Objective To investigate the expression and clinical significance of tumor necrosis factor recep-tor associated factor 6(TRAF6)in human esophageal cancer.Methods The clinical data of 72 patients with esopha-geal cancer were collected.Immunohistochemistry method was used to determine TRAF6 expression in esophageal carcinoma and its adjacent normal tissue,and its relationship with clinical pathological features was explored.Results The TRAF6 positive expression rate in esophageal cancer tissue was 66.13%,which was significantly higher than that of normal tissue (13.89%),the difference between the two groups was statistically significant(χ2 =56.850,P <0.01).And TRAF6 expression level was significantly correlated with esophageal cancer clinical staging,lymph node metastasis(χ2 =6.818,4.428,all P <0.05),but TRAF6 expression was not correlated with age,sex,tumor differenti-ation.Conclusion The expression level of TRAF6 in esophageal carcinoma was significantly increased,and there was a significant correlation between the TRAF6 expression level and clinical pathological characteristics.

BACKGROUND:Mesenchymalstem cels have pluripotent differentiation, and can promote cel engraftment and immune regulation. Therefore,we attempt to use human umbilical cord mesenchymal stem cels as anew source for treatment of lung cancer by exploringcelisolation, identification and transplantation combined with chemotherapyforlung cancer in mice.
OBJECTIVE:To investigate the isolation and identification of human umbilical cord mesenchymal stem cels and its transplantation combined with chemotherapy for lung cancer inmice.
METHODS:Human umbilical cord mesenchymal stem cels were isolated from fresh umbilical cord of newborns and identified using tissue culture and enzyme digestion. Twenty Balb/C nude mouse models of lung cancer were randomly divided into two groups:mice in chemotherapy group were given chemotherapy, and those incombinedgroup given combination of chemotherapy with human umbilical cord mesenchymal stem cel transplantation.
RESULTS AND CONCLUSION:Compared with the chemotherapy group, the gastrointestinal tract was rosy and shiny, intestinal mucosa was smooth and complete, and tumor mass and blood indexes significantly decreased in thecombinedgroup (P< 0.05). To conclude, mature human umbilical cord mesenchymal stem cels can be obtained by tissueculture and enzyme digestion, andthecel transplantation combinedwith chemotherapy can significantly reduce gastrointestinal tract damage and themake peripheral hemogram in a stable level.

BACKGROUND:So far the positive or negative effects of mesenchymal stem cel s on tumor growth and metastasis are under discussion. OBJECTIVE:To explore the mechanism of bone marrow mesenchymal cel s in promoting lung cancer metastasis. METHODS:Primary rat bone marrow mesenchymal stem cel s were obtained by direct adherence method of the whole bone marrow, and differential adherence combined with digestion control method was performed to purify cel s. Lung cancer cel lines were cultured, and the effects of bone marrow mesenchymal stem cel s on the migration, invasion and metastasis of lung cancer cel s were observed by scratch test, cel invasion and migration assays. Orthotopic lung cancer models were established in rats and bone marrow mesenchymal stem cel s were seeded onto the left lung of rats. Then, pathological changes of lung tissues were observed at 14 days after transplannation. RESULTS AND CONCLUSION:After the scratch test, the migration rate of lung cancer cel s became higher, and the scratches healed with time. And after cel transplantation, the number of migrated lung cancer cel s increased, as wel as the ability of lung cancer cel s penetrating the Matrigel was strengthened. Besides, fibrous connective tissues could be found around the lung cancer tissues, and necrosis with distinct boundary and large tumor nuclei;the metastatic tissues showed obvious infiltration and necrosis with large tumor nuclei. These results suggest that bone marrow mesenchymal stem cel s can promote the invasion, migration and metastasis of lung cancer cel lines.

