BACKGROUND:Percutaneous vertebroplasty technique has become an effective means for clinical treatment of spinal osteoporotic fractures, but there is the risk of bone cement leakage.
OBJECTIVE:To explore the clinical effect of percutaneous vertebroplasty with low-dose bone cement for acute osteoporotic vertebral compression fractures.
METHODS:From September 2008 to February 2011, 32 patients with osteoporotic compression fractures were treated by percutaneous vertebroplasty. According to the dose of bone cement, the patients were divided into low dose group (2-4 mL) and routine dose group (4-6 mL). In addition, another patients who were hospitalized over the same period for acute osteoporotic compression and could not receive vertebroplasty due to urgical contraindication served as control group.
RESULTS AND CONCLUSION:The pain relief and vertebral height restoration rate of the low dose group and routine dose group were significantly better than the control group (P<0.05). The bone cement leakage rate and last fol ow-up incidence of adjacent segment vertebral fractures of the low dose group were also significantly lower than those in the routine dose group (P<0.05). Vertebroplasty with modified low dose bone cement can achieve satisfactory clinical effects, and effectively reduce the leakage of bone cement and incidence of adjacent segment secondary fractures.

This study represents the first description of structural variations in the globin beta chains of 19 strains of inbred mice. The trypic pep tide mapping of beta chains of globin from BALB/c, BALB/cA, BALB/cJ, BALBcJ-nu, BALB/nu/ + ,BALB/cyJax,B10,B10A/sui,C57BL/6,C57BL/10snJ,SMMC/B,SMMC/C, C3H/He, CFW, DBA/2,SWI,Swars/nu/+,SSB and 129/sv strains of mice was established. The results showed that the position of peptide spots upon fingerprint mapping of beta chains was obviously different in comparison with each other. The different patterns of variability and polymorphism found in the various mouse species may then have come into being as a consequence of the action of selective forces on the various new beta chains which were created by some exchange processes.

Objective To study the action of the lymphangial immunochemotherapy on the advanced stomach cancer. Methods Group of therapy: To inject the chemotherapeutic medicine and biological response modifiers (BRM) absorbed by active carbon through the stomach mucosa by means of gastroscope and through the stomach serosa by means of surgical operation. Group of contrast: To inject the aqueous solution of the chemotherapeutic medicine and BRM through the arteria femoralis by means of the intervention. Then we examined the immune activity of the blood cell.Results There is a marked difference between the lymphangial immunochemotherapy and the blood immunochemotherapy in the immune activity of the blood cell. Conclusion The lymphangial immunochemotherapy can promote the apoptosis of the transferred cancer in the lymph system and enhance the immune activity of the blood cell.

Inhibitors of epidermal growth factor have played an important role in the treatment of oncology.One of the most common adverse effects is aeneform eruption.This article reviews the incidence,clinical manifestation, mechanism and management for acneform eruption which related to inhibitors of epidermal growth factor.

Objective: To clone and express the preferentially expressed antigen of melanoma (PRAME) gene in E.coli. Methods: The cDNA encoding human PRAME gene was extracted from human AML cell line HL-60 and amplified by RT-PCR, then the PRAME gene was inserted into plasmid PGEM-T-easy. After sequenced, it was cloned into the prokaryotic expression vector pGEX-4T-2 to construct a clone with high level expression and the recombinant plasmid was cloned in E.coli. Results:The protein product reached the highest level at 5 h after IPTG induction. Conclusion: Since PRAME is only expressed at low levels in a few normal tissues and encodes an antigen recognized by autologous cytotoxic T lymphocytes, while expressed at high levels in patients with leukemia, it might be a new targeting candidate for tumor immunotherapy.

