BACKGROUND: Observation and comparison about space-occupying lesions due to herniated nucleus pulposus, as well as nerve root compression in lumbosacral disc herniation and manipulative therapy are easily available; however, there is still lack of related quantitative research regarding the internal pressure in herniated nucleus pulposus.OBJECTIVE: To observe the influence of the internal pressure in herniated nucleus pulposus on nerve root compression in patients with lumbosacral disc herniation.DESIGN: Case control study.SETTING: Bone Setting Therapeutic Center, the Air Force General Hospital of Chinese PLA.PARTICIPANTS: Totally 30 patients with lumbosacral disc herniation received operation in the Orthopedic Department of the Air Force General Hospital between October 2002 and December 2003; meanwhile, 15 patients with lumbosacral disc herniation received manipulative therapy in the Bone Setting Therapeutic Center of the same hospital.ing positive group and negative group according to the results of straight leg raising test. The pressure in herniated nucleus pulposus was detected during operation, and the straight leg raising height was also recorded beThe size of intervertebral disk herniated nucleus was presented by the maximum vertical distance from the intervertebral disk herniating apex to the posterior edge of vertebra on CT and/or MRI transverse section.raising height.RESULTS:Totally 30 patients received operative treatment whereas 15The pressure in lumbosacral disc herniated nucleus andthe size of herniated nucleus pulposus: as for patients who received operation, the pressure in herniated nucleus pulposus was obviously higher in positive group than in negative group [(2.119±0.753), (0.483±0.420) kPa, P ＜ 0.01]. However,the size of herniated nucleus pulposus was not significantly different between positive group and negative group [(4.688±1.991), (4.857±2.033) mm,nipulative therapy, their straight leg raising height was obviously increased compared to that before operation [(54.000±16.388)°, (72.668±15.338)°,P ＜ 0.01], but the size of herniated nucleus pulposus was proved not obviously changed by CT or MRI examination after manipulative therapy (P ＞ 0.05).cleus pulposus on nerve root is related to the iuternal pressure of herniated nucleus pulposus; higher internal pressure in herniated nucleus pulposus would limit straight leg raising height while lower internal pressure has less effect. However, the compression of herniated nucleus pulposus on nerve root has no obvious relationship with the size of herniated nucleus compression by reducing the internal pressure in herniated nucleus pulposus, which may not only depend on changing the space-occupying of herniated nucleus pulposus.

Objective To investigate the pathological features,diagnosis and treatment of primary malignant melanoma in esophagus (PMME).Methods The clinical data of 3 patients with PMME who were admitted to the Beijing Friendship Hospital from January 2008 to June 2009 were retrospectively analyzed.All the patients received esophageal barium radiography,electronic fiberesophagoscopy,esophageal endoscopic ultrasonography,computed tomography,and underwent surgery.Adjuvant therapy and immunotherapy were applied postoperatively.Results The results of barium radiography showed irregular filling defect presentation in the distal esophagus.The results of endoscopy showed a purple black tumor with a length of 3-8 cm in the esophagus.The results of endoscopic ultrasonography showed that the tumor was derived from the mucosal layer with low echo density.The results of computed tomography showed thickness of the lower segment of the esophagus.All the 3 patients received left thoracic approach esophagectomy and esophagogastrostomy.Histopathology and immunohistochemistry confirmed malignant melanoma.The expressions of Mart-1,HMB-45 and S-100 antigen were positive.The survival time of 2 patients was longer than 3 years,and 1 patient died of metastasis 6 months after operation.Conclusions PMME is a kind of rare and malignant tumor with dismal prognosis.Surgical management is the first choice,adjuvant chemotherapy and immunotherapy are hopeful to increase the survival time of the patients.

Objectives:To explore the pathogenesis of nasal polyposis by examining the expression of transforming growth factor beta (TGF-β) in human inflammatory nasal polyps. 　Methods: Twenty five polyposis patients were selected, tissue TGF-β1～3 from nasal polyps and inferior turbinate mucosa were determined with immunohistochemistry APAAP method .The inferior turbinate mucosa from eight healthy volunteers were selected as control. Six polyp tissues were estimated with western-blot analyses to compare the characteristics of TGF-beta isoforms expression. 　Results: ①The expression of TGF-β1～3 in nasal polyps was significantly higher than that in nasal mucosa, it was undetectable in nasal mucosa from healthy volunteers;②TGF-β1 was the main isoform detected in nasal polyps. 　Conclusions: TGF-β, especially TGF-β1 is strongly expressed in inflammatory nasal polyps and its mucosa. TGF-β could induce modification of epithelium and connective tissue and therefore be involved in the pathogenesis of nasal polyposis.

