Objective To discuss the clinical efficacy of transurethral electroresection in the treatment of ureteral orifice tumors. Methods A total of 65 cases of ureteral orifice tumor were treated with transurethral electroresection and chemotherapy.Results The operation time was 5~90 min(mean,35 min),and the intraoperative blood loss was 5~100 ml(mean,50 ml).No blood transfusion was required.No fatal case was encountered.Out of the 65 cases,there were 53 cases of transitional cell carcinoma(grade Ⅰ,43 cases;grade Ⅱ,10 cases) and 12 cases of papilloma.The 65 cases were followed for 6~24 months(mean,15 months).Postoperative urethral stricture happened in 4 cases,which were cured by dilation of the urethra.Recurrence of tumor at the trigone and lateral wall of the bladder occurred in 5 cases,which were given a re-operation of transurethral electroresection and chemotherapy and were followed for 10~20 months(mean,15 months) without recurrence.Conclusions Transurethral electroresection of ureteral orifice tumors gives satisfactory effects and should be further recommended.

The problems in traditional imaging film and its reporting process were described.A virtual printing server network and a self-service printing service model of image film and its reporting model,established by improving the traditional imaging film and reporting process,could shorten the waiting time of patients after examinations,reduce the errors in imaging film reports,and improve the working efficiency of staff.

Objective To study the clinical characteristics, treatment methods and prognosis of primary gastrointestinal diffuse large B-cell lymphoma (PGI-DLBCL). Methods The clinical data of 40 patients with PGI- DLBCL were retrospectively analyzed. All the cases had received surgery treatment. Results In 40 patients with PGI-DLBCL, the major clinical presentation included abdominal pain in 15 cases (37.5%), abdominal mass in 6 cases (15.0%), abdominal discomfort in 5 cases (12.5%), abdominal distension in 5 cases (12.5%), and hematemesis in 5 cases (12.5%). Fifteen cases were misdiagnosed as gastric cancer, 5 cases as colon cancer, and 4 cases as digestive tract ulcer. The misdiagnosis rate was 60.0% (24/40). The survival rates of 1- , 2- and 3- year were 62.3%, 57.5% and 52.6%. The univariate analyses result showed that the clinical stage, international prognosis index (IPI) and treatment method were associated with survival rate (P<0.01), but the gender, age and disease distribution were not associated with survival rate (P > 0.05). The 3-year survival rate of clinical stage Ⅰ - Ⅱ was significantly higher than clinical stageⅢ-Ⅳ(68.0%vs. 13.3%), the 3-year survival rate of IPI 0-2 scores was significantly higher than 3 - 5 scores (66.7% vs. 7.6%), and the 3- year survival rate of surgery combined with postoperative chemotherapy was significantly higher than simple surgery (75.0%vs. 20.0%), there were statistical differences (P<0.01). Conclusions The patients with PGI- DLBCL have no obvious clinical manifestions and a higher misdiagnosed rate. Modified IPI, clinical stage and surgery combined with postoperative chemotherapy are the influencing factors of prognosis.

Objective To discuss the application of longitudinal reduction of Chinese traditional medicine in surgical treatment of distal radius comminuted fractures in the elderly. Methods Before the operation, the 54 elderly patients with the fracture were reduced by longitudinal direction under anesthesia, then they were treated with minimally invasive plate osteosynthesis in the approach upon the reduction condition and fracture types. Results After 12-month follow-up, the fractures were all healed. The mean healing time of the fractures was 8 weeks (6-12 weeks). At the end of follow -up, the mean range of motion of the wrist was at 50°of flexion, 45°of extension, 30° of ulnar deviation, at 20° of radial deviation. According to the criteria of Gartland and Werley, the results were excellent in 35 cases, good in 17 cases, fair in 2 cases and poor in 0 case. Conclusions It is vital to provide a Chinese traditional longitudinal reduction before invasive surgical plate fixation in treatment of distal radius comminuted fractures, to avoid large-area exposure of fracture site, minimize the damage to the soft tissue, maintain reduction of post operation and achieve good wrist function.

