An early and accurate response evaluation is essential for clinicians to decide whether to continue the treatment with current thera-peutic regimen or to make necessary changes.This article briefly introduces the development of response evaluation criteria for tumors,elab-orates on the application of radiological evaluation criteria in local interventional therapy or sorafenib treatment of hepatocellular carcinoma (HCC),compares the four radiological evaluation criteria,i.e.,World Health Organization (WHO)criteria,Response Evaluation Criteria in Solid Tumors (RECIST),European Association for the Study of Liver (EASL)criteria,and the modified RECIST (mRECIST),and thinks that EASL criteria and mRECIST are better than WHO criteria and RECIST and can predict the prognosis of HCC patients at earlier time points.

Echinococcosis is a severe zoonosis parasitic disease and mainly caused by the larvae of Echinococcus granulosus and E. multilocularis. Because of the limitation of operation level,such as recurrence and death,the drug treatment is still the most important method in our country. Meanwhile,the annual number of drug treatments is far greater than surgical treatments. Drugs play a significant role in the preoperative reduction of lesions,reducing pain,extending the life of patients .This article re-views the status of animals treatment and clinical treatment of echinococcosis treated by the benzimidazole drugs and their new formulations,provides the basis for exploring the development direction of anti-echinococcosis drug treatment research.

Objective To explore the value of 18F-fluorodeoxyglucose（18F-FDG）PET-CT and CT in diagnosing bronchioloalveolar carcinoma （BAC）.Methods The PET-CT and CT findings of 15 patients with BAC pathologically confirmed were retrospectively analyzed.Results According to 18F-FDG PET-CT,there was definite diagnosis of malignant in 8 cases（53.3 %）,no exclusion of malignancies in 2 cases （13.3%）,definite diagnosis of benign tumors in 5 cases（33.3%）.The misdiagnosis rate of 18F-FDG PET-CT is higher.According to CT,there was definite diagnosis of malignant tumors in 11 cases（73.3 %）,no exclusion of malignancies in 2 cases（13.3%）,definite diagnosis of benign tumors in 2 cases（13.3%）.Conclusion The false negative rate and the misdiagnosis rate are high when SUVmax as 2.5 was employed as criteria in the diagnosis of BAC.To improve diagnosis accuracy and decrease misdiagnosis of BAC,we should be familiar with the CT images of different BACs and adjust the SUVmax as a diagnosis value.

BACKGROUND: Acute respiratory insufficiency is common complication of surgical treatment of adolescent scoliosis patients. The preventive effects of breathing exercise before surgery is still uncertain.OBJECTIVE: To explore the feasibility and efficacy of breathing exercises for scoliosis patients before operation.DESIGN: Nonrandomized cross sectional study.SETTING, PARTICIPANTS and METHODS: Totally 35 hospitalized kids with scoliosis and pulmonary dysfunction aged from 9 to 15 years old were selected from Shanghai Changhai Hospital. A set of breathing exercise including which included pursed lip breathing, abdominal breathing, diaphragmatic breathing and blowing balloon was performed to these patients one week before surgery. The changes of pulmonary function were recorded and compared before and after exercises.MAIN OUTCOME MEASURES: The change of vital capacity, lung capacity, forced ventilation capacity(FVC), maximal ventilation volume(MVV) before and after breath exercises.RESULTS: All sorts of indes are improved comparing with those before exercises. The vital capacity, lung capacity, FVC and MVV were greatly improved from(1.77 ±0. 36), (2.67 ±0. 84), (2.07 ±0.46), (52.5 ± 14.0) L before exercises to(2.65 ±0. 29), (3.56 ±0.79), (2.41 ±0.41), (70. 1 ± 17.0) L respectively( t = 3.63 - 11.28, P < 0.01).CONCLUSION: Preoperative breathing exercises can improve the pulmonary functions of kids with scoliosis and improve their tolerance to surgery and prevent the postoperative respiratory insufficiency.

Objective To explore the relationship between intrahepatic expression of interleukin-17 (IL-17) and liver fibrosis in patients with chronic hepatitis B virus infection. Methods IL-17 expressions in livers with different inflammation activity grades and hepatic fibrosis stages from patients with chronic hepatitis B virus carriers (n= 30), chronic hepatitis B (CHB, n = 55), liver cirrhosis (LC, n=20) were measured by immunohistochemistry. Serum IL-17 and liver fibrosis indices of haluronic acid (HA), laminin (LN), type Ⅲ procollagen (PC Ⅲ ) and type Ⅳ collagen ( Ⅳ C) were determined by enzyme linked immunosorbent assay (ELISA). The differences between groups were compared by Kruskal-Wallis test, and the Mann-Whitney test, and the correlation analysis was done by Spearman test. Results Intrahepatic IL-17 expression in LC group was significantly higher than CHB group (x2 =25. 3982, P=0. 004), and that in CHB group was higher than chronic hepatitis B virus carriers group (x2 = 11. 5056, P= 0. 001). The inflammation activity grade and hepatic fibrosis stage were both positively correlated with IL-17 expression (r= 0.718, 0. 693, respectively; both P＜0.01). IL-17 mainly located in portal area and the expression was positively correlated with serum levels of HA, LN, PCⅢ and ⅣC (r=0. 793, 0. 834, 0. 722, 0. 883, respectively; all P＜0.01).Conclusion Intrahepatic IL-17 expression is closely correlated with liver inflammation activity grade and hepatic fibrosis stage.

