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Objective: To explore clinical effect of attaching locking plate with bone grafting based on retaining the original intramedullary nail in treating non-union after intramedullary nail fixation of long shaft fractures of lower limbs., Methods: A retrospective study was conducted on 20 patients treated with non-union fractures after intramedullary nailing of long shaft fractures of lower limbs from June 2015 to June 2020. All patients were treated with the original intramedullary nailing and bone grafting from the iliac bone, and were underwent open reduction plate internal fixation and bone grafting for old fractures. Among them, 14 were males and 6 were females, aged from 35 to 56 years old with an average of (42.2±9.6) years old. Nine patients were femoral shaft fracture and 11 patients were tibial shaft fracture. According to characteristics of fracture end nonunion, 6 patients were stable/atrophic, 9 patients were unstable/large, and 5 patients were unstable/atrophic. The nonunion time ranged from 8 to 12 months with an average of(9.8±2.0) months after the initial surgery. Visual analogue scale (VAS), knee range of motion, bone healing time, complications and fracture-end healing were recorded before and at the latest follow-up., Results: All patients were followed up for 18 to 48 months with an average of (36.3±10.5) months. The incision of all patients were healed at stageⅠwithout complications such as infection or internal fixation ruptur. Healing time of femur and tibia was (8.5±2.6) months and (9.5±2.2) months. Knee joint motion increased from preoperative (101.05±8.98) ° to postoperative (139.35±8.78) ° at the latest follow-up ( t =-12.845, P <0.001). VAS decreased from preoperative (5.15±1.72) to postoperative (0.75±0.96) at the latest follow-up ( t =11.186, P <0.001)., Conclusion: On the basis of retaining the original intramedullary nail, the addition of locking plate internal fixation and autogenous iliac bone grafting have advantages of simple operation, less trauma, fewer complications and high fracture healing rate. It is one of the effective surgical schemes for the treatment of nonunion after intramedullary nail fixation of long bone fracture of lower extremity.

Objective: To explore the relationship between low density lipoprotein cholesterol (LDL-C)/high density lipoprotein cholesterol (HDL-C) ratio with the severity of coronary artery disease and 2-yeat outcome in patients with premature coronary heart disease. Methods: This prospective, multicenter, observational cohort study is originated from the PROMISE study. Eighteen thousand seven hundred and one patients with coronary heart disease (CHD) were screened from January 2015 to May 2019. Three thousand eight hundred and sixty-one patients with premature CHD were enrolled in the current study. According to the median LDL-C/HDL-C ratio (2.4), the patients were divided into two groups: low LDL-C/HDL-C group (LDL-C/HDL-C≤2.4, n =1 867) and high LDL-C/HDL-C group (LDL-C/HDL-C>2.4, n =1 994). Baseline data and 2-year major adverse cardiovascular and cerebrovascular events (MACCE) were collected and analyzed in order to find the differences between premature CHD patients at different LDL-C/HDL-C levels, and explore the correlation between LDL-C/HDL-C ratio with the severity of coronary artery disease and MACCE. Results: The average age of the low LDL-C/HDL-C ratio group was (48.5±6.5) years, 1 154 patients were males (61.8%); the average age of high LDL-C/HDL-C ratio group was (46.5±6.8) years, 1 523 were males (76.4%). The number of target lesions, the number of coronary artery lesions, the preoperative SNYTAX score and the proportion of three-vessel coronary artery disease in the high LDL-C/HDL-C group were significantly higher than those in the low LDL-C/HDL-C group (1.04±0.74 vs. 0.97±0.80, P =0.002; 2.04±0.84 vs. 1.85±0.84, P <0.001; 13.81±8.87 vs. 11.70±8.05, P <0.001; 36.2% vs. 27.4%, respectively, P <0.001). Correlation analysis showed that there was a significant positive correlation between LDL-C/HDL-C ratio and preoperative SYNTAX score, the number of coronary artery lesions, the number of target lesions and whether it was a three-vessel coronary artery disease (all P <0.05). The 2-year follow-up results showed that the incidence of MACCE was significantly higher in the high LDL-C/HDL-C group than that in the low LDL-C/HDL-C group (6.9% vs. 9.1%, P =0.011). There was no significant difference in the incidence of all-cause death, cardiac death, myocardial infarction, stroke, revascularization and bleeding between the two groups. Cox multivariate regression analysis showed that the LDL-C/HDL-C ratio has no correlation with 2-year MACCE, death, myocardial infarction, revascularization, stroke and bleeding events above BARC2 in patients with premature CHD. Conclusion: High LDL-C/HDL-C ratio is positively correlated with the severity of coronary artery disease in patients with premature CHD. The incidence of MACCE of patients with high LDL-C/HDL-C ratio is significantly higher during 2 years follow-up; LDL-C/HDL-C ratio may be an indicator for evaluating the severity of coronary artery disease and long-term prognosis in patients with premature CHD.

Objective: To evaluate the screening performance of hypersensitive quantitative fecal immunochemical test (hs-qFIT) and qualitative fecal occult blood test (FOBT) for colorectal cancer and advanced adenoma. Methods: Consecutive participants scheduled to undergo colonoscopy from April 2020 to April 2021 in Qilu Hospital of Shandong University were included in the study. All the participants were 50-75 years old and at moderate to high risk for colorectal cancer. Participants completed hs-qFIT and two kinds of qualitative FOBTs (colloidal gold method and chemical-immunization method) before colonoscopy. The sensitivities and specificities of hs-qFIT and two qualitative FOBTs for colorectal cancer and advanced adenoma were compared. Results: A total of 910 participants were enrolled in the study, including 451 males and 459 females, aged (59.6±6.4) years. There were 22 cases (2.4%) of colorectal cancer, 61 cases (6.7%) of advanced adenoma, 276 cases (30.3%) of non-advanced adenoma, 194 cases (21.3%) of non-adenomatous polyp, 85 cases (9.3%) of other colorectal lesion and 272 cases (29.9%) of non-colorectal lesion. The sensitivities of hs-qFIT for detecting colorectal cancer increased from 72.7% (95% CI : 49.6%-88.4%) to 100% (95% CI : 81.5%-100%) with cut-off value decreasing from 200 ng/ml to 10 ng/ml, and the sensitivities of both colloidal gold method and chemical-immunization method were 63.6% (95% CI : 40.8%-82.0%) ( P =0.008). The detection stability of hs-qFIT for colorectal cancer was higher than colloidal gold method ( P =0.016) and chemical-immunization method ( P =0.031). The sensitivity for detecting advanced adenoma of hs-qFIT at 10 ng/ml was 52.5% (95% CI : 39.4%-65.2%), which was significantly higher than that of colloidal gold method (13.1%, 95% CI : 6.2%-24.8%, P <0.001) and chemical-immunization method (6.6%, 95% CI : 2.1%-16.7%, P <0.001). Conclusions: The sensitivity and detection stability of hs-qFIT for detecting colorectal cancer was higher than qualitative FOBT. Moreover, the sensitivity for detecting advanced adenoma can be further improved using a lower cut-off value.

