[Objective]To assess the efficacy of one-stage allograft fusion and anterior spinal stabilization as an alternative treatment of lumbar leaping tuberculosis.[Methods]Eight patients with lumbar leaping tuberculosis underwent anterior route decompression and fusion.Combined chemotherapy was delivered to each patient at least three weeks before operation.There were 5 men and 3 women ranging in age from 21 to 62 years(average,37.2 years).The involved area included L1 and L3 in 2 patient,L1、2and L4 in 3 patient,L2、3and L5 in 1 patient,L2 and L5 in 2 patients.There were 1 patient with Frankel Grade B,2 with Grade C,1 with Grade D and 4 with Grade E.The kyphosis angle ranged from 5?～40?(average 21.5?).The patients were followed up for 12～24 months.[Results]The patients folerated operation well.The operation time were 120～180 min and the bleeding during operation were 400～900 ml.After surgery,pain reliefed in all patients.One patient in Grade B improved to Grade C,1 patient in Grade C improved to Grade D,1 patient in Grade C improved to Grade E,1 patients in Grade D improved to Grade E.The mean angle of kyphosis correction were 5?～20?(average angle:12.5?).There was no postoperative complication.During the follow-up period,all cases healed without any recurrence.There was no breakage of nails or fall of the internal fixation.Spinal fusion occurred after 4～7 months(average 5.3 months) after operation.[Conclusion]Lumbar leaping tuberculosis treated with this surgical technique can achieve a high satisfactory rate with advantages of restoring the spinal stability,providing early fusion,preventing and correcting progression of the kyphosis.

Objective To investigate the clinicopathologic features and prognostic analysis of intrahepatic mucinous cholangiocarcinoma (IMCC) and intrahepatic cholangiocarcinoma (ICC).Methods The retrospective cohort study was adopted.The clinicopathological data of 20 patients with IMCC and 51 patients with ICC who were admitted to the Fujian Provincial Hospital from March 2003 to March 2014 were collected.The observation indicators included (1) clinicopathologic features:gender,age,clinical symptoms (fever,jaundice,abdominal pain and peritoneal effusion),preoperative laboratory examination [alanine transaminase (ALT),aspartate transaminase (AST),direct bilirubin (DBil),carcinoembryonic antigen (CEA),CA19-9 and alphafetoprotein (AFP)],operation methods (radical resection,palliative resection) and pathological features (tumor location,lymph node metastasis,vascular invasion and pathological stage).(2) The follow-up of outpatient examination and telephone interview was performed to detect the survival of patients up to March 2015.Measurement data with normal distribution were represented as x-± s and comparison between groups was analyzed using t test.Count data were analyzed using the chi-square test.The survival curve was drawn by Kaplan-Meier method,and the survival rate was analyzed using the Log-rank test.Result The numbers of patients with fever,jaundice,elevated level of AST and DBil,lymph node metastasis,vascular invasion and numbers of patients with stage 0,Ⅰ,Ⅱ,Ⅲ,Ⅳ were 13,11,10,11,3,1 and4,6,2,6,2 with IMCC,12,10,9,2,22,36 and 0,14,5,3,29 with ICC,respectively,showing statistically significant differences in the above indicators (x2=10.830,8.639,7.672,25.059,8.036,24.765,26.601,P ＜ 0.05).All the patients were followed up for a median time of 14 months (range,1-118 months).The survival time and 1-,3-,5-year survival rates were (55 ± 8)months,94.4％,44.0％,16.7％ in 20 patients with IMCC and (30 ±6) months,36.5％,12.5％,4.0％ in 51 patients with ICC,respectively,showing a statistically significant difference (x2 =8.126,P ＜ 0.05).Conclusion The patients with MICC are more easily complicated with fever,jaundice and liver dysfunction,while they have less lymph node metastasis and vascular invasion,earlier pathological stage and better prognosis compared with patients with ICC.

