Objective To explore the clinical effect and safety of S-1 combined with paclitaxel in treatment of advanced gastric cancer.Methods 80 patients with advanced gastric cancer accepted in our hospital from Sep.2013 to Dec.2015 were selected and randomly divided into 2 groups.Patients in observation group were given S-l,cisplatin and paclitaxel,and patients in control group were given S-1 and paclitaxel.Then the short term and long term clinical effect and adverse reactions of 2 groups were compared.Results The total effective rate of observation group was 52.50％ (21/40),which was obviously higher than 40.00％ (16/40) of control group (P ＜ 0.05).The median progression-free survival,median overall survival and 1 year survival rate of 2 groups had no great differences.The main adverse reaction of 2 groups were bone marrow suppression and gastrointestinal reactions of grade 0～Ⅱ.The grade of nausea and vomiting of observation group was much lighter than control group (P ＜ 0.05).But the other adverse reaction of 2 groups had no differences.Conclusion Using S-l,cisplatin and paclitaxel has good effect in treatment of advanced gastric cancer,which is safety and worthy of clinical applications.

Objective To establish musculoskeletal model and finite element model of kidney and blood stasis type knee osteoarthritis (KOA),and to analyze the cartilage stress characteristics of kidney and blood stasis type KOA.Methods Data from knee CT,MRI of kidney and blood stasis type KOA volunteers was used to construct musculoskeletal model and finite element model based on AnyBody and ANSYS software.Surface electromyogram (sEMG) verification and mutual verification were conducted.KOA bone stress and strain parameters were observed at the moving angles of 0°,-40°,-90°,-180° of the KOA musculoskeletal model,in order to explore the cartilage stress characteristics.Results When the positions of kidney and blood stasis type KOA patients varied from standing to squatting,the knee cartilage surface stress revealed a nonlinear increasing trend.Kidney and blood stasis KOA patient's knee cartilage stress near the distal end was significant different from that of normal subjects (P＜0.05),while the KOA patient's knee cartilage stress near the distal end and proximal front side had no significant differences with that of normal subjects (P＞0.05).Conclusions For kidney and blood stasis type of patients with KOA,cartilage surface stress displays a nonlinear increasing trend along with the stress concentration at the motion cartilage surface,which is consistent with the clinical features.

Objective To investigate the establishment and application effect of Evaluation Form for Cancer Pain Nursing Quality Control. Methods Nursing quality control team was founded on account of the leadership of the superintendent of nursing department and the head nurse from department of pain clinic. The team consisted of eight nurses containing the head nurse from model ward of the standardized treatment for cancer pain and nurses from department of pain clinic. According to the criteria and content of on- site assessment of cancer pain standardized treatment demonstration unit, indexes for cancer pain nursing quality was made, combining with the management practice of cancer pain nursing. The quality indexes was divided into five one- class indexes which had a total score of 100 and 20 for each including pain assessment, cancer pain treatment, patient education, nursing ability and others. Each one- class index followed with two - level index. And the table was applied to the cancer pain standardized treatment demonstration unit. Results After application of the Evaluation Form for Cancer Pain Nursing Quality Control, the following items were improved compared with those before application: accuracy of pain assessment [97.22%(70/72)vs.90.28%(65/72)], correctness of nursing record [98.61%(71/72)vs.88.89%(64/72)], satisfactory rate of pain control [97.22%(70/72)vs.84.72%(61/72)], accurate usage rate of cancer drugs [100.00%(72/72)vs.88.89%(64/72)] , understanding rate of health knowledge of patients and their family members[100.00%(72/72)vs.80.56%(58/72)], satisfactory degree of patients and their family members with nurses [100.00%(72/72)vs. 88.89%(64/72)], χ2=4.71, 8.87, 10.86, 8.87, 18.00, 8.87, P<0.05 or 0.01. Conclusions Application of Evaluation Form for Cancer Pain Nursing Quality Control in management of cancer pain can improve the nursing quality of cancer patients.

