Severe burns and trauma can lead to insulin resistance (IR), which is associated with the metabolic disorder and hyperglycemia, and routine insulin treatment yield no noticeable outcome. However, long time big-dose insulin treatment can sometimes cause hypoglycemia, threatening the life of patients and making the condition more complicated to treat. By now, the mechanism of IR is not yet clearly understood. This article reviews the recent researches about the post-receptor signal transduction mechanism of IR after severe burns and its influencing factors.

Objective To evaluate the safety of central lymph node dissection with total thyroidectomy for papillary thyroid carcinoma. Methods A meta-analysis on the data of suitable seven clinical researches was performed using the Mantel-Haenszel method and the risk difference was calculated.Results Seven studies with a total of 1524 patients were eligible for inclusion, 620 were with totalthyroidectomy plus central lymph node dissection and 904 with thyroidectomy alone. There was a significant increased risk of temporary hypocalcaemia ( P = 0. 03 ) and temporary vocal cord palsy ( P = 0. 01 ) when central lymph node dissection was performed in addition to a thyroidectomy. However, the risk of permanent hypocalcaemia( P = 0. 32 ) and permanent vocal cord palsy (P = 0. 75 ) has no statistical difference between the two groups. Conclusion Central neck dissection added to thyroidectomy does not increase rate of permanent morbidity in thyroid cancer patients.

Objective To evaluate the impact of PET/CT on the clinical therapeutical strategy of patients with non-small cell lung cancer (NSCLC). Methods Sixty patients with histologically confirmed NSCLC supposed to accept radical radiotherapy or surgical operation were firsthy divided into group A (stage Ⅰ-Ⅱ) and group B (stage Ⅲ) according to CT findings, and the individualized treatment strategy was designed, then restage and compare with different stage and management with initial treatment strategy by PET/CT scanning. Results ①PET/CT scanning restaged the TNM stage in 53.33% (32/60) patients, including 3 of T stage, 23 of N stage and 9 of M stage. Changes of stage occurred in 65.85% (27/41) patients with adenocarcinoma and in 26.32% (5/19) with squamous carcinoma (P＜0.05), while in 34.29 (12/35) with central and 57.14% (20/35) with peripheral NSCLCs (P＜0.05). ②PET/CT scanning resulted in alteration of the managements of NSCLC patients. The management changed from radical into palliative strategy with PET/CT information in 9 (15.00%) patients. In 25 patients who were supposed to accept surgical operation, the treatment changed to radical radiotherapy in 8 (8/25, 32.00%) and to palliative radiotherapy in 5 (20.00%) patients. In 35 patients who were supposed to accept radiotherapy, surgical operation or palliative radiotherapy was finally chosen in 5.71% (2/35) and 11.43% (4/35) patients, respectively. Conclusion PET/CT images can make significant alteration to clinical stage and treatment plan in patients with NSCLC.

Objective To evaluate the safety of performing thyroidectomy together with central lymph node dissection(CLND). Methods Meta analysis was performed on 7 selected clinical papers using MantelHaenszel method and relative risk was calculated. Results A total of 1524 patients were eligible to be included,among whom 904 cases underwent thyroidectomy alone and 620 cases underwent total thyroidectomy combined with CLND. The risk rate of temporary hypocalcemia and temporary vocal cord palsy for CLND was 24. 77% and 9. 12% respectively, which was higher than that in performing thyroidectomy alone. However, the risk of permanent hypocalcemia and permanent vocal cord palsy had no statistic difference between the two groups. Conclusion As there is no increased morbidity of CLND, it is prudently suggested to give a prophylactic CLND for patients with high risk of thyroid papillary carcinoma.

Objective To clarify the effectiveness of QS Nd ∶ YAG laser on melasma in Chinese patients.Methods A group (n=45) of patients previously diagnosed as facial melasma were treated with QS Nd ∶ YAG laser at approximately 1 week intervals.Eleven to twenty treatments were per formed for each patient.The treatment efficacy of QS Nd ∶ YAG laser was evaluated by patients and doctors,respectively,at various time point such as before treatment,5 weeks and 10 weeks after treatment and end of the treatment.The skin melanin index and the transepidermal water loss were e valuated by the skin multifunction tester at different time point,respectively.Results Compared with untreated,the melanin index of melasma areas decreased significantly after the laser treatment for 5 weeks,10 weeks and the end of treatment.But there was no significant difference in the melanin index of normal skin areas with or without laser treatment.Compared with untreated,the transpidermal water loss of melasma areas increased significantly after the laser treatment for 5 weeks,10 weeks and end of treatment.The patients' skin became smooth,delicate,pores shrink and more flexible.In 45 melasma patients treated by QS Nd ∶ YAG laser,8 cases basically cured (17.78 ％),25 cases were markedly effective (55.56 ％),12 cases improved (24.44 ％) and only 1 case was uneffective (2.22 ％).Theoverall effective rate was 73.33 ％.Conclnsions QSNd∶ YAG laser is a useful treatment modality for Chinese women who have melasma with precise efficacy,less side effects and high safety.

