Choriocarcinoma is a highly malignant trophoblastic tumor and is propagated by blood -borne.The diagnosis of choriocarcinoma is based on its histopathologic appearance and a high serum level of hu -man chorionic gonadotropin(HCG).To report a case on multiple organ metastasis of choriocarcinoma ,we retro-spectively analyzed the treatment by reviewing the interrelated articles to analyse the clinical characteristics and treatment of choriocarcinoma .

Objective To translate the English version of an abbreviated eight-item measure of Penn State Worry Questionnaire (PSWQ-A) into Chinese and to test the reliability and validity of the Chinese version of PSWQ-A in patients after total Hip Replacement.Methods Totally 218 patients after total hip replacement were recruited and were investigated by the Chinese version of PSWQ-A.Results The internal consistency coefficient of the Chinese version of PSWQ-A were 0.885.Factor analysis got two factors,which explain 68.428％ of the total variance.The content validity index was 0.924.Using SAS as an external criterion,The correlation coefficients of the PSWQ-A and SAS scores were 0.891,P＜0.05.Conclusions The Chinese version of PSWQ-A has been proved to be reliable and valid.It can be used as a valid tool for the measurement of self-efficacy in patients after total hip replacement.

Objective: To evaluate the applications and problems of statistical methods for articles published in《Chinese Circulation Journal》. Methods: We reviewed the statistical methods for original articles published in《Chinese Circulation Journal》in 2010, 2011 and 2015; general status with problems was analyzed and the situations were compared among different years. Results: A total of 404 articles were enrolled, statistical hypothesis testing was performed in 366 of them, 32 had descriptive statistics only and 6 articles were meta-analysis. The most frequently used statistical methods were student'st-test (57.4%), followed by chi-squared analysis (56.7%), analysis of variance (35.2%) and regression analysis (23.0%). The main statistical problems in Methods included in described method un-matched to really used method and insufifcient or wrong description. The proportion of insufifcient or wrong description in 2010 and 2011 was 36.6% (71/194), while in 2015 was 26.2% (55/210),P=0.02. The major wrong application of statistical approach was ignoring design with improper method and using unsatisifed precondition for speciifc analysis. The proportion of improper statistical method application in 2010 and 2011 was 19.1% (33/173), in 2015 was 19.7% (38/193),P=0.88. Conclusion: The quality of statistics was improved in 2015 than 2010 and 2011 for articles published in《Chinese Circulation Journal》; while there were still problems at certain degree, enhanced statistical review should be conducted in medical journals.

Objective To explore the effect of the combination of video feedback and telephone intervention on postdischarge rehabilitation in patients receiving artificial total hip replacement.Methods A total of 60 patients receiving artificial total hip replacement were divided into intervention group and control group with 30 cases each by random digits table method.The combination of video feedback and telephone intervention was conducted in intervention group,and conventional discharge guidance and telephone follow-up on a regular basis in control group.In intervention group,the patients or their family member were asked to record the video of the exercises and daily living when patients were at home according instructions and researchers assessed the condition of patient's joint and muscle function and provided individual education and instructions to the patients on the basis of the feedback video through telephone.Harris hip function rating scale and Functional Independence Measure (FIM) were investigated at discharge and 1,3,6 months after discharge.Results There were no significant differences in Harris hip function rating scale and FIM score at discharge between 2 groups,P＞0.05.Harris hip function rating scale score were (72.70± 11.65),(83.11±5.12),(94.83±3.08) scores at 1,3,6 months after discharge in intervention group,and (63.20±14.96),(77.00±11.62),(87.50±7.94) scores in control group,there were significant differences,P＜0.05 or ＜0.01.FIM score were (96.30±4.63),(108.76±3.28),(125.79±1.19) scores at 1,3,6 months after discharge in intervention group,and (78.23±5.09),(86.43±6.30),(96.54±5.35) scores in control group,there were significant differences,P＜0.01.Conclusion The combination of video feedback and telephone intervention could help to promote the postdischarge hip function for patients receiving artificial total hip replacement.

