Epidermal growth factor receptor(EGFR) correlates closely with tumor genesis and progres-sion. Several agents targeting EGFR have been used in clinic, and achieved good effect in treatment of ad-vanced and drag-resistant tumors, such as monoclonal antibodies and small molecule tyrosine kinase inhihitors.

Objective:To evaluate the different effect of TACE and TACE combined with PEI and RF in treating liver metastasis.Methods:67 patients with liver metastasis were classified as group TACE(46 cases)and combined group including TACE+PEI(7 cases) and group TACE+RF(14 cases).All patients were analyzed after treatment by follow-up、CT and their blood biochemical tests.Results:The rate of tumor shrinkage and necrosis was 46.8% and 20.7%,while the contrast group was 78.9%,49.2% respectively(P

The tralning system for orthopedic surgeon in Britaln is mature and complete. After completing education in medical college, medical students receive a 2-year base tralning (FY1, FY2), which focus on learning and consolidating basic medical knowledge and clinical skill, followed by a 6-year specialist tralning, which subdivides into tralning of ankle and foot, hand, should and elbow, hip, knee, spine, and pediatric surgery, provided by several district hospital (Peripheral hospitals). Students are required to return to teaching center for review, ward inspection, case discussion at regular inter-vals. Compared with the specialist tralning system based on the hospital staffs in chi-na, the role ofsocial workersin British during the period of tralning makes better mobility of tralnee among medical institutions and medical treatments, which makes the tralning more comprehensive and professional. In addition, there is no consistent system for examination and admittance of specialist, and awareness of specialist tralning among medical institutions and doctors is weak. Therefore, it should be done to form a single tralning system and unify the tralning specification and assessment standard.

Objective To explore the reasonable dose of hydromorphone hydrochloride in the elderly patients after hip surgery. Methods 120 cases of elderly patients who underwent total hip arthroplasty in Affiliated Hospital of Jiangsu University from April 2016 to July 2016 were divided into six groups randomely,with 20 cases each group,they were 0.020,0.035,0.050,0.065,0.080 and 0.095mg/mL group,the corresponding concentrations of HYD were given to each group after surgery,blood rheology, inflammatory cytokine, VAS and Ramsay sedation scores were observed at different time points, Complications were recorded. Results One day and three days after operation,whole blood viscosity and whole blood reduced viscosity level of six groups were significantly increased (P<0.05),with the increase of the concentration of HYD,whole blood viscosity and whole blood reducing viscosity of each group decreased,compared with 0.020-0.050 mg/mL group,the 0.065-0.095 mg/mL group was lower (P<0.05).One day and three days after operation,the levels of inflammatory cytokines were increased in six groups (P<0.05),with the increase of the concentration of HYD,the level of inflammatory factors decreased,compared with 0.020-0.050 mg/mL group,the 0.065-0.095 mg/mL group was lower (P<0.05).The VAS scores of six groups were decreased in different degree with the prolongation of time, with the increase of the concentration of HYD,VAS at different time after operation decreased to some extent (P<0.05),compared with 0.020-0.035 mg/mL group,the 0.050-0.095 mg/mL group was lower (P<0.05). Ramsay sedation scores increased in 0.020-0.035mg/mL group and decreased in 0.065-0.095mg/mL group,but no significant change in 0.050mg/mL group. The incidence of adverse reactions was the lowest in the 0.050 mg/mL group. Conclusion HYD can be used for postoperative analgesia in elderly patients undergoing hip joint surgery,the concentration of HYD was correlated with the analgesic efficiency, and the recommended concentration was 0.050 mg/mL.

