OBJECTIVE: To summarize the progress on the biomaterials of chitin nerve conduit to repair peripheral nerve injury in recent years.DATA SOURCES: A computer-based online search of literatures related to the application of the biomaterials of nerve conduit on peripheral nerve injury was performed in Medline and Springerlink by using the key words of "nerve conduit, peripheral nerve injury" between January 2000 and August 2009 and the language was limited to English. Meanwhile, we searched China Periodicals Full-text Database and Weipu database for the related Chinese articles published between January 2000 and August 2009 with the same key words in Chinese.STUDY SELECTION: Inclusive criteria: Researches about the non-biodegradable materials, biodegradable materials and biological derivative materials that were related to the peripheral nerve injury were included. Exclusive criteria: The irrelevant and repeated articles were excluded.MAIN OUTCOME MEASURES: Nerve tissue engineering, chitin nerve conduit, and preparation of nerve conduit.RESULTS: With the progress of medical materials, the neural tube of natural or synthetic materials used to bridge defect of the neural in nerve tissue engineering scaffold material with a guide and to promote nerve regeneration. In the biodegradable material, chitin neural tube could be degraded within a reasonable period of time, biological control compatibility, performance degradation, mechanical properties and porosity. And in the structure of the conduit, combined other biodegradable materials,surface modification, adding seed cells and nerve growth factor, and other aspects of the experimental study were investigated.Changing the spatial structure of renewable and micro-environment aimed to speed up the rate of nerve growth, and promote the resumption of the good nerve function. And material's surface had to be modified and improved for conduit to adapt nerve during the nerve regeneration.CONCLUSION: With the continued development of biotechnique and cross-correlation technique, the biomaterials of chitin nerve conduit will have a prosperous future on peripheral nerve tissue engineering.

Objective To observe and analyze the clinical efficacy of docetaxel and S-1 in treatment of anthracycline-resistant triple-negtive breast cancer(TNBC).Methods 64 cases with TNBC admitted in People' Hospital of Shaoxing City from June 2009 to June 2011were selected as research object.The clinical data of these cases were analyzed retrospectively.Anthracycline had been used to treat the cases, but with no effect or recurrence.Then docetaxel combined with S-1 was applied to the cases.Clinical efficacy and adverse reactions of the chemotherapy were observed and analyzed. Results After treatment,the efficiency of 64 cases was 54.69%,and the disease control rate was 79.69%.During the treatment,the main adverse reactions were gastrointestinal reactions and bone marrow suppression,without death,and patients could tolerate the adverse event.Follow-up results showed that the median time of progression was 10.5 months.After two years,progression-free survival rate was 0.Conclusion Docetaxel combined with S-1 has good clinical efficacy for anthracycline-resistant triple-negtive breast cancer,with relatively mild side effects,which may be an ideal adjuvant chemotherapy method.

Objective To study the significance of the expression of β-catenin(β-cat) in Barrett esophagus and esophageal adenocarcinoma (EAC) and the relationship between its expression and clinicopathological factom.Methods By using SP immunohistochemistry technique,β-cat wag detected in the normal esophageal mucosa group (20 cases),Barrett esophagus with dysplasia group (26 cages) and EAC group (50 cases).Results The membranous expression of β-cat appeared in all of nomal esophageal mucosa.The rate of cytoplasmic and/or nuclear expression of β-cat in the Barrett esophagus with dysplasia group and the EAC group was 38.5% (10/26) and 60.0% (30/50) respectively,and compared with the normal esophageal mucosa group,the difference was signfficant (P＜0.01).The rate of cytoplasmic and/or nuclear expression of β-cat in the EAC group with lymphatic metastasis and the EAC group exceeding deep smooth muscle was 90.0% (18/20) and 72.2%(26/36) respectively,and compared with that in the nonlymphatic metastasis and the non-exceeding deep smooth muscle patients [43-3%(13/30) and 28.6% (4/14)],the difference was significant (P＜0.01).Conclusion Cytoplasmic and/or nuclear expression of β-cat might play a role in the carcinogenesis and progression of EAC and might be a predictor indicating the metastatic potential of EAC.

