Objective Analyzed from row stone soup combined tan solo symplectic auxiliary row stone calculi in patients with ureteral Duan Jieshi under net rate and the influence of renal colic, so as to provide the basis for clinical treatment.Methods 90 patients with ureteral Duan Jieshi under in our hospital from January 2014 to February 2016 were selected, urology clinic of according to random, the principle of equal distribution is divided into group A (from row stone soup combined tan solo symplectic group) and group B (pure tan solo symplectic group), group C (pure traditional Chinese medicine medicinal broth group), 30 cases in each group.Observe and record the bladder irritation, frequent urination urgency), ureteral colic, discharge time, stones row net rate and incidence of adverse reactions after the comparison.Results In group A discharge time and stones row net both significantly better than B and C groups, the difference was statistically significant (P<0.05); the discharge time and stones row net between group B and C was no statistically significant difference.Group C on frequent urination urgency and ureteral colic happens to have more of A and B groups, the difference was statistically significant ( P <0.05 ); there was no statistically significant difference between group A and B.Adverse reaction of three groups of appeared in the process of treatment: group A in one case of mild diarrhea and one case of mild dizziness , group B in one case of mild headache and one case of mild dizziness, group C not present any adverse reaction, there were no significant differences in the incidence of adverse reactions among the three groups.Conclusion From row stone soup with tan solo symplectic auxiliary platoon stone therapy has good effect for patients with ureteral Duan Jieshi under, can give full play to the acetanilide spasmolysis effect of western medicine, also can better exert TCM row Shi Tong drench, analgesic anti-inflammatory, clear the role of the hot and humid, can improve the stone free rate, relieve patients with renal colic.

Objective To investigate the positive expression of ATP binding cassette transporter protein F2 (ABCF2) in ovarian cancer tissue and its relationship with chemotherapy resistance.Methods 91 patients with ovarian cancer specimens were selected and 42 cases from the tumor 5cm adjacent tissues as normal controls, ABCF2 expression in each sample was detected by immunohistochemical staining , the relationship between ABCF2 expression and clinicopathological features of patients with ovarian cancer were analyzed .Results The positive expression rate of ABCF2 in ovarian cancer tissue was 68.13%, which was significantly higher than that in normal ovarian tissue (9.52%), and the difference was statistically significant (P<0.05).The positive expression of ABCF2 was not related to the age and organization type of ovarian cancer patients.The positive expression rate of ABCF2 in stage III~IV was 86.54%, which was significantly higher than that of phase I~II (43.59%), the difference was statistically significant (P<0.05). The positive expression rate of ABCF2 in patients with chemotherapy resistance was 88.89%, which was significantly higher than that in patients with chemotherapy sensitivity ( 59.38%) , and the difference was statistically significant ( P<0.05 ) .The results of Logistic regression analysis showed that ABCF2 positive expression was the independent influencing factor of ovarian cancer drug resistance (OR =4.586,95% CI:1.121 ~3.392,P<0.05). Conclusion ABCF2 is highly expressed in ovarian cancer, which may be associated with chemotherapy resistance in patients with ovarian cancer .

Objective To evaluate the application of sentinel lymph node biopsy in surgical operation for clinical stage N0 differentiated thyroid carcinoma.Methods One hundred and six patients who were diagnosed clinical stage N0 differentiated thyroid carcinoma in Department of Mammary Gland Thyroid Surgery of Qingdao Women and Children's Hospital between Jan.2012 and Jan.2013 were reviewed retrospectively.Carbon nanoparticles were used to trace sentinel lymph node in the surgery,the patients were divided into the dissection group (46 cases included 2 cases whose sentinel lymph nodes were not detected) and the non dissection group (60 cases) based on the rapid pathological results.The operation index,complications incidence and short-term outcomes were compared.Result The operative time,intraoperative blood loss and the faulty excision of parathyroid gland in dissection group is much higher than those in non dissection group (P ＜0.05).The incidence of provisionality hypoparathyroidism in dissection group is much higher than those in non dissection group (P ＜ 0.05).There were no permanent hypoparathyroidism and damage of laryngeal nerve in the two groups.Postoperative outpatient follow up was 30 months,no significant differences were seen in local regional recurrence rates(6.5％ vs 10％) between the two groups (P ＞ 0.05).There were no distant metastasis occurred in the two groups.Conclusions Lymph node metastasis can be found by sentinel lymph node biopsy,it is helpful for us to decide whether dissect central lymph node or not.Carbon nanoparticles is safe,which is helpful to protect the parathyroid gland.

