[Objective] To investigate the changes of urinary deoxypyridinoline(DPD)in patients with spinal tuberculosis(STB)and evaluate their clinical significance.[Method] All subjects were divided into three groups:group 1,STB patients;group 2,Pulmonary TB patients:group 3,healthy controls.Their DPD was detected by ACS:180 automated chemiluminescence system.The values for urinary DPD were adjusted for urinary creatinine to overcome confounding variables such as body mass index and urine dilution.The results were analyzed.[Result]The mean urinary concentrations of DPD in spinal tuberculosis,pulmonary tuberculosis and healthy controls were 1(4.9?9.8)?mol/mol Cr.,(6.4?2.6)?mol/mol Cr,and(6.3? 2.0)?mol/mol Cr.,respectively(P value=0.001,0.000).Patients with spinal tuberculosis had a higher urinary excretion of DPD than those without spinal tuberculosis.There was no difference in groups of pulmonary tuberculosis and healthy controls(P=0.751).DPD had a better receiver operating characteristic(ROC)curve and the area under the ROC curve was 0.83.For DPD,the sensitivity(87%)and specificity(73%)were seen at the cut-off level of 8.4 ?mol/mol creatinine.[Conclusion]Change of bone matabolic activities can be found in patients with STB.Bone resorption can increase sharply by DPD.The determination of urinary DPD may provide an important reference value for the assessment of STB from Pulmonary TB.

Animal model is very important for anti-EV71 (enterovirus 71) drug and vaccine development. 1-day-old suckling EV71 mouse model is the main in vivo model used in China. 1-day-old suckling EV71 mouse is too small to perform antiviral experiment. And the route of administration and dosage capacity are also restricted. A strong virulence EV71 virus strain was selected after screening from five EV71 strains with 1-day-old suckling mice. A mouse-adapted EV71 strain with increased virulence in 12-day-old suckling mice, EV71-M5, was generated after five serial passages of the parental EV71 strain in mice. Virus titers of EV71 infected mice heart, liver, spleen, lung, kidney, small intestine, brain and muscle tissue were determined by cytopathic effect (CPE) assay. The virus used in this model is the first isolated EV71 strain in China. And 2-week-old suckling mice were used in this model. This is a supplement for the EV71 animal model in China. Establishment of this EV71 model will provide an attractive platform for anti-EV71 vaccine and drug development.

Purpose:To study the expressions and its clinical significances of bcl-2 and integrin?3 in human Non-small cell lung cancer(NSCLC)after radical surgical resection. Methods:Immunohistochemical (IHC) staining of bcl-2 and integrin?3 was performed on paraffin-embedded sections from 269 NSCLC patients who underwent surgery and were followed up for 1.1 to 122.2(median, 48.4) months postoperatively. Differences in survival rates and clinical characteristics were evaluated by SPSS10.0 statistical software packet. Results:The prevalence of bcl-2, integrin?3 and both these proteins expression in NSCLCs was 56.9%, 47.2% and 34.9%, respectively. Bcl-2 expression was seen more frequently in female NSCLCs and smaller tumors. Integrin?3 was seen more frequently in squamous carcinomas. Cox multivariate analysis showed that bcl-2 expression in stage Ⅱ NSCLC was an independent risk factor (5 years survival rate: 39.3% vs 52.1% P=0.04), and both bcl-2 and integrin ?3 positive in stage Ⅲa NSCLC are independent good factors(5 years survival rate: 34.5% vs 23.8% P=0.04). Conclusions:Bcl-2 and integrin ?3 are indicators of NSCLC biological behavior. Combined analysis of expression of these proteins in tumors may indicate the prognosis of NSCLC.

Lipoma of hemangiopericytomas (LHPC) is one ofrare soft-tissue tumors that grow slowly and occur in deep soft tissues. The classical histological morphology of LHPC is circularor spindle undifferentiated tumor cells that grow surrounding the thin-walled branching blood vessels. The clinical and pathological features of one patient with LHPC are retrospective analyzed to strengthen the understanding of LHPC.