BACKGROUND:BIOSSN4 nickel-free stainless steel is an austenitic medical stainless steel material, which has passed the standard hemolysis test, cytotoxicity assays and sensitization test of the National Institute for the Control of Pharmaceutical and Biological Products. OBJECTIVE:To evaluate theinvitro cytotoxicity and corrosion resistance of a new medical BIOSSN4 nickel-free stainless steel. METHODS:The L929 mouse fibroblasts suspension was seeded in 96-wel plates at a concentration of 1×108 /L, and were divided into five groups. BIOSSN4 nickel-free stainless steel extract, 316L stainless steel extract, gold aloy extract, lead material extract (positive control) and RPMI1640 medium (negative control) were added respectively. After 1, 2 and 3 days of culture, cel morphology was observed. The absorbance value in each group was determined using MTT assay. The relative cel proliferation rate was calculated. Toxicity grading was evaluated. In the simulated oral environment, the eletric potential of corrosion, current density of corrosion and polarization resistance of BIOSSN4 no-nickel stainless steel, 316L stainless steel and gold aloy were determined. RESULTS AND CONCLUSION:Within 3 days of culture, in lead material extract group, cels shrunk; the number of cels significantly reduced; the relative growth rate was lower than that in the other four groups (P < 0.05). In the other four groups, the cel morphology was good, and the relative growth rate was over 75%. The toxicity of BIOSSN4 nickel-free stainless steel extract, 316L stainless steel extract and gold aloy extract was grade 1. The toxicity of lead material extract was grades 2-3. These results demonstrate that BIOSSN4 nickel-free stainless steel has good biocompatibility. The corrosion resistance of BIOSSN4 nickel-free stainless steel is higher than that of the 316L stainless steel but lower than that of the gold aloys.

BACKGROUND: Esophageal replacement or reconstruction should be performed after esophageal resection. There are still no suitable substitutes for esophagus if the conventional esophageal substitutes cannot be used.OBJECTIVE : To investigate the feasibility of applying a pulmonary tissue with vascular pedicle to repair the intrathoracic esophageal defect.DESIGN: A prospective animal investigation.SETTING: Department of Thoracic Surgery, Second Hospital Affiliated to China Medical University.MATERIALS: This trial was carried out in the laboratory of Department of Thoracic Surgery, Second Hospital Affiliated to China Medical University during January 2003 to June 2004. Fourteen adult mongrel dogs of either gender, with body mass of 12 to 18 kg, were provided by Animal Room, Second Hospital Affiliated to China Medical University (License No.SYXK (Liao) 2003-0019).METHODS: Of 14 anesthetized dogs, the middle lobe of right lung was dissected and its right middle lobar bronchus was ligated without damaging pulmonary and bronchial vessels in order to make pulmonary flap. A part of full-layer intrathoracic esophageal wall was resected, which was 4 cm long and 1/2 to 2/3 circled esophageal wall. The defect was patched by pulmonary tissue with vascular pedicle which was inosculated with esophageal cross section. On the 3rd day after operation, intravenous transfusion was performed to maintain nutrition. Qn the 7th day after operation, the dogs were given oral liquid soft food gradually 2 weeks after the operation. The access to the food and the survival of dogs were observed. Every 2 dogs were sacrificed respectively at the 2nd, 4th, 6th, 8th and 10th postoperative weeks. To observe the healing of esophageal defect, light microscope, transmission electron microscope, esophagography and endoscope were used in this study.MArN OUTCOME MEASURES: ①Survival situation and access to food of dogs after operation. ② The healing of esophageal defect of dogs.RESULTS: Three of fourteen dogs died within one week after operation. Eleven dogs survived. ① The survival and access to food of experimental dogs after operation: One dog was alive without problems for more than 170 weeks. The living dogs could be fed orally on the 7th day after operation. ② The healing at esophageal defect of experimental dogs:At the 2nd week after operation, the esophageal defect was covered with collagen layer and inflammatory exudation. A little epithelization was observered at free edge of the anastomosis, which was 1 to 2 layers of stratified squamous epithelium cells. At the 4th to 6th weeks after operation, the internal surface of the defect was covered with 3 to 5 layers of stratified epithelium cells. At the 8th to 10th weeks after operation, the luminal surface of the defect was covered with 6 to 8 layers of stratified epithelium cells. The pathological changs of pulmonary flap mainly included pulmonary alveoli atelectasis and pulmonary fibrosis, and some inflammatory cells without infective focus were observed. In the transmission electron microscope examination, newborn stratified squamous epithelium cells were. found on the surface of pulmonary tissue flap at esophageal defect.CONCLUSION: It is feasible to repair the partial irregular intrathoracic esophageal defect with the autologous pulmonary flap in dogs.