Objective To investigate indications,pacing modes,pacing parameters and postoperative complications of pacemaker implantation for patients aged 80 years or over.Methods Patients were recruited on a continuous basis and were assigned into two groups,with 112 patients in the very elderly (80-90 years old) group and 484 patients in the elderly (60-79 years old) group,which served as the control.Follow-up observations with the two groups were conducted concerning indications,mode selection,pacing parameters and postoperative complications.Results Compared with the control group,the very elderly group showed:1) a higher rate of coronary heart disease (58cases vs.163 cases or 51.8％ vs.33.7％ ; x2 =12.78,P＜0.01) ; 2) more single-chamber pacemaker implantations (63 cases vs.217 cases or 56.3％ vs.44.8％; x2=4.76,P＜0.05) and fewer dual-or multi-chamber pacemaker implantations (49 cases vs.267 cases or 43.8％ vs.55.2％ ; x2 =4.76,P＜0.05) ; 3) a higher rate of double bundles branch block (19 cases vs.31 cases or 17.0％ vs.6.4％ ; x2=13.20,P＜0.01); 4) a higher rate of postoperative acute cerebral infarction (x2 =8.34,P＜0.01) ; and 5) increased ventricular [(0.78±0.24)V vs.(0.55±0.16)V,P＜0.05]and atrial [(1.07±0.22)V vs.(0.84±0.28)V,P＜0.05]pacing thresholds.Conclusions Special considerations should be made when pacemaker implantation is planned for patients aged 80 or over.Pacemaker selection decisions ought to be based on a comprehensive evaluation of relevant clinical situations so that clinical benefits can be maximized.

This article expounds on the necessity of the introduction of comparative imaging in bone and joint imaging teaching according to the bone and joint imaging teaching situation and modern medical radiographic features.Meanwhile,it discusses the application of comparative imaging in bone and joint imaging teaching from aspects of teaching method,teaching effect evaluation and prospects of the comparative imaging.

Objective To study the effect of different dose fractionation on overall survival in patients with limited-stage small cell lung cancer (LS-SCLC). Methods LS-SCLC patients treated with radical combined chemotherapy and radiotherapy (RT) between January 2001 and Dec 2007 were analyzed retrospectively. According to the dose fractionation schemes, patients were divided into three groups:conventional fractionated RT (1. 8 -2.0 Gy,once daily), hyperfractionated RT (1.4 Gy, twice daily) and hypofractionated RT (2. 5 Gy,once daily). Overall survival, disease free survival and pattern of failures of the three groups were compared. A total of 177 patients were enrolled, including 63 patients in conventional fractionated RT group, 79 in hyperfractionated RT group and 35 in hypofractionated RT group. Results The overall follow-up rate was 96. 6%. The patient numbers with follow-up of more than 2 and 5 years were 153 and 92, respectively. The median survival time of the entire group was 22. 4 months, and the 2-and 5-year survival rates were 43.4% and 23. 5%, respectively. The 2-year survival rates for three groups were 31%, 46% and 59% (x2 =7.94,P=0.019), respectively. The 2-year disease free survival for three groups were 20%, 31% and 40% ( x2 = 4. 86, P = 0. 088 ), respectively. In the pairwise comparisons,patients in hypofractionated RT group have better survival than those in conventional fractionated RT group ( x2 = 7. 81, P = 0. 005 ), the effect of hyperfractionated RT group lies between the hypo-and the conventional fractionated RT groups, but no significant differences were detected ( x2 = 2. 31, P = 0. 128; x2 = 2. 95, P =0. 086). The mildest side effect was found in the hypofractionated RT group. No statistically significant differences were found in the patterns of first failure. Conclusion The hypofractionated RT scheme showed potential survival benefits for patients with LS-SCLC and should be considered in the setting of randomized clinical trials.