Objective To investigate the expression of interleukin 6 (IL-6) in tumor microenvironment of natural killer/T cell lymphoma (NKTCL) and its relationship with clinical characteristics and prognosis. Methods From January 2005 to December 2012, 93 patients with NKTCL and available paraffin-embedded tissue in Sun Yat-sen University Cancer Center were included. The expression or IL-6 in tumor microenvironment was investigated by immunohistochemistry. The positive IL-6 expression was identified as≥10 cells/HP. The enumeration data and measurement data were compared by t test andχ2 test, respectively. Overall survival (OS) and progression free survival (PFS) were estimated with the Kaplan-Meier method. Survival rates were compared by the Log-rank test. Statistical significance was determined at a level of P<0.05. Results The median count of IL-6 positive cell number was 21 cells/HPF (range, 0-150 cells/HP), and 61.29%(57/93) patients were positive. Positive IL-6 expression was mostly associated with fever and high Korean prognostic index (KPI) score (both P< 0.05). The serum c-reactive protein (CRP) level was (29.28 ± 2.62) mg/L in IL-6 positive patients and (11.14±2.77) mg/L in IL-6 negative patients (t= -2.276, P= 0.025). Patients with negative IL-6 expression had better survival, with 52.7 % of 5-year PFS rate,and 60.0 % of 5-year OS rate; the 5-year PFS and OS rates in those with IL-6 positive were 23.6 % and 27.1 %, respectively (both P= 0.001). Conclusion The high expression of IL-6 in patients with NKTCL might be associated with adverse clinical feature and poor survival.

Objective To investigate clinical efficacy of transforaminal approach debridement with fusion,thoracolumbar single segment of Brucella spondylitis pedicle screw fixation (TLIF surgery).Methods We analyzed retrospectively the clinical data of 28 patients with Brucella spondylitis treated in our department between January 2009 and January 2014 with TLIF surgery (Group A) and internal fixation with a simple posterior anterior interbody disease debridement,autogenous bone graft (Group B).The two groups were compared in operation time,blood loss,postoperative ambulation time,hospitalization days,erythrocyte sedimentation rate (ESR),Creactive protein (CRP),American Spinal Injury Association (ASIA) classification,visual analogue scale (VAS),Oswestry Disability Index (ODI),Cobb angle of vertebral bone graft healing,and complications.Results All the patients were followed up for an average of 20.2 months (18 to 27 months).They were all cured.Compared with those in Group B,patients in Group A had shorter operation time (164.60±59.19)min,significantly reduced blood loss (346.00±108.90)mL and complications (1 case);significantly shorter postoperative ambulation time (3.36±1.11 days),hospitalization days (17.36 ± 4.19) days and duration (13.16 ± 3.94) months (P ＜ 0.05).The two groups did not significantly differ in VAS scores,ODI,ESR CRP,or Cobb angle (P＞0.05).Conclusion On the basis of norms of anti-drug treatment for brucellosis,TLIF surgery on Brucella spondylitis has the advantages including less trauma,shorter operation time,easier operation,less bleeding,earlier postoperative ambulation,and lower complication rate.

Objective To investigate the clinical value of different double-J tube indwelling time in the treatment of ureteral stone-street complications after flexible ureteroscope lithotripsy. Methods Clinical data of 64 kidney calculi patients with ureteral stone-street complications after flexible ureteroscope holmium laser lithotripsy were retrospectively analyzed. The patients were divided into observation group (extubating the double-J tube 2 weeks after the surgery) and control group (retaining the double-J tube) with 32 cases in each group. The calculi clearance results and complication were compared between 2 groups. Results The success rate of stone removal in observation group was significantly higher than that in control group: 100.0% (32/32) vs. 65.6%(21/32), the calculi elimination time was significantly shorter than that in control group:(26.4 ± 6.6) d vs. (45.3 ± 10.9) d, the treatment cost was significantly lower than that in control group:(768.4 ± 152.6) yuan vs. (1 262.3 ± 156.8) yuan, the incidences of irritation symptoms of bladder and macroscopic hematuria were significantly lower than those in control group: 15.6% (5/32) vs. 90.6%(29/32) and 15.6% (5/32) vs. 100.0% (32/32), and there were statistical differences (P<0.05). There was no statistical difference in incidence of renal colic between 2 groups (P>0.05). Conclusions Removing the double-J tube 2 weeks after flexible ureteroscope lithotripsy results in higher stone clearance rate and less complications compared with retaining the double-J tube. It can reduce the occurrence of irritation symptoms of bladder, macroscopic hematuria and treatment cost.

[Objective]This study was aimed to evaluate treatment outcomes and toxicity of continuous-infusion EPOCH regimen for NK/T-cell lymphoma(NK/TCL).[Methods]From June 2003 to June 2008,34 patients including 30 nasal NK/TCL (88.2%)and 4 nasal type NK/TCL(11.8%)received doxorubicin,vincfistine,etoposide over 96 hours infusion with bolus eyelophosphamide and oral predinisone(EPOCH)chemotherapy as first-line treatment.Median cycles of EPOCH administered were 2.5(1-6 cycles).Additional involved field radiation therapy(IFRT)was administered to patients with localized nasal focus after chemotherapy.[Results]Among 34 patients,33 were eligible for response evaluation.The response rate(RR)was 60.6% (20/33)with complete remission(CR)rate of 45.5%(15/33).The RR of patients with nasal NK/TCL was 66.7%(20/30)with CR rate of 50%(15/30).Only one of the 3 nasal type NK/TCL patients achieved stable disease(SD),the other 2 had progressive disease(PD)during chemotherapy.After a median follow-up of 22(2-68)months,the estimated 3-year overall survival rate(OS)was 52.2%.For patients with nasal NK/TCL,the estimated median survival time was not reached,the 3-year OS was 59.4%.For patients with nasal type NK/TCL,the estimated median survival time was only 7 months.The CR rate was 75.0% for localized nasal NK/TCL who received initial EPOCH chemotherapy followed IFRT with the 3-year OS of 75.0%.Major adverse effect was myelosuppression.The incidence of grade Ⅲ～Ⅳ neutropenia was 30.9%.No treatment-related mortality occurred.[Conclusions]EPOCH regiment was effective and well tolerant for nasal NK/TCL.Combined EPOCH chemotherapy followed by IFRT produced promising outcome for patients with localized disease.However,patients with nasal type NK/TCL responded poorly and more efficacious treatment strategies are urgently needed.