OBJECTIVE: To provide reference for establishing and improving clinical pharmacists' working mode in women-children special hospital.METHODS: The work carried out by clinical-medical-nursing team and the situation of clinical pharmacists' involvement in clinical treatment were summarized retrospectively.RESULTS & CONCLUSIONS: The medication safety in women-children special hospital has specificity and urgency,and the establishment of clinical-medical-nursing team is an important approach to realize clinical safe and rational drug use.A platform for clinical pharmacists under unified management of organization and system requirement should be set up in hospital to explore a clinical pharmacy working mode with the characteristics of special hospital,carry out clinical pharmacy research and search for quality management and performance management method for clinical pharmacists.

Objective To investigate the effect of tandem mass spectrometry and gas chromatography-mass spectrometry to make prenatal diagnosis of methylmalonic acidemia (MMA) by detecting organic acid and acylcarnitine in amniotic fluid.Methods From October 11,2007 to December 20,2014,131 pregnant women with MMA proband received prenatal diagnosis of MMA in Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (case group).Another 120 cases of pregnant women for conventional prenatal diagnosis at the same period were as control group.The pregnant women of two groups had the amniocentesis at 16 to 20 weeks of gestation.The levels of propionylcarnitine(C3) and acetylcarnitine(C2)in amniotic fluid were detected by tandem mass spectrometry.The methylmalonic acid and methylcitrate acid were detected by gas chromatography-mass spectrometry.MMA gene of cells in amniotic fluid of eighty fetuses with proband clearly diagnosed were detected by gene testing.Data were analyzed by Wilcoxon test.Results In case group,29 fetuses were found positive for higher level of C3,C3/C2,methylmalonic acid and methylcitrate acid compared with normal reference value,and the detected rate of fetal MMA was 22.1％(29/131).The levels of C3 and C3 / C2 in amniotic fluid of these 29 cases were higher than those in control group[8.13(2.42-16.70) vs 1.04(0.52-3.40) μmol/L,Z =-8.313; 0.77(0.30-1.79) vs 0.10(0.05-0.22),Z=-8.374; P ＜ 0.05 respectively].The levels of methylmalonic acid and methylcitrate acid were also higher[9.13(1.68-61.78) vs 0.00(0.00-1.31) mmol/mol Crea,Z=-11.348; 0.58(0.00-1.90) vs 0.05(0.00-0.52) mmol/mol Crea,Z=-6.632,P ＜ 0.05 respectively].For the other 102 cases in case group,the levels of C3,C3/C2,methylmalonic acid and methylcitrate acid were not higher than normal reference value,and were similar to those in control group (P ＞ 0.05); while they were lower than those of positive MMA fetuses (all P ＜ 0.05).Among 29 positive fetuses,16 fetuses were detected MMA gene,five were diagnosed as MUT forms of MMA and 11 were MMACHC forms of MMA.In 102 MMA negative fetuses,64 fetuses were detected MMA gene,44 were found one mutant site and 20 were found no gene mutation.The coincidence rate between gene detecting and mass spectrometry was 100％(80/80).Conclusions Mass spectrometry could be used to measure the C3,methylmalonic acid and methylcitrate acid levels in amniotic fluid of pregnant women with MMA proband to make prenatal diagnosis.

ObjectiveTo evaluate the clinical outcomes of anterior lumbar discectomy and interbody fusion with cage under laparoscopic assistant.MethodsFrom January 2006 to June 2009,37 cases with degenerative low back pain were entered the study,including 22 males and 15 females with an average age of 43.7 years(range,16-55).The responsible discs were determined according to the three dimensional computed tomography of artery and vein angiography of anterior lumbosacral spine and discography,including L5S1 in 21 cases,L4-5 in 11,L3-4 in 2,L2-3 in 2,and L1-2 in 1.All cases underwent anterior lumbar discectomy and interbody fusion with cage under laparoscopic.ResultsThe operation time was 100 min in average (range,60-140),the blood loss was 120 ml in average(range,50-300).There was no case with severe complications of retrograde ejaculation and injury of great vessels or nerves.Delayed intestinal obstruction was discovered in two intraperitoneal route patients.The average follow-up time was 18.7 months(range,6-35).According to the back pain grading criteria of Chinese Medical Association Orthopedics Society of Spine Group,the results were excellent in 23 patients,good in 11,and fair in 3.The interbody fusion was obtained in 3 months later in 23 cases and 6 months later in 12 cases.Cage subsidence occurred in 2 cases in 6months after operation,in which the height loss of intervertebral space was 1.3 mm and 1.9 mm,but no obvious symptoms of discomfort.No fixation displacement or loosening occurred.ConclusionThe anterior discectomy and interbody fusion by internal fixation with laparoscopic technique is feasible with low complications rate,less trauma and shorter bedtime.Postoperative ileus by abdominal approach is relatively common.The surgeons experience and the anatomy of artery and vein of anterior lumbosacral spine should be considered before the choice of surgical approach.