Objective: To determine the transdermal absorption of phloretin and ligustilide in Fufang phloretin cream.Methods: In vitro percutaneous absorption test using the Franz intelligent transdermal absorption apparatus was adopted, an HPLC method was used to determine the contents of phloretin and ligustilide in the accepting solution at different time points, and then the cumulative release amount and the total penetration amount were calculated to evaluate the percutaneous absorption behavior.Results: Phloretin and ligustilide showed a good linearity within the range of 0.044 2-4.42 μg·ml-1(r=0.999 9) and 0.048 7-4.87 μg·ml-1(r=0.999 9), respectively, the average recovery was 99.85% and 99.92%, and RSD was 0.67% and 0.66% (n=9), respectively.The in vitro permeation behavior of phloretin and ligustilide through the skin of rats fit Higuchi equations(r>0.9), suggesting a good linear correlation between the cumulatine penetration amount (Qn) and (time).Conclusion: Fufang phloretin cream has a good percutaneous permeation property in vitro.

Objective To assess the role of the different pancreatic islet β cell function index in the evaluation of glucose metabolism in different duration of type 2 diabetes mellitus (T2DM).Methods Normal glucose tolerance subjects without diabetes family history (NC group,48 cases) and T2DM patients (182 cases) were enrolled.The T2DM patients were divided into three groups:less than 5 years group (DM ＜5 group,74 cases),5-10 years group (DM5-10 group,51 cases) and more than 10 years group ( DM ＞10 group,57 cases).Oral glucose tolerance test (OGTT) and insulin release test were taken in all groups.Insulin resistance index (HOMA-IR) and whole body insulin sensitivity index [ISI(Matsuda)] were used to estimate insulin sensitivity,and early insulin secretion index ( △ I30/ △ G30) and glucose disposition index (DI) were used to evaluate the function of pancreatic islet β cell.Results HOMA-IR was increased and ISI (Matsuda) was decreased in DM ＜5 group,DM5-10 group and DM ＞10 group compared with those in NC group [HOMA-IR:8.78 ± 7.12,8.08 ± 3.67,7.84 ± 5.08 vs.4.76 ± 3.43;ISI(Matsuda):46.78 ± 29.00,36.71 ± 16.67,38.86 ±21.72 vs.61.13 ± 32.08,P ＜ 0.05],however,there was no significant difference among DM ＜5 group,DM5-10 group and DM ＞10 group.△ I30/ △ G30 and DI were decreased in DM ＜5 group,DM5-10 group and DM ＞10 group compared with those in NC group [ △ I30 △ G30:( 68.41 ± 361.52 ),(4.31 ± 3.42 ),(7.70 ± 5.78 ) mU/mmol vs.(92.65 ± 309.29) mU/mmol;DI:0.0421 ± 0.0123,0.0412 ± 0.0123,0.0363 ± 0.0116 vs.0.1151 ± 0.0236,P ＜ 0.05 ],and there was no significant difference in △ I30 / △ G30 among DM ＜5 group,DM5-10 group and DM ＞10 group,however,DI was decreased in DM＞10 group compared with that in DM＜5 group and DM5-10 group (P＜0.05).ConclusionsHOMA-IR,ISI (Matsuda),△I30/△G30 are not sensitive to evaluate the insulin resistance of different duration.DI can reflect the glucose utilization of pancreatic islet β cell earlier and the ability to regulate blood sugar steady state changes.

Objective To assess incidence rate of different types of cement leakage in percutaneous kyphoplasty (PKP) with or without intravertebral clefts and to determine whether basivertebral foramen could be connected with intravertebral cleft.Methods 270 vertebrae in 224 consecutive patients who underwent percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fractures were classified into two groups on preoperative radiographs,computed tomography scans,and/or magnetic resonance images of the treated levels:Cleft group with an intravertebral cleft in vertebral body and trabecular group without intravertebral clefts.On direct postoperative images,the patterns of cement leakage were classified as 5 types:through a cortical defect into paraspinal soft tissues (type A),through the basivertebral foramen (type B),via the needle channel (type C),through a cortical defect into the disc space (type D),via the paravertebral vein (type E).The incidence of different types of cement leakage between two groups was analyzed.Results In 72 of 270 vertebrae,an intravertebral cleft was confirmed on preoperative images.Leaks through basivertebral foramen as type B (42,15.5％) and through cortical defects into the disc space as type D leaks (21,7.8％) were more common than other types.The incidence of type B leakage in the cleft group (23.6％) was higher than the incidence in the trabecular group (12.6％),which made a statistical significance (P=0.028).There was no statistical difference between the trabecular pattern and the cleft pattern on other types of leaks.Conclusion Type B leaks were more common in vertebrae with the presence of an intravertebral cleft,which support the presence of the connection between an intravertebral cleft and the basivertebral foramen.Thus,care must be taken when PKP was performed in these patients to avoid cement leakage into spinal canal through basivertebral foramen directly.

