Objective To study whether clinical variables could be used to predict the presence of esophageal varices(EV). Methods One hundred and twenty-six patients with decompensated liver cirrhosis were enrolled. Upper endoscopy was performed to identify the EV. The spleen vein (SV), portal vein(PV), spleen index(SI), ascites was determined by ultrasenography. Platelct count(Pt), prothrombin time(PT) and liver function was determined. Results Ninety-five patients with EV, and 42 patients with severe EV. Patients with EV had significant larger SI and lower Pt. Pt and SI were predictive factors for the presence of EV. When SI≥66.9 cm2 and Pt≤89.0×109/L, they had a positive predictive value of 97.4% and 96.5%, and a negative predictive value of 55.4% and 59.8%, respectively. SI was the only predictive factor for the presence of severe EV. When SI≥82.6 cm2, it had a positive and negative predictive value of 89.2% and 75.4%. Conclusions Pt and SI are predictive factors for the presence of EV. SI is the only predictive factor for the presence of severe EV. Non-invasive factors SI and Pt can be used to predict the EV in patients with decompensated liver cirrhosis.

Objective To compare the outcomes of Yang-Monti channels and appendix in the practice of catheterizable continent urinary conduits.Methods Retrospective analyses were conducted in 27 cases with neurogenic bladder from July 2009 to December 2015,including 8 male and 19 female patients whose average age at surgery was 7.6 years old (range:1.5-16 years).The average bladder volume is (203.8 ± 126.0) ml.The bladder compliance values of 24 cases are lower than 20 ml/cm H2O.Seventeen cases had urinary infection combined with fever before surgery,while 6 cases had stress urinary incontinence and 17 cases had dysuria.Seven cases including 2 male patients underwent urinary diversion with YangMonti channels (YM group) and the average age at surgery for patients was 6.7 years old (range:4-16years).Twenty cases including 6 male patients underwent urinary diversion with appendix (AP group) and the average age at surgery for patients was 8.0 years old(range:1.5-14 years).The 3-day urinary diaries were collected in all cases including their records of average catheterization interval,average catheterization volume,stoma stenosis and stoma leakage.The data between the two groups was compared and the statistical analysis was performed.Results Of the 7 patients undergoing Yang-Monti channels,2 cases underwent open surgery and 5 cases underwent laparoscopic surgery in which 2 cases transferred to open surgery.The stoma stenosis occurred in 1 case and the stoma leakage occurred in 1 case.The average catheterization volumc is (239.3 ± 76.2) ml and the average catheterization interval is (2.8 ± 0.9) h.Six patients in the group were followed up less than 3 years,of which the average catheterization interval is (2.6 ± 0.8) h.Of the 20 patients undergoing appendix channels,3 cases underwent open surgery and 17 cases underwent laparoscopic surgery in which 1 case transferred to open surgery.The stoma stenosis occurred in 1 case and the stoma leakage occurred in 2 cases.The average catheterization Volumee is (257.0 ± 67.4) ml and the average catheterization interval is (3.9 ± 0.9)h.Six patients in the group were followed up less than 3 years,of which the average catheterization interval is(3.5 ± 1.0) h.There was no difference in stoma stenosis and stoma leakage and average catheterization volume between the two groups (P ＞ 0.05).There was no difference in average catheterization interval between the patients of two groups who were followed up less than 3 years (P ＞ 0.05).Conclusions Yang-Monti conduits are durable and reliable,which was similar with appendix conduits.

