Objective To explore the efficacy of transpedicular fixation combined with mixed transpedicular structural and cancellous bone granule graft for the treatment of severe compressed or burst thoracolumbar spinal fractures.Methods From January 2001 to January 2008,18 cases of severe compressed or burst thoracolumbar spinal fractures was treated with transpedicular fixation of spondylolisthesis and fracture(SF) or atlas fixation(AF) combined with mixed transpedicular structural and cancellous bone granule graft in the compressed vertebral body.Results In this group,no injuries to the spinal cord or nerves occurred.The mean blood loss was 50-300 ml(average 80 ml).The mean operation time was 100-180 min(mean 120 min),and the mean postoperative hospital stay was 12 to 30 days(14 days on average).Follow-up was available in 18 cases for a mean of 24 months(5-72 months),all the patients achieved satisfying recovery of the height and physiological curve of the vertebral body: 17 of the cases had normal height and physiological curve;in the other patient,the natural curve was partly destroyed;no patient had loosing and disrupted internal fixation.According to preoperative Frankel evaluation,1 case was classified as Frankel A,1 Frankel B;5 Frankel C,3 Frankel D,and 8 Frankel E before the operation;while postoperative classification showed 1 case of Frankel B;1 cases of Frankel C,and 16 cases of Frankel E.Conclusions Transpedicular fixation combined with mixed transpedicular structural and cancellous bone granule graft is safe and effective for the treatment of severe compressed or burst thoracolumbar spinal fractures.

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Objective To investigate the expression of connective tissue growth factor(CTGF),coll agen I and collagen Ⅲ in sacroiliac joint(SIJ)of patients with spondyloarthropathy(SpA).Methods Thirty patients with SpA,including 17 patients with grade Ⅱ saeroiliitis and 13 patients with grade Ⅰ sacroiliitis,were performed on CT guided needie biopsy of SIJ.After sacroiliitis were confirmed by staining with hematoxylin and eosin in sacroiliac joint tissue sample,immunohistochemical assay was performed to determine the expression of CTGF,collagen Ⅰ and collagen Ⅲ in sacroiliac ioint tissue.Univariate Chi-square test was used for data comparison between multiple groups and t-test was used for two group data comparison.Results Contrast to healthy controls,CTGF were found upexpressed on the cytoplasm of inflammatory cells in pannus and bone marrow of sacroiliac tissue samples of patients with SpA,while collagen I and collagen Ⅲ were found up-expressed in bone,cartilage and ligament tissue[(57.9±42.4)/HP vs(2.7±2.5)/HP P<0.05,0.298±0.080 vs 0.044±0.024 and 28.254±41.165 vs 0.105±0.054.P<0.05 respectively].Conclusion CTGF,collagen Ⅰ and collagen Ⅲ are up-expressed in SIJ of SpA patients.CTGF may play an important role in articular cartilage fibrosis and ossification of SpA.

Objective To investigate the expression of transforming growth factor beta (TGF-β) and Smad signaling in ankylosing spondylitis (AS) and to explore their roles in the pathogenesis. Methods Fiftythree patients with AS were included in the study. In these 53 cases, 30 patients were performed computed tomography-guided needle biopsy in sacroiliac joint. Serum TGF-β_1 was determined by enzyme-linked immunosorbent assay (ELISA). Immunohistological studies were performed with the streptavidin-peroxidase conjugated methods to assess the expression of TGF-β_1, p-smad3 and Smad7 in sacroiliac joint tissue sample.One-way ANOVA, two independent samples t test and kolmogoorov-Simimov test were used to do statistical analysis. Results In 53 cases patients with AS, 20 cases were with high level Erythro-cyte sedimentation rate(ESR) and C-reactive protein (CRP), while those of the other 33 cases were normal. Serum average TGF-β_1level [ (15.9±5.6) ng/ml ], in patients with high level ESR/CRP [(5.4±5.8) ng/ml ] was significantly increased as compared to the controls and patients with normal ESR/CRP [(4.1±3.6) ng/ml] (P<0.05). There was no expression of TGF-β_1 could be detected in the pannus and bone marrow in SI joints tissue of 30 cases with AS, while decreased level of smad7 expression was detected. In addition, p-smad3 expression was found in the nuclear. Conclusion TGF-β_1 signaling may play an important role in the inflammatory erosion and cartilage fibrosis of sacrojlitis in AS.

