Objective To investigate the expression of ENO3 gene in hepatocellular carcinoma and its effect on the sensitivity of hepatocellular carcinoma cell lines to OXA, and to explore the possible mechanism. Methods qRT-PCR and immunohistochemical analysis were used to detect the expression of ENO3 in 48 pairs of hepatocellular carcinoma tissues and normal liver tissues.Overexpression plasmid was constructed and transfected into MHCC97H and HepG2 cells.The experiments were divided into empty group (Vector group), ENO3 overexpression group (ENO3 group), empty+OXA group (Vector+OXA group) and ENO3 overexpression+OXA group (ENO3+OXA group).The proliferation ability of MHCC97H and HepG2 cells were detected by CCK-8 assay and cell colony formation assay.The apoptosis rate was determined by flow cytometry assay.Protein expressions of Bcl-2, Bax and Caspase-3 were detected by Western blot assay. Results The expression of ENO3 was significantly decreased in hepatocellular carcinoma tissues, compared with normal liver tissues adjacent to the carcinoma.The expression of ENO3 gene in the ENO3 overexpression group was significantly higher than that in the empty group.Compared with the Vector+OXA group, cell viability was decreased, apoptosis rate was increased, Bcl-2 protein expression was decreased, Bax and Caspase-3 protein expression were increased in the ENO3+OXA group. Conclusion The expression of ENO3 is down-regulated in hepatocellular carcinoma tissues, and the overexpression of ENO3 can enhance the sensitivity of hepatocellular carcinoma cell lines to oxaliplatin by promoting cell apoptosis.

BACKGROUND:It is notable to treat cervical spondylosis using the anterior cervical discectomy and fusion, but there are such complications as cervical instability and low fusion rate. Titanium plate with cage can solve those defects, while anterior unfamiliar matter and dysphagia appear. A new anterior cervical interbody fusionZero-Pwith support and fixation function has been widely used in clinic.
OBJECTIVE:To analyze early stability in repairing cervical spondylosis using a newZero-Pinterbody fixation and fusion system, and compare with a titanium plate with cage interbody fixation andfusion system.
METHODS:We retrospectively analyzed the clinical date of 31 patients with cervical spondylosis who underwent the anterior cervical discectomy and fusion in the Department of Orthopedics, Affiliated Hospital of Jiangsu University between August 2010 and August 2014. Fifteen patients were treated with aZero-P implant (Zero-Pgroup) and sixteen patients with a titanium plate with cage (cage group). We recorded operation time, intraoperative blood loss, preoperative and postoperative Visual Analogue Scale scores and Japanese Orthopedic Association scores, postoperative incidence of dysphagia and degeneration rate of adjacent joint.
RESULTS AND CONCLUSION:(1) Postoperative symptoms were apparently improved, without severe complications in both groups. (2) Operation time and intraoperative blood loss were better in theZero-P group than in the cage group (P< 0.05). (3) Postoperative Visual Analogue Scale scores and Japanese Orthopedic Association scores were significantly improved in both groups (P< 0.05). The recovery rate of Japanese Orthopedic Association scores was similar between the two groups (81%, 81%;P> 0.05). (4) Mild dysphagia was experienced by one case (7%) in theZero-Pgroup, but nine cases (44%) in the cage group. Significant difference in the incidence of dysphagia was detected between the two groups after treatment (P=0.037). However, no significant difference in degeneration rate was detectable between the two groups (P=0.48). (5) These findings verify that in the anteriorcervical discectomy and fusion, the new Zero-Pand titanium plate with cage interbody fixation and fusion system are effective choices for cervical spondylosis. However, theZero-Pinterbody fixation and fusion system showed a low incidence of postoperative dysphagia and better stability.

Objective To investigate the old patients with vagina inflammation Candida and Trichomonas infection situation,provide the basis for clinical diagnosis and treatment.Methods 6 738 patients with vagina inflammation in the vaginal were retrospectively analyzed.Candida and Trichomonas detection results were compared, and focused on elderly patients with three different age groups (group 55 -65years old,>65 -75years old group and the group >75years)of two kinds of pathogenic microorganism infection status.Results 125 cases of detection in elderly patients with vagina inflammation,accounted for 1 .8%,including detection Candida 37 cases,infection rate was 29.6%;Trichomonas detection 12 cases,infection rate was 9.6%;The dual infection in 2 cases,infection rate was 1.6%.55 -65years old group,>65 -75years old group and >5 -year-old group infection rates were 52.2%(chi-square=6.33),30.4%(chi-square=6.21),10.0%(chi-square=6.13).55 -65years old group of two kinds of pathogenic microorganism infection rates were higher than that of >65 -75 years old group and >75 years old group,>65 -75 years old group is higher than that of >75 -year-old,differences were statistically significant (P<0.05 ).Conclusion In elderly patients with vagina inflammation has certain Candida and Trichomonas infection rate,the main pathogen of bacterial infection of Candida,and younger people has higher infection rate than older peo-ple.