BACKGROUND: Effect of nerve growth factor(NGF)on angiogenesis of regenerative perpheral nerve is still researched up to now.OBJECTIVE:To evaluate the dose-response relationship and mechanism of NGF on angiogenesis of regenerative sciatic nerve in rats.DESIGN:Randomized controlled animal study.SEFFING:Department of Neurology,the 324 Hospital of Chinese PLA;the Third Laboratory,Institute of Battle Surgery,Daping Hospital of the Third Military Medical University of Chinese PLA.MATERIALS:A total of 32 healthy adult Wistar rats weighing 200-250 g and of both genders were selected in this study.Silica gel conduit was provided by Shanghai Xinya Medical Rubber-goods Factory and NGF was provided by Sigma Company,USA.METHODS:The experiment was carried out in the Third Laboratory,Institute of Battle Surgery,Daping Hospital Affiliated to the Third Military Medical University of Chinese PLA from August 2003 to February 2005.Experimental grouping:All rats were randomly divided into 4 groups,including saline group,50,100 and 500 ng NGF groups with 8 rats in each group.Experimental intervention:Sciatic nerves were cut to establish defect of 10 mm in length,and then the defect was bridged with silica gel conduit in the left latter limb.After the bridging,rats in the saline group were perfused with 5 μL saline,and rats in the NGF groups were perfused with 2.5,5 and 25μL NGF(20 mg/L),respectively.Experimental evaluation:On the 30th day,immunohistochemical technique was used to detect the expressions of CD34,vWf,vascular endothelial growth factor(VEGF)and trkA in newborn vascular endothelial cells of regenerative sciatic nerve;meanwhile,their forms were performed with quantitative analysis.MAIN OUTCOME MEASURES:Pathological and immunohistochemical changes of nerve regeneration of rats in each group.RESULTS:All 32 rats were involved in the final analysis,①Results of pathological sections of nerve regeneration in rats:Distal end of sciatic nerve was completely bridged at 30 days after operation and thickness of sciatic nerve in silica gel conduit lined in 500 ng NGF group＞50 and 100 ng NGF group＞saline group.Numbers of fiber and regularity of arrangement of sciatic nerve were superior in NGF groups to those in saline group,In addition,angiogenesis was obviously observed at 30 days after operation.②Results of immunohistochemical staining:There were significant differences among three NGF groups as compared with saline group in the expressions of four antigens (P＜0.05).Expressions of four antigens were increased in 500 ng NGF group as compared with those in 100 and 50 ng NGF groups(CD34:94.2±6.4,74.2±10.9,77.0±11,0;vWf:116.2±20.0,72.0±13.1,68.0±9.7;TrkA:105.4±10.6,57.8±11.5,58.8±6.5;VEGF:89.0±3.0,48 6±7.4,35.2±2.9;P＜0.05 or P＜0.01).CONCLUSION: NGF can promote angiogenesis of the regenerative peripheral nerves and show a dose-response relationship,while its mechanism may be related to promoting expressions of TrkA and VEGF.

Objective To evaluate the value of PET/CT in preoperative assessment and postoperative monitoring of ovarian cancer. Methods A retrospective analysis was conducted in 45 patients of ovarian neoplasm with clinical records underwent 18F-FDG PET/CT, including 10 patients underwent PET/CT before surgery and 35 patients after surgery. The clinical follow-up time was 6 months at least. The diagnosis based on pathology and clinical follow-up data. Results (1) The sensitivity, specificity and accuracy of PET/CT in detecting ovarian cancer were 94.6%,75.0%and 91.1%, respectively. (2) Ten patients before surgery were all detected tumor by PET/CT, but 2 of them were false positive based on pathologic results. (3) Two patients with non-standard surgery were detected tumor by PET/CT. In 33 patients after standard surgery, 6 patients were no tumor detected by PET/CT. In addition,4 patients with normal CA125 and no signs of recurrence and metastasis were detected tumor by PET/CT. The pathology and clinical follow-up data supported the results. 23 patients with higher CA125 were diagnosed recurrence and metastasis based on pathology and clinical follow-up data, 21 of them were detected tumor by PET/CT. Conclusion 18F-FDG PET/CT plays an important role in preoperative assessment, early diagnosis and accurate positioning of recurrent and metastasis of ovarian cancer. It can be used to guide the clinical treatment.

