Purpose:To investigate the related factors affecting the prognosis of patients with cervical carcinoma treated with radiotherapy. To analyze the relationship between the survival rate and some factors such as the tumor size,treatment days and local control.Methods:From April 1993 to April 2001,83 cervical carcinoma patients with stage Ⅰ,Ⅱ,Ⅲ were treated with cobalt teletherapy and 192 Ir high-dose-rate brachytherapy as primary treatment. The method of external irradiation: first deliver DT25-26Gy/13 fraction,then increase the dose to DT48-50Gy with middle lead block in the field. The internal radiation method: the dose ir A point is DT 35 Gy/7 fraction. Kaplan- Meier method was used to calculate the survival rate and Log-rank test for the difference significance.Results:①local control: the 1-,2-,3-,5-year survival rates in complete response and partial response patients and progressive patients were respectively 95.87%,77.12%,73.09% 73.09%and 34.29%,0%,0%,0%,there is significant difference between them . ②treatment days :the 1-,2-,3-,5-year survival rates in the patients with treatment days exceeding 56 days and not exceeding 56 days were respectively 93.88%,82.86% 80.19%,80.19% and 78.95%,30.55%,22.91%,22.91%,there is significant difference between them . ③the maximum tumor diameter : the 1-,2-,3-,5- year survival rates in patients with the maximum tumor diameter exceeding 4 centimeters and not exceeding 4 centimeters were respectively 95.12%,82.86%,79.67%,79.67% and 81.93%,58.20%,53.35%,53.35%,there is significant difference between them.Conclusions:①The patients with local residual tumor and bigger tumor volume had relatively poorer prognosis;②The treatment days should be shortened to 8 weeks if possible;③ The comprehensive treatment and shortened treatment days may improve the therapeutic effect for the patients with tumor size ≥4cm,local residual and progressive tumor.

Objective: To study the chemical constituents of the methylene chloride of Rubus chingii Hu.. Methods: Chromatography on silica gel column, Sephadex LH-20 column, and recrystallization technique were used to isolate and purify the compounds. Spectroscopy methods including EI-MS, ES-MS, 1H-NMR, 13CNMR, HMQC, and HMBC were used to elucidate the structures of compounds. Results: Ten compounds were obtained and 9 compounds were identified as: hexacosanol (I), β-sitosterol (II), 4-hydro-3-methlbenzal acid (III), 4-hydrobenzal dehyde (IV), oleanolic acid (V), stigmast-5-en-3-ol, oleate (VI), H-2-indenone, 2, 4, 5, 6, 7, 7a-hexahydro-3-(1-methylethyl)-7a-methyl (VIII), 4-hydroxy-3-methoxybenzoic acide (IX), and liballinol (X). Conclusion: Compounds I, III, IV, VI, VIII, and X have been obtained from Rubus chingii for the first time.

Objective To examine the efficacy of applying clinical pathway (CP) teaching model in orthopedics clinical teaching.Methods Totally 64 medical undergraduates were randomized into 2 groups.The traditional teaching method and CP model were separately preformed on them.Their scores of theoretical,manipulation and case analysis exams at the end of internship were compared.Meanwhile the questionnaire of satisfaction degree also was conducted.Results Scores of exams and satisfaction degree were better in CP group than in classical group (P ＜ 0.05).Conclusions The novel CP model can promote the standardization and systematization of clinical teaching in orthopedics.It is conducive to evaluating teaching effect and performing teaching reform.Meanwhile,it is in accordance with the problem-based learning and can improve clinical teaching effect and satisfaction degree.

Objective To compare the efficacy of Lichtenstein and transabdominal preperitoneal patch repair(TAPP) in the treatment of primary inguinal hernia in adults. Methods The clinical data of 223 patients who received Lichtenste and 121 patients who underwent TAPP in our hospital between January 2002 and January 2006,were analyzed retrospectively.The efficacy and complications of the two methods were compared.Results The rate of intraoperative injury of the inner organs in the TAPP group was significantly higher than that in the Lichtenstein group [5.8%(7/121) vs 0.4%(1/223),?2=7.626,P=0.006],while no significant difference was detected in the rate of abdominal organ injury between the two groups [0.8%(1/121) vs 3.1%(7/223),?2=0.969,P=0.325].The rate of postoperative complications in the TAPP group was significantly lower than that in the Lichtenstein group [14.0%(17/121) vs 36.3%(81/223),?2=18.881,P=0.000].In the TAPP group,during a follow-up of(14?7) months,one case of recurrence was found(0.8%).Whereas in the Lichtenstein group,the patients were followed up for(16?8) months,two of them had recurrence(0.9%).No significant difference existed in the recurrence rate between the two groups(?2=0.000,P=1.000).Conclusions Both the Lichtenstein and TAPP have benefits and drawbacks.Individulized therapy is recommended for the patients with inguinal hernia.It is important for surgeons to know the indications of the operations.

