Objective To explore the expression and significance of HDGF and ADAM9 in esophageal cancer.Methods HDGF and ADAM9 expression in 113 patients with esophageal cancer (78 males and 35 females) with ages ranging from 28 to 87 years,averaged (61.2 ± 8.6) years,were analyzed by SP immunohistoehemical staining.Results The positive rates of HDGF and ADAM9 in esophageal cancer (78.8％ and 68.1％ respectively) were significantly higher than those in normal tissue(all were 30％).ADAM expressions were not correlated with age,sex,tissue types,lymph nodes metastasis,location and tumor size (P ＞ 0.05) ;the positive expression rate of HDGF and ADAM9 was related to differentiation,PT stages,and 5-year survival rate (P ＜0.05).HDGF was correlated with PT stage.Conclusion The expressions of HDGF and ADAM9 in esophageal cancer tissues were more higher than normal esophageal tissues,this means they could promote the development of tumor cells transformation,multiple and moving,and may be an useful tool for providing information about the targeted therapy and prognosis.

Objective To characterize the expressions of androgen receptor (AR) and estrogen receptor (ER) in penis skin of patients with congenital hypospadias. Methods Dorsal prepuce, ventral prepuce, and urethral plate were harvested from 30 patients with congenital hypospadias. The expressions of AR and ER in epidermal cells and dermal fibroblasts were assessed respectively by automated immunohistochemistry. Image Pro plus 6.0 was used to analyze the optical density (OD) value of AR and ER in different parts of epidermal cells and dermal fibroblasts. Results AR and ER were located mainly in nucleis of the squamous basal cells and prickle cells, and were also found in nucleis of subcutaneous fibroblast cells. The expression of AR was lower in epidermis of urethral plate than that of dorsal prepuce and ventral prepuce (P<0.05), but no significant difference was detected in dermal fibroblasts. The expression of ER was higher in epidermis of dorsal prepuce than that of urethral plate and ventral prepuce (P<0.05). The dermal expression of ER in fibroblast cells was increased successively in dorsal prepuce, ventral prepuce and urethral plate (P<0.05). Conclusion Lower expression of AR in urethral plate may contribute the development of hypospadias. Disorder of ER in dermal fibroblast cells of prepuce may play an important role in hypospadias.

[Summary] The characteristics ot clinical data and relevant inspection (quantitative sensory and electrophysiological studies) in 5 patients hospitalized with acute painful neuropathy following rapid glycaemic control with insulin from 2010 to 2012 in our hospital were analyzed.The results showed that 5 patients were all males,aged 31-49 years,with lower body mass index,and diagnosed as latent autoimmune diabetes of adults (LADA) or type 2 diabetes.Glycaemic control was poor before application of insulin.When insulin was used,the hyperglycemia was rapidly corrected in a short time,with recurrent episodes of hypoglycemia during insulin treatment.The painful neuropathic symptoms appeared within 2-4 weeks after application of insulin,and were relieved partially or completely after 2-6 months.Neuropathic symptoms manifested as tingling and tenderness,with worsening during night and after insulin injection.The neuropathic symptoms were not significantly alleviated after application of neurotrophic drugs such as methycobal,protogen,and prostaglandin.These patients often suffered from severe anxiety.Nerve electromyogram examination showed slowed or normal motor conduction velocity of tibial and fibular nerves,and normal feeling threshold.

Objective To study the safety of transfusion of itraconazole through PICC and to evaluate the effect of different amount of blood transfusion before and after the infusion. Methods Patients were recruited from January 1, 2014, until December 31, 2015, in the Hematology hematopoietic stem cell transplantation ward. Thiry-two patients were recruited in the control group. Ninety patients wererecruited in the experience group. They were randomly assigned to three groups with 30 cases each, extracting different amounts of itraconazole before infusion, back phlebotomize in group A, B, C respectively was 10.0, 0.5, 1.0 ml. Comparing the phlebitis and obstruction after ten days from the transfusion day on. Results Catheter obstruction was not observed in any case. There was a significant difference between control group (21.9%,7/32) and observation group (0) regarding the incidence of phlebitis (χ2=21.157,P < 0.05). No statistical difference was noted among the observation groups regarding the incidence of phlebitis (P>0.05). Conclusions Drawing a small amount of blood volume before itraconazole injection through PICC can effectively avoid the drug-induced catheterobstruction. What′s more, transfusion through PICC can significantly reduce the incidence of phlebitis compared with peripheral infusion.

