ca2+ reduction do not affect BGS-180 and HL-60 cell death rate. The mechanism of VP-16 action on BGS-180 and HL-60 cell is different, apoptosis is not the main pattern of cell BGS-180 death induced by VP-16.

Objective To study the correlation between anatomical measurement and CT measurement of adult occipital thickness so as to provide anatomic evidence for the selection of screw length in occipital-cervical fusion. Methods The occipital thickness was measured on the occipital specimens of 10 normal adults in two ways: direct anatomic measurement and CT measurement. Measurements were made on the basis of the McRac' s line and according to a matrix of 66 points following a grid with one cm spacing. The results of both measurements were statistically analyzed using SPSS 10.0. Results The results of both measurements were highly correlated. The external occipital protuberance was the thickest while the region of cerebellar fossa was the thinnest. The regions two cm lateral to the midline between plane Five and plane Six, one cm lateral to the midline between plane Four and at plane Five, and median between plane Three and plane Four were found to have a thickness of more than eight mm. Conclusions The occipital thickness varies with individuals. CT measurement and direct anatomic measurement are highly correlated. Preoperative CT measurements can be reliable evidence for optimal screw placement before performing occipital-cervical fusions.

Objective To analyze endoscopic histological characters and establish diagnostic standards of colorectal polyps with confocal laser endomicroscopy (CLE) examination and to explore the diagnostic value of the CLE in adenomatous polyps and non-adenomatous polyps. Methods From June to December in 2009, 90 patients were recruited in this study, which included 40 pathologically confirmed colorectal polyps patients (total 48 colon and rectal polyps) and 50 patients for prospective study (total 106 colon rectal polyps). At same time 10 spots of normal mucosa was taken for comparison. Firstly the CLE images of 48 pathologically confirmed colorectal polyps (22 adenomatous polyps and 26 non-adenomatous polyps) were analyzed, and the diagnosis criteria for distinguishing adenomatous polyps and non-adenomatous polyps was established with CLE. Then according to the criteria, 106 colorectal polyps underwent prospective diagnosis with CLE. Finally, the CLE diagnosis result was compared with pathologically result to evaluate the diagnosis efficiency of CLE. Results In the 48 colorectal polyps of 40 pathologically confirmed colorectal polyps patients, there were 22 adenomatous polyps and 26 non-adenomatous polyps. The sensitivity, specificity and accuracy of CLE in adenomatous polyps diagnosis were 94. 0%, 92. 9%, and 93. 4%, respectively. The positive predictive value was 92.2% and the negative predictive value was 94.5%. The sensitivity, specificity and accuracy of CLE in non-adenomatous polyps diagnosis were 92. 9%, 94.0%, and 93. 4%respectively, the positive predictive value was 94.5% and the negative predictive value was 92.2%.The coherence of CLE and histopathology in adenomatous polyps diagnosis was pretty good (Kappa=0. 893). Conclusion The accuracy of CLE in adenomatous polyps and non-adenomatous polyps differential diagnosis was high, and the coherence with histopathology diagnosis was good, which provided experience for further detection of early rectal precancerous.

Objective To compare the cost-effectiveness between endoscopic submucosal dissection (ESD) procedure and traditional surgery for the treatment of early gastrointestinal cancer or precancerous lesions.Methods A total of 866 early GI cancer/precancerous patients who had been admitted to Chinese PLA General hospital and Qilu hospital were included in this study.The medical records of all 866 patients were reviewed.Patients were divided into ESD group and traditional surgery group.Parameters of each patient,such as time of hospitalization,total treatment cost and incidence of complications,were documented and later compared in detail.Results A total of 607 patients were included in the ESD group and 259 in the traditional surgery group.There was no statistical difference in complete resection rate between the two groups (93.1％ vs 93.0％,P ＞ 0.05).The ESD group showed a shorter mean hospitalization time (d)(13.01 vs 18.88,P ＜ 0.05) and lower treatment cost (RMB) than the traditional surgery group (22932.17 vs 57993.88,P ＜ 0.05).The incidence of hemorrhage and perforation for each group were 3.63％ and 3.10％ respectively,which were not significantly different (1.98％ vs 3.01％,P ＞ 0.05; 2.80％ vs 1.16％,P ＞ 0.05).Conclusion ESD and surgery are both effective for early gastrointestinal cancer/precancerous lesions therapy,but ESD procedure is superior to surgery in terms of hospitalization time and expediture.