Objective To clarify the inhibitory effect of low molecular weight chitosan(LMCTS)on hepatic fibrosis induced by carbon tetrachloride (CCl4 )in the rats, and to investigate its effect on the expression of Toll-like receptor-4(TLR4 )and to lay the foundation for the development of the clinical candidate drug of liver fibrosis. Methods 72 male Wistar rats were randomly divided into blank control group, CCl4 group (model group), glycyrrhizinate (DG)group,50,100 and 150 mg·kg-1 LMCTS groups (low,middle and high doses of LMCTS groups).In addition to blank control group,the rats in the remaining groups were given 40% CCl4-vegetable oil (1.75 mL·kg-1 ),2 times per week for 8 weeks,by intraperitoneal injection to establish the model of rat hepatic fibrosis.And the rats in blank control group were injected with the same amount of 100% vegetable oil agent. From the ninth week, the rats in DG and LMCTS groups were given DG and LMCTS by intragastric administration, 1 time/week for 4 weeks. Then all rats were sacrificed, the activities of serum glutamic acid aminotransferase (ALT),aspartate aminotransferase (AST)and alkaline phosphatase (ALP)were detected with ELISA kit;the pathological changes in liver tissue were observed under light microscope, and the TLR4 expressions were detected by RT-PCR and Western blotting method. Results The serum ALT, AST and ALP activities in middle and high doses of LMCTS groups were lower than those in model group (P<0.05).The serum ALT activity in middle dose of LMCTS group was lower than that in low dose of LMCTS group (P<0.05),but the activities of AST and ALP had no statistically significant change(P>0.05).There were statistically significant differences in the serum ALT, AST and ALP activities between high dose of LMCTS group and middle dose of LMCTS group (P<0.05).There were obvious hepatocyte steatosis,inflammatory cell infiltration,collagen fiber hyperplasia and hepatic lobule damage in the rats in model group.However,all the changes in liver tissue of the rats in LMCTS group were significantly reduced, especially in high dose group. The results of RT-PCR and Western blotting method showed that the expression of TLR4 was declined in LMCTS groups compared with model group (P<0.05,P<0.01),especially in high dose of LMCTS group,and there were statistically significant differences between different doses of LMCTS groups (P<0.05).Conclusion High dose of LMCTS can decrease the serum transaminase activity of liver fibrosis rats and improve liver function,and this process may be related to declining the expression of TLR4 .

Objetcvi e Inhibitor of growth TNG3 is a candidate tumor suppressor gene ,which belongs to the human ING gene family .It has been interested by scientist because of its putative roles as tumor suppressors . There is a low expression level of ING3 in a variety of tumors.However,the relationship of ING3 and the develop-ment of colorectal cancer is unclear yet .The aim of this studyis to examine the expression of ING 3 in colorectal cancer by qRT-PCR.Methods Statistical analysis was performed with the expression of ING 3 mRNA which has been evaluated in 82 matched samples comprising primary colorectal cancer and paired non -cancerous mu-cosa samples.Results In 51%colorectal cancer patients ,the expression level of ING3 was significantly lower in cancer tissue than that in normal tissue .The expression level of ING3 was closely related to pT、pM stage , and TNM stage(P<0.05).The Univariate analysis showed that the pT、pN、pM stage,TNMstage and ING3 expression levels were associated with disease -free survival(P<0.05).CRC patients with low -expression level of ING3 showed shorter disease -free survivals(P<0.05).Conclusion The expression of ING3 might contribute to the CRC development or progression .

Objective To investigate the relationship between the marrow edema and general clinical index,quadriceps muscle area,and the meniscus grade of knee osteoarthritis(OA).Methods 72 patients were collected with knee OA in our hospital, underwent X-ray and routine MRI examination of knee, and the same X-ray and MRI were reviewed at 12 months later in different time point.The K-L grading, bone marrow edema score, meniscal grading and VAS score of each knee joint were evaluated.The t-test and Rank-sum test were used to compare the two groups of general data, Spearman was used to perform bivariate correlation analysis.Results The age and VAS score of bone marrow edema group at the initial follow-up were significantly lower than those without edema group(P<0.05),the degree of marrow edema was moderately correlated with age and VAS score, and was not significantly correlated with other indexes.12 months later, BMI and the area of quadriceps femoris in the group with marrow edema were different from those in the group without bone marrow edema(P<0.05), the degree of marrow edema was moderately correlated with age, quadriceps area and VAS.Conclusion The range of marrow edema was related to age, quadriceps area, BMI index and VAS score in MRI.The MRI measurement could reflect the progression of knee OA more than that of X-ray.It also revealed some factors related to the progression of knee OA.

