Objective In many types of epithelial tumors,down-regulation or mutation of the epithelial cell-adherent molecule E-cadherin is associated with an increased invasiveness that can be prevented by the forced expression of the cell-adherent molecule.This suggests that E-cadherin is a latestage tumor suppressor that prevents invasion and metastasis.This study was to investigate cell invasion and migration status of human ovary serous cystadeno carcinoma HO-8910 cell line when the E-cadherin expression was down-regulated with RNA interference(RNAi) technology. Methods E-cadherin siRNA was transfected into HO-8910 cells to inhibit the expression of E-cadherin.The effect of RNAi was detected by immunofluoresence assay and Western blotting.The invasive ability of the cancer cells was determined by Transwell assay. Results After RNAi,the expressions of E-cadherin were significantly decreased from 63.7% to 11.9%(P

Objective:To explore the effects of dexmedetomidine on the blood glucose,tumor necrosis factor-α (TNF-α) and interleukin-6(IL-6) in perioperative patients with neurosurgery.Methods:50 patients with meningioma who were ready to accept craniotomy in department of neurosurgery of our hospital from February 2016 to November 2016 were enrolled,they were randomly divided into research group and control group,with 25 patients in each group.The research group was given DEX 1.0 μg/kg at 10 min before anesthesia,which was added in 0.9％ sodium chloride injection 50 mL,the injection was finished in 10 min,then the DEX change to the rate of 0.5 μg/kg/h.Control group was given 0.9％ sodium chloride injection with constant rate and volume.Record heart rate (HR),mean arterial pressure (MAP) and blood glucose,serum TNF-α,IL-6 levels of the two groups at 10min before anesthesia(T1),after the anesthesia (T2),the beginning of surgery(T3),1 hour after the surgery beginning(T4),the end of surgery(T5).Results:Compared with T1,HR of the two groups at T2 and T3 raised significantly,but research group was lower than control group(P＜0.05);In research group,compared with T1,MAP at T3 raised significantly;in control group,compared with T1,MAP at T3 and T4 raised significantly,but MAP of research group at T3 and T4 were lower than control group (P＜0.05).Compared with T1,blood glucose of the two groups at T2,T3,T4 and T5 raised sig-nificantly,but the research group at same points were lower than control group (P＜0.05).Serum TNF-α,IL-6 levels of control group at T2,T3 and T4 were significantly higher than T1 (P＜0.05),which in research group at different time points had no significant change (P＞0.05),and were lower than control group at T2,T3 and T4 (P＜0.05).Conclusion:DEX could maintain stable hemodynamics,antiinflammation,inhibit elevated blood glucose,so as to reduce the inflammatory response and stress response in patients with neurosurgery,then it could promote these patients postoperative recovery.

Objective To study the diagnostic value of calcification in differentiating benign and malignant thyroid lesions. Methods CT images of 318 consecutive patients with pathologically proven thyroid lesions were retrospectively reviewed by two radiologists. The following characteristics of calcification on CT images were evaluated: (1) size (≤2 mm indicating microcalcification and > 2 mm or shelly and irregular shape indicating macrocalcification, and both features indicating mixed calcification), (2) number (single or multiple) and (3)location (internal or edge). χ~2 test was used for statistical analysis. Results Oft he 318 cases, 48 were diagnosed as malignant (papillary carcinoma 26, follicular carcinoma 7, medullary carcinoma 3 and microcarcinoma 12) and 270 were benign (nodular goiter 36, adenoma 170, nodular goiter with adenoma 38 and adenoma with Hashimoto's thyroiditis 26). Calcification was found in 60 cases (18.9%). Among them 21 (papillary carcinoma 12,microcarcinoma 6,follicular carcinoma 2 and medullary carcinoma 1) were malignant(43.8%) and 39(nodular goiter 6, adenoma 13,nodular goiter with adenoma 19 and adenoma with Hashimoto's thyroiditis 1) were benign (14.4%) (P < 0.01). Sensitivity and specificity for diagnosing thyroid carcinoma were 43.8% (21/48) and 85.6% (231/270), respectively. Microcalcification was found in 37 cases (malignant 8, benign 29) and macrocalcification was found in 23 cases(malignant 13, benign 10) (P < 0.01) . Sensitivity and specificity of macrecalcification for diagnosing thyroid carcinoma were 61.9% (13/21) and 74.4% (29/39), respectively. Single calcification was found in 31 cases (malignant 13, benign 18) and multiple calcification was found in 29 cases(malignant 8, benign 21) (P >0.05). Internal calcification was found in 15 cases of malignant lesions(71.4%) and 12 of benign lesions(30.8%); Edge calcification was found in 6 cases of malignant and 27 of benign, (P <0.01). Sensitivity and specificity of internal calcification for diagnosing thyroid carcinoma were 71.4% (15/21) and 69.2% (27/39), respectively. Conclusion Internal calcification or(and) macrocalcification of the thyroid lesions may strongly suspect thyroid carcinoma and fine-needle aspiration or surgery should be further performed.