OBJECTIVE:To study curative effect of the combination of cyclosporine A,mycophenolate mofetil,anti-thymocyte globulin,interleukin-11 and short-term methotrexate as acute graft-versus-host disease(aGVHD) prophylaxis on HLA-matched unrelated donor or HLA-mismatched related donor allogenic peripheral blood stem cell transplantation(Allo-PBSCT).METHODS:Thirteen patients with haematological malignancies who underwent HLA-matched unrelated donor or HLA-mismatched related donor Allo-PBSCT with the combination of cyclosporine A as aGVHD prophylaxis at Haikou Municipal People's Hospital from September to November 2008 were selected,including 7 of unrelated donor,3 of haplotype transplantation,and 3 of 1-locus mismatched.The conditioning regimen was performed at 7 days prior to transplantation,with cyclosporine A 5-10 mg/(kg?d),12 hours per time with twice per day.From day 7 prior to transplantation,mycophenolic acid was intravenous drip once per day,then 2.5 mg/(kg?d) antithymocyte globulin at days 5-2 prior to transplantation,1.5 mg/d interleukin 11 was subcutaneous injected at day 2 prior to and 10 days after transplantation,followed by intravenous drip 15 mg/m2 amethopterin at day 1 and 10 mg/m2 at days 3,6,11 after transplantation.The drug doge was reduced and stopped gradually after 3-6 months,which could be prolonged for haplotype grafter.Recombinant human granulocyte colony-stimulating factor was injected subcutaneously at day 3 prior to transplantation,and PBSCT was collected at days 4 and 5 after medication,which was infused to patients with subclavian vein at the same day.In total(7.82-9.11)?108/kg mononuclearcell and(2.9-7.7)?106/kg CD34+ cells were infused.RESULTS:Hematopoiesis was rebuilt in all patients with 46.15%(6/13) aGVHD incidence rate,including 8 %(1/13) of Ⅲ-Ⅳ aGVHD.Up to April of 2009,all patients live and work as normal except one patient who can not visit public places.CONCLUSION:The combination of cyclosporine A,mycophenolate mofetil,anti-thymocyte globulin,interleukin-11 and short-term methotrexate is effective in the prevention of aGVHD.

Objective Through two nationwide sero-epidemiological survey programs on hepatitis B virus (HBV),hepatitis B markers in Yunnan province were compared between the findings in 2014 and in 2006.Results were used to understand the HBV epidemic status in Yunnan province and to estimate the efficiency of measures on prevention and control of the disease.Methods People at the age of 1-29 years were sampled from 6 counties of the National Disease Surveillance sites in Yunnan province,by multi-stage random sampling method.Demographic information was collected by questionnaire,and 2-4 ml serum sample was taken to detect HBsAg,anti-HBs,anti-HBc,HBeAg and anti-HBe,by ELISA method.Results were logged-in the database and analyzed by SPSS 17.0.Results Between the two studies,no statistically significant differences were observed on the overall HBV infection rates and the positive rates of HBsAg,HBeAg,anti-HBe,anti-HBc.Positive rate of anti-HBs in 2014 was significantly higher than that in 2006.The main two combination profiles of hepatitis B markers were through the fifth model which was positive only for anti-HBs and the sixth model which was negative for all markers in 2006,and the same in 2014.Detection rate through the fifth profile in 2014 was significantly higher than the rate in 2006,while the detection rate of the sixth profile in 2014 was significantly lower than the one in 2006.When analyzing the differences in the same age group,between the two surveys,results showed that the positive rate of anti-HBs in 2014 was significantly higher than that in 2006,in both the10-14 and the 15-19 years-old groups.Positive rate of anti-HBc in the 20-29 year-olds in 2014 was significantly lower than the one of 2006.The positive rates of HBsAg in the age groups of 1-4,5-14 and 15-29 were 1.12％,1.61％ and 1.25％ respectively,in 2014.Conclusion Prevention and control measures on HBV seemed in great progres.However,more effective prevention and control measures should be taken continually among people under the age of 15,in Yunnan province.

To evaluate the therapeutic effect and mechanism of rapamycin (RAPA) on pulmonary fibrosis induced by chlormethine in C57BL/6N mice. Based on body weight, the 18-20 g C57BL/6N mice were randomly divided into five groups: control group, chlormethine group, chlormethine+dexamethasone (1 mg/kg) group, chlormethine+RAPA (1 mg/kg) group and chlormethine+RAPA (2 mg/kg) group, with ten mice in each group. Mice were put to death on the 21st day after the first administration of chlormethine. HE staining and Masson staining were used to observe the pathological changes and degree of fibrosis in the lung tissue of mice, and RT-PCR was used to detect collagen Ⅰ, E-cadherin, vimentin, and α-SMA mRNA expression. After 21 days of administration of chlormethine to mice, significant pulmonary fibrosis characteristics were observed in the lung tissue of the mice. Compared with the chlormethine group, the weight of mice in the chlormethine+dexamethasone (1 mg/kg) group, chlormethine+RAPA (1 mg/kg) group and chlormethine+RAPA (2 mg/kg) group, significantly increased ( P<0.05). Compared with the chlormethine group, the expression of pulmonary fibrosis-related indicators (collagen Ⅰ, E-cadherin, vimentin, and α-SMA) significantly improved ( P<0.05) in the chlormethine+dexamethasone (1 mg/kg) group, chlormethine+RAPA (1 mg/kg) group and chlormethine+RAPA (2 mg/kg) group. Compared with the chlormethine group, the pathological changes and collagen deposition in the lung tissue of mice in the chlormethine+dexamethasone (1 mg/kg) group, chlormethine+RAPA (1 mg/kg) group and chlormethine+RAPA (2 mg/kg) group, were significantly improved. Transcriptome analysis of the lung tissue of mice revealed that RAPA treatment of chlormethine-induced pulmonary fibrosis might be related to NF-kappa B signaling pathway. Compared with the chlormethine group, the mRNA expression of p65 in the lung tissue of mice in the chlormethine+dexamethasone (1 mg/kg) group, chlormethine+RAPA (1 mg/kg) group and chlormethine+RAPA (2 mg/kg) group, significantly decreased ( P<0.01). RAPA has a protective effect on pulmonary fibrosis induced by chlormethine in mice. Its efficacy is comparable to that of dexamethasone, which is currently being used in clinical practice. It is a new alternative therapy, and its mechanism may be related to inhibiting the activation of the NF-kappa B signaling pathway.

