Objective To investigate the expression of survivin/Human leukocyte antigen class I ( HLA-Ⅰ) proteins and its physiological significance in clear cell renal cell carcinoma ( CCRCC ) . Methods Immunohistochemistry was used to analyze survivin/HLA-Ⅰ protein expression in 90 cases of CCRCC and 10 normal tissues to study relationships with clinical symptoms and disease prognosis . Resutl s The level of survivin protein expression was found to be significantly higher in CCRCC tissues 82.2%( 74/90) than in normal tissues( 0/10).However, the relative amount of HLA-Ⅰprotein in colorectal cancer tis-sue was also found to be significantly lower 67.8%(61/90) than in normal tissues 90%(9/10).Survivin expression was associated with tumor grade , stage,and lymph node metastasis ( P=0.000, P=0.016, and P=0.001, respectively ) .Conversely , lost HLA-Ⅰexpression did not have any associations with clinicopath-ological data (P>0.05).Survivin negative patients (25.0%, 4/16) had a higher tumor-free survival rate than patients (52.7%, 39/74)with survivin expression (P=0.037).Patients (27.6%, 8/29) with normal HLA-Ⅰlevels had a higher tumor-free survival rate than those ( 60.7%, 37/61) with reduced HLA-Ⅰlev-els (P=0.020).The univariate and multivariate analyses indicated that expression of survivin and HLA indi -vidually and in combination were independent predictors for CCRCC patient survival . Conclusions Over-expression of survivin but reduced HLA-Ⅰ expression is associated with CCRCC development and progres-sion.

Objective To evaluate the efficacy and safety of quetiapine fumarate as mono-therapy for acute mania in patients with bipolar disorder.Methods The study design was randomized,double blind,double dummy.lithium controlled.multicenter trial.Patients with bipolar disorder were hospitalized for the treatment of an acute manic episode according to the Chinese Classification of Mental Disorders 3rd edition criteria.and with the Young Mania Rating Scale(YMRS)total score≥20 were randomized to receive quetiapine(twice daily up to 800 mg/d)or lithium(twice daily up to 2000 mg/d).The primary endpoint was the change of YMRS total score from baseline to Day 28(last observation carried forward;LOCF).The safety was evaluated with the rate of adverse events(AEs),laboratory test and ECG.Results The ITTincluded 154 subjects.with 77 in each treatment group.Mean doses were 642.9 mg/d and 1377.7 mg/d for quetiapine and lithium respectively.Changes of YMRS total score from baseline to Day 28 in quetiapine and lithium group were-18.2 and-15.9,respectively.At Day 28,the response rate was significantly higher in quetiapine-treated patients(78%vs.60%;P=0.013).Quetiapine was well tolerated up to doses of 800 mg/d,and 78%of patients in quetiapine group and 69%in lithium group reported AEs.The most frequently reported AEs in quetiapine group were constipation(35%),dizziness(15%),and diarrhea (10%),and in lithium group were nausea(17%),constipation(13%),and vomiting(13%).Three subjects in lithium group but none in quetiapine group withdrew due to AEs.Conclusions The study resuhs support that quetiapine monotherapy is effective and well tolerated in the treatment of acute mania.

Objective To evaluate the efficacy and safety of quetiapine fumarate as mono-therapy for acute mania in patients with bipolar disorder.Methods The study design was randomized,double blind,double dummy.lithium controlled.multicenter trial.Patients with bipolar disorder were hospitalized for the treatment of an acute manic episode according to the Chinese Classification of Mental Disorders 3rd edition criteria.and with the Young Mania Rating Scale(YMRS)total score≥20 were randomized to receive quetiapine(twice daily up to 800 mg/d)or lithium(twice daily up to 2000 mg/d).The primary endpoint was the change of YMRS total score from baseline to Day 28(last observation carried forward;LOCF).The safety was evaluated with the rate of adverse events(AEs),laboratory test and ECG.Results The ITTincluded 154 subjects.with 77 in each treatment group.Mean doses were 642.9 mg/d and 1377.7 mg/d for quetiapine and lithium respectively.Changes of YMRS total score from baseline to Day 28 in quetiapine and lithium group were-18.2 and-15.9,respectively.At Day 28,the response rate was significantly higher in quetiapine-treated patients(78%vs.60%;P=0.013).Quetiapine was well tolerated up to doses of 800 mg/d,and 78%of patients in quetiapine group and 69%in lithium group reported AEs.The most frequently reported AEs in quetiapine group were constipation(35%),dizziness(15%),and diarrhea (10%),and in lithium group were nausea(17%),constipation(13%),and vomiting(13%).Three subjects in lithium group but none in quetiapine group withdrew due to AEs.Conclusions The study resuhs support that quetiapine monotherapy is effective and well tolerated in the treatment of acute mania.