Objective To compare the value for predicting prognosis between ENETS and AJCC TNM staging system in G-NEC patients.Methods Clinical data of 28 G-NEC cases from January 2005 to September 2015 in Tianjin Medical University General Hospital were analyzed and follow-up data were staged by he ENETS and AJCC TNM staging system.The survival curves were drawn using Kaplan-Meier method.Univariate analysis was performed by Log-rank test.Results Evaluated by ENETS TNM staging system on these 28 G-NEC patients,5 cases (18％) were classified at stage Ⅱ,20 cases (71％) were at stage Ⅲ,3 cases (11％) at stage Ⅳ,and significant difference in survival time was found between the three stages (P ＜ 0.05).By the AJCC TNM staging system,1 case (4％) was classified at stage Ⅱ,24 cases (86％) were at stage Ⅲ,and 3 cases (11％) at stage Ⅳ,and significant difference in survival time was found between three stages.Conclusions AJCC TNM staging system is more valuable for predicting prognosis of G-NEC,while the ENETS TNM staging system is more accurate in evaluating G-NEC biologic behavior.

BACKGROUND: The reaction of osteoblasts is important role in the reconstruction of osteocytes, and the mechanism of bone remodeling can be known from the cytological level through analyzing the mechanical reaction of osteoblasts under different loading.OBJECTIVE: To analyze the effects of low frequency vibration on the proliferation and differentiation as well as the matrix excretion of cultured human osteoblasts.DESIGN: A comparative observation.SETTING: Department of Orthopaedics, Nanfang Hospital of Southern Medical University.MATERIALS: The experiment was carried out in the laboratory of Nanfang Hospital from January to December in 2002. Human osteoblasts were isolated from the iliac cancellous bone of adults.METHODS: The osteoblasts were cultured for 48 hours, and then treated with low frequency vibration of 0.1, 0.2, 0.5, 2 and 5 Hz. The proliferation of the osteoblasts was detected with flow cytometry, and the activity of alkaline phosphatase (ALP) and content of osteocalcin were assayed by spectrophotometric methods and radioimmunoassay respectively.MAIN OUTCOME MEASURES: ① Effects of low frequency vibration on the ALP activity and osteocalcin excretion of osteoblasts; ② Effects of low frequency vibration on the proliferation of osteoblasts detected with flow cytometry.RESULTS: ① 0.2 and 0.5 Hz vibrations could markedly increase the ALP activity of osteoblast (P ＜ 0.01), but that of 5 Hz obviously decreased the ALP activity (P ＜ 0.01). 0.1 and 2 Hz vibrations had no obvious effects on the ALP activity of osteoblasts. ② 0.2 and 0.5 Hz vibration could significantly increase number of osteoblasts at S phase from 10.4% to 12.45% and 16.12%, and the proliferative index increased from 20.14% to 26.21% and 28.75%; 0.1 and 2 Hz vibration has not obvious effects in osteoblast proliferation index; 5 Hz vibration obviously decreased the proliferative index value to 13.22% (P ＜ 0.05). 0.1 and 2 Hz vibrations had no obvious effects on the proliferative index of osteoblasts (P ＞ 0.05). ③ 0.2 and 0.5 Hz vibrations could obviously increase the amount of osteocalcin excretion to 1.87 μg/L and 2.47 μg/L(P ＜ 0.05), but 2 and 5 Hz vibrations decrease the amount of osteocalcin excretion (P ＜ 0.05), and that of 0.1 Hz had no obvious effect on amount of osteocalcin excretion (P ＞ 0.05).CONCLUSION: Low frequency vibrations of 0.2-0.5 Hz could accelerate the proliferation and differentiation as well as the excretions of active materials of osteoblasts, and it plays an instructive role for low frequency vibration to treat fracture.

Objective To evaluate endoscopic minimally invasive surgery in the treatment of sphenoidal and ethmoidical mucoceles. Methods A total of 25 patients diagnosed as sinus mucoceles, 10 in the sphenoid sinus and 15 in the ethmoid sinus, were subjected in this study, who underwent endoscopic marsupialization in our department from 1998 to 2000. Postoperatively, the patients were followed from 1 to 3 years. Results All 25 sphenoidal and ethmoidical mucoceles were satisfactorily approached endoscopically, and operating cavities received satisfactory marsupialization. The symptoms were improved or relieved in 23 patients. None had significant complications. Conclusion Endoscopic minimally invasive surgery is a safe and valuable way in the treatment of sphenoidical and ethmoidical mucoceles.

