Stroke is characterized by high incidence,high morbidity,and high mortality.It seriously threats to human life and the quality of life.Studies have confirmed that neuroendocrine dysfunction occurs after the onset stroke and dkectly inpact on the outcomes of patients.It has great value for identifying the clinical conditions and outcomes,and has a guiding significance for clinical treatment.This article reviews neuroendocrine biomarkers of the neurological outcomes after stroke.

Objective To evaluate the expression of Survivin,PTEN in tongue squamous cell carcinoma (TSCC) and the correlation with vascular endothelial growth factor (VEGF) and its clinical significance.Methods The expression of Survivin,PTEN and VEGF of 72 TSCC samples and 15 normal tongue mucosa (NTM) samples were detected by immunohistochemical method.Results The positive expression rate of Survivin,PTEN and VEGF in TSCC were 66.7％(48/72),61.1％(44/72),70.8％(51/72)respectively,while the positive expression rate in NTM were 0,100.0％ (15/15),0.There were statistical significance between the rate in TSCC and NTM respectively (P ＜0.01 ).The expression of Survivin and VEGF in TSCC were positively correlated with TNM stage,histological grade and lymph node metastasis (P＜ 0.05 or ＜ 0.01 ),while the expression of PTEN had negative correlation with them (P＜ 0.05 or ＜ 0.01 ).The expression of Survivin was positively correlated with VEGF expression in TSCC (r=0.6482,P＜0.01),while the expression of PTEN was negatively correleted with VEGF expression (r =-0.4027,P ＜0.01).Conclusions The expression of Survivin and PTEN in TSCC are associated with tumor occurrence and development closely,and are both significantly correlated with VEGF.Joint detection of Survivin,PTEN and VEGF have important reference value in clinical diagnosis,metastasis and prognosis of TSCC.

Objective: To intimately assess the internal stress distribution in ceramic veneer bonding layer. Methods:Six buccolingual cross section models of the incisor restored with IPS-Empress ceramic veneer were built with the MSC/NASTRAN software. 2D-finite element method was used to analyze the stress distribution regularity of the bonding layer on the models under different functional load. Results: Stress concentration areas of ceramic veneer bonding layer were regularly located on the incisal margin and cervical margin. Under the same condition, incisal load caused highest stresse on the adhesive layer. Following the load shift from incisal to gingival area, the stress was gradually decreased.When the functional load acted on the palate margin of the restoration, the compressive stress on the bonding layer was significantly increased. Different load angle generated stress change in the bonding layer. The shear stress on adhesive layer increased following the horizontal load angle increasing close to the debonding level. Among the different incisal reduction designs there was no significant Von Mises stress variation under the same load condition. However, when the incisal edge was reduced by more than 4 mm, the tensile stresses in the bonding layer greatly increased. Conclusion: Restoration margin should be kept away from the tooth contact area, be exposed to minimal occlusion contact. The functional load should be induced to follow the tooth long axis. Edge to edge occlusion should be avoided. When incisal areas need to be altered, the incisal overlap or butt margin design will not cause any stress problem in the bonding layer. When restoring the incisal defect for more than 4 mm, the bonding agents must be selected carefully.

Complications are always likely to occur in the treatment of fractures. Once fracture-related complications occur,their management will be difficuh,resulting in a long handling process that increases physical and financial pain on the patients.Fea- turing“management of fracture-related complications”,this issue intends to draw attention from orthopaedists to the challenging task of prophylaxis and treatment of such problems in clinic.Not only non-union,malunion,heterotopic ossification,bone necrosis but also such systemic complications as deep vain thrombosis,soft tissue infection and necrosis are discussed.They involve long tubular bones,pelvic,proximal femur,tibial plateau and calcaneum.Authors introduce their experience from their clinical practice which can benefit readers a lot.It is well known that an effective prevention is the best treatment.In treatment of fractures,principles must be strictly followed and preventive measures taken throughout the whole process.Once a complication has been detected,therapy should be individualized 1o gain the best outcome.

