ObjectiveTo evaluate the instant response and side effects of hypofractionated high-dose 3-dimensional conformal radiotherapy (3-DCRT) for esophageal carcinoma treatment.MethodsSixty-nine patients with esophageal carcinoma were treated by 3-DCRT and 91 patients with routine radiotherapy.The prescribed dose was from 3000 to 4500 cGy in 3-DCRT group, with fractionated dose 300 cGy, one dose a day and five doses a week.The reference dose curve was the 90％ of the isodose curve.For the routine radiotherapy group,the prescribed dose was from 4000 to 6600 cGy,fractionated by 180 ～200 cGy a time,once a day and 5 times a week.Results At the end of the radiotherapy, 3-DCRT produced CR 42.0％ (29/69) , PR 49.3％ (34/69) and instant response rate 91.3％, while routine radiotherapy produced CR 35.2％ (32/91), PR 59.3％ (54/91) and instant response rate 94.5％, respectively.The difference was not significant between the two groups(P ＞ 0.05) .The survival rates one year after the treatment were 82.6.0％ (57/69)and 84.6％ (77/91) ,respectively.The acute radiation esophagitis rate was 66.7％ (46/69) in 3-DCRT group and was 64.8％ (59/91) in routine radiotherapy grouprespectively.ConclusionHypofractionated high-dose 3-DCRT is feasible for treatment of esophageal carcinoma.

Objective]Summary of Professor Liu Hongqi in treating the spleen kidney two deficiency, deficiency of Qi and blood type, kidney deficiency and blood type of threatened abortion experience. [Method]Reading a lot of literatures, combined with the clinical common disease type, respectively, from the basic pathogenesis, basic treatment, and motion etc. summarize professor of treatment of this disease, and 1 case was attached.[Result]Professor Liu Hongqi believes that the clinical syndromes of this disease were spleen and kidney two empty, deficiency of Qi and blood and blood deficiency of the kidney, the incidence of kidney and spleen, closely related. Professor summed up the kidney and spleen during the long clinical course, Yiqi Yangxue Bushen tocolysis and clearing heat, cooling blood to stop bleeding method, were used on prescription Ma ginseng tocolysis particles, the Liangdi Antai Granuales added and subtracting tocolysis, collaborative western medicine, with emotion, achieved a significant effect. Case accurate, fully reflected the clinical experience of Professor Liu Hongqi in the treatment of threatened abortion. [Conclusion]Professor Liu Hongqi's superb skills, rigorous prescription testimonies, have unique insights for the treatment of this disease, the successful experience is worthy of clinical promotion.

Objective To study the value of expression of carcinoma-associated antigens in early diagnosis and prediction of prognosis of gallbladder carcinoma. Methods The expression of PCNA, CEA, CA50 and E-cad were detected by immunohistochemistry in 50 cases of gallbladder carcinoma, 10 gallbladder adenomas and 10 cholecystitis. Results The positive rates of CEA, CA50 and PCNA LI in gallbladder carcinomas were significantly higher than that of gallbladder adenomas and cholecystitis(P

Objective To investigate the clinical presentation, morphological features, immunohistochemical staining of the gastrointestinal stromal tumor (GIST), and its histogenesis as well. Methods The morphologic characteristics of GISTs were studied in 58 cases using light microscopy. The expression of c-kit(CD117), CD34 and vimentin were detected in all of the cases with EnVision staining. Results Among 58 cases of GISTs, 41 were spindle cell type, 5 epithelioid cell type and 12 mixture type, equivalent to 86.6 %(58 of 67) of all of the mesenchymal tumors of gastrointestinal tract admitted in the same period. The epithelioid cell type tumors were mainly composed of the epitheloid cells, predominantly short spindle, oval or round in pattern, with an overall eosinophilic cytoplasm by hematoxylin-eosin stain. Focal cytoplasmic vacuolization was often seen. Sometimes signet-ring like cells and cells with a clear cytoplasm were seen in the epithelioid stromal tumor. The tumor cells arranged in interlacing fascicles forming whorls or sometimes cell clusters. All of the 58 stromal tumors were strongly positive for vimentin (100 %), 55 out of 58 tumors positive for CD117 (94.8 %) and 46 out of 58 positive for CD34(79.3 %). Some cases also expressed SMA, actin, S-100 and MBP. Conclusions GISTs were the most common mesenchymal tumor seen in the gastrointestinal tract. Under light microscope, the morphology of stromal tumors sometimes looks like a leiomyoma or Schwannoma. The application of immunohistochemical markers (particularly CD117 and CD34) is considered necessary for the differential diagnosis. GISTs may originate from the pluripotential precursor cells like the interstitial cells of Cajal.