Objective: To observe the effect of ginkgo biloba extract (GBE) (total ginkgo flavone 50% and qinkgolide 25%) on experimental hyperlipidemic quail.Methods: 60 quail were randomly grouped six:normal group, hyperlipidemic model group and low, middle and high dose GBE groups, as well as lipanthyl group. Except for the normal group, the other five groups were firstly given high fat food for two weeks. Then among them, three groups were treated with GBE(20mg/kg?d, 40mg/kg?d, 80mg/kg?d, respectively) by ig administration, and one group was given lipanthyl(25mg/kg?d)by ig administration as the positve drug, another group was received aqua destillata by ig administration as the hyperlipidemic model. The treatments were consecutively carried out for four weeks. At the end, the vena jugularis externa blood of all the quail was taken and the serum lipid level of each quail was tested.Results: GBE in low dose group could significantly decrease the levels of TC, LDL C( P

Purpose To investigate the value of 3.0T MR T1ρquantitative analysis in early detection of disc degeneration. Materials and Methods Conventional T2WI and T1ρwere collected in 35 healthy volunteers (male 16, female 19) on 3.0T MRI, and the classification of disc nucleus was performed by Pfirrmann classification. T1ρvalue of nucleus pulposus was measured and analyzed for the relationship among Pfirrmann classification, segmental and gender. Results There was a significant negative correlation between T1ρvalue and Pfirrmann grade (r=-0.542, P<0.001). T1ρvalue in L5/S1 segment (94.80±26.60) ms was significantly lower than that in L2/L3 (117.18±25.64) ms and L3/L4 (115.52±28.53) ms (P<0.01), and there was no significant difference among other segments (P>0.05);there was no gender differences among the T1ρvalue of each segment (t=0.006, 0.042, 0.797, 1.022, 0.038, P>0.05). Conclusion T1ρ value is closely related to the degree of disc degeneration, and T1ρimaging can be used as an objective, sensitive and effective tool for early detection of disc degeneration.

Objective To investigate the effects of nitric-oxide synthase inhibitor on matrix metalloproteinases (MMPs) expression in osteoarthritis (OA) cartilage by Luminex analysis,and to explore the mechanism of nitric-oxide synthase inhibitor on modification of the metabolism of OA cartilage.Methods Fifteen specimens of articular cartilage taken from the patients with OA were cultured and divided in two groups.The control group was those with no intervention.L-NIL group was co-cultured with NOS inhibitor L-NIL.After 72 h cultivation,the release of NO and the activity of NOS on OA cartilage were measured by Griess reaction and spectrophotometric methods.MMPs (MMP-1,MMP-2,MMP-3,MMP-9,MMP-13) expression was measured by Luminex analysis.Comparisons between groups were performed with paired sampies t test.Results After cultured for 72 h,spectrophotometric analysis showed high concentration of NO release[(216±47) μmol/L ] and high level of active NOS [(5.7±1.3)U/ml]in supernatants of the control,1 mmol/L concentration L-NIL could evidently reduce NO release [(55±20)μmol/L,P<0.01] and NOS activity [(1.7±0.7)U/ml,P<0.01 ].Luminex analysis demonstrated high MMP-1,MMP-2,MMP-3,MMP-9,MMP-13 expression in cartilages of the control group [respectively for (10.8±5.4)ng/ml,(9.2±3.3) ng/ml,[11.6±4.2 )ng/ml,(1.27±1.07)ng/ml,(3.6±1.3)ng/ml] and 1 mmol/L concentration L-NIL could evidently inhibit MMP-1,MMP-2,MMP-3,MMP-9,MMP-13 expression [respectively for (3.6±1.8)ng/ml,(2.3±1.2)ng/ml,(3.6±1.4)ng/ml,(0.65±0.21)ng/ml,(1.8+0.5)ng/ml,P<0.05 ].Conclusion Luminex analvsis has shown that NOS inhibitor can reduce NO release and NOS activity and modify metabolism of articular cartilage by inhibiting the over-expression of MMPs.

