Limb salvage surgery with comprehensive treatment is the standard care for soft tissue sarcoma in the limbs and trunk. Marginal status is a key factor in determining the quality of surgical treatment, as well as in guiding the selection of adjuvant therapies. The goal of surgery is to obtain an appropriately negative margin, although no consensus exists regarding the adequate thickness of normal tissue cuff. With the development of auxiliary treatments, surgery for soft tissue sarcoma is becoming less extensive. Marginal resection combined with adjuvant therapies may be necessary to preserve limb functions when the tumor is close to critical vessels, nerves, or bones. When preparing the preoperative plans, additional considerations should include histologic type, location, presence of barriers, and response to adjuvant therapies.

Sentinel lymph node biopsy has a very important function in the accurate staging, diagnosis, and treatment of malig-nant melanoma. The operational technique of sentinel lymph node biopsy (SLNB) has been basically mature, but its indications remain unclear, especially for thin melanomas. Adequate evidence to show that SLNB combined with a complete lymph node dissection can prolong the survival of patients with metastasis is unavailable. Given the low incidence of malignant melanoma in the country, the use of SLNB has not been extensively investigated in China and the relevant methods are outdated. This review summarizes the current ap-plication of SLNB in cutaneous malignant melanoma by analyzing related studies conducted in recent years.

Objective To investigate the significance of testing serum homocysteine for renal transplant patients .Methods 445 renal transplant patients from outpatient follow‐up(renal transplant group) and 100 healthy subjects(control group) were enrolled in the study ,whose serum homocysteine(Hcy) ,Cystatin C(CysC) ,creatinine(Cr) were tested .Then according to the eGFR(refered to the principle of NKF‐K/DOQI) patients of renal transplant group were divided into six subgroups .Serum levels of Hcy and Cr were compared among different groups ,and the relationship between serum Hcy concentration and anti‐rejection drugs were ana‐lyzed .Results In the transplant group ,concentrations of Hcy were obviously higher than that in control group(P<0 .05) .There was no significant difference in Hcy concentrations among renal transplants who had taken different anti‐rejection drugs(P>0 .05) . Concentrations of CysC and Cr were significantly associated with Hcy in renal transplant group(r=0 .481 ,0 .456 ,P<0 .05) .There was significant difference between eGFR≥90 subgroup and control group in CysC concentration(P<0 .05) .Conclusion Concen‐tration of Hcy in renal transplant group was obviously higher than that in control group .With the eGFR decreased ,Hcy increased gradually ,and in transplant group was associated with the concentration of CysC and Cr .There was significant difference between eGFR≥90 subgroup and control group in Hcy and CysC concentrations(P<0 .05) .The different anti‐rejection drugs had no effect on serum Hcy levels .

With the development of Chinese education system, academic students in medical university can not meet the demand of current social development. The combination of teaching and research ideas should run through the whole teaching process, which is an important approach to bring up innovative talents. This article focuses on teaching process of rehabilitation medicine, and how to run research ideas through each sections of rehabilitation medicine. Research ideas begins with teaching, shaped in clinical practice, and being applied for clinical work. That is just the right thinking for cultivating outstanding medical specialists in the 21st century.

Objective: To explore the role of integrin ?v?6 in proliferation and apoptosis of gastric cancer AGS cells. Methods: Gastric cancer AGS cells were treated with ?v?6 monoclonal antibody 10D5 or the negative control mouse immunogloblins IgG2a. Cell viability was measured by MTT assay, cell apoptosis was detected by FCM, and caspase-3 activity was examined by Western blot. Results: Compared with the control and IgG2a group, the apoptotic rate and caspase-3 activity of AGS cells treated with 10D5 increased, meanwhile cells survival rate decreased. There were significant differences of the indexes between the 10D5 group and the other two groups (P0.05). Conclusion: Integrin ?v?6 plays an important role in the proliferation and apoptosis of gastric cancer AGS cells.

