Objective To investigate the association of circulating free blood DNA and prognosis of non-small cell lung cancer (NSCLC).Methods Forty-six untreated NSCLC patients and 21 controls were selected as our subjects,and all underwent a 6 years follow-up.The level of circulating free blood DNA was determined by real-time quantitative polymerase chain reaction (qPCR) targeting the human β-globin gene.Overall survival of the patients were analyzed by Kaplan-Meier method and Cox-regression.Results At the end of follow-up,the median free DNA concentration of experimental patients was higher than that of control patients(52 μg/L vs.29 μg/L,P =0.03).The median free DNA concentration of experimental death patients (87％) died was significantly higher than that of still survived patients (59 mg/L vs.25 mg/L,P =0.02).No association of DNA concentration with tumor pathology,clinical stage,age,gender,smoking or pulmonary inflammatory conditions were found in current study.Conclusion For NSCLC patients,the circulating free blood DNA level was negative correlation with the survival of the patients,suggesting that it may be utilized as a prognostic factor for survival analysis.But there is no relationship of free blood DNA concentration with tumor pathology,age,gender,smoking or pulmonary inflammatory conditions.

0.05).The differences of severe postoperative pain,testicular swelling,the time of the body’s restore for normal activities,and recurrence rate of patients between two groups were significant (P0.05).Conclusion The strengthening of posterior wall by transverse fascia and reconstruction of inner ring is a simple and effective method for inguinal hernia repair.

Objective Summarized the therapeutic effect of colonic irrigation by mannitol in one-stage resection and primary anastomosis for left hemicolon obstruction. Method For 31 cases of left hemicolon obstruction in our hospital, After process was cut, firstly we had done coloclysis with normal saline, metron-idazole and 20% mannitol,then one-stage anastomosis. Results With the exception of three cases of in-cision infection, the rest who start eating 4～5 days after operation were cured and no anastomotic fistula. Conclusion During the colon resection in left hemicolon obstruction, coloclysis with normal saline, met-ronidazole and 20% mannitol, then one-stage anastomosis, the intestinal function were quick recovery and can prevent colonic anastomotic fistula.

Objective To evaluate the effect of cholecystokinin receptor antagonist proglumide on the pancreatic function of post-ERCP. Methods The frequency and mortality of acute pancreatitis of post-ERCP, and the plasma contents of cholecystokinin-octapeptide(CCK-OP) and amylase were compared among control group(group C),octreotide treatment group(group O) and proglumide treatment group(group P). Results The frequency of acute pancreatitis of post-ERCP in group C was 13.6%(3/20), which was significantly higher than that in Group O(5%,1/20) and group P (4.0%,1/25)(P0.05). The contents of plasma CCK-OP were significantly lower in group P than those in groups O and C 4h after ERCP (P0.05). Conclusion Proglumide could inhibit the action of cholecystokinin-octapeptide, and decreas the hyperamylasemia and the frequency of pancreatitis of post-ERCP as octreotide.

Objective To assess the diagnostic value of the CT-guided percutaneous lung biopsy in diffuse lung diseases. Methods CT-guided percutaneous lung biopsy was performed using 18G or 20G biopsy needle in 68 patients with diffuse lung diseases. The main imaging changes of these patients included network of diffuse nodular or nodular, diffuse reticular lines shadow and diffuse ground-glass density in the lungs. Results Punctures were successful in all 68 patients, and the diseases were clearly diagnosed, including 19 patients with malignant (9 bronchioloalveolar carcinoma and 10 metastatic carcinoma) and 49 with benign (27 disseminated pulmonary tuberculosis, 8 sarcoidosis, 7 silicosis and coal worker's lung, 2 interstitial pneumonia, 4 pulmonary alveolar proteinosis allergic and 1 pneumonia) lesions. The major complications of puncture were pneumothorax and bleeding, and the incident rate of complications was 17.65%. Conclusion CT-guided percutaneous lung biopsy is a useful, safe technique with low complications, high accuracy rate for the diagnosis of diffuse lung diseases.

Hepatitis B virus ( HBV) is an important pathogen threatening to human health. Up to date, various of cell infection models and animal models for HBV and the host are widely used in the exploring research of infection mechanism, new drug development and effective therapeutic method for HBV. However, these models have some defects, such as low infection rate, rather short infective stage, and comparatively large species differences with human, and so on. Among them, the biggest problem is that these models cannot completely simulate HBV infection process and pathological changes naturally occurred in human. Herein, the major HBV infection models developed in the past fifteen years, as well as the latest research progress, are presented as a brief review, to provide a reference for constructing novel HBV infection models in the future.

Objective To investigate the impact of down-regulation of histone methyltransferase enhancer of zeste homolog 2 (EZH2) on RUNX3 expressions,proliferation and apoptosis in human pancreatic cancer.Methods The expressions of EZH2 and RUNX3 in 38 pancreatic cancer patients and human pancreatic cancer AsPC-1,PANC-1 and BxPC-3 cells were detected by immunohistochemistry and western blot,respectively.Cells were transfected with siEZH2 by lipofectamin 2000.Real time-PCR and western blot were used to detect EZH2 and RUNX3 expressions.Cell growth and apoptosis in vitro and vivo were assessed by MTT,flow cytometry and nude mice experiments,respectively.The correlation among the expressions of EZH2,clinical pathological features and overall survival rate were analyzed.Results Elevated EZH2 and decreased RUNX3 expressions were observed in human pancreatic cancer tissues and cells (P ＜ 0.05).Knockdown of EZH2 reduced cell growth and induced apoptosis in vitro and vivo by upregulating RUNX3 protein expression (P ＜ 0.05).In addition,the EZH2 expressions were correlated with tumor stage,lymph node metastasis and poor prognosis (P ＜ 0.05).Conclusions EZH2 expressions were correlated with malignancy and poor prognosis in pancreatic cancer.Tumor cell proliferation was promoted by EZH2 through down-regulation of RUNX3.EZH2 may be a potential therapeutic target for pancreatic cancer.

