Objective To evaluate the model of end-stage liver disease (MELD) and Child-Tur-cotte-Pugh (CTP) in prognosis for cirrhotic patients with massive hemorrhage from esophageal varieosis, who underwent emergency endoscopic sclerotherapy (EIS). Methods The clinical and follow-up data of a co-hort of 65 liver cirrhotic patients with massive hemorrhage from esophageal varicosis treated by EIS were ana-lyzed retrospectively. Correlation between MELD values and CTP score and classification was analyzed. The area under the receiver operating characteristic (ROC) curve was used to compare MELD with CTP score and classification in predicting mortality risk. The optimal threshold of MELD to determine the prognostic death risk was calculated by ROC curves. Results MELD, CTP score and classification correlated signifi-cantly with each other. Seven patients died within six months and 9 died within the first year of follow-up.There was no significant difference in gender, age and serum bilirubin between the survival and death groups, while the serum creatinine, international normalized ratio (INR), CTP score, and MELD score were significantly different. The areas under the ROC curve of MELD were both greater than 0.8 to predict 6-month and 1 -year survival, and also were greater than those of CTP score and classification. Areas under the ROC curve of MELD is superior to, but not significantly different though, CTP score or classification. The optimal threshold values of MELD and CTP score both showed satisfactory predicting accuracy of mortality risk. Conclusion MELD is an accurate predictive system for 6 months and 1 year in liver cirrhotic patients with massive hemorrhage from esophageal varicosis treated by EIS. The MELD value is very important in the selection of patients for E1S. But it is not more efficient than CTP score and classification.

Objective To examine the relationship between UAE and fibrinolytic activity in patients with type 2 diabetes.Methods 129 type 2 diabetic patients recruited and subgrouped by UAE,and the UAE,FBS,lipids,renal function and the activity of t-PA and PAI-1 were conducted in these patients and 40 health people.Results Compared to control group,the activity of PAI-1 was increased and the activity of t-PA decreased dramaticlly in type 2 diabetic group(P＜0.05);there was significant difference in the ratio of PAI-1 and t-PA between three diabetic groups(P＜0.05),of three group the ratio of PAI-1 and t-PA was most highest in the patients with macroal buminuria,and simple correlation analysis showed positive correlation between UAE and the ratio of PAI-1 and t-PA,especially in the patients with microalbuminuria(r=0.321,P＜0.05).Conclusion The UAE is closely relatedto fibrinolytic activity in patients type 2 diabetes.

Objective To investigate the role of the expression of prostate stem cell antigen(PSCA)in the development of perineural invasion in pancreatic carcinoma.Methods The histopathologic and immunohis-tochemical(SABC)studies were performed on 80 patients with pancreatic carcinoma.The overall incidence of PSCA expression,perineural,lymphatic and vascular vessel invasion were counted to investigate the relationships among them.Results Perineurel invasion was positively correlated with lymphatic and vascular vessel invasion (P<0.01).A positive corelation Was found between tumor PSCA expressioa(53 cases)and the perineurel in-vasion(66 cases).A definite correlation Was also found between cancer differentiation and PSCA tyxplres-sion.Conclusion PSCA is one of the most important molecules and may play a role as a "navigating" and " docking" molecule in the developmeat of perineural invasion.

Objective To establish a novel experimental neural invasion model with human pancreatic cancer cell line MIA PaCa-Ⅱand explore the biological characters. Methods The tumor mass which was formed by injecting human pancreatic cancer cell line MIA PaCa-Ⅱsubcutaneously was orthotopically transplanted into pancreas of nude mice. Morphological and biological features, metastasis and nerve invasion of the transplanted tumor were studied after 4, 6 and 8 weeks. Expression and distribution of K-ras, C-erbB2, COX-2, PSCA, p53 and DPC4 were detected in MIA PaCa-Ⅱ cell, with SABC immunohistochemistry. Results The successful rate of pancreatic cancer orthotopic implantation was all 100 % after 4, 6, and 8 weeks. The rate of nerve invasion was 50 %, 80 % and 60 % after 4, 6, and 8 weeks. Expression of K-ras, C-erbB2, COX-2 and PSCA were higher in pancreatic cancer cells than in normal pancreas cells. However, p53 and DPC4 expression were lower than normal. Conclusion Neural invasion model with human pancreatic cancer cell line MIA PaCa-Ⅱ orthotopic implantation tumor is successfully established in nude mice. The best time for exploring perinerval invasion is the sixth weeks. Every index studied may play important roles in the development of pancreatic cancer.

