A preliminary study on the operation of a Taizhou TCM medical group / 中华医院管理杂志

The newly-formed TCM medical group is characteristic of innovative management,diversified medical service provision,integration of medical resources,building of urban/rural medical service systems,promoting medical resources availability to primary care,perfecting hierarchical medical service mechanism,leveraging advantages of traditional Chinese medicine and its primary care capabilities,centralizing human,financial,and material resources management.

Advances in vertebrobasilar dolichoectasia / 国际脑血管病杂志

This article reviews and summarizes the research data about vertebrobasilar dolichoectasia in recent years from the aspects of epidemiology,pathogeny,pathology,diagnosis,clinical manifestations,as well as its mechanism and treatment.

Diagnosis & treatment for ureter behind lower vena cava CAI Hui-wu,ZHANG / 中国基层医药

Objective To improve the level of diagnosis and treatment for Ureter behind Lower Vena Cava.Methods 11 cases of Ureter behind Lower Vena Cava patients′clinical information have been reviewed and analysed.The main symptom for these patients include waist ache,right kidney colic,hematuria and so on.Through visualizating on vein urinary passage,pelvis visualizating conversely and so on,a correct diagnosis can be gained mostly.Results As for 11 cases of patients who have been done ureteroureteral anastomsis,based on respective follow-up visit conducted during 1 to 10 years,their clinical symptom have disappeared,for example,right kidney hydrocele are mending well,ureter becomes smooth and kidney function normal.Conclusion Visualizating on vein urinary passage and pelvis visualizating conversely will bring mostly a correct diagnosis.When it is difficult to diagnose,a correct diagnosis can be obtained by combining such visualization with MRU or CT inspection.Surgical is a top choice for such patients,and can bring a satifactory effect.

Different expressions of p53 gene family members and their clinical significance in human non-small cell lung cancer / 中国肺癌杂志

<p><b>BACKGROUND</b>To investigate the different expressions of p53 gene family members p53, p63 and p73, and their clinical significance in non small cell lung cancer (NSCLC).</p><p><b>METHODS</b>p53, p63 and p73 protein expressions were detected in 60 NSCLC tissues and 7 normal lung tissues by immunohistochemistry.</p><p><b>RESULTS</b>In NSCLC, positive rate of p53, p63 and p73 protein was 61.67%(37/60), 80.00%(48/60), 73.33% (44/60) respectively. There were significant differences in positive rate of three proteins as compared to normal lung tissue ( P < 0.05). p53 protein expression was closely associated with tumor cell differentiation degree ( P =0.023), but was not associated with histological classification, lymph node metastasis and clinical stages ( P > 0.05). Expression of p63 protein was closely related to lymph node metastasis ( P =0.028) and histological classification ( P =0.001), but not to cell differentiation degree and clinical stages ( P > 0.05). There was no significant relationship between p73 protein expression and clinical characteristics of NSCLC ( P > 0.05). A positive correlation was present between p63 and p73 protein expressions ( P =0.000 1). No statistical correlation was found between p53 and p73 ( P > 0.05).</p><p><b>CONCLUSIONS</b>p53 gene family may be related to the oncogenesis and development of NSCLC. p63 and p73 proteins may have different biological function from p53 protein, and both might play oncogenic roles.</p>

Cyclooxygenase-2, inducible nitric oxide synthase protein expression and vasculature during experimental rat lung carcinogenesis / 中国肺癌杂志

<p><b>BACKGROUND</b>To investigate the expression of cyclooxygenase-2 (COX-2) protein and inducible nitric oxide synthase (iNOS) protein during the experimental lung carcinogenesis in rats, as well as their association with microvessel density (MVD).</p><p><b>METHODS</b>Diethylinitrosamine and 3-methylcholanthrene were instilled into the left lobar bronchus to induce lung squamous cell carcinoma in 88 Wistar rats, and 10 nomal rats as controls. COX-2, iNOS expression and MVD count of the specimens obtained from the rats were examined by immunohistochemistry.</p><p><b>RESULTS</b>A total of 155 specimens of various pathological phase during the carcinogenesis were obtained: 14 hyperplasia, 25 squamous metaplasia, 33 dysplasia, 12 carcinoma in situ, 54 infiltration carcinoma, and 17 metastasis. The immunohistochemical score (IHS) of COX-2 significantly increased in dysplasia, carcinoma in situ and metastasis (P < 0.01,P < 0.05,P < 0.01). IHS of iNOS significantly increased in hyperplasia and metastasis (P < 0.05,P < 0.01 ). Remarkably increased MVD was found in carcinoma in situ, infiltration carcinoma and metastasis (P < 0.01, P < 0.01, P < 0.01). There was a positive correlation between COX-2 and iNOS (r=0.601 6,P < 0.001) expression. Expression of COX-2 or iNOS were remarkably related to MVD count (P < 0.01,P < 0.01)</p><p><b>CONCLUSIONS</b>COX-2 and iNOS may play important roles in the carcinogenesis of experimental rat lung squamous cell carcinoma as well as its progress, and it may be associated with stimulating angiogenesis.</p>

