Objective To analyze the superiority of implanting operation with autoskull stored at ultrahypothermia over low temperature's and frozen skull bone of oneself.Methods 42 case were observed and followed up after operation.Results Incision is healing by firct intention.there were many advantages,such as good biological activity,beautiful appearance,no repellent response,no immunoreaction and hard to infection,etc. After storing 1,3,6 and 12 months,the histological structure of frozen skull observed by electronscope was similar to those of fresh skull.Pestroyed skull bone cells were not found.All cases had no complication during the period of 3 to 12 months(mean 6.5 months) follow-up after operation.After 12 months,X ray and CT scan showed that skulls were healed.Conclusions Implanting operation with autoskull stored at ultra-hypothermia is one of the most effective technique for repairing skull defects.

ObjectiveTo observe the effects of salmeterol fluticasone on the glucose metabolism and bone density of the elderly patients with chronic obstructive pulmonary disease (COPD) combined with type 2 diabetes mellitus (T2DM).MethodsThirty-one patients with COPD combined with T2DM were divided into 2 groups by random digits table,14 cases in control group were given conventional therapy,17 cases in experimental group were given conventional therapy and fluticasone propionate 50/500 μg,twice a day,for 3 months.The fasting blood glucose,postprandial 2 hours glucose,glycosylated hemoglobin,plasma cortisol and bone density respectively before and after treatment were detected.ResultsIn experimental group,the fasting blood glucose,postprandial 2 hours glucose,glycosylated hemoglobin and bone density before treatment was (5.25 ± 0.21 ) mmol/L,(7.14 ± 0.33 ) mmol/L,(5.58 ± 0.26 )％,( 1.96 ± 0.11 ) g/cm2,and after treatment was(5.31 ± 0.27 ) mmol/L,(7.22 ± 0.29 ) mmol/L,(5.67 ± 0.23 )％,(2.03 ± 0.15 ) g/cm2,there was no significant difference (P ＞ 0.05).In control groups,the fasting blood glucose,postprandial 2 hours glucose,glycosylated hemoglobin and bone density before treatment was (5.33 ± 0.35) mmol/L,( 7.26 ± 0.29 ) mmol/L,( 5.62 ± 0.19 )％,( 1.88 ± 0.20 ) g/cm2,and after treatment was ( 5.36 ± 0.31 ) mmol/L,(7.30 ± 0.35 ) mmol/L,( 5.69 ± 0.26 )％,( 1.98 ± 0.17 ) g/cm2,there was no significant difference (P ＞ 0.05 ).There was no significant difference in plasma cortisol before and after treatment in two groups (P ＞0.05).ConclusionInhaling salmeterol fluticasone for elderly patients with COPD combined with T2DM is safe.

Objective To analyse the normal helical CT appearances of the bronchial stump or anastomosis after pulmonectomy for central bronchial carcinoma.Methods The available 110 contrast-enhanced spiral CT images in 55 patients undergone different surgical procedures for central bronchial carcinoma were evaluated retrospectively.Results The CT findings of bronchial anastomosis in shape appeared as smooth,concave and convex,sharp angle,obtuse angle,spininess,irregulated or short tube.The thickness of anastomosis was (3.26?1.46) mm.Conclusion Spiral CT can display the bronchial anastomosis clearly after pulmonectomy for central bronchial carcinoma.

Objective To investigate the correlation between helicobacter pylori infection and pathological characteristics of gastric mucosal in the elderly.Methods Retrospective analysis was conducted in 278 patients with benign upper gastrointestinal disease from January 2014 to June 2014.The patients were examined by endoscopy and 13C-UBT,and divided into elderly group (aged 60 years and over,n=111) and non-elderly group (aged＜60 years,n=167).The relationships between Hp infection and pathological changes in gastric mucosal tissue (severe chronic inflammation,neutrophil infiltration,lymph follicles,gastric gland atrophy,intestinal metaplasia) were analyzed.Results There was no significant difference in helicobacter pylori infection rate between the elderly group and non-elderly group [27.0％ (30/111) vs.36.5％ (61/167),P＞0.05].The rate of gastric gland atrophy was higher in elderly group than in non-elderly group [13.5％ (15/111) vs.6.0％ (10/167),P=0.028].The rates of severe chronic inflammation,neutrophil infiltration,lymph follicles,gland atrophy and intestinal metaplasia were 73.6％,70.3％,14.3％,18.7％,29.7％ in patients with helicobacter pylori infection,which were higher than those in patients without helicobacter pylori infection (19.8％,3.2％,0.5％,4.3％,8.6％,respectively,all P=0.000).Removing the factor of Hp infection,the rates of glands atrophy and intestinal metaplasia were higher in elderly group than in non-elderly group (8.6％ vs.0.9％,43.3％ vs.23.0％,P=0.013 and 0.045).Conclusions Helicobacter pylori infection correlates with severe chronic gastric mucosal inflammation,neutrophil infiltration,lymph follicles formation.Gland atrophy and intestinal metaplasia are related to the Hp infection,and age is also their influencing factor.

