To illustrate the kinds of applicator, indication, side effects, long term follow?up results, clinical experience and the latest developments of intracavitary/interstitial brachytherapy (IC/IS?BT),more than 50 research articles concerning IC/IS?BT about cervical cancer were reviewed.

Hypoglycemia is a common metabolic problem in newborn infants,which might lead to brain injury even brain death when it keeps extremely low for a long time.Therefore,it is of great importance to monitor blood glucose in neonates,especially in groups of infants who are at risk of hypoglycemia,in order to identify and treat this condition and prevent adverse neurological outcomes promptly.It is given that infant of a diabetic mother,preterm neonate,low birth weight and asphyxia are its risk factors.Relative to blood glucose monitoring methods in clinical,continuous glucose monitoring system is comprehensive,continuous and with low pain.Continuous glucose monitoring system has been applied in high-risk neonates of hypoglycemia in recent years.It is of great help to understand the complete picture and change trend of blood glucose,optimize blood glucose management,study newborn glucose metabolic characteristics and the relationship between hypoglycemia and brain damage,so as to define and manage neonatal hypoglycemia.

Objective: To analyze the correlation between single nucleotide polymorphisms (SNP) of solute carrier family 22 member4 (SLC22A4) and runt-related transcription factor 1 (RUNX1) gene with rheumatoid arthritis (RA) and ankylosing spondylitis(AS) in Chinese Han ethnicity. Methods: Case-control studies were conducted with an RA cohort (104 RA patients and 109 healthy subjects) and an AS cohort (278 AS patients and 417 healthy controls). Three SNPs of SLC22A4 gene and an SNP of RUNX1 gene were genotyped by direct sequencing; we also assessed whether these alleles and genotypes were associated with RA and AS. Results: No significant differences in the distribution of the alleles and genotypes of SLC22A4 and RUNX1 polymorphisms were found between patients with RA and AS and healthy controls. Conclusion: Our results suggest that SLC22A4 and RUNX1 polymorphisms analyzed in the present study are not the susceptible genes for RA and AS in Chinese Han ethnicity.

Objective: To evaluate the relationship between the levels of serum uric acid (SUA) and prevalence of coronary artery disease (CAD) by Meta analysis. Methods: We searched the databases of Pub Med, Elsevier and Web of Science for internationally published cohort study for the relationship between SUA levels and CAD prevalence and conducted a general analysisby using Stata software. Results: A total of 11 cohort study including 463,918 subjects were enrolled in this study. For both male and female genders, increase SUA level was the risk factor for CAD occurrence (RR=1.11, 95% CI 1.00-1.24) and (RR=1.24, 95% CI 1.15-1.34). Dose-response Meta-analysis indicated that by 1 mg/dl SUA elevation, the risk of CAD occurrence would increase 4.8% in male and 12.4% in female, the risk in female gender was higher than male. Conclusion: SUA level has been closely related to CAD prevalence.

Objective To investigate the current situation of occupational burnout of doctors in west China and to explore the relationships among burnout,social support and work-family conflicts.Methods 611 doctors in west China were assessed by Chinese Maslach burnout inventory( CMBI),social support rating scale(SSRS) and work-interference-with-family and family-interference-with-work questionnaire.Results 14.1％ of the doctors in west China got high scores on emotional exhaustion(EE),49.4％ of them high scores on depersonalization(DP) and 33.1％ high scores on reduced personal accomplishment (RPA) ; 27.3％ experienced mild burnout,43.7％ moderate burnout and 3.3％ severe burnout.Doctors who had worked for 5 ～ 10 years and those for 11 ～ 20 years experienced greater EE.Those doctors with bachelor or master degree and intermediate or senior titles got highest level of depersonalization.Doctors in second-class hospitals got highest scores of depersonalization,and those who worked in first-class hospital experienced the highest sense of achievement.Logistic regression analysis showed that social support was a protective factor for burnout,but the conflict between work and family was a risk factor.Conclusion The status of occupational burnout among the doctors in west China is in a grave condition,the balance between family and work,and social supporting is crucial for doctors to resist the occupational burnout.

