Objective To assess the rationality of using CT for clinical staging in esophageal carcinoma.Methods 103 esophageal carcinoma patients with radical resection were selected,patients were examined by CT before surgery.To compare the clinical staging on the basis of CT findings with pathology.Results Lymph node enlargement were mentioned in 29 cases (28.2 ％) with CT findings before surgery,but 70 cases (68.0 ％) by pathology.The CT findings and pathology were inconsistent (x2 =11.719,P =0.001).Although the pathology staging in the cases which were positive with CT findings could be later (Z =-3.04,P =0.002),there was no correlation between the two methods (x2 =10.885,r =0.055,P =0.055).Conclusion The accuracy rate in esophageal carcinoma clinical staging by CT before surgery is low.Combining with PET-CT or endoscopic ultrasonography may improve the accuracy rate.

Objective To analyze the clinical features,therapy and outcome of systemic lupus erythematosus (SLE) combined with lupus myelopathy (LM).Methods Ten SLE patients combined with LM treated in Department of Rheumatology and Immunology,People' s Hospital from 1990 to 2011 were retrospectively analyzed and 43 cases of SLE combined with LM reported home and abroad were reviewed.Results All the ten patients were women with age of 23-53 (36.9 ± 3.4) years old and duration of 1-18 years.MRI of spinal cord revealed long T2 signal in one case,and normal in two cases.Seven patients received methylprednisolone pulse plus cyclophosphamide (CTX),two were given glucocorticoid pulse only,and one was given moderate dosage of glucocorticoid,CTX and plasma exchange (PE).The results revealed that four patients received complete recovery,four received partial recovery,and two received no improvement.Conclusions LM is a rare but severe complication of SLE with poor prognosis,which usually occurs in early phase of young SLE patients.Pulse methylprednisolone and CTX may be effective.Early and active treatment may improve the outcome.

Objective To investigate and analyze the health care seeking behavior,financial burden and relative factors of patients with rheumatic diseases in Fujian Province.Methods Patients diagnosed with rheumatic diseases were investigated in Fujian Provincial Hospital from December 2013 to February 2014,including demographic data,health care seeking behavior and financial burden.Relevant factors were analyzed by Logistic regression.Results ① In this study,474 patients were enrolled.The ratio of male to female was 1∶2.38.② At the onset of symptoms,51.9％(246 cases) of patients visited a doctor as soon as possible,and 36.1％(171 cases) of them went to hospital within a month after disease onset.③ 74.1％(351 cases) of patients could adhere to medication regimen prescribed by doctors,and the most common reason for stopping medication was symptoms relieved (33.3％,41 cases).④ 63.1％(299 cases) of patients learned about the knowledge of rheumatic diseases from hospitals and doctors.⑤ 34.2％(162 cases) of patients spent 1 000-5 000 yuan every month on treatment.⑥ Insurance type could affect the time of first visit to hospital (P=0.004),while income and cost of therapy might impact patients' compliance (P=0.013,P=0.004).Conclusion Most patients will go to hospital as soon as possible and adhere to treatment.Economic situation is the main factor influencing health care seeking behavior of patients with rheumatic diseases.

Objective To investigate the clinical effects and safety of spiral stone basket assisted with FURL in the treatment of unilateral upper ureteral stones for diameter>1.0 cm. Methods 140 patients with unilateral upper ureteral stones for diameter>1.0 cm from January 2012 to December 2015 were randomly divided into control group (70 patients) with FURL used alone and observation group (70 patients) with spiral stone basket assisted application on the basis of control group;the perioperative clinical indicators, the lithotripsy success rate, the stone clearance rate, the stone removal rate and the postoperative complication incidence of both groups were compared. Results The operation time of observation group was signiifcantly longer than control group (P<0.05). There was no signiifcant difference in the blood loss volume in operation and hospitalization time between 2 groups (P>0.05). The lithotripsy success rate and the stone clearance rate of observation group was signiifcantly higher than control group (P<0.05). The stone removal rate of observation group was signiifcantly lower than control group (P<0.05). The postoperative complication incidence of observation group was no difference between 2 groups (P> 0.05). The total treatment expenses of observation group was signiifcantly fewer than control group (P<0.05). Conclusion Spiral stone basket assisted with FURL in the treatment of unilateral upper ureteral stones for diameter>1.0 cm can efifciently higher the stone removal effects, reduce the stone removal risk and not increase the postoperative complications incidence.