Objective To explore the clinical effect of low-dose bone cement injection in percutaneous vertebroplasty for treating osteoporotic vertebral compression fractures .Methods 41 cases of osteoporotic vertebral compression fractures from February 2009 to February 2012 were treated with percutaneous vertebroplasty .The patients were divided into the low-dose group and the conventional dose group according to the amount of bone cement injection .The postoperative VAS score ,cement leakage rate ,verte-bral height restoration degree and incidence rate of adjacent segment fracture were observed ,evaluated and compared .Results The follow-up period ranged from 3 months to 15 months(average 11 .2 months) .The postoperative pain relief effect in the conventional dose group and the low dose group was similar .The vertebral height restoration rate of the conventional dose group was superior to that of the low-dose group .In the aspects of the bone cement leakage rate and adjacent segment vertebral secondary fracture ,the low-dose group was superior to the conventional dose group .Conclusion In the procedure of percutaneous vertebroplasty ,applying the low-dose bone cement injection can reach the satisfactory clinical effect ,at same time can effectively reduce the complication oc-currence rate of bone cement leakage and adjacent segments secondary fractures .

With the increasing of doctor-patient conflicts,the communication between them gradually becomes a critical element in medical service activities.How to improve the doctor-patient communication is an important content in resident communication skill training.Oncology is a developing discipline with fast development and high risk and residents in oncology department need more communications with patients in the era which individualized treatment is emphasized.Systematization and institutionalization of the training system of doctor-patient communication is beneficial to popularizing doctor-patient communication experiences,protecting the rights and interests of them and ensuring the smooth process of medical treatment.

Objective To evaluate the accuracy of Cr measurement value from commonly used homogenous detection systems,to investigate the variation among different systems and the corresponding bias of eGFR.Methods According to the CLSI EP14-A2 protocol,commutability of LN24 was validated among 10 enzymatic assays and 1 picrate assay.LN24 included 6 vials of solution with Cr values assigned by IDMS at NIST,and concentrations of Cr for each vial were 68.1,126.9,185.7,244.5,303.2 and 361.9μmol/L LN24 was used to evaluate the accuracy of the included systems and the variation among them,and the assigned values were taken as the target values.eGFR were calculated by MDRD equation using IDMStraced picrate Cr and CKD-EPI equation using enzymatic Cr.Results Commutability was exist among the 11 systems for LN24 detection.Four systems showed bias ＜ 4.4 μmol/L at each level of LN24,two system showed bias ＞4.4 μmol/L at each level of LN24,one system showed a fixed negative bias( -4.2 ±0.7)μ mol/L,the other 4 systems showed diverse bias at different levels.Cr-bias-caused eGFR bias could reach 14.9 ml · min-1 · (1.73 m2) -1 at Cr level of 68.1 μmol/L SD among systems ascended with Cr level (2.6 -6.1 μmol/L) ;CV among systems descended with Cr level(4.0％ - 1.7％ ) ;After the 2 systems with obvious negative bias were removed,SD,CV among systems and eGFR bias decreased obviously.By measuring fresh serum,it was found that Cr bias among enzymatic systems was mostly ＜ 10 μmol/L;that between enzymatic assays and picrate assay was much diffused(from - 15 to 20 μmol/L).When Cr ＜ 100μmol/L,the eGFR difference between result of MDRD equation and that of CKD-EPI equation ranged from - 18 to 40 ml · min-1 (1.73 m2) -1.Conclusions Some enzymatic systems show good accuracy.Difference of Cr value is relatively fixed among enzymatic systems,and comparability can be reached through mathematic way.Un-acceptable difference between picrate assay and enzymatic assays still exists,thus comparability cannot be reached through mathematic way.At low Cr level,bias of Cr and using different equations may lead to significant bias of eGFR.We recommend that clinical laboratory should pay much attention to the accuracy and comparability at low level of Cr,and use uniform equation to calculate eGFR.

