Objective To explore the expression of serine/threonine kinase 15 (STK15) gene and its significance for papillary thyroid carcinoma. Methods SP immunohistochemical method was used to detect the expression of STK15 gene in 71 cases of papillary thyroid carcinoma and 45 cases nodular goiter tissue. Results The positive expression rates of STK15 gene in 71 cases of papillary thyroid carcinoma were 100%, and the adjacent of papillary thyroid carcinoma expressions of STK15 gene 8.5%, nodular goiter tissue of STK15 gene expression rates 24.4%. The expression of STK15 gene was positively correlated with that of STK15 gene in papillary thyroid carcinoma (P < 0.01). Conclusion High expression of STK15 gene is confirmed in papillary thyroid carcinoma. The detection of STK15 gene can provide valuable evidence for diagnosis of papillary thyroid carcinoma and evaluation of the malignant potential of nodular goiter.

Objective To investigate the selection of surgery and clinical outcomes of upper cervical injuries.Methods 25 upper cervical injury patients were involved in this retrospective study from November 2011 to June 2014.Including 20 males and 5 females with mean age of 37.1 years old (range,14-55 years old).Individual operation methods were based on the comprehensive evaluation of specific situations including the clinical manifestation,the type of the injuries and the imaging data.HaloVest distraction was applicated before operation.The surgery by anterior approach were performed for 7 patients and posterior approach were performed for 18 patients.Preoperative and postoperative American Spinal Injury Association (ASIA) grade and Functional Independence Measurement (FIM) score were studied to evaluate the nerve functional restoration.Imaging data before and after the operation were contrasted to evaluate the reduction of the fracture,the bone union,the fusion of the bone graft and the condition of the internal fixation.Wilcoxon Singed Rank Test was applied to compare the FIM score between pre-operation and last follow-up.Results 15 patients presented neurological function deficit because of cervical spinal cord compromise.All cases were followed up for 6-35 months (mean 18.2 months),showing good clinical and radiological effects.Solid fusion was obtained in all patients among 3-12 months.The ASIA grade improved by an average of 1.1 (6 months after operation) and 1.2 (12 months after operation).There was significant difference in FIM score between pre-operation and last follow-up.One patient got cerebrospinal fluid leakage.Conservative treatment was implemented with the Trendelenburg position,rehydration fluids and so on.Removal of drainage tube 8 days later when the drainage was less than 30 ml/24 h.No incision infection,cerebrospinal fluid leakage,migration or breakage of internal fixation was observed at the last follow-up.Conclusion The type of upper cervical injuries are complicated,the characteristics of fracture,dislocation and nerve injury in different patients are different.The specific situation should be evaluated comprehensively to make individual operation methods.The success of the operation requires the proficiency of the anatomic basis,the biomechanical characteristics,precise entrance point and direction in operation,appropriate diameter of the screw and suitable depth of the screw road.

Objects:To investigate the current situation of counselors'implementation and their attitude to informed consent in Beijing.Methods:Eleven counselors who worked in Beijing were interviewed,the average of their working years was (7.4 ± 4.4).A semi-structured interview was used to learn about their practicing processes in and viewpoints on informed consent,and their interview transcripts were analyzed through qualitative method.Results:The results could be categorized into four categories,including the content of informed consent,the influential factors of informed consent,problems and confusions,and the significance of informed consent.The crucial role of informed consent in psychotherapy was generally recognized by counselors,and they could obey the related rules as well.The therapists had some confusion and problems about informed consent,such as the form and length,the consent for special population and online consultation.Conclusion:Basically,the counselors in Beijing could comply with the ethical standards of informed consent.However,they also suggest that certain limitations of these rules should be noticed.

