Abstract:Based on a case study on the health communication practice aiming at the Lisu ethnic group located in the Sino-Burmese frontier in Tengchong area, Yunnan province,the article tried to discuss how to find pointed ways to minimize the health risks of specific populations based on the local knowledge by integrating the in-depth fieldwork research and the practice of the health communication.

Abstract:With information network as the carrier, the network health communication shows superiority of the features compared to the traditional medium such as multi-interaction, rich capacity, real time and anonymous. Due to our country government network health communication start late, there are many problems in the interaction, which is the main characteristic of new generation of Internet. The article summarized the problems in the health communication online, then put forward some countermeasures to make a perfect interaction of the health communication.

Abstract:Objective: To analyze AIDS-related health beliefs and the relationship between them and AIDS preventive behavior of migrant workers in Jiangsu province. Methods:Questionnaire survey was applied to collect the data of AIDS health beliefs and AIDS preventive behaviors of migrant workers. Results:The total score of AIDS health beliefs of migrant workers was 7.2,within which scores of susceptibility and behavioral effectiveness were lower than scores of the other two items. Only 8.9% of migrant workers always used condoms when they had sex. Correlation analyses showed that frequency of using condom when having sex was positively correlated with the four dimensions of health belief model (HBM). Conclusion:Condom utilization rate was low when migrant workers had sex. The study also implied that health belief model should be used as theoretical framework in the designation of AIDS behavioral intervention strategies in future.

Abstract:Objective: Before and after health education intervention,the situation of grasping health knowledge and healthy behavior were discovered among the community residents in part of Jiangsu province. The actual situation of the development of community health education was studied in Jiangsu province,and health education activities in communities were guided. Methods:By questionnaire survey,1 800 residents in 12 communities were investigated,and the effectiveness of health education intervention was evaluated. Results:Less than 50% people had sense of the knowledge on “prevention of influenza”,“the diagnosis of diabetes”,“the frequency of measurement of blood pressure in people over 35 years of age”,“the treatment after dog and cat bite”,and “the benefits of iodized salt”. Less than 50% of the subjects were aware of “how to properly use range hoods”,“how to separate raw and cooked”,“how to participate in health check over the past year”,“how to replace a toothbrush every three months”,“how to correct method of oral hygiene”,“how to bath towel hangs on the balcony”,“how to wash hands in time”,and “how to do not spit”. After the intervention,though the healthy behavior was observed no significantly improved,the degree of knowing health knowledge of community residents had significantly improved. Conclusion:Urban community health education should be strengthened consistently,people’s health knowledge should be enhanced,and the development of residents of health behavior should be promoted.

Abstract:Objective: To put forward some suggestions about the sustainable development of new rural cooperative medical scheme(NRCMS) according to the fund operation and the cost of hospitalization of NRCMS of the certain city in Jiangsu province from 2008 to 2010. Methods:Relevant data were collected,and statistic descriptions and key informants interviews were applied. Results:The overall operation of NRCMS was in good condition,but some problems about policies and management still existed:the time of raising money and adjusting scheme was not match;the cost of hospitalization in city hospital was high;the cost of medicine and material outside the reimbursement directory was much too high;the aging of population influenced the operation of NRCMS. Conclusion:The research area should take some measures to solve the problems,establish stable financing mechanism,adjust the scheme of compensating timely,continue the supervision and payment scheme reform of medical institutions,improve the performance appraisal and the referral system,strengthen the construction of grassroots medical institutions.

Abstract:On the Internet,a portal is a site that consists of links to other websites. The article analyzed portals’ online patient service of 30 large hospitals from 7 countries through search engines and introduced some characteristic columns to give some advice for our hospital website construction and improvement,then advanced that with the development of Internet,hospitals which serving as the backbone of China’s healthcare industry should establish high-level websites to meet the increasing demands from patients.

Abstract:Combining with the latest medical reform in China,the article discussed on practice of vertical nursing management in hospitals including management,evaluation,cultivation and initial results,then considered that the plan and operation of the vertical nursing management should be beneficial to the work of department of nursing administration,and advantageous to the advancement of nursing.

