Metastasis is the main cause of the high mortality of lung cancer. Research is currently underway to understand metastasis at molecular level. Many molecular markers have been shown to participate in metastasis, including thymidylate synthase, angiogenesis lymphangiogenesis-related factors, cell adhesion molecules, extracellular matrix metalloproteinases, cytokines, and metastasis-associated genes. Elucidating the molecular mechanism of metastasis will help improve the early diagnosis and treatment of lung cancer.

[Objective] To observe the effect of medical ozone on cartilage in the model of osteoarthritis(OA)to explore its therapeutic mechanism.[Method] Forty healthy adult SD rats were randomly divided into five groups :A(group normal)、B(group model)、C(group air),D(group O2~O3 35 ?g/ml)and E(group O2~O3 70 ?g/ml)(n=8 in each group).The OA model was duplicated by performed anterior eruciate ligament transection(ACLT)and partial meniscectomy of 1/3 inside.Air was injected into joints of group C,according to concentration different,which O2~O3 35 ?g/ml and O2~O3 70 ?g/ml were respectively injected into joints to D and E group every other day,every time 1～1.5 ml,and after a week injected again.After the model was successfully made,the condylar cartilage of femur was excised after 4 weeks for the observation by transmissive microscope of HE staining.Mankin's index was recorded.At the end of the experiment,douche fluid of the diseased joints were obtained for the measurements of superoxide dismutase(SOD)and malondialdehyde(MDA).[Result]The OA model in B group founded obviously degenerative changes under microscopy,resulting in mostly blue and green color destaining of Masson staining at superficial cartilage.The activity of SOD in the douche fluid of the diseased joints degraded and the quantity of MDA in the serum in the OA model group increased.The Mankin's index in the group D was significantly higher than that in the group B、 C(P

Objective To investigate the radiation pollution level of radon and ? radiation in air in different type of buildings. Methods 22 different type of rooms were selected and common measuring methods and REM-2 Radon exhalation rate apparatus and FD-125 Rn-Th measuring instrument were used. Results It indicated that the indoor radioactive contamination mostly root in the exhalation of soil and building material, secondly outdoor radon and ? radiation, water and the wall contributed little. Conclusion The results of the present paper have laid a foundation for the further study on the effect of radiation on human health and the protective technique.

The subject of clinical medicine contains abundant humanism educational material.When students start the clinic learning and contact with the patients for the first time,clinical teacher should endeavor to cultivate medical students' humanistic spirit in clinical practice.The paper discussed how to merge humanistic spirit into medical clinic teaching by illustrating the gynecology and obstetrics teaching.

Objective Based on the liver biopsy samples in the past 10 years, this study aimed to investigate the incidence of fatty liver, the relationship among fatty liver and other underlying liver diseases, the clinical and pathological characteristics and the risk factors of fatty liver. Methods In the total 658 cases of liver biopsy from 1988 to 1997, there were 71 cases of fatty liver, among them 68 cases were nonalcoholic fatty liver. Matched by sex and age, 155 cases of non fatty liver cases were taken as control. All cases had had the tests of liver function, blood lipid profile, blood glucose and hepatitis virus markers. Liver biopsy samples were investigated by pathologists. Results The incidence of fatty liver among all the liver biopsy cases was 10.8%. The patients' ALT, AST, TB and CB levels in fatty liver group were significantly lower than in non fatty liver group ( P

Heart rate is the most common index to directly monitor the level of physical stress by comparing the subject's heart rate with an appropriate "target heart rate" during exercise. However, heart rate only reveals the cardiac rhythm of the complex cardiovascular changes that take place during exercise. It is essential to get the dynamic response of the heart to exercise with various indices instead of only one single measurement. Based on the rest-workload alternating pattern, this paper screens the sensitive indices of exercise load from electrocardiogram (ECG) rhythm and waveform, including 4 time domain indices and 4 frequency domain indices of heart rate variability (HRV), 3 indices of waveform similarity and 2 indices of high frequency noise. In conclusion, RR interval (heart rate) is a reliable index for the realtime monitoring of exercise intensity, which has strong linear correlation with load intensity. The ECG waveform similarity and HRV indices are useful for the evaluation of exercise load.
Electrocardiography ; Exercise ; Heart Rate ; Humans ; Monitoring, Physiologic ; Workload

Objective To study the clinical features,treatment methods and clinical outcomes of acute tibialis posterior tendon rupture.Methods Using [(posterior tibial tendon) OR (tibialis posterior tendon)] AND (rupture OR injury OR disruption OR trauma OR tear) as the search words,we searched the PubMed database to retrieve the 19 articles involving 24 cases of acute tibialis posterior tendon rupture.The injury mechanisms,X-ray manifestations,operational findings,treatment methods and clinical outcomes were analyzed.Results The mechanisms of the fracture-related tibialis posterior tendon rupture included motor accident (50.0％,12/24),falling from a height (41.7％,10/24) and sports injury (8.3％,12/24).The tendon rupture was mostly complicated with malleolar fracture (91.7％,22/24),especially the pronation type (70.8％,17/24).Direct suture of the tendon was adopted in 91.7％ of the cases (22/24).Favorable outcomes were achieved in 95.5％ of the cases (21/24).Conclusions Acute tibialis posterior tendon rupture is mostly seen in high-energy medial malleolus fracture.The mechanism of the rupture might be tendon distraction or bone flake incision.Early operation can lead to favorable outcomes.