Objective To evaluate the efficacy and toxicity of three dimensional confoimal radiotherapy(3D-CRT)concurrent taxotere for patients with esophageal carcinoma.Methods Ninty-six patients with esophageal carcinoma were received 3D-CRT concurrent taxotere,the radiotherapy was carried out by 3D-CRT,to a total dose 95% PTV 66Gy/33f/6.6W.The trial results were evaluated by the clinical curative effect criterion.Results Complete response rate(CR)was 67.7%.Overall response rate(CR+PR)was 89.6%.The local control rates of 1 year and 3 years were 86.5% and 63% ,respectively.The survival rates of 1 year and 3 years were 76.1% and 50.0%,respectively.The main acute toxic effect was radioactive esophagitis.Conclusions 3D-CRT concurrent taxotere could improve the overall response rate and survival rate of esophageal carcinoma.Although it increased the acute toxic effect,the patients could accept the therapy.

BACKGROUND:Discectomy is an important therapy for lumbar disc herniation, but a smal number of patients undergoing discectomy wil relapse.
OBJECTIVE:To investigate the spinal stability fol owing posterior pedicle screw fixation combined with interbody fusion cage for treatment of recurrent lumbar disc herniation.
METHODS:Twenty-six patients with recurrent lumbar disc herniation from January 2007 to December 2011 were enrol ed and subjected to posterior pedicle screw fixation combined with interbody fusion cage. Pain relief and lumbar stability were observed postoperatively. We analyzed the spinal stability in recurrent lumbar disc herniation patients after posterior pedicle screw fixation combined with interbody fusion cage depending on literature search.
RESULTS AND CONCLUSION:Al the 26 patients were fol owed up for 12-36 months. After treatment, al patients effectively al eviated the symptoms of low back pain, and lumbar interbody fusion was good, with a good rate of 96.2%. There was no pedicle screw loosening, broken, non-fusion phenomenon. Posterior decompression and interbody fusion cage combined with posterior pedicle screw fixation for recurrent lumbar disc herniation, characterized as fast symptom relief, strong fixation, exact interbody fusion exact, is an ideal treatment for recurrent lumbar disc herniation.

Objective : To screen differentially expressed miRNAs and explore its effect and mechanism on cell mi- gration in lung adenocarcinoma (LUAD) ． Methods : Differentially expressed miRNAs in LUAD tissues and normal lung tissues were screened by miRNA microarrays，and then bioinformatics analysis was used to predict their poten- tial biological functions and signaling pathways．The cancer genome atlas (TCGA) analysis and quantitative real- time PCR (qRT-PCR) verified the expression level of hsa-let-7e-5p in LUAD tissues and cell lines．The effect of hsa-let-7e-5p cell migration in LUAD was examined by would healing experiment．After screening the underlying target genes by bioinformatics analysis ，the targeting relationship between hsa-let-7e-5p and DTX2，NME6， C8orf58，GATM and DHX57 were verified by qRT-PCR. Results : The miRNA microarray results showed that 347 miRNAs were down-regulated while 229 miRNAs were up-regulated in lung adenocarcinoma tissues．Compared with normal lung tissue and cells，the expression level of hsa-let-7e-5p was significantly down-regulated．Besides，over- expression of hsa-let-7e-5p inhibitedLUAD cell migration． Conclusion Non-coding RNA hsa-let-7e-5p is down- regulated in LUAD and inhibits the migration of lung adenocarcinoma cells．DTX2，NME6，C8orf58，GATM and DHX57 are the potential target genes of hsa-let-7e-5p.