Objective To assess the influence of allergic rhinitis(AR)on the quality of life and anxiety and depression symptoms in the elderly.Methods Retrospective analysis of elderly patients with AR treated at our hospital from January 2015 to October 2016 was conducted on quality of life and anxiety and depression symptoms.The participants were investigated using the rhino-conjunctivitis quality of life questionnaire(RQLQ),self-rating depression scale(SDS)and self rating anxiety scale (SAS).The correlation between SDS,SAS and RQLQ was also analyzed.Results RQLQ scores of AR patients in 7 demensions were higher than those of healthy individuals (P＜ 0.05 for all).The scores of SAS(44.8±10.1 vs.40.7±4.9)and SDS(46.7 ±12.2 vs.41.3±4.8)in AR patients were also higher than in healthy individuals (F =21.59 and 26.63,respectively,each P＜ 0.01).Furthermore,anxiety and depression symptoms were significantly associated with seven RQLQ dimensions.Conclusions Compared with healthy individuals,elderly patients with AR has poor quality of life,which is further negatively impacted by increased anxiety and depressive symptoms.Appropriate intervention measures should be taken to alleviate anxiety and depressive symptoms and enhance quality of life for elderly patients with AR.

OBJECTIVETo classify the patients with cleft lip and palate who need orthognathic surgery and to propose the corresponding operations.

METHODSFrom January 2005 to May 2015, 121 patients with cleft lip and palate diagnosed as maxillary retrusion were treated by orthognathic surgery. Inclusion criteriar: (1) male aged over 16, female aged over 14; (2) diagnosed as non-syndromic cleft lip and palate without systemic disease and other genetic diseases; (3) without previous orthodontic and orthognathic treatment; (4) having no other craniofacial malformation. Maxillary features and repaired types were recorded.

RESULTS93 patients were included and divided into two categories depended on the dental crowding. Class I: the teeth quantity and bone quantity is coordinated, space analysis ≤ 4 mm (mild dental crowding). The forward distance of maxillary less than 6 mm was defined as Class I a (36 cases) more than 6 mm as Class I b (28 cases). Class II: the teeth quantity and bone quantity is not coordinated, space analysis > 4 mm ( moderate or severe dental crowding). After the simulation of distraction osteogenesis, the anterior crossbite was corrected defined as Class II a (23 cases), not corrected defined as Class II b (6 cases). Class I a were corrected by conventional orthognathic surgery. While Class I b were corrected by Le Fort I maxillary advancement using distraction osteogenesis. Class II a were repaired just by anterior maxillary distraction. While Class II b need to combine conventional orthognathic surgery with anterior maxillary distraction. All the patients were satisfied with the treatment effect.

CONCLUSIONSThe patients of cleft lip and palate with maxillary retrusion who need orthognathic surgery can be classified as the method mentioned above, and then choose the appropriate operations.

Adolescent ; Adult ; Cleft Lip ; complications ; Cleft Palate ; complications ; Female ; Humans ; Male ; Maxilla ; Osteogenesis, Distraction ; Osteotomy, Le Fort ; Retrognathia ; classification ; surgery

Objective To evaluate the quality of life,emotional symptoms (anxiety and depressive symptoms)and their influencing factors in elderly patients with presbycusis.Methods From May 2015 to May 2017,288 patients with presbycusis and 123 healthy controls were consecutively included into this study.Quality of life and emotional symptoms were evaluated by a series of questionnaires including the generic questionnaire medical outcomes study short-form 36 items health survey(SF-36),self-rating depression scale (SDS) and self-rating anxiety scale (SAS).Results The prevalences of anxiety(SAS score≥50)and depression(SDS scores≥53)were 23.3％ (67/288)and 20.1％(58/288),respectively;and the prevalence of the two in combination was 13.2％ (38/288).When assessed with SF-36,the scores of physical functioning,physical role,bodily pain,general health,social functioning,emotional role,and mental health were 71.0 ± 9.0,77.3 ± 9.1,73.3 -±9.6,69.6±8.6,71.9±9.9,72.1±12.7,and 73.1±10.5,respectively,which were lower than those in the control group(82.1±10.2,82.4±4.3,86.4±11.3,2.1±7.9,82.8±9.9,83.1±7.7,and 82.2 ±3.6,respectively;all P＜0.05).The scores of SDS and SAS in the presbyacsis group were 53.2± 13.3 and 51.9 ± 11.2,respectively,which were higher than those in the control group(42.5± 10.3 and 43.9± 6.2,respectively;t =10.09 and 7.52,respectively;all P＜0.05).SDS was negatively correlated with general physical and mental health (r =-0.787,P ＜ 0.05;r =-0.743,P ＜ 0.05);SAS was negatively associated with general physical and mental health(r =-0.801,P ＜0.05;r =0.750,P＜0.05,respectively);and SDS was positively correlated with SAS(r =0.958,P ＜0.05).Multiple linear regression analysis showed that concomitant hearing impairment,educational level,marital status,living condition,and sleep condition were positively correlated with SF-36 general health scores;severity of hearing loss and number of comorbidities were negatively associated with general health.However,severity of hearing loss,concomitant hearing impairment,educational level,marital status,and number of comorbidities were positively correlated with SAS and SDS scores;educational level and sleeping were negatively associated with SAS and SDS scores.Conclusions Poor quality of life and high prevalences of depression and anxiety are found in elderly patients with presbycusis,and their influencing factors include severity of hearing loss,concomitant hearing impairment,education level,marital status,sleeping and number of comorbidities.