BACKGROUND:Ribbed anatomic femoral stem meets the biomechanical features of the femur, and has achieved satisfactory clinical efficacy with good initial stability, rapid bone growth and low stress shielding.
OBJECTIVE:To evaluate the design features and clinical results of the cementless anatomic Ribbed femoral stem (Ribbed stem) in total hip arthroplasty.
METHODWe retrospectively analyzed 52 patients (52 hips) with hip joint disease who were treated with Ribbed stem in total hip arthroplasty between March 2010 and March 2012. There were 20 males and 32 females. The mean age was 59 years (range 22-78 years). The mean fol ow-up was 3.1 years (range 2-4 years). The preoperative and postoperative Harris hip scores, the rate of postoperative thigh pain, the incidence of intraoperative femoral fracture, wound healing, dislocation and revision were recorded. Radiographic evaluation was used to evaluate the rate of stem fil , subsidence of femoral stem, periprosthetic radiolucent line, bone ingrowth, stress shielding, and osteolysis.
RESULTS AND CONCLUSION:The incidence of intraoperative femoral fracture was 6%. Al incisions were healed. There were no cases of hip dislocation and revision;the rate of thigh pain was 6%, no patient had thigh pain after 1 year postoperatively. The mean preoperative Harris hip score was 48 points, which improved to a mean of 96 points at the final fol ow-up. Postoperative X-ray showed that al patients had a satisfactory femoral fil in both planes and al of the femoral stems were wel-fixed at the final fol ow-up. The average fil ing rate was 91%, 88%and 86%by normotopia imaging, while 88%, 85%and 81%by lateral imaging, at the metaphysic, middle and distal ends respectively. At the final fol ow-up, 49 hips (92%) showed stable bone ingrowth, 3 hips showed stable fiber ingrowth. No osteolysis around the components at the femur or acetabulum was observed. 5 (10%) hips appeared the subsidence of femoral stems, which were<2 mm. The stress shielding phenomenon occurred in al patients, including first-degree in 31 hips, second-degree in 19 hips, third-degree in 2 hips, and fourth-degree in no case. Experimental findings indicate that, Ribbed stem with a rational design can achieve satisfactory clinical outcomes with good initial stability, rapid bone growth and low stress shielding.

10.3969/j.issn.2095-4344.2013.25.003

Cell therapy has a very promising potential for end-stage liver diseases (ESLD).Fetal liver stem/progenitor cells (FLSPCs) have advantages of safety,high survival and proliferation rates,and a small volume,all which make them ideal for liver disease stem cell therapy.During the early phase of our study,we applied a three-step separation method to enrich FLSPCs and obtained a separation efficiency similar to that of the flow-cell sorting method.Additionally,using a fulminant hepatic failure model in rats,we have demonstrated that FLSPCs can contribute to morphological and functional recovery of the liver.This manuscript will discuss how FLSPCs can be induced to accurately differentiate into hepatocytes and cholangiocytes and how FLSPCs maintain self-renewal.The Notch signaling plays a critical role in regulating the differentiation and self-renewal of many types of stem cells.Our previous findings have shown that the Notch signaling plays an important role in FLSPCs differentiation into hepatocytes.Therefore,the Notch signaling might be involved in the differentiation and self-renewal of FLSPCs.We conducted a study on the regulatory effects and relative molecular mechanisms of the Notch signaling on FLSPCs and found the corresponding interfering target,which might become an index for the clinical application of FLSPCs.

Objective To investigate the expression of angiotensinⅡ (Ang Ⅱ ) and its type 1 receptor (AT1) in circulation, placenta and kidney of the rots preeclampsia. Methods Preedampsia rat model was developed by inhibitor of nitric oxide synthase (L-NAME). The systolic blood pressure (SBP), 24 h urine protein, hepatic and renal function were compared among the precelampsia group, the normal pregnant group and nonpregnant control group. The kidney tissue was observed by light microscopy. ELISA and radioimmunoassay were used to detect Ang Ⅱ in rat plasma and kidney homogenate respectively. Placental AT1 was measured by Westem blot. The level of kidney AT1 was evaluated by immunohistochemistry and Western blot. Results In preeclampsia rats, SBP and 24 h urine protein were significantly higher compared with control groups. Compared to normal pregnant group, plasma Ang Ⅱ of preeclampsia rats was much higher [(0.706±0.086) ng/L vs (0.540±0.085) ng/L, P＜0.05]; placental AT1 was increased by 46%(P＜ 0.05); kidney Ang Ⅱ was decreased signigicantly [(65.543±40.634) ng/g vs (165.543±33.078) ng/g, P＜0.05]. The expression of ATI in kidney of preeclampsia rats was reduced evidently,which was only 33% of normal pregnancy group and 59% of nonpregnant control greup,respeetively (P＜0.05). Conclusions In preeclampsia rat model, the circulating Ang Ⅱ is increased, the placental RAS isactivated, while the kidney BAS is suppressed. The underlying mechanism of proteinuria and kidney damage associated with this phenomenon in preeclampsia needs further research.

Objective To explore the value of Toll-like receptor 2(TLR2) on the diagnosis of neonatal septicemia especially for the early diagnosis.Methods Twenty-two newborns with septicemia were divided into 2 groups according to the time of onset:early-onset group(n=12) and late-onset group(n=10).Another 14 non-infectious newborns were collected as control group.The TLR2 mRNA in peripheral blood was detected by real-time polymerase chain reaction,and mononuclear cells were isolated by the density gradient centrifuga-tion;the C reaction protein(CRP) was detected,and the co-relationship of the indexes was analyzed by Pearson correlation analysis.Results 1.The level of CRP in early-onset group were(157.89?32.96) ng?L-1,and(89.78?16.24) ng?L-1 in late-onset group,and there was significant difference between both groups(P=0.001);(6.91?1.20) ng?L-1 in control group,which was significantly lower than that in early-onset group and late-onset group(P=0.000,0.001).2.The expression of TLR2 mRNA in early-onset group and late-onset group was(57.38?10.72)?1012 copies?L-1and(32.74?4.65) ?1012 copies?L-1,which was significantly higher than that in control group[(4.12?0.68) ?1012 copies?L-1].3.CRP is positively correlated with TLR2 mRNA(C=0.972,P=0.000).Conclusions TLR2 expression is proven to be related to both the level of CRP and the stage of onset and may play a key role in the pathogenesis of neonatal septicemia.Detection for TLR2 may assist the earlier diagnose of atypical neonatal septicemia.