Objective To explore the clinical value of combined detection of lysophosphatidic acid(LPA),tumor-specific growth factor(TSGF)and carbohydrate antigen 1 9-9(CA1 9-9)in the diagnosis of non-small cell lung cancer(NSCLC).Methods The ser-um levels of LPA,TSGF and CA1 9-9 in 97 cases of patients with NSCLC(NSCLC group),43 cases of patients with benign lung disease(benign lung disease group)and 50 cases of healthy individuals(healthy control group)were detected,and diagnostic value of combined detection of these three tumor makers in the diagnosis of NSCLC was analysed.Results Serum levels of LPA,TSGF and CA1 9-9 in the NSCLC group were significantly higher than those in the benign lung disease group and healthy control group,had statistically significant differences(P <0.05).The sensitivity and specificity of combined detection of LPA,TSGF and CA1 9-9 was 68.63% and 37.1 7% respectively,and the sensitivity was higher than that of single detection and combined detection of any two of the three indicators.Conclusion Combined detection of tumor markers can improve the sensitivity in the diagnosis of NSCLC, which could provide reliable laboratory references for diagnosing NSCLC.

PBL is problem-based and student-centered learning pattern. PBL has been proved to be an effective teaching,which is helpful to improving the students’learning enthusiasm and learning efficiency,and to training their clinic thoughts and the capability of teamwork.

Objective To assess the radiological imaging findings of hepatic inflammatory myofibroblastic tumor and to discuss the appropriate morphological classification.Methods A total of 22 patients with hepatic inflammatory myofibroblastic tumor confirmed by pathology were enrolled.Imaging performance of hepatic inflammatory myofibroblastic tumor were analyzed and the lesions were classified into appropriate type based on the imaging findings.Results Totally 23 lesions were found in 22 patients.The typical imaging features included great enhancement at later phase (13/20),moth eat en central necrosis (12/23) and peripheral shell (12/23).Seed in fruit was the most typical classification (8/23),followed by Seedless fruit (7/23).Conclusion Hepatic inflammatory myofibroblastic tumur typically shows as a single nodular lesion with moth eaten necrosis and peripheral shell like a Seed in fruit.The enhancement at later phase (especially the peripheral enhancement) can be regarded as a particular feature.

ObjectiveTo explore the effects of phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/nuclear factor-kappa B (NF-κB) signal pathway on the process of follicle-stimulating hormone (FSH) facilitating cell proliferation and invasion in human epithelial ovarian cancer. Methods Ovarian cancer cell lines SKOV3 and 3AO were cultured to exponential phase,then assigned to control group,FSH group,LY294002 group and FSH + LY294002 group,respectively.Cells were treated with different concentration of FSH and LY294002,respectively.The effects of FSH on cell proliferation were observed by methylthiazolyl tetrazolium (MTT).Morphological changes were observed by phase contrast microscope.The ability of cell invasion was investigated by transwell invasion assay.The expression of FSH receptor (FSHR),Akt1/2,phosphorylated-Akt (p-Akt) and NF-κB p65 protein were detected by western blot.Results( 1 ) FSH could promote the proliferation of SKOV3 and 3AO cells.When the cells were treated with 40 U/L FSH for 48 hours (SKOV3) and 24 hours (3AO),compared with those in control groups,they reached the highest proliferation rate (P ＜ 0.05 ),respectively.(2) The morphology of SKOV3 and 3AO cells in four groups:in control group,SKOV3 cells were short spindle and 3AO cells were long spindle,the nuclei of them were both roundness or oval,the cytoplasm were bright.In FSH group,the cells changed to slightly longer or polygonal,they were full in shape,meanwhile,the cell intensity were higher than control group.In LY294002 group,some cells changed from spindle to round,and began to shrink.The cell intensity diminished.The morphology of FSH + LY294002 group was similar with control group,but the cell intensity was lower than that in FSH group.(3)The number of SKOV3 cell that passed through the membrane in control group,FSH group,LY294002 group and FSH + LY294002 group was (26 ± 6),( 118 ± 19),( 18 ± 5) and ( 38 ± 7 ),respectively.The number of 3AO cell was ( 19 ± 4 ),( 134 ± 20),(12 ±3) and (58 ± 11 ),respectively.The results showed that the number of cells in FSH group was significantly higher than that in control group ( P ＜ 0.05 ),while the number of cell in FSH + LY294002 group was significantly fewer than that in FSH group (P ＜ 0.05 ).(4) There was no significant difference in the expression of FSHR and Akt1/2 between FSH group and control group (P ＞ 0.05 ),but FSH increased the expression of p-Akt and the ratio of NF-κB p65 in the nucleus versus cytoplasm in SKOV3 and 3AO cells,there were significant differences compared with control group ( P ＜ 0.05 ).LY294002 reversed the effects of FSH on increasing the expression of p-Akt and the ratio of NF-κB p65 in the nucleus versus cytoplasm,there were significant differences among LY294002 group,FSH + LY294002 group and FSH group (P ＜ 0.05 ).ConclusionThe effects of FSH on proliferation and invasion of ovarian cancer cell lines SKOV3 and 3AO may be realized by regulating the activity of NF-κB in PI3K/Akt signal pathway.