Abstract:Shortage of medicines caused by the market mechanism including price,production and circulation,such as production loss,reducing supply owing to production cycle length,high costs and low profits,has affected the safety of clinical and public health. The establishment of early warning system of medicine shortage and medication management system of China is both inevitable and necessary,and the relevant rules set by government are also essential.

Abstract:Auxiliary examination is a major factor contributes to diagnosis and treatment. The article expounded the intensified preengaging platform for auxiliary medical checkup,which was a effective method for optimizing the procedure of examination and reducing the time limit of preengagement,analyzed the problems existed in the preengagement system,and then put forward the specific way and experience of the construction of preengaging platform for auxiliary medical checkup,such as observing the rules and applying in the flexible way,giving service to both patient and medical department,and combining dynamical management with continuous improvement.

Abstract:Alice in Bed,the most important drama by Susan Sontag,layed the theme on a historical character,Alice James from the famous James’. Through revealing Alice’s illness-trapped life,Sontag expressed her humanistic care to sick people. In this 8-act play,Sontag tried to abate imaginations and connotations on illness,preventing physical sickness being transformed to mental sickness,embodying profound medical humanity value.

Abstract:The Analects of Confucius is one of Confucianism,the learning thought in it still has lessons education. The article told the medical students the importance from learning objective,learning attitude,learning method in The Analects of Confucius.

Abstract:The federal government always played a key role in the development of American education. By means of granting lands,endowing funds,passing laws and so on,the federal government continuously exerted great influence on American education profoundly and thoroughly. In one word,the United States federal government had been adjusting goals of educational reforms on the basis of needs of social development in different periods in order to ensure the leading position in the world. The article attempted to analyze the federal government’s role in promoting American education and its enlightenment to Chinese educational reform.

Abstract:Medical students,taking medicine as occupation career,need the ability of interpersonal communications. Even in the system of the international medical education,interpersonal communications ability has been hardly required,which is the social expectations of the medical personnel as well. However,the survey we did before found that there were restrictions of the interpersonal communications ability of medical students. The article analyzed the cause of current situation,including the lack of both theoretical knowledge and practical experiences of interpersonal communications,as well as the leading functions of school and families.

Abstract:The article analyzed the correlations and differences among formative,summative and comprehensive assessment of six clinical courses with SPSS. The results showed that summative assessment was more effective and had a significant correlation with comprehensive assessment no matter the proportion, and the correlation between formative and comprehensive assessment was related to the big proportion of formative assessment. These results suggested that it was necessary to adjust and clear the goal and requirement of course assessment, different methods of assessment should be applied to different goals and requirements of assessment,and many methods of formative assessment for existing courses should be further improved.

Abstract:Medical English teaching is an important component of the English teaching in medical colleges and universities, while its current personnel training system drifts away from the social needs and cannot fully satisfy the students’ demand for employment. Based on the survey of the English teaching for medical personnel,the article identified and analyzed the current situation and existing problems,aiming to put forward some feasible reform strategies, promoting the quality of medical English teaching in our university,as well as the English proficiency in practical application of the medical personnel.

Abstract:Department of biomedical engineering in Nanjing Medical University has enrolled students since 2006,and continues to explore on cultivation model for biomedical engineering in medical college. After 5 years of practice,it forms its own distinctive characteristics following the educational ideas of “combination between medicine and engineering,closing to clinical,focusing on innovation”. Complex-type talents graduated are highly recommended by their employers.

Abstract:Morphology is the base of human parasitology. Many problems exist in the morphology teaching in medical schools such as the shortage of specimens,untypical morphology of specimens and insufficient ability of young teachers in morphological identification. Chinese parasite germplasm resources with a large amount of information and standardized form can be shared as teaching resources,which provides a basis for open learning and training for young teachers.

Abstract:Objective: To study the epidemiological characteristics of leprosy and to provide evidences for specific strategies on leprosy control. Methods: Descriptive analysis was carried out based on the data of 2010 from the national leprosy surveillance system. Results: A total number of 1 324 new cases were detected in 2010 with a case detection rate of 0.099 per 100 000 population. The proportions of children under 15-year-old,multibacillary and disability grade 2 were 2.9%,84.9%,22.5%,respectively. A total number of 96 relapse cases were reported,among which 35 cases were those relapsed after multi-drug therapy. The registered cases were 6 032 by the end of 2010 with a prevalence rate of 0.450 per 100 000 populations,among which 2 886 cases were in the progress of multi-drug therapy. Conclusion: In China,the overall leprosy situation is still at low endemic but the distribution is unequal,with pocket areas in southwest such as Yunnan,Sichuan and Guizhou provinces. In order to reduce the burden of the disease and reach the target of leprosy elimination,which was considered as a public health and social problem,the input and efforts are needed for many years.