Objective To evaluate the clinical efficacy of extraperitoneal laparoscopic radical prostatectomy(ELRP)for prostate cancer patients, and to summarize the experience of surgical treatment. Methods The clinical data of 50 prostate cancer patients who underwent ELRP by the same performer from January 2010 to June 2015 were retrospectively reviewed. Results All cases were all successfully completed ,no case was converted to open surgery. The average operation time was 238.8 min,average operative blood loss was 409.1 mL,and intraoperative or postopera?tive blood transfusion was 6(12%). The mean postoperative catheterization time was 23.7(17?38)d. The mean postoperative hospital stay was 15 (10?34)d. The postoperative recovery time of eating was 2?4 d,and the ambulation time was 1?3 d. Totally 3 cases(6%)had lymph node metasta?sis,and 7 cases(14%)had positive surgical margin. Totally 9 cases(18%)had surgery?related complication. Patients were followed up for 6 to 58 months,with an average of 12.5 months. One case(2%)had biochemical recurrence,and the tumor?free survival rate was 84%. At the end of fol?low?up,all of the patients were continent. Conclusion ELRP is safe and effective for the treatment of prostate cancer. With the development of minimally invasive techniques,the applications of RP are increasingly widespread. However,large?scale and long?term follow?up studies are still needed for high?risk prostate cancer patients.

ObjectiveTo explore the effects of myoblast formation around the urethra of stress urinary incontinence (SUI) rats after treated with bone marrow mesenchymal stem cells(BMSCs) or musclelike cells/calcium alginate composite gel injection therapy.MethodsIsolation,cultivation and identification of Sprague-Dawley rat bone marrow mesenchymal stem cell were performed.5-azacytidine was introduced to induce muscle-like cells.Calcium alginate gel was initially prepared by 2％ sodium alginate and 1％ calcium chloride solution at a volume ratio of 5∶1.Compounds of stem cells or muscle-like cells were mixed with gel,respectively,and were prepared for microinjection.SUI was produced in 72 6-week-old female Sprague-Dawley rats.The rats were then divided into 4 groups:Gel group,stem cell-gel group,muscle-like cell-gel group and mock control group.Each group was further divided into 3 groups.Submucosal injection of gel was performed at urethra and bladder neck.After preparation of cross sections of rat urinary tract at 4 weeks and 8 weeks after injection,HE staining,fluorescent tracing,staining of Desmin and α-skeletal muscle actin (α-SMA) were performed.OD values of positive rates were compared.ResultsAt 4 weeks and 8 weeks after injection in stem cell-gel group and muscle-like cell-gel group,growth of blood vessels gradually increased at gel edge,BMSCs and muscle-like cells gathered around the new blood vessels observed by fl(u)orescence tracer,muscle-like cells grew into elongated spindle-like cells.Desmin and α-SMA staining were positive in these groups,and the OD values in the stem cell-gel group and muscle-like cell-gel group was significantly higher than that from the gel only group and control group,but no difference was found between stem cell-gel group and muscle-like cell-gel group.ConclusionsCompound of BMSCs,muscle-like cells and calcium alginate composite gel has the potential to differentiate into muscle cells in the microenvironment of SUI rat model.In short term,the myoblast formation potential is the same whether the BMSCs was introduced into the micro-environment in vivo directly,or the BMSCs was implanted into microenvironment after the formation of the muscles cells induced by 5-azacytidine in vitro.

The implementation of the "Healthy China" policy is inseparable from public health. The improvement of the national health level, the control of health risk factors and the improvement of health service ability and other aspects need to rely on the talent training and discipline construction of public health and preventive medicine in medical colleges, which highlights that the public health discipline construction and development of our country has a certain lag and limitations: unprofessional public health academic team and disciplines; separation of teaching research and practice in public health; lack of public health expertise and insufficient personnel scale; health emergency and legal system that do not match economic development, etc. Therefore, in order to promote the construction of healthy China, we should promote the integration of public health disciplines, strengthen the teaching and practice of health emergency response, improve the health emergency response and dynamic monitoring system focusing on prevention so that we can make public health disciplines both scientific and contemporary.

