Objective:To examine the expression of VEGF gene in the endometrial carcinoma tissues,para-tumor tissues,normal endometria and peripheral blood,and analyze the role of VEGF in tumor growth and tumor metastasis.Methods:Real-time fluorescence quantitative PCR was used to detect the expression of VEGF gene in 51 endometrial carcinoma samples and the corresponding para-tumor tissues,40 normal endometria samples and their corresponding peripheral blood samples.The relation between the VEGF expression and clinical pathological parameters was analyzed.Results:The expression of VEGF gene was higher in the endometrial carcinoma tissues than in the corresponding para-tumour tissues and normal endometrial tissues(P0.05).The expression of VEGF in peripheral blood was higher in patients with endometrial carcinoma than that in the normal controls;and the expression was significantly correlated with the clinical stage,histological grades,pathological types and the presence of lymph node metastasis(P0.05).Conclusion:Real-time fluorescent quantitative PCR can sensitively,specifically detect the expression of VEGF in the endometrial carcinoma tissues and peripheral blood samples.VEGF might play an important role in the development,invasion,and metastasis of endometrial carcinoma.

BACKGROUND:At present, there are no studies of comparing the effect of silk fibroins from different sources in repair of osteochondral defects. OBJECTIVE:To compare the effect of mulberry silk- and tussah-derived silk fibroin scaffold materials in repair of osteochondral defect. METHODS:Totaly 20 New Zealand white rabbits were obtained to prepare osteochondral defect models on the unilateral knee joint and randomly divided into five groups: control group, experimental group 1, experimental group 2, experimental group 3 and experimental group 4. Rabbits in the control group were not implanted any materials. In the experimental group 1, 3 layers of mulberry silk protein scaffolds stuck together to fil in defects. In the experimental group 2, one mulberry silk protein scaffold coated with transforming growth factor-β3 was stuck with two mulberry silk protein scaffolds coated with bone morphogenetic protein-2 to fil in defects. In the experimental group 3, three layers of tussah protein scaffolds stuck together to fil in defects. In the experimental group 4, one tussah protein scaffold coated with transforming growth factor-β3 stuck together with two tussah protein scaffolds coated with bone morphogenetic protein-2 to fil in defects. At 8 weeks post surgery, articular cartilage repair area was observed histopathologicaly. Type I and II colagen expressions were determined. RESULTS AND CONCLUSION:The colagen fibers in experimental group 1 were widely distributed in the ful-thickness defect area. The colagen fibers in the experimental group 2 were paralely distributed on the surface of repair area, verticaly distributed from the middle and bottom to the top direction. Colagen was observed on the surface of repair area in the experimental group 3. The cartilage-like cels presented clumped distribution on the surface and at the bottom of scaffold. The type I colagen expression in the repair area was strongly positive in these four experimental groups. The type II colagen expression in the repair area of experimental 1 and experimental 2 groups was weak. The type II colagen expression in the repair area of experimental 3 and experimental 4 groups was strongly positive. These results demonstrate that these two kinds of silk fibroins can both repair osteochondral defects, in which mulberry silk proteins tend to form bone tissue, and tussah silk proteins tend to form cartilage tissue.

Objective To explore the feasibility and safety of combination of thoracoscopy and laparoscopy for the treatment of esophageal carcinoma.Methods Combining thoracoscopic and laparoscopic esophagectomy was attempted in 23 patients with esophageal cancer between August 2007 and July 2008.Being placed at a left lateral decubitus position,the patients received right thoracoscopic mobilization of the intrathoracic esophagus as well as lymph node dissection;then with lithotomy position,laparoscopic mobilization of the stomach and lymph node dissection were carried out,followed by creation of a gastric tube through a small incision under the xiphoid;finally we pulled out the gastric tube from the esophageal bed to the neck and made an intermittent gastroesophageal anastomosis.Results One of the patients was converted to open abdominal surgery,whereas no one was converted to open thoracic operation.The total operation time ranged from 240 to 330 minutes with a mean of 270 minutes,the operation time for laparoscopy was 38-90 minutes(mean,65 minutes),and for thoracoscopy was 55-100 minutes(mean,70 minutes).No massive hemorrhage occurred during the operation,the total blood loss ranged from 100 to 300 ml(mean,225 ml),of which 10 to 50 ml were intra-abdominal blood loss(mean,20.4 ml).Totally 225 lymph nods were removed(9.8 per patient in average).Of the resected lymph nodes,65 were para-left gastric arterial or pericardial lymph nodes(2.8 per case).The mean hospital stay in this series was 9.2 days(range:8-12 days).During the hospitalization,no patient died;postoperative complications included pulmonary infection(3 cases),cervical anastomotic leak(one case,occurred in 8 days after the surgery),chylothorax(1 patient,cured by ligation via open thoracic surgery),and hoarseness(3 cases).Of the patient,23 received an follow-up for 1 to 11 months(mean,7.7 months),during which,1 patient died and 1 patient showed extensive metastasis to the mediastinal lymph node.Conclusion Combination of thoracoscopy and laparoscopy with cervical anastomosis is feasible and safe for the treatment of esophageal carcinoma.