Objective To assess the usefulness of spiral CT examination in detecting the local recurrence and the metastatic lymph nodes of chest in the patients with post-pulmonectomy for central lung cancer.Methods The data of 110 contrast spiral CT of chest in 55 patientswith central bronchial carcinoma post-operation were retrospectively analysed.Results 12 person-time in 9 cases recurred in thebronchial stump or anastomose.The short diameter of lymph nodes in the thorax ≥1 cm was showed in 33 person-time of 26 cases,of them,14 cases was considered as metastasis in combination with the clinical data.Conclusion Spiral CT is the one of the best examination indetecting the post-operation recurrence in the patients with central bronchial carcinoma,but it is still of limitation in evaluating the nature of lymph nodes.

Objective To explore the mediating role of self-confidence in the parental rearing style and facing-audience com munication apprehension(FACA).Methods The Chinese College Students' Facing-audience Communication Apprehension Scale (revised version of 2011),the Short-form Egna Minnen av Barndoms Uppfostran for Chinese(s-EMBU-C) and the Overall Self-confidence Questionnaire Version of College Students were adopted to survey on 1 072 college freshmen from Guizhou Province.Results FACA in the freshmen of non-one-child was significantly higher than that in the freshmen of one-child,FACA in the freshmen of good performance was significantly lower than that in the freshmen of middle and poor performance;FACA of college freshmen,parental rearing style and self-confidence were significantly correlated with each other;self-confidence played a complete mediated role between the parental care and FACA,and a partial mediated role between the parental control and FACA.Conclusion Self-confidence has significant mediate effect between the parental rearing style and FACA of college freshmen.

Objective To investigate the in vitro effects of bone marrow mesenchymal stem cells (BM MSCs) on the replication of HBV with the participation of lymphocytes and to analyze the possible mechanism.Methods The HBV genomic DNA transfected HepG2.2.15 cell line was used to evaluate the HBV replication.Bone marrow and spleen samples were collected from BN rats for the isolation of BM MSCs and T lymphocyte cells, respectively.Five groups of co-culturing with different cells were designed in this study.The cellular activities of lymphocytes and HepG2.2.15 cells were detected at the time of 24 h, 48 h and 72 h after co-culturing by using MTT method.The levels of HBV DNA and HBV cccDNA were detected by real-time polymerase chain reaction ( PCR) .T cell subsets in co-culture were measured by using fluores-cence labeled antibodies and flow cytometry analysis.ELISA was used to detect the levels of cytokines in the supernatant of cultured cells.Results Compared with HepG2.2.15 cells group, BM MSCs+HepG2.2.15 cells and splenic lymphocytes+HepG2.2.15 cells co-culture groups, the levels of HBV DNA and HBV cccDNA were significantly decreased in splenic lymphocytes+BM MSCs+HepG2.2.15 cells co-culture group after 48 h of culture [ HBV DNA: ( 181.000 ±14.731 ) IU/ml vs ( 6270.000 ±300.450 ) IU/ml, (2564.000±231.058) IU/ml, (2433.300±302.379) IU/ml;HBV cccDNA: (4.330×105 ±0.464×105 ) IU/ml vs (11.100×105±0.375×105) IU/ml, (8.930×105±0.778×105) IU/ml, (9.850×105±0.810× 105) IU/ml;P<0.01].The secretion of IFN-γin the supernatant of co-cultured cells was negatively corre-lated with HBV DNA level, but the levels of IL-10 and IL-22 were positively correlated with HBV DNA.The ratio of CD4+/CD8+cells was increased in splenic lymphocytes+BM MSCs+HepG2.2.15 cells co-culture group.The percentage of CD8+cells showed a positive correlation with HBV DNA.Conclusion BM MSCs could inhibit the expression of HBV DNA to enhance the clearance of HBV strains.It might be possibly due to rebalancing of Tc1/Tc2 cells and regulating the expression of autocrine agents and cytokines.