To evaluate the therapeutic effect and mechanism of rapamycin (RAPA) on pulmonary fibrosis induced by chlormethine in C57BL/6N mice. Based on body weight, the 18-20 g C57BL/6N mice were randomly divided into five groups: control group, chlormethine group, chlormethine+dexamethasone (1 mg/kg) group, chlormethine+RAPA (1 mg/kg) group and chlormethine+RAPA (2 mg/kg) group, with ten mice in each group. Mice were put to death on the 21st day after the first administration of chlormethine. HE staining and Masson staining were used to observe the pathological changes and degree of fibrosis in the lung tissue of mice, and RT-PCR was used to detect collagen Ⅰ, E-cadherin, vimentin, and α-SMA mRNA expression. After 21 days of administration of chlormethine to mice, significant pulmonary fibrosis characteristics were observed in the lung tissue of the mice. Compared with the chlormethine group, the weight of mice in the chlormethine+dexamethasone (1 mg/kg) group, chlormethine+RAPA (1 mg/kg) group and chlormethine+RAPA (2 mg/kg) group, significantly increased ( P<0.05). Compared with the chlormethine group, the expression of pulmonary fibrosis-related indicators (collagen Ⅰ, E-cadherin, vimentin, and α-SMA) significantly improved ( P<0.05) in the chlormethine+dexamethasone (1 mg/kg) group, chlormethine+RAPA (1 mg/kg) group and chlormethine+RAPA (2 mg/kg) group. Compared with the chlormethine group, the pathological changes and collagen deposition in the lung tissue of mice in the chlormethine+dexamethasone (1 mg/kg) group, chlormethine+RAPA (1 mg/kg) group and chlormethine+RAPA (2 mg/kg) group, were significantly improved. Transcriptome analysis of the lung tissue of mice revealed that RAPA treatment of chlormethine-induced pulmonary fibrosis might be related to NF-kappa B signaling pathway. Compared with the chlormethine group, the mRNA expression of p65 in the lung tissue of mice in the chlormethine+dexamethasone (1 mg/kg) group, chlormethine+RAPA (1 mg/kg) group and chlormethine+RAPA (2 mg/kg) group, significantly decreased ( P<0.01). RAPA has a protective effect on pulmonary fibrosis induced by chlormethine in mice. Its efficacy is comparable to that of dexamethasone, which is currently being used in clinical practice. It is a new alternative therapy, and its mechanism may be related to inhibiting the activation of the NF-kappa B signaling pathway.

Objective:To explore the effect of combined orbicularis muscle double stitch operated on blepharoplasty.Methods:A total of 90 patients, 79 females and 11 males, aged 18-49 years, were treated by using combined orbicularis muscle double stitch procedure, that is, to fix upper lifting muscle, to remove partial fat, and to perform blepharoplasty.Results:All 90 cases＇ incisions were healed at the first phase, no obvious swelling and bleeding. Within 3-24 months follow up, all patients＇ upper eyelids were significantly improved. The skin was smoothy when closing eyes, and eyelash was up when opening eyes, and arc was natural and satisfactory.Conclusions:This method can improve the shape of the upper eyelid swelling and get long-lasting and stable physiological eyelid.

The multi-campus mode is an important way to give full play to the advantages of public hospitals and promote the expansion of high-quality medical resources and balanced regional layout. The authors summarized the practical experience of the Second Affiliated Hospital Zhejiang University School of Medicine in promoting multi-campus cultural integration, including vertical dimensional initiatives including raising cultural construction to a strategic level, improving the working mechanism of cultural construction, and building a distinctive cultural identity system; horizontal dimensional initiatives including creating equal status and intergroup cooperation conducive to cultural integration, building a variety of forms of the main cultural communication platform, and building a unified and diverse cross-campus communication bridge. Through cultural integration, the internal cohesion of the hospital was enhanced and the influence of the hospital brand was improved. The authors suggested that cultural integration should always be based on the principle of " seeking common ground while preserving minor differences" , focusing on the construction of systems and standards, and focusing on the construction of communication platforms.