Objective To evaluate the diagnostic value of MR cholangiopancreatography(MRCP) using three-dimensional fast recovery fast spin-echo(3D FRFSE) in differentiating benign from malignant causes of biliary and pancreatic duct dilatation.Methods 106 cases suspected biliary and pancreatic duct dilatation underwent 3D FRFSE MRCP.The images were prospectively analysed by two skilled radiologists,and the results were compared with that of surgery,biopsy or follow-up.Results MRCP was successful performed at one time in all cases.On MRCP,the visual rate of intra-and extrahepatic bile duct was 100% and that of main pancreatic duct was 93.4%.80 patients had benign lesions: bile duct lithiasis(n=66),papillitis(n=6),descending part of duodenum diverticulitis(n=2),duodenal adenomatoid hyperplasia(n=1) and chronic pancreatitis(n=5).26 patients had malignant lesions: extrahepatic cholangiocarcinoma(n=9),ampullary carcinoma(n=5),gallbladder carcinoma(n=4) and pancreatic head carcinoma(n=8).The sensitivity,specificity and accuracy in differentiating benign from malignant causes of biliary dilatation were 92.3%,96.3% and 95.3%,respectively.Conclusion 3D FRFSE MRCP plays an important role in diagnosis of differentiating diagnosis of the causes of biliary dilatation in clinical practice.

Objective To investigate the effect and safety of early intervention and delayed intervention therapy on elderly patients and younger patients with non-ST segment elevation acute coronary syndrome. Methods The patients with non-ST segment elevation acute coronary syndrome were randomly divided into early intervention group (coronary angiography taken within 24 hours after grouping) and delayed intervention group ( coronary angiography taken after 36 hours after grouping). The primary endpoint was a composite endpoint of death, myocardial infarction and stroke during 180 days follow-up. Results A total of 815 patients were enrolled, including 198 elderly patients aged 75 years and above, and 617 younger patients aged below 75 years. The elderly patients had a greater incidence of the primary endpoint than that of younger patients ( P = 0. 00). The primary endpoint of early intervention group were obviously lower than that of delayed intervention group of younger patients ( P = 0. 01 ). There was no significant difference in primary endpoint incidence of early intervention group and delayed intervention group of the elderly patients (P =0. 39). Conclusions The elderly patients with non-ST segment elevation acute coronary syndrome who underwent intervention had greater incidence of death and myocardial infarction. Early intervention reduced the rate of myocardial infarction for the younger patients. There was no significant difference in primary endpoint incidence between early intervention and delayed intervention among elderly patients.

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BACKGROUND: Percutaneous laser disc decompression (PLDD) and automated peroutaneous lumbar discectomy (APLD) have been widely used in the treatment of lumbar intervertebral disc prolapse.OBJECTIVE: To compare the symptoms and improvements of patients after receiving PLDD and APLD and analyze the characteristics of the two operations.DESIGN: A non-randomized concurrent controlled observation.SETTING: The 474 Hospital of Chinese PLA.PARTICIPANTS: Totally 106 inpatients with lumbar and leg diseases of different extent were selected from the 474 Hospital of Chinese PLA as the subjects. The patients were divided into APLD group( n =46) and PLDD group( n = 60) according to different intervention measures.INTERVENTIONS: APLD group: The dilating tube was probed at different levels, and working cannula of 4.8 mm was retained at last. The fenestration was made at the fibrous rings with the trepan, then nucleus pulposus of about 1 - 5 g was clipped by the pliers for nucleus pulposus. Electric discectomy apparatus was used to aspirate the nucleus pulposus of about 0.5 - 1.5 g at 600 - 300 rounds per minute. The electric discectomy apparatus and working cannula were pulled out after operation. PLDD group: The stylet was removed and optical fibers were inserted with the naked front segment (5 mm) com pletely going beyond the needle end. Cautery was made with 15 W laser for 1 s once a time at the interval of 4 s. The total output power of laser was adjusted between 1 200 - 1 700 joules. The patients lay at supine position to be examined for pain relief and functional recovery, and then they were sent back to the ward with flatbed cart for bed rest of 3 days. Therapeutic effects were evaluated according to modified Macnab' s criteria. The curative effect was presented as percentage.operations.excellent(47.8% ), 18 good(39. 1% ), 5 passable (10.9%), and 1 poor APLD group, there were 29 cases of excellent(48.4% ), 20 good (33.3%), 9 passable (15.0%), and 2 poor(3.3% ), with 81.7% excellent the two groups. Pain in the lumbar part usually sustained for several days,then was relieved and disappeared gradually. One patient in APLD group had infection of intervertebral disc. No complications occurred in PLDD group.CONCLUSION: PLDD and APLD do not differ significantly in excellent and good rate of treating prolapse of lumbar intervertebral disc. Compared with APLD, PLDD is a more convenient and minimally invasive technique causing fewer complications.

