Objective:To explore the infuence of calf spleen extractive injection combined with chemotherapy on immune function of the patients after colorectal carcinoma. Methods:Totally 128 cases of postoperative colorectal carcinoma patients were randomly di-vided into two groups with 64 ones in each. The control group only received FOLFOX 4 regimen, while the study group received calf spleen extractive injection additionally from the first day to the tenth day, 10ml, ivd, and 14-day was one cycle. After 4 weeks, im-mune function, peripheral blood leukocytes ( WBC) , hemoglobin ( Hb) and platelet ( Plt) in the two groups were compared, and the adverse reactions were evaluated as well. Results: After the treatment, CD3 +, CD4 +, CD8 + and CD4/CD8 were increased in the study groups, and those in the study group were much higher than those in the control group (P<0. 05). After the treatment, there were no significant changes in WBC, Plt and Hb in the two groups (P>0. 05), while WBC and Plt in the study group were higher than those in the control group (P<0. 05). The incidence of adverse reactions in the study group was lower than that in the control group (P<0. 05). Conclusion:Calf spleen extractive injection combined with chemotherapy not only can increase the immune func-tion, but also alleviate myelosuppression and gastrointestinal toxicity in the treatment of postoperative colorectal carcinoma patients.

Objective To evaluate the clinical effects of sitagliptin and sitagliptin combined with glimepiride in the treatment of type 2 diabetes (T2DM).Methods Ninety-two patients with T2DM were randomly divided into sitagliptin group (group J),glimepiride group (group G) and sitagliptin combined with glimepiride group (group U),group J took sitagliptin,group G took glimepiride,group U took sitagliptin and glimepiride.Before and after treatments,blood glucose and insulin were determined in the fasting and 2-hour blood samples after taking glucose (fasting blood-glucose (FPG),2-hour postprandial blood glucose (2hPG),insulin (FIns),2-hour postprandial insulin (2hIns),and glycosylation hemoglobin (HBA1 c) were also determined and homeostasis model assessment was applied to estimate the functions index of islet β cell(HOMA-β).Results The levels of blood glucose and HBA1C in three groups decreased after treatments(FPG,(before treatment:(9.2±3.0),(9.2±2.8),(9.3±3.2) mmol/L),(after treatment:(7.7 ± 3.0),(6.9 ± 2.6),(6.0 ± 2.5) mmol/L),and t values are 2.205,3.203,3.691,P ＜ 0.01,P ＜ 0.05 ;2 hPG (before treatment:(14.1 ± 5.7),(14.8 ±6.3),(15.0±6.8) mmol/L),(after treatment:(7.9 ±2.9),(9.0 ±3.1),(7.1 ±3.1) mmol/L),and t values are 3.881,3.159,4.189,P ＜ 0.01 ; HBA1c (before treatment:(8.52 ± 2.01)％,(8.48 ± 1.94)％,(8.56 ±2.27)％,(after treatment:(7.64 ± 1.92)％,(6.81 ± 1.55)％,(6.19 ± 1.84)％),t values are 2.292,2.184,3.269,P ＜ 0.01,P ＜ 0.05) ; HOMA-β in the three groups increased after treatment ((before treatment:1.42 ± 0.07,1.44 ± 0.06,1.41 ± 0.11),(after treatment:1.76 ± 0.14,1.68 ± 0.20,1.85 ±0.17),t values are 2.180,2.073,2.882,P ＜ 0.01,P ＜ 0.05);levels of HBA1c and blood glucose in group U were lower than those in group J and G(HBA1 c:t values are 2.785,2.138,P ＜ 0.05,P ＜ 0.01 ;FPG:t values are 2.252,2.346,P ＜0.05;2hPG:t values are 2.147,2.829,P ＜0.01,P ＜0.05),HOMA-β in which was higher than that of group G(t =2.153,P ＜ 0.05),but with no significant difference compared with group J (t =1.796,P ＞ 0.05),levels of HBA1C,FPG and HOMA-β in group J were higher than those of group G (t values are 2.108,2.202,2.121,P ＜ 0.05),level of 2hPG of group J was lower than that of group G(t =2.307,P ＜ 0.05).Conclusion Sitagliptin provides significant glycaemic control,together with glimepiride,clinical effect of treatment of type 2 diabetes will be enhanced.

In order to establish a simple and useful way for preimplantation genetic diagnosis (PGD) of chromosomal diseases in general IVF laboratory, the methods that are most commonly used in the embryo biopsy, fixation of blastomere and fluorescence in situ hybridization were compared. The three aspects of PGD were analyzed respectively. There was no significant difference in further development capacity of embryos between mechanical (79.7%) and chemical biopsy group (78.6%) (P>0.05). In this study, more cells were successfully fixed with the Tween/HCL method (93.8%) than with the methanol/acetic acid method (80.5%, P<0.05). There was no significant difference in cytoplasm remains between methanol/acetic acid method and Tween/HCL method (P>0.05). The hybridization efficiency of fluorescence in situ hybridization was 89.5% in successive denaturation method and 90.9% in codenaturation method with the difference being not significant (P>0.05). In conclusion, the mechanical or chemical method, Tween/HCL fixation method and codenaturation fluorescence in situ hybridization method can constitute a simple and useful way for PGD of chromosomal diseases.

