Objective To design and apply a kind of controllable enema input apparatus in patients with spinal cord injury (SCI). Methods 20 SCI patients with chronic constipation were included. Their defecation time, nature of defecation and usage of enema of 5 times of defecation were recorded before and after using the new apparatus. Results There were significant differences in the defecation time, nature of defecation and usage of enema before and after using the new apparatus (P<0.05). Conclusion The application of the new controllable enema input apparatus may shorten the defecation time, improve the nature of defecation, and reduce the usage of enema in SCI patients with chronic constipation.

Objective To investigate the expression of hepsin and its role in the pathogenesis of breast infiltrating ductal cancer ( BIDC) .Methods The expression level of hepsin was examined by immunobloting and immunohistochemistry in breast tissue samples from 8 healthy controls and 139 patients with BIDC,respectively. The correlation between hepsin level and its significance in clinical pathology of BIDC was assessed by statistical analysis.Results High level of hepsin was detected in nearly 70.5 percent of BIDC samples(98 out of 139)by immunobloting and immunohistochemistry , while the level of hepsin was relatively low or hardly detectable in healthy controls.In addition,there was a significant correlation between hepsin level and clinical stages as well as the level of histological differentiation of BIDC .Conclusion Increased expression of hepsin might play an impor-tant role in pathogenesis and progression of BIDC .The level of hepsin is positively correlated to clinical stages of BIDC,but negatively correlated with the level of histological differentiation of BIDC .

In the context of precision medicine, although individual treatment of breast cancer under the guidance of molecular classi-fication has become the norm, a precision treatment program with increased efficiency and quality is still required. Compared with the traditional real-time fluorescent quantitative polymerase chain reaction (PCR), the droplet digital PCR (ddPCR) has obvious advantages in the detection of rare mutations and copy number variations, as well as the integration with the second-generation-sequencing tech-nology. This paper reviews the application of a ddPCR platform in different breast cancer subtypes and explores new horizons of breast cancer research through the ddPCR technology.

Objective To investigate the changes of serum immunoglobulin E(IgE)?T cell subgroups and cytokines in asthmatic children and to provide theoretical basis for the management of asthmatic children.Methods T cell subgroups were determined by indirect immuofluorence method mono clone antibody, the detection of IgE,interleukin(IL) 4,IL 6,IL 8,interferon ?(IFN ?) were done by ELISA method, and 20 normal children were served as control group.Results There were significant differences of CD3 +,CD4 +,CD4 +/CD8 + among the stages of exacerbation and convalescence of asthmatic children and control group.( P0.05).In the stage of convalescence the levels of IL 2,IFN ? were lower than control group( P0.05).Conclusions Allergic asthmatic patients between the exacerbation and convalescence stages still had immunologic imbalance,indicating increased number of CD4 +T cell(mainly Th2 cells)and hyperfunction;the insufficient number and(or) the inactivity of CD8 +T cell may induce immunological disturbance ,which is the major mechanism of asthmatic attacks. These findings suggest the patients in an abnormal immunological state should receive continuous anti allergic therapy.

Objective To investigate the relationships between hyperuricaenia,serum uric acid (SUA) level and the chronic kidney disease (CKD) in adult residents of Pudong New Area,Shanghai.Methods 3326 residents aged 20-80 years were randomly selected from Pudong New Area,Shanghai through multistage sampling and interviewed between April and July of 2008.Fasting blood sample and morning ovid urine sample were collected for each participant for testing of SUA,serum creatinine,urinary albumin and creatinine.Both urine albumin to creatinine ratio (ACR)and glomerular filtration rate (GFR) were calculated to estimate the renal function.Results The overall prevalence of CKD was 16.0％ (age standardized 13.2％ ).The mean values of estimated GFR in participants with CKD and without CKD were (89.19 ± 27.25) and ( 105.88 ± 98.37) ml· min-1 ·(1.73 m2) -1,respectively.The prevalence rates of CKD in serum uric acid quartiles:first quartile,less than 4.2 mg/dl; second quartile,4.2-5.0 mg/dl; third quartile,5.0-6.0 mg/dl; and fourth quartile,6.0 mg/dl or more were 13.9％,15.0％,15.8％and 19.4％ (P＜0.05) respectively,increasing along with the increase of SUA among both sexes.Compared to the serum uric acid first quartile,the multivariate-adjusted odds for CKD of the second,third and fourth quartiles were 1.19 [95％ confidence interval (CI):0.90-1.58],1.27 (95％ CI:1.02-1.70),1.28 (95％ CI:1.10-1.68),respectively. Conclusion Hyperuricaemia was independently associated with the increased prevalence of CKD among population living in the Pudong New Area,Shanghai.