Objective To investigate the psychopathological characteristics in families of presbycusis patients and its influencing factors.Methods The psychopathological characteristics were evaluated with the Symptom Checklist-90(SCL-90) Chinese version in 157 families of presbycusis patients(FPP) in the Affiliated Hospital of Yangzhou University from July 2015 to July 2017. Somatization, obsessive - compulsive disorder, interpersonal sensitivity,depression,anxiety,hostility,phobic anxiety,paranoid ideation,psychoticism and other were assessed and compared with the Chinese standard norm.The correlation between SCL-90 and related data had also been analyzed. The general information and clinical data of patients were analyzed.Results The SCL-90 score in the FPP group was (146.3 ± 42.8)points.The total score and total average score of SCL-90 had statistically significant difference between the FPP group and the Chinese standard group(t=14.557,14.765,all P<0.05).The scores of somatiza-tion,interpersonal sensitivity,depression and anxiety factors in the FPP group were higher than those in the Chinese standard group(t=5.417,13.588,20.857,22.475,all P<0.05).Age,sleeping condition,educational level,hearing aids and the level of patients＇hearing loss were correlated with the total score of SCL-90( TSCL-90) in FPP( all P<0.05).Multiple linear regression analysis showed that age(t=2.550,P<0.000),the educational level( t =4.087,P<0.000),and the level of patients＇hearing loss ( t =2.188, P <0.05 ) were positively correlated with TSCL-90,and sleeping condition(t= -2.004,P<0.05) and hearing aids(t= -4.643,P<0.05) were negatively associated with TSCL-90.Conclusion The psychopathological characteristics are generally poor in families with presbycusis patients,accompanied by obvious depression and anxiety;and age,sleeping condition,educational level, hearing aids and the level of patients＇hearing loss are important influencing factors.It is important to pay attention to overall health in families with presbycusis patients.

Objective:To explore the characteristics of cognitive impairment in elderly adults with deafness and assess its influencing factors.Methods:This was a cross-sectional study.From July 2015 to July 2017, 117 elderly patients with age-related hearing loss(presbyacusis group)admitted to Otolaryngology Clinic of the Yangzhou University Affiliated Hospital and 97 healthy elderly adults(control group)undergoing healthy physical examination in the same period were included.We evaluated the cognitive function was with Montreal cognitive assessment(MoCA)scale Chinese version, and calculated their MoCA total score, and recorded the clinical data and the hearing loss level.The correlation between hearing loss level and MoCA was analyzed.Results:The total scores of MoCA was significantly lower in the presbyacusis group(21.6±5.8)than that in the control group(26.8±1.5)( t=8.49, P<0.05). Patients in the presbyacusis group were associated with significantly lower levels of visuospatial and executive function(4.1 ± 0.9 vs.4.8 ± 0.5), naming(2.2 ± 1.0 vs.3.0 ± 0.0), attention(5.2 ± 1.7 vs.5.9 ± 0.5), language(2.0 ± 0.9 vs.3.0 ± 0.2), abstraction(1.6 ± 0.5 vs.1.9 ± 0.3), delayed recall(1.8 ± 0.7 vs.2.2 ± 0.4), orientation(4.4 ± 1.2 vs.5.8 ± 0.4)than the control group( all P <0.05). The level of hearing loss was negatively correlated with the total scores of MoCA and all the subscale of MoCA(all P<0.01). Univariate analysis showed that age, educational level, marital status, hearing loss level, course of hearing loss, and hearing aid were correlated with MoCA total score in elderly patients with presbcyusis(all P<0.05). Multiple linear regression analysis showed that marital status( t=6.596, P<0.05), and hearing aid( t=2.182, P<0.05)were positively correlated with MoCA total score, and age( t=-2.691), the educational level( t=-2.691), hearing loss level( t=-7.626), and course of hearing loss( t=-6.11)was negatively associated with MoCA total score(all P<0.05). Conclusions:Cognitive function is generally decline in elderly patients with presbycusis, and age, educational level, marital status, the course of hearing loss, hearing loss level and whether or not hearing aid are important factor affecting cognitive function in elderly patients with presbycusis.