Background and purpose: Accumulating evidence has revealed that long non-coding RNA (lncRNA) is correlated with carcinogenesis and tumor development. Recent literature suggested that lncRNA promoter of CDKN1A antisense DNA damage activated RNA (PANDAR) was involved in the development of various cancers. However, the functional role of PANDAR in colorectal cancer (CRC) has not been elucidated yet. The present study aimed to explore the functional role of lncRNA PANDAR in promoting CRC metastasis and its mechanism.Methods: The expression of lncRNA PANDAR in CRC cell lines and tissues was detected by real-time fluorescent quantitative polymerase chain reaction (RTFQ-PCR), and the correlation between lncRNA PANDAR expression and CRC clinicopathological characteristics was statistically analyzed. Then, lncRNA PANDAR stably silencing CRC cells (HCT116-shPANDAR), overexpression cells (DLD1-PANDAR) and control vector cells (HCT116-shNC and DLD1-vector) were established using lentiviral vectors. Moreover, Transwell assay and Matrigel assay were performed to investigate the function of lncRNA PANDAR in CRC migration and invasion. Furthermore, the expression of transcriptional factors mediating epithelial-mesenchymal transition of lncRNA PANDAR overexpression cells were monitored by RTFQ-PCR assay, and the function of the target gene in modulating lncRNA PANDAR mediated CRC metastasis was also explored. Results: The expression levels of lncRNA PANDAR in normal colorectal epithelial cells were much lower than in CRC cell. The levels of lncRNA PANDAR in tumor-adjacent tissues were verified to be much lower than in CRC tissues [(171.52±97.80)% vs (100.00±63.18)%, P<0.05]. Moreover, the expression of lncRNA PANDAR was detected to be significantly correlated with CRC TNM stage, lymph node metastasis and distant metastasis (P<0.05). Besides, lncRNA PANDAR deficiency significantly reduced the migration [100.00% vs (42.08±4.77)%, P<0.05] and invasion [100.00% vs (39.14±3.81)%, P<0.05] capabilities in CRC cells, in contrast, the migration [100.00% vs (194.12±9.33)%, P<0.05] and invasion [100.00% vs (204.08±12.27)%, P<0.05] capa-bilities of CRC cells were obviously increased with lncRNA PANDAR overexpression. Furthermore, zinc-finger E-box binding homeobox 1 (ZEB1) expression was detected to be positively correlated with lncRNA PANDAR expression, and ZEB1 silencing could significantly reverse the increased migration and invasion capabilities induced by lncRNA PANDAR in CRC cells. Conclusion: LncRNA PANDAR could promote CRC metastasis by potentially targeting ZEB1. LncRNA PANDAR might be a promising diagnostic marker and therapeutic target for CRC patients.

Matrix metalloproteinase (MMP)plays an important role in the degradation of extracellular matrix components,which is crucial for tumor growth,invasion and metastasis.As one with the largest relative molecular mass in MMP family,MMP-9 takes part in the generation and progression of colorectal cancer. Research shows that MMP-9 can be used for the early diagnosis of colorectal cancer.The expression levels of MMP-9 in tissue and plasma are negatively correlated with prognosis of the postoperative patients with colorectal cancer.In addition,targeted therapy drugs will be designed on the basis of MMP-9 expression increased in colorectal cancer.

