Brachytherapy ; Combined Modality Therapy ; Female ; Humans ; Hysterectomy ; methods ; Lymph Node Excision ; Neoplasm Staging ; Survival Rate ; Uterine Cervical Neoplasms ; drug therapy ; pathology ; radiotherapy ; surgery

[Objective]To investagate the anatomic features in the approach to the brachial plexus in neck in order to make the exposure of brachial plexus more convenience and safer.[Method]Neck of six embalmed adult cadavers were made serial sectional specimens,which was observed to identify the border,composition and anatomic relation of fat layer between the superficial and deep layer of cervical fascia in the posterior triangle of neck with the brachial plexus.[Result]There was no branches of superficial cervical plexus in the fat layer between the superficial layer and deep layer of cervical fascia below the middle neck,in which there was no important structures except omohyoid muscle and transverse cervical artery.The deep layer of cervical fascia was dense and was directly superficial to the brachial plexus.[Conclusion]Exposure of brachial plexus in the neck would be more safe and convenience upon the understanding of anatomic relatiowship between cervical fascia and brachial plexus.

Objective To study the anesthetic effect and influence to circulatory and respiratory function of target controlled infusion(TCI)and intravenous injection of propofol anesthesia in elderly patients undergoing colonoscopy.Method 50 patients above 55 years of age undergoing colonoscopy were randomly allocated to 2 groups.The TCI group received target controlled infusion of propofol with a target concentration of 3?g/ml.The injection group received intravenous injection of 2mg/kg propofol with addition of 20-50mg propofol for each time at intervals during anesthesia when necessary.BP,HR,SpO2,and limb motion were detected during colonoscopy operation,and the time of eye-open and word-response after colonoscopy were also recorded.Results No significant difference was found in colonoscopy time and limb motion response between the two groups.Patients in TCI group consumed more propofol and opening of eyes was delayed compared to those patients in the injection group(P

Objective To compare hip arthroplasty versus internal fixation for treatment of displaced femoral neck fractures in the elderly patients in terms of reoperation,surgery-related complications and postoperative 1-2-year mortality.Methods All the randomized controlled trials (RCTs) up to May 2013 on hip arthroplasty versus internal fixation for displaced femoral neck fractures in the elderly were electronically searched for in Pubmed/Medline,EMBASE,Cochrane CENTRAL,CNKI,WanFang and VIP databases.The 2 treatments were compared in terms of reoperation,surgery-related complications and postoperative 1-2-year mortality.The Meta analysis was performed with RevMan 5.2.5 software.Results Five eligible RCTs involving 1 288 cases were included for this review.The rate of reoperation (including implant removal and other operations),either within 2 years or over 2 years,in the internal fixation group was significantly higher than that in the arthroplasty group (P ＜ 0.05).The surgery-related complications in the internal fixation group was significantly higher than that in the hip arthroplasty group [OR =8.82,95％ CI (6.45,12.07),P ＜0.001].No significant difference was found in the postoperative 1-2-year mortality between the 2 groups (P ＞0.05).Conclusion In the treatment of displaced femoral neck fractures in the elderly,compared with internal fixation,arthroplasty should be recommended as the first choice,because it can significantly reduce surgery-related complications and reoperations though it cannot decrease the postoperative 1-2-year mortality.

With the development of therapeutic antibodies over the past decade, they have become the treatment options for immunity and inflammation diseases. Major limitations of mouse antibodies as therapeutic agents - immunogenicity, lack of effectors' functions and short serum half-life -- were subsequently identified and largely overcome by the advent of humanized and fully human antibody technologies. The therapeutic antibodies for immunity and inflammatory diseases are primarily utilized in the treatment of allograft rejection, autoimmune disease, autoinflammatory syndromes, allergies and other chronic inflammation. The action mechanisms of therapeutic antibody include blocking ligands or receptors, regulating receptor activity, clearing the target cells or activating receptor. Strategies for generating the antibody drugs with high efficacy and low side effects can be realized by modulation of Fc-mediated activities and optimization of antigen-binding domains.

Objective To investigate the distribution and drug resistance ofEnterococcus faecium,provide evidence for clinical rational use of antimicrobial agents.Methods Retrospective analysis of drug resistance of Enterococcus faecium,summarize the specimen type,distribution of departments and so on,to explore the trend of drug resistance.Results Enterococcus faecium to vancomycin resistance rate from 3.54％ (4/113) in 2010,rose to 8.45％ (18/213) in 2013.One strains of hnezolid resistant Enterococcus faecium 717 was found,the minimum inhibitory concentration of 7.9 mg/L,not tigecycline resistance in Enterococcus faecium found.Conclusion Vancomycin resistant Enterococcus faecium for linezolid and tigecycline susceptibility is still high,the two kinds of antimicrobial agents can be used for the treatment of vancomycin resistant Enterococcus faecium.

