Breast cancer ranks among the most prevalent malignancies in women. Specific aspects of both breast cancer cells and the bone microenvironment contribute to the development of bone metastases. Breast cancers express chemokine receptors, integrins, cadherins, and bone-resorbing and bone-forming factors that contribute to the successful and preferential spread of tumor from breast to bone. Bone is rich in growth factors and cell types that make it a favorable environment for breast cancer cell growth. Once breast cancer cells enter the bone, breast cancer cells can secrete factors that act on bone cells and other cells within the bone, causing them to secrete factors that act on adjacent cancer cells. The steps in the metastatic cascade and the vicious cycle within bone offer unique targets for adjuvant treatments to treat and cure bone metastasis.

Objective To report the surgical technique and preliminary clinical results of bilateral decompression under microscope via unilateral approach for the treatment of lumbar stenosis. Methods Sixteen eases of lumbar stenosis were treated in our institute. For the surgical treatment, only one side paraspinous muscle was dissected. The upper and lower margins of the adjacent laminae were drilled, and the underlying ligament flavum was exposed. By changing the direction of the microscopy, the base of the spinous process and the internal side of the contralateral laminae were also drilled off till the lateral recess. Finally, decompression of the spinal canal was achieved by removing the ligament llavum. Results Follow-up ranged from 6 to 47 months. Intermittent claudication was totally relieved in 14 out of 16 cases, and markedly relieved in 2 cases. Back pain was relieved totally in 6 cases, marked improved in 8 cases, not change in 2 cases. Pain was significantly relieved in all 5 cases with sciatica, among them, diseetomy had to be performed in 3 cases. During follow-up, there was no symptom recurrence, and dynamic X ray did not show lumbar in-stability. Conclusion Bilateral decompression under microscope via unilateral approach for the treatment of lumbar stenosis is minimally invasive surgery, the effect of the operation is good. The technique has little in-fluence on spinal stability.

Objective To observe the effect of repetitive transcranial magnetic stimulation (rTMS) and functional magnetic stimulation over spinal cord (SC-MS) on motor function recovery after spinal cord hemisection in rats. Methods T10 spinal cord hemisection model was made. The stimulation (5×10 s bursts of 5 Hz at 35% maximal stimulator output, each burst separated by a 2 m interval) was delivered daily, 5 d per week for 2 weeks. The treatment began at 4 d after surgery for rTMS group and SC-MS group. Motor function recovery was assessed with Basso, Beattie & Bresnahan locomotor rating scale (BBB) and the Horizontal Ladder test. The tibialis anterior was surgically removed at 38 d after spinal cord injury for calcitonin gene-related peptide (CGRP) iummunohistochemical staining. Results The scores of BBB and Horizontal Ladder test were significantly more at 17 d after spinal cord hemisection in rTMS group than before treatment and in spinal cord injury group (P<0.05). In SC-MS group, the scores of BBB and Horizontal Ladder Test were significantly more 10 d after SCI than before treatment and in SCI group (P<0.05). The score of Horizontal Ladder test of SC-MS group was more 10 d after SCI than that in the rTMS gourp (P<0.05). The expression of CGRP on motor endplates of the tibialis anterior in rTMS group and SC-MS group were more than those of SCI group (P<0.01). Conclusion rTMS and SC-MS in acute stage can improve the motor function recovery and muscle plasticity after spinal cord hemisection in rats. The magnetic stimulation can facilitate the recovery of motor function after spinal cord hemisection in rats.

Objective To use the syphilis helicoid gelatin aggregation experiment (TPPA ) method to compare the results of syphilis serological detection reagents between the ELISA method and the colloidal gold method for evaluating the clinical applica ‐bility of each detection reagent .Methods 6 291 serum samples were selected from the hospitalized patients before surgery or before blood transfusion ,and performed the preliminary screening detection by the ELISA method (reagent A and B) and the colloidal gold method ,the positive or weakly positive specimens in preliminary screening were performed the confirmation test by the TPPA method .Results In 6 291 serum specimens ,the positive cases of the reagent A ,reagent B and colloidal gold method were 66 ,64 and 56 cases respectively ,the positive detection rate of colloidal gold method had no obvious difference between the reagent A and rea ‐gent B (P> 0 .05) .The positive samples were confirmed to be 66 cases by TPPA ,including 61 cases of reagent A and reagent B positive ,and the colloidal gold method had 56 cases .5 cases of reagent A positive and 3 cases of reagent B positive were confirmed to be 3 and 2 cases by TPPA respectively ,the sensitivity of the colloidal gold method had significant difference between the reagent A and reagent B(P< 0 .05) .Conclusion ELISA method has high sensitivity and is easy to realize the automated enzyme‐linked im‐munoassay ,which is suitable for the screening of the patient sample before surgery or before blood transfusion .The colloidal gold method has low sensitivity ,but high specificity ,is simple and convenient which is suitable for large‐scale healthy physical examina‐tion and preliminary screening test before emergency surgery .In order to avoid medical disputes ,the positive samples by the ELISA method and colloidal gold method should be confirmed by the TPPA method .

