Stroke is characterized by high incidence,high morbidity,and high mortality.It seriously threats to human life and the quality of life.Studies have confirmed that neuroendocrine dysfunction occurs after the onset stroke and dkectly inpact on the outcomes of patients.It has great value for identifying the clinical conditions and outcomes,and has a guiding significance for clinical treatment.This article reviews neuroendocrine biomarkers of the neurological outcomes after stroke.

Objective To evaluate the expression of Survivin,PTEN in tongue squamous cell carcinoma (TSCC) and the correlation with vascular endothelial growth factor (VEGF) and its clinical significance.Methods The expression of Survivin,PTEN and VEGF of 72 TSCC samples and 15 normal tongue mucosa (NTM) samples were detected by immunohistochemical method.Results The positive expression rate of Survivin,PTEN and VEGF in TSCC were 66.7％(48/72),61.1％(44/72),70.8％(51/72)respectively,while the positive expression rate in NTM were 0,100.0％ (15/15),0.There were statistical significance between the rate in TSCC and NTM respectively (P ＜0.01 ).The expression of Survivin and VEGF in TSCC were positively correlated with TNM stage,histological grade and lymph node metastasis (P＜ 0.05 or ＜ 0.01 ),while the expression of PTEN had negative correlation with them (P＜ 0.05 or ＜ 0.01 ).The expression of Survivin was positively correlated with VEGF expression in TSCC (r=0.6482,P＜0.01),while the expression of PTEN was negatively correleted with VEGF expression (r =-0.4027,P ＜0.01).Conclusions The expression of Survivin and PTEN in TSCC are associated with tumor occurrence and development closely,and are both significantly correlated with VEGF.Joint detection of Survivin,PTEN and VEGF have important reference value in clinical diagnosis,metastasis and prognosis of TSCC.

Complications are always likely to occur in the treatment of fractures. Once fracture-related complications occur,their management will be difficuh,resulting in a long handling process that increases physical and financial pain on the patients.Fea- turing“management of fracture-related complications”,this issue intends to draw attention from orthopaedists to the challenging task of prophylaxis and treatment of such problems in clinic.Not only non-union,malunion,heterotopic ossification,bone necrosis but also such systemic complications as deep vain thrombosis,soft tissue infection and necrosis are discussed.They involve long tubular bones,pelvic,proximal femur,tibial plateau and calcaneum.Authors introduce their experience from their clinical practice which can benefit readers a lot.It is well known that an effective prevention is the best treatment.In treatment of fractures,principles must be strictly followed and preventive measures taken throughout the whole process.Once a complication has been detected,therapy should be individualized 1o gain the best outcome.

Objective: To intimately assess the internal stress distribution in ceramic veneer bonding layer. Methods:Six buccolingual cross section models of the incisor restored with IPS-Empress ceramic veneer were built with the MSC/NASTRAN software. 2D-finite element method was used to analyze the stress distribution regularity of the bonding layer on the models under different functional load. Results: Stress concentration areas of ceramic veneer bonding layer were regularly located on the incisal margin and cervical margin. Under the same condition, incisal load caused highest stresse on the adhesive layer. Following the load shift from incisal to gingival area, the stress was gradually decreased.When the functional load acted on the palate margin of the restoration, the compressive stress on the bonding layer was significantly increased. Different load angle generated stress change in the bonding layer. The shear stress on adhesive layer increased following the horizontal load angle increasing close to the debonding level. Among the different incisal reduction designs there was no significant Von Mises stress variation under the same load condition. However, when the incisal edge was reduced by more than 4 mm, the tensile stresses in the bonding layer greatly increased. Conclusion: Restoration margin should be kept away from the tooth contact area, be exposed to minimal occlusion contact. The functional load should be induced to follow the tooth long axis. Edge to edge occlusion should be avoided. When incisal areas need to be altered, the incisal overlap or butt margin design will not cause any stress problem in the bonding layer. When restoring the incisal defect for more than 4 mm, the bonding agents must be selected carefully.

The development of society raises demands for high-level talents,which requires high level post graduate education.The model of post graduate education is changing from research centered to professional skill centered.The research centered program has a long history and has gained consensus,while the professional skill program is still new.To address the social and economic needs,we explored the professional skill centered post graduate program and report our experience here.

Objective To compare the functional and radiographic outcomes of modified dual plating and less invasive stabilization system(LISS)in treatment of patients with complex tibial plateau fractures.Methods From November 2003 to November 2004,84 patients with complex tibial plateau fracture were treated with modified dual plating or LISS fixation.Their functional and radiographic outcomes were reviewed to compare the differences in bone union time,full weight-bearing time,knee joint's HSS(The Hospital for Special Surgery)scores,complications, tibia plateau angle(TPA)and posterior slope angle(PA).Results The 84 cases had complete follow-up records and a mean tollow-up of 16.2 months(range,12 to 23 months).Nine complications occurred in the modified dual plating group.The mean full weight-bearing time and radiographic bone union time were 16.8 and 15.1 weeks respectively for this group which had a mean HSS score of 87.4 points.Six complications were found in the LISS group.The mean full weight-bearing time and radiographic bone union time were 14.1 and 13.8 weeks respectively for this group which had a mean HSS score of 89.6 points.There were no significant differences between the two groups in changes of TPA and PA.Conclusion LISS can provide as good fixation as modified dual plating can for most complex tibial plateau fractures,but additional medial plate fixation may be necessary for some special cases.

