Doxorubicin (DOX)belongs to anthraquinone anti-tumor antibiotics,which is now one of most widely used anti-cancer drugs in clinic,but it possesses cardiotoxicity.How to reduce its cardiotoxicity is still a hot problem in current research.This article made an overview for monitoring and prevention of DOX cardiotoxicity.

Objective To research the biomechanical characteristics and clinical applicant of posterior transarticular screws (Magerl technique) with bene graft in atlantoaxial instability.Methods 30 fresh cadaver human cervical spine specimens were obtained and randomized subdivided into 5 groups:intact group,atlantoaxial destabilized group,atlantoaxial destabilized and fixed with pedicle screws group,fixed with Magerl screws group and fixed with Maged screws combined with Brooks way group.ROM(range of motion)and NZ(neutral zone)of extend,flex,right and left lateral bend,right and left rotation of each specimen in 5 groups were measured.Transarticular screws were placed in 23 patients with atlantoaxial instability from 2000 Feb.to 2005 Jan.,with 16 males and 7 females,age from 17 to 62 years.20 of them were traumatic dislocation and 3 were congenital instable.Results Biomechanical study indicated that stability of all 6 degrees were Magerl+Brooks＞Magerl screws＞Pedicle screws＞Intact＞Destabilized.23 patient were fixed with 46 Maged screws in total,none were suffered from vertebral artery injury and neurological deterioration.All patients were followed-up from 4 to 36 months.2 of them complained that difficult in rotation of head.Conclusion Single use of Magerl screw can provide enough biomechanical stable for adantoaxial instability,and is an effective,low-risky way combined with intra-spinal-process bone graft.

Purpose:To clarify the association between renal cysts and renal cell carcinoma (RCC), we analyzed the clinical characteristics of patients with renal cell carcinoma and renal cyst. Methods:From May 1996 to January 2004, a total of 198 patients were hospitalized for renal cell carcinoma in our department, and 64 patients had both renal cysts and renal cell carcinoma (RCC). The clinical characteristics of the 64 patients were evaluated, and compared to 106 renal cell carcinoma (RCC)patients without renal cysts from the 198 patients in the same period. Results:Renal cysts were identified by preoperative ultrasonography, computerized tomography and magnetic resonance imaging in 37%(22/59)、24%(15/61) and 35%(6/17) respectively. Histopathological examination revealed renal cyst in 15 patients (23%). The sizes of renal cyst were 0.5 to 12 cm. The pathological examinations showed clear cell carcinoma in 61, chromophilic cell carcinoma in 2 and a combined type of clear cell carcinoma and chromophilic cell carcinoma in 1. Compared to RCC patients with those without renal cyst,younger and male RCC patients were easier to also have with renal cyst(P

Objective To investigate the expression and significance of TLR-2 and HO-1 in recurrent nasal polyps,and to discuss the relationship between the expression and the recurrence of nasal polyps. Methods The immune protein imprinting technology was used to detect the protein expression of TLR-2 and HO-1 in 20 cases of recurrent nasal polyps,20 cases of nasal polyps and 20 cases of normal mucosal tissue in control group, and the relationship between the two proteins were analyzed. Results Expression levels of TLR-2 and HO-1 in the tissues of the recurrent nasal polyps had statistically significant difference with nasal polyps group ( <0.05) . Expression levels of TLR-2 and HO-1 in the tissues of the nasal polyps had statistically significant difference with normal nasal mucosa tissues ( <0.05) .The expression of TLR-2 and HO-1 had significant correlation in each group ( <0.05) .Conclusion TLR-2 and HO-1 plays an important role in the recurrence mechanism of nasal polyps, and both of them may be as objective indicators for postoperative follow-up of patients with recurrent nasal polyps and judging the recurrent trend.

Objective To investigate the potential roles of tumor necrosis factor -related apoptosis -indu-cing ligand(TRAIL)signaling system in the pathogenesis of colorectal cancer.Methods Immunohistochemistry tech-niques were used,the TRAIL and its receptor(TRAILR3,TRAILR4)protein were analyzed in both 41 colorectal cancer samples(colorectal cancer group)and normal samples beside cancer tissue(normal group).Results The lev-els of TRAIL and TRAILR3 protein expression in the colorectal cancer group were significantly lower than those in the normal group[(0.237 ±0.036)vs.(0.289 ±0.069);(0.226 ±0.052)vs.(0.281 ±0.068),t =4.125,4.025,all P <0.01],while the positive rate of them were nonsignificant difference between the two groups(88% vs.90%;95%vs.93%,χ2 =0.125,0.213,all P >0.05).The expression levels of them in the colorectal cancer group with poorl differentiation were notably lower than those with high -moderate differentiation[(0.205 ±0.021 )vs (0.245 ± 0.034);(0.185 ±0.032)vs (0.236 ±0.051),t =4.025,2.664,P <0.01,P <0.05],but they were not strongly correlated to lymph nodes metastasis[(0.235 ±0.035 )vs (0.241 ±0.338);(0.216 ±0.048)vs (0.231 ± 0.054),t =0.448,0.862,all P >0.05].Moreover,the positive rate and expression levels of TRAILR4 protein was non -statistic significant difference between the two groups[93% vs 98%;(0.196 ±0.085)vs (0.219 ±0.061),χ2 =1.051,t =1.353,all P >0.05],and it was also non -significantly correlated with cancer cell differentiation and lymph nodes metastasis[(0.176 ±0.052)vs (0.201 ±0.091);(0.194 ±0.054)vs (0.197 ±0.100),t =0.667, 0.448,all P >0.05].Conclusion The levels of TRAIL and TRAILR3 expression are attenuated at colorectal cancer tissue.The expression of them are correlated with cancer cell differentiation grade.These findings indicate that TRAIL system may be associated with the malignant phenotype in colorectal cancer.

