Volume 88  ·   Issue 01  ·  2008

The plan of medical reform has not yet been issued. Any plan will not go smoothly, let alone be universally applicable. However, as long as it reflects health fairness, allows the majority of ordinary people to share the fruits of reform and opening up and national prosperity, improves the environment for seeking medical treatment, and plays a good role in enhancing people's health, it is a good plan.

Objective To screen the serum protein expression profiles in patients having polycystic ovary syndrome(PCOS)with or without insulin resistance(IR) and search for discriminatory proteins.Method Fasting serum samples of 30 PCOS patients with IR,30 PCOS patients without IR,and 30 control individuals from Reproductive Center of Peking University Third Hospital were studied.Results There were 27 differential protein peaks between PCOS IR patients and controls,17 between PCOS non-IR patients and controls,and 19 between PCOS IR patients and non-IR patients.Marker proteins from differentially expressed proteins were screened out using support vector machine(SVM),and were used to establish three diagnostic models for PCOS IR,PCOS non-IR,and IR,respectively.Conclusionss There were significantly different serum proteomic patterns in different types of PCOS.Using ProteinChip combined with SVM,computer diagnostic models for PCOS with and without IR were set up quickly and efficiently.These discriminatory proteins may help us understand the proteomic changes in serum and find out potential biomarkers of PCOS and IR.

Objectives To research the clinical features of pancreatic cavernous hemangioma.Methods Retrospectively analyzed 3 pancreatic cavernous hemangioma cases treated in our hospital during the last 20 years,and reviewed correlative literature.Results The incidence of pancreatic cavemous hemangioma Was very low.It occurred more often in woman. As the early symptoms were not obvious and the imaging studys were not specific, the misdiagnosis rate was high.Usually,the diagnosis Was confirmed by the pathological result.Conclusion Pancreatic eavemous hemangioma is a rare benign tumor of the pancreas. It's difficult to diagnosis before surgery.Surgery is the best treatment with satisfactory results,and its prognosis is fairly good.

Objective To sum up the experience in diagnosis and treatment of isolated superior mesenteric artery(SMA)dissection and determine the best management for this disease.Methods We retrospectively reviewed clinical data of two patients with isolated SMA dissection admitted in the first hospital of China medical university from October to December 2006 and 69 cases reported in the literature.Results SMA dissection without aortic involvement is a rare event. Most diagnoses were established by CT and arteriography.Therapeutic option has not yet been established,however,conservative and interventional treatments have been reported more frequently.In our two cases,CT angiography allowed the rapid diagnoses.They were treated by conservative method and interventional stent separately,and have been followed-up for seven months.The managements were successful. Conclusion Early diagnosis and management directly influence the prognosis.The strategy of management should be determined by symptoms,blood supply of SMA,peritonitis et al.

Objective To value a new presurgical classification system of submucons myomas for predicting the difficulty and the safety of hysteroscopic myomectomy.Methods The clinical data of 491 patients who underwent hysteroscopic resection of submucous myomas were analyzed.The myomas were classified according to the Classification of the European Society for Gynaecological Endoscopy(ESGE)and our group's new classification,which consists of five parameters.The possibility of total resection of submucous myoma,the operating time and the frequency of any complications were considered.Results The ESGE classification showed significant differences between the level 0 and level Ⅰ or Ⅱ(both P＜0.01).Hysteroscopic myomectomy was considered incomplete in 9 patients with myomas.The numbers of complete surgeries of level Ⅱ was significant lower compared to level 0 or level Ⅰ(P＜0.01).Using our new classification,the differences of both operating times and the numbers of complete surgeries between group B and A was significant(P＜0.01).Conclusion The new classification gives more clues as to the difficuhies of hysteroscopic myomectomy than the standard ESGE classification.Although a larger number of patients need to be evaluated by this classification.