Objective: To investigate the difference in the expression of Ras-associated protein 1 (Rap1) in necrotic and healthy areas of non-traumatic osteonecrosis of femoral head (NONFH) patients., Methods: Femoral head tissue samples from 30 cases of NONFH and 30 cases of traumatic osteonecrosis of the femoral head (TONFH) were collected after hip replacement surgery, respectively. No significant difference of Association Research Circulation Osseous (ARCO) staging was found between the NONFH and the TONFH groups ( Z =-0.769, P =0.442). In the NONFH group, 8 patients were ARCO stage IIIb, 10 were stage IV, and 12 were stage V, while in the TONFH ground, 11 patients were ARCO stage IIIb, 9 were stage IV, and 10 were stage V. There were 19 males and 11 females in the NONFH group, with an average age of 49.6 yr. (26-69 yr.), and 16 males and 14 females in the TONFH group, with an average age of 54.2 yr. (37-68 yr.). There was no significant difference in gender or age between the two groups ( P >0.05). Specimens were collected from different bone areas, including those from the necrotic areas (area A) and the healthy areas (area B) of the NONFH group, and those from the healthy areas (area B') of the TONFH group, i.e., the control group. Western blot and quantitative real-time reverse transcription PCR (qRT-PCR) were used to analyze the different expression of Rap1, vascular endothelial growth factor (VEGF) protein, phosphoinositide 3-kinase (PI3K), and Akt protein and their corresponding mRNA in the three areas of bone tissue. HE staining and immunohistochemisty staining were done in order to observe the morphological changes of each area., Results: Western blot results indicated that there was no statistical difference in the relative expression of Rap1, VEGF, PI3K, and Akt proteins ( P >0.05). The relative expressions of Rap1, VEGF, PI3K, and Akt proteins in the area A were lower than those in the area B and the difference was statistically significant ( P <0.05). qRT-PCR results showed that the relative expressions of Rap 1, VEGF , PI 3 K and Akt mRNA in area A were lower than those of area B, and a statistical difference was found ( P <0.05). The relative expression of the mRNA of Rap 1, VEGF , PI 3 K and Akt in area B and area B' were not significantly different ( P >0.05). HE staining and immunohistochemisty staining showed that chondrocytes decreased in the necrotic area (area A) of NONFH, chondrocytes nucleus disappeared, subchondral bone trabeculae were broken, bone trabeculae thickened, and empty bone lacunae appeared. Granulation tissues composed of new capillaries and fibrous cells have proliferated and crawled around the necrotic area. Positive expressions of the Rap1, VEGF, PI3K and Akt proteins in area A were weaker than those of the normal area. In addition, there were positive expressions of Rap1, PI3K and Akt on the trabecular bone of both area A and area B at similar intensity of expression. There were strong positive expressions of Rap1, VEGF, PI3K and Akt on the intima of arterioles and venules, and on the peripheral stromal cell membrane, but the positive expression in area A was significantly lower than that in area B. However, the positive expression positions and intensity of all indicators were similar in area B and area B'., Conclusion: The necrosis in NONFH may be related to vascular endothelial damages caused by the inhibition of the Rap1-PI3K/Akt signaling pathways and the subsequent decline in the protein expression., (Copyright© by Editorial Board of Journal of Sichuan University (Medical Sciences).)

Objective: To analyze the epidemiological and temporal-spatial distribution characteristics of hemorrhagic fever with renal syndrome (HFRS) in Shandong province during 2010-2016 and provide references for developing prevention and control measures. Methods: Based on the data of Infectious Disease Reporting Information System in China, the incidence and temporal-spatial distribution of HFRS in Shandong from 2010 to 2016 were analyzed by spatial autocorrelation and space-time scan statistics. Results: A total of 9 114 HFRS cases were reported in Shandong during this period. The cases were mainly distributed in age group 30-70 years, and the male to female ratio of the cases was 2.63 ∶ 1. Most cases were farmers. The higher incidence rate was reported in southeastern Shandong, while the lower incidence rate was reported in northwestern Shandong. Among the epidemic periods, the highest incidence rate was 1.87/100 000 in 2013. The results of spatial autocorrelation and space-time scanning indicated that the high-high clusters of HFRS were concentrated in southeastern Shandong and then spread to central Shandong. The cluster mainly occurred from the end of 2011 to the first half of 2015. Both the incidence rate and the cluster decreased in 2016. Conclusions: The epidemic and cluster of HFRS still existed in Shandong from 2010 to 2016. The key areas for the prevention and control of HFRS were in southeastern and central Shandong.

Purpose: The objective of the present study was to evaluate the potential application value of diffusion-weighted magnetic resonance imaging (DW-MRI) to differentiate solid benign from malignant tumors affecting the base of tongue and glossopharynx., Methods: Sixty-one patients who presented with solid tumors affecting the base of tongue and glossopharynx underwent conventional MRI and DW-MRI before pathologic verification. Based on pathologic findings, the tumors were classified into 4 groups: Group 1, solid benign tumor (n=10); Group 2, epithelial carcinoma (n=35); Group 3: non- epithelial malignant tumor (n=16); and Group 4: malignant tumor (n=51, a combination of Group 2 and 3). The mean apparent diffusion coefficients (ADCs) were computed from DW-MRI scans obtained with b factors of 0 and 1000 s/mm2. SAS 9.1 software package was used for Wilcoxon test., Results: The mean ADCs were significantly different (P<0.05) between group 1 and the other 3 groups, and between group 2 and group 3, respectively. Among all kinds of pathological types of lesions, non-Hodgkin lymphoma had a lowest mean ADC value, and schwannoma had a highest mean ADC value. In addition, the mean ADCs among epithelial carcinoma subtypes were not significantly different(P>0.05)., Conclusions: DW-MRI has differential diagnostic value of solid tumors affecting the base of tongue and glossopharynx, especially in distinguishing between benign solid tumors and malignant tumors, and between epithelial carcinomas and non-epithelial malignant tumors.

Objective: To establish the control charts for early warning of diarrhea based on the syndromic surveillance data from enteric clinic in Beijing., Methods: The outpatient data from enteric clinic of a Grade Three General hospital in Haidian district, Beijing from April 1 to Oct. 31, 2009 and from May 1 to Nov.10, 2010 were collected, according to the moving average method, the baseline calculated, the value of probability α and μα, the early warning value based on the formula "w=Xj+μαSj" calculated and the early warning control charts drew at last., Results: According to the harmfulness, the severity and controllability of diarrheal diseases, the value of probability α was determined as 0.01, then μα (unilateral) as 2, based on the early warning value, the control charts of diarrheal diseases, bacillary dysentery and other infectious diarrhea were established., Conclusion: The enteric clinic requires to further collect baseline data to evaluate and continuously adjust the established control charts for the best early warning model in accordance with the enteric clinic.

Objective: To determine the characteristics and diagnostic value of dynamic contrast enhanced MRI (DCE-MRI) in differentiating benign soft tissue lesions from malignant tumors affecting the masticator space (MS)., Methods: Prior to managements, conventional MRI and DCE-MRI were performed in 53 patients who suffered from primary or secondary soft tissue lesions affecting the MS. The time to peak (TTP), relative maximum enhancement (RME) and relative washout ratio (RWO) were separately calculated., Results: Mean TTP of benign and malignant lesions were (130.3 ± 13.2) and (69.6 ± 6.9) s, respectively. Mean RWO of benign and malignant lesions were (29.7 ± 5.5)% and (8.7 ± 2.1)%, respectively. Malignant lesions had a significantly shorter TTP(P = 0.001) and lower RWO (P = 0.003) than benign lesions. When TTP was less than 92.2 s and RWO less than or equal to 16.0%, malignant tumors were considered. DCE-MRI had a sensitivity of 72.3%, specificity of 93.5%, accuracy of 84.9%, positive predictive value of 88.9%, and negative predictive value of 82.9%., Conclusions: As a non-invasive imaging technique, DCE-MRI is valuable to differentiate benign soft tissue lesions from malignant tumors affecting the MS.