Expression of inflammation related enzymes during experimental rat lung carcinogenesis / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the expression of two inflammation related enzymes - cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS) during the experimental rat lung carcinogenesis.</p><p><b>METHODS</b>Eighty Wistar rats were instilled with 3-methylcholanthrene (MCA) and diethylinitrosamine (DEN) into the left lobar branchus to induce lung squamous cell carcinoma. To obtain specimen in every pathological phase during the carcinogenesis, these rats were sacrificed at different intervals. The expression of COX-2 and iNOS in every pathological phase during the carcinogenesis were examined by immunohistochemical method. The immunohistochemical scores (IHS) were calculated by combining an estimate of the percentage of immunoreactive cells with that of the stain intensity.</p><p><b>RESULTS</b>155 specimens of every pathological phase during the carcinogenesis showed: hyperplasia 14, squamous metaplasia 25, dysplasia 33, carcinoma in situ 12, infiltrating carcinoma 54 and metastasis 17. Inflammation and elevated expressions of COX-2 and iNOS were shown in the precancerous lesions. The COX-2 IHS was significantly increased in dysplasia, carcinoma in situ and metastasis (P < 0.01, P < 0.05, P < 0.01 respectively). The iNOS IHS significantly increased in hyperplasia and metastasis (P < 0.05, P < 0.01 respectively). There was a positive correlation between the expression of COX-2 and iNOS (gamma = 0.601 6, P < 0.001).</p><p><b>CONCLUSION</b>COX-2 and iNOS, two inflammation related enzymes, playing important roles in the carcinogenesis of MCA and DEN, induce rat lung squamous cell carcinoma as well as its metastasis. The relation between inflammation and carcinogenesis may partly be explained by the elevated expression of these two enzymes. Nonsteroidal antiinflammatory drug (COX-2 inhibitors) and iNOS inhibitors may possess antitumor activities because of their prevention of bronchial dysplasia, carcinogenesis and metastasis.</p>

Study on the specific expressions of p53, bcl-2 and c-myc in non-small cell lung cancer with neuroendocrine differentiation / 中国肺癌杂志

<p><b>BACKGROUND</b>To study the specific expression of tumor-related genes (p53, bcl-2 and c-myc) in non small cell lung cancer with neuroendocrine differentiation (NSCLC-NE).</p><p><b>METHODS</b>The expression of neuron-specific enolase (NSE), chromogranin A (CgA), synaptophysin(Syn), c-myc, bcl-2 and p53 was detected in 60 surgically resected and paraffin-embedded non-small cell lung cancer (NSCLC) specimens by immunohistochemistry (S-P method).</p><p><b>RESULTS</b>The positive rates of NSE, CgA, Syn expressed in 60 cases of NSCLC were 45.00%(27/60), 13.33%(8/60), 31.67% (19/60) respectively. According to the results of these three markers, 41.67%(25/60) of 60 specimens was proved to be as NE differentiation cancer. The NE differentiation in NSCLC was remarkably related to differentiation of tumor cells (P < 0.05). NSCLC-NE had a higher metastatic rate (P < 0.05) and a higher clinical staging (P < 0.05) than NSCLC without NE differentiation. The positive rates of bcl-2, p53 and c-myc expression in NSCLC-NE were 68.00% (17/25), 80.00% (20/25), 68.00% (17/25) respectively, and the expression of bcl-2 and p53 was closely related to NE differentiation (P < 0.05).</p><p><b>CONCLUSIONS</b>A certain part of NSCLC have NE differentiation, which has different biological features from NSCLC without NE differentiation. High expression of bcl-2 and mutant p53 can be observed in NSCLC-NE, and bcl-2/Bax unbalance associated with p53 mutation may play an important role in oncogenesis and development of NSCLC-NE.</p>