Objective To investigate the reliability and clinical value of functional magnetic resonance imaging(fMRI)-integrated neuronavigation in minimally invasive neurosurgery and protection of brain function.We demonstrate the correlation between the lesion-to-fMRI activation distance and occurrence of new postoperative deficit.Methods fMRI-integrated neuronavigation was used for minimally invasive neurosurgery in 20 patients with intracranial lesions located in or near eloquent brain areas.During standardized paradigms for hand,foot,and tongue movement,language and visual activation,echo-planar imaging T2 blood oxygen level dependent sequences were acquired by Siemens Medical Systems Trio 3.0 T and processed with SPM2.Neuronavigation was performed with Stealth station.Resuits fMRI data was integrated into neuronavigation successfully in all cases,functional neuronavigation with integration of fMRI allowed easy and precise identification of the eloquent brain areas and lesions except for 1 case for brain shift because of tumor stroke just before the operation.The localization of the tumor was corrected by intraoperative ultrasonography.Gross total resection was achieved in18 patients,2 patients had a subtotal resection.Neurological deterioration was seen in 4 patients,tumors all located in eloquent brain areas,2 patients were recovered in 3months the morbidity was 10.0%.The distance of a lesion to fMRI activation Was more than 10 mm in 14 cases.The functional maps were located in left Brodmann's 9,46,17,18 and 19 areas in 11 cases when the patients reading and understanding the Chinese words.Conclusions Functional neuronavigation with integration of fMRI allows precise identification of the eloquent brain areas protects the brain function and decreases the morbidity especially for Chinese patients because of our special functional area of language.Our data suggest that the distance of a lesion to fMRI activation was more than 10 mm,complete resection can be achieved safely.

Objective To set up a new method to detect occult micrometasteses of lymph nodes in patients with no-small-cell lung cancer (NSCLC).Methods We had detected 195 lymph node samples taken from 25 patients with NSCLC during the operations.Each lymph node sample was divided into two same Darts in size.The one half part of lymph node should be examined by conventional histopathologic examination and immunohistochemical(IHC)staining.All the remaining lymph node samples of each patient should be mixed together for the reverse transciptase--polymerase chain reaction (RT-PCR)if they located in the same region.As long as the presence of metastatic tumor in one lymph node was found by H&E staining,all other lymph node samples in the same region should not be detected by IHC staining or RT-PCR techniques.Results Frozen tissue sections of 135 lymph nodes that were staged as free of metastases by conventional histopathologic examination were screened by IHC staining.31 lymph nodes showed single cell or cells clusters.Of 39 groups mixed regional lymph nodes which were diagnosed to be devoid of metastases by conventional histopathologic examination.11 groups were found to have positive reactions to cyokeratin 19-mRNA by RT-PCR.There was a correlation between IHC staining and RT-PCR for detection of nodal micrometastases of NSCLC(U=7.682,P=0.0001).Conclusion IHC staining analysis can facilitate the detection of occult micrometastases in lymph nodes of NSCLC.and its assessment of nodal micrometastases can provide a refinement of TNM stage for partial patients with stage Ⅰ toⅡ.RT-PCR has the same value as IHC staining in detection of lymph nodal micrometastases.RT-PCR technique can reduce expense of the detecting micrometastases in lymph nodes.

Objective To investigate the detection rate of prostate cancer in difierent PSA values and evaluate the importance of free PSA/total PSA in the diagnosis of prostate cancer in Chinese men.Methods We have analyzed 1244 patients who were submitted to needle biopsy since Jan 2000 to June 2005 in the Institute of Urology,Peking University.Systematic 12-or 13-core biopsies were taken transrectally under ultrasound(TRUS)guide for all of the patients.Results The prostate cancer detection rates in the tPSA ranges of＜4 ng/ml with positive DRE;4-10 ng/ml with f/tPSA＞0.16;4-10 ng/mlwith f/tPSA＜0.16;10.1-20 ng/ml and＞20 ng.ml.The positive biopsy rates were 18.1%(13/72),11.6%(10/86),17.4%(45/258),24.9%(110/442),56.7%(219/386)respectively.The higher levels of the PSA,the higher percentage of high grade(Gleason score≥8)prostate cancer.In conclusion,patients with PSA＞10 ng/ml or positive digital rectal examination(DRE)were strongly recommended to biopsy for detecting prostate cancer because of hish positive rate.For the patients with PSA 4-10 ng/ml,the free PSA(fPSA/t PSA＜0.16)will play an important role to improve cancer detection rate.

Objective To investigate dynamic changes of CT performance and pulmonary function in renal transplant recipients with pneumocystis pneumonia.Methods A retrospective analysis was made upon the clinic data of chest CT,arterial blood gas and pulmonary function in renal transplant recipients with pneumocystis pneumonia from 2002 to 2006 in the first affiliated hospital of Wenzhou Medical College.Results 16 cases were enrolled,followed by average age(36±11)years,mean duration after transplantation(4.3 ±2.1)months,mean course of disease(4.5 ±1.8)days.CT performance after admission revealed diffuse alveolar exudates and consolidation in all patients,and others still showed focal emphysema.With effective treatment,CT performance showed resolution of lung opacities completely until the second month,just little fiber remained.The pulmonary dysfunction showed apparent restrictive ventilatory abnormal and decreased DLco.Pulmonary dysfunction improved in the coming 3-4 weeks,and all dysfunction became complete resolution by the third month.Conclusions The characteristic CT performance was focused on the alveolar,with exudates,consolidation and focal emphysema.The main pulmonary dysfunction showed restrictive ventilatory abnormality and decreased DLeo.Under effective therapy,these abnormalities would improve significantly by the third month.

