Objective To investigate the therapeutic effect and analgesic mechanism of percutaneous vertebral angioplasty in the treatment of painful osteoporotic thoracolumbar vertebral compression fracture.Methods80 cases of patients with painful osteoporotic thoracolumbar vertebral compression fracture in Shaoxing second hospital from May 2014 to May 2016 were selected, they were randomly divided into percutaneous vertebroplasty group (40 cases) and conservative treatment group (40 cases) two groups, the clinical efficacy, VAS scores and ODI scores of the two groups were statistically analyzed.ResultsThe total treatment effective rate of the percutaneous vertebroplasty group 95% (38/40) was significantly higher than the conservative treatment group (30/40) (P<0.05);The VAS scores and ODI scores of the two groups after treatment were significantly lower than before treatment (P<0.05);The differences of VAS scores and ODI scores before treatment between the two groups were not significant.The VAS score and ODI score after treatment of the percutaneous vertebroplasty group were significantly lower than the conservative treatment group (P<0.05).ConclusionThe therapeutic effect of percutaneous vertebral angioplasty in the treatment of painful osteoporotic thoracolumbar vertebral compression fractures is more significant than conservative treatment, it has better analgesic effect, so is worthy of promotion in the clinical.

Objective: To investigate the feasibility and advantages of supraclavicular approaching thyroidectomy for benign thyroid diseases. Methods: From February 2004 to December 2007, 64 cases of thyroidectomies were performed via the lateral cervical supraclavicular incision, and were selected as experimental group, of whom, there were 37 cases of thyroid adenomas and 27 cases of nodular thyroid goiters, respectively. At the same time period, 63 cases of consecutive thyroidectomies through the conventional anterior neck incision were selected as a control group, of whom, there were 39 cases of thyroid adenomas and 24 cases of nodular thyroid goiters, respectively. Results: All the operations in two groups were successfully accomplished. In the experimental group, there were 9 subtotal thyroidetomies, 40 subtotal lobectomies and 15 nodulectomies. While in the control group, there were 8 total thyroidetomies, 37 subtotal lobectomies and 18 nodulectomies. The statistical analysis between the two groups was carried out in terms of tumor size, operative time-consuming, blood loss, postoperative drain volume, time for return of motion and postoperative complications. There were no injuries of laryngeal recurrent nerve, superior laryngeal nerve and parathyroid glands. Two cases of postoperative complications in the experimental group and 3 in the control group were observed, respectively, the statistical differences were not significant between the two groups. Conclusion: The supraclavicular incision for thryoidectomy for benign thyroid diseases is a feasible and safe technique with a satisfactory cosmetic result. It is accessible to the treatment of bilateral thyroid diseases and can facilitate the detection of lymphatic metastases.

Objective To evaluate the efficacy and value of mediastinoscopy in the diagnosis of superior vena cava obstruction syndrome (SVCOS). Methods 12 patients with SVCOS underwent mediastinoscopy. This group consists of 9 males and 3 females aged 16 to 71 years. 7 cervical mediastinoscopies and 5 parasternal mediastinoscopies were performed. Results In eleven patients, definite pathological diagnosis was obtained, included: primary lung cancer in 8, lymphoma in 3 and invasive thymoma in 1. There were no operative morbidity and mortality. Only in 1 patient with lymphoma the symptom got worse after cervical mediastinoscopy and soon released by chemotherapy. Conclusion Mediastinoscopy is an effective method in the diagnosis of SVCOS.It can be considered as a routine procedure if other methods failed.