Objective:Dexamethasone (DEX) has been proved to be an effective therapy for a variety of oral mucosal disorders, especially for oral submucous fibrosis(OSF) .The mechanisms behind its therapeutic effects are not known but have largely been ascribed to its anti proliferation and immunosuppressive effects. The recruitment, extravagation and retention of leucocytes which may play an important role in the development of oral mucosal disorders depends in part on the interaction of LFA 1 with its ligand intercellular adhension molecules(ICAM 1).The study aimed to investigate the effects of DEX on proliferation and expression of ICAM 1 by human oral fibroblasts (FB).Methods:The fibroblasts were obtained from normal buccal mucosa (NM FB) and OSF buccal mucosa (OSF FB) and cultured in vitro. Then the cell proliferation of fibroblasts incubated with or without DEX in the presence of 10%fetal calf serum for 48 hours at 37℃ in 5%CO 2 and air were monitored by use of thiazolyl blue (MTT) assay and the level of ICAM 1 expressed by fibroblasts were monitored by using cell based ELSA for ICAM 1.Results:OSF FB had an increased proliferation compared to NM FB and DEX inhibited fibroblast proliferation in a concentration dependent manner; OSF FB produced ICAM 1 at high levels and DEX decreased ICAM 1 expression levels on both cell types.Conclusion:DEX can directly inhibit human oral fibroblasts proliferation and reduces the levels of ICAM 1 expressed by oral mucosal FB, and may be useful in the treatment of some oral mucosal disorders.

Objective Using the Chinese anthropomorphic chest phantom to measure the absorbed dose of various tissues and organs under different noise index, and to assess the radiation dose of MSCT chest scanning with the effective dose(ED). Methods The equivalence of the Chinese anthropomorphic chest phantom(CDP-1C) and the adult chest on CT sectional anatomy and X-ray attenuation was demonstrated. The absorbed doses of various tissues and organs under different noise index were measured by laying thermoluminescent dosimeters(TLD) inside the phantom, and the corresponding dose-length products(DLP) were recorded. Both of them were later converted into ED and comparison was conducted to analyze the dose levels of chest CT scanning with automatic tube current modulation (ATCM) under different noise index. Student t-test was applied using SPSS 12.0 statistical software. Results The Phantom was similar to the human body on CT sectional anatomy. The average CT value of phantom are -788.04 HU in lung,45.64 HU in heart,65.84 HU in liver,254.32 HU in spine and the deviations are 0.10%,3.04%, 4.49% and 4.36% respectively compared to humans. The difference of average CT value of liver was statistically significant(t=-8.705,P＜0.05),while the differences of average CT values of lung, heart and spine were not significant(t value were -0.752,-1.219,-1.138,respectively and P＞0.05).As the noise index increased from 8.5 to 22.5, the DLP decreased from 393.57 mGy·cm to 78.75 mGy·cm and the organs dose declined. For example, the average absorbed dose decreased from 22.38 mGy to 3.66 mGy in lung. Compared to ED calculating by absorbed dose, the ED calculating by DLP was lower. The ED values of the two methods were 6.69 mSv and 8.77 mSv when the noise index was set at 8.5. Conclusions Application of the Chinese anthropomorphic chest phantom to carry out CT dose assessment is more accurate. The noise index should be set more than 8.5 during the chest CT scanning based on ATCM technique.

Objective To compare T and N staging of esophageal and cardia cancer by endoscopic ultrasonography (EUS) and computed tomography (CT) before operation, and to evaluate clinical value of EUS.Methods Twenty-eight patients received examination of EUS and CT preoperatively, and the T and N staging was determined. The accuracy rates of both T, N staging were compared by the postoperative pathological results, at the same time, the accuracy rates of lymph node metastasis were compared, and the value of application of EUS was investigated. Results In the twenty-eight cases, the accuracy rates of EUS were higher than that of CT by 89.3% ( 25/28 ) to 46.4% ( 13/28 ) in T staging. And the difference had statistical significance( P = 0. 004 ,P ＜ 0.01 ). The N stagings of both were 82.1% (23/28) and 50.0% ( 14/28), and the difference had statistical significance ( P = 0. 035, P ＜ 0. 05 ). The accuracy rates of lymph node metastasis of both were 88.7% and 72.2% respectively, and the difference had statistical significance (χ2 = 7.031,P = 0.008, P ＜ 0. 01 ). Conclusions EUS has very important value in preoperative staging for esophageal cancer and cardia cancer, and the T staging of EUS is better than that of CT. The short axis and the ratio of short to long axis (S/L) combined with the lymph node ultrasonography image can improve the accuracy rates of lymph node metatsasis and N staging.

Objective To improve the mode of clinical medicine postgraduates for specialty degree by OSCE. Methods Clinical medicine postgraduates for specialty degree of Grade 2010 and 2011 were enrolled as research objects. The OSCE scores of the students of Grade 2010 were analyzed and the problems in clinical skills training were summarized. In the last year of clinical training for the clinical medical students of Grade 2011, the reform of clinical skills training was implemented with such improvement measures as publishing last year achievement, analyzing OSCE assessment, strength-ening the supervision of the department of clinical skill training, strengthening the examination as-sessment efforts and organizing collective training. And finally the OSCE scores of the students of Grade 2011 were compared with the scores of the students of Grade 2010. SPSS 19.0 was used to analyze the OSCE scores. Quantitative data were expressed as x±s. T test and Chi-squared test were em-ployed to do statistical analysis, with the inspection level of α=0.05. Result The graduate exami-nation OSCE scores of clinical medicine professional master's degree postgraduates of Grade 2010 display that the failure rate of SP, Physical, Surgical Operation, CPR and Case analysis are more than 5%. After the improvement of clinical skill training, using independent samples t test and chi square test, and contrasting grade 2010, the failure rate of the OSCE score of Grade 2011 in physical examination, surgical operation, site emergency station, CPR station, and case analysis station is significantly improved (P<0.05). Conclusions Improving the mode of clinical skill training by OSCE and performance analysis can effectively enhance clinical competence.