Objective: To study the feasibility of adenovirus-based nuclear factor-κB (NF-κB) reporter as a model to screen the upstream signal regulators of NF-κB., Methods: A type 5 (E1/E3 deficient) adenovirus vector pAdxsi was used to construct the NF-κB reporter adenovirus. Multiple adherent and suspending cell lines were infected by the NF-κB reporter adenovirus, and the luciferase activity of the NF-κB reporter gene was measured., Results: An NF-κB reporter adenovirus (Ad-NF-κB-luc) was successfully constructed. The virus was capable of infecting HepG2, MGC803, THP-1 and U937 cell lines and showed high activities of NF-κB-luc reporter gene when stimulated by tumor necrosis factor-α (TNF-α) or lipopolysaccharide (LPS)., Conclusion: The Ad-NF-κB-luc reporter gene transfer system can effectively infect those cells hard-transfected by conventional transfection reagents. It also produces a high activity of NF-κB-luc reporter gene with stability and reliability. Our study expands the application of NF-κB reporter gene.

Aim: To prepare and characterize the polyclonal antibody against human VSTM1., Methods: VSTM1 has two main isoforms, VSTM1-v1, a type I transmembrane protein, and VSTM1-v2, a classical secretory protein, lacking only the transmembrane domain compared with VSTM1-v1. Two recombinant prokaryotic proteins of VSTM1-v2, Trx-His-S-VSTM1-v2 and GST-VSTM1-v2, were constructed, expressed, purified, and then used for immunization of New Zealand rabbits to prepare anti-VSTM1 antibody and coupling with CNBr-activated Sepharose 4B to purify the antibody by immunoaffinity chromatography, respectively. ELISA was performed to detect the titers of the antiserums. After purification, the antibody was identified by Western blotting and immunofluorescence cytochemistry., Results: The titers of the antiserums from the two immunized rabbits were both 1:10(6);. Western blotting confirmed that the purified antibody could recognize both the overexpressed and endogenous VSTM1 specifically. Immunofluorescence cytochemistry verified that the antibody could also recognize the overexpressed VSTM1-v1 on the surface of HEK293T cells., Conclusion: The rabbit antibody against human VSTM1 of a high titer has been obtained, which can be used for recognizing endogenous VSTM1 in immunofluorescence cytochemistry.

Melt water samples collected continuously from 29 August to 3 September 2009 in the Baishui Glacier No. 1 at elevation of 4750 m were analyzed for pH, conductivity, delta18O and inorganic ions. The results showed that the pH had obvious diurnal variations and was increased slightly by the influence of precipitation. The dissolution of alkaline soluble salts in the dust was the main reason for the increase of melt water conductivity; the value of delta18O was relatively low in strong ablation period and high in slight ablation period. Different from other research areas, the concentrations of Na+, K+, which were influenced by lithological and marine water vapor, were higher than that of Mg2+ in the study area; HCO3- and Ca2+ accounted for more than 80% of total ions in snow and ice melt water, indicating that the ions mainly came from limestone and the melt water was a typical carbonate solution; The content of melt water had an obvious daily change with temperature change, but the response amplitudes were different; Monsoon transport, local rock lithology, human industrial and agricultural activities were the main sources of inorganic ions and the deciding factors of the ion composition in the Baishui Glacier No. 1.

Purpose: The aim of this study was to evaluate the MR-DWI findings of the normal and abnormal tongue tissues, and to determine the potential role of apparent diffusion coefficient (ADC) value obtained from different b values in the accurately diagnosing lesions arising from the tongue., Methods: MR-DWI was performed in 15 healthy volunteers and 79 patients with tongue lesions, respectively. All the tongue lesions were pathologically proved (19 benign lesions and 60 malignant tumors). Two ADC values from b values (500 and 1000 s/mm²) in the 15 volunteers and 79 lesions were used for comparison. The diversities of ADC values between the normal and abnormal tongues, and the benign lesions and malignant tumors of tongues were statistically analyzed. The data was subjected to SPSS10.0 software package for t test., Results: (1)There was significant difference between the volunteer's tongue and the abnormal tongues(P<0.01), and between the benign lesions and the malignant tumors of tongues (P<0.05). (2)The mean ADC value of the benign lesions of tongues was significantly higher than that of the surrounding tongue tissues and volunteer's tongues (P<0.05). (3)The mean ADC value of the malignant tumors of tongues was higher than that of the volunteer's tongues, but no difference was found between the malignant tumors and its surrounding tongue tissues., Conclusion: MR-DWI might be considered as a valuable imaging index for the discrimination of normal tongue from abnormal tongue.

Purpose: To analyze and evaluate the MR diffusion-weighted imaging (MR-DWI) features of head and neck hemangioma and venous malformation in children., Methods: We retrospectively observed 10 head and neck hemangiomas and 40 head and neck venous malformations in children, which underwent both conventional MR imaging and MR-DWI. In the MR-DW images, the apparent diffusion coefficient(ADC) mean value was taken from b=500 s/mm² and 1000 s/mm², The data was analyzed using SPSS13.0 software package for t test., Results: The mean ADC obtained from b value of 500 s/mm² was (1.227±0.324)x10⁻³mm²/s in hemangioma and (1.851±0.364)x10⁻³mm²/s in venous malformation, and from b value of 1000 s/mm² was (0.728±0.256)x10⁻³mm²/s in hemangioma and (1.200±0.228)x10⁻³mm²/s in vein malformation. There was significant difference between both lesions (P<0.01)., Conclusion: There are different features in MR-DWI between head and neck hemangioma and venous malformation in children, which may be helpful for radiological differential diagnosis.

Objective: To express antibacterial peptide thanatin in the prokaryotic expression system and test its antibacterial activity., Methods: The DNA sequence coding for the 21 peptides of thanatin was synthesized using the preferred genetic codes of E. coli, cloned into pTYB11 plasmid, and transformed into E.coli ER2566. The expression of thanatin fused with intein was induced by IPTG in E.coli, and intein-thanatin specifically bound to the column through intein tag was cleaved overnight at 4 degrees celsius; in DTT/cysteine buffer., Results: The cleaved thanatin was eluted with a protein concentration of 245 microg/ml in the first 4 ml. The purified thanatin had showed strong antibacterial activities against G- bacteria such as Shigella flexneri, Klebsiella pneumoniae, Shigella snnei, Escherichia coli O157, toxin producing Escherichia coli, Pseudomonas aeruginosa, and fungi such as Candida albicans, with especial potency in killing drug-resistant Klebsiella pneumoniae, Pseudomonas aeruginosa, and extended-spectrum beta-lactamases (ESBL)-producing E.coli. Eighty strains of drug-resistant (ESBL-producing) and 30 strains of sensitive E. coli were used for anti-bacterial assay, and no significant differences in the antibacterial activity of thanatin were found between the sensitive and drug-resistant E. coli (P>0.05)., Conclusion: The recombinant thanatin obtained shows strong antibacterial activity against drug-resistant and sensitive bacteria, and can be a potential substitute for routine antibiotics in the treatment of G- bacterial infections.

Objective: To compare the different prognosis between enteral nutrition (EN) and parenteral nutrition (PN) in patients after gastrointestinal surgery (GIS), and to investigate a reasonable regimen of enteral nutrition (EN) after GIS., Methods: Randomized controlled trials (RCTs) on EN/PN after GIS from 1970 to 2008 retrieved from the data bank of Pubmed, EMBASE and Cochrane Library were analyzed. Evaluation endpoints were anastomotic dehiscence, infection (catheter sepsis, wound infection, pneumonia, intra-abdominal abscess and urinary tract infection), vomiting and abdominal distention, other complications, length of hospital stay and mortality rate., Results: Twenty-three RCTs including 2784 patients met the entering criteria. Compared with PN, EN was beneficial in the reduction of anastomotic dehiscence (RR = 0.67, 95%CI: 0.50 - 0.91; P = 0.010), infections (RR = 0.72, 95% CI: 0.64 - 0.81; P < 0.001), other complication (RR = 0.82, 95%CI: 0.73 - 0.92; P < 0.001) and duration of hospital stay (weighted mean difference: -3.60; 95%CI: -3.88 - -3.32; P < 0.001). But the risk of vomiting was increased among patients with EN (RR = 1.39, 95%CI: 1.21 - 1.59; P < 0.001), and there was no significant differences in mortalities between the two groups (P = 0.400)., Conclusions: There is no advantage in treating patients 'nil by mouth' after gastrointestinal surgery. It indicated that early commencement of enteral feeding is beneficial.