[Objective]To evaluate the clinical efficacy and side effects of DHAOx±R regimen in the patients with relapsed and refractory non-Hodgkin's lymphoma(NHL).[Methods]Twenty patients with relapsed or refractory NHL were enrolled into this study in Cancer Center of Sun Yat-sen University.These patients were treated with DHAOx±R regimen(Dexamethasone 20 mg/day intravenous(Ⅳ)on day 1 to day 4,cytarabine 2 000 mg/m~2 3 h Ⅳ,every 12 hours on day 2;oxaliplatin 130 mg/m~2 2 h Ⅳ on day 1;with or without rituximab 375 ms/m~2 on day 0).Six patients were followed by high dose chemotherapy with autologous peripheral blood stem cell transplantation.Response to treatment wag assessed according to The International Working Group Criteria,including CR,PR,SD and PD.Side effects were graded according to WHO criteria,including 0-Ⅳ grades.[Results]Twenty patients received 47 cycles chemotherapy,13 patients(65%)received DHAOx chemotherapy and 7(35%)received DHAOx+R.The response rate(RR)for the whole group was 55%(11/20)with comeplete response(CR)rate 35%(7/20).The response can also be obtained in the patients who were already treated by platinum-based regimen before.The major toxicity Wag myelosuppression.The incidence of grade Ⅲ～Ⅳ neutropenia Wag 35%(16/47),and febrile neutropenia was 17%(8/47).The incidence of grade Ⅲ～Ⅳ thrombocytopenia was 20%(9/47).Eight cycles(17%)occurred mild neumtoxicity.With median follow-up of 12 months,1 and 2-year overall survival rate were 70.6%.[Conclusion]DHAOx was an effective regimen for recurrent and relapsed NHL patients with mild side effects and further investigation is needed.

OBJECTIVE: To evaluate the clinical outcomes of single-balloon kyphoplasty in the treatment of thoracic osteoporotic compression fractures via extrapedicular approach METHODS: From July 2004 to May 2008, 38 cases (52 vertebra) of thoracic osteoporotic fractures were treated by balloon kyphoplasty via unilateral extrapedicular approach, including 12 males and 26 females with an average age of 60.3 years (range 55-72 years). There were 34 cases of primary osteoporosis, and 4 had administrated hormone due to other diseases for over 6 months. Symptomatic levels ranged from T_4 to T_(12) confirmed by physical examination, MRI and X-ray. The pain relief, restoration of vertebral height and kyphosis correction were compared before and after operation by using visual analogue scale (VAS) and radiograph, respectively. In addition, bone cement leakage location and complications were recorded. RESULTS: Operation were successfully performed in 38 cases with an average injection of bone cement volume of (3.2+ 1.4) mL (2.25-4.60 mL in unilateral infusion). The mean time of surgery was 25-55 minutes, and that of follow-up was 9.5 months (6-24 months). Back pain of 36 cases was improved, and the VAS 3 days postoperatively and the final follow-up was significantly reduced (P < 0.05). The vertebral anterior margin and median height following surgery were significantly improved detected by X-ray (P < 0.05), and average median height restoration was (50.90+34.60)%, but no significant change was found in posterior height (P > 0.05). No lateral wedging or changes in the coronal alignment was found. Three cases (5 vertebra) had cement leakage: the bone cement of 1 case leaked to posterior margin through the puncture channel, and 2 cases leaked to lateral vertebra through vertebral venous system without any adverse event. The patients could move the second day after surgery, discharged from the hospital at days 3-4, and restored to normal life at 1 month postoperatively. No blood vessel or spinal cord puncture injury or pulmonary embolism, or blood vessel embolism was found. CONCLUSION: Unilateral extrapedicular kyphoplasty is safe and effective in treating thoracic osteoporotic fractures. It rapidly releases backache, restores the body height of fractured thoracic vertebrae and improves quality of life of the patients.