AIM:To investigate whether gonadotropin-releasing hormone analogue(GnRHa)affect the sensitivity of breast cancer cells to 5-FU and epirubicin in vitro.METHODS:Two breast cancer cell lines(MCF-7 and MDA-MB-231)were treated with different concentrations of GnRH analogue,triptorelin acetate,or with a GnRHa+5-FU or GnRHa+epirubicin.The cellular growth profiles were determined by CCK-8.The mRNA levels of GnRH receptor,PCNA and MDR1 were measured by RT-PCR.RESULTS:Both cell lines had positive GnRH receptor mRNA expression detected by RT-PCR.GnRHa did not suppress cell growth after GnRHa exposure.IC50 of 5-FU and epirubicin was not changed in the presence of GnRHa.Suppression of cell growth by the exposure to 5-FU and epirubicin was not changed in the presence of GnRHa.GnRHa treatment up-regulated PCNA mRNA expression in MDA-MB-231 cells but not in MCF-7 cells.The expression of MDR1 mRNA was down-regulated by GnRHa in MCF-7 cell lines.No MDR1 mRNA expression in MDA-MB-231 cells was observed.CONCLUSION:The present data suggest that GnRH analogue(triptorelin acetate)does not affect the sensitivity of breast cancer cell lines MCF-7 and MDA-MB-231 to 5-FU and epirubicin.GnRHa may decrease the drug resistance by down-regulating MDR1 mRNA expression.

Objective To discuss the clinical value of simultaneous morcellation in situ in laparoscopic myomectomy (LM). Methods One hundred and eighty-nine women who underwent LM for symptomatic myomas were randomly divided into in situ group(94 cases) and standard group(95 cases). The operation time, hemorrhage perioperative,exhaust time postoperative, length of hospital stay were compared.Results The operation was successful in two groups. The operation time and hemorrhage perioperative in situ group were significantly less than those in standard group [ (98.20 ± 40.70) min vs. ( 129.20 ± 68.50)min (P＜0.05) and (113.40± 38.30) ml vs. (168.90±61.70) ml (P＜0.01)]. There was no statistical difference in exhaust time postoperative, length of hospital stay between two groups (P ＞0.05). One case occurred eechymoma in two groups respectively. Conclusion The application of simultaneous morcellation in situ in LM is safe and feasible.

An expression of ras oncogene protein (p21) was assessed with immunohistochemistry in normal, dysplasia, benign hyperplasia, chronic prostatitis and prostatic carcinomatous tissues. The results showed that the positivity rate of p21 was higher in prostatic carcinoma than that in other prostatic lesions and was markedly correlated to histologic tumor grade. The expression level of p21 was more intentive in prostatic dysplasia surrounding carcinoma than that in simple prostatic dysplasia. It is suggested that overexpression of ras oncogene p21 product may play an important role in progressing from dysplasia to cancer and may be used as a new tumor marker for assessment of biological behavior of prostatic carcinoma.

Objective To study the changes of heart rate variability (HRV) and the effects of treatment with nasal continuous positive airway pressure (nCPAP) in elderly patients with sleep apnea/ hypopnea syndrome (SAHS). Methods SAHS patients and controls were examined by polysomnography(PSG) and dynamic cardiograph(DCG). Mean RR interval(Mean RRi), standard deviation of RR interval (SDRRi), low frequency(LF), high frequency(HF) and their ratio(LF/HF) were calculated. Results When compared with controls(847.9?113.8)ms vs (45.7?16.2) ms, there was significantly decrease in the Mean RRi and SDRRi in moderate, severe elderly patients and non-elderly SAHS patients(764.3?131.0)ms, (709.4?101.8)ms, (759.5?80.0)ms and (37.5?12.2)ms, (31.5?9.6)ms, (41.4?10.6)ms. There was statistical differences in LF, HF, and LF/HF between elderly and non-elderly severe SAHS (P

Objective To evaluate the clinical outcome of Vancouver B2 and B3 periprosthetic femoral fractures treated with uncemented modular stems.Methods From September 2011 to April 2014,Twenty-four patients (12 males and 12 females,with the average age 63 years,ranging from 28 to 85 years) with periprosthetic femoral fractures (16 Vancouver B2 and 8 Vancouver B3) were treated with uncemented modular stems.Revision arthroplasty was conducted in all cases by using modular stems with 12 cerclage wirings and 11 great trochanter claw plates.One patient was treated with revision arthroplasty without additional fixations.Extended trochanter osteotomy was performed on 11 patients.Cortical strut allograft was used in 9 patients with severe femoral bone loss.Intraoperative complications including vascular or nerve injury and systemic complications including cardiovascular events,cerebrovascular events and deep vein thrombosis were recorded.Severe postoperative complications such as nonunion,re-fracture,periprosthetic joint infection and dislocation were recorded.The clinical outcome was evaluated by Harris score,Visual Analogue Score and Parker Mobility Score.The radiological outcome was taken to observe the healing status,stem subsidence and stability of the prosthesis.Results Two patients were lost to follow-up.Twenty-two patients were clinically followed-up.Radiological data was recorded in 16 patients.The average follow-up was 33 months (range,12-68 months).All fractures healed within 6 months.The average Harris score improved from 4.0± 1.1 preoperatively to 78.8± 16.2 postoperatively (t=-20.195,P=0.000).The mean Parker Mobility Score improved from 0.5±0.9 preoperatively to 7.0± 1.8 postoperatively (t=-14.835,P=0.000).The mean Visual Analogue Score decreased from 6.4± 1.2 preoperatively to 2.0± 1.5 postoperatively (t=10.879,P=0.000).No nonunion,infection or dislocation was found.One patient underwent re-operation because of re-fracture.Eight mm of prosthesis subsidence was observed in one case at 3 months postoperatively,and reached stable fixation at 6 months postoperatively without further subsidence.Conclusion Uncemented modular stems can achieve distal fixation and implant stability of periprosthetic femoral fractures while retaining optimal biomechanics of the hip.Assisted by femoral reconstruction techniques such as extended trochanter osteotomy,cortical strut allograft,great trochanter claw plates and cerclage wiring,revision arthroplasty using uncemented modular stems could realize optimal outcomes in treating Vancouver B2 and B3 periprosthetic femoral fractures.