Objective To investigate the expression and clinical significance of FoxA 2(hepatocyte nuclear factor 3β)in human non-small cell lung cancer(NSCLC)tissues and adjacent normal lung tissue.Methods The expressions of FoxA 2 protein in 80 cases with NSCLC tissues and adjacent normal lung tissue were tested by immunohistochemistry,the expressions of mRNA was detected by RT-PCR.Results The expressions of FoxA 2 both on protein and mRNA in NSCLC lung tissue were significantly less than those of adjacent normal lung tissue(protein expression comparison t value was 187.51,186.43,178.24 respectively;mRNA expression comparison t value was 236.70,260.13,126.27,respectively,P ＜ 0.05).However there was no difference on histopathological variability.F value equal to 1.86 and 1.69,P ＞ 0.05).In low differentiated group,the group of Ⅲ stage,with lymph node metastasis,the expression of FoxA 2 protein and mRNA was less than that in the group of high differentiated,the group of Ⅰ-Ⅱ stage,the group of non lymph node metastasis(pretein expression t values were 4.31,3.92,341,mRNA expression t values were 5.44,3.28,5.07,P＜0.05).Conclusion FoxA 2 might inhibit progression of human NSCLC.It may participate in the process of tumor tissue differentiation and lymph node metastasis in NSCLC.

Objective To study the related prognostic factors influencing rectal neuroendocrine tumor prognosis.Methods We retrospectively reviewed tumor clinical and pathology material of 183 cases with rectal neuroendocrine in our hospital during recent 10 years and reclassified them according to the 2010 WHO pathology classification.Single factor and multivariate analysis were performed to find related prognostic factors.Results Single factor analysis showed that tumor size (＜ 1 cm,1-2 cm,＞2 cm,98.77％ vs 78.57％ vs 28.57％,x2 =71.4793,P =0.0001),pathological grading (G1,G2,G3,98.73％ vs.76.19％ vs 25.00％,x2 =56.5121,P =0.0001) and the stage (stage Ⅰ,Ⅱ,Ⅲ,Ⅳ period,99.40％ vs 50.00％ vs 60.00％ vs 16.67％,x2 =105.0383,P =0.0001) among the three variables survival difference was statistically significant.Multivariate analysis (Cox regression) indicated that the tumor stage were independent factors affecting the prognosis,regression coefficient was 1.277 (B),Wald value of 28.145,Exp (B) a value of 3.586,95％ CI:2.237-5.747.Conclusion Tumor staging is an independent risk factor of survival,without considering other factors,different tumor size and pathologic grade also have different prognosis.Clinicians in making treatment plan should fully consider the above factors before choosing the appropriate follow-up plan.

Objective To explore the efficacy and adverse reactions of diminishing scheme of cefaclor sustained re-lease tablets in the treatment of recurrent urinary tract infection(RUTI).Methods 60 RUTI patients in a hospital were divided into treatment group(n=30)and control group (n=30),patients in treatment group were treated with diminishing scheme of cefaclor sustained release tablets,patients in control group were treated with diminishing scheme of levofloxacin tablets,clinical therapeutic efficacy and adverse reactions of two groups were observed. Results The curative rate in treatment group was higher than control group ([80.00%,n =24]vs [53.33%,n =16])(χ2 =4.80,P =0.028).The incidence of RUTI in treatment group was lower than control group ([6.67%,n=2]vs [26.67%,n=8])(χ2 =4.32,P =0.038).Incidence of adverse reactions in treatment group was lower than control group (16.67% vs 50.00%)(χ2 =7.50,P =0.006).Conclusion The diminishing scheme of cefaclor sus-tained release tablets in the treatment of RUTI has good curative efficacy,low recurrence rate,fewer adverse reac-tions,and can be used for the treatment of recurrence of RUTI.