Objective To investigate the effects of Bushen Yangxue decoction combined with hormone replacement effects on sex hormone level and symptom score in patients with premature ovarian failure .Methods 112 patients with premature ovarian failure from March 2014 to November 2015 in Zhejiang Tongde Hospital were divided into two groups with 56 cases in each group.The control group was treated with hormone replacement therapy , the combined group was treated with Bushen Yangxue decoction on the basis of the control group.The curative effect was compared between the two groups, the sex hormone, traditional Chinese medicine symptoms score, QOL score and endometrial thickness were compared between the two groups before treatment, at the end of treatment and 3 months after discontinuation.Results At the end of the treatment, there was no significant difference in total effective rate between the combined group (91.07%) and the control group (85.71%).At the end of the treatment, the scores of TCM symptoms and QOL scores were significantly lower in the two groups, and the endometrial thickness was significantly higher (P<0.05), compared with the control group at the end of treatment,the combined group TCM symptom score was lower(P<0.05), QOL score and endometrial thickness had no significant difference, after stopping drug for three months, there was no significant difference in the levels of TCM score, QOL score, endometrial thickness between the two groups.In the control group TCM score, QOL score were significantly higher, and significantly higher than the levels of the same period of the combined group, endometrial thickness was significantly lower, and the level of the same period was significantly lower than that of the combined group(P<0.05), at the end of treatment, the two groups of FSH, LH significantly decreased, E2 significantly increased(P <0.05), there was no significant difference between the two groups, after stopping drug for three months, there was no significant difference in the levels of E2, LH, FSH.The control group, LH and FSH levels were lower and E2 levels were higher in the control group at three months after discontinuation compared with those at the end of treatment (P<0.05).Compared with the control group, LH and FSH levels were lower and E2 levels were higher in the combined group after 3 months of drug withdrawal (P<0.05).Conclusion Bushen Yangxue decoction combined with hormone substitution method can significantly increase in patients with premature ovarian failure of sex hormone level, improve the recovery of patients with ovarian function.

Objective To explore the feasibility of quantitative hemodynamics measurement of inferior vena cava (IVC) in healthy volunteers with phase-contrast sequence on 3.0 T MR system (3.0 T PC-MRI),and to evaluate the relationship between IVC lumen area,blood flow,and velocity.Methods Fifty healthy adult volunteers prospective underwent IVC PC-MRI at 3.0 T MR system.All volunteers were from our hospital for the routine chest or abdomen examinations,no heart disease and lung disease always,heart rate,blood pressure,electrocardiogram was in normal range,no abnormalities were found in clinical and abdominal imaging examinations,and IVC disease was excluded by ultrasonic examination.The area (A),mean velocity (MV),mean flux (MF),regurgitant fraction (RF) and time-flow curve of upper and middle segments of IVC during one cardiac cycle were observed.Independent samples t test was used to compare IVC lumen area and blood flow,velocity between different genders,different age groups (18 to 30 years old group,more than 30 years old group) and different phase velocity encoding value of IVC middle segment,one-way ANOVA was used to compare different phase velocity encoding value of IVC upper segment [(60,80,100)cm/s].Pearson correlation coefficient and regression equation were used to evaluate the relationships between area,blood flow,and velocity.Results Among 50 patients with successful completion of the examination,significant difference was found in A,MV,MF and RF between the different IVC segments.MF of the IVC middle segment were (37.94 ± 7.32) and (33.68 ± 6.65) ml/s in male (n =24) and female (n =26),respectively ; significant difference was found in different genders (t =2.49,P =0.017).MF of upper segment and middle segments of IVC were (54.89 ± 10.98)and (38.29 ± 7.54)ml/s in 18 to 30 years old group(n =27),while MF of upper segment and the middle of IVC were (44.96 ± 8.49) and (32.65 ± 5.59) ml/s in older than 30 years old group (n =23) with significant difference(t =3.34,2.15,P ＜ 0.01).Peak positive velocity were (55.36 ± 6.30),(61.30 ± 12.42),(62.55 ± 13.09) cnm/s in different phase velocities (60,80 and 100 cm/s),while peak negative velocity (PNV) were (42.37 ± 19.18),(32.79 ± 24.67),(24.61 ± 21.20) cm/s with significant differences (F =4.258,7.794,P ＜ 0.05).The overall image quality was good for quantitative measurement between different phase velocity encoding values of upper segment and the middle IVC (image evaluation are greater than or equal to 3,11 patients were three points,24 patients were four points,15 patients five points).The relation between the PC flow image of IVC and the cardiac cycle was sine wave,the area and the velocity of upper and middle segments of IVC was negative (r =-0.466 and-0.765,P ＜ 0.01),and no linear correlation between the area and the flow of upper and middle segments of IVC (r =0.259,0.046,P ＞ 0.05).There were slight reverse flow during systolic and diastolic cycle.Conclusion The area,flow and velocity of IVC can be rapidly,accurately and noninvasive measured with PC-MRI,and different ages,different genders and different anatomical parts of IVC had obvious hemodynamic differences.