Objective To observe the effect of elemene on cell cycle of rat C6 glioblastoma cells.Methods Cell cycle analysis and expression of p38 in C6 glioblastoma cells under elemene treatment were measured by flow cytometry and Western blot.Flow cytometry and MTT assay were used to examine cell cycle and cell proliferation while C6 glioblastoma cells were pretreated with p38 inhibiotr and DN-p38 plasmids.Results The fraction of C6 in the G0/G1 phase increased 11%.6.95%,19.57%respectivelv in the presence of 40,60 and 80 μg/ml elemene.The level of phosphorylated p38 MAPK was greatly increased in a dose and time-dependent manner.Inhibition of p38 MAPK activation with SB203580 and DN-p38 blocked elemene-induced anti-proliferation effect.Conclusion Elemene could induce G0/G1 cell cycle phase arrest of C6 glioblastoma cells through up-regulation of phosphorylated p38.

Objective To investigate the expression of RhoC in prostate cancer cells with different metastatic potential and the correlation with invasiveness.Methotis Expression of RhoC mRNA and protein in human prostate cancer cell subclones PC-3M-2B4 with non-metastatic potential and PC-3M-1E8 with highly metastatic potential was detected bv RT-PCR and Westren blot.Eukaryotic expression plasmids of RhoC were constructed and transfected into PC-3M-2B4.The biological effects were observed,including in vitro invasion by Boyden charmber assay,motility by would healing assay,alteration of microfilament network by the staining of TRTIC-phalloidin,activities of matrix metalloproteinases(MMP)by gelatin zymography analysis and expression of p-Akt by Westren blot assay.Results The expression levels of RhoC mRNA and protein varied in the two different metastatic subclones of human prostate cancer cell.RhoC was significantly upregulated in the highly metastatic subclones in comparison to the nonmetastatic counterpart(P＜0.01).As shown in Boyden charmber assay,the invasive capacity of transfected cells overexpressing RhoC was significantly promoted as reflected by more penetrating cells(125.21±10.43)than the antisense transcripts (46.22±8.12),the negative(53.77±8.56)and blank controls(57.68±7.25).Further study by would healing assay indicated that cells overexpressing RhoC were more motile in actin-based active movement(would healing ratio after 16 h of the sense transcripts,antisense transcripts,negative controls and blank controls was 62.38±2.36,29.47±1.86,32.23±2.43,31.88±2.67 respectively).The TRITC-phalloidin staining revealed less actin filament bundles and a fuzzy network of shorter filaments in the sense transcripts.In addition,MMP-2 activity and p-Akt expression level were upregulated in the sense transcripts.Conclusion RhoC overexpression could promote the invasive capacity of human prostate cancer cell in vitro and it's expression level correlated positively with the metastatic capacity of human prostate cancer cell,so RhoC may be a potential target in the development of a novel strategy for treating metastasis of prostate cancer.

Objective To establish a rat model of chronic pulmonary infection by inoculating two different Pseudomonas aeruginosa embedded in minute seaweed algiante beads made by an ejection set with an acuminate hole to Sprague-Dawley rats.To evaluate the animal model with bacteriology and pathology values.Method (1)300 healthy,clean Sprague-Dawley rats were divided into 3 groups randomly:the wide-type Pseudomonas aeruginosa group(PAO1 group),the mutant type Pseudomonas aeruginosa group (PAO-JP2 group)and the control group.(2)Two different Pseudomonas aeruginosa were embedded in minute seaweed algiante beads by an ejection set with an acuminate hole.Then the beads were inoculated into the rats' lung through tracbeal intubation.The bacteria numbers in lung and pathology scores were measured 3,7,14,28 days after infection.Results (1)The bacteriology values:No bacterium were detected in the control group.PAO1 and PAO-JP2 were detected from rats of PAO1 and PAO-JP2 infected groups respectively.Bacterial number was higher than 105 CFU/g 3,7 days after infection(LgCFU/g):3 d:PAO1 group:19±6,PAO-JP2 group:17±7;7 d:PAO1 group:13±4,PAO-JP2 group:12±4)and higher than 103 CFU/g 14,28 days after infection(LgCFU/g:14 d:PAO1 group:11.3±2.8,PAO-JP2 group:9.6±3.3;28 d:PAO1 group:9.1±1.5,PAO-JP2 group:4.2±3.0).(2)The pathological changes showed:3,7 days after infection,lung abscess, edema, consolidation, haemorrhage can be seen from lungs of both groups.And at optical microscopic,alginate-Pseudomonas aeruginosa caused a pronounced inflammatory reaction with polymorphonuclear cells surrouding a bead.Small microcolonies formed at the periphery of the bead were also seen.14,28 days after infection,the consolidation reduced gradually and lung atelectasis、fibrinous adhesions and granulomas became the major pathological changes,which is more significant in the PAO1 group.Condusion The animal model of chronic pulmonary infection can be established by inoculatingPseudomonas aeruginosa embedded in minute seaweed algiante beads mode by an ejection set with an acuminate hole to Sprague-Dawley rats.