Abstract A suspected case of cutaneous anthrax was reported by Gongliu County Disease Control and Prevention Center, Ili Kazak Autonomous Prefecture, Xinjiang Uygur Autonomous Region on August 19, 2021. Then, an epidemiological survey was performed by a joint investigation team consisting of professionals from Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, intermediate-level trainees from the Field Epidemiology Training Program of Chinese Center for Disease Control and Prevention, and professionals from Ili Kazak Autonomous Prefecture Center for Disease Control and Prevention. A total of 11 cutaneous anthrax cases were identified, including 8 suspected cases and 3 clinically diagnosed cases, and all cases were villagers in Y Village, X Township, Gongliu County, without severe case or deaths found. The onset of the first case occurred on July 27, and the onset of the last case occurred on August 16. The main clinical manifestations included ulcerative eschar on hands and exposed skin of the upper extremity. A Bacillus anthracis isolate was detected in meat samples from infected cattle. Epidemiological surveys showed that villagers did not report infected cattle to related sectors and privately slaughtered and ate meat from infected cattle without any effective protective measures, resulting in this outbreak. It is recommended to strengthen health education for people raising, selling and slaughtering livestock, and publicize zoonotic disease control knowledge, including anthrax, and establish an effective surveillance and response system for anthrax for immediate identification and treatment of epidemics.

Objective To determine the perioperative risks of partial hepatectomy by determining the preoperative liver functional reserve in patients with hepatocellular carcinoma (HCC),and to compare the model for end-stage liver disease (MELD) score with the Child-Pugh classification in predicting prognosis.Methods We reviewed the clinical data of 202 patients with HCC who underwent partial hepatectomy.The MELD score and the Child-Pugh classification were determined preoperatively.Results The incidence of postoperative liver dysfunction happened in 44.0％ of Child A patients,50％ in Child B patients,41.6％in patients with a MELD score below 14,and 91.7％ in patients with a MELD score of ＞ 14.The difference between the rates of postoperative liver dysfunction in patients with a preoperative MELD score above 14 and below 14 was significant (P ＜ 0.05),while that between patients with Child-Pugh A and B was insignificant (P ＞ 0.05).The incidences of postoperative liver dysfunction in patient with a MELD ＜ 8,8 ≤ MELD ≤ 14,MELD ＞ 14 were 38.2％,57.6％ and 91.7％,respectively,indicating that there was a positive co-relationship between the MELD score and the incidences of liver dysfunction.The Spearman rank correlation test showed the MELD score was significant correlated with the Child-Pugh score (r =0.404 ; P ＜ 0.05).The areas under the ROC curves of the MELD score and the Child-Pugh score were 0.703 and 0.587 (P ＜ 0.05).Conclusions The MELD score predicted postoperative liver dysfunction more accurately than the Child-Pugh classification.HCC patients undergoing partial hepatectomy with a preoperative MELD score ＞ 14 had a high perioperative risk.To ensure the safety of partial hepatectomy,HCC patients with a preoperative MELD score ＞ 14 requires active preoperative preparation,bringing the score near to or less than 14.

Objective To analyze the MRI data of misdiagnosed and missed diagnosed of breast lesions and their histopathological features.Methods Data from 241 breast lesions within 121 patients were recruited in this study.The data included MRI images,uhrasounds and X-ray images were retrospectively interpreted by two radiologist and each lesion was assessed according to the BI-RADS classification.The pathologic features of miss or error diagnosed lesions on MRI were analyzed.Results In 241 breast lesions (malignance 120,bcnign 121),4 lcsions were miss diagnosed on MRI.Thcy were 2 intraductal papillomatosis and 2 fibroadenoma.All was benign.Twenty three lesions were misdiagnosed on MRI.Sixteen were overestimation,including 3 chronic inflammations,3 sclerosing adenosis,2 fibroadenoma,4 fibrocystic changes with or without atypical ductal hyperplasia (ADH),2 intraductal papilloma,1 infiltration of pectoralis major muscle and 1 axillary lymphnode metastasis.Meanwhile,there were 7 lesions were underestimation.These lesions included 2 invasive ductal carcinomas,1 mucinous adenocarcinoma,2 DCIS and 1 blunt duct adenosis with ADH and focal cancerous,1 inflammatory breast cancer underwent chemotherapy.The sensitivity and specificity and accuracy of breast MRI were 95.83 ％ (115/120),72.73 ％ (88/121),84.23 ％ (203/241),respectively.MRI findings had no difference with respect to mammogram or ultrasound was 75.10 ％ (181/241).Conclusion MRI misdiagnosis and missed often occurs in smaller breast lesions,morphologic and hemodynamic malignant manifestation atypical,especially intraductal lesions.MRI diagnosis should be combined with physical examination,X-ray mammogram and ultrasound to improve diagnostic accuracy and reduce missed diagnosis.