Objective To observe the influence of inactive FRMD4A gene′s expression on the biological behavior of tongue cancer CAL-27cell. Methods FRMD4A-siRNA was transfered into CAL-27 cell by lipidosome, to the expression of FRMD4A-siRNA in CAL-27 cell after transfection was detect by qRT-PCR cell proliferation , was checked by CCK-8,the influence of inactive FRMD4A gene on cell cycle distribution of CAL-27 cell was assayed by flow cytometry. Results Compared with the control group, FRMD4A mRNA expression significantly reduced in FRMD4A-siRNA interfering group (94%) and the cell proliferation index decreased(P<0.05). The cell cycle arrested in G1 period (P<0.05). Conclusion FRMD4A-siRNA could effectively inhibit FRMD4A mRNA expression in tongue cancer CAL-27cell, impact the distribution of cell cycle, and reduce cell proliferation.

Objective:To explore the technique of two-flap in ear reconstruction.Method:Quantitative tissue expansions were used in the mastoid area in the first stage.After the final injection,there was 1 month of sustaining time.Expanded skin flap and unexpanded fascia flap were designed in the second stage,so thetwo-flaptechnique was used in the ear reconstruction.From January 2004 to December 2008,1 427 patients of microtia were treated using two-flap technque.Result:The expanded skin flap could show the fine structures of the reconstructed ears.The reconstructed ears had vivid cranioauricular angle after using the unexpanded fascia flap.Conclusion: Two-flap method was easily manipulated and the complications were rare.The reconstructed ears had lucid and three-dimensional contour.

OBJECTIVETo investigate and evaluate the appropriate virus titer and transfection efficiency of recombinant adenovirus p53 into the oral dysplastic epithelial cells (POE-9n) and provide reference for oral precancerosis research.

METHODSThe transfection sensitivity of adenovirus into oral dysplastic epithelial cells was evaluated by the recombinant adenovirus p53 containing green fluorescent protein (rAd-GFP). Different titre rAd -p53 was transfected into oral dysplastic epithelial cells to evaluate the effects of rAd-p53 on cell proliferation inhibition by MIT assay. The expression of exogenous p53 gene in POE-9n cells was detected by immunocytochemistry.

RESULTSMore than 95% POE-9n cells were transfected by rAd-GFP with MOI from 100 to 500 and there was no statistical difference between different MOI values (r=-0.124, P>0.05). It was found that rAd-p53 had significant inhibition effects on POE-9n cell proliferation with MOI from 100 to 500, and there were no significant differences at 96 h and 120 h after the transfection on cell proliferation inhibition (P>0.05). P53 protein was well expressed in rAd-p53 transfected POE-9n cells.

CONCLUSIONExogenous p53 can be successfully transfected into POE-9n cells by rAd-p53 and the virus titer of MOI 100 was high enough to ensure efficient transfection.

OBJECTIVETo investigate the differently expressed Homeobox genes between adenoid cystic carcinoma of salivary gland and normal gland tissue, and find out the effect of homeobox genes on oncogenesis and differentiation of adenoid cystic carcinoma of salivary gland.

METHODSSix strictly paired specimens including adenoid cystic carcinoma and its surrounding normal gland tissue and two pairs of specimens including cell strain of adenoid cystic carcinoma and its surrounding normal gland tissue were established. Customized Oligo microarray which contains probes of 232 human homeobox genes was used to analyze and conclude two groups of different genes data. RT-PCR technique was used to examine the mRNA expressing level of highly suspected relevant genes of adenoid cystic carcinoma in different specimens. Obvious differently expressed Homeobox genes were found through statistical analyses.

RESULTSIn tissue specimens homeobox genes were found 67 up-regulated and 54 down-regulated, and in cell specimens homeobox genes were found 12 up-regulated and 15 down-regulated. One up-regulated gene and 7 down-regulated genes were found both in tissue and cell specimens, among which EVX1 and PITX1 were the most frequent. RT-PCI showed that there was statistical expressing difference between TGIF, EVX1 and normal gland tissue in ACC-M.

CONCLUSIONAs the key gene to cellular proliferation and differentiation, homeobox genes are closely relevant to the oncogenesis of adenoid cystic carcinoma of salivary gland.

OBJECTIVETo explore altered molecular phenotype of lymphatic endothelial cells (LEC) induced by oral cancer cells. It is relevant to develop therapeutic strategies for blocking oral cancer spread through lymphatic vessels.

METHODSLEC were co-cultured with oral cancer cells in a model. Differential gene expression profiles between tumor-derived lymphatic endothelial cell (TLEC) and LEC were analyzed by Human Genome U133 Plus 2.0 GeneChip arrays. Differential expression genes of functional similarity were classified.

RESULTSDifferential gene expression profiles revealed that 677 unique genes had at least a twofold change in expression level between the two groups, 384 were overexpressed, and 293 were underexpressed in TLEC. These genes were related to cell adhesion, apoptosis, cell motility, development, and angiogenesis. In addition, some genes were involved in signal transduction, immune response, cell metabolism, and so on.

CONCLUSIONLEC and TLEC are distinct at the molecular level. A novel therapeutic strategy of lymphatic metastasis is encouraging and anticipated based upon manipulation of LEC responses to oral cancer cells.