Objective To investigate the possible associations of two polymorphisms (5-HTTLPR and STin2VNTR)of the serotonin transporter gene with alcohol use disorders (AUD).Methods 281 AUD cases (AUDIT score≥ 10) and 277 healthy controls (AUDIT score ≤5) were recruited in this study.All participants were genotyped using the PCR technique.Results The frequency of the L-allele of the 5-HTTLPR was 39.01％,and the 10-allele of STin2VNTR was 8.42％ in this population,the allele frequencies of both polymorphisms were consistent with Asian normal populations.No significant association was observed between 5-HTTLPR and AUD,but the genotypic and allele frequencies of the STin2VNTR were significant different between two groups even after Bonferroni adjustment,the 12 repeat allele of the STin2VNTR was significantly associated with the risk effect for AUD.Haplotype analysis for those two polymorphisms revealed no association between 4 haplotype combinations and AUD.Conclusion There is no relationship between 5-HTTLPR and AUD.The STin2VNTR polymorphism of 5-HTT may play a role in the pathogenesis of AUD.

Objective To understand the cognition ,attitudes and needs of the science and technology achievement trans-formation policies among the medical personnel of 21 tertiary hospitals in Shanghai .Methods Convenient sampling method was used .The self-designed questionnaires were used to survey 420 personals in 21 tertiary hospitals in Shanghai ,and 411 valid questionnaires were responded with a valid rate of 97 .86％ .Results The cognition of science and technology achievement transformation policies of the respondents was low ,and the degree of cognition was related to the professional titles ( P<0 .05) .While the recognition degree of some policies was high ;40 .47％ agreed that enterprises could be the decision-maker during the transformation process ;85 .99％ agreed that it is OK to hire the Technology intermediary service agencies to evalu-ate the achievements value ,confirmed that need such agencies to provide the services of information collection and screening . Conclusions More Policy publicity should be enhanced among the medical personnel ,communications about their needs and suggestions on the science and technology achievement transformation should be carried out to further update related policies , as well as improve the transformation of science and technology achievements in health system .

Immune checkpoint inhibitors have been approved for clinical application in China. However, the increased immune-related adverse event (irAE) needs more attention. This review summarized the incidence, characteristic clinical manifestation and treatment of irAEs associated with programmed cell death protein-1(PD-1) and programmed cell death ligand-1(PD-L1) inhibitors. To have a deep insight into irAE, the potential mechanisms, the different incidences of cancer types, influencing factors and the direction of future research were also discussed here to provide guidance for clinical oncologist to identify and monitor irAE.

Objective To determine the acceptance and willingness to pay for breast cancer screening among populations at high risk of breast cancer in urban China. Methods From 2012 to 2014, a cancer screening program in urban China (CanSPUC) was carried out in 13 provinces. The current survey was conducted among participants who were evaluated as having"high?risk for breast cancer"using a Harvard model (community?based) and then underwent breast mammography or ultrasonography screening procedure (hospital-based). The study mainly focused on their acceptance and willingness to pay under certain self?payment assumption for breast cancer screening. Results A total of 3 049 participants, with a mean age of 52.4±7.0 years, were included. The group aged 45 to 55 years accounted for 50% of the patients, and the median annual income per capita in the recent 5 years was 22 000 (15 000-34 000) Chinese yuan (CNY). Educational level, occupation, and marital status may affect their full acceptance and voluntary payment (P<0.05). Of all the participants, 99% (3 016 participants) could totally or substantially accept the breast cancer screening. When the breast cancer screening was assumed to be conducted every 3 years in the low?cost self?paid context, 85% (2 581 participants) of the participants had the willingness to pay, while only 17% were willing to pay >100 CNY. The remaining 15% of the residents showed no willingness to pay, and the unaffordable expenditure (70%, 438 participants) and unnecessary screening (24%, 112 participants) were the primary considerations. Significant differences in acceptance, willingness to pay, and payment were found among the provinces. Conclusion Almost all high?risk populations for breast cancer could accept breast cancer screening. The willingness to pay was relatively high, but the amount of payment was limited and low.