Microdissection and PCR-SSCP detected mutation and expression of p53 and K-ras gene in carcinogenesis and development of induced rat lung carcinoma / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the roles of p53 and K-ras gene in carcinogenesis and development of the lung carcinoma induced by 3-methylcholanthrene (MCA) and diethylinitrosamine (DEN) in Wistar rats, and to elucidate the relationships between the protein expression and gene mutation of p53 and K-ras.</p><p><b>METHODS</b>Microdissection was used to obtain pure cell populations of each phase in the carcinogenesis and development of lung carcinoma induced by MCA and DEN. DNA of the microdissected cell populations was extracted and used to analyze the mutations of p53 exons 5 approximately 8 and K-ras exons 1 approximately 2 by PCR-SSCP. The expressions of p53 and K-ras protein in each phase were detected by immunohistochemistry.</p><p><b>RESULTS</b>No mutation and protein expression of p53 and K-ras was found in the 30 cases with normal bronchial epithelium. Mutation of p53 was detected in 3.1% of 18 hyperplasia and 14 squamous metaplasia cases, 28.6% of 21 dysplasia, 30.0% of 12 carcinomas in situ, 51.2% of 43 infiltration carcinomas, 52.9% of 17 metastases. The positive immunostaining rate of p53 protein was 0, 42.9%, 50.0%, 60.5% and 64.7% respectively. K-ras mutation rate was 0, 4.8%, 8.3%, 9.3%, 11.8% respectively, while the overexpression rate of K-ras protein was 15.6%, 19.0%, 25.0%, 41.9%, 52.9% respectively. p53 protein expression was closely related with p53 mutation (P < 0.005, Pearson's R = 0.599 6). There was no relationship between the protein expression and gene mutation of K-ras (P > 0.500).</p><p><b>CONCLUSIONS</b>p53 gene mutation and K-ras overexpression were early events in the carcinogenesis and development of rat lung carcinoma induced by MCA and DEN, while K-ras mutation does not play any important role.</p>

The relationship between caspase-3 expression and cell proliferation in rat lung squamous cell carcinoma / 中国肺癌杂志

<p><b>BACKGROUND</b>To analyse the relationship between caspase-3 expression and cell proliferation, and to find molecular-biology markers to adjust canceration during rat lung squamous cell carcinogenesis.</p><p><b>METHODS</b>The 3-methylcholanthrene(MCA) and diethyinitrosamine (DEN) were used to induce lung squamous cell carcinoma by intra-left lobar-bronchial instillation in 50 Wistar rats, and 10 normal rats as controls. Expression of caspase-3 and PCNA were evaluated by immunohistochemistry (IHC).</p><p><b>RESULTS</b>Caspase-3 protein positive rate was 44.12% in 34 rat lung squamous cell carcinomas, and positive coefficient value was 1.38±0.95, which were significantly lower than that of normal bronchial epithelium (P=0.007, P < 0.01) and premalignant lesions (P < 0.05, P < 0.05). The mean PCNA-labeling indexes (PCNA-LI) of normal rat bronchial epithelium, premalignant lesions and lung cancer were 14.10±5.02, 28.13±8.72 and 41.88±14.24 (P < 0.05), respectively. There was a negative correlation between caspase 3 and PCNA LI (r=-0.730 6, P < 0.01).</p><p><b>CONCLUSIONS</b>Loss expression of caspase-3 may promote tumor cell growth, and it may be important in rat lung squamous cell carcinogenesis. Detection of caspase-3 and PCNA proteins can be regarded as major markers in the diagnosis of lung canceration.</p>

The review study on correlation between the expression of CD_(44V6), MMps and lung cancer metastasis / 肿瘤研究与临床

The process of lung cancer invasion and metastasis consists of a complex series of multigene and multistep, CD44V6 is a broadly distributed transmembrane glycoprotein, which mainly participates in the specific adhesion process and plays an important role in cell-cell and cell-matrix interactions.The researches showed that the high expression of CD44V6 was helpful for metastasis ability of tumor cell. MMps is a groups of metal hydronium depend-proteinase, it exhibits proteolytic activity against components of the extracellular matrix (ECM). The recent study indicated that MMps has been played important roles not only in degradation of ECM proteins, but also in the regulation of tumorigenesis. Combined with two marker might be an important significant to judge prognosis ,metastasis and development.

Practice in and exploration of marketing by medium-sized and small hospitals / 中华医院管理杂志

The paper analyzes the marketing circumstances for the operation of medium-sized and small hospitals under a market-oriented economy and gives an account of how the hospital the author works with has treaded the path of rapid and healthy development by actively changing marketing concepts, implementing marketing strategies in the light of local conditions, promoting one-to-one marketing, and persisting in people-oriented services. The experiences will hopefully shed light on the survival and development of medium-sized and small hospitals.