Objective To explore the expression of methyl CpG binding protein 2 (MeCP2) in gastric cancer tissues and its role in multi-drug resistance (MDR) in gastric cancer cells.Methods The expression of MeCP2 in 90 gastric cancer tissues and the adjacent normal tissues was detected by immunohistochemistry,and the relationship between MeCP2 expression level and clinicopathological parameters was analyzed.The expression level of MeCP2 in gastric cancer cell line SGC7901,MDR cell variants SGC7901/doxorubicin hydrochloride(ADR) and SGC7901/vincristine(VCR)was determined by Western blot.After the expression of MeCP2 was silenced by short interference RNA (siRNA),half inhibitory concentration (IC50) of 5-fluorouraeil and cisplatin in gastric cancer cell was tested by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide(MTT) assay.The t test or chi square test was performed for statistical analysis.Results The positive rate of MeCP2 expression in gastric cancer tissues was 72.2％ (65/90),which was significantly lower than that in adjacent normal tissues (93.3％,84/ 90),and the difference was statistically significant (x2 =14.068,P＜0.01).MeCP2 expression was not correlated with age,tumor maximum diameter and lymph node metastasis (all P＞0.05),however which was related to gender,clinical TNM stages and distant metastasis (x2=4.680,4.186 and 4.327;aH P＜ 0.05).The gray scale ratios of MeCP2/β-actin in SGC7901/ADR and SGC7901/VCR were 0.593 7 ± 0.030 5 and 0.651 2 ± 0.018 6,which were lower than that of parental SGC7901 cells (1),and the differences were statistically significant (t =23.080,17.360;both P ＜ 0.01).After the expression of MeCP2 was silenced by siRNA,the IC50 of 5-fluorouracil and cisplatin in SGC7901 transfected with MeCP2 specific siRNA were (11.540 0±0.469 3) μg/mL and (2.273 0±0.265 4) μg/mL,which were higher than the IC50 of 5-fluorouracil and cisplatin in SGC7901 transfected with non-related oligonucleotide sequence ((8.663 0±0.160 1) μg/mL and (0.884 0 ±0.038 6) μg/mL),respectively.The differences were statistically significant (t =15.380 and 8.153;both P ＜ 0.01).Conclusions The expression of MeCP2 in gastric cancer tissues significantly decreased,which was correlated with clinical stages,distant metastasis.MeCP2 can inhibit the MDR of gastric cancer cell,which indicated the dysregulated expression of MeCP2 might participate in the genesis and development of gastric cancer.

Objective To establish a model of full-thickness avascular meniscal defect to assess outcome of bone-marrow mesenchymal stem cells (BMSCs) modified with human insulin-like growth factor Ⅰ (hIGF-Ⅰ) gene and compounded with injectable calcium alginate gel in repair of meniscal defect.Methods Models of full-thickness defect were created in the anterior comer of meniscus in goats,an area lacking of blood supply.The trial categorized the models to four groups:gene-ehanced tissue engineering (GETE) group (hIGF-Ⅰ transfected BMSCs were mixed with calcium alginate gel),BMSCs group (BMSCs were mixed with calcium alginate gel),empty group (calcium alginate gel was used alone) and control group (the defect was excluded from repair).Macroscopy was done at 4,8,and 16 weeks after operation.Variation of repair tissue was observed by light and scanning electric microscopy and aggrecan in repair tissue was determined as well.Results Meniscal defect was on the mend at 4-16 weeks after operation in GETE group,with the defect area being thoroughly filled with the white,elastic and tight repair tissue similar to normal meniscal tissue.Macroscopic examination showed a better result in GETE group than that in other groups.Light microscopy showed that repair tissue which was mainly fibrochondrocytes was arranged in line with calcium alginate fibers and that space between the fibers was mostly crammed with the matrix secreted by those cells.At the same time,those cells were tightly arranged and the matrix secreted by those cells was equally distributed according to light microscopy.Electroscopy demonstrated neat and tight arrangement of fibers and tight extracellular matrix in fiber space in GETE group.Aggrecan concentration in GETE group was relatively higher than in other groups,but still had difference from the normal meniscus.Conclusion hIGF-Ⅰ gene-transfected BMSCs combined with injectable calcium alginate gel can improve the effect in repair of full-thickness meniscal defect.