Abstract:Comprehensive and systematic physical examination is an important means for gastroenterologists, however, lots of medical students are found to be lack of these basic skills during clinical teaching. This report illustrated the main aspects of physical examination by explaining and summarizing cases, and vividly highlighted the importance of “eyes-hands-ears”to doctors, as well as helped medical students to better grasp physical examination of digestive system and put it into clinical applications.

Abstract:Objective: To investigate the status of infant birth weight in Nanjing area and explore potential risk factors of low birth weight and macrosomia. Methods: A multi-stage sampling method combined by stratified sampling and cluster sampling was used and five districts and town streets of Xuanwu and Luhe area were respectively taken as the program field. Total 3305 subjects of live birth from 2002 to 2004 were chosen as retrospective observation objects with the questionnaire survey. The information of maternal age,weight,educational level,gestational age,gravidity and neonatal birth weight etc. were collected according to the maternal health card provided by local maternity and child care center. Results:① The average birth weight of the neonates in Nanjing in the year 2002-2004 was 3 373.76 ± 466.23 g. The incidence rate of low birth weight was 1.4% and that of macrosomia was 6.8%. ② The average birth weight and height of the neonates in Xuanwu district(3 505.71 ± 541.92 g,49.69 ± 3.37 cm) were significantly higher than those in Luhe district (3 293.09 ± 392.01 g,48.63 ± 2.70 cm)(P < 0.05). The birth weights of male were significantly higher than those of female in Xuanwu and Luhe districts,respectively (both P < 0.001). ③ The birth weight of the neonates of 2004 was significantly higher than that of 2003,and the birth weight of female of 2003 was lower than that of 2002 (P < 0.05) in Xuanwu district,whereas no statistical differences of birth weight was found between the years of 2002,2003 and 2004. ④ With the increase of gestational age,birth weights of the neonates elevated significantly in different districts and different gender(P < 0.01). Additionally,birth weights of female linearly increased with the increase of pregnancy age (F = 3.887,P < 0.01). Conclusion: The results suggest that there were significant rural-urban difference and sex difference for birth weight in Nanjing City. Birth weight arises significantly with the increase of gestational age and pregnancy age.

Abstract:Objective: To study the tissue distribution of docetaxel liposomes modified with galactose ligand (Gal-DOC-L) in mice after intravenous injection,and to discuss the liver targeted effects of Gal-DOC-L. Methods: The determination of drug tissue distribution in mice was measured by HPLC,relative uptake rate (re),peak concentration ratio (Ce) and targeting efficiency (te) were used as the evaluation parameters to evaluate the DOC-L,Gal-DOC-L’s liver targeted effect. Results: The relative uptake rates of DOC-L and Gal-DOC-L were 2.80 and 4.34,peak concentration ratios of DOC-L and Gal-DOC-L were 1.67 and 2.38,targeting efficiency percentages of DOC-L and Gal-DOC-L were 28.44% and 38.91%. Conclusion: The drug encapsulated by liposomes has a certain effect of targetability,and liposomes modified with galactose ligand-targeted could further improve the hepatic targeted effect.

Abstract:Objective: To investigate the effect of high-cholesterol diet on renal artery atherosclerosis and the amelioration of berberine. Methods: Thirty SPF male Wistar rats were randomly divided into control group (n = 10),experimental group(n = 10) and berberine group(n = 10). Rats of control group were fed with normal diets while the other two groups were fed with high cholesterol diet starting from the second week for 3 months,after which the berberine group were administrated berberine(100 mg/kg) through intragastric administration daily,and the rats from experimental group were given normal saline for totally 6 weeks. Lidocaine was used for anesthesia and blood biochemical parameters such as cholesterol and creatinine were checked. Hematoxylin and Eosin (HE) staining and immunohistochemistry were used to investigate the effect of berberine on the AS lesion of renal artery. RT-PCR and Western blotting was used to study the expression of the IL-18 mRNA and protein. Results: Some of the blood biochemistry parameters of experimental group were significantly different from the other two groups (P < 0.01). The rats of experimental group have generated a significant accumulation of the foam cells and migration of the smooth muscle cells compared with that of the control group,while rats treated with the berberine showed less accumulation of the foam cells and no significant migration of the smooth muscle cells. The relative expression of the IL-18 mRNA increased significantly after induction of renal artery AS compared with that of the control group and the berberine group(both P < 0.01). Conclusion: Berberine can suppress the expression of IL-18 and prevent the formation and development of the AS,consequently protect the renal artery,renal artery stenosis and the damage from renal artery stenosis.