Objective To investigate the clinical features and prognosis of rectal neuroendocrine neoplasms (NENs) in different pathological grades.Methods The clinical data of 183 patients with rectal NENs who were admitted to the PLA General Hospital from January 2001 to April 2012 were retrospectively analyzed.All the clinical and pathological data of the patients who received endoscopy and (or) surgical resection were retrieved from the work station and the database of the endoscopic center.Based on the 2010 WHO pathology classification of digestive tumors,the pathological data were ranked according to the mitotic count.The prognosis of the patients was learned by re-examination or phone call.The follow-up ended till July 2014 or at the death of patients.Data were analyzed using the chi-square test.Results A total of 183 patients were enrolled in this study including 120 males and 63 females.The median age of the patients was 48 years (range,14-83 years).Seventy-four patients had the symptom of hemafecia,9 patients had abdominal pain and change in bowel habit,and 70 patients were diagnosed by body examination.Other symptoms included increased level of tumor markers and abdominal distension.Carcinoid syndrome was not detected in all the patients.Fourteen patients were complicated with polyp of intestine,5 with tubular adenoma,3 with colorectal adenocarcinoma and 1 with small cell lung cancer.The diameters of the tumor under 1 cm were detected in 162 patients,the diameters of the tumors ranged between 1 cm and 2 cm in 14 patients,and the diameters of the tumors above 2 cm in 7 patients.The mean distance between the tumor and the anus was (5-± 3)cm.Of the 183 patients,130 received endoscopic treatment,43 received surgical treatment and 10 received clamping because the tumor was misdiagnosed as polyps.There were 158 patients in grade1 (154 in stage Ⅰ,1 in stage Ⅱ,1 in stage Ⅲ and 2 in stage Ⅳ),21 in grade2 (13 in stage Ⅰ,3in stage Ⅱ,3 in stage Ⅲ and 2 in stage Ⅳ),4 in grade 3 (1 in stage Ⅰ,1 in stage Ⅲ and 2 in stage Ⅳ).Six patients had liver metastasis and 9 had lymph node metastasis.Fourteen patients died (4 in grade 1,6 in grade 2 and 4 in grade 3).The 5-year survival rate of patients was 92.35％ (169/183).There were significant differences in the gender,tumor diameter,tumor staging,lymph node metastasis distal metastasis and 5-year survival rate among patients with rectal NENs in different pathological grades (x2=60.949,71.587,32.135,55.486,56.512,P ＜ 0.05).Conclusions Rectal NENs lacks the specific clinical manifestation and is more likely to happen in males,and it often locates at the middle-lower rectum.Most of the rectal NENs belongs to stage Ⅰ and grade 1 and is less than 1 cm in size.The prognosis of patients with rectal NENs in different pathological grades is different.The 2010 WHO pathology classification of digestive tumors is useful to asses the prognosis of rectal NENs.Different grades of rectal NENs could be taken into account when designing the treatment plan.

Objective To investigate and analyze the mental health status of the students from poor families and non-poor students by comparative study.Methods Conducting the cluster sampling methods,the author investigated 885 medical students with questionnaires.We input data with Epidata 3.0 software and described it with SPSS 11.0 statistical software,which also did the nonparametric rank sum test.Results 92.7％(667/719) students from poor families considered their economic status among the general level or much lower level.There were 41.9％(294/702) students from poor families who thought families' financial difficulties had positive effects on mental health.92.3％(664/719) students from poor families were never afraid that people around knew they were in work-study program.87.5％(629/719) students from poor families were satisfied with their life.Facing psychological problems,there's no difference with dissatisfaction in daily life and recourses for help between students from poor families and non-poor students except psychological consultation center and lovers P＞0.05).Conclusion Compared with non-poor students,the mental health of students from poor families in medical universities is good.The universities are supposed to pay more attention to the mental health of students who are neither poor nor non-poor and few students from poor families who are negatively impacted by their families' financial difficulties.