Objective To study the safety and efficacy of ultrasound-guided puncture combined with surgical resection for liquefied cavitary hepatic alveolar echinococcosis (HAE).Methods A retrospective study was conducted on 17 patients who had liquefied cavitary HAE and were treated at the Affiliated Hospital of Qinghai University from January 2014 to August 2016.Ten patients were treated with ultrasound-guided puncture combined with surgical resection (the case group),and 7 patients were treated with resection (the control group).The basic characteristics,operation time,blood loss during operation,preoperative and postoperative laboratory tests and complications were compared between the 2 groups.Results There were no significant differences between the 2 groups in basic characteristics,such as age,gender,and lesion diameter (P ＞ 0.05).The operation time and blood loss during operation showed significant differences between the 2 groups,(308.0 ± 23.0) min (389.0 ± 95.7) min and (1 360.0 ± 182.9) ml vs.(1 607.1 ± 205.0) ml,respectively (all P ＜ 0.05).The prothrombin time (PT) after day 3 of operation and alanine aminotransferase level after day 5 of operation showed significant differences between the 2 groups,(13.8 ±0.9) s vs.(15.5 ±1.7) s and (81.9 ±20.9) U/L vs.(108.1 ±29.5) U/L,respectively (all P ＜ 0.05).There was no significant difference in postoperative complications between the 2 groups.Conclusions Ultrasound-guided puncture combined with surgical resection shortened the operation time,reduced blood loss and avoided serious complications after surgery.This treatment is efficacious and safe for liquefied cavitary HAE.

Objective:To investigate the efficacy and safety of video assisted thoracic surgery and thoracic surgery in the treatment of myasthenia gravis.Methods:60 patients with myasthenia gravis were selected and randomly divided into two groups.The observation group(32 cases) received video assisted thoracic surgery.The control group(28 cases) received thoracic surgery.The efficacy and safety of video assisted thoracic surgery and thoracic surgery in the treatment of myasthenia gravis was evaluated by perioperative indexes,QMG scores before operation,after 3 months,6 months operation and complications during 6 months follow-up.Results:During the perioperative period,there was no statistical significance in the operation time between two groups(P＞0.05).The bleeding volume of observation group was less than that of the control group (P＜0.05).The drainage time,hospitalization and incision length of observation group were shorter than those of the control group (P＜0.05).Before operation,there was no statistical significance in the QMG scores.At 3 months,6 months after operation,the QMG scores were decreased in both groups.The QMG score of observation group was lower than that of the control group (P＜0.05).During 6 months' follow-up,complications were observed in 7 cases of the observation group and 17 cases of the control group,the major complication was pulmonary infection.The incidence of complications in the control group was higher than that of the observation group (P＜0.05).Conclusion:Video assisted thoracic surgery had advantages of smaller surgical incision,faster recovery and higher safety in the treatment of myasthenia gravis.

Objective To clarify the effects of HBV co-infection on liver function of patients with different types of hepatic echinococcosis.Methods We recruited 409 patients diagnosed with hepatic echinococcosis at three hospitals in western regions in China from 2014 to 2015.Venous blood was withdrawn to detect to liver function indications.ELISA was performed to detect HBsAg.We analyzed liver function in patients stratified by different types of hepatic echinococcosis with or without HBV infection.Results The hepatic echinococcosis patients infected with HBV had more severe impairment in liver functions such as reduced albumin and increased transaminase.The patients with hepatic alveolar echinococcosis were more vulnerable to HBV infection compared with those with hepatic cystic echinococcosis (38.4％ vs.86.4％, P<0.05).In addition, liver injury was more severe in patients diagnosed with alveolar hepatic echinococcosis and HBV infection compared with those diagnosed with cystic hepatic echinococcosis and HBV infection (all P<0.05).Conclusion Hepatic alveolar echinococcosis patients co-infected with HBV have worse liver injury compared with those hepatic cystic with HBV. Therefore, they deserve special attention in clinical treatment.

Objective To assess the effect of hybrid debranching technique in treatment of patients with traumatic aortic arch rupture combined with pseudoaneurysm.Methods Clinical data of 3 patients with traumatic aortic arch rupture combined with pseudoaneurysm repaired using debranching technique from June 2011 to June 2013 were analyzed to determine their clinical features and treatment options.Hypersound or computed tomography angiography (CTA) was performed to confirm the therapeutic effects at postoperative 1 week,3,6,and 12 months as well as annually thereafter.Results All patients underwent operation uneventfully.Operation time was 6.8-10.5 hours (mean,7.6 hours) and intraoperative blood loss was 250-450 ml (mean,310 ml).Length of stay was 26-45 days (mean,32 days).There were no deaths at the 0.5-2 years of follow-up.Hypersound or CTA revealed no leakage of contrast medium after operation.Conclusion Hybrid debranching technique greatly reduces surgical trauma and provides satisfactory outcome and good function recovery.