Objective To explore the role of integrin αvβ6 in mediating the tolerance of gastric cancer AGS cells to 5-fluorouracil, and to determine whether direct β6-extracellular signal-regulated protein kinase(ERK) binding is involved. Methods Gastric cancer AGS cells in the logarithmic phase were incubated with either 5-fluorouracil for 24 hours ( control group), with 0.1 g/L of mouse anti-αvβ6 monoclonal antibody 10D5 for 6 hours and then with 5-fluorouracil for24 hours ( 10D5 group), with IgG2a and 5-fluorouracil ( IgG2a group), or with 5-fluorouracil and 20 μnol/L of ERK inhibitor PD98059 for 24 hours ( PD98059 group). Cell proliferation,apoptosis and the expression of Bcl-2 and caspase-3 protein were detected by MTT assay, flow cytometry and western blotting, respectively. All data were analysed by one-way analysis of variance and LSD test. Results The cell inhibition rates of the control group, 10D5 group, IgG2a group and PD98059 group were 28.1% ±2.7%,84.5% ± 1.6%, 31.4% ±5.2%, 86.7% ±5.2%, respectively, with a significant difference ( F = 342. 5, P ＜0.05). The apoptosis rates of the control group, 10D5 group, IgG2a group, and PD98059 group were 6.6% ±1.4%, 30.6% ± 2.4%, 8.1% ± 1.3%, 36.0% ±4.0%, respectively, with a significant difference among the four groups (F = 105.4, P ＜0.05 ). There was a significant difference in the expression of caspase-3 and Bcl-2 among the four groups (F=292.1, 181.6, P＜0.05). Conclusion Integrin αvβ6 can mediate the tolerance of gastric cancer AGS cells to 5-fluorouracil through direct β6-ERK binding.

Objective:To explore the outcome of soft tissue sarcoma (STS) on patients with soft tissue metastasis. Methods:We ana-lyzed 25 STS patients with soft tissue metastasis primarily localized on extremity and trunk. The study was conducted from June 2010 to June 2016 by retrospective analysis of the clinical and pathological characteristics of the patients. The assessed endpoints were overall survival. Results:Six patients (24%) had synchronous soft tissue metastasis, and 19 patients (76%) had metachronous metasta-sis. The average time for primary tumor recession of metastatic lesions was 45.3 months. Metastases were most common in parts of the trunk in 18 patients (72%), followed by the head and neck in 5 patients (20%). Eleven patients (44%) with lung metastasis had poor prognosis. Conclusion:STS occurred more rarely in soft tissue metastasis than in pulmonary metastasis. Neoadjuvant chemotherapy and surgical treatment were the major therapies employed. Targeted therapy as a new treatment rendered good results.

Objective Through studying the relationship between different concentrations of arsenic in drinking water and ECG changes,to investigate the effects of arsenic on human cardiovascular system.Methods During 2008-2013,people that over 20 years old and over 10 years of drinking arsenic water were investigated in 15 villages of Shanxi Province and Inner Mongolia according to the historical data of endemic arsenic poisoning through drinking water,who were divided into control group (＜ 0.01 mg/L),low arsenic group (0.01-＜ 0.05 mg/L),medium arsenic group (0.05-＜ 0.10 mg/L) and high arsenic group (≥0.10 mg/L) according to the concentration of water arsenic.Arsenic concentrations in drinking water samples were detected by the method of hydride generation atomic fluorescence spectrometry.ECG-site inspections were finished to record 12-lead ECG.The effect of different concentrations of arsenic in drinking water on ECG was studied.Results ECG of 1341 people were surveyed,and abnormal rate was 11.56％ (155/1 341),including abnormal rate of control group,low arsenic group,medium arsenic group and high arsenic group which was 5.7％ (9/158),12.85％ (59/459),12.02％ (28/233),and 12.02％ (59/491),respectively.The abnormal rate of control group was lower than that of low arsenic group,medium arsenic group and high arsenic group (x2 =6.141,4.391,5.090,all P ＜ 0.05).ECG changes were characterized by cardiac arrhythmias and ST-T changes.A variety of arrhythmias abnormal rate of control group [0(0/158)] was lower than that of low arsenic group,medium arsenic group and high arsenic group [4.58％ (21/459),3.86％ (9/233),3.46％ (17/491); x2 =7.483,6.247,5.618,all P ＜ 0.05].In addition,there were significant differences among the four groups in the rates of right ventricular enlargement and myocardial ischemia (x2 =9.525,9.848,all P ＜ 0.05).Conclusions ECG changes of the residents in the areas of water-borne-endemic arsenic poisoning are characterized by cardiac arrhythmias and ST-T changes.Water arsenic concentration exceeding 0.01 mg/L could significantly increase the ECG abnormal rate,indicating that arsenic in drinking water has a certain effect on heart tissue.