Objective To investigate the effect of dexmedetomidine on liver function,plasma cytokine levels,and oxidative stress due to ischemia/reperfusion injury in patients undergoing hepatolobectomy.Methods A total of 106 patients who underwent hepatolobectomy in General Hospital of Jizhong Energy Fengfeng Group Co.,Ltd.from January 2014 to January 2016 were enrolled and randomly divided into control group and observation group,with 53 patients in each group.The patients in the observation group were given 1 μg/kg/h dexmedetomidine within 10 minutes,followed by continuous intravenous infusion of 0.5 μg/kg/h dexmedetomidine,and those in the control group were given an equal volume of 0.9％ sodium chloride.The two groups were compared in terms of liver function parameters,plasma cytokine levels,and oxidative stress due to ischemia/reperfusion injury after anesthesia (T1),before abdominal closure (T2),and at 1,4,and 8 hours after surgery (T3,T4,and T5,respectively).The chi-square test was used for comparison of categorical data between groups;the t-test was used for comparison of indices between groups,the sphericity test was used for comparison of indices at different time points,and an analysis of variance was performed for repeated measurement data with P ＜ 0.05.Results The two groups had significantly higher alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels at T2,T3,T4,and T5 than at T1 (ALT:F =43.72 and 44.16,both P ＜ 0.001;AST:F =53.87 and 65.44,both P ＜ 0.001),and the observation group had significantly lower levels than the control group atT2,T3,T4,andT5 (ALT:t =20.54,22.01,36.68,and 38.15,all P＜0.001;AST:t =32.27,41.08,52.82,and71.89,all P ＜ 0.001).The two groups had significantly higher levels of tumor necrosis factor α (TNFα) and interleukin-8 (IL-8) at T3,T4,and T5 than at T1 (TNFα:F =54.37 and 24.75,both P ＜ 0.001;IL-8:F =47.24 and 27.39,both P ＜ 0.001),and the observationgroup had significantly lower levels than the control group at T3,T4,and T5 (TNFα:t =59.39,86.32,and 83.16,all P ＜ 0.001;IL-8:t =74.47,72.29,and 76.67,all P ＜ 0.001).The two groups had a significantly higher level of malondialdehyde at T3,T4,and T5 than at T1 (F =37.65 and 17.44,both P ＜0.001),and the observation group had a significantly lower level than the control group at T3,T4,and T5 (t =17.35,19.11,and 24.12,all P ＜ 0.001).The two groups had a significantly lower level of superoxide dismutase at T3,T4,and T5 than at T1 (F =36.54 and 33.65,both P ＜0.001),and the observation group had a significantly higher level than the control group at T3,T4,and T5 (t =68.64,66.35,and 59.48,all P ＜0.001).Conclusion Dexmedetomidine can effectively inhibit liver injury,reduce the levels of cytokines,and alleviate ischemia/reperfusion injury in patients undergoing hepatectomy.

Objective:To investigate the influence of preoperative biliary drainage (PBD) on morbidity of severely obstructive jaundice patients after pancreaticoduodenectomy (PD).Methods:A total of 98 severely obstructive jaundice(Serum total bilirubin＞300 μ mool/L) patients underwent PD between February 2010 and October 2015 were enrolled in the study.The patients were divided into two groups based on undergoing PBD or not.The no-PBD group comprised 52 patients and the PBD group comprised another 46 patients.Perioperatives parameters,including operative time,intraoperative blood loss,postoperative mortality and morbidity and postoperative hospital stay were compared between the two groups.Results:The demographics,preoperative examinations and pathological results were similar between the two groups (P＞0.05).Operative time of the no-PBD group was statistically longer than the PBD group (379.44 ± 88.57min vs 346.98 ± 57.17 min,P＜0.05).Besides,intraoperative blood loss of the no-PBD group were much more than the PBD group (365.00 ± 187.07mL vs 297.83 ± 139.57 mL,P＜0.05).There was no statistical difference of mortality rate between the no-PBD group and the PBD group(3.85％ vs 2.17％,P＞0.05).The overall morbidity rate of the 2 groups were similar (53.85％ vs 43.48％,P＞0.05),but the pancreatic fistula rate of no-PBD group was significantly higher than the PBD group (30.77％ vs 13.04％,P＜0.05).Conclusion:PBD could reduce operative time,intraoperative blood loss and pancreatic fistula rate after PD.Meanwhile,the mortality and overall morbidity rates were similar between the two groups.PBD should be considered for severely obstructive jaundice patients.

Objective To evaluate the method, clinical effects and influential factors of using three dimensional external fixators in the treatment of severe open comminuted tibiofibular fractures 5 cm near the knee or ankle joints. Methods We retrospectively analyzed 32 cases of open comminuted tibiofibular fracture 5 cm near the knee (11 cases) or ankle joints (21 cases). They were treated with three dimensional external fixators from October 2000 to May 2005. The patients with small wounds were treated with manipulative reduction or leverage reduction through the wound under the guidance of C-arm radiography. In case of malreduction or soft tissue being tangled by the fracture ends, visible reduction was carried out after the wound was lengthened or a small incision was added. Limited internal fixation was used in case of necessity. The results were evaluated in terms of shortening of the fractured limbs, X-ray manifestation, bilateral flexion differences and postoperative walking complaints. Results Follow-ups from 5 to 18 months (nine months on average) showed that all the cases achieved osseous union. The mean union time was 5.6 months. The total excellent and good rates of fracture healing and functional recovery were 81.3% and 87.5% respectively. Conclusion Application of the three dimensional external fixator is appropriate for the treatment of severe open comminuted tibiofibular fracture 5 cm near the knee or ankle joints, because its operative procedure is simple, the injury it causes is minimal, its fixation is reliable and its complications are quite limited.