Objective To analyze the clinical characteristics,therapy and follow-up of the patients with ulcerative colitis (UC).Methods Collect the date of 77 inpatients with UC at the Second Affiliated Hospital of Chongqing Medical University be-tween November,2009 and october,2014,and assigned the patients randomly.Results 69.9% of the patients who were in the ac-tivity stage were moderate severity.E2 (46.6%,34/73)and E3 (50.7%,37/73)were the common lesions range.The main clinical manifestations were abdominal pain,diarrhea,mucopurulent bloody stool and bloody stool.The enteroscopy mostly showed that in-testinal mucosa hyperemia,eddma,erosion,and small ulcers had the common features of UC.The common biopsy results were chro-nic inflammation and/or erosion.The average value of serum ALB decreases while the severity of UC patients increases.Drug thera-py was the main treatment of UC.The maintenance therapy was aminosalicylic acid,the effective ratio of treatment is 89.0%(55/73).Conclusion UC treatment plan basically follow the consensus and we should enhance the follow-up of UC patients.

Objective To detect cytokeratin in routine pathology negative regional lymph nodes postoperatively in non-small cell lung carcinoma (NSCLC). To investigate the relationship of lymph node micrometastasis in P-TNM stages NSCLC and survival rates. Methods From Jan. 1996 to Dec. 2003, 107 paraffin-embedded specimens of T1-T4N0-N1M0 NSCLC patients were collected. Anti-cytokeratin(CK) an- tibody AE1/AE3 was applied to detect cytokeratin with Envision~(TM) method in routine pathological negative re- gion lymph nodes in NSCLC, and selected negative control, positive control and blank control. The pulmo- nary hilar lymph node micrometastasis was upward regulated with stage pCK-N1, mediastinal lymph node mi- crometastatsis was upward regulated with stage pCK-N2. The result applied to SPSS11.0 software to process. Results The CK positive rate was 29.9% in all the patients. The CK positive rate was 27% (21/78), 30% (7/23), 67% (4/6)in stage p-Ⅰ, p-Ⅱand p-Ⅲ, respectively. All these data showed the tendency by which detectable rate increased and was accompanied by disease progress. Comparing the annual survival rate and median survival time of the non-micrometastasis group with the mierometastasis group in two groups, the survival rate difference was statistically significant. Comparing the annual survival rate and median sur- vival time in pCK-ⅢA stage with p-Ⅰ-Ⅱstage, pCK-ⅢA stage annual survival rate and median survival time was significantly different (P=0.020). Similarly, comparing the survival rate in pCK-ⅡB stage with p-ⅠB stage, pCK-ⅡB stage survival rate was significantly different(P=0.059). Comparing the survival time of pCK-ⅢA stage with p-Ⅲstage, pCK-ⅡB stage, with p-ⅡB stage, euther survival time difference was statistically significant (P=0.838, 0.518). Conclusions The rate of positive cytokeratin increase is ac- companied by the disease progress in NSCLC. Positive cytokeratin has disadvantagious prognosis. It is showed that pCK-N1 may be equal to p-N1 and pCK-N2 which also may be equal to p-N2. Micrometastasis may affect the UICC staging currently in use.

Objective To investigate the expression level of lipocalin-type prostaglandin D synthase (L-PGDS) mRNA and its protein in glioma.Methods The L-PGDS mRNA was determined by real-time quantitative RT-PCR in 23 glioma and 5 healthy brain specimens. L-PGDS protein was detected by Western blot in cerebrospinal fluid (CSF) and brain tissue specimens.Results In 23 glioma specimens L-PGDS mRNA expression ranges from 1.5?10 3～7.0?10 4 copy/?g RNA, mean value is 1.6?10 4 copy/?g RNA. In 5 normal brain specimens, the mean value is 8.1?10 5 copy/?g RNA, statistic analysis indicates a distinct discrepancy ( P

Objective To assess the value of ultrasonography in distinguishing pharyngoesophageal diverticulum from thyroid nodule.Methods High-frequency sonography was used to detect the size,shape, echo and blood flow of cervix masses in 1219 patients in a lateral decubitus position after drinking water. Results On enhanced power,the image changing rates of pharyngcesophageal diverticulum and thyroid nodule were 71.43% and 14.19% respectively,and their difference was statistically significant(P<0.05). On drinking water,the image change rates of pharyngoesophageal diverticulum and thymid nodule were 100.00% and 1.98% respectively,and their difference was statisfically significant(P<0.05).The detection rates for pharyngoesophageal diverticulum and thyroid nodule were 0.098% and 17.042% respectively. Conclusions Ultrasound examination is of value in distinguishing pharyngoesophageal diverticulum from thyroid nodule in general health check up and regular health examination.