The development of society raises demands for high-level talents,which requires high level post graduate education.The model of post graduate education is changing from research centered to professional skill centered.The research centered program has a long history and has gained consensus,while the professional skill program is still new.To address the social and economic needs,we explored the professional skill centered post graduate program and report our experience here.

objeetive To consecutively understand the current national clinical testing quality and enforce quality-control of auto-antibody detection.Methods Hospitals or departments were recruited by letters or telephone communications:The autoantibodies examined for quality control survey included anti-nuclear antibodies (ANA),anti-double-stranded DNA (A-dsDNA)antibody,anti-extractable nuclear antigens(A-ENA)antobodies,anti-mitochondria antibody(AMA)/anti-smooth muscle antibody(ASMA),and anti-CCP antibody.Each autoantibody was tested in 3 samples, and altogether 15 samples in total for testing.Sample designation and testing results data analysis were double-blinded.Results Fifltv-five hospitals/departments participated in this survey.The accuracy rates for this survey were 92%,89%,96%,72%respectively for ANA,A-dsDNA,AMA/ASMA,and anti-CCP.Anti-ENAs were further divided into anti-RNP,Sm,SSA,SSB and Scl-70 subgroups,and the accuracy rates were 98%,89%,92%,75%and 77% respectively.Conelusion Compared to the previous 3 national surveys.accuracy rates in our country's autoantibody testing is increaseing steadly with more testing items included each year.This indicats that the quality of auto-antibody testing is improving across the country.

Objective To demonstrate the effect of tumor necrosis factor-α induced protein 8 like-2 (TIPE2) expression in patients with acute respiratory distress syndrome (ARDS) and its mechanism. Methods A prospective observation was conducted. Thirty-nine patients with ARDS admitted to department of emergency of PLA General Hospital from July 2013 to July 2015 were enrolled, and 35 healthy persons served as control group. The acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score within 24 hours after admission, blood gas analysis, procalcitonin (PCT), and C-reactive protein (CRP) were recorded. The mRNA expressions of TIPE2 in peripheral blood mononuclear cell (PBMC) and myxoma resistance protein 1 (MX1) in plasma were determined by real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR). The correlations were analyzed by Spearman rank correlation analysis. Results The mean of APACHE Ⅱ score in 39 patients with ARDS was 25±3, the mean of PCT was (1.85±0.41) μg/L, and the mean of CRP was (18.0±3.0) mg/L. The TIPE2 mRNA expression in PBMC of ARDS patients was significantly down-regulated as compared with that of healthy control group (2-ΔΔCt: 3.28±0.15 vs. 8.87±0.20, P < 0.001), and the MX-1 mRNA expression in plasma was significantly higher than that of healthy control group (2-ΔΔCt: 39.44±0.46 vs. 20.10±0.32, P < 0.001). It was shown by correlation analysis results that the TIPE2 mRNA expression was negatively correlated with MX1 mRNA expression (r = -0.630, P < 0.001), so as APACHE Ⅱ score (r = -0.781, P < 0.001), but no correlation was found between TIPE2 mRNA and PCT as well as CRP (r value was 0.143 and 0.330, respectively, both P > 0.05). The MX1 mRNA expression was positively correlated with APACHE Ⅱ score (r = 0.893, P < 0.001), but no correlation was found between MX1 mRNA and PCT as well as CRP (r value was 0.230 and 0.210, respectively, both P > 0.05). Conclusion TIPE2 expression was decreased in ARDS patients, which negatively correlate with disease severity, and indicate TIPE2 might be involved in the pathogenic process of ARDS.