Objective:To describe the secular trends of premarital medical examination ( PME ) in China during 1996 and 2013 and to assess the impacts of national health policies on the PME rate. Methods:The information on marriage and PME for districts and counties in 31 provinces of China was annually collected by the Office for National Maternal & Child Health Statistics of China, and the infor-mation on the health policies was from official governmental websites. According to the main health poli-cies, the calendar years were categorized into 3 periods:1996 to 2003 was mandatory PME period;2004 to 2008 was encouraged voluntary PME period; and 2009 to 2013 was free-paid voluntary PME period. Results: During the 18-year period, 284 242 719 people were registered for a marriage in which 107 198 795 were examined, giving the PME rate of 37. 7%. During the mandatory PME period, the rate ranged 52 . 7% -67 . 7% with an average of 60 . 9% ( urban 71 . 5%, and rural 51 . 7%) . In 2004 , the first year when the PME became voluntary, the rate was abruptly dropped to 2. 6%, and thereafter gradually increased to 11 . 5% in 2008 . As the policies of the free-paid voluntary PME were subsequently issued, the rate was quickly increased to 52. 3% (urban 49. 8%, and rural 54. 6%) in 2013. The in-creasing trend was consistently observed both in urban and rural areas, and across East, Middle, West, and Northeast economical regions. However, the rates differed greatly among provinces. In 2013, 5 pro-vinces had rates of >90% ( Guangxi 97 . 5%, Fujian 96 . 0%, Ningxia 95 . 4%, Zhejiang 93 . 4% and Anhui 90. 1%), whereas some provinces were stuck at a low rate, including developed and underdeve-loped provinces/cities. The PME rate in 2013 was 27. 4% for Shanghai, 25. 5% for Guangdong, 12. 4%for Chongqing, 5. 8% for Beijing and 4. 6% for Tianjin. Underdeveloped provinces were Guizhou (6. 4%) and Qinghai (1. 8%). Conclusion:As various national policies to promote voluntary PME were issued, the PME rate was significantly increased after a sharp decline, though it varied greatly by provinces. For provinces with high PME rate, PME-related health benefits need to be evaluated;for provinces with low rate, it is of important practical significance to explore a cost-effective health service model that is likely incorporated with pre-pregnancy examination.

Objective Methods To explore the value of VEGF levels in serum and pleural effusion for diagnosis of benign and malignant tumors, and evaluate clinical value of VEGF-A, C, D in malignant pleural effusion.Methods Serum and pleural effusion of 34 cases patients with lung cancer were collected in our hospital, the application of ELISA method for the detection of VEGF level in serum and pleural effusion in patients with lung cancer and with benign pleural effusion.VEGF-A, C, D levels were detected.Results VEGF levels in serum and pleural effusion in malignant group were significantly higher than those in benign group(P<0.05).In addition, patients with lung cancer before initial treatment, the VEGF levels in serum and pleural effusion of distant metastasis group were significantly higher than those of without distant metastasis group(P<0.05).There was a correlation between the level of VEGF and the malignant pleural effusion(r=0.878, P<0.05).No correlation existed between VEGF level and benign pleural effusion.The content of sVEGF-A in serum had no statistical difference in cancer group and benign group.Effusion supernatants of pVEGF-A content in lung cancer group were higher than those in benign effusion group(P<0.05).pVEGF-A and sVEGF-A levels were similar in benign effusion group. Effusion supernatants pVEGF-A in malignant group was higher than that in benign effusion group(P<0.05).pVEGF-A was significantly higher than that of sVEGF-A in malignant effusion(P<0.05).Serum VEGF-C, VEGF-D content had no significant difference between cancer group and benign group. pVEGF-C, pVEGF-D content had no significant difference between cancer group and benign group.Conclusion Level of VEGF in serum and pleural effusion detection would help to diagnose and differentially diagnose benign and malignant pleural effusion.Effusion VEGF-A is different in benign and malignant effusion, which may become benign and malignant effusion tumor markers.

