Objective To identify the chemoresistant factors predicting the response to preoperative chemotherapy and clinicopathological prognosis in bulky cervical cancer. Methods 68 patients with bulky cervical carcinoma treated with two courses of intraarterial infusion of cisplatin 80mg, 5 fluorouracil(5Fu) 1500mg and AT 1258 or EADR 60mg, followed by radical hysterectomy and pelvic lymphnodenectomy at our hospital between 1996-1999 were retrospectively reviewed. Expressions of the chemoresistance related proteins, such as P glycoprotein glutathione S transferase ?(GST ?), and proliferating cell nuclear antigen(PCNA) in the tumor cells were examined by immunohistochemistry in previous biopsy specimens. These results were compared with the chemotherapeutic response obtained by gynecological examination and vagina ultrasonic. 68 patients were followed up. SPSS 8.0 was used. Results P glycoprotein expression rate was 31% and GST ? expressioin rate was 51%. There were 38 patients whose PCNA labellings were more than 50% and 30 less than 50%. The total chemotherapeutic response rate was 84%. Chemotherapeutic response rate was significantly correlated with P glycoprotein expression( P =0.013) and PCNA labelling ( P =0.001), but not GST ? expression in the tumor cells. Parautrial involvement and lymph node metastasis were independent factors for prognosis in this group. The survival rate in MDR(+) group was lower than MDR(-) group. No significant correlation between eigher the expression of GST ? or PCNA. Conclusions The expression of P glycoprotein and PCNA is potentially useful for predicting the response to preoperative chemotherapy for cervical cancer. The parautrial involvement and lymph node metastasis were independent prognostic factors for the survival rate including. the expression of P glycoprotein.

Objective To evaluate the effects of modulated, medium frequency electrotherapy on hemodynamics after thoracic surgery to provide non-pharmacological measures for preventing deep vein thrombosis (DVT).Methods Seventy thoracic surgery patients were divided into an experimental group and a control group. Both groups received conventional treatment and nursing. The experimental group (35 patients) was treated with modulated, medium frequency electrotherapy additionally while the control group (35 patients) was not. The vein systolic maximum velocity (Vmax), vein diastolic minimum velocity (Vmin) and time-averaged mean velocity (TAVM) in the femoral vein, the superficial femoral vein, the deep femoral vein, the popliteal vein and the anterior tibial vein were observed before the operation, 4h after the operation, just after 20 minutes of electrotherapy, 15 min after the electrotherapy and 30 min after the electrotherapy. Results There were significant differences among the time points in the experimental group. There was no significant difference among the time points in the control group.There were significant differences in lower extremity hemodynamics between the experimental group and the control group at end of the electrotherapy session, but no significant differences at the later time points. Conclusions Modulated, medium frequency electrotherapy has a significant effect on lower extremity hemodynamics. It is an effective method for DVT prophylaxis in perioperative thoracic surgical patients.

Background and purpose:Blood vessel metastasis often occurs after the operation of rectal cancer of stage Ⅱ and Ⅲ,angiogenesis is an important step of the procedure.Cycloxygenase-2(COX-2) and vascular endothelial growth factor(VEGF-C) are correlated to angiogenesis. The purpose of this study is to investigate the expressions of Cycloxygenase 2(COX-2) and vascular endothelial growth factor(VEGF-C) in rectal cancer of stage Ⅱ and Ⅲ,to explore the relationships between them and the tumor biological characteristics,tumor angiogenesis.Methods:The expressions of COX-2,VEGF-C and the microvessel density(MVD) were detected by immunohistochemical staining.Results:①The positive rates of COX-2 and VEGF-C expression in rectal cancer were 72.5%,higher than those in peritumoral normal tissue(P

Purpose:To evaluate the relationship between the expressions of MDR and GST-? and the response to neoadjuvant chemotherapy and prognosis in cervical carcinoma. Methods:The expressions of MDR and GST-? were examined by Envision immunohistochemistry using pretreatment biopsy specimens. The stage distribution of 57 patients in the study was 7 stage Ib, 35 stage IIa, 15 stage IIb. Treatment consisted of 2 courses of neoadjuvant chemotherapy followed by radical hysterectomy and lymphonectomy. If the patient was found to have parametrial involvement, pelvic lymph node metastasis, microscopic tumor emboli or disease in vagina stemp, she was given adjuvant radiotherapy after operation. All patients were followed up and the median follow-up time was 35 months (21-66 months). Statistical method used was SPSS 8.0 package. Results:There were 14 patients with cervical carcinoma who had expression of MDR. The rate of expression of MDR was 24.6% (14/57). Also there were 29 patients who had expression of GST-?. The rate of expression was 50.8% (29/57). The total response rate of neoadjuvant chemotherapy was 81%. The complete clinical response rate was 19% (11/57) and partial response rate was 61% (35/57). All patients were treated by operation following chemotherapy and 13 patients were given adjuvant radiotherapy after operation. The 5-year survival rate in stage Ib was 100%, stage IIa 90% and stage IIb 78.5%. The results showed the expression of MDR was related to response of neoadjuvant chemotherapy and 5-year survival. It is 93%(40/43) in group of MDR(-) and 43%(6/14) in group of MDR(+)( P =0.001). But it was not related to FIGO, histopathologic, parametrial involvement, and pelvic lymph nodes metastasis. The expression with GST-? only related to response of chemotherapy. The response rate in the group with expression of GST-? is 69% and it is 93% in the group with GST-?(-)( P =0.02).Conclusions:The response rate of neoadjuvant chemotherapy in group of MDR(-) and GST-?(-) was better than in the group with expression of MDR and GST-?. The measure of MDR and GST-? is helpful to predict the response of neoadjuvant chemotherapy in cervical cancer and MDR may related to prognosis of cervical cancer.