Abstract:Objective: To investigate the expression changes of EphB4/ephrinB2 in normal bone marrow derived mesenchymal stem cells (MSCs) co-cultured with myeloma cell lines U266 or RPMI8226. Methods: Bone marrow MSCs from normal subjects were co-cultured with U266 or RPMI8226 by transwell for 7 days to 12 days. The mRNA expression levels of EphB4/ephrinB2 in MSCs were detected by real time quantitative PCR (RT-PCR) at point times and the protein levels of EphB4/ephrinB2 were analyzed by immunocytochemistry. Results: No evident morphologic and proliferative alterations could be observed in MSCs after co-culture with U266 or RPMI8226. The mean mRNA expression levels of EphB4/ephrinB2 were down-regulated in MSCs after co-culture with U266 or RPMI8226 as compared with controls. There was a significant difference on the point time of the 7th day’ point(P < 0.05) except EphB4 of MSCs co-cultured with RPMI8226 and no significant difference on the 12 day’ point(P > 0.05) between co-cultured MSCs and the controls. The protein levels of EphB4/ephrinB2 were also reduced in co-cultured MSCs. Conclusion: The communication between bone marrow MSCs and myeloma cells induced dysregulation of EphB4/ephrinB2,which may contribute to uncoupling of bone remodeling in myeloma bone disease.

Abstract:Objective: To investigate potential effects of vasoactive intestinal peptide(VIP) in colonic submucous plexus of mice with severe acute pancreatitis (SAP) complicated by gastrointestinal dysmotility. Methods: Twenty Sprague Dawley rats weighing 200~250 g were distributed into two groups: induced acute pancreatitis and control group. Acute pancreatitis was induced by intraductal infusion of 5% sodium taurodeoxycholate,and small intestinal impelling ratio were detected. Pancreatic lesion was scored. Whole mount samples of submucous plexus were prepared and stained with double immunofluorescence to observe the morphology of VIP neurons. The percentage of VIP neurons in the total neurons was calculated. Results: Compared with the control gourp,the small intestinal impelling ratio in the SAP group was significantly lower(P < 0.01),the score of pancreatic lesion was remarkably higher(P < 0.01),the VIP neurons were bigger and more deeply stained,and the nerve fibers between ganglions of the VIP were thicker,and the percentage of VIP neurons was significantly higher(P < 0.01). Conclusion: A high expression level of VIP neurons in colonic submucous plexus may be one of the nervous mechanisms underlying gastrointestinal dysmotility in SAP rats.

Abstract:Objective: To explore the inhibitory effect of minocycline (MC) on lipopolysaccharide-induced production of nitric oxide(NO) and expression of induced nitricoxide synthase(iNOS) in BV-2 microglial cells and its molecular mechanisms. Methods: The BV-2 microglial cells were treated with LPS (100 ng/ml) or various concentrations of minocycline (0,0.1,1,10,100 μmol/L). Accumulated NO was measured in the cell supernatant by enzyme method,iNOS protein and mRNA were examined by immunochemistry staining and RT-PCR technique,respectively. p38MAPK protein was examined by Western blot in BV-2 cells. Results: The NO production and iNOS protein and mRNA levels were significantly increased in LPS group than those of the control group(P < 0.05, 0.01,0.01,respectively). The pre-treatment of MC(10 μmol/L) significantly inhibited the NO production and the increments of iNOS protein and mRNA induced by LPS. The NO contents and the levels of iNOS protein and mRNA in MC+LPS group were significantly lower than those of the LPS groups (all P < 0.01),but still significantly higher than those of the control group (all P < 0.05). There was not significant differences of total p38MAPK protein expression in all groups,but no phospho-p38MAPK proteins were detected in the control group and MC group. The level of phospho-p38MAPK in the control group was significantly lower than that of the LPS group (P < 0.01),in which the increased phospho-p38MAPK level was reversed by MC (P < 0.01),Conclusion: The pre-treatment of MC could significantly inhibit the NO production and the increase of iNOS protein and mRNA induced by LPS through inhibiting the p38MAPK pathway in microglial cell.

