Objective To analysis the effect of compound betamethasone injection combined with radiation on keloid in frontal facial region. Methods 60 cases of keloid patients in zhejiangprovincial people's hospital from January 2014 to January 2016 were selected,all patients were treated with surgery,the patients were randomly divided into observation group and control group,30 cases in each group,radiotherapy was used in the control group,the observation group was treated with local injection of compound betamethasone on the basis of the control group,the therapeutic effects, pain scores, adverse reactions and complications were compared between the two groups. Results The recurrence rate of the observation group was 3.33% which was significantly lower than that of the control group 10%,the improvement rate of the observation group 93.33% was significantly higher than the control group 80%,the difference was statistically significant (P<0.05).one,two and three months after operation,the pain scores in the observation group were significantly lower than those in the control group at the same time point,the difference was statistically significant (P<0.05).The adverse reaction rate was 6.66% (2/30) in the observation group and 23.33% (7/30) in the control group, there was no significant difference between the two groups.The incidences of skin sag, pigmentation, incision delayed union and telangiectasia in the observation group were significantly lower than those in the control group (P<0.05). Conclusion Compound betamethasone injection combined with radiation on the frontal facial keloid patients with significant effect,can significantly reduce the recurrence rate,improve the rate of improvement,reduce pain and complications in patients.

Objective To investigate the significance of combined detection of tumor markers in serum and pleural fluid on differential diagnosis of benign and malignant pleural effusion.Methods Three hundred and seventy six cases of pleural effusion were selected.The levels of carcinoembryonic antigen (CEA),neuronspecific enolase(NSE),cancer antigen 125 ( CA125 ),squamous cell carcinoma antigen (SCC) in serum and pleural fluid were examined and they were analyzed combined with histological or cytological evidence using statistical methods.Results There were 298 cases in malignant group and 98 cases in benign group.The levels of the four tumor markers in malignant group were significantly higher than in benign group both in pleural fluid (CEA:[279.9 ± 170.0]μg/L v.s.[ 12.6 ± 6.2 ] μg/L,t =6.29,P ＜ 0.01; NSE:[ 112.3 ± 86.8 ] μg/L v.s.[14.7 ±7.3] μg/L,t =5.13,P ＜0.01 ;SCC:[ 10.6 ± 5.4] μg/L v.s.[ 1.2 ±0.6 ] μg/L,t =2.34,P ＜0.01;CA125:[ 409.2 ± 206.7] U/ml v.s.[ 44.0 ± 20.5 ] U/ml,t =7.46,P ＜ 0.01 ) and in serum ( CEA:[ 86.7 ±42.0] μg/L v.s.[6.2±3.1]μg/L,t=3.14,P＜0.01;NSE:[31.6±18.2]μg/Lv.s.[11.2±5.0]μg/L,t=4.61,P＜0.01;SCC:[3.5±2.2]μg/Lv.s.[1.8±0.g]μg/L,t=1.70,P＜0.01;CA125:[134.0±72.6]U/ml v.s.[ 19.8 ± 9.6 ] U/m1,t =4.04,P ＜ 0.01 ).Moreover,the levels of tumor markers in pleural fluid were higher than in serum.The sensitivity were 100％ by combined detection of pleural fluid and serum tumor markers in parallel and the specificity were 100％ in sequence.Conclusion The levels of CEA,NSE,CA125,SCC in pleural effusion were more sensjtive than which in serum.Combined detection of tumor markers in pleural fluid and serum could improve the sensitivity of diagnosis for benign and malignant pleural effusion.

Objective To compare the treatment effect of laparoscopic appendectomy(LA)and open appendectomy(OA).To investigate the worth of endoscopic technology in LA.Methods 123 cases of LA and 989 cases of OA performed were studied retrospectively.The clinical data of two groups were summarized,contrasted and analyzed respectively.Results The times of operation,taking food and hospitalization in LA group were obviously shorter than those in OA group.The postoperative pain and the rate of incision infection in LA group were obviously superior to those in OA group.While the cost of hospitalization in LA was obviously higher than that of OA.Conclusion LA have advantages of minimal invasion,quicker recovery.safety and reliability,has significant advantages in treaing appendicitis and should be promoted.

Objective To compare the clinical effect of procedure for prolapse and hemorrhoids(PPH)improved,Milligan-Morgan hemorrhoideeomy and Ferguson-Mitchell hemorrhoidecomy in the treatment of the Ⅲ～Ⅳdegree mixed hemorrhoids.Methods 45 cases admitted for surgical treatment of Ⅲ～Ⅳ degree hemorrhoids,were randomly divided into 3 groups,the improved PPH,MMH and FMH were retrospectively reviewed,and it is separately reviewed for the operation time,pain index,length of hospital stay,return to normal activity time,postoperation complication and patients satisfaction etc.Results There was reasonably evidence in favor improved PPH for operating time,hospital stay,pain,anal discharge,and patients satisfaction.Conclusion The improved PPH is a safe and effective procedure for Ⅲ～Ⅳ hemorrhoids and its short-term outcome is more better than Milligan-Morgan and Ferguson-Mitchdl group.