Objective:To evaluate the role of miR-124 in breast cancer and its underlying mechanism. Methods:Quantitative re-verse transcription-polymerase chain reaction (qRT-PCR) was employed to quantify the expression level of miR-124 in the breast can-cer cell lines and matched tissues of 52 patients. Cell proliferation, invasion, and migration of MDA-MB-231 and T-47D were deter-mined by miR-124 overexpression in vitro. Luciferase vectors (pMIR-SP1 3'UTR) were also constructed. The predicted target gene of miR-124 was identified via luciferase activation assay. The mRNA and protein expression of SP1 was detected via qRT-PCR and West-ern blot, respectively. Results:MiR-124 was decreased in breast cancer tissues and cell lines. This result is correlated with metastatic capacity, TMN stages, and prognosis in breast cancer tissues. In breast cancer cell lines, ectopic overexpression of miR-124 inhibited cell proliferation, invasion, and migration in vitro. MiR-124 mimics significantly inhibited luciferase activation (P<0.05) in HEK293 cells and could significantly decrease the mRNA (P<0.05) and protein expression levels of SP1 in MDA-MB-231 and T-47D cells. Con-clusion:MiR-124 could be inhibited in breast cancer. The low miR-124 expression is associated with poor prognosis. In addition, miR-124 could inhibit cell proliferation, invasion, and migration by targeting SP1. These findings confirm that miR-124 downregulation may be a key mechanism for breast cancer carcinogenesis.

Objective To investigate the current situation and development of geriatrics in Jiangsu Province, and to find out the characteristics and trend in development of geriatrics in Jiangsu Province. Methods The literatures in geriatric field of Jiangsu Province from 1998 to 2007 were collected from the database, www. cnki.net. Bibliometric methods and Mann-Whitney Test (performed by SPSS) were used to analyze the distribution of time, area, author, fund and discipline of the literatures. Results The total number of the literatures about geriatrics of Jiangsu Province from 1998 to 2007 was 4623, accounting for 7.72% of the total number of the literatures about geriatrics of China. The number of the literatures in South Jiangsu was the highest, followed by North Jiangsu and Center Jiangsu (P＜0.001). The authors publishing only one article made up 81.51% of the total number of the authors. The literatures with cooperating affiliations made up 12.24% of the total literatures. There were 212 literatures with research sponsorship. The literatures in geriatrics of Jiangsu province covered 39 subjects, and the literatures about cardiovascular diseases accounted for 14.56%. Conclusions Geriatrics in Jiangsu province shows a slow development and an imbalance between different areas and subjects. The core author team does not exist. This suggests that Jiangsu Province should increase the investment, and carry out a large and cooperating researchplan to promote the development of geriatrics in Jiangsu province.

BACKGROUNDMediastinoscopy has experienced a renaissance due to the introduction of neoadjuvant treatment protocols and recognition of the limitations of noninvasive mediastinal staging of lung cancer by CT and PET. The aim of this study is to determine the value of video-mediastinoscopy in mediastinal staging of lung cancer.

METHODSA total of 60 patients who underwent video-mediastinoscopy for known or suspected lung cancer were retrospectively reviewed. There were 52 cervical mediastinoscopies, 2 parasternal mediastinoscopies and 6 combined procedures. All the patients were found to have enlarged mediastinal lymph nodes on radiographic examination of the chest (more than 1.0cm on its shortest axis).

RESULTSOf the 60 patients, 42 patients were found with N2 or N3 disease on video-mediastinoscopy and then were confirmed pathologically. The other 18 mediastinoscopy-negative patients underwent thoracotomy for pulmonary resection and mediastinal lymph node dissection in the same operative session, in which thoracotomy-proven N0 was found in 17 patients, and N2 in 1 patient (false-negative result by video-mediastinoscopy). The sensitivity, specificity, and accuracy of video-mediastinoscopy for mediastinal staging of lung cancer were 97.7%, 100% and 98.3%, respectively. In the entire group of 60 patients, there was 1 complication (1.7%) , and no perioperative death.

CONCLUSIONSVideo-mediastinoscopy is a highly effective and safe procedure. It can be used routinely in mediastinal staging of lung cancer.