Objective To explore the clinical character,diagnosis and treatment principals of pyeloureteritis glandularis and cystitis glandularis.Methods The clinical manifestation,character of imageology and endoscopy images of the case for one year follow-up were analyzed and the relevant literatures were reviewed.Results During one year follow-up,there was no clinical symptoms and any progress on imageology.The patient is still in close following-up.Conclusions According to literatures,cystitis glandularis is not common in clinical,and it should be paid more attention by clinicians.There were a few reports about the ureteritis glandularis.Pelvis,ureter and bladder have the same epithelial tissue,pyelitis glandularis is very rare,up to now there is no efficient treatment ways.

Objective To compare superiorities of liver malignant tumors underwent regular and irregular hepatectomies through approaching perioperative factors.Methods 1019 consecutive hepatectomies of liver malignant tumor from 1986 to 2009 at Air Force General Hospital and General Hospital of Chinese PLA were investigated retrospectively according to their medical documentation.Results Multivariate analysis showed that liver malignant tumors on which regular hepatectomy and irregular hepatectomy were performed,there was no significant difference in the blood loss,complications,mortality related to operation,hospital stay,and so on.But the operating time of regular hepatectomy was obvious more than that of irregular hepatectomy (P＜ 0.001,OR=1.004).Conclusions Although for liver malignant tumor,regular hepatectomy seems to be superior to irregular hepatectomy based on oncological theory,in clinical practice,there were no significant difference between the perioperative risk of regular hepatectomy and that of irregular hepatectomy.

ObjectiveTo study the role of hepatic arteriography before precise hepatectomy in primary liver cancer,Methods207 patients with primary liver cancers resected from 2005 to 2010 at Air Force General Hospital of Chinese PLA were studied retrospectively.There were 81 patients who received routine hepatectomy and 126 who received precise hepatectomy with hepatic arteriography before surgery.ResultsAnalysis showed that precise hepatectomy was superior to routine hepatectomy for lesions less than 1.0 cm (81.48％ vs 18.18％),with less operative time (168.20±35.81 min vs 221.75±30.33 min),volume of resection,blood loss (168.20±35.81 min vs 221.75±30.33 min),transfusion rate (256.13±185.24 ml vs 436.97±590.12 ml),and hospital stay (20.53± 12.41 d vs 25.72±17.27 d),(all P＜0.05).Hepatic arteriography did not affect liver function before precise hepatectomy.ConclusionsHepatic arteriography was significantly better in showing blood vessels of the primary liver cancer,and in detecting liver metastases or satellite lesions of less than 1.0 cm before surgery.

Objective To study the white matter fiber integrity in patients with posttraumatic stress disorder by using MR diffusion tensor imaging (DTI).Methods Twelve patients with posttraumatic stress disorder and twelve healthy volunteers were examined with MR T1WI、T2WI and DTI.Fractional anisotropy maps、directionally encoded color maps were created with the software of DTV-II.Fractional anisotropy (FA) were measured in the genu (anterior),body and splenium (posterior) of corpus callosum,horizontal part and posterior part of the bilateral cingulste fibers.Results In normal volunteers group,FA measurements in white matter regions were normal and reconstructed FA images and directionally encoded color(DEC) maps could display main white fibers in normal controls.The FA value of the splenium (posterior) of corpus callosum and horizontal part of the bilateral cingulate fibers was significant lower in PTSD patients than in normal controls (P<0.05).Conclusions The fiber bundle of the limbic system in patients with PTSD may have structural abnornalities.

[Objective]To comprehensively compare the feasibility of three different treatment strategies consisting of low-dose chemotherapy(LDC),surgery and surgery with adjuvant low-dose chemotherapy(SLDC)for children with solitary bone lesions of eosinophilic granuloma(SBL-EG).[Methods]We retrospectively reviewed the records of 149 pediatric patients with SBL-EG at our institutions from 2002 to 2014. Our study included 86 patients who received LDC ,33 patients who received surgery and 30 patients who received SLDC. The duration of hospital stay ,time to symptom relief,recovery time,cost,complications and relapse-free sur-vival(RFS)of each strategy were analyzed.[Results]Hospital stay,time to symptom relief,recovery time and cost in the LDC group were significantly shorter or less than those in the surgery or SLDC group (P < 0.05). No statistically significant differences were observed in the above-mentioned factors between the surgery and SLDC groups (P > 0.05). Chemotherapy-related adverse events in the LDC and SLDC groups included nausea(8.62%),aminotransferase elevation(7.76%),slight hair loss(4.31%), immunity decline (21.55%),growth retardation (10.34%) and moon face (7.76%). LDC and SLDC treatment resulted in a significantly longer RFS (147 months and 126 months ,respectively) than surgery alone (114 months)(P = 0.005 and 0.019 , respectively). However ,there was no statistically significant difference in RFS between the LDC and SLDC groups (P = 0.732).[Conclusions]Compared with surgery or SLDC,LDC appears to promote more rapid recovery,less invasion,increase safety and eco-nomic treatment strategy for pediatric patients with SBL-EG.