Objective: To study the effects of potentill on all systems of experimental animals to provide experimental evidence for the comprehensive safety evaluation of potentill.Methods: Mice and rats were given potentill orally to determine the influence on all systems, and the general pharmacological activities of potentill were recorded.Results: The general behavior of mice was normal after the adminisration of potentill , the test samples showed no synergetic hypnotic effect with nembutal at subthreshold dose, and had no influence on the spontaneous activity and body coordination ability of mice (P＞0.05).The test samples showed no obvious influence on the cardiovascular system and respiratory system of rats (P＞0.05).Conclusion: Potentill meets the general requirements of pharmacology at the prescribed dose.

Objective To investigate the relationship between nuclear factor(NF)-κB activity and lactacystin induced prostate cancer cell apoptosis.Methods Two prostate cancer cell were divided into two groups:blank control group treated with culture solution,lactacystin group treated with different concentration of lactacystin(0.5,1.0,2.0,4.0 μ mol/L),the action time were 8,16 and 24 hours.The cell survival rate was measured by MTT assay.NF-κB DNA binding activity was measured by enzyme-linked immunosorbent assay,the expression of NF-κB P65 nuclear protein was detected by Western blot assay,and caspase-3 activity was analyzed by enzyme analysis assay.Results On basal condition,the NF-κ B DNA binding activity was much higher in DU145 cell than that in LNCaP cell(t=4.728,P=0.001).Compared with blank control group,different concentration of lactacystin groups'NF-κ B DNA binding activity in both the LNCaP and DU145 cell were reduced.The expression of NF-κB p65 nuclear protein decreased along with raising of lactacystin concentration in LNCaP cell,but it did not change in DU145 cell.On basal condition,caspase-3activity in DU145 cell was higher than that in LNCaP cell(t=4.519,P=0.001).After lactacystin acting of 24 hours,caspase-3 activity increased along with raising of lactacystin concentration in both the LNCaP and DU145 cell(2.0 μmol/L lactacystin group compared with 1.0 μmol/L lactacystin group,DU145 cell P=0.000,LNCaP cell P=0.000).Conclusions Lactacystin has different killing effects on prostate cancer cell.The mechanism may be related to inducing the apoptosis by down-regulation of NF-κB activity.There may be additional cell survival/death pathway in androgen-independent prostate cancer cell.

Background Hypoxia is the main factor of retinal neovascularization and is closely associated with retinal ganglial cells (RGCs) degeneration.However, the study of retinal neural tissue lesions is rare.Objective This study was to investigate the influence of hypoxia environment on the expression of annexin A2 (ANXA2) in mouse RGC-5 cells and explore the mechanism of RGCs damage induced by hypoxia.Methods Immortalized mouse RGC-5 cells were cultured in high glucose DMEM with 10％ fetal bovine serum.The cells were identified by detecting the expression of Thy-1 ,a specific biomarker of RGCs.CoCl2 was added into the medium at the final concentrations of 50,100,200 and 300 μmol/L, and the cells without CoCl2 served as the control group.Cell viability (absorbance) was assayed by cell counting kit-8 (CCK-8) method in 12,24 and 48 hours after addition of CoCl2.The hypoxic cell models were established in DMEM with 100 μmol/L CoCl2 and divided into the hypoxic 3-hour group, hypoxic 6-hour group, hypoxic 12-hour group and hypoxic 24-hour group,with the normal cultured cells as the normal control group.Apoptotic cells were determined by using hoechst 33342 stain.The expression levels of ANXA2 mRNA and protein in the cells were detected by real-time quantification PCR and Western blot,respectively.The expression and location of ANXA2 in the cells were examined by using immunofluorescence technique.Results The cultured cells grew well and showed the fusiform and polygonal shape,with positive expression of Thy-1 protein.Compared with the normal control group, the viabilities of the cells were insignificantly changed in the 50 μ mol/L CoCl2 group and 100 μmol/L CoCl2 group (all at P＞0.05) ,but the cell viabilities were significantly reduced in the 200 μμmol/L CoCl2 group and 300 μmol/L CoCl2 group in various time points (all at P＜0.05).Hoechst 33342 staining showed that the apoptotic cells with nuclear condensation and high green fluorescence intensity were obtained in the hypoxia groups.The relative expression levels of ANXA2 mRNA were significantly lower in the hypoxic groups than those in the normal control group (all at P ＜ 0.05).The relative expression levels of ANXA2 protein were significantly lower in the hypoxia 3-,6-, 12-and 24-hour group than those in the normal control group (all at P＜ 0.05).Apoptotic cells were seen in the hypoxic 3-hour group, hypoxic 6-hour group, hypoxic 12-hour group and hypoxic 24-hour group compared with the normal control group, showing the bright blue fluorescence in cellular nucleus for hoechst 33342.The relative expressing levels of ANXA2 mRNA in the cells were 0.80±0.14,0.67±0.33, 0.49±0.17 and 0.39±0.02 in the hypoxic 3-hour group,hypoxic 6-hour group, hypoxic 12-hour group and hypoxic 24-hour group, which were significantly declined in comparison with the normal control group, with a statistically difference among the groups (F=434.354, P =0.000).The relative expression values of ANXA2 protein were 0.552 6±0.012 3,0.425 9± 0.033 4,0.344 9 ± 0.017 8 and 0.382 7 ± 0.022 1 in the hypoxic 3-hour group, hypoxic 6-hour group, hypoxic 12-hour group and hypoxic 24-hour group,which were remarkably lower than 0.602 1 ±0.001 4 in the normal control group, showing considerably difference among the groups (F =3.057, P =0.000).ANXA2 proteins were highly expressed in the cellular nucleus and less expressed in the cell membrane and cytoplasm in the normal cells.Compared with the normal control group, the ANXA2 protein showed weak expression in the hypoxia group and primarily in the cytoplasm.Conclusions The expression of ANXA2 down-regulates in hypoxic mouse RGC-5 cells,which may participate in the apoptosis process of RGCs in high glucose environment.