Objective To develop an indicator system for evaluating midwifery quality. Methods Guided by the latest evidence-based framework of midwifery quality,based on indicator selection principle,the indicator system for evaluating midwifery quality was preliminarily developed by literature review,expert meeting,theoretical analysis and expert consultation,for further validation through large-scale Delphi method. Results The indicator pool for mid-wifery quality evaluation was identified by literature review,including indicator name and definition of special indi-cator. The indicator system was finalized through comprehensive analysis and selection,and consisted of 45 indica-tors. The expert consultation questionnaire response rate was 100%,the rate of experts who provided written sug-gestions was 81.3%,the authority coefficient was 0.92,the coefficients of variation of indicators ranged from 0 to 0.29. Conclusion The preliminarily developed indicator system for midwifery quality evaluation guided by the lat-est evidence-based framework of midwifery quality was scientific,oriented and accessible,which could be further ex-amined through large-scale Delphi method.

OBJECTIVE:To investigate the current situation of unreasonable prescriptions in outpatient and emergency depart-ments of our hospital,and to provide reference for rational drug use in the clinic. METHODS:The evaluation of outpatient and emergency prescriptions in our hospital during 2013-2015 were summarized and analyzed. Irrational prescriptions were divided into 3 categories,involving 19 items. The main,secondary and general factors of irrational prescriptions were analyzed by Pareto chart. RESULTS:Among 19 types of irrational prescriptions,main factors included unsuitable drug selection,inappropriate usage and dosage,inappropriate drug combination,prescribing not in accordance with the antibiotics management regulations,incomplete di-agnosis. No indications of medication,drug dosage beyond the regulations ofthree urgent seven slowwere treated as the second-ary factors. Other 12 items were general factors. CONCLUSIONS:According to the main and secondary irrational drug use types, clinical pharmacists should carry out effective intervention and pharmaceutical care to improve the level of rational drug use and en-sure the safety of clinical drug use.

In order to adapt to the education of the professional who work in thecurrent medical lab,we set up the course of'Experimental Technology of Medical Function'. It is a required subject for the professional with laboratory skill. This article explores the curriculum sys-tem,teaching contents,teaching methods and examination.

Background The commonly used method of typing the adenovirus (AdV) for epidemic keratoconjunctivitis is direct DNA sequence.However,heteroduplex mobility assay (HMA) is found to be a faster method to identify the subtypes of adenovirus and is more conforming to the principle of cost and economic benefit.There are few studies to illustrate the application of HMA in epidemic keratoconjunctivitis.Objective This study analyzed the conserved region of hexon coding sequence and compared the outcomes between direct DNA sequence and HMA for classification of adenovirus in epidemic keratoconjunctivitis patients.The validity of HMA is evaluated by comparing the result of both studies Methods Two hundreds and fourteen patients with suspicious epidemic keratoconjunctivitis were included in Shanghai Eye Disease Prevention and Treatment Center or the clinical sites supervised by the Shanghai Prevention and Monitoring Office of Acute Hemerragic Conjunctivitis from January 2010 to December 2012.Sacconjunctival swab samples were collected from each patient under the informed consent.DNA of pathogens was extracted from the samples using QIA-amp minikit,and the conserved sequence with 366 bp at hexon protein coding region was amplified by PCR and sequenced subsequently to determine the infected adenovirus and their subtypes.These samples were simultaneously assayed by HMA,and the outcomes between DNA sequence and HMA were compared.Results Extracted DNA presented a yellow fluorescence band with the fragment size 35 kb and absorbance ratio at the wavelength 260 nm and 280 nm (A260/A280) was I.7.In the 214 samples,AdV type 1 (AdV1) was found in 4 samples,AdV2 in 33 samples,AdV3 in 15 samples,AdV4 in 12 samples,AdV8 in 19 samples,AdV19 in 15 samples and AdV37 in 8 samples.HMA showed the same outcome for the identification of AdV1,AdV2,AdV3,AdV8,AdV19 and AdV37 with direct DNA sequence.AdV4 was not feasible to HMA owing to 59.6％ (over 10％) mutation sites.Conclusions Direct DNA sequencing for conserved regions in coding sequence of hexon is an important way to identify causing-disease adenovirus subtypes in the patients with epidemic keratoconjunctivitis.HMA can offer a consistent result with the DNA sequencing,and it might be used as a suitable tool for large-scale molecular epidemiology researches.