Objective To prospectively evaluate the survival of different metastasis organs with concurrent chemotherapy and thoracic three-dimensional radiotherapy (CCTTRT) for stage Ⅳ non-small cell lung cancer (NSCLC).Methods Two hundred and one patients of stage Ⅳ NSCLC were enrolled from January,2003 to July,2010.Of the 182 patients eligible for analysis,The number of patients with single-organ metastasis or multiple-organ metastasis was 107 and 75,respectively.Patients were treated by platinum-based chemotherapy,the median number of cycle was 4.The median dose to planning target volume of primary tumor (DTPTv) was 63 Gy.Survival was calculated by Kaplan-Meier method and compared using the Logrank.Results The follow-up rate of 201 patients was 97.5％.with 201,170 and 134 patients finished ＜ 1,1 -2 and ≥3 years'follow up.Of 182 patients,the 1-,2-,and 3-year overall survival (OS) rate and median survival time (MST) was 41.0％,17.0％,10.0％ and 10.5 months,respectively ;with single-organ metastasis and multi-organ metastasis were 50％,20％,14％ and 13 months and 29％,12％,0％ and 8.5 months ( x2 =10.10,P =0.001 ),respectively; compared with multi-organ metastasis,the 1-,2-,and 3-year OS arte and MST of patients with bone,lung metastasis only was 58％,25％,16％ and 14 months (x2 =10.42,P=0.001 ) and 49％,21％,21％ and 11 months (x2 =6.39,P=0.011 ) respectively;patients with brain metastasis only did not show advantage of survival comparing with patients with multi-organ metastasis (49％,8％,0％ and 12 months and 29％,12％,0％ and 8 months,respectively;x2 =0.71,P =0.401 ) ;the 1-,2-,and 3-year OS rate and MST was 63％,23％,19％ and 15 months and 42％,15％,0％ and 10 months,respectively for patients with single-organ metastasis and multi-organ metastasis patients who accepted 4 - 5 cycles of chemotherapy ( x2 =6.47,P =0.011 ) ; for patients under the same metastasis and 4 - 5 cycles of chemotherapy,no matter whether single-organ or multiple-organ metastases,the 1 -,2-,3-year OS rate and MST of patients with enough radiotherapy on DTPTV ≥63 Gy were better than patients without enough radiotherapy ( DTPTV ＜ 63 Gy ) ( 71％,25 ％,25％ and 16.8 months and 33％,17％,0％ and 10.5 months,respectively;x2 ＝4.73,P =0.030 ;54％,21％,0％ and 14.3 months and 29％,10％,0％ and 7.6 months,respectively,x2 =8.16,P =0.004).The MST of liver metastases was 6 months,there was significantly difference when comparing with non liver matastasis ( x2 =17.21,P =0.000).Conclusions It is very important to treat stage Ⅳ NSCLC with CCTTRT,especially patients with single-organ metastasis.Liver metastases is a unfavorable prognostic factor.

Objective To evaluate the overall survival and safety among patients for stage Ⅳ non-small cell lung cancer (NSCLC) treated with concurrent chemotherapy and thoracic three-dimensional radiotherapy (CCTTRT).Methods From Jan.2003 to July 2010,201 patients with stage Ⅳ NSCLC were included.All patients were treated with CCTTRT.Those patients who received only one cycle chemotherapy were not included in survival analysis,but analysis of toxicity.One hundred and eighty-two patients were eligible for survival analysis.All patients received platinum-based two-drug chemotherapy.The median number of cycles was 4.The median dose to planning target volume of primary tumor ( DTPTV ) was 63 Gy.Treatment-related gastrointestinal and hematological toxicity were scored according to WHO criteria.Radiation-related pneumonitis and esophagitis were evaluated according to the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTC) version 3.0.Survival was calculated by Kaplan-Meier method and compared using the Logrank.Cox regression model was used to examine the effect of CCTTRT on overall survival.Results The follow-up rate of 201 patients was 97.5％.with 201,170 and 134 patients finished ＜ 1,1 -2 and ≥3 years' follow-up,respectively.Of the 182 patients eligible for survival analysis,further stratified analysis showed that the 1-,2-and 3-year overall survival rate and median survival time (MST) was 54％,20％,13％ and 14.3 months,respectively for patients treated with concurrent 4 -5 cycles chemotherapy and CCTTRT,and 66％,23％,19％ and 16.1 months,respectively for those treated with 4 -5 cycles chemotherapy and DTPTV ≥ 63 Gy.Under similar chemoradiotherapy intensity,the MST of patients with single organ metastasis was significantly longer than that with multiple organ metastases ( 13.0 months versus 8.5 months,x2 =10.10,P =0.001 ).For patients eligible for survival analysis and received 4 - 5 cycles of systemic chemotherapy,MST of patients treated with DTPTV≥63 Gy was significantly longer than those treated with DTPTV ＜63 Gy[14.9 months vs.8.4 months (x2 ＝20.48,P =0.000) and 16.1 months vs.8.8 months ( x2 =11.75,P =0.001 )].For patients with single organ metastasis,MST was 16 months for those treated with DTPTV ≥63 Gy and 9 months for those with DTPTV ＜63 Gy (x2 =10.51,P=0.000) ;for patients with multiple organ metastasis,it was 11 months and 7 months,respectively ( x2 =7.90,P =0.005 ).Multivariate analysis showed that concurrent 4 - 5 cycles chemotherapy and DTPTV ≥63 Gy (β =0.243,P=0.019) and improved KPS (β =1.268,P=0.000) were independent factors for survival.For the whole group,45％ patients had Grade 2 -3 gastrointestinal toxicity,35.0％ grade 3- 4 leukopenia,18％ grade 3- 4 thrombocytopenia.15.0％ grade 3- 4 anemia,9.5％ Grade 2 - 3 radiation pneumonia and 13.4％ radiation esophagitis,respectively.Conclusions For stage Ⅳ NSCLC,CCTTRT can prolong survival time with acceptable toxicity.Radiotherapy to thoracic primary tumor should be under consideration.