Objective To evaluate the safety and efficacy of magnetic resonance-guided focused ultrasound surgery (MRgFUS) in treatment of symptomatic uterine leiomyoma among Chinese reproductive age women.Methods From April 2010 to April 2012,80 premenopausal women with symptomatic leiomyoma volunteered to participate in this prospective study in Department of Outpatient of Peking Union Medical College Hospital.Among 23 reproductive aged patients with size of uterus less than 16th gestational weeks,2.5 to 10 cm of diameter of myoma,less than 10 myomas and expressing symptoms clearly were treated by MRgFUS.Treatment data,non-perfused volume ratio (NPVR) and adverse events were recorded.After treatment,patients were followed up at 1 week,1,3,6,12 and 24 months,respectively.Patients at initial screening and each time of the follow-up filled out uterine fibroid symptoms quality of life (UFS-QOL),which include symptoms severity score (SSS) and health-related quality of life (HRQL).The volumes of leiomyoma and uterine were evaluated on MRI before and after the treatment (at 6 and 12 months,respectively).Before operation,routine blood test were performed on all patients,anemia patients at 3 months and 1 year after treatment were checked with blood test.Results (1) Treatment data and adverse events:the mean therapeutic temperature was (69 ± 7) ℃,the mean treatment time was (144 ±62) min,the mean NPVR was (62 ±23)％.Adverse events included mild erythema(1/23),abdominal cramp(8/23),vaginal discharge (5/23),and leg numbness (4/23).(2) The rate of secondary surgery:one patient was treated by myoectomy and hysterectomy within one year following up and 4 patients chose surgical treatment during the second-year follow-up.(3) Volume change:the volumes of leiomyoma before the treatment and 6,12 months after the treatment are 75.6 (P25 =43.8,P75 =128.9),52.3 (P25 =23.8,P75 =111.2),45.9 (P25 =26.3,P75 =71.7) cm3,respectively; and the volumes of uterine before the treatment and 6,12 months after the treatment are 270.0 (P25 =208.4,P75 =390.3),216.4 (P25 =151.1,P75 =290.0),200.0 (P25 =149.1,P75 =267.6) cm3,respectively.Both leiomyoma and uterine volumes decreased significantly after treatments (P ＜ 0.01).(4) UFS-QOL change:the symptoms severity score (SSS) before the treatment and 3,12 months after the treatment are (34 13),(22 ± 11),(19 ± 12),which decreased significantly (P ＜ 0.01).The health-related quality of life (HRQL) before the treatment and 3,12 months after the treatment are (74 ± 15),(82 ± 13),(89 ± 10),which increased dramatically (P ＜0.01).(5) Hemoglobin(HGB) change:eleven patients suffered from anemia before treatments,the mean HGB before treatment was (87 ±6) g/L and were (106 ± 14) g/L 3 months after treatment,(112 ± 10) g/L 12 months after treatment.The HGB was increased significantly after treatments (P＜0.01).Conclusions MRgFUS is a safe and effective non-invasive management for symptomatic uterine leiomyoma in short-term follow up.But there is additional treatment ratio after MRgFUS.

ObjectiveTo acquire the basic information of trainees and analyze the training results and it' s influence factors in the training of rural health appropriate technology in Jiangsu.MethodsWe used the questionnaire to collect data of the trainees' personal information and training results after training.Results A total of 2284 valid questionnaires were collected. There were 73.6％ trainees came from township hospitals,95.1 ％ of them under 45 years old,62.9％ for females,79.2％ have been working for 8 years,3％ with senior professional titles,only 0.4％ had acquire the master's degree or above.Multiple regression analysis showed that the different level of hospitals,the training needs, suitable degree,knowledge familiarity before the training,expert instruction and learning were the main influence factors for the master of the technology; The influence factors for the wish to be re-training were working age,education,the demand for training technology,ease of learning,expert instruction,grasp of this time,appliance of the technology.Conclusionlong-term mechanism for trainning and continue education should be established,and medical workers in rural areas should be strengthen to take the technical training to further improve the rural medical services.

BACKGROUND:Articular cartilage injury is often complicated by subchondral bone damage to form osteochondral defects, and its treatment remains a pressing problem in orthopedics. Osteochondral composite grafts fabricated by tissue engineering technology provide a new way to repair osteochondral defects. OBJECTIVE:To explore the feasibility of fabricating osteochondral composite grafts in an independently designed double-chamber stirring bioreactor. METHODS: Goat bone marrow mesenchymal stem cels were seeded into β-tricalcium phosphate scaffolds. The cel/scaffold constructs were subjected to chondrogenic and osteogenic induction simultaneously in the double-chamber stirring bioreactor. According to the applied shear stress, they were divided into dynamic and static culture groups. The proliferation of bone marrow mesenchymal stem cels was detected by MTT test and scanning electron microscope examination. Osteogenesis and chondrogenesis related genes were detected by RT-PCR for the evaluation of chondrogenic and osteogenic differentiation. RESULTS AND CONCLUSION:The bone marrow mesenchymal stem cels in both dynamic and static culturegroups demonstrated satisfactory proliferation and differentiation. Better proliferation and differentiation ability were found in the dynamic culture group. Fabrication of osteochondral composite grafts in the independently.designed double-chamber stirring bioreactor is feasible, which is better under the mechanical stimulus environment than the static environment.