Abstract:Objective: To investigate the pathogenesis of diaphragmatic fatigue by diaphragm fibers classification changes and diaphragmatic apoptosis in rats with chronic obstructive pulmonary disease(COPD),in order to find new treatment of diaphragmatic fatigue. Methods: Forty male Wistar rats were randomly averagely divided into healthy control group and COPD group. The rats in the COPD group were exposed to 5% smoke in a sealed box(twice for each day,30 minutes for each time,interval 8 hours,lasting for 28 days),and 200 -滋g lipopolysaccharide was injected intratracheally on the 1st and 14th day. On the 29th day,the rats were sacrificed for detection of apoptosis rate,Fas protein and Caspase-3 gene expression of diaphragmatic muscle cell,and observation of the morphologic changes by electron microscope and diaphragm myofibers classification dyeing. Results: On the 28th day,destruction of alveolar walls and enlargement of alveolar space were observed in the COPD group,the diaphragmatic muscle cell apoptosis rate,the Fas protein and Caspase-3 gene expression were higher than those of the control group(P < 0.01). Compared to the healthy controls,the type I fiber proportion in the COPD group was increased,while the Ⅱ type fiber proportion was reduced (both P < 0.01). Conclusion: Abnormal apoptosis of diaphragmatic muscle cell and fiber type of change were present in rats with COPD. Caspase-3 and Fas/FasL way could be involved in the apoptosis of diaphragmatic muscle cell,the regulation of fiber type of change in the late patients with COPD,which causes difficult to treat diaphragmatic muscle fatigue.

Abstract:Objective:To investigate whether human alveolar type Ⅱ epithelial cells express IL-22R and whether it generates human β-defensin-2 (HBD-2) under the stimulation with IL-22. Methods: First,flow cytometry(FCM) detected the expression of IL-22R on alveolar type Ⅱ epithelial cells;second,cells were stimulated with recombinant human IL-22(rhIL-22) for 0,2,4,8,16,24 hours,separately,and then RT-PCR tested the expression of HBD-2;third,the cells were stimulated with different concentration (0,4,20,100,500 ng/ml) of IL-22 for optimal dose. Results: The membranes of alveolar type Ⅱ epithelial cells highly expressed IL-22R and the positive rate is (99.90 ± 0.13)%;24 hours is an effective time for HBD-2 expression with IL-22 treatment,and the optimal concentration is 100 ng/ml. Conclusion: The alveolar type Ⅱ epithelial cells highly express IL-22R,and the interaction of IL-22 and IL-22R induces the HBD-2 gene expression in alveolar epithelium in a time- and concentration-dependent manner.

Abstract:Objective: To study the expression and significance of squamous cell carcinoma antigen-1 (SCCA1) in keratinocytes from the lesion of cutaneous lupus erythematosus. Methods: The keratinocytes were isolated from the human skin and cultured in serum-free media. The total proteins of keratinocytes were separated by 2-dimensional gel electrophoresis. The differential proteins were analyzed using ImageMaster 2D analysis software after staining and identified by MALDI-TOF-MS. The expressional levels of the proteins were further confirmed by Western blot analysis. Results: We successfully in vitro cultured human skin primary keratinocytes and established 2-dimensional electrophoresis profiles with high resolution and reproducibility. The SCCA1 protein was up-regulated in the keratinocytes from lesion of CLE compared to the normal group,and the result from both proteomics approach agreed with that of Western blot analysis. Conclusion: The SCCA1 protein was up-regulated in the keratinocytes from lesion of CLE,which may be related to the development of CLE. However,the pathogenesis of over expression of SCCA1 need further study.