Objective To investigate the effects of injuried pulmonary arterial endothelial cell induced by endotoxin on proliferation of pulmonary artery smooth muscle cells and interference effeet of bone morphogenetic protein-2,and at the same time explore its possible mechanism.Methods Upper liquid of normal PAEC incubated by DMEM for 24 h without serum(EC-CMI)or that of PAEC incubated by the same DMEM and same period after incubating with endotonxin at concentration of 1 μg/ml for 1 h(EM-CMⅡ)were collected and preserved for PASMC incubating.Confluent monolayer PASMC of rats were incubated with EC-CM Ⅰ(group Ⅰ),EC-CMⅡ(group Ⅱ),EC-DMⅡ+BMP-2 1ng/ml(group Ⅲ),EC-DMⅡ+BMP-2 10 ng/ml(group Ⅳ)and EC-DMⅡ+BMP-2 100 ng、ml(group Ⅴ)for 24 h.The cultured cells were identified by phase-contrast microscope and immunofluorescent stain of SMC specific antigen.The proliferation of PASMC were evaluated by the BrdU assay.The cell cycle analysis including proliferation index(PI)and S-phase cell fraction(SPF)were performed by the flow cytometry.the DNA synthesis was detected by[methyl-3H]-thymidine incorporation;the expression of cyclinD1 mRNA was elucidated by RT-PCR techonology;the analysis of phosphorylated Smad1(pSmad1)and expression of cyclinD1 protein were detected by Western-blot expenement.Results Cells were confirmed as smooth muscle by their typical "hill-valley"morphological features displayed under phase-contrast microscope and by immunofluorescent staining of smooth muscle,Compared with group Ⅰ,there were a significant increase in proliferation rate,S-phase cell fraction(SPF),DNA synthesis in group Ⅱ.Compared with group Ⅱ,there were no significant changes in group Ⅲ about that data.But the groups with 10 or 100 ng/ml(group Ⅳ and group Ⅴ)of BMP-2 significantly attenuated proliferation rate,S-phase cell fraction(SPF),DNA synthesis and expression of cyclinD1 mRNA and protein compared with EC-CM2 alone(group Ⅱ,P＜0.01).Phosphorylated Smad1 increased in group Ⅳ and group Ⅴ compared with group Ⅱ,(P＜0.01).Conclusion The BMP-2 could downregnlate expression of cyclinD1 gene by smad signaling transconduction system,then depressed proliferation of PASMCs by EC-CM2 in vitro culture.And this effect is dependent in the concentration range of 1-100 ng/ml.

Objective To investigate the inhibitive role of the invasion and growth of laryngeal cancer by lentivirus mediated Matrix Metalloproteinase-2(MMP-2)and Matrix Metalloproteinase-2(MMP-9)gene silence.Methods RNA interference(RNAi)technic was used.Recombinant lentivirus of small interference RNA targeting MMP-2 and MMP-9 gene were transduced into Hep-2 cells,and Reverse transcdptase polymerase chain reaction(RT-PCR)was used to test MMP-2 and MMP-9 expression in Hep-2 cells.The effect of the invasive capability in Hep-2 cells after MMP-2-RNAi-lentivirus and MMP-9-RNAi-lentivims transduction was observed by Boyden assay.In vivo experiment.the nude mouse model of laryngeal squamous carcinoma was established and MMP-2-RNAi-lentivirus and MMP-9-RNAi-lentivirus were intratumoral injeeted.Finally,the tumor inhibitive effect was observed and the Prolirerating cell nuclear antigen(PCNA)expression in xenografts were examined to evaluate proliferation change of the Hep-2 cells.Results The recombinant lentivirus can transduce the target cells efficiently.RT-PCR showed the expression of MMP-2 and MMP-9 were negative.Boyden assay showed there were(14±4)Hep-2 cells permeate artificial basement which was less than that(32±6)in the control group.In vivo,the average tumor weight and volume in treated group were significantly lower than those in the control group(P＜0.01)and the tumor inhibitive rate was 46.59%.Immunohistochemistry showed PCNA index in treated group was obviously lower than that in control group(P＜0.01).Conclusion The invasion,growth and proliferation of laryngeal cancer can be inhibited by lentivirus mediated MMP-2 and MMP-9 gene silence together.