Objective: The aim of this study was to systematically evaluate the health status of Asian immigrants in Canada and the associated factors., Methods: Using data from the 2003 Canadian Community Health Survey, a descriptive analysis was performed to estimate the frequency of health associated factors among different populations. Age-standardization rates was also used to compare the prevalence of chronic conditions among Asian immigrants, other immigrants and native residents. Logistic regression analysis was used to estimate the adjusted Odds ratio (OR) associated with each health outcome and 95% confidence interval (95% CI) after controlling for potential confounding factors., Results: After age-standardization, Asian immigrants had a similar prevalence of 1-5 chronic conditions and a lower prevalence of 5+ chronic conditions (3.56%) compared with non-immigrants (5.31%). Asian immigrants were less likely to report any chronic disease (OR = 0.49, 95% CI: 0.46-0.51) than non-immigrants (OR = 1.00). Recent Asian immigrants were less likely to report any chronic condition (OR= 0.34, 95% CI: 0.31-0.37) than long-term Asian immigrants (OR = 0.62, 95% CI: 0.58-0.66). After adjusting for socioeconomic status and lifestyle factors, Asian immigrants had a slightly changed risk of four chronic conditions with exception of heart disease., Conclusion: Asian immigrants had lower risk of chronic conditions as a whole, however, these health advantages decreased along with increasing length of residence in Canada. Socioeconomic factors and lifestyles cannot fully explain the differences of health status between Asian immigrants and non-immigrant Canadians reported in this paper.

Objective: To investigate the factors affecting the long-term survival of patients with carcinoma of esophagus and gastric cardia after curative resection., Methods: The clinical data of 906 patients with carcinoma of esophagus and gastric cardia treated by radical resection in 1996 - 2004 were analyzed retrospectively. Twelve clinicopathological factors possibly influencing survival were encoded and assessed by Cox regression analysis., Results: The 1-, 3- and 5-year cumulative survival rates were 89.8%, 75.4% and 71.7%, respectively. The univariate analysis showed that age, length of tumor, pathological differentiation, number of metastatic lymph nodes, depth of invasion, involvement of adjacent organs and the TNM stage influenced the prognosis significantly (P < 0.01). However, multivariate analysis showed that pathologic differentiation, number of metastatic lymph nodes, involvement of adjacent organs and TNM stage were independent prognostic factors (P < 0.05)., Conclusion: The independent prognostic factors of the patients with carcinoma of esophagus and gastric cardia are pathologic differentiation, TNM stage, number of metastatic lymph nodes, and involvement of adjacent organs. The other factors influencing survival are age, length of tumor and depth of invasion. Furthermore, invasion of adjacent organs suggests worse prognosis, and should be followed-up closely.

Objective: To observe the regulation of bFGF on mRNA expression of integrin subunits alpha2, alpha5, beta1, in osteoblasts., Methods: Osteoblasts were pre-cultured for 24 h with F12 medium containing bFGF with different concentration and planted on the sand blasting titanium disks. Three days after planting, osteoblasts were harvested. The mRNA expression of integrin subunit alpha2, alpha5, beta1, were examined by immunofluorescent quantitative real-time polymerase chain reaction (RT-PCR)., Results: The mRNA expression of integrin beta1 is most abundant and the mRNA expressions of integrin alpha2, as are relatively lower than integrin beta1. In the study, the mRNA expression levels of integrin alpha2, alpha5 and beta1 were up-regulated after bFGF stimulation. However, the effective concentration range of bFGF to the three subunits was different., Conclusion: bFGF could up-regulate the mRNA expression of integrin subunits in osteoblasts.

Objective: To investigate the effects of intrathecal ouabain and tizanidine injection for treatment of neuropathic pain in rats., Methods: Male SD rats weighing 250-300 g were randomly divided into 5 groups (n = 6), namely the control group, ouabain group, tizanidine group, combined ouabain and tizanidine injection group, and the antagonist group. Intrathecal catheter was implanted 7 days before spinal nerve ligation to establish the neuropathic pain model. Mechanical withdrawal threshold (MWT) before and after intrathecal administration of the agents was recorded in the rats. Isobolographic analysis was performed to evaluate the interactions between the agents., Results: Intrathecal injection of ouabain (0.25-5 microg) or tizanidine (0.5-5 microg) alone produced dose-dependent analgesic effect against the neuropathic pain (P < 0.05). Isobolographic analysis revealed a synergistic interaction between ouabain and tizanidine. Intrathecal pretreatment with atropine (5 microg) or yohimbine (20 microg) antagonized the effects of ouabain and tizanidine administered alone or in combination (P < 0.05)., Conclusion: Intathecal injection of ouabain or tizanidine produces dose-dependent analgesic effects against neuropathic pain, and their synergistic effect after combined injection probably involves the cholinergic transmission and alpha2 receptor.

Objective: To investigate the expression and distribution of intrahepatic CD4+ CD25+ regulatory T cells in immuno-tolerant and immuno-clearance phase of patients with chronic hepatitis B., Methods: The expression of FoxP3 was detected in 19 cases of immuno-tolerant phase and 12 cases of immuno-clearance phase by immunohistochemistry. The relation between the intrahepatic expression of FoxP3 and the clinicopathological features were analyzed., Results: The positive signal of FoxP3 is located in nuclear of lymphocyte and mainly aggregated in portal areas as well as occasionally scattered in hepatic sinusoids. The expression of intrahepatic FoxP3 in the group of immuno-tolerant phase was significantly increased than those in normal control (P < 0.01), and greatly decreased than those in immuno-clearance phase (P < 0.01). No correlation was observed among the expression of intrahepatic FoxP3, ALT, levels of HBV DNA, HBeAg positive, in patients of immuno-clearance phase, respectively. There were significant differences between immuno-tolerant phase and immuno-clearance phase age, ALT, TBIL, PTA, HBV-DNA and detection of HBeAg but not in sex and family history of HBV infection., Conclusion: CD4+ CD25+ regulatory T cells may play important roles in the clearance of HBV as well as in liver inflammation and injury during chronic HBV infection.

Objective: To analyze the predictive factors and the unfavourable prognostic factors of interstitial lung disease (ILD) in patients with polymyositis (PM)/dermatomyositis (DM)., Methods: The clinical data were collected from 87 inpatients with DM or PM, who were admitted to Shanghai Changhai Hospital from January 1997 to November 2006. The patients were divided into an ILD group and a non-ILD group. The clinical feature, incidence and prognosis of ILD were retrospectively analyzed. The clinical and laboratory data were analyzed by using the SPSS 13.0 software. The t-test and rank-sum test were used, depending on the measurement data. The enumeration data were analyzed with chi-square test. Logistic regression and Kaplan-Meier survival curve were used to analyze the correlative and prognostic factors of interstitial lung disease (ILD) in patients with PM/DM., Results: The incidence and mortality of ILD in PM/DM patients were 46% (40/87) and 40% (16/40), respectively. Compared with the non-ILD group, the age in the ILD group was markedly older [(54 +/- 13) years vs (45 +/- 18) years], and the percentages of fever (21/40 vs 7/47, chi2 = 14.00, P < 0.01), dysphagia (16/40 vs 8/47, chi2 = 5.71, P < 0.05), arthralgia (26/40 vs 9/47, chi2 = 18.89, P<0.01), Gottron's rash (14/40 vs 2/47, chi2 = 13.61, P <0.01) and heart impairment (26/40 vs 14/47, chi2 = 10.28, P <0.01) were significantly higher in the ILD group. The levels ofLDH [(472 +/- 285) IU vs (310 +/- 238) IU, t =2.86, P<0.01], ESR [(44 +/- 24) mm/1 h vs (26 +/- 24) mm/l h, t = 3.19, P <0.01] and immunoglobulin G [(18 +/- 9) g/L vs (14 +/- 5) g/L, t = 2.31, P <0.05] were statistically different between the two groups. By multivariate nonparametric logistic regression analysis, Gottron's rash, arthralgia, fever, and > or = 40 years of age were identified as predictors with relative risk ratio of 12.048, 7.812, 6.329 and 5.236 respectively. The unfavourable prognostic factors of ILD were Gottron' s rash (chi2 = 5.35, P <0.05), cardiac impairment (chi2 = 5.68, P < 0.05) and pulmonary fibrosis (chi2 = 5.42, P <0.05) by survival analysis., Conclusion: The occurrence of ILD in PM/ DM patients was closely correlated to Gottron's rash, age > or = 40 years, arthralgia and fever. Gottron's rash, heart impairment and pulmonary fibrosis were poor prognosis factors of PM/DM patients complicated with ILD.