Objective To study the expression and enzyme activity of thioredoxin reductase 1 (TrxR1) in liver and peripheral blood of human and rats exposed to airborne arsenic through coal-burning as well as its role in liver injury of coal-burning-borne arsenic poisoning.Methods This study was divided into 2 parts.Part 1 was a population study:133 local residents exposed to airborne arsenic through coal-burning were selected as arsenic exposure groups including a non-patient group (25 cases),no obvious hepatopathy group (38 cases),mild (43 cases) and moderate to severe hepatopathy groups (27 cases) from areas affected by endemic arsenism in Guizhou Province.Thirty-four healthy residents from arsenic not affected areas were selected as controls.Peripheral blood samples were collected from all these people.The expression of TrxR1 mRNA was determined by real-time fluorescence quantitative PCR (qPCR),and enzyme activity of TrxR was tested by visible spectrophotometry.Part 2 was an animal experiment study:Thirty Wistar rats,weighing about 80-100 g,were divided into control group,drinking-waterborne arsenic poisoning group and coal-burning-borne arsenic poisoning group (including low,medium and high arsenic contaminated grain groups) by means of a table of random number according to body mass,6 rats in each group.The control group was fed with normal diet for 3 months; drinking-water-borne arsenic poisoning group and coal-burning-borne arsenic poisoning group were fed with 10 mg/kg As2O3 solution and different concentrations(25,50,100 mg/kg) of arsenic-containing feed,respectively,for 3 months.The expression of TrxR1 mRNA was determined by qPCR; protein expression level of TrxR1 in liver tissue was detected by immunohistochemistry,and enzyme activity of TrxR in serum and liver tissue was tested by visible spectrophotometry.Results The mRNA expressions of TrxR1 in peripheral blood were 1.599 8 (1.128 9-2.156 8),1.469 3 (1.146 1-1.976 3),1.203 6 (0.463 1-1.816 2) and 0.912 3(0.631 8-1.535 0),respectively,among non-patient group,no obvious hepatopathy group,mild and moderate to severe hepatopathy groups.Compared to the control group[1.649 7(1.161 1-2.380 2)],the differences were significant statistically in mild and moderate to severe hepatopathy groups (all P ＜ 0.05).The enzyme activity of TrxR in peripheral blood was (3.12 ± 0.76),(2.81 ± 0.84),(2.52 ± 0.73),(2.42 ± 0.76)U/ml,respectively,in those corresponding groups.Compared to the control group [(3.02 ± 0.70)U/ml],the differences were significant statistically in mild and moderate to severe hepatopathy groups (all P ＜ 0.05).The mRNA expressions of TrxR1 in peripheral blood were 1.05 ± 0.14,1.18 ± 0.18,1.04 ± 0.10 and 0.97 ± 0.13,respectively,among drinking-water-borne arsenic poisoning group,low,medium and high arsenic contaminated grain groups; all of which were lower than that in the control group (1.23 ± 0.15,all P ＜ 0.05) except that of the low arsenic contaminated grain group.The mRNA expressions of TrxR1 in liver tissue were 0.78± 0.10,0.83 ± 0.10,0.79 ± 0.09 and 0.77 ± 0.11,respectively; all of which were lower than that in the control group (0.94 ± 0.12,all P ＜ 0.05).The protein expression of TrxR1 in liver tissue was 310.33 ± 38.81,312.50 ± 23.36,305.67 ± 20.57 and 298.17 ± 23.52,respectively,among the arsenic poisoning groups; all of which were lower than that in the control group (348.50 ± 32.35,all P ＜ 0.05).The enzyme activity of TrxR in serum was (4.22 ± 0.73),(4.86 ± 0.63),(4.04 ± 0.57),(3.73 ± 0.64)U/ml,respectively; all of which were lower than that in the control group [(9.52 ± 1.08)U/ml,all P ＜ 0.05].The enzyme activity of TrxR in liver tissue was (14.82 ± 1.67),(18.76 ± 2.76),(14.90 ± 2.17),(11.55 ± 1.74) U/mg,respectively; all of which were lower than that in the control group [(23.71 ± 3.05)U/mg,all P ＜ 0.05].Conclusion Arsenic aggravates liver injury of coal-burning arsenic poisoning through down-regulating the expressions of TrxR1 mRNA and protein and reducing its enzyme activity as well.