Background There are few studies on the diet quality of patients with thyroid cancer, and the relationship between diet quality and thyroid cancer remains uncertain. Objective This study aims to assess the diet quality with the Chinese Health Diet Index (CHDI) and to explore the relationship between diet quality and papillary thyroid carcinoma (PTC). Methods A 1∶1 gender- and age-matched hospital-based case-control study included newly diagnosed PTC patients and matched controls from Shanghai Cancer Hospital and Renji Hospital (East) in Shanghai, China. A structured questionnaire was applied to collect data on general characteristics, history of diseases, dietary intakes, and lifestyles. Food intakes in the past one year were assessed using a validated food frequency questionnaire, from which the CHDI score was calculated. The CHDI, according to the Dietary Guidelines for Chinese Residents, was employed to evaluate the diet quality of the two groups. A multiple conditional logistic regression model was conducted to explore the relationship between diet quality and PTC. Results A total of 350 pairs of cases and controls were recruited. The overall median CHDI score of the cases was lower than that of the controls (67.8 vs. 73.4, P<0.001). The cases had lower median scores of fruits (6.8 vs. 9.5), dairy products (3.6 vs. 5.6), and soybeans (4.6 vs. 5.5) than the controls (P<0.05); the cases had a higher median score of refined grains than the controls (5.0 vs. 4.9), and the percentage of the cases that met diet recommendations for refined grains was higher than the percentage of the controls (65.4% vs. 48.6%) (P<0.05); the cases showed lower median scores of whole grains/beans/tubers, total vegetables, dark vegetables, and fish/shrimps (0.9 vs. 1.4, 3.1 vs. 4.4, 3.6 vs. 5.0, and 3.3 vs. 4.0, respectively), and the percentages of the cases meeting their diet recommendations were lower than the percentages of the controls (6.3% vs. 8.6%, 32.6% vs. 42.0%, 38.6% vs. 50.6%, and 34.0% vs. 40.3%, respectively, P<0.05). The results of multiple conditional logistic regression analysis suggested that qualified and good diet quality were associated with a reduced the risk of PTC (qualified diet quality, OR=0.37, 95%CI: 0.23−0.62; good diet quality, OR=0.19, 95%CI: 0.10−0.36); the statistical significance remained after excluding patients who had a history of benign thyroid conditions (qualified diet quality, OR=0.28, 95%CI: 0.15−0.52; good diet quality, OR=0.20, 95%CI: 0.09−0.43). Conclusion Those with qualified or good diet quality have a lower risk of PTC. PTC patients have insufficient intakes of fruits, dairy, soybeans, whole grains/beans/tubers, vegetables, and fish/shrimps.

Background Thyroid carcinoma is a serious threat to human health in Shanghai and a focus of cancer prevention and treatment. Objective This study aims to assess the relationship between foods rich in iodine and papillary thyroid carcinoma (PTC)．Methods In a hospital-based case-control study matched by gender and age (±3 years old), 402 pairs of cases (new incidences) and controls were included and studied. A validated questionnaire and food frequency questionnaire survey was conducted face to face to obtain demographic characteristics and dietary intake. A multiple conditional logistic regression model was applied to explore the relationship between foods rich in iodine (including seaweeds, kelp, and dried shrimps) and PTC. Results The mean age of the participants was (41.17±11.51) years in this study. Compared with the controls, more cases had a lower education and a manual occupation (P<0.05); more cases were overweight or obese, had a history of benign thyroid conditions, and had a family history of thyroid diseases (P<0.05); the two groups were different in the frequency of CT examination in the past ten years (P<0.05). The results of multiple conditional logistic regression analysis showed that consumption of iodine-rich foods was associated with a lower risk of PTC (for <1 time per week, OR=0.20, 95%CI: 0.12−0.35; for 1−2 times per week, OR=0.18, 95%CI: 0.10−0.33; for ≥3 times per week, OR=0.13, 95%CI: 0.04−0.44) (P<0.05). Specifically, those who consumed seaweeds (for <1 time per week, OR=0.18, 95%CI: 0.11−0.30; for 1−2 times per week, OR=0.11, 95%CI: 0.05−0.23; for ≥3 times per week, OR=0.15, 95%CI: 0.03−0.75), kelp (for <1 time per week, OR=0.28, 95%CI: 0.18−0.43; for ≤2 times per week, OR=0.24, 95%CI: 0.11−0.50), and dried shrimps (for <1 time per week, OR=0.44, 95%CI: 0.29−0.69; for ≤2 times per week: OR=0.34, 95%CI: 0.18−0.65) had a lower risk of PTC (P<0.05). After excluding patients who had a history of benign thyroid conditions, the favorable association remained significant among patients who had consumption of iodine-rich foods, seaweeds, shrimps, and kelp (P<0.05). Conclusion Less PTC patients consume iodine-rich foods than the controls.