Objective:To investigate the influence of chemotherapy on the phenotype of secreted protein, acidic and rich in cysteine (SPARC) in gastric cancer (GC). Methods:Immunohistochemistry was used to analyze SPARC expression in 132 GC patients. Among these patients, 54 with preoperative chemotherapy and 78 without preoperative chemotherapy were selected to analyze the effect of chemotherapy on SPARC phenotype by comparing the postoperative specimens of the two cohorts. Results:SPARC expression was higher in GC lesions than in the desmoplastic stroma surrounding the tumor cells and noncancerous tissues. High SPARC expression was related to invasion depth, lymph node metastasis, and TNM staging. SPARC expression was lower in patients with preoperative chemotherapy than in controls ( P<0.05). Gross type, histology, depth of invasion, lymph node metastasis, TNM staging, and SPARC phenotype correlated with the overall survival of the patients with preoperative chemotherapy. Further multivariate analysis suggested that lymph node metastasis, histology, and SPARC phenotype after chemotherapy were independent prognostic indicators of GC. Conclusion:SPARC expression was associated with invasion depth, lymph node metastasis, TNM staging and GC prognosis. Preoperative chemotherapy may change the phenotype of SPARC in GC patients.

Background:Small intestinal bleeding is difficult to diagnose and treat because of its complex etiology and limit to examination method. Aims:To analyze the etiology,diagnosis,treatment and prognosis of small intestinal bleeding. Methods:The clinical data of 118 consecutive patients with small intestinal bleeding admitted from Oct. 2006 to Oct. 2016 at Daping Hospital,the Third Military Medical University were retrospectively analyzed. Results:Melena was the most common manifestation of small intestinal bleeding (41. 5％),followed by dark bloody stool,positive fecal occult blood test,hematochezia,and anemia with unknown cause. The major causes of bleeding were benign or malignant tumors (43. 2％),vascular lesions (28. 0％)and inflammatory lesions (15. 3％). Diagnosis was made by means of capsule endoscopy,colonoscopy,digital subtraction angiography (DSA),barium meal examination,multi-slice CT (MSCT)and CT enterography (CTE). Forty-one patients were treated by surgical operation,7 by selective arterial embolization,2 by endoscopic therapy,56 by conservative therapy,and all these patients achieved hemostasis. One patient died of massive hemorrhage and 11 were discharged with giving up of treatment. Conclusions:The leading cause of small intestinal bleeding is tumor,followed by vascular and inflammatory lesions. Capsule endoscopy is able to make definite diagnosis with high accuracy,and MSCT is the most widely used diagnostic approach. In addition to conventional treatment,surgical operation,interventional and endoscopic therapies also play important roles in treating small intestinal bleeding.

Objective: To analyze the association of thrombocytosis with the prognosis of patients with gastric cancer.Methods: The clinical materials of 782 patients with gastric cancer who underwent initial surgery in our hospital between January 1995 and December 1999 were retrospectively analyzed.Kaplan- Meier and Log-Rank test were used to analyze the data.Prognostic factors were analyzed by multivariate Cox proportional hazards model.Results: Thrombocytosis oc-curred in 11.4% (87/782) patients.The platelet level was not significantly different among patients of different gender, tumor stage, and histological differentiation (P>0.05).However, a significant difference was observed in the platelet level among patients with different age and surgical approach (P<0.05).The 1-, 3-, and 5-year survival rates were 75.0%, 40.1% and 28.9% in patients without thrombocytosis and 52.8%, 16.9%, and 13.5% in patients with thrombocytosis (P=0.002).Univari-ate analysis showed that histological differentiation, pathological stage, surgical approach and thrombocytosis significantly affected the survival of patients.While age and gender had no significant impact on patient survival.Multivariate analysis showed that pathological stage, surgical approach, and thrombocytosis were independent prognostic factors for gastric can-cer.The relative risk of death of patients with thrombocytosis was elevated by 1.454 times (RR=1.454, 95% CI: 1.135～1.861, P=0.005).Conclusion: Thrombocytosis is an independent prognostic indicator for the survival of initially treated pa-tients with gastric cancer.