Objective:We aimed to explore the clinical features, computed tomography (CT) findings, treatment, and prognosis of bronchopulmonary carcinoid. Methods:Clinical data of 31 patients with primary carcinoid tumor of the lung were retrospectively re-viewed. The prognostic factors were analyzed via Cox univariate and multivariate analyses. Results: Clinical symptoms included coughing or expectoration in 17 of the 31 cases, hemoptysis or blood-stained sputum in 7 cases, and chest pains or shortness of breath in 8 cases. Six cases were asymptomatic. The CT scans showed round or oval nodules with clear boundaries, and enhancement CT scans indicated mild, homogeneous enhancement. Immunohistochemistry results revealed the positive expression rates of synaptophy-sin (Syn), chromogranin A (CgA), and neuron-specific enolase (NSE) were 90.3%(28/31), 87.1%(27/31), and 90.3%(28/31), respec-tively. Therapy and prognosis results were as follows:28 of the total number of patients underwent surgery, among which 3 underwent postoperative adjuvant therapy, 2 received chemotherapy; and only 1 refused treatment. The 1-year overall survival rates were 100%(18/18) and 92.3%(12/13), whereas the 3-year survival rates were 94.4%(17/18) and 69.2%(9/13) in the typical and atypical carcinoid cases, respectively. Cox univariate analysis results revealed that lymphatic metastasis (P=0.02), tissue types (P=0.017), TNM stage (P=0.005), and therapies (P=0.01) were the prognostic factors. Cox multivariate analysis results showed that lymphatic metastasis (P=0.032) and tissue types (P=0.002) were the independent prognostic factors. Conclusion:Compared with other lung cancers, the bron-chopulmonary lung carcinoid has no special clinical manifestation in clinical and radiographic images. The diagnosis was mainly based on histopathology results. Surgery was the main and effective treatment, whereas chemotherapy and radiotherapy showed unsatisfactory results. The overall prognosis was satisfactory. However, the atypical carcinoid was inferior to the typical carcinoid in terms of progno-sis. Pathological typing and lymph node metastasis were significant prognostic factors.

Objective:To evaluate the value of ultrasound-guided transperineal systematic prostate biopsy(SPB)and cognitive fusion multi-parameter magnetic resonance imaging(mpMRI) suspicious transperineal targeted biopsy(CFTB) in the prostate cancer with different serum prostate specific antigen(PSA) levels.Methods:A retrospective analyses were performed in 527 patients with suspected prostate cancer who underwent ultrasound-guided SPB from January 2018 to December 2019 in Shanghai Jiaotong University Affiliated 6th People′s Hospital. According to the PSA levels, they were divided into group A(PSA 4-10 μg/L) and group B(PSA>10 μg/L). All the patients underwent ultrasound-guided SPB, 376 patients with suspicious mpMRI had two additional targeted biopsies. The detection rates of ultrasound-guided SPB and CFTB in prostate cancer were tested by χ 2 test. Compared with pathological results, the sensitivity, specificity, accuracy of two methods were calculated and tested by χ 2 test, and a P<0.05 was defined as statistically significant difference. Results:Prostate cancer was detected in 319 of 527 patients(60.5%). One hundred and three cases of 198 patients in group A were diagnosed as prostate cancer, with an overall detection rate was 52.0%. Among them, ultrasound-guided SPB detected 72 cases of prostate cancer, the detection rate was 36.4%, sensitivity was 67.9%, specificity was 17.7%, accuracy was 26.5%, the detection rate, sensitivity, specificity and accuracy of CFTB were 39.9%, 75.6%, 91.6% and 88.8%, respectively. In this group, there were no statistically significant differences in the detection rate and sensitivity of the two methods in the diagnosis of prostate cancer (χ 2=0.525, 0.005, both P>0.05), and the differences in specificity and accuracy were statistically significant (χ 2=108.340, 79.829, respectively, both P<0.05). Two hundred and sixteen cases of 329 patients in group B were diagnosed as prostate cancer, with an overall detection rate was 65.7%. Among them, 160 cases of perineal prostate cancer were detected by ultrasound-guided SPB, with the detection rate was 48.6%, sensitivity was 78.2%, specificity was 37.6% and accuracy was 49.5%. A total of 189 cases of prostate cancer detected by CFTB, the detection rate was 57.4%, the sensitivity was 89.3%, the specificity was 90.6%, and the accuracy was 90.2%. All the differences were statistically significant in group B(χ 2=5.131, 4.391, 61.339, 38.982, all P<0.05). Conclusions:When PSA is greater than 10 μg/L, CFTB has a higher diagnostic efficiency than SPB.When PSA is 4-10 μg/L, there are no significant differences between the two methods in the detection rate and sensitivity of prostate cancer.

Objective:To observe the clinical effect of TOMY self-ligation appliance technique in the treatment of anterior crossbite and moderate crowding, and to explore its clinical application.Methods:A patient, manifested as anterior crossbite and moderate dentition crowing, diagnosed as Angle class Ⅲ subclass malocclusion, MaoⅡ1+Ⅰ1 malocclusion, high angle,and facial asymmetry, was selected.This patient was treated with TOMY self-ligation appliance technique without tooth extraction.The length and width of the dental arch, the width of the alveolar bone and the width of the basal arch were measured before and after treatment;the lateral radiographs of the patient were taken too.Results:After treatment,the upper and lower dentition arranged in neat rows, reached a neutral occlusal relationship;SNA, SNB and ANB had no obvious changes;the lip inclination of anterior teeth was increased by 10 degrees, and reached the normal value;the upper and lower dental arch width, alveolar bone width, basal bone arch width and dental arch length were lower than before treatment.Conclusion:For the patient with anterior crossbite and moderate dental crowding treated with non-extraction, the TOMY self-ligation technique can be considered to use, by increasing the arch width and length to improve the anterior crossbite and moderate crowding, in order to achieve the effective treatment.