Cytokine-induced killer (CIK) cells play important roles in the treatment of solid tumors.In particular,they have broad application prospects for the patients with recurrence or metastasis.Although recently CIK treatment strategy has achieved encouraging results in preclinical studies,there are still some difficulties in the clinical applications.Some key issues remain to be resolved,such as how to ensure that the antitumor immune effector can be a lot of amplified and can stay longer in the body,how to selectively kill tumor cells,and how to ensure the security of application.

Objective:To explore the efficacy and safety of different surgical methods in papillary thyroid carcinoma (PTC) patients with negative cervical lymph nodes (cN0) and to provide theoretical basis for the selection of surgical procedures. Methods:A total of 225 PTC cN0 patients were selected and divided into two groups according to the operation method. Only 110 patients underwent total thy-roidectomy, whereas the 115 cases in the lobectomy group underwent ipsilateral lobectomy and isthmus resection. Al patients were treated with ipsilateral central lymph node dissection. We analyzed both groups of patients in terms of surgery, hospitalization, pathological characteristics, complications, follow-up, and recurrence. Results:(1) The length of incision, blood loss, operation time, and length of stay were not significantly different between the two groups (P>0.05). (2) In the total resection group, the number of multiple foci of the cancer cases was significantly more than that of the lobectomy patients (P<0.05). The average tumor diameter in both groups were not significantly different (P>0.05). Between the two groups, the number of central lymph node dissection and total lymph node metastasis, and the number of cases with central lymph node metastasis were not significantly different (P>0.05). Likewise, the incidence rates of mistakenly cut parathyroid, extremely low blood calcium levels, temporary larynx return nerve paralysis, and superior laryngeal nerve injury were not significantly different between the two groups (P>0.05). No permanent hypocalcemia or permanent recurrent laryngeal nerve injury occurred. (3) All patients were followed up for 2-4.5 years. No recurrent cases were reported in the total resection group. For the lobectomy group, 8 patients with adenocarcinoma had contralateral tumor metastasis and underwent contralateral lobe resection, whereas 4 patients suffered from ipsilateral neck lymph node metastasis at the side area and underwent functional lymph node clearance. Significant differences were noted in the metastasis and recurrence rates between the two groups of patients (P<0.05). No deaths were reported during the follow-up period. Conclusion:For PTC cN0 patients, total thyroidectomy with joint ipsilateral central lymph node clearance can reduce the residual tumor, metastasis, and risk of recurrence,compared with surgery limited to the affected lobe and isthmus. Postoperative complications were not significantly increased.

ObjectiveTo investigate the feasibility of preventing tendon adhesion by using bFGF/ vitamin C composite biodegradable membrane.MethodsSixty Newzerland rabbits were divided into experimental and control groups randomly.After the animal model was established, the tendon autografts were encapsulated with the bFGF/vitamin C composite biodegradable membrane in experimental group, while no tendon autografts encapsulation in control.Three weeks after surgery, regular HE staining and AgNO3 staining were performed to observe the fibroblast nuclei and vitamin C.The quantity of collagen fibrils was measured by Luzex-F Image Analyzer.Eight weeks after surgery, the peritendinous adhesion and the maximum tensile load were analyzed.Results At 3 weeks after surgery, the numbers of vitamin C granules, fibroblast nuclei and collagen fibrils in the experimental group were significantly more than those in the control group(t = 11.78 ,P ＜0.001) .At 8 weeks after surgery, the peritendinous adhesion in the experimental group was significantly slighter than that in the control group(Z =3.922,P ＜0.005) ,and the maximum tensile load in the experimental group was significantly higher than that in the control group (t = 8.39, P ＜ 0.001) .ConclusionbFGF/vitamin C composite biodegradable membrane can stimulate the proliferation of fibroblasts and synthesis of collagen fibrils,improve the biomechanical property of tendon autografts and prevent the tendon adhesion.

Objective To construct the ultrasound PACS image system based on B/S mode.Methods The modern internet technology was used to build the PACS image system based on B/S mode.The B/S mode was typical three layer structures,namely,client presentation layer,middle service logic layer and storage layer.Results Client presentation layer was a figure surface to provide application service for clients.The function of service logic layer was performing application strategy and packaging application mode which was shown to client application program.Storage layer was used to define,service,visit and update data.Conclusion The versatility of B/S mode is good.Besides,the software is easy to operate and upgrade with low cost.

