BACKGROUND:Extracel ular vesicles (EVs) are a kind of subcel ular component produced by paracine mechanism including exosomes, microparticles and microvesicles, which have become hotspots in recent years. OBJECTIVE:To review the research status and progress of EVs, especial y in the studies about definition, secreting mechanism, isolation and identification, biological characteristics and functions in diseases as wel as in biomedical research. METHODS:The first author retrieved PubMed and CNKI databases for relative articles published from July 2006 to August 2016. The keywords were“extracel ular vesicles, exosome, microvesicle, microparticle”in English and Chinese, respectively.RESULTS AND CONCLUSION:A total of 44 eligible literatures are enrol ed. Almost al cel s can secrete EVs, which contain a variety of metrocyte-derived bioactive molecules, such as lipids, proteins, mRNAs, microRNA, lncRNA, cicrRNA, and non-coding RNA. These bioactive molecules are encapsulated in EVs or binding with the membrane. EVs are described to be involved in inflammation, immunity, signal transduction, cel survival and apoptosis, angiogenesis, thrombogenesis, and autophagy, which are of great significance to the maintenance of homeostasis and disease progression. Special EVs may be used as new biomarkers for the diagnosis and prognosis of many diseases and serve as novel tools in the fields of antitumor therapy, regenerative medicine, immunoregulation and vaccination and drug delivery. But the molecular mechanisms regulating the secretion of EVs and the specific pathways activated upon EVs interaction with the target cel are not ful y understood. Based on miRNA, lncRNA and circRNA are attracting researchers’ attention.

Protons and heavy ion radiation therapy have proven highly effective against a wide range of cancers and in recent decades there have been rapid advances.Due to the physical characteristics of the Bragg-peak and superior biological properties,proton and heavy ion radiation is able to focus its energy on the tumor while minimizing exposure to surrounding normal tissues and organs,which is expected help enhance the tumor dose and reduce normal tissue damage.In recent years,many studies have explored the efficacy and safety of proton and heavy ion radiotherapy on various malignancies,such as head and neck cancer,lung cancer,esophageal cancer,and liver cancer.The results of these studies enable a better understanding of the characteristics and advantages of proton and heavy ion therapy.

Objective To evaluate the effects of intraoperative intraperitoneal chemotherapy with sustained release 5-fluorouracil for implantation(5-Fu SRI) for the treatment of locally advanced colon cancer. Methods A total of 70 patients with locally advanced primary colon cancer(T4N0M0 and stage Ⅲ) undergoing radical resection were divided into treatment group(n=36,intraoperative intraperitoneal chemotherapy with 600mg 5-Fu SRI)and control group(n=34,intraoperative intraperitoneal flushing with 1000mg 5-fluorouracil injection). Both groups received the same postoperative chemotherapy regime.The 2-year survival rate,local recurrence rate and distant metastasis rate were retrospectively analysed. Results The 2-year survival rate and local recurrence rate were more favourable in treatment group than those in control group(P0.05). Conclusion Intraoperative intraperitoneal chemotherapy with 5-Fu SRI may decrease postoperative local recurrence rate and increase 2year survival rate.

Objective To study the diagnosis and therapy of Hashimoto's disease (HD) with thyroid nodule. Methods The clinical data of 187 patients with nodulous Hashimoto's disease who had operation in our hospital from 1995 to 2008 were analysed retrospectively. Results The nodules coexisting with Hashimoto's disease were thyroid carcinoma, nodular goiter, thyroid follicular adenoma and lymphoma accounting for 11.2% (21/187), 26.7% (50/187), 15% (28/187) and 1.6% (3/187) respectively. Conclusions HD patients with thyroid nodules especially the single nodule that can not be distinguished from cancer should have operation in time. Ultrasound guided needle aspiration will be helpful for the preoperative diagnosis and the frozen section may guide the surgical modality.

Objective To investigate the effect of hyperoxia on the expressions of cysteinyl aspartate specific proteinase -3(Caspase -3)and proliferating cell nuclear antigen (PCNA)in bone marrow mesenchymal stem cells (BMSCs).Methods Primary BMSCs from SD rats were cultured in vitro,BMSCs grew to 70% -80% degrees of fu-sion and then were randomly divided into room air group and hyperoxia exposure group.Each group was divided into 5 sub -groups,and cultured for 0,3,6,1 2,and 24 h respectively.Morphology investigation with inverted phase contrast microscope was adopted.The expressions of Caspase -3 and PCNA protein levels were detected by Western blot. Results (1 )As time wenty by,compared with room air group,the gap between cells increased,some of the cells be-came circular,and cell detachment and floating appeared in the hyperoxia -exposure group (>1 2 h)compared with room air group.(2)As time went on,compared with the room air group,the expression levels of Caspase -3 protein in the hyperoxia -exposure group were increased,and the difference was significant after 6 hours of culture (0.27 ± 0.04 vs 0.1 4 ±0.02,t =5.03,P =0.007).(3)Compared with room air group,the PCNA levels of the hyperoxiaexpo-sure group(6 h)decreased,and the difference in PCNA protein expression levels was significant after 6 hours of culture (0.27 ±0.04 vs 0.38 ±0.04,t =3.37,P =0.028).Conclusions Hyperoxia exposure increases Caspase -3 expres-sion levels and decreases PCNA expression,which may affect the proliferation and apoptosis of BMSCs.