The bleeding in liver resection is an important factor influencing the operation risk and postoperative out comes.Hepatic vascular exclusion technique is an effective method to control the bleeding,which has been improved after being widely used in clinical practice.In this paper,the research progress on the clinical application of various kinds of hepatic vascular exclusion techniques was reviewed.

Objective To investigate the value of ultrasound in differential diagnosis of benign and malignant thyroid lesions with rimlike peripheral calcification.Methods Seventy-three patients of thyroid nodules with rimlike peripheral calcification were analyzed retrospectively.All cases were confirmed by surgery and pathology.The efficacy of sonographic features on diagnosis of thyroid nodules was analyzed.Results Among 73 patients,58 (58/73,79.45％) were benign and 15 (15/73,20.55％) were malignant.Among the sonographic features mentioned,the mean size,margin,internal echo and presence of halo showed no significant differences between malignant and benign nodules (all P＞0.05).Proportion of thyroid nodules coexisting with nodular goiter,irregular thickness and interruption of rimlike peripheral calcification had significant differences between malignant and benign nodules (all P＜0.05).The sensitivity,specificity,positive predictive value and negative predictive value of coexisting with nodular goiter for diagnosing benign nodules were 77.59％ (45/58),60.00％ (9/15),88.24 ％ (45/51),40.91％ (9/22),respectively.The sensitivity,specificity,positive predictive value and negative predictive value of irregular thickness for diagnosing malignant nodules were 53.33 ％ (8/15),87.93％ (51/58),53.33％ (8/15),87.93％ (51/58),respectively.The sensitivity,specificity,positive predictive value and negative predictive value of interruption of rimlike peripheral calcification for diagnosing malignant nodules were 73.33％ (11/15),68.97％ (40/58),37.93％ (11/29),90.91％ (40/44),respectively.Conclusion Ultrasonography is helpful to diagnosis of thyroid nodules with rimlike peripheral calcification.Irregular thickness and interruption of calcification are associated with malignancy.

Objective To explore clinical effect and safety of intermittent androgen suppression treatment of advanced prostate cancer in elderly patients.Methods 78 patients with advanced prostate cancer were enrolled,and randomly divided into the observation group and the control group (n=39 each).Patients in observation group were treated with intermittent androgen suppression treatment.Patients in control group were treated with persistent androgen suppression treatment.Results The time of therapy was much longer in observation group than in control group (P＜ 0.001).Quality of life was better in observation group than in control group (P＜0.05).The incidences of adverse reactions including anemia,fever and abnormal liver function were lower in observation group than in control group (all P＜0.05).Conclusions Intermittent androgen suppression treatment prolongs time to androgen-independent progression,improve the quality of life,reduce drug dosage and the incidence of adverse reactions in the treatment of advanced prostate cancer in the elderly.

Objective:To study the pathological mechanism of the inducible co-stimulator molecular and ligand ( ICOS/ICOSL) in Graves disease animal.Methods:45 out-bred BALB/c mice were randomly divided into three groups with 15 rats in each group;using gene gun to deliver different plasmid injection.Group A was delivered with pCDNA3.0-mICOSL and pCDNA3.0-hTSHR, Group B with pCDNA3.0-hTSHR and null pCDNA3.0 with Group C for immunization as the control group.The concentration of serum free thyroxine immunization was deter mined with immunoassay and serum thyrotropin receptor antibody ( TRAb ) with ELISA, supernatant of IFN-γconcentration in mouse spleen cells was measured with radioimmunoassay,and hTSHR transected CHO cells were incubated to detect the concentration of cAMP to deter mine autoantibody TRAb activity.Results: After plasmid injection serum FT4 level in Group A (0.49±0.25) pg/ml ( q=6.571,P=0.023) was higher than that in Group C,the standard rate was higher than Group B and C (χ2=14.47,P=0.005).IFN-γconcentration of mice spleen cultured supernatant in Group A (1.88±0.41) pmol/L was significantly higher than the other two groups.The activity of autoantibody TRAb in Group A 188.3 (179.7-260.2) %was higher than that in the other two groups ( P=0.027 ) .Conclusion: Exogenous delivery of pCDNA3.0-mICOSL plasmid in GD mice could stimulate the spleen lymphocytes to secrete more IFN-γ,increase the activity of TRAb autoantibodies and might lead to upregulation of immune response in Graves animal model in vivo.