Objective To evaluate early diagnostic value of quantitative analysis of contrast-enhanced ultrasound (CEUS) in acute radiation-induced liver injury.Methods Sixty female rats were divided into two groups:50 rats in an experimental group (model group) and 10 rats in a negative control group.The rats in model group were radiated with stereotactic single dose of 20Gy on their liver to establish acute radiationinduced liver injury models.Each 10 rats from model groups and 2 rats from control group were randomly selected and underwent CEUS and histopathological examination on the 3,7,14,21,28 days after radiation.The degree of injury was classified into four groups according to pathological grading:non-injured group,mild injured group,moderated injured group and severe injured group.The dynamic images of CEUS were off-line analysis and the parameters of arrival time of contrast agent to hepatic artery (HAAT),the arrival time of contrast agent to hepatic vein (HVAT),and the transit time of hepatic artery-hepatic vein (HAHVTT) were recorded.Time intensity curve (TIC) of liver parenchyma drawn by the software of quantitative analysis was used to obtain quantitative parameters including time to peak (TTP) and peak intensity (PI).Results Along with the severity degree of radiation-induced liver injury,the quantitative parameters,PI decreased while TTP extended.PI of mild injured group,moderated injured group and severe injured group were lower than that of non-injured group (P ＜0.05).TTP of the three liver injuried groups was higher than non-injured group (P ＜0.05).The quantitative parameters HA-HVTT of moderated injured group and severe injured group were decreased than the non-injured group (P ＜0.05),whereas the difference between mild injured group and non-injured group was not significant.Conclusions Quantitative analysis of CEUS can provide a certain value for early diagnosis in acute radiation-induced liver injury.

OBJECTIVETo investigate the effects of cyclosporin A (CSA) on the level of intercellular adhesion molecule-1 (ICAM-1) expressed by oral fibroblasts (FB).

METHODSThe fibroblasts were obtained from normal buccal mucosa (NM-FB) and cultured in vitro. Then the levels of ICAM-1 expressed by fibroblasts incubated with or without CSA in the presence of 10% fetal calf serum for 48 hours at 37 degrees C in 5% CO(2) and air were monitored by using cell-based ELISA for ICAM-1.

RESULTSWe demonstrated that NM-FB had ICAM-1 expression (A = 0.324 +/- 0.030), and after 48 hours incubated with CSA the ICAM-1 levels expressed by oral buccal mucosa fibroblasts were dose-dependently decreased.

CONCLUSIONSCSA reduces the levels of ICAM-1 expressed by oral mucosal FB, and may be useful in the treatment of some oral mucosal disorders.

Cells, Cultured ; Cyclosporine ; pharmacology ; Dose-Response Relationship, Drug ; Enzyme-Linked Immunosorbent Assay ; Fibroblasts ; cytology ; drug effects ; metabolism ; Humans ; Immunosuppressive Agents ; pharmacology ; Intercellular Adhesion Molecule-1 ; biosynthesis ; Mouth Mucosa ; cytology ; drug effects ; metabolism

In recent years, it is found that the classical IKKα and IKKβ pathway were closely relates with hematological tumors, except the classical pathogenesis, moreover the classical IKKβ pathway is deeply studied. The studies indicated that the IKKβis activated to phosphorylate the NF-κB through multiple cascades under the effect of extracellular IL-6, TNF-α and other stimulating factors. At the cellular level, the classical IKKβcan promote the tumor cell survival and proliferation, reduce the cell apoptosis, and promote the angiogenesis and cell transfer. Although the classical IKKα plays a role in regulating IKKβ activity, but its role in non-classical pathway is more prominent. This review briefly summarizes the latest advance of researches on the pathogenesis of hematological malignancies in term of IKKα and IKKβpathway, so as to provide the theoretic basis for deeply understanding and studying the pathogenesis of hematologic tumors. At present, blocking the classical IKKα and IKKβ pathway has become a new target for treatment of hematological tumors, moreover, some specific inhibitor for IKKα and IKKβpathway have been developed, for example, LY2409881, BMS 345541 and so on. Most of these drugs are in clinical trials and display some good anti-tumor effects.
Cell Survival ; Hematologic Neoplasms ; Humans ; I-kappa B Kinase/metabolism* ; NF-kappa B/metabolism* ; Signal Transduction ; Tumor Necrosis Factor-alpha