Objective To study the protective effect of Xinfuli Granula(XG) on acute and chronic cardiac failure in cats and rats. Methods The cat models of acute cardiac failure were established by injecting pentobarbital. Then the cat models were given XG through duodenum. After medication,hemodynamics parameters such as heart rate(HR),mean arterial pressure(MAP),left ventricular systolic pressure(LVSP),left ventricular end-diastolic pressure(LVEDP),+ dp/dtmax and cardiac output(CO) in cats were determined. The rats were divided randomly into 5 groups:the control group,the model group,the positive control group,and high-dose and Low-dose XG groups. The rat models of myocardial injury were induced by isoproterenol(20 mg/kg). The normal group and the model group were treated with normal saline(10 mL/kg) orally,the positive contral group were treated with cedilanid(0.2 mg/kg) by intravenous,the high-and low-dose XG groups were orally treated with XG(10 g/kg and 5 g/kg respectively),and the propranolol group was orally treated with propranolol(4 mg/kg),once a day for successive 8 days. Animals were sacrificed on the 9th day,then the heart was taken out and the cardiac index was calculated. The pathological changes in myocardial cells of the rats were observed under electron microscope. Results XG had no effect on hemodynamics of cats with acute cardiac failure,but had obvious protective and therapeutic effect on isoproterenol-inducedmyocardial injury and myocardial ischemia of rats. Conclusion Xinfuli Granula has good preventive effect on isoproterenol-induced myocardial injury and sub-acute cardiac failure of rats,but has no effect on acute cardiac failure of cats.

Objective To explore the possibility and effectiveness of minimally invasive osteotomy and cable osteosynthesis for the treatment of adolescent eubitus varus. Methods Eleven cases of adolescent cubitus varns(2 cases complicated with internal rotation of 10°)were treated with minimally invasive supracondylar wedged osteotomy to preserve the integrity of the contralateral codex and periosteum.Two screws were inserted above and below the fracture line.They were fixed with cable after the greenstick fracture and internal rotation were adjusted.Plastic bandage was applied for 1 week postoperatively before rehabilitation. Results Bone fractures healed in the 11 cases in 36.3 days averagely,without infection or nerve palsy.Before operation,the mean angles of varus,flexion and extension were 35°±5°,125°±10°and 10°±5°respectively.After a mean follow-up of 33.5 months,the mean valgus angle of the elbow was improved to 8°±2°(t=16.632,P<0.05),flexion to 130°±8°and extension to 8°±3°(P>0.05).Internal rotation deformity was also ameliorated in the 2 cases. Conclusion It is practical and effective to treat adolescent eubitus varus with minimally invasive osteotomy and cable osteosynthesis,for it can lead to stable fixation,short healing time,and does not affect the flexion and extension of the elbow joint.

Objective To investigate the antitumor effect of specific cytotoxic T lymphocytes induced by renal cell carcinoma multiple antigen peptide dendritic cell (DC) vaccine in vitro. Methods Dendritic cells were induced by hGM-CSF,hIL-4 from blood.Peptide of renal cell carcinoma cell line (RCC786-0)was got by citrate-phosphate buffer elution.Peripheral blood mononuclear cell was cultured.Multiple antigen peptide DC cell vaccine was obtained by acid-eluted peptide pulsed DC.The tumor antigen specific CTL was generated from activated T cell by vaccine.Killing activity of the tumor antigen specific CTL was activated by vaccine. Results Antigen peptide DC cell vaccine could show a strong cytotoxic activity of CTLs(31.93±5.05%),which was much higher than control groups(5.88±2.26%,8.03±6.70%,9.70±2.09%,9.35±3.58%). Conclusion Renal cell carcinoma antigen peptide DC vaccine could show a high antitumor effect in vitro.