As the main means of mastication, teeth can withstand countless functional contacts. The mechanical properties of teeth are closely related to their tissue structure. Enamel and dentin have a high hardness and modulus of elasticity, and their graded structure allows them to withstand bite forces without being susceptible to fracture. When tooth tissue is defective, full crown restoration is often needed to restore the normal shape and function of the tooth. Metal materials, ceramic materials, and polyetheretherketone (PEEK) materials are commonly used for crown restoration. Metal materials have certain disadvantages in terms of aesthetics and are relatively rarely used in clinical practice. Ceramic materials with different compositions exhibit differences in performance and aesthetics, but their elastic modulus and hardness are much higher than those of dental tissue, resulting in mismatching mechanical properties. In contrast, the elastic modulus of PEEK is lower than that of tooth tissue and similar to that of bone tissue, but its properties can be improved by fiber reinforcement. Notably, when the mechanical properties of a restoration material and tooth tissue are not fully matched, the interface between them often forms a potential weak link, which ultimately affects the stability and long-term effect of the restoration. This article introduces the mechanical properties and corresponding structural characteristics of enamel and dentin. On this basis, the advantages and limitations of existing restoration materials are analyzed, and the possibility of biomimetic design of full crowns is further explored.

Objective To study the roles of ethyl pyruvate ( EP ) in spinal cord edema after spinal cord injury ( SCI ) and in spinal cord astrocytic swelling after oxygen-glucose deprivation and reoxygenation ( OGD/R) in vitro in rats. Methods After SCI models were established in adult Sprague-Dawley ( SD ) rats, an intraperitoneal injection of EP was conducted to inhibit high mobility group box-1 ( HMGB1 ). Effects of EP on spinal cord edema, HMGB1 expression and astrocyte activation ( glial fibrillary acidic protein ( GFAP ) expression) in SCI rats were analyzed. Spinal cord astrocytes were cultured in post-natal SD rats and incubated under OGD/R procedure. Effects of EP on cell swelling, expression of HMGB1, aquaporin-4 ( AQP4 ) and toll-like receptor 4 ( TLR4 ) , and nuclear expression of nuclear factor-kappa B ( NF-κB ) in spinal cord astrocytes were observed. Results The water content in the spinal cord was increased significantly more at 1 d after SCI than at 12 h and 3 d ( P ＜0.05 ). Intraperitoneal injection of EP at 50 mg/kg reduced spinal cord water content, HMGB1 expression and astrocyte activation ( GFAP expression ) in SCI rats signif-icantly more than that at 25 mg/kg or 100 mg/kg ( P ＜0.05 ). The volume of spinal cord astrocytes cultured in vitro after OGD 6 h/R 24 h was significantly greater than that after OGD 6 h/R 6 h or OGD 6 h/R 12 h ( P ＜0.05 ). EP at 12 μmol/L reduced cell swelling, decreased expression of HMGB1, AQP4 and TLR4, and downgraded nuclear expression of NF-κB in spinal cord astrocytes after OGD/R significantly more than EP at 6 μmol/L( P ＜0.05). Conclusion EP may reduce early spinal cord edema after SCI, attenuate spinal cord astrocyte swelling and decrease AQP4 expression after OGD/R in vitro by inhibiting HMGB1 in rats.