Objective To elucidates the effects of HPV18 E6 siRNA targeting at human papillomavirus(HPV)18 E6 gene on the proliferative activity of HeLa cells and chemotherapy sensitivity.Methods HPV18 E6 expression of HeLa cells was inhibited by siRNA interference,the change of P53 and P21 proteins expression level was measured by Western blot.MTT assay was used to detected proliferative activity and sensitivity to paclitaxel liposome of HeLa cells.Results After inhibition of E6 expression,P53 and P21 proteins increased and the growth of HeLa cells was decreased(P ＜0.01).The inhibition rate of HeLa was markedly increased after transfection of HPV18 E6 siRNA and paclitaxel liposome.Conclusion HPV18 E6 siRNA can effectively silence gene expression of E6 and inhibit proliferation of HeLa cells.HeLa cells are more sensitive to combine HPV18 E6 siRNA with paclitaxel liposome than that of control groups.

In order to solve fund shortage of medical service projects and to lower investment risk,a military hospital should widen investment channel,introduce medical equipment,fill up the military hospital's gap and raise the hospital's social,military and economic benefits by developing cooperation and joint venture with external units.In the aspect of developing the cooperative management of projects with external units,our hospital has established a cooperating project management organization.It is especially important to strengthen the prophase proof of cooperating projects,follow the principles of advancement,rationality,specificity and effectiveness,strictly review the clauses of the contracts,clarify the responsibilities of both parties,enhance the supervision and management in the period of project cooperation,etc.

Objective To evaluate the efficacy and safety of paclitaxel plus cisplatin combination in treatment patients with advanced or metastatic squamous-cell carcinoma of the esophagus(ESCC).Methods Twenty-five patients with advanced or metastatic ESCC received paclitaxel 175mg/m2 by 3-hour infusion on day 1 and cisplatin 25mg/m2 by infusion on day 1 ～ 3.3 weeks as one cycle.Results Twenty-four patients were eligible to be evaluated the efficacy and safety.The overall response rate was 45.8％ with complete and partial response rates of 4.1％ and 41.7％,respectively.The median survival time of all patients was 11 months(95％ CI:8.35 ～ 13.65 months).There was significant difference in the median overall survival between the patients who had showed response versus those who had not(P =0.022).Median survival was 12.5 months(95％ CI:9.11 ～ 15.90 months) and 8 months(95％CI:5.50 -9.50 months),respectively.The 1-year survival probability was 37.3％.The most common toxicities were leukopenia,neutropenia,thrombocytopenia and alopecia.Conclusion The effect of paclitaxel and cisplatin which seems beneficial as first-line therapy in advanced squamous-cell carcinoma of the esophagus had a high effective rate with acceptable toxicity.

Objective To compare the efficacy and safety of icotinib therapy alone versus icotinib combined with thoracic radiotherapy for the treatment of advanced non-small cell lung cancer (NSCLC) patients with an activating epidermal growth factor receptor (EGFR) gene mutation.Methods A total of 83 patients with advanced NSCLC harboring an activating EGFR gene mutation was enrolled in this study.All the patients were randomly divided into 2 groups.Patients in group A (n =41) received thoracic radiotherapy (prescribed at 60-66 Gy) combined with icotinib (three times per day,125 mg once).Patients in group B (n =42) were given icotinib therapy alone (three times per day,125 mg once).Treatment was continued until disease progression or unacceptable toxicity or death.The primary end points were median progression-free survival (mPFS) and 12 month-PFS rate.The secondary end points included objective response rate (ORR),disease control rate (DCR) and adverse events.Results With a median follow-up of 18.2 months,mPFS was 15.2 months (95％ CI:12.2-17.4) in group A and 13.2 months (95％ CI:10.8-14.9) in group B (x2 =4.29,P=0.036).PFS rates of 12 months for group A and group B were 70.3％ and 61.2％,respectively.The ORR were 78.0％ vs.57.1％ (x2 =5.16,P =0.028),and the DCR were 95.1％ vs.92.9％ (P＞0.05) in groups A and group B,respectively.No grade 3-4 adverse events was observed in both groups except the rashes (4 cases in each group).Besides,10 patients had grade 1-2 radiation-related pneumonitis and 15 patients suffered grade 1-2 radiation-related oesophagitis in group A.Conclusions In advanced NSCLC patients with an activating EGFR gene mutation,the combination of thoracic radiotherapy and icotinib had achieved an improvement on ORR and PFS with good tolerance.Clinical trial registration Chinese clinical trial registry,ChiCTRINR-16010262.