BACKGROUND:Once lumbar degenerative diseases merge with lumbar spinal stenosis, lumbar instability and degenerative scoliosis, surgical therapy is required for corresponding clinical symptoms, and the usage of internal fixators cannot be inevitable. Osteoporosis is rather common in the elderly. Therefore, how to implant stable pedicle screw fixation system in serious osteoporosis patients wil be a big difficulty. In recent years, some studies have proven the biomechanical stability of polymethylmethacrylate augmentation of a cannulated and fenestrated pedicle screw in the vertebral body, so it becomes very hot in the spine surgery. OBJECTIVE: To explore the clinical efficacy of the use of polymethylmethacrylate augmentation of a cannulated and fenestrated pedicle screw fixation for the treatment of lumbar degenerative disease accompanied with osteoporosis. METHODS:Thirty-one patients with lumbar degenerative disease accompanied with osteoporosis from Jun 2008 to Jan 2013 were selected, including 11 males and 20 females with an average age of 73.5 years (range, 65-86 years). There were 14 cases of lumbar degenerative stenosis, 9 of lumbar intervertebral disc herniation combined with segmental instability, 6 of lumbar degenerative spondylolisthesis, and 2 of lumbar degenerative scoliosis. The patients were treated with lumbar canal decompression, fusion and polymethylmethacrylate augmentation of a cannulated and fenestrated pedicle screw fixation according to their clinical features and imaging data. Visual analog scale for pain evaluation was used before and after fixation, the Japanese Orthopaedic Association (JOA) scale was used for assessment of neurological function and life skils before internal fixation and during folow-up. RESULTS AND CONCLUSION:Al cases were folowed up for 40 months (range, 36-48months). No screw breakage, rod breakage, screw extraction, loosening, pseudoarticulation formation, or incision infection was found. The postoperative visual analog scale score and the JOA score was remarkably improved (P < 0.05). For patients suffering from lumbar degenerative disease accompanied with osteoporosis, polymethylmethacrylate augmentation of a cannulated and fenestrated pedicle screw fixation is helpful for increasing the stabilization of screw and preventing from loosening and dislocation of the screws, and thereby beneficial for improvement and maintenance of clinical efficacy.

BACKGROUNDSurgical resection is the most effective treatment for renal cell carcinoma (RCC). Currently several prognostic factors and models are used for outcome prediction. However, whether intratumoral changes are independent prognostic factors for RCC or not remains unclear. The aim of the study was to investigate the prognostic roles of intratumoral changes in surgical treated localized clear cell renal cell carcinoma (ccRCC).

METHODSPatients who received partial or radical nephrectomy between 2004 and 2009 in our center were retrospectively reviewed. Univariate and multivariate analyses were used to assess gender, age, body mass index (BMI), intratumoral hemorrhage, tumor necrosis, cystic degeneration, sarcomatoid change, Ki-67 expression, Fuhrman grade, and T stage on recurrence-free survival (RFS) and cancer-specific survival (CSS).

RESULTSA total of 378 patients were included in our study. In univariate analysis, age, BMI, intratumoral hemorrhage, tumor necrosis, sarcomatoid change, Ki-67 expression level, Fuhrman grade, and T stage were prognostic factors for RFS. Age, BMI, tumor necrosis, sarcomatoid change, Ki-67 expression level, Fuhrman grade, and T stage were prognostic factors effecting CSS. In multivariate analysis, age, BMI, tumor necrosis, sarcomatoid change, Ki-67, Fuhrman grade, and T stage were independent prognostic factors for both RFS and CSS.

CONCLUSIONIntratumoral changes such as tumor necrosis and sarcomatoid change are independent prognostic factors for ccRCC.

Adult ; Aged ; Carcinoma, Renal Cell ; metabolism ; pathology ; surgery ; Female ; Humans ; Ki-67 Antigen ; metabolism ; Kidney Neoplasms ; metabolism ; pathology ; surgery ; Male ; Middle Aged ; Multivariate Analysis ; Nephrectomy ; Prognosis ; Retrospective Studies ; Survival Rate