Education history and characteristics of oral implantology especially in China were reviewed and commented.Curriculum establishment in China medical universities was proved to be necessary and feasible by analysis of current domestic education condition of graduate and postgraduate.education in oral implantology.In recent three years.practices in implantology education was carried out in School of Stomatology,Fourth Military Medical University.Implantology curriculum was established,with teaching experiences and methods summarized for reference of lmplantology education in other universities.

Reverse transcription-PCR and methylation-specific PCR (MSP) were used to determine the expression levels of Syk gene and the methylation status of its promoter in tissue samples from 60 patients with cervical cancer, 50 patients with cervical intraepithelial neoplasia (CIN), and 20 normal controls. We also analyzed the association of the methylation status and expression levels of Syk gene with linicopathological features of patients. The expression rates of Syk gene in 20 normal cervical tissue samples and 18 CIN Ⅰ samples were both 100% ; those of CIN Ⅱ- Ⅲ and cervical carcinoma were 56% (18/32)and 35% (21/60) respectively. Among cervical carcinoma patients, the expression of Syk mRNA was detected in one out of 13 cases with lymph node metastasis (1/13) and in 20 out of 47 cases with no lymph node metastasis (43%). The methylation of Syk gene in promoter region was detected in 34 out of 60 cases of cervical carcinoma (57%) ; while there was no methylation in CIN cases. In 13 cases with lymph node metastasis, 11 were found to have the methylation of Syk gene. The methylation rate of Syk promoter in cervical carcinoma was higher than that of CIN tissue( x~2 = 7. 13, P ＜0. 01 ). The methylation status of Syk gene was correlated with the lymph node metastasis ( P＜ 0. 05 ), but not with other clinicopathological parameters ( P ＞ 0. 05). There was a significant correlation between methylation status and expression level of Syk gene ( P ＜ 0. 05 ). The hypermethylation leads to silencing of the Syk gene in human cervicalcarcinoma. Syk hypermethylation may be associated with oncngenesis, metastasis of cervical carcinoma.

The strategy of optimizing anesthetic management was carried out in all the patients un?dergoing thoracic surgery in our hospital from January 1, 2012: the patients were monitored using routine electrocardiogram combined with invasive arterial blood pressure monitoring, double?lumen central venous catheter pathway was established, and when severe bradycardia ( heart rate<40 beats∕min) occurred, inter?vention was carried out immediately, and chest compression was performed timely. Medical records of 15 212 patients from July 1, 2006 to December 31, 2011 ( before optimizing anesthetic management) as well as medical records of 17 078 patients from January 1, 2012 to January 15, 2015 ( after optimizing an?esthetic management) were reviewed. The data including baseline patient characteristics as well as the time period and causes of cardiac arrest, rescue time, rescue measures, successful resuscitation and prognosis in the patients developing intraoperative cardiac arrest were collected. Before optimizing anesthetic manage?ment, 28 patients developed cardiac arrest, the incidence was 0?184%, successful resuscitation was found in 25 cases, the success rate of resuscitation was 89%, and there were 3 cases in whom resuscitation failed due to massive hemorrhage?induced cardiac arrest. After optimizing anesthetic management, 17 patients de?veloped cardiac arrest, the incidence was 0?109%, massive hemorrhage?induced cardiac arrest was not found in patients, and the success rate of resuscitation was 100%. Prognosis was good after surgery in suc?cessfully resuscitated patients. Compared with the values before optimizing anesthetic management, the in?cidence of cardiac arrest was significantly decreased (P=0?05), and no significant change was found in the other parameters after optimizing anesthetic management ( P>0?05) , and the incidence of cardiac arrest was decreased by 45% after optimizing anesthetic management. In conclusion, the strategy of optimizing anesthetic management is helpful in decreasing the occurrence of cardiac arrest during thoracic surgery.

Digitalization of ancient medical documents has become an important platform for the development and protection of medical literature and digitalization of ancient medical documents based on ancient medical documents themselves will lead to a series of intellectual property rights. After the relationship between ancient medical docu-ments and protection of intellectual property rights was analyzed, the major intellectual property rights involved in current digitalization of ancient medical documents were pointed out with their solutions elaborated from the reasona-bleness, rationality, legality and normality.