Objective To comparative study the effect on colorectal cleansing of CT colonography with gulping down 10 mg bisacodyl before or 1 h after oral taking 2 liter polyethylene glycol .Methods Forty participants with informed consent were appor‐tioned to group A ,group B randomly ,20 cases in each group .On the day before CT colonography ,participants in group A oral took 20 mL of 40% W/V barium sulfate prior to 3 mealtime ,and 20 mL of 60% diatrizoate meglumine diluted in 250 mL of water after supper ,then gulped down 10 mg bisacodyl enteric‐coated tablets 1 hour before oral taking 2 liter polyethylene glycol electrolyte so‐lution .Participants in group B were the same as that in group A ,with the exception of gulping down 10 mg bisacodyl enteric‐coated tablets 1 hour after oral taking 2 liter polyethylene glycol electrolyte solution .Cleansing efficacy of stool and fluid ,and attenuation value of remainder fluid between the two groups were analyzed statistically .Results In group A ,score of cleansing efficacy of stool (1 .96 ± 0 .11) was lower than that in group B (2 .01 ± 0 .12) ,segments with good cleansing efficacy of stool (87/120 segments , 72 .50% ) was higher than that in group B (83/120 segments ,69 .17% ) ,the difference was not statistically significant (P>0 .05) .In group A ,score of cleansing efficacy of fluid (1 .50 ± 0 .06) was lower than that in group B (1 .53 ± 0 .06) ,segments with good cleansing efficacy of fluid(113/120 segments ,94 .17% ) was higher than that in group B (111/120 segments ,92 .50% ) ,the differ‐ence was not statistically significant (P>0 .05) .Attenuation value of remainder fluid [(729 ± 29)HU ] in group A was higher than that in group B[(653 ± 25)HU] ,the difference was statistically significant(P<0 .05) .Conclusion Gulping down 10 mg Bisacodyl before or after oral taking 2 liter polyethylene glycol has no effect on cleansing of stool and fluid ,with good cleansing efficacy .The former has better cleansing efficacy of fluid ,is beneficial to detecting polyps for CT colonography .

Objective To retrospectively design an intensity?modulated radiotherapy ( IMRT) plan with split field and fixed jaw techniques for peripheral lung cancer with mediastinal lymph node metastasis, to compare dosimetric characteristics between the IMRT plans with fixed jaw and dynamic jaw, and to study lung protection by the plan with split field and fixed jaw. Methods Treatment plans were collected from 12 patients with peripheral lung cancer and mediastinal lymph node metastasis who were treated with IMRT in our hospital. All plans used the dynamic jaw technique. The plans with split field and fixed jaw were designed based on the identical computed tomography images and planning target volume ( PTV) . Each jaw position in split field depended on each separate PTV. The prescription dose was 60 Gy in 30 fractions. 95%PTV was planned to receive 100% of the prescription dose. Dosimetric parameters of PTV, conformity index ( CI) , heterogeneity index ( HI) , number of monitor units ( MUs) , and dose?volume values of the lung and heart were obtained from dose?volume histogram. Comparison between the two plans was made by paired t test. Results Both plans met clinical requirements. There were no significant differences in D2 , D98 , CI, or HI of PTV between the two plans ( all P>005) . Compared with the dynamic jaw plan, the fixed jaw plan had MUs increased by 15%?20%( P=0010) . The V5 , V10 , V20 , V30 , and mean dose for the whole lungs were significantly lower in the fixed jaw plan than in the dynamic jaw plan ( P=0000, 0000, 0000, 0002,0000) . The V5 , V20 , and mean dose for the healthy lung were also significantly lower in the fixed jaw plan than in the dynamic jaw plan ( P=0000,0017,0000) . There were no significant differences in dose?volume values for the spinal cord or heart between the two plans ( all P>005) . Conclusions IMRT with split field and fixed jaw is recommended for patients with peripheral lung cancer and mediastinal lymph node metastasis. The therapy to a certain extent reduces low?dose volume for the lung and the incidence of radiation?induced pneumonitis.