Objective: TO evaluate the effect of custom-made artificial total knee prosthesis replacement on pathological fracture of distal femur caused by giant cell tumor of bone. Methods." A total of 12 knees of 12 patients with pathological fracture of distal femur caused by giant cell tumor of bone were treated with cus-tom-made artificial total knee prosthesis replacement. There were 5 males and 7 females aged from 23 to 40 years (34.2 years on average). Results: All patients tolerated surgery very well. The surgical duration was 120～ 180 rain and the intraoperative bleeding was 500 ～ 900mL. The drainage tube was taken out in 5 days after surgery. The postoperative drainage volume was 300 ～ 700mL. There were no postoperative complica-tions. The postoperative X-ray examination showed that all of the prosthesises were in the right position. Lo-cal pain disappeared in all patients after surgery. The pathological examination identified all the patients with giant cell tumor of bone. All patients were followed up for 18 ～ 30 months (24 months on average). No recur-rence was observed after surgery. No infection or implant loosening occurred during the follow up. According to the Enneking assessment system of function after limb salvage surgery, the mean Enneking scale was 23.8 points (ranged from 15 to 28 points) at the last follow-up visit. Conclusion: Custom-made artificial total knee prosthesis replacement can achieve a high satisfactory rate in clearance of lesion and restoring function of the knee in patients with pathological fracture of distal femur caused by giant cell tumor of bone, improving patients' quality of life.

Pender′s health promotion model explains the factors influencing health behaviors, which provides a framework for nursing practice and research. Functional exercise compliance in postoperative patients with breast cancer was in a low level, this article reviewed factors influencing functional exercise among breast cancer survivors through three aspects based on health promotion model and made some suggestions on nursing intervention, to promote the rehabilitation of this population.

This device is an apparatus which can remove intracranial hematoma rapidly and offer a mild damage to the brain tissue.So,with the device,the hematoma which cased by hypertensive cerebral hemorrhage can be removed effectively,and the damage caused by cerebral hemorrhage can be lighten,and the mortality can be reduced,This device is making up of overcoat tube,rotation-sucking tube,guide tube,and spray tube,which can be used for rotating broken suction and multidirection spraying washing.Used clinically to treat more than 400 patients with hypertension cerebral hemorrhage,the device can lighten space occupying effect of intracranial hematoma rapidly,and thus many patients are saved.It's indicated this device is the most effective device for removing brain hematoma at present.

Objective To investigate clinical value of levels of CA125 and LPA as a panel for early diagnosis of ovarian cancer.Methods The levels of two tumor markers(CA125 and LPA)in serum were determined in 76 patients with ovarian cancer,35 patients with benign tumor and 29 healthy control.Results The results showed that the levels of two tumor markera in ovarian cancer patients were significantly higher than those in benign tumor patients and controls(P＜0.05).Butuo siguificant difforences was loud betwcen benigutumor patient and coatrols.Conclusion Combined detection of the two markers represent a potential biomarker for diagnosis of epithelial ovarian cancer because of its diagnostic accuracy in ovarian cancer case.

ObjectiveTo investigate the effect of Tongxinluo by the dynamic changes of the expression of matrix metalloproteinase-9(MMP-9) on local cerebral ischemic-reperfusion injury in rats.MethodsMale Wistar rats were randomly divided into sham-operated control group, normal saline control groups (24-hour and 5-day) and Tongxinluo treatment groups(24-hour and 5-day). Animals in the latter four groups were subjected to focal ischemia by filament occlusion of the middle cerebral artery for 90 min. At the different end point, the expression of MMP-9 were assayed using immunohistochemistry staining method. ResultsCompared with the control groups, the expressions of MMP-9 were significantly decreased in both 24-hour and 5-day Tongxinluo treatment groups(P<0.05).ConclusionThe protective effects of Tongxinluo on cerebral ischemia reperfusion injury may be mediated by pharmacological inhibition of MMP-9 activity.The protective effects of Tongxinluo on cerebral ischemia reperfusion injury may be mediated by pharmacological inhibition of MMP-9 activity.