Objective To evaluate the effects of silicone pessary treatment on relieving the symptoms and improving the life quality of the pelvic organ prolapse patients.Methods From November 2005 to March 2009,33 pelvic organ prolapse (POP-Q stage Ⅲ～Ⅳ) patients received silicone pessary coneervative treatment were followed up and required to complete the Pelvic Floor Distress Inventory-20 (PFDI-20) before and after initiating pessary treatment.Results 31 of 33(93.94%) patients finished the follow-up completely.23 of 31(74.19%) patients continually used the pessary.The follow up time was 3 to 17 (10.04±2.57) months.27 patients completed the PFDI-20 questionnaires.Before silicone pessary treatment, PFDI20 total score,POPDI6 (Pelvic organ prolapse distress inventory),CARDI8 (colorectal anal distress inventory 8) and UDI6 (urinary distress inventory 6) scores were (54.16±36.12),(27.78±17.30),(0.61±1.01) and (25.77± 24.10),respectively.After the treatment of pessary,the scores decreased to (20.20±25.98), (4.48±5.88), (0.45±0.84) and (15.28± 21.53),respectively.Except for CARDI8,the PFDI scores decreased significantly after the pessary treatment (P＜0.05).Conclusion Silicone pessary is a viable noninvasive treatment for pelvic organ prolapse.It could relieve the symptoms and improve the life quality of protrusion and voiding dysfunction patients.

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by the degeneration of upper and lower motor neurons selectively. Although the motor system lesion is the most predominant clinical manifestation of ALS, with the progression of the understanding of the pathogenesis and clinical detection of the disease, more and more patients are found to have extra-motor features of ALS, such as somatosensory involvement, etc. The research results demonstrated that ALS might be a kind of disorder combined with sensory disturbance according to the electrophysiology, neuropathology, neuroimaging, animal model simulation, genetic evidence, and other methods detected. We, herein, review the prevalence and detection methods especially the aspect of genetic associations implicated in the sensory nerve disturbance of ALS.

Objective To evaluate the quality of observational studies on pelvic organ prolapse in China.Methods The checklist of strengthening the reporting of observational studies in epidemiology (STROBE) statement was applied to evaluate the observational studies.The articles were searched in the SinoMed database using the terms:prolapse,uterine prolapse,cystocele,rectal prolapse and pelvic floor;limited to Chinese core journals in obstetrics and gynecology from January 1996 to December 2015.With two 10-year groups (1996-2005 and 2006-2015),the x2 test was used to evaluate inter-group differences.Results (1) A total of 386 observational studies were selected,including 15.5％(60/386) of case-control studies,80.6％(311/386) of cohort studies and 3.9％ (15/386) of cross-sectional studies.(2) There were totally 22 items including 34 sub-items in the checklist.There were 17 sub-items (50.0％,17/34) had a reporting ratio less than 50％ in all of aticles,including:1a (study's design) 3.9％ (15/386),6a (participants) 24.6％(95/386),6b (matched studies) 0 (0/386),9 (bias) 8.3％ (32/386),10 (study size) 3.9％,11 (quantitative variables) 41.2％ (159/386),12b-12e (statistical methods in detail) 0-2.6％ (10/386),13a (numbers of individuals at each stage of study) 18.9％ (73/386),13b (reasons for non-participation at each stage) 18.9％,13c (flow diagram) 0,16b and 16c (results of category boundaries and relative risk) 9.6％ (37/386) and 0,19 (limitations) 31.6％ (122/386),22 (funding) 20.5％ (79/386).(3) The quality of articles published in the two decades (1996-2005 and 2006-2015) were compared,and 38.2％ (13/34) of sub-items had been significantly improved in the second 10-year (all P＜0.05).The improved items were as follows:1b (integrity of abstract),2 (background/rationale),6a (participants),7 (variables),8 (data sources/measurement),9 (bias),11 (quantitative variables),12a (statistical methods),17 (other analyses),18 (key results),19 (limitations),21 (generalisability),22 (funding).Conclusions The quality of observational studies on POP in China is suboptimal in half of evaluation items.However,the quality of articles published in the second 10-year have significantly improved.

Objective To study the cholesterol nuclear-cytoplasmic interaction effect and position cholesterol traits QTL in mice.Methods Improving the nuclear-cytoplasmic interaction models and methods that have been constructed, and analyzing the public database of total cholesterol and lipoprotein data of F2 group that derived from DBA/2J ( D2) and CAST/EiJ ( CAST) mice.Results Six QTL that controlling total cholesterol, HDL and nonHDL were located in 4 linkage groups in the genome.In the models constructed in this study, we found a QTL has significant interaction with cytoplasmic background, which changes the previous results of data analysis, the genetic mouse cholesterol and lipoprotein components opened up new ideas.Conclusion Mouse cholesterol trait is the result of interaction of nuclear genes and cytoplasmic background.