In recent years,along with the deepening study of bone marrow mesenchymal stem cells (BMSCs),the repair effect of BMSCs in various tissue injury have been gradually revealed.And in recent years,except the ability of differentiate to the target cells,its paracrine effect,for example,a variety of cyto-kines secreted by BMSCs,also plays an important role in the process of repairing.

Objective To investigate the factors affecting the efficacy,safety and prognosis of R0 resection in hepatocellular carcinoma(HCC)patients with portal hypertension(PH).Methods Clinical data of 600 patients with cirrhosis related HCC undergoing hepatectomy at the Dept.of Hepatobiliary Surgery were studied retrospectively.According to whether the patients with portal hypertension or not,they were divided into PH group and non PH group.Postoperative complications and mortality were compared between the two groups.Kaplan-Meier was used to analyze influencing factors of patients with R0 postoperative survival.Cox regression risk model was used to analyze the risk factors.Results The operative mortality of PH group and non PH group was 3.6%(3/84)and 0.5%(1/216),respectively.The difference was statistically significant(P<0.05).The incidence of postoperative complications in PH group was 22.6%,significantly higher than 9.7% in non PH group(P<0.05),especially the incidence rate of the liver related complications(ascites>800 ml/d,hepatic insufficiency and liver failure).Alcoholism,with PH,AFP ≥20 ng/ml,tumor size>5cm and non-solitary type HCC(all P<0.05) were important factors for overall survival.Cox regression analysis showed that tumor size>5cm and non-solitary type HCC were independent predictors for survival.Conclusion PH combined with HCC patients after R0 resection can significantly increase the incidence of complications related to liver disease and mortality,tumor size >5cm and non-isolated HCC are the risk factors for long-term survival of patients.

Objective To analyze 206 cases of pregnant women with multiple organ dysfunction syndrome(MODS)due to different primary diseases and the prognosis.Method A retrospective study was conducted of 206 cases of pregnant women with MODS who were treated during January 2000 to December 2006 in the Third Affiliated Hospital of Guangzhou Medical College,regarding their primary disease and prognosis.Results Fourty-four cases among the 206 pregnant women with MODS died.The main primary causes were postpartum hemorrhage in 63 cases(30.6%),severe preeclampsia or eclampsia 60 cases (29.1%),pregnancy with hepatitis C in 23 case(11.2%),pregnancy with heart disease in 11 cases (5.3%),12 cases of ectopic pregnancy(5.8%).The mortality was mainly because of pregnancy complicated with heart disease(63.6%),ectopic pregnancy(41.7%),pregnancy with hepatitis (22.7%),of postpartum hemorrhage(17.5%)and severe preeclampsia-eclampsia(11.7%).The difference was statistically significant(P

Objective To evaluate the efficacy of Grosse Kempf interlocking intramedullary nailing (Grosse Kempf IIN) and AO plate in the treatment of tibial fractures. Methods A retrospective analysis was done on the recovery of 55 cases with tibial fractures treated with the Grosse Kempf IIN (Group A) and 40 treated with AO plate (Group B) from 1994. Results The 10 26 months follow up showed that the healing rate and the infection rate were 98.2% (54/55) and 1.8% (1/55) respectively in the Group A with a mean healing time for 5.6 months and 90.0% (36/40) and 12.5% (5/40) respectively in the Group B with a mean healing time for 7.5 months. Conclusions The Grosse Kempf IIN has obvious advantage of excellent biodynamics, reliable fixation, simple operation, less trauma on regional blood supply and is more effective in the treatment of tibial fractures than the AO plate. Nevertheless, I IN itself has limitation for further application.

Objective:To study the effects of treatment of Angle Ⅱ division 2 malocclusion with upper/lower arch expansion and Class Ⅱ elastics in adults. Methods:Expanding upper/lower arch and Class Ⅱ elastic were used to treat Angle Class Ⅱ division 2 malocclusion in 15 adults. Study models and cephalograms were analyzed before and after treatment. Results:Before and after treatment the maxillary variables of cephalograms showed no significant differences, the mandibular variables showed significant differences in sagittal and vertical direction. U1-NA, U1-PP, L1-NB, L1-MP, U1-L1 and L6-Ptm were significantly increased after treatment(P