To prepare large naive phage antibody library, the host bacteria with high transformation efficiency is used in the Cre-LoxP recombination system. The variable regions of immunoglobulin light and heavy genes were amplified from lymphocytes collected from adult peripheral blood and newborn cord blood. The genes were spliced to form the single-chain variable fragments (scFv) by overlap PCR, cloned into pDAN5a vector and then transformed into XL2-blue MRF' with the Hte gene. Compared with XL1-blue strain, the size of the primary library was increased by 3.9 times. The primary library infected Cre recombinase-expressing bacteria, and the genes between phagemids created many new VH/VL combinations. The library was calculated to have a diversity of 1.7 x 10(11) and validated by the selection of antibodies against six different protein antigens. This library provides the basis for further selection of antibody-based drugs. It is the first time to report that XL2-blue MRF' can be used to improve the diversity of the library in the recombination system.

Objective To study the effects of different stimulators on the production of matrix metalloproteinases (MMPs) by peripheral blood mononuclear cells (PBMCs),and to evaluate the effects of the culture supernatant of activated PBMCs,named conditioned media (CM),on the proliferation of and production of MMPs by cultured human fibroblasts.Methods PBMCs were isolated from the venous blood samples of healthy volunteers and divided into three groups to be stimulated by phytohemagglutinin (PHA group),the combination of antibodies against CD3 and CD28 (double-antibody group),or the RPMI 1640 medium containing 10％ fetal calf serum (control group).After 72-hour stimulation,CM was collected from all the three groups,diluted to several different degrees.Cultured human fibroblasts were classified into several groups to be treated with different dilutions of CM from the three groups for 48 or 24 hours,with the fibroblasts untreated with CM serving as the control group.Methyl thiazolyl tetrazolium (MTT) assay was performed to evaluate cellular proliferative activity,semi-quantitative reverse transcription (RT)-PCR to detect the expressions of MMP-1,MMP-3 and MMP-9 mRNAs in cells,and enzyme-linked immunosorbent assay (ELISA) to measure the levels of interleukin (IL)-6,MMP-1,MMP-3 and MMP-9 proteins in the culture supernatant of cells.Statistical analysis was carried out mainly by using one-way analysis of variance (ANOVA),Tukey HSD test,and GamesHowell test.Results Compared with the control group,the PHA group showed increased cellular proliferative activity,IL-6 and MMP-3 protein levels in the culture supernatant of activated PBMCs (all P ＜ 0.05).Significant differences were observed among the PHA group,double-antibody group and control group in the relative mRNA expression level (expressed as the ratio of target mRNA to β-actin mRNA) of MMP-1 in activated PBMCs (0.083 ± 0.016 vs.0.188 ± 0.030 vs.0.714 ± 0.104,F =85.905,P ＜ 0.05),but neither MMP-3 nor MMP-9 mRNA was expressed by activated PBMCs.MMP-3 protein was detectable in the culture supernatant of fibroblasts after the treatment with CM,and the level of MMP-3 protein was highest in that of fibroblasts treated with undiluted CM,and lowest with 1/10 diluted CM;at the same dilutions,the level of MMP-3 protein was highest in the culture supernatant of fibroblasts treated with CM from the PHA group,but lowest with that from the control group.Neither MMP-1 nor MMP-9 protein was detected in the culture supernatant of activated PBMCs or treated fibroblasts.There were no significant differences in cellular proliferative activity of and mRNA expressions of MMP-1 or MMP-3 in fibroblasts among these groups (all P ＞ 0.05),and MMP-9 mRNA expression was undetected in the treated fibroblasts.Conclusions PBMCs can be induced to express MMP-1 mRNA and secret MMP-3 protein after activation.However,the culture supernatant of activated PBMCs has no capacity to stimulate the expressions of MMP-1,MMP-3 and MMP-9 mRNAs or proteins by fibroblasts,suggesting that inflammatory cells may function through self-production of MMPs.

Objective To summarize the experience with adapalene in the treatment of ache vulgaris and to provide a clue to improve the clinical use of adapalene in ache vulgaris. Methods Chinese literature over the past ten years related to the evaluation of efficacy and safety of 0.1% adapalene gel in acne vulgaris were searched and assessed. Results Combination therapy with 0.1% adapalene was more effective than monotherapy with it. The efficacy of adapalene gel was higher than that of non-tretinoin topical agents, but equivalent to that of other tretinoins. Furthermore, the incidence of adverse events was lower for adapalene than for other tretinoin formulations. Conclusions Adapalene is safe and effective for the treatment of mild to moderate acne vulgaris, and can be used as monotherapy, maintenance treatment, or in combination therapy of acne vulgaris.