Objective: To observe the histological changes of lamina extema cranii at both the graft and donor areas after having been grafted in animal experiment. Methods; 4 mini pigs aged from 8 to 12 months were selected. Part of the outer table of skull (2.5 cm × 1.0 cm) was decorticated and was divided equally. Both were implanted on each side of the snouts of animals. 2 pigs were selected randomly and were killed 12 weeks postoperation. Each 1, 0 cm ×0. 5 cm specimen was harvested and histological study was performed. The other 2 animals were killed 24 weeks after operation. Gross inspection of the donor site was performed and histological study was done. Results; In the graft area; bone absorption was obvious 12 weeks postoperation, but bone matrix increased obviously at 24 weeks postoperation. Results of scanning electron microscope showed that interface between bone graft and recipient site was discernment and collagen type I was malaligned 12 weeks postoperation. Collagen fibers were in good order and good mineralization was found 24 weeks postoperation. In the donor area; small amounts of new bone formation could be seen and alignment of cemental line was chaotic 12 weeks postoperation. At 24 weeks, bone formation was obvious and alignment of haversian canal was regular. Scanning electron microscopy showed that structure of the tissue was uneven and disorder at 12 weeks postoperation. Collagen fibers were in good order and good mineralization was found 24 weeks postoperation. On gross view, raw surface of the donor site got complete healing, os-teanagenesis was incomplete and introcession could be observed in the local area. Conclusion; Histological remodeling of lamina exter-na cranii is complete at 24 weeks after having been grafted. The donor site can regenerate but morphologic introcession could be observed.

Hepatocellular carcinoma ( HCC ) is one of the commonest malignant tumors in China .The therapeutic effects of conventional therapies including surgery resection at early stage ,chemotherapy or radiothera-py are greatly less than expected .One of the most possible reasons is the blockage of apoptosis in HCC cells .This review collects literatures about the studies on the roles of key signal pathways including RA ,STAT3,PDT,p53,β-catenin,TRAIL,microRNA and RAS in HCC therapy .This study may contribute greatly to providing outline in-sights for using apoptosis induction in liver cancer therapy .We hope it can promote the development liver cancer therapy in China .

Objective:To investigate the clinical characters and treatments of maxillofacial fractures. Method: A review of 101 maxillofacial fractures was presented with respect to age, sex, cause of fractures, pattern of fractures, treatments and therapeutic effect. Result:The majority of fractures were found in 20-to-50-years-old males. Most fractures happened in summer and the leading causes were traffic accidents. Mandible was the most part of fractures and associated combined injures were found in 31 cases. Rigid internal fixation was the primary treatment. Conclusion:Maxillofacial factures mainly occurred in young adult males and traffic accidents were the main causes. Rigid internal fixation after exact replacement was the primary common treatment.

To promote clinical medical students' personal harmonious development,we have established the new problem-based teaching mode and reform the evaluation system in clinical teaching of obstetrics and gynecology and have obtained more satisfied teaching result.

Objective This study aimed to investigate the incidence and the cause for duodenalbiliary reflux and reflux cholangitis after metallic stent placement in distal common bile duct Methods After percutaneous transhepatic bile duct puncture and biliary outside drainage was performed, 16 cases with malignant distal biliary stricture underwent metallic stent placement in distal common bile duct Before stent placement, the routine laboratory studies including leukocyte, neutrophil percentage and the levels of total bilirubin and direct bilirubin in blood were performed for all patients. Two to five days [ an average of (3.3 ±0. 9) days ] after stent implantation, the above indexes were tested again, and 1 ml of water containing 185 MBq of 99Tcm-DTPA was given orally before extubation, then 99Tcm radioactivity in the bile was detected 2 hours later. For the measurement data obtained from the experiment, t test or Wilcoxon signed rank test was adopted to compare them, and P ＜ 0. 05 was considered to be statistically different Results In 14 cases, radioactivity was successfully detected in the bile 2-5 days after stent implantation. Twelve of them was detected to have radioactivity in the bile 2 hours before extubation with duodenal-biliary reflux. The technetium count in the bile accounted for 1.82% of the total intake dose. There was no radioactivity in the bile in 2 cases. In 14 patients, there were no symptoms of cholangitis such as high fever, chills, increased jaundice, and so on after stent implantation. The mean of white blood cell count was (7.59 t2. 62) × 109/L, and the median of neutrophil percentage was 0. 74. Compared with those before stent implantation, the difference did not reach statistical significance ( t = 0. 423, Z = 1. 036, P ＞ 0. 05 ).After stent implantation, the median of total bilirubin and direct bilirubin were significantly lower, which were 92. 2 and 74. 3 μmol/L. Compared with those before stenting,the difference was statistically significant (Z= -3. 170, -3. 170, P ＜0.05). Conclusions There is a high incidence of duodenal-biliary reflux after stent implantation in distal common bile duct in the early stage. However, there is no simultaneous cholangitis caused by duodenal-biliary reflux.

Objective To explore the method and value of percutanously interventional therapeusis for treatment of obstructive jaundice caused by hepatocellular carcinoma accompanied with bile duct thrombosis.Methods Sixteen cases with bile duct thrombosis proved by pathology and imaging examinations were retrospectively analyzed.According to the clinical symptoms, all the patients received percutaneous transhepatic biliary drainage (PTBD) including permanent external drainage, temporary internal drainage and implantation of covered stents.Serum total bilirubin (TBIL) after the interventional therapeusis were measured and compared with that before the treatments by t test to evaluate the efficacy of these treatments.The relief of clinical symptoms was also reviewed to evaluate the efficacy of these treatments.The patients were followed up within 2 years.Results The PTBD was successfully performed in 16 cases.Permanent external drainage, temporary internal drainage and implantation of covered stents were performed in 2 patients, 7 patients and 7 patients respectively.TBIL after the interventional therapy decreased significantly (t=7.366, P<0.01) to (161.2±80.5) μmol/L averagely from (261.9±77.2)μmol/L before the treatments.All the patients died before the end of followed-up.The average survival time was 204 days (30 to 391 d)and the median survival time was 200 days.Bleeding and infection were the main complications, which could be controlled successfully by routine treatments.Conclusion With high achievement ratio and good efficacy, percutanously interventional therapeusis are good choices for the treatments of obstructive jaundice due to bile duct thrombosis.