Objective To investigate the effect of cytarabine (Ara-C) on proliferation and apoptosis of human erythroleukemia K562 cell linethrough autophagy pathway and its possible mechanism.Methods The cellular proliferation inhibiting rate after different concentrations of Ara-C acting for 24,48 h was detected by CCK-8;the cell cycle and apoptosis were detected by flow cy tometry(FCM);the chromatin morphological changes in nucleus were observed by Hoechst staining;the cell acidic autophagy vesicles were detected by acridine orange staining;the expression changes of p38 and p-p38 proteins were detected by Western blot.The expressions of autophagy apoptosis related gene and protein were examined by RT-PCR and immunofluorescence.Results The CCK-8 results found that different concentrations of Ara-C could inhibit the proliferation of K562 cells with dose-and time-dependent manners.FCM detecting indicated that Ara-C could increase apoptosis and could arrest the cell cycle at S phase;Hoechest staining showed that K562cells had typical apoptotic morphological changes after Ara-C treating;the Acridine orange staining revealed that Ara-C caused the inclease of the green fluorescene in cells of the Ara-C group,and the cells appeared a great number of acidic autophagy vesicles;RT-PCR results showed that Ara-C up-regulated the expression of autophagy key genes Beclin-1,LC3A and LC3B;Western blot results showed that Ara-C increased the expression of phosphorylated p-p38.Immunofluorescence results showed the expression of LC3B was significantly enhanced.Conclusion Ara-C canactivate p-p38 mediated K562 cells to generate autophagy,then inhibit the cell proliferation and promotes apoptosis.

Objective:To investigate the clinical features of direct and indirect carotid cavernous fistulas (CCFs).Methods:Patients with CCF treated in the Affiliated Hospital of Xuzhou Medical University from January 2010 to August 2020 were enrolled retrospectively. Relevant clinical data were collected, including the main clinical manifestations, neuroimaging features, and treatment methods. The clinical features of direct and indirect CCFs were compared.Results:A total of 31 patients were enrolled in the study, 29 (93.5%) had ocular symptoms, of which conjunctival hyperemia and edema ( n=24, 77.4%), exophthalmos ( n=19, 61.3%) and orbital murmur ( n=18, 58.1%) were most common. There were 23 patients (74.2%) in direct CCF group and 8 (25.8%) in indirect CCF group. The former had more history of head trauma (78.2% vs. 12.5%; P=0.002), more flow volume (high-flow CCFs: 100% vs. 37.5%; P<0.001) and more likely to cause orbital murmur (69.6% vs. 25.0%; P=0.043). Endovascular embolization was safe and effective. The common methods of endovascular embolization were EVAL glue combined with coil embolization ( n=18, 66.7%) and detachable balloon embolization alone ( n=6, 22.2%). Conclusion:Ocular manifestations are most prominent in patients with CCFs. Direct CCF is more common, usually with a history of head trauma, and the clinical and imaging features are more typical. Interventional embolization is the preferred treatment option for patients with CCF.

An internal-external fixator for stabilization in three cases with unstable pelvic fractures were reported. Compared with external fixation, the internal-external fixator, which is placed in the subcutaneous layer, decreased the risk of pin-track infection, pin site pain, and bowel obstruction; meanwhile, it had the advantage of external fixation: it was easy to apply, controlled damage, and resulted in minimal injury.
Adolescent ; Adult ; Aged ; External Fixators ; Female ; Fracture Fixation ; methods ; Fractures, Bone ; surgery ; Humans ; Internal Fixators ; Male ; Pelvic Bones ; injuries ; surgery

Background and purpose:Bone metastases leads to the destruction of bones by changing the level of bone turnover markers.The purpose of this study was to assess the clinical application value of bone turnover markers in bone metastases for non-small cell lung cancer,which included the diagnosis and spread behavior of bone metastases.Methods:AKP,β-CTx,OST and BALP were measured in 76 NSCLC with bone metastases patients and 44 normal people.Results:The level ofAKP,β-CTx and BALP in patients with bone metastasis was significantly higher than in the subjects without bone metastases.There were significant correlations among the bone turnover markers.The levels of BALP and OST were significantly positively correlated with the extent of bone metastasis.Patients with high-levels of CTx and low-levels of BALP had a higher risk of pathologic fracture.Conclusion:In patients with bone metastases from NSCLC,bone turnover markers can help make diagnoses and evaluate severity of disease.It potentially has a wide range of uses in clinical practice.

Objective To explore the effect of humidification of oxygen delivered by nasal cannula on the respiratory symptoms. Method A total of 540 patients receiving low-to-mid flow oxygen therapy (<4L/min) by nasal cannula for more than 12 hours were assigned to receive humidified (n=235) or dry (n=305)oxygen. While 226 patients receiving a low-to-mid flow oxygen therapy for more than 24 hours received humidified or dry oxygen respectively. The patients' respiratory symptoms were observed and recorded. Results Dryness over naso-pharyngeal region was the only symptom reported by patients in this study. There was no significant difference on the rate of dryness over naso-pharyngeal region between patients receiving humidified oxygen and patients receiving dry oxygen (P>0.05) either in the same patients when receiving dry and humidified oxygen (P>0.05). Conclusion Routine humidification is not necessary in low-to-mid flow oxygen therapy by nasal cannula.