Abstract:Objective: To investigate the effect of gentamicin loaded chitosan nanospheres(GS/CS NPs) on the treatment of chronic osteomyelitis of rabbit. Methods: Forty-eight rabbits were used to establish the chronic osteomyelitis model,and observation of affected limb and X-ray were done 3 weeks later. Forty-four rabbits had symptoms and signs of chronic osteomyelitis and were divided into 4 groups. Group A has no treatment,group B was treated with chitosan nanospheres,group C was treated with gentamicin sulfate,and group D was treated with GS/CS NPs. The X-Ray,observation of the bone marrow cavity,bacterial culture and the HE staining were done after 3 weeks of treatment. Results: After 3 weeks of treatment,the X-Ray of groups A~C showed apparent signs of chronic osteomyelitis,the formation of abscess were observed in bone marrow cavity,and the cultures of the Staphylococcus aureus were positive. The HE staining of groups A~C showed neutrophil accumulation,and the formation of dead bone were observed in groups A~B. The Norden and Smeltzer scores showed significant differences between group D and groups A~C(both P < 0.05). Conclusion: GS/CS NPs has significant effects on the treatment of rabbit chronic osteomyelitis as local drug delivery system.

Abstract:Objective:To compare the effect of three adhesive resin cements on microleakage of amalgam restoration. Methods:Forty premolars were randomly divided into four groups. The three experimental groups were restored with bonded amalgam restoration using three adhesive resin cements, respectively(Clearfil SA Luting,Panavia F,Rely X Unicem). The controls was restored with amalgam only. The teeth were immersed in 2% methylene blue solution for 4 hours and then cutted perpendicularly to the bonding surface. The interfaces were then observed under the stereomicroscope,and the depth of immertion of the methylene blue into the interface was recorded and analyzed,and finally investigate the micromorphology of the interface using the scanning electron microscopy. Results:The microleakage of the three experimental groups is less than that of the control group. And there is no differences among the three experimental groups. The microleakage at gingival margin is significantly greater than that of the occlusal margin. Conclusion:The adhesive resin cement can significantly improve the marginal seal of amalgam restorations.

Abstract:Objective: To compare clinical value of different biomarkers (CK19,hMAM,SBEM) used to detect circulating tumor cells(CTCs) in peripheral blood of patients with breast cancer using real-time quantitative PCR (QPCR) platform. Methods: The expression of CK19,hMAM,SBEM in human breast cancer cell lines MCF-7 was detected by real time QPCR,peripheral blood samples of 20 healthy volunteers and 20 patients with breast benigh disease were detected to identify the base line expression of CK19,hMAM,SBEM. The expression of CK19,hMAM,SBEM in peripheral blood from 94 patients with operable breast cancer was detected also. Results: CK19,hMAM and SBEM were all detected in MCF-7,and the Ct value were 13.87,34.47,and 20.14,respectively;among the 40 control persons,one sample expressed CK19,one sample expressed hMAM,and no sample expressed SBEM;among the 94 patients with operable breast cancer,46 (49%) samples expressed CK19,32 (34%) samples expressed hMAM,and 12(13%) samples expressed SBEM,53 (56%) samples were positive by combined detection using the three biomarkers. Conclusion: It is higher sensitivity to detect circulating tumor cells in peripheral blood of breast cancer combined detection using multimarkers(CK19,hMAM,SBEM) based on a real time QPCR platform,yet specificity was not depressed.

Abstract:Objective: To study the expression of Gadd45a and p53 protein in breast cancer and its correlation with clinical pathologic features in breast cancer. Methods: The expressions of Gadd45a and p53 proteins in 78 cases of breast cancer and mammary gland tissues were determined by the immunohistochemical staining. Results: The expression of Gadd45a in patients was lower than that in the control mammary gland tissue,while the expression of p53 in cancer samples was higher than that in the adjacent mammary gland tissue (P < 0.05). The positive rate of Gadd45a correlated differentiation level of cancer (Grade I,83.3%,Grade II,46.7%,Grade III,16.7%,P < 0.05),meanwhile,the positive rate of p53 in patients with lymph node metastasis was 76.6%,which was much higher than that in no metastasis patient (48.4%,P < 0.05). p53 correlated with Gadd45a negatively. Survival analyses showed significant differences between the positive class and negative class of these three proteins[MST(median survival time):Gadd45a:57.3m,46.3m;p53:47.7m,58.6m,5-year survival rate:Gadd45a:89.6%,60.0%;p53:70.6%,92.6%]. Survival analyses shown significant differences between the positive class and negative class of p53(+)Gadd45a(-)[MST:p53(+)Gadd45a(-):37.5m;58.3m,5-year survival rate:p53 (+)Gadd45a (-):50.0%,89.2%]. Conclusion: Gadd45a and p53 testing could predict the invasive behavior of breast cancer. The expression of Gadd45a correlates with a favorable prognosis,and the expression of p53 correlates with unfavorable prognosis,p53 (+)Gadd45a (-)predict poor prognosis. Gadd45a and p53 could be developed to be a new breast cancer therapeutic target.