Objective To summarize the construction,upgrading process and clinical application of prostate cancer database (PC-Follow).Methods From September 2008 to December 2014,we designed two versions of off-line PC-Follow clinical databases based on Microsoft Access to support clinical follow-up and research in prostate cancer patients.Then,in order to achieve unified management of clinical data import and multi-center clinical research,we further upgraded PC-Follow to a browser/server (B/S) schema based web database.After upgrade,a simulated multi-center operation pattern was adopted to transfer all existed data-We then attempted to linkage our database with the hospital information system (HIS) and had eventually undertaken reality and stress testing on 3,124 cases'data migration in the hospital.The nationwide software testing and personnel training was conducted in 12 major medical centers.Results Twice of upgrade and alteration of schema of PC-Follow preserved the original user interface.Multiple functions,including data import,follow-up,research support,were obviously enhanced.Notably,the perfection in multi-user and hierarchical access control meet the future needs for multi-center clinical research.Via the import tool for PC-follow V3.0,we successfully migrated all data from the original one.After linking our database with the HIS software by one-way transmission protocol,the safety data extracting could be achieved.Specified administrators were appointed to process and analyze PC-Follow data in bulk,and data were voluntarily shared between attending centers,and showed stable performance on the 3,124 patients in our database.Feedback from nationwide multicenter training and testing indicated that our database was easy,readily accessible,with functionally stable modules,accurate website displays,and ideal response time.Conclusions The online PC-Follow database with hierarchical access provides support for multi-center clinical research in prostate cancer.The off-line PC-Follow database also grants certain degrees of data management for underdeveloped clinical centers,and it has its advantage to serve as prototypes for data migration to future online PC-Follow database once conditions are ripe.

Objective To investigate the effects of comprehensive geriatric assessment (CGA) and health intervention on outcome in discharged patients.Methods Discharged patients in geriatric ward from May to July 2012 were randomly assigned to control (n=36) and intervention (n=36) groups.Patients in the two groups were given comprehensive geriatric assessment (CGA) before discharging from hospital.Both groups were followed up for 3 months.Patients in intervention group received health intervention when leaving hospital,at 1 week,3 weeks and 3 months after discharge from hospital,while patients in control group were not given any intervention.The comprehensive illness condition (MCIRS-G),ability of daily life (ADL and IADL),rehospitalization and survival rate were compared between the two groups 3 months after the intervention.Results After 3 months,the scores of MCIRS-G,ADL and IADL were significantly better in intervention group than in control group[(29.06±4.51) vs.(33.09±4.34),(75.69±16.57)vs.(63.86±19.37),(11.72±3.20) vs.(9.77±2.52),respectively,t=3.84,2.77,2.85,all P=0.01].The total times ofreadmission and readmission length were less in intervention group than in control group [3 vs.17,x2 =8.79,P=0.02; (1.94±6.68) days vs.(8.81±14.09) days,t=2.64,P=0.01].There was no difference in survival rate between the two groups [100％ (36/36) vs.97.2％ (35/36),x2=1.01,P=0.30].Conclusions Comprehensive geriatric assessment and health intervention can alleviate symptoms and improve the ability of daily life.

As a zinc finger protein with ubiquitin-modifying activity, A20 is highly expressed in most mammalian cell in response to stimuli of tumor necrosis factor (TNF), lnterleukin-1 (IL-1), lipopolysaccharide (LPS) and other factors. A20 has been found to play a crucial effect in control of the cell maturation, cytokine production and immunostimulatory potency of dendritic cells (DCs) via modulating down-regulation of NF-κB signaling transduction pathway. In this brief review, we descript the biological characteristics of A20 and the involvement of the A20 in the pathway of the immune responses toward to the DC cell maturation and immunostimulatory potency.