Objective To study on the association of apolipoprotein E(apoE)genotype with coronary heart disease(CHD)and type 2 diabetes mellitus(T2DM).Methods PCR-RFL,multiplex amplification refractory mutation system(muli-ARMS)and PCR-SSCP methods were used to detect the genotype of apoE,and DNA sequencing technique were used for further confrm the genotype and gene variations in 2 446 Chinese individuals,including 238 cases of CHD,316 cases of T2DM and 1 892 healthy controls.Fasting blood glucose(FBG)and plasma lipids levels[TC,TG,HDL-C,LDL-C,apoA I,apoB and Lo(a)]were measured by usual methods.Results Compared with the controls,plasma HDL-C(t=2.66)and apoA I(t=2.30)levels in the CHD group were significantly lower(P<0.05),but not in T2DM group;plasma TC level(t=5.22)in the T2DM group were significantly higher(P<0.05),but not in CHD group;systolic pressure(t=8.48,5.74)diastolic pressure(t=5.66,3.35),plasma TG(t=3.38, 4.56),LDL-C(t=2.48,7.00),apoB(t=1.67,2.24),Lp(a)(t=4.16,4.15)and FBG(t=7.04, 16.93)levels were significantly higher in both CHD group and T2DM group(P<0.05).The distributions of apoE ε2/2,ε2/3,ε3/3,ε2/4,ε3/4 and ε4/4 respectively were 0.4%,13.4%,58.0%,1.3%, 26.5%,0.4% in the CHD group;0.6%,5.7%,72.8%,1.9%,14.9%,4.1% in the T2DM group; 0.5%,10.5%,69.6%,1.6%,16.8%,1.1% in the control group.Significant differences were found between the CHD group(χ2=14.90,P=0.00),T2DM group(χ2=7.08,P=0.03)and the control group for the frequencies of apoE genotype.The distribution of ε3/4 was higher(26.5% vs 16.8%)and ε3/3 Was lower(58.0% vs 69.6%)in the CHD group.In the T2DM group.the distribution of εε4/4 Was higher (4.1% vs 1.1%),and 2 cases of ε3/3 with Arg 150 His mutation in exon 4 of apoE gene were firstly reposed in China,which is none in the CHD and control groups.Conclusions The results suggested that apoE ε3/4 and ε4 genotypes might be associated with the susceptibility of CHD and T2DM.respectively. To some extent,apoE ε3/3 may not be a good genotype for T2DM because of the Arg 150 His mutation. Blood pressure and plasma lipids could be used for diagnosis of the two diseases.

Venous thromboembolism had drawn great attention of global experts, as it is the third leading cause of cardiovascular-associated death, ranking after coronary heart disease and stroke. Numerous health care organizations had introduced guidelines for thromboprophylaxis during the perioperative period in their own fields. The paper reviewed the available guidelines pertaining to urological surgery from America Urological Association, American College of Chest Physicians and European Association of Urology. Compared with the first two guidelines, the European Association of Urology guideline is a milestone which recommended the most detailed prophylactic measures for the procedure-specific and patient-specific according to the evidence-based medicine. Meanwhile, there was still no reliable evidence in fields of the effect of new oral anticoagulants in urology, needing further study. Although they were similar in patient management and prophylaxis principles, there are still some differences in risk factors, assessments, and recommendations of prophylactic measures. In this context, we planed to summarize the highlights and compare the differences of three guidelines addressing the use of thromboprophylaxis in urology, in order to provide reference for Chinese urologists to select the best prevention strategies for patients in the perioperative period.

Objective To determine the development characteristics of social anxiety of peasant-worker's children in Harbin,and explore the effect of gender,parents quarrel,parents divorced and maternal factors on social anxiety.The study provided a scientific basis for the intervention of social anxiety.Methods The children in grade 1-5 from 3 schools in Harbin were collected by random cluster sampling in 2012.Then the same questionnaire was used to track the peasant-worker's children in 2014.The questionnaire included general information,Social Anxiety Scale for Children (SASC),Egna Minnen av Bardndosna Uppforstran (EMBU),Acceptance Subscale and Psychological Control Scale.Results (1) The detection rates of social anxiety of peasant-worker's children in 2012 and 2014 were respectively 29.3％,30.2％,and the detection rates had no significant difference (x2=0.111,P=0.790).But there was significantly difference between the two years(2012:6.90±4.26;2014:5.88±4.20;t=3.419,P=0.001).Children of newly occurring social anxiety in high grade was fewer and the ability to symptom relief was better.There was no significant difference between boys and girls on newly occurring and symptom relief(newly occurring:x2=0.018,P=0.910;symptom relief:x2 =0.541,P=0.518).(2) In 2012,the differences of the detection rate of children's social anxiety on parents quarrel,parents divorced were not significant (parents quarrel:x2 =0.881,P=0.393;parents divorced:x2=0.246,P=0.658).In 2014,the detection rate of children's social anxiety on parents quarrel,parents divorced were significantly higher than children in normal families (parents quarrel:x2=11.758,P=0.001;parents divorced:x2 =9.907,P=0.004).The detection rate of children's social anxiety of divorced parents increased with age(x2 =4.398,P=0.041).(3) In 2012 and 2014,children' s social anxiety had positive correlation with mother excessive interference and over-protective,mother refusing and denying,mother punishment,and had negative correlation with mother acceptance (P＜ 0.05).In 2014,it had positive correlation with mother control and negative correlation with mother emotional warmth understanding (P＜0.05).(4) In 2012,the regression coefficient of mother refusing and denying was 0.186.In 2014,the regression coefficient of mother acceptance and control were-0.266,0.169.Conclusion Social anxiety can be spontaneous remission,and the ability was better in high grade.Parents quarrel,parents divorced and maternal factors can affect the development of peasant-worker's children' s social anxiety,which should be concerned.