Aim: To construct the eukaryotic expression vector pEGFP-claudin-1 and to make it express expressed in 293T cells., Methods: Claudin-1 ORF was amplified by reverse transcription polymerase chain reaction (RT-PCR). The eukaryotic expression vector pEGFP-claudin-1 was constructed by introducing claudin-1 DNA fragment into the sites of Xho I and BamH I of pEGFP-C3 vector. The plasmid was transfected into 293T cells with lipofectamine. The expressed EGFP was observed by fluorescent microscope. The EGFP-claudin-1 was detected by Western blot., Results: The eukaryotic expression vector pEGFP-claudin-1 was constructed successfully. The expression of EGFP-claudin-1 was observed in the membrane of transfected cells by fluorescent microscope and a 49 kD protein was detected by Western blot., Conclusion: The recombinant expression vector pEGFP-claudin-1 has been successfully constructed and claudin-1 gene can be expressed in 293T cells. This study lays a foundation for further research into the function of claudin-1.

Aim: To investigate the role of bacterial Lipopolysaccharide (LPS) in inducing TLR7 protein expression in DC2.4 cells., Methods: DC2.4 cells were cultured in RPMI1640 medium supplemented with 100 mL/L FBS. Optical microscope was used to observe the cells morphology before and after LPS induction. RT-PCR and Western blot were employed to analyze the expression of TLR7 at mRNA and protein lever, respectively., Results: Without LPS induction, DC2.4 cells were small and shine with a few dendrites, didn't express TLR7 protein. However, DC2.4 cells become bigger and the dendrites of them become more robust with LPS induction. DC2.4 cells start to express TLR7 protein after 12 hours LPS induction, and there is no much difference on TLR7 protein expression after 12 h, 24 h, 48 h LPS stimulation., Conclusion: LPS can induce TLR7 protein expression in DC2.4 cells.

Aim: To investigate a method for isolating exosomes by ultrafiltration centrifugalization based on their physical size and density so as to advance traditional method and promote recovery rate., Methods: The culture supernatant of murine dendritic cells line (DC2.4) was collected and clarified through a hollow fiber cartridge to remove cells and their debris. The clarified supernatant was concentrated by Amicon ultrafiltration tube and then the concentrated supernatant was purified when loaded into density gradient centrifugation to obtain the DC-Ex. The traditional differential centrifugation method was used in control group. Transmission electron microscope (TEM) was used to identify the morphology of the two products. Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and Western blot were employed to analyze their proteins., Results: The obtained pellets possessed the features of dendritic cell exosomes described in previous literature, including morphology and SDS-PAGE profile. Moreover,these particles contained characteristic molecular markers MHC class I, MHC class II, CD80 and CD86. Compared with the differential centrifugation method, ultrafiltration centrifugalization technique is a shorter and more producible process resulting in production being highly purified., Conclusion: Ultrafiltration centrifugalization technique is a convenient and useful method for DC-Ex isolation.

Purpose: To investigate CT imaging and clinical features of myoepithelioma (ME) of the salivary glands., Methods: The imaging manifestations of 17 patients from 2003 to 2007 were retrospectively analyzed. The age of the 17 patients ranged from 23 years to 70 years (mean age: 46 years). The numbers of males and females were 7 and 10, respectively., Results: The diameter of the lesions were less than 2.5 cm. 13 of the lesions located in the major salivary glands, were shallow, mostly contacted with the capsule of the gland (12/13) with obvious nodular enhancement. 4 of the lesions were located in the minor salivary glands with non-enhancement. The palate plate was absorbed with compression (2/3)., Conclusions: Understanding of the imaging and clinical characteristics of ME can increase the accuracy of diagnosis.

The G1 cytoplasmic tail of Hantaan virus (HTNV) harbors a highly conserved region, which is homologous to immunoreceptor tyrosine-based activation motifs (ITAM) and is termed the ITAM-like sequence. To demonstrate the potential signal-transducing activity of G1 ITAM-like sequence resembling the canonical ITAM within immune and endothelial cells, a series of experiments were performed to define its interaction with cellular kinases. The synthesized G1 ITAM-like peptide was shown to coprecipitate with cellular phosphoprotein complexes by an immune-complex kinase assay. Mutational analyses showed that this ITAM-like sequence was a substrate for the Src family kinase Fyn, and two conserved tyrosine residues were required for coprecipitating Lyn, Syk, and ZAP-70 kinases. These findings demonstrated that HTNV envelope glycoprotein G1 contains a functional ITAM-like sequence in its cytoplasmic tail, which can bind critical cellular kinases that regulate immune and endothelial cell functions.

Purpose: To investigate the imaging feature of desmoplastic fibroma (DF) of the jaw bones., Methods: The records including diagnostic radiograph images of 8 patients were retrospectively analyzed. The age of the 8 patients ranged from 2 years to 70 years (means,28 years). The numbers of males and females were 3 and 5 respectively. Of 8 patients, 4 had local recurrence, which occurred 1 year after curettage., Results: On conventional radiographs, the lesion was presented as a purely lytic tumor that did not contain any mineralized matrix. The zone of transition between tumor and normal bone was typically narrow and well defined but not sclerotic. Bone expansion in DF had an eccentric (n=3) and lace-like, reticular pattern (n=3). On CT scan, increased bone marrow density (n=3), a homogeneous soft-tissue density mass displaced adjacent muscle with lingual cortex eroded (n=3) were noted. On MRI, the lesion was displayed as large bony destruction area, with homogeneous hypointensity on T1-weighted images, non-homogenous hyperintensity on T2-weighted and did not enhance after Gd-DTPA administration. Images with Choline peek (Cho, at 3.2 ppm) was displayed at TE of 144 ms( PRESS, single voxel).Six mandibular cases and 2 maxillary tumors were located posteriorly., Conclusions: Recognition of DF is important because DF is more aggressive than other benign fibrous lesions, necessitating a wide surgical and careful long-term follow-up for local recurrence.

Objective: To study the influence and mechanism of HBV core region mutation on HLA-I expression., Methods: Eukaryotic expression vectors of HBV core region mutations L97, G87 and V60 were constructed and transfected into HepG2 cells. Then the expressions of HLA-I were detected by RT-PCR and Western blot. The mRNA of antigen-presentation-associated genes, including LMP2, TAP1 and tapasin, were measured using RT-PCR., Results: Different levels of HBsAg in the supernatants of transfected cells were detected by ELISA. The HBsAg of the mutated groups was markedly higher than that of the wild ones. All the transfected cells expressed HLA-I molecules, especially the L97 group. It was also found that the mRNA of TAP1 gene was up-regulated, while the mRNA of LMP and tapasin genes had no changes., Conclusion: The core region mutation of HBV can lower the expression of HBsAg; mutated groups and wild ones both can increase the expression of HLA-I molecules. The up-regulation of TAP1 gene expression might be the cause of these changes.