Objective Evaluate data of 1270 cases with free flap transplant,to find the problems in the process of operation,and then to analyse its causes and how to prevent and solve it,as well as providing reference for clinical colleagues. Methods To study 1270 cases of free flaps,musculocutaneous flap and perforator flap who was treated in our hospital from October 2000 to October 2010 retrospectively. A total of 722 cases of the group were followed-up 6 months to 5 years. To detective and search the problems and imperfection from designing,harvesting,tranfer,to the management and function of donor site after free flap transplantion.And also to analysis the couse of problems and operation failure,discuss the conclude of and to provide advisable measure. Results Total 1270 free flaps were transplanted successfully except 64 can-celled or failured for some reason, the success rate was 95.0％, the postopertive necrosis rate was 3.8％.Seventy-six cases were encountered vascular complications venous crisis in 42,arterial crisis in 38.Fifty-five cases were saved successfully without surgery,and 15 cases survived completely by vessel explorative operation. Five cases were partial necrosis and 7 cases necrosis. The rate of postoperative infection of emergency cases and chronic one were 4.7％ (682 cases)and 8.8％(588 cases) which show the infective incidence of latter was higher than former. In addition, there were many other problems were found such as distal flaps necrosis,contracture,deformation,impairment function of doner site,etc. Conclusion Preventing and management timely to vessle crisis is the key to flap suvive. The principle of dissecting flap should be followed strictly,and control the indications of modified processing during flap harvest,keep the proper flap tension were technical requirements in flap transplantion. Right way of donor site closed and management of insufficient timely were equally important to prevent and solve to complications and dysfunction.

Objective Inhibitor of growth 1 ( ING1 ) gene has been identified as a novel candidate of tumor suppressor gene .Over-expression of ING1 plays well-established roles in numerous cell processes ,inclu-ding DNA repair and cell apoptosis .Our study is to investigate the clinical significances of expression of ING 1 in colorectal cancer ( CRC) .Methods The mRNA level of ING1 in 82 matched samples comprising primary CRC and paired non-cancerous mucosa were detected and compared by quantitative RT -PCR.Then the correlations of mRNA level of ING1 with the clinicopathological characteristics and prognosis of patients with CRC were ana -lyzed.Results (1)In the same matched tissues,the expression level of ING1 was significantly higher in normal tissues than that in cancer tissues.(2)mRNA expression of ING1 was associated with certain clinical -pathologic variables such as tumor infiltrating level ,lymphatic metastasis,distant metastasis and advancing TNM stage .(3) We obtained the expression levels ratio of cancer tissue and normal tissue and found the lower ratio has a lower Disease-Free Survival(DFS)(P<0.0001).(4)ING1,as a candidate of tumor suppressor gene ,remained a sta-tistically-significant prognostic marker in the Cox regression analysis .Conclusion Down-regulation of ING1 may be correlated tightly with the occurrence and progression of sporadic colorectal cancer .Its expression level can be used to predict prognosis of CRC .