Abstract:Objective: To study clinical significances of survivin expression,a marker of circulating tumor cells(CTC),in peripheral blood of esophagus squamous cell carcinoma(ESCC) patients treated with radiotherapy. Methods: Survivin mRNA expression was determined using nest RT-PCR in pre- and post-radiotherapy blood of 72 esophageal cancer patients with radiotherapy,and its associations with clinicopathological features,radiotherapy response and 2-year progression-free survival (PFS) were further evaluated. Results: The positive expression of survivin mRNA in pre- and post-radiotherapy were 54.2%(39/72) and 38.9%(28/72),respectively,and the difference has not statistical significance (P = 0.066). Furthermore,survivin mRNA expression was associated with lymph metastasis both in pre- and post-radiotherapy (P = 0.012 and P = 0.005,respectively). Survivin expression of post-radiotherapy was associated with poor radiotherapy response (P = 0.030). Kaplan-Meier analysis also showed that survivin mRNA expression predicted adverse 2-year PFS both in pre- and post-radiotherapy(P = 0.023 and P < 0.001). However,Cox proportional hazard models indicated that only post-radiotherapy survivin mRNA expression apart from KPS scores and standard chemotherapy were independent prognostic factors for ESCC. Conclusion: Post-radiotherapy survivin mRNA expression may be an useful biomarker related to poor radiotherapy response and adverse prognosis in ESCC patients treated with radiotherapy.

Abstract:Objective: To study the expression and clinical significance of Notch1 and human epidermal growth factor receptor 2(HER2) in gastric carcinoma. Methods: The expression of Notch1 was detected by immunohistochemistry,and assessment of HER2 protein overexpression and gene amplification were done by immunohistochemistry and fluorescence in situ hybirdizaton(FISH) in tissue microarrays containing 317 gastric carcinomas and relatively normal gastric mucosa tissue. Results: Overexpression of HER2 protein was observed in 64 cases(20.2%) and HER2 gene amplification was detected in 58 cases(18.3%) of gastric carcinoma. The concordance rate between the immunohistochemistry and FISH was 89.1%. HER2 protein overexpression and gene amplification were significantly associated with tumor location and the Laurén’s classification(P < 0.01),but not with differentiation grade and clinical stage (P > 0.05). The expression of Notch1 protein was observed in 197 cases (62.1%) of gastric carcinoma,and was significantly associated with differentiation grade and clinical stage(P < 0.05). The expression of Notch1 was negatively correlated to the protein overexpression and gene amplification of HER2 (r = -0.191,P < 0.01;r = -0.169,P < 0.01,respectively). Conclusion: The significantly dys-regulated expression of Notch1,which could promote growth and invasion of gastric carcinoma cells and correlated to the higher clinical TNM stage,was observed in gastric carcinoma. The expression of Notch1 negatively correlated to the protein overexpression and gene amplification of HER2 suggests that Notch1 may act as a novel therapeutic target molecule for gastric carcinoma.