Objective To investigate the role of three-dimensional (3D) radiotherapy to the thoracic primary tumor in non-small cell lung cancer (NSCLC) patients with bone metastases during chemotherapy with concurrent 3D radiotherapy.Methods From 2003 to 2010,the clinical data of 95 stage Ⅳ NSCLC patients with bone metastases were collected.All patients received 3D radiotherapy to the thoracic primary tumor and at least 2 cycles of chemotherapy.Of the 95 patients,47 had only bone metastases,and 48 had metastases to bones and other organs.The Kaplan-Meier method was used to calculate overall survival (OS) rates.The log-rank test was used for survival difference analysis and univariate prognostic analysis.The Cox regression model was used for multivariate prognostic analysis.Results The follow-up rate was 95％.The 1-,2-,and 3-year OS rates were 44％,17％,and 9％,respectively.The univariate analysis showed that radiation dose to the planning target volume (PTV) of primary tumor of ≥ 63 Gy,response to treatment of primary tumor,and at least 4 cycles of chemotherapy were favorable prognostic factors for OS in all patients (P =0.001,0.037,and 0.009).Radiation dose to the PTV of primary tumor of ≥ 63 Gy remained the favorable prognostic factor for OS in patients with only bone metastases and those with metastases to bones and other organs (P =0.045 and 0.012).Among patients with only bone metastases,those with T1 + T2 primary tumors had longer OS than those with T3 + T4 primary tumors (P =0.048).The multivariate analysis showed that radiation dose to the PTV of primary tumor of ≥ 63 Gy and metastases to bones only were independent favorable prognostic factors for OS in all patients (P =0.036 and 0.035).Conclusions For NSCLC patients with bone metastases,3D radiotherapy to the thoracic primary tumor and its dose play an important role in improving OS during chemotherapy with concurrent 3D radiotherapy.