Objective To study the expression and significance of apoptosis-related genes caspase-3,caspase-9,Bax and Bcl-2 in oral normal mucosa,oral simple hyperplasia,oral epithelial dysplasia and oral squamous cell carcinomas (OSCC) in Chinese hamsters.Methods The expressions of mRNA and protein of caspase-3,caspase-9,Bax and Bcl-2 in the oral normal mucosa,oral simple hyperplasia,oral epithelial dysplasia and OSCC tissues in Chinese hamsters were examined by immunohistochemistry and RT-PCR.Results During the process of oral carcinogenesis,the expression of Bcl-2 protein was significantly higher in OSCC than in oral normal mucosa,oral simple hyperplasia,and oral epithelial dysplasia (P<0.05).In dysplastic epithelia,the protein expressions of caspase-3,caspase-9 and Bax were more than that of normal epithelia,and along with the increased dysplasis,the expression level was decreased.Further analysis showed that expression of Bcl-2 was negatively related with the expressions of Bax,caspase-3 and caspase-9 (P<0.05).The result of RT-PCR showed that Bcl-2 was significantly increased in OSCC compared with normal mucosa,while the expressions of caspase-3,caspase-9 and Bax were decreased (P<0.05).Conclusions In the Chinese hamster squamous carcinoma,the expressions of caspase-3,caspase-9 and Bax are reduced and the Bcl-2 expression are increased,indicating that the expressions of caspase-3,caspase-9,Bax and Bcl-2 are closely related with the occurrence and development of oral squamous cell cancinoma.This study can offer some clues for gene therapy of OSCC,or can provide a reference for evaluating the biological characteristics and prognosis of OSCC.

Objective To investigate the gene expression of PIWIL2 in the bladder urothelial carcinoma (BTCC) and siRNA interact on PIWIL2 gene expression in human bladder cancer cell line BIU-87.Methods Semi-quantitative reverse transcription polymerase chain reaction (qRT-PCR) was applied to detect the PIWIL2 expressions in tissues of BTCC (46 cases),cystitis glandularis(21 cases),adjacent non-cancerous tissues (17 cases) and normal bladder tissues (7 cases). 3 specific siRNA targeted PIWIL2 gene were synthesized after designed and transferred. After siRNA was transferred into BIU-87 cells, MTI and TUNEL methods were applied to detect the proliferation inhibitory rate (IR) and apoptosis index (AI) in BIU-87 cells,qRT-PCR and Western blot were used to examine effects of siRNA on the expressions of the PIWIL2 gene and protein,respectively.Results The expression rate of PIWIL2 mRNA in BTCC tissues was 76.08 ％(35/46) and significantly higher than those in the cystitis glandularis tissues (42.86 ％,9/21),adjacent non-cancerous tissues (41.17 ％,7/17) and normal tissues (7.14 ％,1/14) (P =0.008,P =0.010,P =0.000).The IR [(37.52±8.84) ％,(64.36±9.64)％] and (62.94±8.43) ％] and AI [(26.18±5.42) ％,(38.75±6.19) ％ and (40.02±5.64) ％] of BIU-87 cells in the siRNA 1～3 groups were respectively significantly higher than those [(1.97±0.02) ％ and (3.35±0.47) ％] in the control group(P=0.000),and expressions of PIWIL2 mRNA and protein in the siRNA groups were both lower than those in the control group. Moreover, the effects of siRNA 2 group and siRNA 3 group on inhibiting PIWIL2 expression, IR and AI of BIU-87 cells were stronger than siRNA 1 group. Conclusion The over-expression of PIWIL2 suggested that it played an important role in the mechanism of development and malignant progression of BTCC. The siRNA of transcription can significantly inhibit its expression, induce cell apoptosis and inhibit the growth of BIU-87 cells which might provide the experimental evidence for the gene targeting therapy of bladder tumor.