Objective:To evaluate the follow-up clinical results of W-shaped acetabular angular plate for the treatment of acetabular posterior wall fractures through a direct posterior approach (DPA).Methods:Fifteen cases (10 males and 5 females, average aged 42.1±10.0 years) were involved in this study, with acetabular posterior wall fractures treated by using the W-shaped acetabular angular plate through a DPA between March 2017 and June 2019. Nine patients with fractures were injured by traffic accidents and the other 6 cases by falling. Based on the three-column classification for acetabular fractures, all of the cases belonged to posterior wall fractures (A2.1), which included 6 cases of simple fractures and 9 cases of comminuted fractures. The mean time interval between injury and surgery was 5.6±1.1 (range, 4-8) days. The DPA was adopted in all cases. The posterior wall fractures of the acetabulum were reduced and fixed with W-shaped acetabular angular plates. The reduction quality of the acetabulum was evaluated by X-ray and CT scan during follow-up visits according to the criteria proposed by Matta. The function of the hip joint was assessed by the Merle d'Aubigné-Posteal score modified by Matta.Results:The length of the surgical incision was 9.5±1.1 (range, 8-12) cm. The operation time was 45.3±10.1 (range, 35-75) mins. The amount of intraoperative blood loss was 248.0±94.7 (range, 100-380) ml. All the patients who were followed up for 20.5±6.3 (range, 16-38) months. All cases were evaluated according to Matta's reduction quality criteria, the satisfactory ratio of reduction was 100%. Among cases, 10 cases were matched the anatomic reduction, and the other 5 cases have belonged to satisfy. All cases of fractures had healed (the mean of healing time was 9.4±1.3 (range, 8-12 weeks). At the final follow-up visit, the mean of modified Merle d'Aubigne-Postel score was 16.9±1.6 (range, 13-18). Excellent clinical outcomes were obtained in 10 cases, good in 3 cases, and fair in 2 cases. One case had deep venous thrombosis of the lower extremities. The clots disappeared after anticoagulation treatment. One case had the heterotopic ossification, Brooker grade I, without any special treatment due to not affecting the hip joint activity in the follow-up visits. One patient had incision fat liquefaction and the wound healed after intensive dressing change. No internal fixation loosening or losing of fracture reduction was found at the follow-up visits.Conclusion:This study shows that using W-shaped acetabular angular plate for the treatment of acetabular posterior wall fractures through the DPA could obtain early satisfactory clinical outcomes.

Sixty-three elderly patients with allergic rhinitis and symptoms of anxiety and depression attending in the Affiliated Hospital of Yangzhou University from August 2016 to August 2018 were randomly divided into two groups: 30 patients received deanxit combined with anti-allergic drugs for treatment (study group) and another 30 patients received anti-allergic drugs treatment alone (control group). Subjective nasal obstruction was evaluated by Visual Analogue Scale (VAS), and the quality of life of patients was assessed by Rhinoconjunetivitis Quality of Life Questionnaire (RQLQ).The anxiety and depression mood changes were assessed by Self-rating Anxiety Scale (SAS) sand Self-rating Depression Scale (SDS).The scores of symptoms and mood were compared after 4 weeks and 8 weeks of treatment. The clinical nasal symptoms VAS score, the total RQLQ scores and its 7 domains scores, SDS and SAS scores of patients in two groups were significantly reduced compared to those before treatment ( P<0.05). The VAS score, the total of RQLQ scores and its 7 domains scores, SDS and SAS scores were significantly lower in the study group than those in the control group after 4 weeks and 8 weeks of treatment.The total effective rate of study group was significantly higher than those of the control group (χ 2=6.922, P=0.031; χ 2=11.544, P=0.003). Deanxit combined with anti-allergic drugs shows significant clinical efficacy, it also can improve the symptoms of anxiety and depression, and the quality of life for elderly patients with allergic rhinitis.