In this paper,the method about hydrolysis of fish oil with lipases for concentrating DHA(docosahexenoic acid) in glycerides was studied.Six lipases were screened with comparing the activities of hydrolysis of fish oil.Candida lipalytica Lipase is resistant to generating DHA in fish oil.The Effects of the quantity of lipases,the emulgent,hydrolysis time,temperature in the process,the ratio of oil to water were studied.The optimum conditions for the hydrolysis of fish oil are 12 hours of hydrolysis under 45℃,with 300 u?g -1 .The emulgent was and the ratio of oil to water was 0.4 mL?g -1 .Under these conditions,the content of DHA in glyceride were concentrated from 18.7% to 34.0%.But the EPA content remained close to that of fish oil.The DHA glyceride containing triglyceride,diglyceride and monoglyceride was identified by IR spectrum combining with separation of HPLC.

Objective To explore the differences of the proliferation ability and the antineoplastic activity of CIK cells against origenal hepatocellullar cancer cells between healthy adults and tumor patients in vitro. Methods Peripheral blood mononuclear cells (PBMC) from healthy donors and tumor patients were incubated to induce CIK cells in the presence of interferon gamroa(IFN-γ) ,IL-2 and anti-CD3 monoclonal antibody (mAb). The changes in the proliferation activity and phenotypes of the CIK cells were identified by flow cytometric analysis. Single cell suspension was prepared bom the fresh hepatocellular carcinoma tissue by using mechanical trituration method. MTT assays were used to determine the cytotoxicity of CIK cells against origenal hepatocellullar cancer cells. Results The CIK cells from both healthy donors and tumor patients were significantly increased with the extension of time. The expression rate of CD3+/CD56+ cells from healthy donors rose from 1.053% ±0.22% on 1st day ,25.36% ±2.19% on the 7th day to 55.12% ±1.99% on the 14th day ,which was significantly higher than that of tumor patients ( P ＜ 0.05). MTT assays showed that the cytotoxicity of CIK cells from both enhanced obviously with the addition of Effect/Target rate and extension of time(P ＜0.05). After the origenal hepatocellullar cancer cells were treated by CIK cells 24 hours, the cytotoxicity of CIK cells from healthy donors at the effector:target ratio of 10 ∶ 1,20 ∶1 and 40 ∶1 was significantly higher than that of tumor patients(P＜0.05) ,respectively. After treated 48 hours, compared with tumor patients, the cytotoxicity of healthy donors? CIK at the three effector:target ratio was alsosignificantly higher(P ＜0.05), respectively. Conclusion CIK cells from both have amplification ability and cytotoxic activity in vitro,and the proliferation ability and killing activity of healthy adults CIK is stronger than that of tumor patients,which provides an experimental basis for CIK to clinical application as an adoptive immunotherapy.

Objective To detect double immuno-phenotype of acute leukemia by the application of flow cytometry (FCM). Methods Four-color FCM was used to analyse 23 cases of acute leukemia of double immune phenotype. Results Among 23 cases, cCD3 was expressed in 10 cases (43.4 %), cCD79a in 16 cases (69.6 %), cMPO in 20 cases (87.0 %), TdT in 14 cases (60.9 %), CD34 in 19 cases (82.6 %) and CD117 in 20 cases (87.0 %). 13 cases (56.5 %) expressed both myeloid and B lymphocyte antigens, in which cCD79a and cMPO were positively expressed, 7 cases (30.4 %) were found to express both myeloid and T lymphocyte antigens of cCD3 and cMPO 3 cases (13.04 %) were positive for both cCD3 and cCD79a. Conclusion cCD3,cCD79a, and cMPO were lineage specific antigen markers, which could be used for diagnosis and differential double phenotype leukemias. FCM is a useful and reliable method for diagnosis of acute leukemia, and guidance of treatment and prognosis of leukemia in clinical.