BACKGROUND: Limb salvage operations with preservation of the epiphysis (LSPPE) had been used clinically in order to overcome discrepancy of affected limb and poorer limb function, but more post-operation complications existed, including infection, grafting bone resorption, fracture and internal fixation cinch.OBJECTIVE: To study the clinical related matters of inactivated bone replantation with preservation of the epiphysis in children limb salvage with osteosarcoma.DESIGN: Clinical observation regularly.SETTING: General Hospital of Jinan Military Area Command of Chinese PLA.MATERIALS: Eleven patients corresponded selected standard and accepted treatment from January 1999 to January distal metastasis was found with lung X-ray check and CT scanning, the patient would be excluded this study. There were 5 males, 6 females, and the mean age of (8±2) years old (4-11 years). The disease history was 1-6 months.FO) were adopted. After 2 weeks of chemotherapy, the operations of inactivated bone replantation with preservation of the epiphysis were performed. The operation was performed under epidural or general anesthesia. The patient lied on operating table. The knee anteriomedialis incision was adopted. Firstly, femur periosteum was opened beyond proximal end 2-3 cm from tumor, subperiosteum stripping was done to the proximal femur, descend femur with wire saw, separated and disconnected aboral periosteum, blunt dissecting femur aboral blood vessel and nerves to the popliteal fossa,deligating blood vessel around the tumor. Attachment of gastroenemius was cut off. Epiphyseal plate was identified carefully. According to pre-operation MR, the distal femur descend level was determined and the femur was descend with electro-saw. It was determined with cytology that no tumor cell existed in descend level, and reconstruction of bone de-fect with inactivated tumor-bone shell with 95% alcohol and bone cement containing ADR (20 g bone cement: 10 mg ADR), the diaphysis was fixed by intramedullary nail and screws were inserted in the residual epiphysis for the osteosynthesis of the distal osteotomy. One drainage tube was placed into and closed incision The affected limb was protected with plaster cast. Post-operative treatment: Regular usage of antibiotics was adopted to prevent infection. The drainage tube was pulled out when drainage amount ＜ 50 Ml/24 hours. The progressive passive exercise was initiated during the protection of affected limb with plaster cast for 8 weeks. Twelve to 14 days after operation, stitches were taken out. The postoperative chemotherapy then initiated, drug and dosage were identified on the response to the preoperative chemotherapy. Eight weeks after operation, patients were permitted to walk with the protection of double crutches and ery analysis: To observe ncision healing and existing of nerve and blood vessel injure, or not. During follow-up, patient recoveries were determined with affected knee function, limb length, distal metastasis, post-operative complications and dynamic imaging inspection of bone healing.imaging inspection of bone healing.MAIN OUTCOME MEASURES: ① The response to chemotherapy was evaluated with tumor cell necrosis rate. ② Post-operative recovery was determined with parameters such as knee function, limb length, distal metastasis, etc. ③ Dynamic imaging inspection of bone healing.MAIN OUTCOME MEASURES: ① The response to chemotherapy was evaluated with tumor cell necrosis rate. ② Post-operative recovery was determined with parameters such as knee function, limb length, distal metastasis, etc. ③ Dynamic imaging inspection of bone healing.RESULTS:All patients in this study were done follow-up.①The histological response of 11 patients to preoperative chemotherapy were classified as 7 in gradeⅣ,4 ingrade Ⅲ.②Post-operation recovery:No nerve and blood vessel injury existed and all incision healed well,there was not incision infection and healing.Eleven patients were followed-up from 10 to 72 months.Three patients could flexed affected knee joint ≥110,90-110 in 3 cases,60-90 in 4 cases,＜60 in one patient .The length of both lower extremity equaled in 4 cases,the length of affected limb was shorter than 2.0 cm in 5 cases,2.0-3.0 cm in 2 cases. One patient with recurrence,two with metastasis,three died.Screw cinch in one patient and one patient with inactivated bone fracture. ③Dynamic imaging inspection: No recurrence was found around epiphysis. Essential bone healing existed between the inactivated bone and epiphysis,callus formation between the inactivated bone and diaphysis at 2 months after operation; more callus formed and 4 months; 6 months after operation,bone complete healing was found between the inactivated bone and diaphysis.④Post-operation recovery:During follow-up, a screw cinch was found in one patient, and dislodged the screw because of bone healing well. One patient underwent open reduction, bone grafting and internal fixation with encircle device because of inactivated bone fracture.four months of the operation, grafting bone healed well. At post-operative 24 months, the length of both lower extremities equaled and the affected knee flexed to 110°.CONCLUSION: Inactivated bone replantation with preserving epiphysis for osteosarcoma in children was propitious to recover limb function and keep limb length.