Background and purpose: Although crizotinib could manifest marked antitumor activity in anaplastic lymphoma kinase (ALK)-rearrangement-positive non-small cell lung cancer (NSCLC) patients, but brain metastases is always occured in such patients. This study aimed to explore the efifcacy and treatment mode of crizotinib for brain metastases in ALK-rearrangement-positive NSCLC. Methods: The clinical data of 6 patients with brain metastases in ALK-rearrangement-positive NSCLC treated in 81 Hospital of PLA from Jan. 2011 to Aug. 2014 were analyzed retrospectively. Results: Three patients had brain metastases before crizotinib administration, 1 obtained partial response (PR) and 2 obtained stable disease (SD) in intracraninal tumors. The median progression free survival (PFS)for the ifrst period of crizotinib administration were 5.7 months, and the sites of ifrst disease progression were brains. All the 6 patients continued to receive crizotinib after radiotherapy with the median PFS of 4 months. One patient even experienced a median PFS of 23.3 months for the second period of crizotinib administration, and her brain tumors obtained complete response (CR). Conclusion:The data of this study suggest that crizotinib is effective for brain metastases in ALK-rearrangement-positive NSCLC, and continued administration of crizotinib after radiotherapy for isolated intracraninal tumor progression is a elective treatment option for such patients.

Background and purpose:Alpha fetoprotein (AFP)-producing gastric cancer (AFPGC) is considered to be a special type of gastric cancer. Currently, the effect on AFPGC is not as good as the common AFP-
negative gastric cancer. Therefore, it is very important to explore clinicopathological features of AFPGC cancer, to improve diagnosis and individualized treatment. This study is to investigate the expressions of hepatocyte growth factor receptor c (c-Met), vascular endothelial growth factor (VEGF), epidermal growth factor receptor (EGFR), human epidermal growth factor receptor 2 (HER-2) in the AFPGC.Methods:A total number of 44 cases of AFPGC (serum AFP≥10 μg/L) tissues were selected as a test group. There were 30 cases of serum AFP≥200 μg/L. This study collected 30 cases of gastric cancer with normal AFP and 30 cases of hepatocellular carcinoma with increased AFP (serum AFP≥200 μg/L) as 2 control groups. The cases of the 3 groups had the same clinical stage basically. The expressions of c-Met, VEGF, EGFR and HER-2, CD34 were detected by immunohistochemistry (EnVision staining method). Tumor microvessel density (MVD) was calculated by marking CD34, and the results were analyzed. The clinicopathologic parameters were recorded accurately: gender, age, highest level of serum AFP, tumor differentiation, tumor stage, tumor location, lymph node metastasis, liver metastasis, Lauren classiifcation, etc. These patients were followed up regularly. The clinical pathological features of AFPGC patients were investigated.Results:AFPGC clinical characteristics showed that, among 44 cases of AFPGC group, 86.36% (38/44) had lymph node metastasis, 54.55% (24/44) had hepatic metastasis, intestinal type was 36.36% (16/44), diffuse type was 56.82% (25/44), mixed type was 6.82% (3/44). The positive expression rates of c-Met protein in AFPGC, gastric cancer with normal AFP, hepatocellular carcinoma with increased AFP were 73.33% (22/30), 70.00% (21/30) and 53.33% (16/30), respectively. The positive expression rates of VEGF protein were 76.67% (23/30), 56.67% (17/30) and 66.67% (20/30), respectively. The positive expression rates of EGFR protein were 53.33% (16/30), 40.00% (12/30) and 73.33% (22/30), respectively. The “++ and +++” expression rates of HER-2 in AFPGC, gastric cancer with normal AFP and hepatocellular carcinoma with increased AFP were 38.64% (17/44), 23.33% (7/30) and 26.67% (7/30), respectively. The MVD values in AFPGC, gastric cancer with normal AFP and hepatocellular carcinoma with increased AFP were 23.03±10.24, 21.92±11.45 and 19.43±7.83, respectively. Compared with gastric cancer with normal AFP, expression of VEGF protein was signiifcantly higher in the AFPGC (P<0.05). Compared with hepatocellular carcinoma with increased AFP, the expression of c-Met protein was significantly higher in AFPGC (P<0.05).Conclusion:AFPGC is prone to lymph node metastasis and hepatic metastasis. The major part is the diffuse type in Lauren classiifcation. The positive expression rates of VEGF protein in AFPGC were signiifcantly higher than the gastric cancer with normal AFP. The positive expression rates of c-Met protein in AFPGC were signiifcantly higher than the hepatocellular carcinoma with AFP increased.