Nowadays,one of the most challenging aspects of retinoblastoma (RB) therapy is how to control the resistant or recurrent viable vitreous seeds,for which intravenous chemotherapy appears to be ineffective.Recently,intravitreal chemotherapy offers another option to control advanced stage and vitreous seeds of RB,and may be a promising new approach to RB therapy.However,intravitreal injection for RB patients raises considerable controversy due to concerns of possible extraocular extension along the injection route,and should not replace the primary standard of care for bilateral RB or group E eyes of RB.Close follow-up and further studies are needed to determine appropriate indications,to determine the effective drugs and concentrations,to optimize RB therapy protocols and to investigate the relationship between long-term efficacy and toxicities.

Objective The aim of this study was to explore the association of tumor necrosis factor-α (TNF-α)promoter-308A/G polymorphism with rheumatoid arthritis(RA)susceptibility in East Asian population based on the meta-analysis. Methods We searched all the publications about the association between TNF-α promoter -308A/G polymorphism and RA in East Asian population from PubMed, Ebsco, Chinese Biomedical Literature Database(CBM), Chinese National Knowledge Infrastructure(CNKI), and Wanfang (Chinese). Meta-analysis was performed for genotypes AA versus GG, GA versus GG, AA versus GG+GA,GA+AA versus GG, and A allele versus G allele in a fixed/random effect model. Results A total of 4 studies (957 cases and 1196 controls)were included in the current meta-analysis(three Chinese and one Japanese studies). When all groups were pooled, significant association of A allele and decreased RA risk was found (OR=0.36, 95%CI=0.16～0.80, P=0.01). When analyses were limited to race homogeneous population,significant association of A allele and decreased RA risk was found in Chinese population(OR=0.40, 95%CI=0.16～1.01, P=0.05). Conclusion This meta-analysis demonstrates significant negative association between TNF-α promoter-308A/G polymorphism and RA in East Asian and Chinese population.

Objective To explore the relationship between preoperative serum pro-adrenomedullin (pro-ADM) in the patients with closed rupture of small intestine,and postoperative secondary abdominal infection,and to study the value of postoperative serum pro-ADM in assessment of severity of postoperative secondary abdominal infection of this patients.Methods Eighty-five patients with closed rupture of small intestine treated in the emergency surgery from June 2014 to May 2015 were selected.According to the presence of postoperative abdominal infection or not,these patients were divided into infection group and non-infection group.The infection group was further divided into SIRS,sepsis,severe sepsis,septic shock subgroups as per the severity of infection.The levels of serum pro-ADM,interleukin-6 (IL-6),C-reactive protein (CRP) were determined and the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score was calculated at admission and the first day、the second day and the third day after operation.Comparisons of these biomarkers were carried out to find out the factors associated with postoperative abdominal infection.In addition,ROC curve was used to verify the factors for predicting the abdominal infection of these patients after operation.The relationship between serum levels of pro-ADM and APACHE Ⅱ score after operation was analyzed.The severity of abdominal infection after operation was assessed with laboratory findings.Results Compared with non-infection group,preoperative and postoperative serum pro-ADM (P =0.03,P ＜ 0.01),IL-6 (P =0.02,P ＜0.01) levels and APACHE Ⅱ scores (P ＜ 0.01,P ＜ 0.01) were significantly higher in infection group (P ＜ 0.05).In the infection groups,the postoperative levels of serum pro-ADM and APACHE Ⅱ scores were increased with the severity of infection increased (r =0.924),and the difference between the groups was statistically significant (P ＜ 0.05),but there were no significant differences in IL-6 and CRP levels between two groups.Conclusion (1) The serum levels of pro-ADM before operation has value in predicting the genesis of abdominal infection in these patients after operation.(2) The serum levels of pro-ADM after operation has value in severity assessment of abdominal infection in these patients after operation.

Objective:To explore the relationship between tobacco smoking and liver cancer risk.Methods:Cohort studies of cigarette smoking and risk of liver cancer were identified by searching MEDLINE and CBM databases from January 1989 to September 2009. Results from individual studies were combined synthetically by Meta analysis using R software and Meta package. Results:A total of 19 articles were included in our analysis. The cohort totally included 3 023 558 followed-up persons and 9 525 cases of liver cancer patients. The pooled relative risk (RR) of liver cancer was 1.49 (95%CI: 1.17-1.92) for smokers compared with non-smokers. The results showed a statistically moderate association between tobacco smoking and the risk of liver cancer. Subgroup analysis indicated that the pooled RRs for smoking were 1.53(95%CI : 1.29-1.83)for male smokers and 1.70(95%CI :1.17-2.48)for female smokers, respectively.Conclusion:Tobacco smoking is a risk factor for liver cancer in both males and females.