Objective To investigate and analyze the military operation ability and influence factors of soldiers alongthe border in an extremely cold environment and to provide a scientific basis for effectively improving the combat effective -ness of the army stationed the cold regions.Methods According to relevant standards, recruits(the length of service <1month) and old soldiers(the length of service >1 year) were randomly selected to investigate their military operationfactors, physical condition, sleep condition, mental health and cognitive ability.Results Cold was the main factor whichaffected military operation capability in cold regions.According to physical standards,border troops were in poor physicalcondition.Results of SCL-90 showed that the total score, the number of positive items , the score of each factor of the 130recruits were significantly lower than those of the Chinese army model and 46 veterans (P <0.05).There was nosignificant difference in these aspects between the 46 veterans and Chinese army model.Recruits were in better sleepcondition and had better instantaneous memory(P <0.05).Birthplace had no effect on these factors .Recruits from Centraland South China were in poorer sleep condition than those from cold regions (P <0.05).Results of SCL-90 showed that thetotal score,the factors of somatization, coercion, depression and anxiety of communication veterans were significantly higherthan those of the Chinese army model (P <0.05).The sleep condition of communication veterans was poorer than that ofmotorized infantry and patrol veterans (P <0.05).Conclusion Cold is the main factorthat impacts the ability of militaryoperations in cold regions.The physical work capacity of border guards in cold regions was significantly below the militarystandard, so the level of military training should be strengthened .Research on cold-protection equipment for special tasks should be strengthened.

Objective To evaluate the efficacy of treating female conyloma acuminatum with the CO2 laser under colposcopy guidance and traditional Chinese medicine sticking therapy.Methods Female patients with conyloma acuminatum whose diagnosis were confirmed by pathologic examination,were randomly assigned to two groups:a treatment group of 100 cases and a control group of 80 cases,with no statistical differences of the age and the duration.The treatment group was treated by CO2 laser to remove conyloma acuminatum and subclinical damage,and then by TCM wart-washing decoction sticking after operation; The control group was treated by CO2 laser to remove the wart,and then by TCM wart-washing Decotion for fumigating after operation.Results The curative rate of the treatment group and the control group was 79.00％and 60.00％ respectively.There was significant difference between the two groups (x2=7.723,P＜0.01).Conclusion The treatment of CO2 laser under colposcopy guidance combined with Chinese medicine sticking therapy is effective for female conyloma acuminatum.

Cultivating Clinical thinking ability is an important tache of clinical medical education. Teachers'guidance, the charateristics that suit teaching, the organic combination of the active methods which can mobilize clinical medical interns' learning enthusiasm, such as problem-based learning, and humanity education are effective approaches to enhancing interns' clinical thinking ability.

Background and purpose: Primary signet ring cell carcinoma(SRCC) of the bladder is rarely diagnosed in the clinic. Few cases have been reported in the literature, so there was lack of understanding of the primary bladder SRCC in terms of diagnosis and treatment. Our study was to investigate the clinical features and treatment strategy for primary SRCC of the bladder and review the status of the disease along with the literature. Methods: 3 cases of primary bladder SRCC were studied, including clinical features, treatment, follow-up and their prognosis.The literature was reviewed. Results: All cases received ultrasound, computerized tomography, cystoscopy, biopsy and other related lab tests for diagnosis and differential diagnosis. Laparoscopic radical cystectomy and orthotopic ileal neobladders were performed in 2 cases, while the other case received laparoscopic radical cystectomy and ileal conduit diversion, Chemotherapy (cisplatin and 5-fluorouracil) was delivered in one case after surgery. One patient died at 6 months postoperatively because of multiple metastasis. The other 2 cases have been followed-up only for 8 and 12 months postoperatively, and no recurrence or metastasis have been observed. Conclusion: Primary SRCC of the bladder lacks distinctive clinical and imaging manifestations. The tumor grows very invasively. Radical cystcctomy is one of the optimal approaches for treatment of SRCC of bladder.

Background and purpose: The prognostic factors on survival for the patients with prostate carcinoma are still underdeterrnined. This study was to analyze the survival of three common treatment methods for prostate carcinoma and the prognostic factors on survival. Methods: 494 male patients who were diagnosed as prostate cancer were enrolled into the retrospective study. All of the data like age, stage, grade, PSA level, ALP, Hb and treatments were collected. Overall survival and disease specific survival rates for patients were analyzed by Kaplan-Meier method. Prognostic factors on disease specific survival were also analyzed by Log-rank test and Cox proportional hazards model. Results: Disease specific survival rates at 1, 3 and 5 year were 96.0%, 89.0% and 80.0% for all 494 patients, respectively. Disease specific survival rate at 3-year was 92.4% for brachytherapy, 100.0% for radical prostatectomy and 80.6% for hormonal therapy (P=0.008). Multivariate analysis by Cox model showed that stage, PSA level and age significantly impacted on disease specific survival. Conclusion: Brachytherapy and radical prostatectomy provides longer survival time than hormonal therapy for patients with prostate cancer. Clinical stage and PSA level and age of prostate cancer are independent factors impacting on survival significantly.