Purpose:To explore the clinical and pathological characters and immunophenotype of 2 cases nasal type extranodal NK/T cell lymphoma primarily derived from adrenal gland.Methods:The clinical and pathological features of the 2 cases were analyzed and the immunostaining for UCHL-1,CD43,CD3,CD56,TIA-1 and LMP1 was performed using EnVision TM . IgH and TCR? gene rearrangement was analyzed by using PCR techniques.Results:Both patients were male and aged 50 and 51. Occupying masses in their right adrenal glands was detected. The two tumors showed similar morphological features, composing of small to middle sized and multi formed cells and growing invasive. Inflammatory background,necrosis and vessel involvement were seen. Positive surface staining of UCHL-1,CD43,CD56 and cytoplasma staining of CD3 was demonstrated. TIA-1 and LMP1 expression was also detected. No clonal rearrangement in both IgH and TCR? genes was detected.Conclusions:Nasal type extranodal NK/T cell lymphoma can occur primarily in adrenal gland. It should be distinguished from other small cell malignant tumor of this site.

Objective To discuss the mechanism of injury,treatment decisions,complications and surgical results of the floating hip injuries (FHI).Methods Thirty-three patients with FHI were retrospectively analyzed in our hospital from June 2001to June 2011.There were 25 males and 8 females,with an average age of 34.6 years (range,4-73 years).The mechanism of injury was motor vehicle collision for 20 patients,fall down from a height for 11,crushed injury for 1,and sports-related injury for 1.According to Liebergall classification for the floating hip injuries,there were 7 cases for type Ⅰ (21.2％),9 for type Ⅱ (27.2％)and 17 for type Ⅲ (51.6％).All patients had associated injuries,the average injury severity score (ISS) was 28.9.Thirty-two of the femoral fractures underwent surgical stabilization of their femoral fractures.Surgical stabilization methods included ORIF or intramedullary nailing (29 cases),external fixation (1 case),total hip arthroplasty (2 cases).Acetabular fractures were treated with open reduction and internal fixation (ORIF) in 16 cases.Thirteen patients suffered pelvic fractures underwent surgical stabilization for at least one component of ring disruption.Results Twenty-eight cases (84.8％) were followed up for 2.3 to 10.1 years (average,3.5 years).Thirteen patients were followed up in the 16 patients who suffered type Ⅰ or Ⅱ fractures.According to Majeed functional evaluation,the results were excellent in 8 cases,good in 3 and fair in 2,with the excellent and good rate being 84.6％.Fifteen patients with type Ⅲ were followed up,according to D'Aubigné and Postel evaluation criterion.The joint functions were excellent in 7 cases,good in 4,fair in 3,and poor in 1,with the excellent and good rate being 73.3％.According to Ma Yuanzhang functional evaluation,the knee functions of the all patients were excellent in 23 cases,good in 3,and fair in 2,with the excellent and good rate being 92.9％.Complications seen in these patients included post-traumatic osteoarthritis of the hip developed in one hips,2 patients developed heterotopic ossification (HO),one case of avascular necrosis of the femoral head,and two femoral nonunions.The most severe complication was traumatic sciatic nerve palsy,which was found in 5 patients.Conclusion Ipsilateral injuries to the femur and the pelvis or acetabulum (floating hip) are severe injuries usually caused by high-energy trauma.The femur fracture will most commonly be addressed first,and surgeons should be aware of the high incidence of sciatic nerve palsy as well as treatment options and potential complications associated with this devastating combination of injuries.