Objective To evaluate the expressions of TBX2 and MDM2 protein in urothelial carcinoma of bladder.Methods The expressions of TBX2 and MDM2 protein were examined by immunohistochemistry EnvisionTM Plus method in 90 cases of urothelial carcinoma of bladder and 20 cases of normal bladder mucosa tissue.Results The positive rate of TBX2 and MDM2 protein was 0 in normal bladder mucosa tissues.The positive rate of TBX2 in urothelial carcinoma of bladder was 65.6％ (59/90).With the increased of TBX2 expression degree,the carcinoma tissue was worse cell differentiation,later clinical stage,more prone to recurrence (P ＜ 0.01).The positive rate of MDM2 in urothelial carcinoma of bladder was 31.1％(28/90).With the decreased of carcinoma tissue differentiation degree,the positive rate of MDM2 was increased (P ＜ 0.01).The positive rate of MDM2 in recurrence patients was 57.5％ (23/40),in non-recurrence patients was 10.0％ (5/50),there was statistical difference (P ＜ 0.01).The positive rate of MDM2 in pTNM stage Ta-T1 was 0,in pTNM stage T2-T3 was 73.7％ (28/38),there was statistical difference (P ＜0.01).There was positive correlation between the expression of TBX2 and MDM2 in carcinoma tissue (r =0.487,P ＜ 0.05).Conclusions The over expression of TBX2 and MDM2 protein may closely associated with aggressive biological behavior and recurrence in urothelial carcinoma of bladder.Combined analysis of TBX2 and MDM2 may provide a theoretical basis for prognostic information and treatment of patients with urothelial carcinoma of bladder.

Objective To evaluate the clinical effect of one-stage posterior-anterior approach surgery for patients with cervical fracture and dislocation combined with locked facet.Methods A retrospective review was conducted on 21 cases of cervical dislocation and fracture combined with locked facet treated by one-stage posterior-anterior approach surgery between April 2011 and December 2012.There were 16 males and 5 females at age ranging from 23 to 61 years (mean,38.3 years).Posterior unlocking reduction by partial facetectomy and lateral mass screw fixation was performed,followed by anterior decompression,internal fixation and interbody fusion by titanium meshes.Outpatient or telephone follow-up was performed to evaluate bone fusion and recovery of neurologic function.Results Mean operation time was 140 minutes (130-210 minutes) and mean blood loss was 340 ml (range,150-600 ml).All incisions got primary healing with no operation-correlated complications.Five patients complicated with severe lung infection after surgery and one died of respiratory failure two week later.Titanium meshes achieved bone fusion within 3-9 months (mean,6 months) after surgery.At a mean follow-up of 17 months (range,12-30 months),there was no implant breakage and mesh displacement or collapse.According to the American Spinal Injury Association (ASIA) score,preoperative neurologic deficit restored by mean one grade at final follow-up.Conclusion One-stage posterior-anterior approach surgery is an ideal choice for cervical fracture and dislocation combined with locked facet,for it provides unlocking reduction,canal decompression,and rigid reconstruction of the anterior-posterior column.

BACKGROUND:Traditional external fixation of tibial fractures exhibits obvious stress shielding that delays fracture healing. Polyetheretherketone (PEEK) material has a similar elastic modulus to the bone, and it wil be possible to address this clinical problem.
OBJECTIVE:To compare the outcome of PEEK external fixator versus traditionaly external fixator in the treatment of tibial fractures.
METHODS:Clinical data of 86 patients with tibial fractures, including 64 males and 22 females, aged 24-78 years (mean age of 56 years), were retrospectively reviewed. There were 30 cases of closed fractures and 56 cases of open fractures; 32 cases received flat-patient surgery and 54 cases underwent emergency surgery. Al the patients were divided into two groups according to different fixation methods: PEEK group and traditional external fixator group. After operation, patients were checked regularly and at the last folow-up, functional recovery was evaluated according to Johner-Wruhs criteria.
RESULTS AND CONCLUSION:Al the patients were folowed up for 5-20 months. The mean fixator removal time of the PEEK group was 8.7 weeks and the mean duration of fracture healing was 4.2 months. The mean fixator removal time of the traditional external fixator group was 10.6 weeks and the mean duration of fracture healing was 6.1 months. At the last folow-up, in the PEEK group, 26 cases were assessed as excelent, 13 as good, 4 as poor; in the traditional external fixator group, 19 cases were assessed as excelent, 13 as good, 11 as poor. These findings indicate that PEEK external fixator for different types of tibial fractures can maintain the fracture stability, promote fracture healing and contribute to the functional recovery of the affected limbs.