BACKGROUND:Recent studies have demonstrated that Niacinamide is capable of promoting the proliferation of intervertebral cells and improving intervertebral disc degeneration.Overloading is thought to the main cause of intervertebral disc degeneration.However,the protective effects of Niacinamide in loading induced intervertebral disc degeneration remains uncertain,OBJECTIVE:To investigate the protective effects of Niacinamide against axial loading induced degeneration of rabbit lumbar disc.DESIGN,TIME AND SETTING:A randomized controlled experiment was carded out in the Central Laboratory and the Laboratory of Department of Orthopaedics,Union Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology from November 2008 to April 2009.MATERIALS:Twenty-four Japanese white rabbits (4 months old,weighing 2.0 kg).Niacinamide was supplied by Tianjin Damao Chemical Reagent Factory.METHODS:Twenty-four Japanese white rabbits were randomly divided into 6 groups.The controllable axial loading induced rabbit lumbar disc degeneration model was adopted to impose 98N pressure on the rabbit discs to induce degeneration.Various doses of Niacinamide were given intragastrically to the rabbits in different groups:2 rabbits in group 1,the loading device was installed without pressing,and no Niacinamide was given;2 rabbits in group 2,given 50 mg/kg Niacinamide for 1 week;5 rabbits in group 3,loaded with 98N for 1 week;5 rabbits in group 4,loaded with 98N for 1 week,then the pressure was released for another week's recovery;5 rabbits in group 5,loaded with 98N and given 50 mg/kg Niacinamide for 1 week;5 rabbits in group 6,loaded with 98N for 1 week and then the pressure was released for another week's recovery,50 mg/kg Niacinamide was continually given during the 2 weeks.MAIN OUTCOME MEASURES:Magnetic resonance image and Thompson's grading system were used to assess degeneration degree of the discs;hematoxylin and eosin staining,immunohistochemical staining for type Ⅱ collagen,and Safranin O staining were used to evaluate histological changes;immunohistochemical staining for P161NK4A was used to evaluate cell proliferation and senescence.RESULTS：①According to the Thompson's grading system，there was no disc exhibited degeneration in group 2；5 rabbits graded Ⅱ in group 3；4 rabbits graded Ⅱ and 1 rabbit graded Ⅲ in group 4；2 rabbits graded Ⅰ and 3 rabbits graded Ⅱ in group 5；3 rabbits graded Ⅰ and 2 rabbits graded Ⅱ in group 6.MRI results revealed the alleviated degeneration in Niacinamide given groups.②The content of type Ⅱ collagen of annulus fibrosus of group 6 was 53.2% higher than that of group 4 (P＜0.01).③Safranin O-Fast Green staining density of group 2 was higher than that of group 1；The staining density of nucleus pulposus and annulus fibrosus of groups 5 and 6 was higher than the corresponding parts of group 4，especially that of nucleus pulposus (P＜0.01，P＜0.01)，and group 6 exhibited slightly increased levels than group 5.④P16INK4A positive staining rates decreased with the extension of Niacinamide administration time.CONCLUSION：Niacinamide can help to alleviate overloading-caused damage to intervertebral disc，and can benefit the recovery of damaged intervertebral disc.

BACKGROUND: Studies have reported that Niacinamide is capable of promoting the proliferation of intervertebral cell and protecting intervertebral disc (IVD) against interleukin-1 β-induced degeneration. However,the mechanism of Niacinamide underlying protecting IVD degeneration remains uncertain. OBJECTIVE: To investigate the regulatory effect of Niacinamide on interleukin-1 β-induced cell apoptosis and energy metabolism related gene in IVD in vitro. DESIGN, TIME AND SETTING: Experiments were performed in the Central Laboratory of Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology from November 2007 to May 2008. MATERIALS: Fifty-six IVDs from L16 lumbar spine often Japanese white rabbits,aged 3-4 months and weighing 1.5-2.0 kg,were harvested and cultured in alginate gel for further experiments. METHODS: IVD cultured models were randomly divided into 4 groups: normal control group (with the absence of drags), Niacinamide group (administrating 0.5 g/L Niacinamide), degeneration group (administrating 10 μg/L interlenkin-1β),treatment group (administrating 10 μg/L interleukin-1β and 0.5 g/L Niacinamide).After 2 weeks of culture,TUNEL staining and immunohistochcmical staining for FAS,Bcl-2, Caspase-3, hypoxia induced factor 1a, glucose transporter-1 and vascular endothelial cell growth factor were used to detect alternated cell apoptosis and expression of energy metabolism related genes. MAIN OUTCOME MEASURES: The positive cell rates of TUNEL staining and immunohistochemical staining in each group. RESULTS: The rate of TUNEL positive-staining cells of degeneration group was higher than normal control group (P=0.001). The rate of FAS positive-staining cells of degeneration group was obviously higher than normal control group (P＜0.01). The rate of Bcl-2 positive-staining cells of Niacinamide group was higher than normal control group (P=0.004). The rate of Caspase-3 positive-staining cells of treatment group was lower than degeneration group significantly (P=0,024).The rate of hypoxia induced factor- 1α positive-staining cells of Niacinamide group was lower than normal control group (P＜0.01),and the rate of degeneration group was higher than normal control group (P＜0.01 ). The rate of glucose transporter-1 positive-staining cells of treatment group was higher than normal control group(P＜0.01). CONCLUSION: Niacinamide can inhibit interleukin-1β-induced IVD cell apoptosis and alleviates interleukin-1β induced disturbance of energy metabolism.

Objective To investigate the effect of sleep position guidance on deformational plagiocephaly and/or brachycephaly (DPB) in the prematures. Methods 321 preterm infants in neonatal intensive care unit from October, 2012 to September, 2015 were divided into sleep positions guidance group (n=159) and control group (n=162). The sleep positions guidance group accepted sleeping positions guidance when they were in neonatal intensive care unit and followed up in child care clinic, and the control group accepted routine treatment and nursing. The incidences of DPB were compared. Results The incidences of mild (χ2=6.591, P=0.010), moderate (χ2=4.862, P=0.027) and se-vere (χ2=11.261, P=0.001) DPB were less in the sleep positions guidance group than in the control group. Conclusion Sleeping positions guidance may reduce the incidence of DPB in prematures.