Objective To investigate the apoptosis mechanism induced by BH3 mimetic S1 in human leukemia cell line K562.Methods Cell viability was detected by XTT to S1 in leukemia cell line K562.K562 cells was incubated with S1 for different time,the apoptosis rate of K562 cells was determined by flow cytometry analysis.Caspase-3,-8,and-9 activities were measured by absorption spectra.Co-immunoprecipitation was used to analyze the releasing of bax,bak from bcl-2 and mcl-1.Results Compared with control group,a dose-dependent increase in apoptosis coincided with a dose-dependent decrease in cell viability following S1 treatment suggested that S1 inhibits cell proliferation through the induction of apoptosis.The IC50 value at 24 h for S1 was 13.5 μ mol/L.Exposure of K562 cells to S1 for 12 h resulted in a time-dependent increase in FITC-Annexin-positive/PI-negative early apoptotic cells.The strong increase of FITC Annexin/PI doublepositive cells after a 24 h treatment indicated a shift to late apoptosis.S1 activated Caspase-3 and-9,but not Caspase-8 indicated that S1 induced K562 cells apoptosis via the intrinsic pathway.K562 cells treated with 5 μmol/L of S1 showed a disruption in bcl-2/bax,mcl-1/bak complexes after 8 h S1 treatment.Conclusion The main mechanism that S1 induces K562 cells apoptosis might be through the inhibition of bcl-2/bax,mcl-1/bak complexes dissociation.

Objective To investigate the value of X-ray Knife in the stereotaxis radiotherapy of lung cancer.Methods 52 cases with pulmonary carcinoma were treated with X-ray knife,before and after that,general radiotherapy was applied.After whole radiotherapy,2 or 3 months later,all patients were followed by CT scan.The changes of tumor and clinical appearances were compared before and after therapy.The curative effect was estimated according to clinical appearances and CT findings.Results 6 patients were complete response(11.5%) ,29 patients were partial response(55.8%) and 13 patients were no changes or reduced less than 50%.The total responsive rate was 92.3%.Conclusion The treatment of lung cancer with X-ray Knife can give tumor accuracy high dosage irradiation.The short term therapeutic effectiveness is significant and safe on clinical.

OBJECTIVE: To develop a method of HPLC/MS/MS to determine phenacetin and paracetamol in rat liver microsomal incubation system. METHODS: Samples were separated on XTerra MS C18 column, different ratios of methanol- 0.1% formic acid were used as the gradient eluent, and the flow rate was 0.2mL?min-1. The electrospray ion-quadrupole mass spectrometry and multiple reaction monitor were adopted to detect the concentration of phenacetin and paracetamol. RESULTS: The calibration curves were linear in the ranges of 45～9 000ng?mL-1(r=0.999 8)and 15.2～1 520ng?mL-1(r=0.999 6) for phenacetin and paracetamol respectively; The lowest limits of assay were 9ng?mL-1 and 10ng?mL-1.The average recoveries at three concentrations of phenacetin were (96.2?2.3)%～(98.3?2.4)% and those of paracetamol were (99.6?2.1)%～(100.2?2.6)%; RSD of the intra-day and inter-day were less than 5%. CONCLUSION: The method is rapid, sensitive and suitable for determination of phenacetin and paracetamol in rat liver microsomal incubation system.

Objective To summarize the experience in transanal local excision (LE) for rectal cancer (RC). Methods The clinical data of 28 cases of RC treated by LE from 1988 to 1998 were analyzed retrospectively. Results In this series, five-year survival rate was 83.4?6.2%, and the local recurrence rate (LRR) was 17.8%. In well-differentiated carcinoma, 4 cases were convinced as local recurrence with a LRR of 17.4%(4/23); in moderately- differentiated carcinoma, one case with a LRR of 20.0%(1/5). The LRR in T 1 and T 2 group was 15.0% (3/20) and 25.0% (2/8) respectively. LRR was 16.7% (4/24) in patients with less than 1/3 bowel wall involved, LRR was 16.7%(4/24),whereas LRR was 25.0%(1/4) in more than 1/3 bowel wall involved group. In total bowel wall resection group the LRR was 16.7%(3/18) while in partial resection group was 20.0% (2/10). In patients with tumour size larger than 4 cm LRR was 22.2% (2/9), tumour size smaller than 4 cm LRR was 15.7% (3/19). Conclusion LE for RC might only be successfully performed in selected patients (T 1～T 2, N 0M 0, well or moderately-differentiated carcinoma,low RC within 6 cm from anal edge). The indications of transanal LE must be controlled strictly. Total excision of tumor and prevention of implantation of carcinoma are the main points in the prophylaxes of recurrence. Postoperative follow-up is needed in order to find local recurrence as early as possible.