Objective: To investigate the possibility of using single-voxel (1)H MR spectroscopy to evaluate malignant soft tissue tumors of oral-maxillofacial region., Methods: Forty-two patients with oral-maxillofacial malignant tumors, examined by single-voxel (1)H MR spectroscopy at a 1.5 T MR unit before treatment and confirmed by histo-pathological examination, were retrospectively studied. The localization for (1)H MR spectroscopy was used with a point-resolved spectroscopy (PRESS) at echo time of 144 ms. Choline (Cho), one of tumor's metabolites, was considered as a criterion to assess the malignant tumors., Results: Of 42 oral-maxillofacial malignant tumors, the Cho peak was identified in 37 lesions, including 15 of 17 squamous cell carcinomas, 9 of 12 salivary carcinomas, and 13 of 13 sarcomas and non-Hodgkin lymphomas., Conclusions: Single-voxel (1)H MR spectroscopy might provide useful information for the assessment of malignant soft tissue tumors in the oral-maxillofacial region. Most malignant tumors in this study were characteristic of containing Cho metabolites. The Cho peak was more frequently recognized in the sarcomas and non-Hodgkin lymphomas than in the carcinomas.

Objective: To observe the pathology of AIDS-related lymphadenopathy and its relationship to the expression and distribution of CD4 + CD25 + regulatory T cells in lymphoid node tissue., Methods: Totally 22 biopsy and 13 autopsy lymphoid node tissues from HIV-positive patients were examined under microscopy and pathological staging was performed. Specific marker for CD4 + CD25 + regulatory T cells in lymphoid node tissue was detected with anti-Foxp3 monoclonal antibody by immunohistochemistry., Results: Among all the 35 specimens, 5, 4, 14, and 12 specimens were histopathologically staged from 1 to 4, respectively. FoxP3 were detected in all lymphoid node tissues. The distribution of FoxP3-positive lymphocytes were mainly in intermediate zone of follicle and cortical area in stages 1 and 2. The counts of FoxP3-positive lymphocytes remarkably decreased in stages 3 and 4, following depletion of lymphocytes., Conclusions: CD4 + CD25 + regulatory T cells exist in lymphoid node tissue of patients with HIV infection. Their amounts decrease or deplete along with the progression of AIDS-related lymphadenopathy.

Objective: To evaluate the effect of compound branch chain amino acid(BCAA) injection on nutritional support in patients after radical resection for colorectal cancer., Methods: Fifty patients with radical resection for colorectal cancer were randomly divided into two groups, and received compound branch chain amino acid (n=25) or compound amino acid(n=25) as control per day from postoperative day(POD)1 to POD 7. The levels of total protein, albumin, pre-albumin, transferring, nitrogen balance and complications were compared between the two groups., Results: On POD 8, the levels of albumin, pre- albumin, transferring were (36.12+/-3.16)g/L, (237.10+/-37.29)mg/L, and (2.18+/- 1.34)g/L in study group, and (30.61+/-3.55)g/L, (191.73+/-27.60)mg/L, and (1.71+/-0.84)g/L respectively in the control group(all P< 0.05). Nitrogen balance increased significantly from POD5, and increased to normal on POD 6 in study group, significantly higher than that in the control group (9.91+/-6.53 vs - 9.73+/-11.21, P=0.024). The complication rate of incision infection and delayed healing was 8.3% in study group, significantly lower than 38.1% in the control group(P< 0.05)., Conclusion: Compared with compound amino acid, compound branch chain amino acid injection can reduce proteolysis, correct negative nitrogen balance and promote wound healing.

Objective: To evaluate the efficacy and safety of postoperative adjuvant chemotherapy with imatinib in gastrointestinal stromal tumor(GIST) patients who had high risk of recurrence., Methods: A prospective, open-label, multi-center trial conducted in sixteen teaching hospitals in China was carried out. The criteria of the enrolled patients included age more than 18 years old, CD117 positive GIST, tumor size more than 5 cm, pathological mitosis counts more than 5/50 HPF, and treatment beginning within 4 weeks after complete resection and with imatinib (400 mg, once a day) for at least 12 months. The 1, 3 year recurrence rates, disease free survival, overall survival rate and quality of life were evaluated., Results: From Aug. 16th 2004 to Sep. 13th 2005, there were totally 74 patients screened and 57 patients (34 men, 23 women) enrolled in the imatinib treatment group. The primary tumors were located in the stomach in 50.9%, the small intestine in 38.6% and the colorectum in 10.5% of the cases. All the patients received radical resection. Until the cut-off date of interim analysis, there was no evidence of tumor relapse or metastasis in all patients and no death was reported either. Among the 57 enrolled patients with intention to treat(ITT), twelve patients finished the protocol (per protocol, PP). The disease free survival was (268.3 +/-120.2) d in ITT analysis, and (396.7+/-38.2) d in the PP analysis. The incidence of adverse effect was 44.4% . The score in quality of life showed no statistically significant difference between the baseline visit and the follow-up visits., Conclusion: Imatinib is a promising postoperative adjuvant chemotherapy in GISTs patients with high risk of recurrence, and the adverse effects are receivable.

Objective: To study the effect of 5-fluorouracil-FU in combination with astragalus membranaceus(AM) on amino acid metabolism in mice model of gastric carcinoma induced by 3-methylcholanthrene(MC)., Methods: Mice gastric carcinoma models were established by 3-methylcholanthrene induction and randomly divided into different groups, and received 5-FU treatment (group A) 5-FU plus AM (group B), 5-FU plus a high dose of AM(group C), no treatment (group D). Normal mice were used as control (group N). Free amino acid in the tumor specimens were examined., Results: The levels of free Valine, Methionine, Leucine, Arginine and cystine in the tumor specimens in group D were significantly higher than that in group N(P< 0.05). The levels of free serine in group A, B, C, D were significantly higher than that in group N. The levels of free glutamic acid in group A, B were significantly higher than that in group N(P< 0.05). The levels of free proline in group C, D were significantly higher than that in group P, N(P< 0.05)., Conclusions: The increasing levels of free serine and proline in tumor specimens in gastric cancer mice model reveals metabolic disturbance of amino acid. 5-FU plus astragalus membranaceus can decrease the level of free glutamic acid in the mice models, and inhibit tumor growth.

Objective: To summarize the experience in diagnosis and surgical treatment of parathyroid adenoma and carcinoma (PTA and PTC) in our department., Methods: The clinical and pathological data of 48 cases admitted in our department from Jan 1995 to Dec 2005 were reviewed. Among the 48 cases, 46 cases were of parathyroid adenoma and 2 cases of parathyroid carcinoma. The average clinical history of the 48 cases was 3.65 +/- 2.83 years. The serum calcium and PTH levels were elevated in all the 48 cases. In 31 cases ultrasonographic results were consisted with that of 99mTc-MIBI scintigraphy. Unilateral neck exploration was performed in 18 cases and no case with post-operative tumor remnants was found. In other 13 cases bilateral exploration was performed but no one case was found to be tumor positive in the opposite side of the glands. Tumors resection was performed in all the 48 cases, among which in the 2 cases with PTC, ipsilateral thyroid lobe excision and modified neck dissection were also performed., Results: Clinical symptoms of all the patients were relieved after operation. No recurrent case was found during the follow-up periods (from 1 month to 10 years). The average level of serum calcium and PTH declined significantly after operation. The post-operational serum calcium and PTH levels at 3 days after operation were even lower than normal. Transient post-operational hypocalcemia was found in almost all the patients. The serum calcium and PTH levels in all patients recovered to normal level within a periods from 1 week to 3 months after operation. The sensitivity and positive prediction value of localization methods were 97.0% and 94.1% of ultrasonography, respectively, and 100% and 97.3% of 99mTc-MIBI scintigraphy, respectively., Conclusion: Patients with chronic bone diseases, repeatedly recurrent nephrolithiasis, peptic ulcer disease or pancreatitis should be regarded as suspicious cases of PTA and PTC, and serum calcium assay should be performed as a routine screening procedure. Serum calcium and PTH assays are both reliable methods for the diagnosis of PTA and PTC. A combination of ultrasonography and 99mTc-MIBI scintigraphy is sufficient for locating adenomas. Accompanied by intraoperative pathological examination, unilateral neck exploration is an acceptable approach for patients with definitely preoperative confirmed adenoma localization.