Objective To analyze the stress state of magnetic attachment in mandibular complete overdenture supported by nature roots and implant, and to provide neference for designing of clinical prosthodentics. Methods Three-dimensional finite models (model,Ⅱ,Ⅲ)of three groups of mandibular overdentures depending on the different location of the implant and natural tooth root, placing three pairs of magnetic attachment, were constructed by application of CT scanning,computer photo processing system,and Solidworks finite element model building software.The natural teeth and implant neck bone stress of the models in three groups under different stress were calculated and compared.Results The stress of the bone around the implant in the area of molar teeth in model with both sides of the implants under oblique load (Model Ⅱ)was significantly increased compared with the model with one side of the implant (Model Ⅲ). The supporting bone stress of oblique load was increased compared with the vertical load;among them under the oblique load at one side’ s molar teeth, the stress of the bone around the implant in the area of molar teeth in modelⅠ,modelⅡ and model Ⅲ was increased about 30%, 43%,and 55%.Conclusion When there only one nature teeth remain,two implants should be at least added, one in the area of opposite cuspid, and the other in the area of molar teeth of the same side. The magnetic attachment is better than other kinds of attachment in preventing the damage of abutment when it suffers inclined load.

Objective To explore the roles and possible mechanism of calcium-sensing receptor(CaSR) in cell cardiac hypertrophy model using angiotensin Ⅱ (Ang Ⅱ ).Methods The cultured neonatal rat ventricular myocytes were treated with Ang Ⅱ as cell cardiac hypertrophy model.Hypertrophic neonatal rat cardiomyocytes were treated with GdCl3(a specific agonist of CaSR) and/or with Ro318220(a specific inhibitor of PKC pathway).To evaluate the status of cardiac hypertrophy,cell diameter was observed by HE dyeing,and protein content was determined through coomassie brilliant blue protein kit.The intracellular calcium concentration( [ Ca2+]i) was determined by laser scanning confocal microscope.The protein expression of CaSR and PKC pathway were analyzed using Western blotting.Results ①Compared to the control group(0.1263 ± 0.0443),the protein expression of CaSR was increased in Ang Ⅱ group and in GdCl3 group(0.1963 ± 0.0375,0.2778 ± 0.0564,all P＜ 0.05).Moreover,compared with Ang Ⅱ alone,the increase was significant in GdCl3 group(P ＜ 0.05).②Compared to control group(222.70 ± 22.09),AngⅡ group(392.16 ± 36.85) remarkably increased [Ca2+]i(P＜ 0.05),and this increase of [Ca2+]i was further enhanced in GdCl3 group (502.60 ± 44.21) versus Ang Ⅱ group (P ＜ 0.05).③Compared to control group,Ang Ⅱ could induce cardiomyocyte hypertrophy,and GdCl3 enhanced the effect.Moreover,this enhancement was attenuated by Ro318220.④Compared to control group(0.27 ± 0.07,0.69 ± 0.06,0.87 ± 0.04),the protein expression of PKCα,PKCε and PKCδ was increased in Ang Ⅱ group(0.60 ± 0.16,1.02 ± 0.13,1.20 ± 0.18,all P＜ 0.05) and the protein expression of PKCα,PKCε was increased in GdCl3 group(0.82 ± 0.16,1.34 ± 0.12,all P ＜ 0.05).Moreover,compared with Ang Ⅱ group,the protein expression of PKCα,PKCε was obviously increased in GdCl3 group (all P ＜ 0.05);compared with GdCl3 group,the protein expression of PKCα,PKCε(0.41 ± 0.10,0.85 ± 0.14) was obviously decreased in Ro318220 group(all P ＜ 0.05).Conclusions CaSR is involved in cardiac hypertrophy induced by Ang Ⅱ through PKC pathway in cultured neonatal rat cardiomyocytes.

Adult ; Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Diagnosis, Differential ; Histiocytosis, Langerhans-Cell ; pathology ; Humans ; Immunohistochemistry ; Male ; Meningeal Neoplasms ; metabolism ; pathology ; surgery ; Meninges ; pathology ; Peroxidase ; metabolism ; Sarcoma, Myeloid ; metabolism ; pathology ; surgery