Objective To investigate the relationship between polymorphism of interleukin-1β(IL-1β)-31,-511C/T and chronic obstructive pulmonary disease.Methods Two hundred and sixty patients with chronic obstructive pulmonary disease (COPD) were selected as our subjects who were hospitalized in General Hospital of Kailuan from January 2009 to June 2012.At same time,the 260 healthy controls were recruited in medical examine center.The data was collected by the physical examination and a unified questionnaire.Enzyme-linked immunosorbent assay (ELISA) was used to measure the level of IL-1β in serum.Polymerize chain reaction-Restriction fragment length polymorphism (PCR-RLFP) was used to detect the genotypes of IL-1β (-31,-511).Multivariate logistic regression was used to analyze the relations between risk factors with susceptibility of COPD.Results The level of serum IL-1β was (3.92 ± 0.42) μg/L in COPD group,higher than that in control group ((2.69 ± 0.11) μg/L,t =12.889,P ＜ 0.001).The frequency of genotype of IL-1β-31 site in COPD group were 20.8％ (54/260) for TT,58.1％ (151/260) for CT and 21.2％ (55/260) for CC respectively.Meanwhile IL-1β-31 genotype rate were 19.2％ (50/260),58.8％ (153/260) and 21.9％ (57/260) respectively in control group and no significant difference was found between two groups (x2 =0.203,P =0.904).The frequency of genotype of IL-1β-511 site were 20.0％ (52/260) for CC,63.1％ (164/260) for CT and 16.9％ (44/260) for TT in COPD group.The three genotype rate in control group were 21.9％ (57/260),60.8％ (158/260) and 17.3％ (45/260) respectively,and no significant difference was found between two groups (x2 =0.352,P =0.838).Moreover there was also no significant difference in terms of gender(P ＞ 0.05)Conclusion The concentration of IL-1β in serum in COPD group was higher than in control group.The polymorphism of-31 and-511 were proved non association with COPD.

Purpose:To study the histogenesis,the differential diagnosis and the prognosis of melanotic schwannoma.Methods:The age of the patients was 4,17,28 years old, respectively.Three cases of melanotic schwannoma were examined using histologic (HE), immunohistochemical (ABC method) and electron microscopic techniques. Results: The diameter of tumor was 2,4,8, respectively. Histological examination showed pigmented spindle cells arranged in interlacing fascicles and occasional nuclear palisading. The pigmented polygonal cells were loosely arranged in sheets. After bleaching, the nuclei were oval and some showed slight pleomoprohism with prominent nucleoli, and nuclear mitoses were found. There was local invasion in two cases. Immunohistochemical stains for S 100 protein, HMB45, Vim, Leu 7, NSE were positive. Ultrastructrual examinations showed a lot of melanosomes in all stages of development and seldom basal lamina. Conclusions:①Melanotic schwannoma usually occurs in young adults. Most of the tumors are benign or only potentially malignant. Malignant MS is rare,and require follow up. ②MS originate from neural crest with a proliferation of the bipotential cell.

Objective To analyze Candida species causing vulvovaginal candidiasis in Qingdao and surrounding areas.Methods Vaginal discharge specimens were collected from 362 patients with suspected vulvovaginal candidiasis in the Affiliated Hospital of Qingdao University Medical College from May 2011 to November 2011,and subjected to routine fungal culture.The Candida isolates were identified by using Sabouraud dextrose agar,CHROMagar medium,germ tube test with serum,and API 20C AUX Clinical Yeast System.Results Totally,313 (86.46％) Candida strains were isolated from the specimens of 362 patients.Of these Candida strains,275 were identified as Candida albicans,38 as non-albicans Candida species,including 13 Candida glabrata strains,8 Candida parapsilosis strains,7 Candida tropicalis strains,5 Candida krusei strains,1 Candida lusitaniae strain,1 Candida dubliniensis strain,1 Rhodotorula mucilaginosa strain,1 Pichia ohmeri strain and 1 Trichosporon mucoides strain.Conclusions As far as vulvovaginal candidiasis is concerned,Candida albicans is still the most prevalent pathogen,and Candida glabrata appears to be the predominant species in pathogenic non-albicans Candida species.

Objective To analyze the feasibility and practicality of the navigational template for antegrade lag screw fixation of the fractures in the posterior column of acetabulum.Methods Spiral CT scan data of 40 normal adult pelvis was collected.3D CT scans of pelvics were performed.Virtual 3D pelvic models were reconstructed with software Mimics 10.01.Virtual cylindrical implants were placed along the longitudinal axis of the acetabular posterior column via the ischial tuberosity among the ipsilateral hemipelvis and some anatomical parameters were measured.To adjust cylinder position to determine the best projection point,the shortest distance of the point to the linea terminalis and the anterior border of the auricular surface,the angle between the cylindrical and the coronal plane (α),and the angle between the quadrilateral district and iliac fossa plane (β) were measured respectively.The 3D models were imported into software UG 6.0.The models of navigational templates were designed according to the anatomic features of the acetabulums and the measured parameters.16 cases of dry left side of pelvis specimens were collected.Simulate acetabular posterior column screw fixation from different screw holes and verify the accuracy of navigation template assisted in the nail.Results The navigational templates was designed and manufactured successfully which was more consistent with the anatomical features of the quadrilateral plane.Placement of lag screw from the first hole:6.3％ achieved accurate positioning,75％ well positioning,and 18.7％ loose.From the second hole:81.3％ had accurate positioning,18.7％ well positioning.From the third hole:37.5％ had accurate positioning,62.5％ loose.Conclusion The navigational template designed according to the anatomic features of acetabulum and the measured parameters can accurately assist lag screw placement.