Objectives: To study the clinical value analyzing of colorectal cancer prognosis by the Sixth Edition TNM Stages., Methods: 5481 cases with colorectal cancer and treated by operational methods, were collected. All the cases were separately staged by the Fifth Edition or Sixth Edition TNM Stages standards. The 5-year survival rates were analyzed by the life table method., Results: The 5-year survival rates of the Fifth Edition TNM Stages of I, II, III and IV were 80.1%, 68.0%, 40.5% and 9.8% respectively. The 5-year survival rates of the Sixth Edition TNM Stages of II(A) and II(B) were 71.6% and 66.4% respectively, and of the stages III(A), III(B) and III(C) were 46.2%, 40.1% and 28.3% respectively. There were statistical differences among the sub-stages II and III, P < 0.05., Conclusion: The Sixth edition TNM Stages laid more stress on effect of the local infiltration depths and lymphatic metastasis in the prognosis of colorectal cancer, therefore, the stages were more fine, to analyze prognosis of the colorectal cancer were more precise. It is high clinical value for the individual complex treatment with every sub-stages.

Purpose: The aim of this study was to determine whether CT perfusion was valuable in differentiating benign tumors from malignant ones in the parotid gland., Methods: Fifty-three parotid gland tumors, 35 benign and 18 malignant, in 51 patients were included in this study. All the tumors were confirmed histopathologically and examined with CT perfusion before operations. The parameters of CT perfusion, including blood flow (BF: ml x 100g(-1) x min(-1)), blood volume (BV: ml x 100g(-1)), mean transmit time (MTT:s) and permeability surface (PS: ml x 100g(-1) x min(-1)) were evaluated. Wilcoxon sign sum test, a nonparameters test for paired data were used to determine the statistical differences of parameters between the benign and malignant tumors., Results: The mean values +/- standard variations of BF, BV, MTT and PS were 139.85+/-175.13, 17.16+/-15.67, 13.27+/-4.42, and 24.38+/-14.52 respectively in benign tumors, versus 231.69+/-205.29, 32.22+/-20.56, 11.40+/-3.95 and 38.28+/-19.00 respectively in malignant tumors. Except for MTT, the differences of BF, BV and PS between benign and malignant tumors were statistically significant (P<0.01)., Conclusions: On the basis of the results of this study, the parameters of CT perfusion, BF, BV and PS, were valuable in differentiating benign and malignant tumors of the parotid gland.

Objective: To investigate the binding activity of activator protein-1 (AP-1) with DNA probe in the colorectal carcinoma (CRC) tissues and surrounding tissues and explore the correlation between the activation of AP-1 signal transduction pathway and metastasis of CRC., Methods: The AP-1 DNA binding activities were investigated by electrophoretic mobility shift assay (EMSA) in CRC specimens (T), surrounding tissues including 2 cm (P(2)), 5 cm(P(5)) far away from primary tumor margin and distal resection margin of the specimens (N). The mRNA expression level of vascular endothelial growth factor (VEGF), matrix metalloproteinase-9 (MMP-9) were measured by quantitive reverse transcription polymerase chain reaction (Q- RT-PCR)., Results: The AP-1 DNA binding activity in T was significantly higher than those in P(2), P(5) and N (P< 0.05) tissues. There were significantly positive correlations between AP-1 DNA binding activity in tumor and invasive degree, lymphatic metastasis respectively (P< 0.01), but no correlation with histological classification and differentiation (P> 0.05). The transcription levels of VEGF and MMP-9 in CRC were significantly higher than those in P(5) and N (P< 0.01, P< 0.05) tissues. The transcription levels of VEGF and MMP-9 were significantly correlated with increasing AP-1 DNA binding activity (P< 0.01)., Conclusions: AP-1 is significantly correlated to the invasion and metastasis in CRC. The activation of AP-1 signal transduction pathway might be involved in the angiogenesis and of degradation extracellular matrix during tumor metastasis.

Purpose: The aim of this article is to evaluate the CT findings of malignant tumors of upper cervical lymph nodes invading the carotid sheath., Methods: Seventy-seven patients (83 lesions) with malignant tumors in the upper cervical lymph nodes shown on CT scans were collected. All lesions were certificated with pathological examination by operation or biopsy., Results: The CT manifestations of malignant tumors of upper cervical lymph nodes invading the carotid sheath included :(1) compression and deformation of vessels in the carotid sheath in 52 lesions (ICA, one lesions; ICV, 51 lesions); (2) disappearance of vessels in the carotid sheath (ICV, 13 lesions); (3) displacement of vessels of the carotid sheath in 67 lesions (ICA, 22 lesions; ICV, 50 lesions); and (4) malignant tumors encompassing the carotid sheath in 15 lesions., Conclusions: On CT images, the most common form of malignant lymph node lesions invading the carotid sheath is displacement of ICA and ICV. It is concluded that all forms of affecting carotid sheath demonstrating on the CT images are important in diagnosing the malignant invasion of the ICA and ICV.

Objective: To study the correlation of hepatic metastasis of colorectal cancer to vascular endothelial growth factor (VEGF), angiopoietin- 2 and fibronectin (FN)., Methods: The transcription and expression of VEGF, angiopoietin- 2 and FN were detected by semiquantitative reverse transcription- polymerase chain reaction (SQRT- PCR) and immunohistochemical staining in the specimens from sixty patients with colorectal cancer., Results: The mRNA transcription and expression levels of VEGF, angiopoietin- 2 and FN in colorectal cancer tissues were obviously higher than those in paratumor normal tissues P< 0.05. The transcription and expression levels of VEGF were correlated with tumor invasion P< 0.05,Dukes' stage P< 0.05,and lymph node and/or hepatic metastasis P< 0.05. Angiopoietin expression and transcription levels were correlated with tumor differentiation. The expression of FN in extra cellular matrix (ECM) was significantly higher (P< 0.05),whereas ECM in basement membrane was significantly lower in cancer tissues than that in paratumor normal tissues (P< 0.05),which both were correlated with tumor invasion P< 0.05,Dukes' stage P< 0.05,and lymph node metastasis P< 0.05. Absence of FN protein in basement membrane was also correlated with hepatic metastasis., Conclusion: Colorectal cancer cells can secrete VEGF and contribute to metastasis and proliferation of tumor by stimulating the growth of tumor vessel. Both of VEGF and angiopoietin- 2 contribute to angiogenesis and the decrease of FN in basement membrane of cancer tissue is an important primary factor of hepatic metastasis.