Objective To construct a nomogram for estimating disease free survival of node-positive penile cancer treated with surgery.MethodsThe clinicopathological data of 32 node-positive penile squamous cell carcinoma patients were retrospectively reviewed.All patients had undergone primary tumor excision and regional lymphadenectomy.The pathological records showed that 10 were N1,13 were N2 and 9 were N3.Median level of preoperative squamous cell carcinoma antigen (SCCAg) was O.9 μg/L.With a median follow-up of 16.5 months,13 patients developed recurrence.Based on the stage,histological grade and preoperative serum squamous cell carcinoma antigen level,a nomogram was drawn on the basis of the Cox regression model.Results Stage and preoperative serum SCCAg levels were independent prognostic factors for disease free survival in node-positive penile cancer treated with surgery.The hazard ratio of SCCAg level and N stage was 2.76 (95％ CI:1.40-5.44,P=0.0034) and 28.51 (95％ CI:2.55 -319.11,P =0.0066).The nomogram demonstarted good discrimination and calibration with a concordance index of 0.855.Conclusions Based on the N stage and preoperative serum SCCAg level,a nomogram to predict disease free survival in node-positive penile cancer treated with surgery was set up.The prediction model could be helpful in predicting the risk of recurrence.

Objective To evaluate the prognostic value of bilateral inguinal lymph node metastases in node-positive penile cancer. Methods Sixty patients with surgically resected node-positive penile cancer were analyzed. All the patients underwent regional lymph node dissection. Recurrence free survival curves were plotted by Kaplan-Meier method and compared by the Log-rank test. Multivariate survival analysis was performed using Cox regression model. Results Of all the patients, 18 cases had bilateral inguinal lymph node metastases. The 3-year recurrence free survival rate in patients with bilateral invovlement was significantly lower than those with unilateral disease (26.7 % vs 65.3 %, χ2 =10.6, P=0.001). In order to evaluate wether the prognostic significance of bilateral lymph node metastases was dependent of increased number of positive nodes, the two predictors were included in multivariate survival analysis.Both the number of metastatic nodes and bilateral nodal disease were independent prognostic factors (P ＜0.05).Comparisons of survival curves showed those patients with bilateral nodal disease and more than 2 metastatic nodes had worst outcome. Conclusion Bilateral inguinal lymph node metastases is an important prognostic factor in penile cancer irrespective of the number of positive lymph node.

BACKGROUND:Animal model of infection is established using bioluminescent gene-labeled bacteria, which stimulate local environment of spine infection and reveal the pathophysiological mechanism of spine infection.
OBJECTIVE:To evaluate the feasibility and safety of anterior one-stage debridement, autogenous iliac bone grafting and titanium plate internal fixation in the management of pyogenic spinal infections in spine.
METHODS:Total y 24 Chinese dogs were adopted in the study to develop a canine model of acute pyogenic spondylodiscitis using a bioluminescent strain of Staphylococcus aureus Xen29. The animal models were detected by X-radiography, CT and MRI examinations. After 4 weeks of modeling, al the animals underwent one-stage debridement, autogenous iliac bone grafting and anterior titanium plate internal fixation. Antibiotics contained Cefazolin and Gentamicin were administrated daily since perioperative period to 4 weeks after surgery. The titanium plate and adjacent vertebra were removed surgical y at various postoperative time points (4, 8, 12, 24 weeks) when the dogs were kil ed. The excised tissues and retrieved implants were cultured with conventional bacteria, bacteria 16S rRNA and specific Nuc gene of Staphylococcus aureus. PCR and bioluminescence imaging technique were used to detect the presence of bacteria.
RESULTS AND CONCLUSION:The surgical wound was healed uneventful y. Gross observation and MRI examination of the specimens showed that there was no abscess formation or signs of infection recurrence. The infection rate was 41.7%(10/24) and 75%(18/24) in the procedure of conventional bacteria and bacteria 16S rRNA cultivation. The results showed that the sensibility of PCR technique used to detect the presence of bacteria by amplifying the highly conservative gene sequence of 16S rRNA was significantly higher than that of conventional bacterial cultivation procedure (P<0.05). The PCR detection of specific Nuc gene of Staphylococcus aureus showed the existence of Staphylococcus aureus (1/24). However, Staphylococcus aureus Xen29 with genetic marker was not detected around the implant by bioluminescence imaging technique (0/24). Al of the results showed that bacterium adhering to prosthesis in vivo is an universal phenomenon. The bacteria identified from prosthesis which was taken during the surgery and the bacteria by which the spine was infected before the surgery was not homologous. The one-stage debridement, autogenous bone grafting and anterior titanium plate internal fixation is safe and effective in the management of pyogenic spinal infections. Using of internal fixator can not lead to recurrence or persistence of infection.