Objective To discuss the 3D printing modeling used to assist minimally invasive fixation with hollow screws for unstable pelvic fractures.Methods From January 2014 to January 2016,137 patients with unstable pelvic fracture received minimally invasive fixation with hollow screws and obtained complete follow-up at our department.In 65 of them,the fixation was assisted by 3D printing modeling;they were 37 men and 28 women,with an average age of 33.1 ± 4.9 years.In the other 72 cases,conventional fixation was performed without assistance of 3D printing modeling;they were 45 men and 27 women,with an average age of 32.6 ±4.7 years.The 2 groups were compared in terms of operation time,frequency of intraoperative fluoroscopy,reduction quality and curative effect.Results This cohort were followed up for 6 to 15 months (average,9 months).The 3D printing modeling group needed significantly less operation time (58.6 ± 13.4 min) and intraoperative fluoroscopy (29.3 ± 3.6 frequencies) than the conventional group (72.4 ± 12.4 min and 36.6 ± 2.8 frequencies) (P ＜ 0.05).According to the Matta scoring criteria,the quality of pelvic reduction was evaluated as excellent in 21 cases,as good in 30 cases,as fair in 13 cases and as poor in one in the 3D printing group,yielding an excellent and good rate of 78.5％ while as excellent in 22 cases,as good in 36 cases,as fair in 12 cases and as poor in 2 cases in the conventional group,yielding an excellent and good rate of 80.6％.According to the Majeed scoring criteria,the curative effect was evaluated at the last follow-up as excellent in 27 cases,as good in 26 cases,as fair in 11 cases and poor in one in the 3D printing group,giving an excellent and good rate of 81.5％ while as excellent in 30 cases,as good in 28 cases,as fair in 13 cases and as poor in one in the conventional group,giving an excellent and good rate of 80.6％.There were no statistically significant differences between the 2 groups in reduction quality or curative effect (P ＞ 0.05).No nonunion or iatrogenic neurovascular lesions happened during the follow-up period.Conclusion 3D-printing modeling is helpful for a good reduction and minimally invasive fixation with hollow screws for unstable pelvic fractures by reducing operation time and intraoperative fluoroscopy.

Objective To assess the effects of tacrolimus (FKS06) on podocyte in type 2 diabetic model rats and to explore the potential mechanism.Methods The model rats were fed with high fat and high sugar food and combining with a low-dose of streptozotocin (STZ).They were then randomly divided into a diabetic mellitus group (DM group) and a FK506 group.A normal control group (NC group) was also set.The rats in FK506 group were given with 0.5 mg· kg-1· d-1 FK506 for 8 weeks.The biochemical parameters were measured.The changes of renal pathology and ultrastructure of podocyte were observed by the light and electron microscopy.The expression of nephrin and LC3-Ⅱ was determined by immunohistochemistry and Western blotting.Results (1) Compared with those in NC group,KW/BW,systolic blood pressure (SBP),fasting blood glucose (FBG),triglyceride (TG),total cholesterol (TC),urinary albumin excretion rate (UAE) and creatinine clearance rate (Ccr) in DM group were significantly increased (all P ＜ 0.05).And the KW/BW,UAE and Ccr were decreased in FK506 group compared to those in DM group (all P ＜ 0.05),while other parameters had no significant difference (all P ＞ 0.05).(2) Compared with those in NC group,the glomerular volume,mesangial cell proliferation and accumulation of mesangial matrix were increased,and the foot process became disorder and fusion in DM group,while these changes were significantly reduced in FK506 group.(3) Compared with that in NC group,the expression of nephrin and LC3-Ⅱ was decreased in DM group (all P ＜ 0.05),and both of parameters were higher in FK506 group than those in DM group (all P ＜ 0.05).Conclusion FK506 may enhance podocyte autophagy in type 2 diabetic model rats and attenuate podocyte injury.