Objective To explore the relationship between the expression levels of excision repair cross complementation group 1(ERCC1), breast cancer susceptibility gene 1(BRCA1), thymidylate synthase (TS) mRNA and clinicopathological features, prognosis in advanced colorectal cancer, and the correlation between the expression levels of ERCC1 and BRCA1. Methods The expression levels of ERCC1, BRCA1 and TS mRNA of postoperative paraffin embedded tissue were tested by real-time quantitative reverse transcription polymerase chain reaction (RT-PCR) in 49 advanced colorectal cancer cases. The results were analyzed by χ2 test of the correlation between the expression levels and clinicopathological characteristics. Patients were followed up by clinic or telephone. The prognosis was analyzed by small sample Kaplan-Meier survival analysis and Log-rank time series analysis, and P<0.05 was statistically significant. Results The expression level of ERCC1 mRNA in patients with colorectal carcinoma had no obvious correlation with the clinical and pathological characteristics such as gender, age, tumor location, lymph node metastasis, distant metastasis, CEA and differentiation degree (P>0.05). The expression level of BRCA1 mRNA had no significant correlation with the above clinical and pathological features (P>0.05) except distant metastasis (P=0.030) and differentiation degree (P=0.002). The expression level of TS mRNA had no significant correlation with the above clinical and pathological features (P>0.05) except distant metastasis (P=0.003). The expression level of ERCC1 and BRCA1 mRNA obviously correlated (P=0.002). The 1 year overall survival rate was 95.92%(47/49);the 2 year overall survival rate was 83.67%(41/49);and the 3 year overall survival rate was 73.47%(36/49). Overall survival and progression-free survival time in ERCC1 mRNA low expression group (47.8, 41.0 months) was higher than that in ERCC1 mRNA low expression group (27.3, 20.0 months) respectively (P=0.001, P=0.001). Overall survival and progression-free survival time in BRCA1 mRNA low expression group (43.7, 42.7 months) was higher than that in BRCA1 mRNA high expression group (29.3, 25.1 months) respectively (P=0.009, 0.006). Overall survival time in TS mRNA low expression group (39.8 months) was higher than that in BRCA1 mRNA high expression group (25.2 months). Conclusions The expression level of ERCC1 mRNA is not correlated with its clinical and pathological characteristics, but with its biological characteristics. BRCA1 and TS levels are correlated with invasion and metastasis. Low levels of ERCC1 and BRCA1 expression have a better prognostic effect on platinum based first-line chemotherapy for advanced colorectal cancer, and they are correlated. Low level of TS also has longer disease-free survival. Three joint detection could be used as a prognostic factor for colorectal cancer chemotherapy.

A maxillary first molar with 2 distinct palatal roots and an accessory canal was diagnosed by CBCT and microscope.An enamel protuberance at the cervical area was found.A properly usage of CBCT and microscope is helpful for the diagnosis and treatment of tooth with complex root canal system.

Objective To investigate the value of ultrasound in differential diagnosis of benign and malignant thyroid lesions with rimlike peripheral calcification.Methods Seventy-three patients of thyroid nodules with rimlike peripheral calcification were analyzed retrospectively.All cases were confirmed by surgery and pathology.The efficacy of sonographic features on diagnosis of thyroid nodules was analyzed.Results Among 73 patients,58 (58/73,79.45％) were benign and 15 (15/73,20.55％) were malignant.Among the sonographic features mentioned,the mean size,margin,internal echo and presence of halo showed no significant differences between malignant and benign nodules (all P＞0.05).Proportion of thyroid nodules coexisting with nodular goiter,irregular thickness and interruption of rimlike peripheral calcification had significant differences between malignant and benign nodules (all P＜0.05).The sensitivity,specificity,positive predictive value and negative predictive value of coexisting with nodular goiter for diagnosing benign nodules were 77.59％ (45/58),60.00％ (9/15),88.24 ％ (45/51),40.91％ (9/22),respectively.The sensitivity,specificity,positive predictive value and negative predictive value of irregular thickness for diagnosing malignant nodules were 53.33 ％ (8/15),87.93％ (51/58),53.33％ (8/15),87.93％ (51/58),respectively.The sensitivity,specificity,positive predictive value and negative predictive value of interruption of rimlike peripheral calcification for diagnosing malignant nodules were 73.33％ (11/15),68.97％ (40/58),37.93％ (11/29),90.91％ (40/44),respectively.Conclusion Ultrasonography is helpful to diagnosis of thyroid nodules with rimlike peripheral calcification.Irregular thickness and interruption of calcification are associated with malignancy.