Objective:To assess the value of platelet-to-albumin ratio on overall survival(OS) and cancer specific survival(CSS) in patients with upper urinary tract urothelial carcinoma(UTUC).Methods:169 patients with UTUC in Qilu hospital of Shandong University from January 2006 to December 2013 were included in this study, retrospectively. 107(63.3%) were male and 62(36.7%) were female. Their age ranged from 36 to 87 years old, mean 65 years old. 73(43.2%)were less than 65 years old and 96(56.8%) were more than 65 years old. 38 patients had the history of smoking.15 patients had the history of bladder cancer. The single tumor was found in 159 cases (94.1%). 10 patients(5.9) owned more than one site of tumor. For the ECOG, 159 cases (94.1%) were 0 score and 10 cases(5.9%) were ≥1 score. The mean Platelet count was 217.0×10 9/L, ranging (68.0-772.0)×10 9/L. The average serum albumin was 42.0 g/L, ranging (27.3-52.7)g/L. The mean PAR was 5.40×10 9, ranging(0-17.31)×10 9. 147(87.0%) patients accepted radical nephroureterectomy and 22(13.0%) cases accepted segmental ureterectomy.155 cases(91.7%) used postoperative adjuvant chemoradiation. The patients were divided into two groups as low PAR or high according to the receiver operating curve (ROC)analysis of PAR. And the Kaplan-Meier analysis was used to assess the OS and CSS and test the equivalences of the curves by log-rank tests. Univariate and multivariate survival analyses were carried out using Cox proportional hazards regression model. Results:We set 6.67×10 9 was the optimal cutoff value of PAR. Therefore, the cohort was divided into 2 groups, 133(78.7%) patients had low PAR (<6.67×10 9) and 36 patients had high PAR (≥6.67×10 9). The 3-year OS and 5-year OS of high preoperative PAR group were 50.0% and 46.2%, respectively. And low preoperative PAR group were 77.6% and 66.7%, respectively. In univariate analysis, no difference was found in gender, age, tumor size, history of smoking and LVI. Meanwhile, tumor grade (G 1-2 or G 3), pathological T stage (pT a/T 1 or pT 2-4) and PAR (<6.67×10 9 or ≥6.67×10 9) were significantly associated with OS and CSS. Multivariate analysis with a Cox proportional hazards regression model were performed and showed that PAR was significantly associated with OS and CSS (OS: HR=1.850, 95% CI 1.095-3.127, P=0.022; CSS: HR=2.154, 95% CI 1. 242-3.736, P=0.006). Conclusions:Preoperative PAR is an independent prognostic factor in predicting patient with UTUC. And the platelet and serum albumin level are low cost and easy to obtain. PAR may be expected to become a biological factor to predict the prognostic factor in patients with UTUC.

Objective:To study the clinical manifestations, diagnostic methods and therapeutic outcomes of transverse testicular ectopia (TTE).Methods:Clinical data of 8 cases of TTE treated in the Department of the First Urologic Surgery, Xinxiang Central Hospital and Department of Pediatric Surgery, the First Affiliated Hospital of Zhengzhou University from May 2004 to November 2018 were retrospectively analyzed.Clinical manifestations, diagnostic methods, surgical treatment and follow-up results of TTE were summarized.Results:The age of 8 cases of TTE was 1 year 5 months to 5 years.Among the 8 cases of TTE, 6 cases were involved with the left side and 2 cases with the right side.All patients were admitted due to scrotal emptiness.Three cases were combined with persistent Müllerian duct syndrome (PMDS) and 1 case combined with hypospadias.Preoperative diagnosis of TTE was definitely made in 5 cases, involving 4 cases diagnosed by ultrasound and 1 case diagnosed by magnetic resonance imaging.Laparoscopy was performed in 2 cases, including 1 case treated with laparoscopic scrotopexy, and the other one transferred to an open surgery of trans-septal orchiopexy due to poor development of the spermatic cord.Open surgery was performed in 6 cases, including 1 case with bilateral testicular fixation in the ipsilateral scrotum due to adhesion of spermatic cord closely, and 5 cases with trans-septal orchiopexy.Müllerian ducts residues were excised during surgery in 3 cases combined with PMDS.Postoperative wound infection or hematoma was not reported in all cases.Orchiepididymitis and the involvement of contralateral testes occurred in 1 case treated with trans-septal orchiopexy at 11 months postoperatively, which were relieved after anti-inflammatory treatment.All cases were postoperatively followed up for 3-48 months, and the development and blood supply of bilateral testes were detected normal by ultrasonography.Postoperative testicular atrophy was not reported.Conclusions:The possibility of TTE should be considered in patients with unilateral cryptorchidism combined with contralateral inguinal mass.Ultrasonography is preferred to the diagnosis of TTE.Laparoscopic surgery plays an important role in the diagnosis and treatment of TTE, which is helpful to identify abnormalities in the Müllerian duct structure.