Objective To build a three-dimension finite-element model of patella and to make a preliminary mechanics analysis on the model.Methods According to the model-building principle of Ansys software which started from point to line to area to volume,a three-dimension finite-element patella model was reconstructed on the basis of the images of spiral CT.Then,loading on the model patella were simulated and the stress magnitude and distribution on the patella were analyzed.Results Finite element analysis of the patella showed that stress concentration zone located in the middle and lower patella,indicating that fracturepredilectionsitesinthelower patellar.TheVon misesstresson thetensionsidewas significantly greater than that on pressure side.Conclusion The established finite element model of the patella can reflect the real geometry of patella treated in clinics.

Objective To observe the effects of neurotrophin 3 (NT3)-chitosan on motor function, and proliferation and differentiation of the neural stem cells (NSCs) in the injury area and subventricular zone (SVZ) in rats with motor cortex injury. Methods Sixty-five Wistar rats were divided into control group (n=7), injury group (n=29) and NT3-chitosan group (n=29). The motor cortex was aspirated and re-moved as cerebral injury model. NT3-chitosan was immediately implanted into the injured area after operation, and the control group re-ceived no intervention. Pellet reaching test was performed to detect the recovery of the forelimb function, HE staining was used to observe the lesion cavity size, and immunofluorescence staining was used to observe the proliferation and differentiation of NSCs 3 days, 7 days, 14 days, 1 month, 2 months and 3 months after operation. Results The grasp success rate was higher (F>6.00, P≤0.05), and the lesion cavity size was significantly smaller (F>629.5, P<0.001) in the NT3-chitosan group than in the injury group. In the NSCs differentiation experi-ment, the number of BrdU cells at all the time points was significantly higher in the NT3-chitosan group than in the injury group (F>171.43, P<0.001). In the NSCs proliferation experiment, the number of BrdU positive cells was still significantly higher in the NT3-chitosan group than in the control group and in the injury group (F>155.06, P<0.001), the number of Dcx positive cells was significantly higher in the NT3-chitosan group than in the injury group (F=62.367, P<0.001), and the number of BrdU/Dcx positive cells was significantly higher in the NT3-chitosan group than in the control group (F=33.527, P<0.001). Conclusion NT3-chitosan could activate NSCs in the SVZ, and pro-mote endogenous neurogenesis and forelimb function recovery in rats after motor cortex injury.

Objective To study the clinicopathological features and biological behavior of inflammatory pseudotumor-like follicular dendritic cell tumor.Methods We studied the clinical data,HE sections,immunohistochemical staining,Epstein-Barr virus encoded nuclear RNA(EBER)in situ hybridization and outcome of one patient with inflammatory pseudotumor-like follicular dendritic cell tumor of liver,and thirteen patients with inflammatory pseudotumor of liver and spleen treated at the Shengjing Hospital of China Medical University from 2001 to 2010.Results Among the thirteen inflammatory pseudotumors,we diagnosed 1 patient with inflammatory pseudotumor-like follicular dendritic cell tumor of spleen and 1 patient with inflammatory pseudotumor-like follicular dendritic cell tumor of liver using immuno-histochemical staining and EBER in situ by hybridization.The liver case had pathological morphology consistent with those described in the literatures,but the splenic case had specific histologic features.They were both female,and were alive 2.5 and 6 years after operation.Conclusions Inflammatory pseudotumor-like follicular dendritic cell tumor should be distinguished from inflammatory pseudotumor.It is a rare tumor seen mainly in liver and spleen.The diagnosis depends on histopathological and immunohistochemical findings.Inflammatory pseudotumor-like follicular dendritic cell tumor is a low-grade malignant tumor.Surgical excision is the treatment of choice.The two cases provided evidence for its indolent behavior.

Objective To deeply understand the risk factors of lymphedema for patients with breast cancer after surgery. Methods The phenomenological method was applied in this study. Semi-structured interview was used to collected data from 9 female breast cancer patients with lymphedema after surgery in our hospital from June to September 2016 for generic analysis. Results The risk factors of lymphedema could be categorized into four themes:(1)choice of treatment is the primary cause:axillary lymph node dissection; radiotherapy; chemotherapy; (2)not paying enough attention to lymphedema:lacking the knowledge of lymphedema; imbalance of physical activities for the affected limb; lacking awareness of exercise and protection of the affected limb. Conclusions Axillary lymph node dissection after radical surgery for patients with breast cancer is the primary cause of lymphedema, and paying not enough attention is an important factor, especially lacking the consciousness of prevention, so the nurses should emphasize education about prevention of lymphedema after surgery for patients, to improve the consciousness of them to reduce the occurrence of lymphedema and its influence on their quality of life.