Objective To investigate the genetic polymorphisms of the glutathione S-transferase M1 and T1 genes(GSTM1 and GSTT1),and eval-uate the oxidative damage in patients with non-small lung cancer(N-SCLC). Methods A total of 110 patients with N-SCLC and 100 healthy indi-viduals were recruited in this case-control study. Multiplex polymerase chain reaction(PCR)analysis was used to identify the genotypes. The activi-ty of malondialdehyde(MDA),nitric oxide(NO),and the total antioxidant capacity(T-AOC)were detected by spectroscopic analysis using assay kits. Results The frequencies of the GSTM1,T1,and GSTM1/T1 null genotypes in the patient group were significantly higher than those in control group(OR1=2.071,P1=0.009;OR2=1.900,P2=0.024;OR3=3.258,P3=0.003). The activity of MDA and NO were obviously higher in the pa-tient group compared with the control group(P<0.001),and T-AOC was obviously lower in patient group than those in control group(P<0.001). The activity of MDA,and NO were higher but the T-AOC were lower in patients with GSTM1,T1 and GSTM1/T1 null genotypes than those in pa-tients with GSTM1,T1 and GSTM1/T1 present genotypes(P<0.001). Conclusion Our results suggest that oxidative damage may play a impor-tant role in patients with N-SCLC,and the N-SCLC patients with GSTM1and GSTT1deletion genotypes are more susceptible to oxidative damage.

Objective To construct the genetic recombinant adenovirus vector carrying the human growth and differentiation fac-tor-5(GDF-5) gene by using AdEasy-1 adenovirus vector system and to amplify and prepare the recombinant adenovirus in HEK 293 cells .Methods Human GDF-5 gene obtained by PCR was inserted into plasmid pMD19-T and the 1 .7 kb GDF-5 cDNA sequence was cloned into the adenoviral shuttle plasmid pShuttle-cytomegalovirus(CMV) of the AdEasy-1 system .It was identified by DNA sequencing and a digestion with Hind Ⅲ restriction enzyme .The resultant pShuttle-CMV-GDF-5 was used to generate the adenovi-ral GDF-5 vector through homologous recombination with the adenoviral backbone plasmid ,pAdEasy-1 in BJ5183 bacterial cells .It was selected by kanamycin and identified by a digestion with Hind Ⅲ restriction enzyme and amplified in XL10-Gold competent bac-teria .The DNA of recombinant adenovirus vector was finally linearized by Pac Ⅰ and the adenoviral recombinants were used to pro-duce adenoviruses in HEK293 packaging cells ,resulting in an Ad-GDF-5 identified by Western blot .The virus titer was assayed by TCID50 .Results GDF-5 cDNA sequence obtained by PCR was 1 .7 kb .Gene sequencing results indicated that the sequence was i-dentical with the one in GENBANK .Cloned sequence 1 .7 kb(GDF-5) was obtained by a digestion with Hind Ⅲ restriction enzyme after GDF-5 cDNA segment was cloned into pShuttle-CMV and AdEasy-1 .Western blot showed that two bands migrating at ap-proximately 15 and 55 kDa were clearly observed in PVDF membrane .These data confirmed that HEK293 cells expressed a large number of mature GDF-5 protein after infected with Ad-GDF-5 .Our research results demonstrated that recombinant adenovirus vector GDF-5 was successfully constructed .The virus titer was 5 .6 × 109 PFU/mL .Conclusion Recombinant adenovirus vector carrying the human GDF-5 gene is successfully constructed by using the AdEasy-1 adenovirus vector system .Moreover ,the Ad-GDF-5 with high titer is prepared .These provide the basis for further study of the biological function of GDF-5 and the gene thera-py of its related diseases .