Objective To explore the effects of self-differentiation,social support,social adaptation on suicidal ideation.Methods A simplified cluster sampling method,involving the random selection of 3097 college students in 23 departments,was used to estimate the scores of Chinese version of Self Differentiation Inventory for university student(SDI),Social Support Rating Scale(SSRC),College Student Adaptability Scale (CSAS) and Adult Suicidal Ideation Questionnaire(ASIQ).The independent-samples t-test,Pearson correlation coefficients and stepwise regression analyses were used as statistical analysis techniques.Results The correlation coefficients were negatively significant between suicidal ideation and self-differentiation,social support and social adaptation (r=-0.24,-0.17,-0.29,P＜0.001).Social adaptation showed the strongest predictability for suicidal ideation (β=-0.19,P＜0.001),followed by self-differentiation (β3=-0.13,P＜0.001),social support (β3=-0.08,P＜0.001).Independent samples t-test showed that college students with suicidal ideation showed a significant reduction in interpersonal adaptation,social support,self-differentiation compared to those without suicidal ideation.Conclusion Self-differentiation level,social support and social adaptability may be effective predictors for suicidal ideation among college students.Future intervention programs may focus on enhancing the interpersonal skills of college students to reduce prevalence of suicidal behavior.

Objective To investigate the clinical significance of apoptosis of B cells in the peripheral blood of patients with rheumatoid arthritis (RA).Methods The proportions of B cells in the peripheral blood (PB) of 51 active and 30 remission patients with RA and 80 healthy controls were detected by flow cytometry.B cells in the PB of 10 active,10 remission and 10 healthy individuals were isolated by MACS.The apoptosis of cultured B cells,which were collected at 24,48,72,96 h respectively,were assessed by flow cytometry.ANOVA,t test and,Spearman correlation analysis were used for statistical analysis.Results The proportions of B cells marked as CD19 and CD22 in the PB of active and remission patients with RA and healthy controls were (26±11)％,(12±8)％,(10±7)％,(26±10)％,(12±8)％,(11±5)％ respectively.The proportions of B cells in the PB of active patients was significantly higher than that of remission patients and healthy controls (P＜0.01).There was positive correlation between B cell proportion in the PB of active patients and DAS 28 and IgG level.The proportion of apoptosis of B cells in the PB with active patients was less than healthy controls.Conclusion The pathway of apoptosis of B cells in the PB of active patients is inhibited,which could increase B cell proportion.Moreover,the high proportion of B cells in the PB of active patients is closely related to disease activity.

Objective To explore the possible pathological essence of HIZ in lumbar intervertebral disc by means of CT,MRI and histomorphology analysis.Methods All of 41 patients of low back pain with the HIZ in the lumbar disc on MRI were identified.There is 23 males and 18 females with mean age of 38 years (range 33-50 years).All the patients were divided into 2 groups according to the characteristics of HIZ on MRI:group A,29 patients with high intensity on MRI T2WI and low intensity on MRI T1WI; group B,12 patients with high intensity both on T2WI and T1WI.All these patients underwent X-rays and CT scan on the targeted level.26 patients in group A were performed discography and pain provocative test.15 patients in group A and 7 patients in group B underwent operation and those samples of HIZ region were excised for HE staining and immunohistochemical analysis.Results All the patients in group A were proved intervertebral disc degeneration on CT and MRI.21 patients in 26 who underwent discography and pain provocative test were proved positive and 15 of them underwent operation(Transforaminal lumbar interbody fusion or posterior lumbar interbody fusion).Histomorphology examination showed annular tear combined with granulation tissue in the samples of HIZ region which were excised in operation.Neoformative blood capillary could be seen through CD34 staining.Macrophage could be found in CD68 staining,but the regions off the HIZ were less stained.In group B,all those targeted discs showed calcified or ossified lesion on the posterior annular on CT scan,HE staining showed calcification or ossification of the posterior annulus fibrosus with frontier line.Conclusion The HIZ on MRI T2WI with low intensity zone on T1WI possibly refers to annular tear combined with granulation in-growth.But the HIZ both on MRI T2WI and T1WI might be calcification or ossification.The conventional concept of HIZ might be modified as HIZ on MRI T2WI,but low intensity zone on MRI T1WI.In addition,CT scan might be helpful in the distinguished diagnosis.