Objective To explore the degeneration of motor end plates (MEP) by observing the expression of calcitonin gene-relative peptide (CGRP) and acetylcholine esterase (AChE) in the MEP after different types of spinal cord injury. Methods 60 adult female Wistar rats were randomly assigned to 3 groups: sham group, completely transection group and contusion group. The content of AChE in the MEP was detected with Karnovsky-Roots staining and the expression of CGRP was then determined with immunohistochemistry. Results The content of both AChE and CGRP significantly decreased after either type of spinal cord injury. However, their activity gradually recovered to the normal level in the contusion group, but not in the transection group. Moreover, the changes of CGRP occurred earlier than those of AChE. Conclusion The motor end plate degenerates differently after different kinds of spinal cord injury in adult rat, CGRP and AChE are related to the degeneration of MEP.

Objective To observe the effect of the chitosan tube combined with basic fibroblast growth factor(bFGF) on inducing nerve axon regeneration of rats with peripherial nerve injury.MethodsA novel chitosan tube combined with bFGF was developed and used to suture the 10 milimeter long right sciatic nerve gap of 10 rats,single injury group(10 rats) were the control with sciatic nerve injury alone,and other 10 rats were assigned to sham group.Immunohistochemistry and electrophysiology study had been done to observe the effect of repairing.Results3 months after operations,the sciatic nerve gap were repaired by the regeneration nerve in the experiment group.And there was no evident inflammation in the defects.ConclusionThe chitosan tube combined with bFGF can induce the sciatic nerve to regenerate.

Objective To compare and analyze the accuracy and safety of robot-assisted and conventional freehand open approach in pedicle screw fixation using meta-analysis.Methods PubMed,Embase,Cochrane,China Biology Medicine,Wanfang and CNKI databases were searched by computer retrieval to identify the relevant literatures published before December1,2016.The qualified literatures were selected according to the preestablished the inclusion criteria and exclusion criteria,and processed for data extraction and quality evaluation.The RevMan 5.3 software was used for the meta-analysis.The relative risk (RR) and 95％ confidence interval (CI) were adopted to represent the effect differences in the dichotomous variable data.The effect difference of continuous variable data was represented by mean difference (MD) or standardized mean difference (SMD).When P＜0.05 and 95％ CI does not contain the value of 1,the difference was considered statistically significant.Results A total of 266 patients were enrolled,including 138 cases of robot-assisted group and 128 cases of conventional freehand open group,in which 1 200 screws were implanted,including 608 screws by robot-assisted system and 592 screws by conventional freehand open approach.The Gertzbein-Robbins grading criteria (grade A to C) were used.The results showed that there was no significant difference in the accuracy of pedicle screw fixation between the robotic-assisted and conventional freehand open approach according to the grading criteria,i.e.grades A (RR =1.07,95％CI:0.82,1.39,I2=46％,P=0.62),grades B (RR=l.56,95％CI:0.86,2.82,I2=0％,P=0.14) and grades C (RR=0.91,95％CI:0.32,2.55,I2=0％,P=0.85).For the two groups,the difference was no statistically significance in the complication rate (RR=0.33,95％CI:0.05,2.17,I2=0％,P=0.25),and in the revision rate (RR=0.53,95％CI:0.10,2.90,I2=0％,P=0.47).The difference was statistically significance in the overall surgical time (MD=20.90,95％CI:5.54,36.26,I2=15％,P=0.008),and in the exposure time (MD=-1.19,95％CI:-1.63,-0.75,I2=15％,P＜0.000 01).The difference was no statistically significance in the distance between screws and facet joint surfaces (SMD=-1.15,95％CI:0.79,1.51,I2=16％,P＜0.000 01).Conclusions Compared with the conventional freehand open approach,the current evidence cannot confirm that the robot-assisted system has significant advantages in the surgical accuracy of pedicle screw fixation and complication rate.The spinal surgical robot-assisted system,as a new technology,has considerable potential for further development and application in spinal surgery.