Objective To analyze and summarize the clinical-pathological features,immunophenotype and prognosis of the lymphoepithelioma-like gastric carcinoma (LELGC).Methods The clinical,radiographic and histological data of four patients with LELGC were retrospectively analyzed.The expression of cytokeratin (CK),CD20,CD3,CD4,CD8,E-cadherin,β-catenin,bcl-2,p16,p53,p63,c-erbB-2,cyclin D1,Ki67 and DNA methyl-transferase 1 (DNMT1) in tumor was detected by Epstein-Barr virus-encoded small RNA (EBER) in situ hybridization and immunohistochemical methods.Results The size of four tumor was 1.8 cm× 1.6 cm,1.5 cm× 2.0 cm,2.5 cm× 2.0 cm and 4.0 cm× 2.5 cm.Under light microscope,tumor cells appeared like cords,small lumps or scattered single infiltration with vacuolized nucleus; clear nucleoli and obvious interstitial lymphocytic infiltration.The results of immunohistochemical examination indicated that in four tumors CK was positive in membrane of all the tumor cells,while EBER was positive in all cell nucleus.The number of lymphocytes with CD3 positive was over those with CD20 positive,which was mainly CD8 positive lymphocytes.The percentage of E cadherin and β-catenin positive in the cell membrane of four tumors was between 10 ％ and 90 ％,and two cases with β-catenin positive in cytoplasm.The expressions of DNMT1,cyclin D1 and bcl-2 were all positive,while p16 and c-erbB-2 were all negative.The expression of p63 was positive in only one case,and p53 was negative in one case.The percentage of Ki67 positive was 40％,15％,60％ and 40％,respectively.Conclusions LELGC is a rare neoplasm with better prognosis.The features of clinical pathology and immunohistology may help to make a correct diagnosis.

Objective To explore the clinico-pathological features, immunophenotype, treatment and prognosis of urologic primary primitive neuroectodermal tumor (PNET). Methods The clinical data of 3 patients with urologic PNET were analyzed retrospectively. All patients were male, aged 29, 32 and 75 years respectively. Two of the lesions were located in the kidney, and the third was located in the bladder. The sizes of renal tumors were 7.7 cm×6.2 cm and 12.6 cm×9.4 cm respectively. Imaging examinations revealed a well-defined mass with inhomogeneous echo inside. The size of bladder tumor was 10.0 cm×10.0 cm. CT scan demonstrated irregular thickening of the bladder wall, and the density of the wall was inhomogeneous. In the 2 cases of renal PNET radical surgery was performed, while an emergency palliative surgery to remove a blood clot and biopsy were performed in the bladder PNET case. Results In light microscope, the tumors were characterized by uniform small round or oval cells and nest-like or dense sheet structures surrounded by sparse fibrovascular stroma. Homer-Wright rosettes or pseudorosettes were observed, as well as mitoses. Immunohistochemical study revealed that all cases showed positive staining for CD99, synaptophysin and vimentin. One of the renal tumor cells showed positive for CD56, and the other renal tumor and urocystic tumor cells were focally positive for chromogranin A. Additionally, in 1 of the cases of renal tumor there was a high positive rate of 80% for Ki67 staining while the other case showed less than 5%. All 3 cases were eventually diagnosed as PNET. The first renal tumor case was not treated with radiotherapy and chemotherapy postoperatively, and the patient died of recurrence 14 months after surgery. Both the second renal tumor case and the bladder tumor case underwent chemotherapy postoperatively, and they died 4 and 6 months after surgery respectively. Conclusions The urologic primary PNET is a very rare, highly malignant soft tissue tumor, and the diagnosis must be based on pathologic findings and immunohistochemical phenotypes. The multimodal treatment for urologic primary PNET consists of surgery, chemotherapy and radiotherapy.

Objective To understand the mental health status of residents aged 15 years old or above in Hainan Province,and and to analyze its influencing factors to provide a scientific basis for improving the psychological health level of populations.Methods A multistage randomsampling method was used to extract 3 295 residents in Hainan Province and perform the investigate on the mental health status.Results Among 3 295 surveyed residents,410 respondents had mental disease,accounting for 12.44％ of respondents total number.The total score of SCL-90 in the residents of Hainan Province was lower than that of the national norm(t=14.65,P=0.00).(2)The morbidity of mental disease had no statistical difference between different genders(wald x2 =0.27,P=0.60);which had statistical difference among marital status,environmental satisfaction and family harmony (wald x2 =46.53,P =0.00;wald x2 =51.98,P =0.00;wald x2 =89.47,P =0.00).(3) The non-conditional Logistic regression analysis results showed that the influencing factors entering the regression equation were marital status(OR=0.52),family type(OR =0.57;0.53),environment satisfaction(OR=1.26),family harmony(OR=1.31),health self-examination(OR=0.72),borrowing 5 000 yuan within 2 d when urgent need(OR=1.31) and general well-being(OR=0.86).Conclusion The factors influencing mental illness in residents are multiple,so synthetic measures should be taken for its prevention.