Objective To investigate the expressions of Smad3 and Smad7 in patients with ulcerative colitis(UC)and their relation with clinicopathology.Methods The expressions of Smad3 and Smad7 were measured by immunohistochemistry with SABC method in 60 UC specimens and 16 normal colonic tissues.The association of expressions of Smad3 and Smad7 proteins with clinical staging,lesion extent and pathologic grading were retrospectively analyzed.Results The expression of Smad3 was significantly lower in UC patients than in normal controls(P＜0.05),however,there was no relation between Smad3 expression and lesion extent(P＞0.05).There was a negative correlation between the expression of Smad3 and histological grade(r=-0.283,P＜0.05).The expression of Smad7 was significantly higher in UC patients than in normal controls,and its expression in active disease was higher than that in clinical remission(Z=2.097,P=0.036).There was a positive correlation between the expression of Smad7 and histological grade(r_s=0.453,P=0.000),and no relation between Smad7 expression and lesion extent(r_s=0.066,P=0.614).The statistical analysis showed a negative correlation between Smad3 expression and Smad7 expression(r=-0.420,P＜0.05).Conclusion The abnormal expressions of Smad3 and Smad7 are correlated with pathogenesis of UC.Furthermore.Smad7 may serve as marker for disease activity of UC.

Objective To study change of the declarative memory in patients with the calcification of the pallidum.Method The Chinese version of Wechsler Memory Scale(WMS-RC)test and dmwing forgetting curve were applied in 30 patients and 30 normal controls.Results There was no differences in the WMS-CR test's scores between the two groups.The patients had poorly memory preservation rate at the delays of 2 hours((64.10±0.87)%Vs(44.83±1.57)%,P<0.01),despite normal memory preservation rate over 30 mins and the similar slope after the delays of l day in the forgetting curve.There were negative correlations between the size of calcification and the memory preservation rate at the delays of 2 hours and 9 hours(r=-0.743,r=-0.483.P<0.01).Conclusion The results may reflect the effect of the pallidum on"slower confiolidation"declamtive memory process which aroused by a consequence of the repeated firing of hippocampal-neocortieal connections while the patients have normal memory encoding and retrieval.

Objective Short-segment fixation is one of the most commonly used methods for the management of thoracolumbar vertebral fractures.In this study, we compared the clinical effects of short-segment fixation via and across the injured vertebrae in the treatment of thoracolumbar vertebral fractures . Methods We retrospectively analyzed 75 cases of thoracolumbar vertebral fractures treated by short-segment fixation, 39 via the injured vertebrae (group A) and 36 across the injured vertebrae (group B).We obtained the pre-and post-operative anterior vertebral body height ratio (AVBHr) and sagittal Cobb angle, operation time, and intraoperative blood loss, and compared them between the two groups of patients . Results Compared with the baseline, the AVBHr and the sagittal Cobb angle were significantly restored after surgery in both groups A ([56.32 ±12.53] vs [85.76 ±11.48]%and [20.41 ±5.73] vs [8.72 ±5.34]°, P<0.05) and B ([57.67 ±13.81] vs [83.51 ±12.54]%and [19.87 ±5.76] vs [9.18 ±5.42]°, P<0.05).The last follow -up examinations showed the AVBHr and Cobb angle to be (81.74 ±10.38)% and (10.93 ±6.32)°in group A and (76.82 ±11.06)%and (15.42 ±6.14)°in group B (P<0.05), with statistically significant differences from the postoperative parame-ters in group B (P<0.05).However, no remarkable differences were found between the two groups in the operation time or intraopera-tive blood loss (P>0.05).The losses of the AVBHr and Cobb angle were (3.78 ±1.24)%and (2.25 ±1.06)°in group A, signifi-cantly lower than (6.69 ±2.52)% and (6.31 ±2.18)°in group B (P<0.05). Conclusion For thoracolumbar fractures, short-segment fixation either via or across the injured vertebrae can effective-ly improve the vertebral height and Cobb angle , but fixation via the injured vertebrae may achieve a better maintenance of correction .

Objective To understand the available preventive strategies of unplanned endotracheal extubation (UEX) among adult patients.Methods Twelve nurses were in-depth interviewed and data were processed and analyzed using categorization analysis method.Results Major themes were identified as follows:the incidence rate of UEX,tube fixation,efficacious physical restraint,appropriate sedation and training for younger nurses.Conclusions Nursing leaders should further standardize nursing process related to prevention of UEX,strengthen training for nurses,choose appropriate fixation method for patients and promote physical restraint and sedation care to prevent UEX and improve patient clinical outcomes.