BACKGROUND:Transplantation of alogeneic intervertebral disc can be facilitated by the cryopreservation of the intervertebral disc. But the traditional cryopreservation methods always lead to the appearing of ice crystals inside and outside the cels which can cause celular injury. The vitrification method that can avoid the formation of ice crystals have been widely applied in the cryopreservation field. However, only a few reports have assessed the vitrified cryopreservation of the intervertebral disc, and the toxicity of cryoprotectants to the nucleus pulposus cels have not been fuly explored.
OBJECTIVE:To determine the order of toxicity of five commonly used cryoprotectants that are used alone or in combination to rabbit nucleus pulposus cels, and to select the optimal cryoprotectant for the vitrification of the intervertebral disc.
METHODS: We chose five most commonly used cryoprotectants including dimethyl sulphoxide, formamide, ethylene glycol, propylene glycol and glycerol. Then, 5 single commonly used cryoprotectants, 10 mixed agents containing any 2 commonly used cryoprotectants, and 10 mixed agents containing any 3 commonly used cryoprotectants were formulated. Cel viability of nucleus pulposus cels was determined using cel counting kit-8 and fluorescein diacetate/propidium iodide method. Al data obtained were analyzed statisticaly to choose the appropriate combining scheme with less toxicity.
RESULTS AND CONCLUSION: The order of the toxicity of these five commonly used cryoprotectants from low to high was ethylene glycol, glycerol, formamide, dimethyl sulphoxide, and propylene glycol. The toxicity of the combined agents containing two or three commonly used cryoprotectants was lower than that of any commonly used cryoprotectants that were used to formulate them. The toxicity of the mixed agents that contained ethylene glycol or glycerol was lower than that of any other mixed agents. So we can choose the mixed cryoprotectants that contain ethylene glycol and (or) glycerol for the vitrification of the intervertebral disc.

Objective To explore the treatment method for femoral neck fracture in the young adult patients and discuss the corresponding curative efficacy.Methods Closed reduction and internal fixation with hollow screws were carried out in treatment of 58 young adult patients with femoral neck fracture.There were 37 males and 21 females at age range of 19-56 years(average 37.5 years).According to Garden classification,there were seven patients with type Ⅰ fractures,19 with type Ⅱ,23 with type Ⅲ and nine with type Ⅳ.Results Follow-up lasted for 0.5-7.0 years(average 3.8 years),which showed the average one stage healing time of 5.8 months in 50 patients.Nonunion occurred in three patients and avascular necrosis of the femoral head(ANFH)in five patients,of which six patients were treated with two stage sartorius pedicled iliac graft,with fracture healing in three patients.According to Harris evaluation,the result was rated as excellent in 29 patients,good in 22,fair in two and poor in five,with excellence rate of 88％.Conclusions Closed reduction and internal fixation with hollow screw takes advantages of minor wound,few complications,high healing rate and satisfactory function recovery,and is effective in treatment of femoral neck fracture in the young adult patients.Open reduction and internal fixation with sartorius pedicled iliac graft can be used as remedial treatment for fracture nonunion and avascular necrosis.

Objective:To identify anti-dipeptidyl-peptidase-like protein 6 (DPPX) antibody in patients with encephalitis of unknown etiology and describe the clinical features of anti-DPPX antibody-associated encephalitis in Chinese patients.Methods:For patients registered in the Peking Union Medical College Hospital Encephalitis and Paraneoplastic Syndrome Registration Project from 2016 to 2019 with negative findings in autoimmune encephalitis routine antibody profile and paraneoplastic antibody profile, but with positive tissue-based assay (TBA) results, further tests for rare antibodies, including cell-based assay (CBA) of anti-DPPX antibody, were performed. Patients positive for anti-DPPX antibody were enrolled and the clinical data were collected.Results:Two patients with anti-DPPX antibody-associated encephalitis were found from 2016 to 2019 among about 15 000 patients. Both were females, aged 46 and 75 years. One patient had diarrhea, cachexia, cognitive dysfunction, agitation, myoclonus, tremor, and seizures. The other had cognitive impairment, restlessness, memory loss, disorientation, and sleep disturbance. The second patient had medical history of systemic lupus erythematosus and secondary Sj?gren′s syndrome.Conclusions:TBA should be combined with CBA in identification of anti-DPPX antibody to confirm the diagnosis. Anti-DPPX antibody-associated encephalitis has clinical manifestations of encephalopathy with diarrhea and cachexia, and can coexist with systemic lupus erythematosus.