Objective:To compare the clinical efficacy of oxycodone hydrochloride controlled-release tablets (OHCT) and pa-tient-controlled intravenous analgesia (PCIA) in the treatment of intractable cancer pain. Methods:Retrospective analysis was conduct-ed to evaluate the intractable cancer pain of 89 elderly patients who were admitted to the medical oncology departments of The Second Affiliated Hospital of Fujian Medical University and the Fuzhou General Hospital of Nanjing Military Command between September 2012 and March 2014. Among the 89 patients, 47 were treated with OHCT, and 42 received PCIA. The total dosage ranged from 60 mg/d to 400 mg/d PO q12h for patients in the OHCT group, whereas abackground dose+patient-controlled dosemode was adopted for patients in the PCIA group. The therapeutic efficacy, presence of adverse reactions, cost of treatment, and degree of patient satisfaction were compared between the two groups. Results:The average dosages of analgesics in the two groups were almost the same (P>0.05). Visual analogue scale (VAS) values and daily average VAS values were both lower in the PCIA group than in the OHCT group at 24 h after analgesia (P<0.05). The incidence of adverse reactions, such as nausea and vomiting, was also lower in the PCIA group than in the OHCT group (P<0.05). The cost of treatment and degree of patient satisfaction were the same in both groups (P>0.05). Conclusion:Pa-tients who received PCIA attained better analgesia and exhibited less adverse reactions than those who received OHCT whereas the treatment cost and patient satisfaction did not differ in both groups.

In this paper,we report the effective killing radius and the biological killing effects of the antitank mines after bursting to cut through a base deck of the tank.The mines had different types of structure and were exploded at various angles. It was found that the fragmentation damage was the primary killing factor and a blast wave came second, accompanied by a minor thermic burn. The incidence of the blast wave was higher than the casting structure when the antitank mines with separate layer structure were exploded, as compared to those with the casting structure, but there was no significant difference in the effective killing radius.

Objective:To establish an HPLC method to determine the entrapment efficiency (EE) and drug loading (DL) of curcumin (CUR)and quercetin (QUE)loaded self-microemulsifying drug delivery system.Methods:A centrifugation method was used to isolate the free drug.The content of drug was determined by HPLC.The analytical column was a Purospher STAR LP C18 column (250 mm×4.6 mm,5 μm) and the column temperature was 30 ℃.The mobile phase was acetonitrile-4% acetic acid (50∶50) and the flow rate was 1.0 ml·min-1.The UV detection wavelength was set at 370 nm and the injection volume was 10 μl.Results:CUR and QUE were linear within the range of 10.728-96.552 μg·ml-1 (r=0.999 8) and 1.08-9.72 μg·ml-1 (r=0.999 9),respectively.The average recovery was 99.98%(RSD=1.46%,n=9) and 100.34%(RSD=1.06%,n=9),respectively.In CUR-QUE-SMEDDS,the EE of curcumin and quercetin was (95.97±0.50)% and (95.91±2.52)%,and the DL was (25.82±0.15) mg·g-1 and (1.80±0.05)mg·g-1,respectively.Conclusion:The method is accurate,rapid and simple,and suitable for the determination of DL and EE in CUR-QUE-SMEDDS.