Objective To evaluate low-mechanical-index contrast-enhanced ultrasound (CEUS) in assessing the clinical efficacy and feasibility of percutaneous microwave ablation (MWA) for the treatment of renal cell carcinoma (RCC). Methods From March 2006 to July 2013, a total of 105 RCC patients with 109 lesions, mean size being (3.1 ± 1.3) cm, were treated with ultrasound-guided percutaneous MWA. CEUS results obtained on the third day after MWA were compared with the contrast-enhanced CT/MRI and biopsy findings in the corresponding period. Follow-up examinations with CEUS and CT/MRI were carried out 1, 3 and 6 months after the treatment and once every 6 months thereafter to evaluate the short-term and the long-term therapeutic effectiveness. Results Three days after MWA, CEUS showed that 94 of 109 lesions (86.2%) were completely ablated, and residual tumor tissue was seen in 15 of 109 lesions (13.8%). Among the 15 lesions with residual tumor tissue, 13 (86.7%) were proved by contrast-enhanced CT/MRI and/or biopsy performed in the corresponding period. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of CEUS for the evaluation of the short-term MWA effectiveness were 100%, 97.9%, 98.2%, 86.7% and 100%, respectively. Patients were followed up for 3 - 90 months with a median period of 24.6 months. During the follow - up period, CEUS detected recurrence in 7 patients, and 6 of them were consistent with CT/MRI results. The sensitivity, specificity, accuracy, positive and negative predictive value of CEUS for the evaluation of the long-term MWA effectiveness were 85.7%, 99.0%, 98.2%, 85.7% and 99.0%, respectively. Conclusion For the evaluation of the effectiveness of percutaneous microwave ablation in treating renal cell carcinoma, CEUS is a sensitive, reliable and convenient technique.

OBJECTIVETo investigate the value of real-time contrast-enhanced ultrasound (CEUS) in the diagnosis and differential diagnosis of renal solid renal lesions (RSLs).

METHODSWe retrospectively analyzed 140 cases of 152 RSLs with a mean diameter 3.1∓1.9 cm. CEUS was performed and the perfusion characteristics were analyzed using contrast pulse sequences (CPS) technique. CEUS findings were compared with biopsy histopathologic findings.

RESULTSA total of 137 malignant lesions (including 127 renal clear cell carcinomas, 8 renal papillary carcinomas and 2 chromophobe cell carcinomas) and 15 benign lesions (13 angiomyolipomas and 2 renal oncocytomas) were detected. Of the 137 malignant lesions, 98 (71.5%) showed contrast agent fast perfusion and hyper-enhancement or iso-enhancement in cortical phase, 104 (75.9%) showed hypo-enhancement in later corticalmedullary and late phase, and 125 (91.2%) showed rim-like enhancement. Tumors with a diameter ≤2 cm presented with homogeneous enhancement, and those ranging from 2 to 4 cm showed heterogeneous enhancement with a honeycomb feature; tumors greater than 4 cm featured heterogeneous enhancement with large no-enhancement necrotic areas. Of the benign lesions, 13 angiomyolipomas and 2 renal oncocytomas showed slow wash-in and slow wash-out mode. The diagnostic specificity, accuracy and positive predictive value of CEUS for RSLs were 94.9%, 96.1%, and 73.7%, as compared to 72.3%, 71.1%, and 19.1% with conventional US, respectively (P<0.001). The sensitivity and negative predictive value of CEUS were 93.3% and 99.2%, respectively, significantly higher than those of conventional US (60% and 94.3%, P=0.084, and 0.062, respectively).

CONCLUSIONReal-time CEUS can provide valuable information for improving the diagnosis and differential diagnosis of RSLs.

Adenoma, Oxyphilic ; diagnostic imaging ; Carcinoma, Renal Cell ; diagnostic imaging ; Contrast Media ; Diagnosis, Differential ; Humans ; Kidney Diseases ; diagnostic imaging ; Kidney Neoplasms ; diagnostic imaging ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography

Objective: To observe the short-term efficacy and side effects of bevacizumab combined with pemetrexed for the treat-ment of recurrent and metastatic cervical cancer. Methods: The clinical data of 32 patients with recurrent metastatic cervical cancer admitted to the Department of Oncology, Guizhou Provincial People's Hospital between January 2014 and December 2016 were retro-spectively analyzed. All patients were treated with bevacizumab plus pemetrexed. In the 21-day cycle, chemotherapy was adminis-tered for 4 to 6 cycles. The efficacy and grade of adverse reactions were evaluated. Results: Of the 32 patients with cervical cancer, 0 had complete remission, 7 (21.9%) had partial remission, 19 (59.4%) had stable disease, and 6 (18.7%) had disease progression. The ef-fective rate was 21.9% (7/32) and the disease control rate was 81.3% (26/32). The 32 patients had mild common adverse reactions, which can be tolerated. Conclusions: Bevacizumab combined with pemetrexed has good short-term effects for patients with recurrent and metastatic cervical cancer, and its side effects can be tolerated. The long-term efficacy warrants further study.