BACKGROUND:Autologous bone graft is the best method to repair bone defects after tumor curettage, but its shortcomings are as folows: increased surgical trauma, sequelae at bone graft site such as infection and pain, and a limited amount of autologous bone. OBJECTIVE:To analyze the effectiveness of xenograft and calcium sulphate artificial bone in treating bone defects after benign bone tumor removed. METHODS:Totaly 26 cases of benign bone tumor were selected, including 8 cases of giant celltumor, 5 of enchondroma, 4 of fibrous histiocytoma, 3 of bone fibrous dysplasia, 2 of non-ossifying fibroma, 2 cases of bone cysts, 1 of aneurysmal bone cyst and 1 of aneurysmal bone cyst and 1 case of chondroblastoma. Of the 26 cases, 12 cases underwent calcium sulphate pelets alone to fil bone defects after benign bone tumor removed, 6 cases were subjected to xenograft alone, and 8 cases were treated with calcium sulphate pelets combined with xenograft. The X-rays were taken at 1 week, 3 months, and 1 year after the operation in al patients to assess the bone healing process. RESULTS AND CONCLUSION:Al the patients were folowed up for 36-72 months. The absorption of calcium sulphate appeared to be absorbed earlier, the earlier absorption appearance could be observed as earlier as 1 month after the implantation, and most calcium sulphate was absolved and replaced by new bone at 3 months after the operation. The xenograft bone was degraded at 3 months post implantation and new bone formed. Osseo integration of the graft was observed at the periphery of the implant at 6 months post implantation. One year post implantation, trabecular bone was observed at the site with uniform bone density. In the combined group, thecalcium sulphate pelets were absorbed earlier and new bone formed earlier than the calcium sulphate alone group, and the xenograft absorbed later than the calcium sulphate pelets. Generaly, bony union was detectable 1 year after operation. These findings indicate that xenograft and calcium sulphate in treating benign bone tumor have acquired good results, which can be used as a substitute of autologous bone.

In the present study, the total RNA was extracted from three instar larvae of Musca domestica, the cDNA sequence encoding the ORF of cecropins was amplified by RT-PCR, and the target fragment was further sequenced after being cloned into T vector pUCm-T. Then, the cDNA sequence of the mature cecropins was amplified by PCR with recombinant plasmid pUCm-T/cecropin as template, the N-terminal rare codon GGA of E. coli was changed to the favorable codon GGC,and a Asn codon AAC was added in front of the stop coden TAA in the C- terminus. This mutant gene designated as mCecropin was then ligated with the fusion expression vector pGEX-4T-1. After restriction analysis and DNA sequencing, the positive recombinant plasmid pGEX-4T-1/mCecropin was transformed to different strains of E. coli cells and the fusion protein was expressed after IPTG induction. The fusion protein was assayed by SDS-PAGE and the E. coli BL21(DE3) cell was chosen as the host cell for the expression of the fusion protein. The expressed fusion protein GST-mCecropin was purified by GSTrap affinity coloum and the GST marker was then cleaved by thrombin. In this way, the fusion protein mCecropin with antibacterial activity was obtained after purification with HiTrap benzamidine column.