Objective To investigate changes of synapse related protein,such as synaptophysin(SYP)and postsynaptic dense material 95(PSD-95),in brains of 10 months old transgenic mice,and the effects of Epimedium flavanoids(EF)on expression of SYP and PSD-95 in brain of 10 months old of APP transgenic mice.Methods The mice of drug treated group were administered introgastrically by EF(at low negative transgene group were administered of distilled water by the same way.The expression of SYP in CA1,CA3,and dentate gyrus(DG)areas of hippocampus and cortex,and PSD-95 in hippocampus and cortex were detected by immunohistochemistry and Western blot respectively.Results Compared to negative transgenic mice,the expression of SYP in cortex was decreased by 51.3%(P＜0.01).The IOD value of SYP immuno-reactivity cell in CA1,CA3 and DG areas of hippocampus in 10 months old transgenic mice were significantly decreased(the suppression rates were 59.1%,57.7%and 56.5%in CA1,CA3 and DG respectively,all P＜0.01).The expression of PSD-95 in cortex decreased by 36.4%(P＜0.01).The count of PSD-95 immuno-reactivity cell in CA1 area of hippocampus decreased with the suppression rate pf 18.5%(P＜0.05).After being administered introgastrically by EF for 6 months,the expression of SYP in cortex of EF low doses and hish dose group mice increased by 40.0%(P＜0.05)and 106.4%(P＜0.01)respectively in comparison with that of the control group.The IOD value of SYP immuno-reactivity cell in hippocampal CA1,CA3 and DG areas of EF low and high dose group mice were all significantly increased(all P＜0.01).The expression of PSD-95 in cortex of EF low and high dose group mice increased by 57.3%(P＜0.05)and 84.3%(P＜0.01)respectively when compare to the control group.The count of PSD-95 immuno-reactivity cell in CA1 area of hippocampus of mice in EF high dose group increased by 22.5%(P＜0.05).Conclusion Epimedium flavanoids could protect the synaptic structure and function by promoting the expression of synaptophysin and postsynaptic dense material 95,which suggest that Epimedium Flavanoids may have a promising application prospect in improving the synaptic impairment of AD.

A female, 18 years old, was admitted to hospital on 2 March 2006 due to high fever in February. The patient developed fever after exertion in early January 2006, with the highest body temperature exceeding 40℃, accompanied by fatigue and night sweats. Multiple antibiotics were ineffective in the local hospital. In February 2006, routine blood examination showed white blood cells 1.0×109/L, lymphocytes 0.6, hemoglobin 92 g/L and platelets 466×109/L. Chest X-ray examination showed no abnormalities. CT examination showed multiple enlarged lymph nodes in the right upper mediastinum, hepatosplenomegaly, and patchy low-density shadow in the spleen. 　　

Parkinson's disease (PD) is a chronic and progressive neurodegenerative disease common in middle-aged and elderly people. Its etiology and pathogenesis are still not completely understood. At present, it is believed that it is the result of genetic factors and environmental factors. Studies have shown that abnormal aggregation of α-synuclein is closely related to the pathogenesis of PD [1].

As early as 1966, scholars found that sensitized lymphocytes can release a soluble substance that inhibits the free migration of macrophages, so it was named macrophage migration inhibitory factor (MIF).

Hepatoid adenocarcinoma is a rare adenocarcinoma with liver-like differentiation, and it can often see adenocarcinoma components and hepatocellular carcinoma-like components. Hepatoid adenocarcinoma is commonly reported in gastric cancer [1], and other organs such as lung, kidney, urinary tract, ovary, endometrium, etc. are also reported [2], while those that occur in gallbladder are less common. We retrieved 2 cases reported in foreign literature [3-4] and 2 cases reported in domestic literature [5-6]. A case of hepatoid adenocarcinoma of gallbladder admitted to the Second Affiliated Hospital of Zhejiang University School of Medicine in 2006 is reported and the literature is reviewed.