Abstract:Objective: To assess the overall response rate and toxicity of pemetrexed puls a platinum agent(cisplatin or carboplatin) in the patients with unresectable stage ⅢB/Ⅳ non-small-cell lung cancer(NSCLC). Methods: Sixty-nine chemotherapy-naive patients with stage ⅢB/Ⅳ NSCLC received pemetrexe 500 mg/m2 plus cisplatin 75 mg/m2(n = 47) or pemetrexed 500 mg/m2 plus carboplatin area under the curve of 5 (AUC=5,n = 22) on day 1,one cycle of treatment is 21 days,and the whole treatment lasted 2 to 6 cycles. RECIST 1.0 was used to assess the efficacy of the treatment,and NCI CTC-AE version 3.0 was used to describe adverse events. Results: In the 69 patients,none showed complete response,27 patients showed partial response,24 had stable disease,the overall response rate was 39.1 %,and the disease control rate was 73.9%. There were higher overall response rates and disease control rates in the patients with nonsquamous histology than that of the patients with squamous histology(41.1% vs 30.8% and 76.8% vs 53.8%). Among the 69 patients,the median progression-free survival was 5.3 months,there was no significant difference in progression-free survival (PFS) between the patients with and without squamous histology (4.5 months vs 5.4 months,P > 0.05),but there was a significant difference in PFS between the patients with adenocarcinoma and with squamous cell carcinoma(5.6 months vs 4.5 months,P = 0.03);In multivariate analysis using the Cox regression model,the histology emerged as an independent indicator(P < 0.05). The principal drug-related adverse events were myelosuppression,gastrointestinal response and fatigue,most of which were grade 1 to 2. Conclusion: Pemetrexed plus platinum compunds was safe and efficacious for the treatment of patients with advanced NSCLC,and the nonsquamous histology may be probably associated with better outcomes.

Abstract:Objective: To evaluate the energy metabolism and mitochondrial function of skeletal muscle in type 2 diabetic patients offspring using dynamic 31P magnetic resonance spectroscopy(31P-MRS). Methods: Dynamic 31P-MRS was performed on 21 type 2 diabetes patients offsprings and 18 healthy volunteers. Spectra were acquired from quadriceps muscle while subjects were at rest,exercise and recovery. The peak area of inorganic phosphate (Pi),phosphocreatine (PCr) and adenosine triphosphate (ATP) were measured. The concentration of adenosine diphosphate (ADP) and intracellular pH value were calculated from the biochemistry reaction equilibrium. The time constant and recovery rate of PCr,Pi and ADP were analyzed using exponential curve fit. Results: There were no significance differences of Pi,PCr,ADP,β-ATP and the ratio of Pi/PCr between the type 2 diabetes patients offsprings and the healthy volunteers at rest. The type 2 diabetes patients offsprings showed significantly lower β-ATP concentration at the end of exercise compared to the healthy subjects. At recovery phase,the PCr and β-ATP concentration and pH of the type 2 diabetes patients offsprings were lower than those of the healthy subjects. The ratio of Pi/PCr of the type 2 diabetes patients offspring is significantly higher than that of the healthy subjects at the third spectrum of recovery phase. The mean PCr recovery rate of the offspring is significantly slower than that of the healthy subjects. Conclusion: Noninvasive 31P-MRS could detect the energy metabolism inefficiency and mitochondrial function impairment in skeletal muscle of type 2 diabetes patients offsprings.

Abstract:Objective:To investigate effects of surgery frequency on the laparoscopic radical gastrectomy learning curve. Methods: A retrospective analysis of the laparoscopic radical gastrectomy by the same physician group Ⅰ and Ⅱ,respectively,from January 2008 to June 2010 (n = 100) and from January 2008 to January 2011(n = 90),the average monthly surgery rate was 3.33 and 2.50. Ⅰ group was divided into four phases (A,B,C,D),each phase of 25 cases,Ⅱgroup divided into six phases (E,F,G,H,I,J),each phase of 15 cases. Operative time,blood loss,postoperative hospital stay,complications,laparotomy number,number of lymph node dissection were compared between all groups. Results: As for four phases,the operative time and blood loss of C,D groups were significantly less than A,B phases. For six phases,the operative time and blood loss of I,J were significantly less than E,F,G,H phases,the number of lymph node dissection,complications,postoperative hospital stay and rate of transit laparotomy of each phase were not significantly different. The surgical time of 100 cases from Ⅰ group,was significantly less than 90 cases of Ⅱ group,the blood loss of patients in Ⅰ group was significantly less than the Ⅱ group,the difference of the number of lymph nodes and transit laparotomy rate and surgical complications between the two groups has no statistical significance. Conclusion: A shorter learning curve will be getten by increasing the surgery frequency appropriately,and benefit the understanding of the laparoscopic radical gastrectomy.