Osteosarcoma is the most common maligant in skeletal system.Its treatment is always the focus of most clinical research workers.This article is a brief overview of the research progress of the therapy for osteosarcoma.In addition to neoadjuvant chemotherapy,surgical treatment,this article also includes molecular targeted therapy,gene therapy,and immune therapy.These new advances will contribute to the clinical work.

Objective: To itvestigate the effect of Antidepressant on refractory irritable bowel syndrome(IBS).Methods: A self-control study of subclincal dosage of antidepressants therapy(fluoxetine 10mg/d or paroxetine 10mg/d) for 12 weeks in 46 patients with refractory IBS was performed.The clinical outcomes were evaluated by indexs of symptom severity and symptom frequency and the score of Hamiton depession scale(HAMD) and Hamiton anxiety(HAMA).Results: All 46 cases completed the therapy.After the course of treatment,indexes of symptom severity and symptom frequency and the scores of HAMD and HAMA were significantly lower than those before treatment(P

0.05),but the rate of recurrent bleeding in EBL group was significantly lower than that in EIS group (6.3% vs. ~40.0% , P0.05). Conclusions EBL is an effective and safe ~endoscopic treatment for hemorrhagic Dieulafoy's lesion.

The growing trend of childhood obesity has attracted much attention globally.Overweight and obesity are not only popular in developed countries,but have spread to developing countries.China has entered an overall epidemic stage of childhood obesity.Studies have shown that obesity does not only impairs children's health,but also leads to health hazards in adult stage.Diabetes,coronary heart disease and other cardiovascular diseases may take place sooner or the incidence may become higher.The causes of obesity include genetic,early life events,physical activity patterns,diet and social psychological factors.This article reviews the current epi-demic status and the influencing factors of childhood obesity worldwide.

[Objective]To introduce the effect of reversed sural neurofasciocutaneous flap with muscle repairing the soft tissue defect of foot and ankle.[Method]Reversed sural neurofasciocutaneous flap with muscle was applied for repairing the soft tissue defect simultaneous open fracture of tibia lower section 6 cases,the soft tissue defect simultaneous chronic osteomyelitis of tibia lower section 5 case,the soft tissue defect of sole of foot simultaneous calcaneus epicarp 3 case, the soft tissue defect of sole of foot simultaneous calcaneus osteomyelitis or dead space 2 case. The scope of the flap was 18 c m?13 cm～11 c m?7 c m and that of the gastrocnemius flap was 4 cm?3 cm～9 c m?6 cm,the thickness was 1～3 cm,the skin flap was bigger than the muscle flap.[Result]Muscle side of the muscle flap was errhysising actively and the skin flap was good circulation duing operation, the muscle flaps were used clinically in 16 patiens all survived completely after operation. All cases were followed up from 5 to 17 months ,incision of open fracture healed primarily, osteomyelitis without reoccurring, the muscle flaps were satisfactory in appearance,feel recovered and walk well.[Conclusion]Reversed sural neurofasciocutaneous flap with muscle has sufficient blood supply and high survival rate,so it is an effective and feasible method in repairing the soft tissue defect of foot, ankle and tibia lower section in special cases.

Gastrointestinal benign stricture is a common disease with symptoms of dysphagia,abdominal pain and difficult defecation,which severely impair the quality of life for patients.Endoscopic intervention is the first-line treatment,and the available methods include balloon dilation,local drug injection and stent insertion,etc.Endoscopic incision was first used for the treatment of Schatzki's rings,and later it was used for the treatment of other gastrointestinal benign strictures,and the promising results were achieved.

Ojective To determine the risk factors and the clinical distribution of multiple drug resistant bacteria in stroke- associated pneumonia (SAP) patients with multiple drug-resistant bacterial infections from in-tensive care unit, providing guidance for clinical treatment of SAP. Methods A retrospective study was de-signed to analyze the clinical data of the SAP patients from January 2012 to December 2015. Univariate analysis and multivariable regression analysis were taken for risk factors of MDR infections , and investigated the distribu-tion and drug resistance of MDR. Results There were 183 SAP patients, of which 131patients (71.6%) had MDR infection. There are 193 MDR strains in the 131 patients , the first 5 MDR strains were Acinetobacter bau-mannii, Pseudomonas aeruginosa, Klebsiella pneumoniae, Staphylococcus aureus and Escherichia coli. MDR in-fection is highly associated with sever unconsciousness , time of stay in ICU longer than 7 days , ventilator time longer than 7 days and late-onset pneumonia and the difference was significant (P < 0.05). Conclusion SAP patients with MDR bacterial infections are in association with the following risk factors: sever unconsciousness , time of stay in ICU longer than 7 days, ventilator time longer than 7 days and late-onset pneumonia. The rate of MDR bacterial infections was high , and these MDR strains were widely different degrees of resistance to many antibiotics.

Objective To observe the effects of Ulinastatin on pulmonary vascular endothelium permeability and respiratory function in patients with extrapulmonary acute respiratory distress syndrome(ARDS exp). Methods The data of 39 patients with ARDS exp were retrospectively analyzed.According to whether treated with Ulinastatin or not, all patients were divided into Ulinastatin group(n = 21)and control group(n = 18); The level of extravascular lung water index (EVLWI), pulmonary vascular permeability index(PVPI) and respiratory function were measured before and after the treatment. Results The mortality rate of Ulinastatin group was lower than that of control group (28.6% vs 38.9%). The time of decreasing EVLWI, PVPI and improving PaO2/FiO and respiratory function in Ulinastatin group was shorter than that of control group, and the effect was superior. Conclusion Ulinastatin could reduce EVLWI and PVPI, improve pulmonary compliance and oxygenation, and reduce mortality rate in patients with extrapulmonary acute respiratory distress.

Dietary surveyis a method to evaluate whether dietary intake meets body requirements by recording food consumed during a certain period.Widely-used dietary survey methods include:24 h dietary recall,dietary record,food frequency questionnaire and dietary history questionnaire.Since each method has its own advantages and limitations,researchers need to choose appropriate methods according to research purposes,accuracy requirements,availability of resources,etc.Obese children who are the focus and the major difficulty in dietary survey,it is important to choose an appropriate survey method.This article reviews widely-used dietary survey methods and evaluates them in the study of obese children related dietary surveys.

0.05), but the rate in eradicating varices after the first treatment session was significantly higher(66.7% vs. 10.0%, P 0.05); the comparison of the Kaplan Meier estimate of survival did not show any statistically significant differences in the two groups. Conclusions The sandwich method leads to longer retention of sclerosant in varices and is far superior to EVL alone with respect to the rate in eradicating varices after the first treatment session and prevention of rebleeding and variceal recurrence. The study shows the sandwich method is the optimal endoscopic method for the treatment of EVB.