Objective:To evaluate osteointegration condition and mechanism of surface porcelainized titanium implants(Bio-Ti implant) by studying the characteristics of implant-bone interface. Methods: Edentulous mandible models of dogs were established. Pure titanium implants were designed for in vivo experiments. Bio-Ti implants were installed in dogs' mandible. All animals were sacrificed in 3, 6, 12 weeks respectively. Osteoid deposition on implants surface was observed and analyzed by SEM and EDX. Bone-implant interface of holistic specimen was analyzed by element linear scanning. All procedures were under the control of pure titanium implants. Results: Relatively great quantity of osteoid deposition could be found around Bio-Ti implants in 3 weeks, with tight combination with implants. Bio-Ti implant surface was found to have been reconstructed, Ca and P content markedly increased in partial exposed implant surface by SEM element analysis, with osteoid granules deposited inside micropores. Linear and planar scanning results showed no component breaks in the area along from bone tissue to implant, which suggested mutual infiltration and integration between implants and bone tissues. Conclusion: Bio-Ti implants can induce early osteoid deposition in vivo and chemically combine with bone tissues, within the period of markedly shortened osteointegration duration.

Objective To observe the serum and cerebrospinal fluid (CSF) levels of procalcitonin (PCT),matrix metalloproteinase-9 (MMP-9) in children with purulent meningitis and viral encephalitis,and evaluat the differential diagnosis value of PCT and MMP-9.Methods The clinical data of 73 patients with intracranial infection admitted to neurology of Qingdao Women and Children's Hospital from September 2014 to December 2015.Twenty-two patients with pumlent meningitis were se1ected as purulent meningitis group,51 patients with viral encephalitis as viral encephalitis group,and another 20 non-infectious convulsion children as a control group.Samples of 2 ml CSF and 3 ml venous blood from all the subjects were collected within 24 hours after admission.The levels of MMP-9 were detected by Enzymelinked immunosorbent assay (ELISA),and the PCT 1evels were measured by electrochemiluminescence immunoassay.The data in multiple groups were compared with analysis of variance,and by SNK-q test to carry on pairwise comparison among groups.The positive rate significance compared by Chi-square test.Linear correlation analysis was used for correlation analysis.Results Mean serum and CSF levels of PCT in the pumlent meningitis patients group were significantly higher than those in the viral encephalitis group as well as the control group (P ＜ 0.01),but the levels of serum or CSF there were no significant difference between the viral encephalitis group and the control group (P ＞ 0.05);Mean serum and CSF levels of MMP-9 in the pumlent meningitis patients group were significantly higher than those in the viral encephalitis group and control group (P ＜ 0.01),and the levels in patients with viral encephalitis were significantly higher than those in control group (P ＜ 0.01);The increased percentage of the serum and CSF PCT in pumlent meningitis group were significantly higher than in viral encephalitis group (P ＜ 0.01).,but there were no significant difference for MMP-9 (P ＞ 0.05);The PCT level of serum or CSF in pumlent meningitis patients was positively correlated with MMP-9 (r =0.498,P ＜ 0.01),but there was no significant correlation in viral encephalitis group (P ＞ 0.05).Conclusion Detection of PCT and MMP-9 level is valuable in differential diagnosis for the pumlent meningitis or viral encephalitis.

Objective To compare the development of intraoperative atrial fibrillation in elderly patients undergoing thoracic surgery using different anesthetic methods in a large sample clinical trial.Methods A total of 1 380 patients of both sexes,aged 60-80 yr,with body mass index of 16-33 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective radical operations for lung or esophageal cancer,were divided into 3 groups (n =460 each) using a random number table:general anesthesia group (group G),general anesthesia combined with paravertebral block group (group GP),and general anesthesia combined with epidural block group (group GE).After induction of anesthesia,an epidural catheter was placed at T4-7 interspace on the operated side,and 0.375％ ropivacaine 8 ml was administrated via the catheter in group GP.After induction of anesthesia,the patients were tracheally intubated and mechanically ventilated,and the end-tidal pressure of carbon dioxide was maintained at 35-45 mmHg in the 3 groups.Maintenance of anesthesia was as follows:propofol was given by target-controlled infusion with the target plasma concentration of 2.5-4.0 μg/ml in the 3 groups;intermittent iv boluses of sufentanil 10 μg were given,and the total dosage was not expected to exceed 1.0 μg/kg in group G;sufentanil 10 μg was injected intravenously when necessary in group GP;0.25％ ropivacaine 5 ml was injected epidurally every 1.5 h in group GE;bispectral index value was maintained at 40-60;rocuronium was injected intravenously according to the condition in the 3 groups.The development of intraoperative atrial fibrillation was recorded.Results The incidence of intraoperative atrial fibrillation was 6.1％,3.7％ and 2.2％ in G,GP and GE groups,respectively.Compared with group G,the incidence of intraoperative atrial fibrillation was significantly decreased in group GE (P＜0.05),and no significant change was found in the incidence of intraoperative atrial fibrillation in group GP (P＞0.05).Conclusion Compared with general anesthesia,general anesthesia combined with epidural block can decrease the development of intraoperative atrial fibrillation,it is more suitable for this type of patients,however,general anesthesia combined with paravertebral block produces no improvement in the development of intraoperative atrial fibrillation in elderly patients undergoing thoracic surgery.