Objective To investigate the expression of CD133 and CD44 proteins in gastric stromal tumors (GST) and their clinical significances. Methods The expression of CD44 and CD133 proteins in the GST tissues of 112 patients was detected by immunohistochemical staining. The relation between the expression of CD44 and CD133 proteins and the clinicopathological characters was analyzed. The survival and prognosis of GST were also analyzed. Results Both CD44 and CD133 were expressed on the cell membranes. The expression rates of CD44 and CD133 were 58.04 % (65/112) and 42.86 % (48/112) separately; the co-expression rate of CD44 and CD133 was 27.68 % (31/112). CD44 and CD133 were negative in normal peritumoral tissues. No correlation was found between CD44 and CD133 and the clinicopathological parameters including gender, age and lymphatic vessel invasion (all P>0.05), but the expression levels of CD44 and CD133 in patients with the mitotic count ≥ 5/50 high-power field, large diameter and vascular invasion were significantly higher (all P<0.05). No correlation was found between co-expression of CD44 and CD133 and the clinical clinicopathological parameters including gender, age, the mitotic count ≥ 5/50 high-power field and vascular invasion (all P>0.05), but the co-expression level of CD44 and CD133 in patients with tumor diameter ≥5 cm was significantly higher than that in patients with tumor diameter < 5 cm (χ2=5.040, P=0.025). The overall survival rate of the patients with co-expression of CD44 and CD133 was shorter than that in other groups (χ2 = 8.758, P= 0.001). No correlation was found between CD44 and CD133 expression (r=0.126, P=0.210). Multivariate analysis with the Cox regression models showed that the tumor diameter ≥5 cm (P=0.042) and co-expression of CD44 and CD133 (P=0.003) were significantly associated with poor prognosis. Conclusion CD44 and CD133 as robust cancer stem cell markers in GST might be the prognostic factors.

Objective To explore the correlation between CT perfusion imaging parameters and differentiation degree of gastric cancer.Methods Fifty patients with gastric cancer proved by surgery and pathology underwent 64-slice spiral CT perfusion imaging before surgery,and the CT perfusion parameters were obtained including blood flow(BF),blood volume(BV),mean transit time (MTT)and permeability surface(PS).The patients were divided into 3 groups (well,moderate and poor differentiation)according to the degree of cell differentiation.Statistical analysis was performed by using the SPSS 17.0 statistics software.Results The perfusion parameters of BF (mL·min-1 ·100 g-1 ),BV (mL/100 g),MTT (s)and PS (mL·min-1 ·100 g-1 )were as follows:75.28±6.81,9.01± 0.94,9.89±1.65 and 10.05±0.71 in well differentiation group with 10 patients (20%),110.01±31.90,18.18±5.62,9.81±3.69 and 40.08±1 5.82 in moderate differentiation group with 24 patients (48%),138.59±38.09,21.08±4.1 1,9.47 ±1.80 and 57.50± 13.28 in poor differentiation group with 1 6 patients (32%)respectively.Among three groups,there were statistic differences in BF, BV and PS between well differentiation group and moderate differentiation group or low differentiation group (P <0.05),however there was no statistic difference in MTT among three groups (P >0.05).Conclusion The BF,BV and PS values may be regarded as the evaluation index for malignant degree of gastric cancer.

Objective To study the method of solving the complications of large allograft including resorption, nonunion and refracture by means of vascularization and the way of improving bone healing. Methods The bone defect longer than 10 cm of limbs were found in 21 cases, plate or external fixator were used to fix allograft bone, and then vascularied autologous bone or periosteum were transplanted or inserted to the massive allograft In order to vascularizate allograft, improve bone healing and prevent complications of bone resorption and osteolysis. 4 cases were implanted by local vascular bondle in one end. 4 cases were transplanted vascular iliac bone into middle part the allograft bone, 2 cases were into one end. 2 cases were transplanted by vascular fibular bone. 6 cases were used vascular periosteum. 3 cases were used combined methods. Results Twenty-one cases with 10 cm or more bone defect in this group were treated by the method above. 14 cases were achieved primary healing, 6 were healing by farther operation, 1 failure. Complications were found in 7 cases, 4 occur infection in all. All were achieved satisfactory function and outlook by follow-up. Conclusion The method of vascularied autologous bone or periosteum combined with massive allograft are effective to improve bone union, reduce the complication of bone resorption and osteolysis,which proved usefull to treat large bone defect.