Objective:To study the prevalence and distribution of adult thyroid diseases in urban and rural areas of Hebei Province.Methods:A multi-stage stratified cluster sampling method was used to select Renqiu City and Licun Town, Luquan City of Hebei Province as the urban and rural survey sites, respectively. Questionnaire survey, physical examination and thyroid B ultrasound examination were conducted on local permanent residents (≥ 5 years of residencies) over 18 years old. The fasting venous blood sample was collected to determine the serum thyroid function indicaters.Results:A total of 2 650 adults were surveyed, including 1 393 urban residents and 1 257 rural residents (1 357 males and 1 293 females). A total of 435 patients with thyroid diseases were diagnosed, the detection rate was 16.42%. There were seven thyroid diseases, including subclinical hypothyroidism (60.92%, 265/435), Hashimoto's thyroiditis (34.02%, 148/435), hypothyroidism (4.83%, 21/435), simple goiter (3.22%, 14/435), hyperthyroidism (2.53%, 11/435), subclinical hyperthyroidism (2.53%, 11/435), and thyroid cancer (1.84%, 8/435). The detection rates of thyroid diseases in urban and rural areas were 21.18% (295/1 393) and 11.14% (140/1 257), respectively. The detection rates of thyroid diseases in males and females were 11.42% (155/1 357) and 21.66% (280/1 293), respectively. The detection rates of thyroid diseases in 18-< 30, 30-< 40, 40-< 50, 50-< 60 and ≥60 years old were 13.46% (91/676), 14.81% (81/547), 15.42% (89/577), 20.94% (85/406) and 20.05% (89/444), respectively. There were statistically significant differences between different areas, gender and age groups (χ 2 = 48.54, 50.53, 14.68, P < 0.05). Conclusions:The detection rate of subclinical hypothyroidism in adults in urban and rural areas of Hebei Province is relatively high, followed by Hashimoto's thyroiditis. Attention should be paid to the screening, evaluation, and intervention of thyroid function among urban female populations.

Objective To gather available evidence related to the economic evaluation on breast cancer screening in mainland China and to provide reference for further research.Methods A systematic review was conducted to identify articles in PubMed and three Chinese databases (CNKI,Wanfang and VIP) during 1995-2015.Data related to descriptive characteristics,rates on participation and detection for population-based studies,methods for model-based studies,types of economic evaluation and results,were extracted.A Consolidated Health Economic Evaluation Reporting Standards (CHEERS) was used to assess the reporting quality of included studies.Results Of the 356 records searched in the databases,13 studies (all published between 2012 and 2015) were included in the current paper involving 11 population-based studies and 3 model-based evaluations (1 study using both methods).Age of the participants who started to be engaged in the screening program ranged from 18 to 45 years old,but terminated at the age of 59 years or older.The screening modalities included single-used clinical breast examination,mammography and ultrasound or combined applications.Study persepectives were described in 7 studies,with 5 from the healthcare providers,and 2 from societal angles.Only 5 studies discounted cost or effectiveness.Out of 11 papers,9 showed the results on cost-effectiveness analysis (CEA) that reporting the cost per breast cancer detection,with median as 145.0 thousand Chinese Yuan (CNY),ranging from 49.7 thousand to 2 293.0 thousand CNY.From 4 papers with results of cost-utility analysis (CUA),the cost per quality adjusted life year (QALY) gained or cost per disability adjusted life year (DALY) averted,were evaluated.The incremental cost-effectiveness ratio (ICER) was from 2.9 thousand to 270.7 thousand CNY (GDP per capita of China was CNY 49.3 thousand in 2015).In 13 studies,the quality of reporting varied,with an average score of 14.5 (range:9.5-21.0).In the domains of study perspective,discounting,ICER and uncertainty,all the scores of equalities were relatively levels.Conclusions Currently,evidence on economic evaluation of breast cancer screening in mainland China remained limited and weakly comparable,particularly model-based studies.Comprehensive analysis from societal perspective and QALY or DALY related cost-utility analysis should be implemented.