Objective: To evaluate the diagnostic value of the carotid artery invasion by the oral-maxillofacial and neck malignant tumors with computed tomography (CT)., Methods: Fifty-three patients (55 tumors) of oral-maxillofacial and neck malignant tumors were examined with enhanced axial CT examination in pre-operation. The CT manifestations of all tumors were retrospectively corresponded with the surgical findings., Results: Oral-maxillofacial and neck malignant tumors with abnormal common carotid artery (CCA) or internal carotid artery (ICA) manifestations were shown on CT as five types: type I, compression and deformation of CCA or ICA in six tumors; type II, displacement of CCA or ICA in 15 tumors; type III, the tumors encompass the carotid vessels more than 180 degrees in 8 tumors; type IV, the segmental deletion of fat or fascia planes between tumor and CCA/ICA in 25 tumors; and type V, ill-defined CCA/ICA wall in 12 tumors. Surgical findings recorded that 20 CCAs or ICAs were adhered by the oral-maxillofacial and neck malignant tumors. Of these 20 lesions, 14 malignant tumors (70%) with more than two abnormal changes of CCA or ICA were shown on CT images. The respective sensitivity, specificity and accuracy were 30.0%, 100.0% and 74.5% for type I, 20.0%, 68.6%, 50.9% for type II, 22.2%, 100.0%, 49.1% for type III, 90.0%, 80.0% and 83.6% for type IV, and 45.0%, 88.6% and 72.7% for type V., Conclusions: The main CT findings of maxillofacial and neck malignant tumors affecting the carotid artery are different. Comparatively, the signs of type I, type III and type IV may be valuable in evaluating CCA or ICA invasion, although the accurate diagnosis of the CCA or ICA involvement by the maxillofacial and neck malignant tumors remains difficult.

Objective: To construct three recombinant shuttle plasmids of adenovirus expression vector which can express hepatitis C virus(HCV) different structure genes(C, C+E1, C+E1+E2) in order to pack adenovirus expression vectors which can express HCV different structure gene effectively., Methods: The different HCV structure genes derived from the plasmid pBRTM/HCV1-3011 by using polymerase chain reaction (PCR) were inserted into the backward position of cytomegalovirus(CMV) immediate early promotor element of shuttle plasmid(pAd.CMV-Link.1) of adenovirus expression vector respectively, then the three recombinant plasmids (pAd.HCV-C, pAd.HCV-CE1, pAd.HCV-S) were obtained. The recombinant plasmids were identified by endonuclease, PCR and sequencing. HCV structure genes were expressed transiently with Lipofectamine 2000 coated in HepG2 cells which were confirmed by immunofluorescence and Western-Blot., Results: Insert DNAs of the three recombinant plasmids' were confirmed to be HCV different structure genes by endonuclease, PCR and sequencing. The three recombinant plasmids can express HCV structure gene (C, C+E1, C+E1+E2) transiently in HepG2 cells which were confirmed by immunofluorescence and Western-Blot., Conclusion: The three recombinant shuttle plasmids of adenovirus expression vector can express HCV structure gene(C, C+E1, C+E1+E2) transiently. This should be useful to pack adenovirus expression vector which can express HCV structure genes.

Objective: The aim of this study is to retrospectively evaluate the diagnostic value of head and neck neoplasms detected with 2D gradient-echo sequence (GRE) MR imaging., Methods: One hundred patients with a total of 107 head and neck neoplasms underwent conventional spin-echo and 2D gradient-echo sequences MR imaging (T1- weighted image: 270-350ms/12-15ms/75 degrees; T2- weighted image: 400-500ms/20-25ms/15 degrees). All of 107 head and neck neoplasms (58 benign lesions and 49 malignant lesions) were histopathologically confirmed by biopsy and operation., Results: The hyperintense and mixed hyperintense signal neoplasms showed on GRE-T1 images in 42 lesions (18 benign and 24 malignant lesions), on SE-T1 images in three lesions (benign), on GRE-T2 images in 102 lesions (53 benign and 49 malignant lesions), and on SE-T2 images in 92 lesions (50 benign and 42 malignant lesions). The capsule of head and neck masses was demonstrated on GRE images in 41 lesions, and on SE images in 34 lesions., Conclusion: The authors concluded that 2D gradient-echo MR imaging is superior to spin-echo MR imaging in delineating the extent and capsule of masses, but it is difficult to make differentiating diagnosis between most of benign and malignant head and neck neoplasms.

OBJECTIVE:To introduce double-contrast arthrography of TMJ with reformatted sagittal and coronal CT imaging and to evaluate the value of its application in the diagnosis of temporomandibular joint dysfunction. METHODS: 14 patients in whom diagnosis can not be established with conventional arthrography were examined by double contrast arthrography with reformatted sagittal and coronal CT imaging. RESULTS: In double-contrast arthrography with CT imaging, 1 case was normal;1 case had anterior displacement with reduction;2 cases were anterior displacement without reduction, and 8 cases were with disk adhesion. CONCLUSION:The double contrast arthrography with reformatted sagittal and coronal CT imaging was a very important alternative to conventional arthrography, and has special value to demonstrate adhesion of TMJ.

OBJECTIVE:To evaluate the role of CT in the diagnosis of temporomandibular joint dysfunction MATERIAL: 48 temporomandibular joints of 26 patients suspecting osseous changes were examined by CT, with 1mm of layer thickness. All patients had Sch llers position projection as comparison. RESULTS:CT is more sensitive to detect the osseous changes of TMJ than Sch llers position projection, but not well demonstrating sclerosis of TMJ. The Sch llers position projection can only shows the lesion of lateral 1/3 of condyle, but CT including total condyle. CONCLUSION: CT is an important and sensitive tool in detecting osseous changes of temporomandibular joint.

OBJECTIVE:To compare the results of CT-assisted double-contrast arthrography and MRI in the diagnosis of adhesion of TMJ. MATERIAL:18 patients with adhesion of TMJ were examined by CT-assisted double-contrast arthrography and MRI, and their results were analysed including position, degree and with or without osseous changes. RESULTS:18 cases of adhesion were demonstrated on CT-assisted double-contrast arthrography, and that only 6 cases of them were diagnosed on MRI.CONCLUSION: CT-assisted double-contrast arthrography is more sensitive and accurate than MRI in demonstrating the disk adhesion of TMJ.

OBJECTIVE:To domonstrate the CT manifestations of the recurrent oral maxillofacial tumors invading the middle skull base.METHODS:CT detections with axial (37 cases) and coronal (26 cases) scans were performed in thirty-seven patients who suffered from the recurrent oral maxillofacial tumors.All lesions were proven histopathologically.RESULTS:Four patterns of the central skull base erosion showing on CT images were encompassed:1.resorption of the outer cortical margin (5 cases);2.resorption of both outer and inner cortical laminae (24 cases);3.enlargement of the ovale foramen (3 cases);4.combined of sclerosis and resorption of the skull base (5 cases).The sphenoid greater wing involvement by the recurrent lesions was more frequently seen in our series (36 cases).Twenty four patients with the recurrent lesions were identified as following intracranial structures affected:the cavernous sinus (n=16),temporal lobe (n=15),and pituetary (n=1).CONCLUSION:It is believed that involvement of the intracranial structures is in close relationship with the aforementioned erosive patterns of the central skull base.The role of CT examination for evaluating the oral maxillofacial recurrent lesions invading the central skull base is very important.

Twenty-eight cases of MRI of the salivary malignancies confirmed histopathologically were shown in this paper.By observing separately and comparatively with SE (spin echo) T2 weighted imaging and PE(field echo) imaging,the authors consider that (1)the malignant tumors within the salivary glands displaying low and intermediate signal intensities on T2 weighted image may be thought as a characteristic sign in the diagnostic processes. (2) PE imaging as an effective method is able to differentiate the tumors from the calcification and fibrosis which were low and intermediate signal intensities on T2 weighted image. (3)the locations and sizes of the tumors have directly influenced on their marginal manifestations and adjacent normal tissue structures.