Objective To investigate the HBV reactivation status and clinic outcomes in the renal allograft recipients with inactive HBsAg carriers,and explore the preventive measures.Methods A retrospective analysis of clinical manifestation was processed in 88 cases of inactive HBsAg carriers before and after renal transplantation.Preoperative liver function in all cases was normal and serum HBsAg positive,HBV DNA＜106 copies/L.Tacrolimus (or cyclosporine A) + mycophenolate mofetil (MMF) + prednisone were given in prevention of rejection after transplantation.In 88 cases,56 cases were given nucleoside analogues (acid) for prophylactic antiviral therapy,in which 31 cases were given lamivudine (LAM) (LAM group),25 cases were given entecavir (ETV) (ETV group) ; The rest 32 cases were not given prophylactic antiviral therapy,only receiving routine liver-protecting therapy (inosine,glucurolactone) (control group).Incidence of HBV re-activation,liver function,response to treatment and the pathological changes of hepatic tissue were observed.Results During the follow-up period,the incidence of HBV reactivation in LAM group and ETV group was 45.2％ and 28.0％ respectively,significantly lower than in control group (84.4％,P＜ 0.05).In prophylactic treatment groups,HBV reactivation occurred later,liver function damage was milder,and HBV DNA load peak was lower (P＜0.05).In LAM group,HBV reactivation occurred in 14 cases,including 10 cases occurred during administration of LAM,and ETV treatment was given for about 2 months,serum HBV DNA levels in 7 cases were under detection line;in the rest 4 cases,HBV reactivation occurred in patients with treatment less than 1 year and noncompliance,who withdrew medicine blindly.After the original scheme of antiviral therapy was done,serum HBV DNA levels in 3 cases were under detection line,and the effect was not obvious in one case.In control group,HBV reactivation occurred in 27 cases.Fourteen cases therefore accepted nucleoside (acid) analogs antiviral therapy,and HBV DNA levels in 10 cases were under detection line.Histological examination revealed the liver with fibrotic cholestatic hepatitis changes in 9 patients,including 8 cases in control group,and 1 case in LAM group due to blind withdrawal of medicine.Conclus(i)on LAM and ETV prophylactic use may decrease the HBV reactivation rate in inactive HBsAg carriers after renal transplantation,reduce the severity of liver damage and the occurrence of fibrotic cholestatic hepatitis.

Objective To explore the independent risk factors for the 1 year stroke event in Chinese patients with atrial fibrillation (AF) and hypertension (HT).Methods Data of AF and HT patients in the Chinese Emergency Atrial Fibrillation Registry Study were retrospectively analyzed.The eligible patients were divided into the stroke group and the non-stroke group according to the result of 1 year follow-up.The predictors for the 1 year stroke event were identified by uni-and multi-variate Cox regression analysis with the baseline and therapeutic variables.Results A total of 1 118 AF and HT patients were enrolled in the study with the incidence of 1 year stroke event of 8.7％.All patients were divided into the stroke group (n =97) and the non-stroke group (n =1 021).Compared with the non-stroke group,more female patients were in the stroke group (68.0％ vs 54.5％,P ＜ 0.05) and the patients in the stroke group were older [(76.0 ± 9.4) years vs (71.9 ± 10.6) years,P ＜ 0.01] with higher proportion of previous history of stroke (38.1％ vs 23.8％,P ＜0.01).More patients were observed on the antihypertensive treatment in the non-stroke group (91.6％ vs 85.6％,P ＜ 0.05),while more patients on statins in the stroke group(45.4％vs 34.5％,P ＜ 0.05).Multi-variate Cox regression analysis showed that age (HR =1.036,95％ CI 1.010-1.062),female (HR =1.908,95％ CI 1.170-3.110),previous stroke history (HR =1.680,95％ CI 1.084-2.603),and no antihypertensive treatment (HR =1.955,95％ CI 1.008-3.791) were independent risk factors for the 1 year stroke event in patients with AF and HT.Conclusion Age,female,previous stroke history and no antihypertensive treatment are the independent risk factors for the 1 year stroke event in patients with AF and HT.