Objective To quantify the incidental irradiation dose (ⅡD) to lymph node stations of esophagus when treating patients with T1-4N0 M0 thoracic esophageal squamous cell carcinoma (ESCC) with a dose of 60 Gy/30f.Methods Twenty-nine patients with medically inoperable T1-4N0M0 thoracic ESCC were treated with three-dimensional radiotherapy on involved-field.The conformal CTV was re-created using a 3 cm margin in the proximal and distal direction (following the course of the esophagus) beyond the barium esophagogram,endoscopic examination and CT defined GTV and a 0.5 cm margin in the lateral and anteroposterior directions of the CT defined GTV.The PTV encompassed 1 cm proximal and distal margins,0.5 cm radiaI margin on the basis of CTV.Cervical,mediastinal and abdominal lymph nodes were delineated respectively.Equivalent uniform dose (EUD) and other dosimetric paraneters were calculated for each nodal station.Nodal region whose metastasis rate is greater than 5％ was considered a high risk lymph node subgroups.Results Under a 60 Gy dose prescription,the median Dmean and EUD,V40 and V50 were ≥40 Gy,≥85％ and ≥75％ in most of the high risk nodal regions.For the subgroups whose EUD were less than 40 Gy,most of the ⅡD of these regions was significantly associated with the length and location of esophageal tumor (r =0.892,P =0.000).Conclusions Lymph node stations nearby of ESCC received considerable ⅡD with involved-field irradiation which could control subclinical lesions.But more clinical studies should be needed.

Objective To investigate the clinical effect of pedicle screw fixation in the treatment of fracture and dislocation of atlantoaxial spine via posterior approach .Methods 19 patients with fracture and dislocation of atlantoaxial spine in this hospital from June 2011 to December 2013 were selected and treated with open reduction and pedicle screw fixation via posterior approach . The X‐radiographs were postoperatively re‐examined at regular time for understanding the correction of fracture and dislocation and implant fusion results ,the neurological functions were evaluated according to the Japanese Orthopaedic Association(JOA) scores . Results All cases got bony fusion without the occurrence of internal fixation loosening ,broken screw or broken rod .The JOA score was improved from preoperative (7 .35 ± 2 .39) points to postoperative (13 .21 ± 2 .53) points (P<0 .05) .Conclusion The posteri‐or atlantoaxial pedicle screw fixation and fusion for treating upper cervical spine injury has satisfactory effect .

Objective To summarize the experience in treating coronary artery fistula (CAF) by using Guglielmi detachable coils. Methods During the period from July 2009 to November 2014 at the Affiliated Changhai Hospital of Second Military Medical University, interventional treatment of CAF by using Guglielmi detachable coils was performed in 40 patients. The clinical data were retrospectively analyzed. The feasibility, safety and effectiveness of this technique were evaluated. Results Successful transcatheter closure of CAF with Guglielmi detachable coils was achieved in all 40 patients; the average Guglielmi detachable coils used in each patient was(2.33±1.38) coils. No procedure-related complications occurred. Intra-operative angiography showed that residual shunt completely disappeared in 12 patients (30%) and blood flow was significantly decreased in 28 patients (70%). All the patients were followed up for 1-65 months, neither complications such as recurrent bleeding and ischemia nor stenosis and occlusion of related arteries, or fistula cavity rupture occurred. Conclusion The use of Guglielmi detachable coil in interventional treatment of CAF is safe and effective, although its long-term effect needs to be further verified.

Objective To evaluate the clinical value of CTPA combined with V/Q imaging to guide the end point of anticoagulant therapy in reducing the recurrence rate of pulmonary embolism. Methods A total of 159 cases of pulmonary embolism diagnosed by CTPA were randomly divided into experimental group(n=80)and control group(n = 79). After the regular low molecular weight heparin and warfarin anticoagulation therapy ,the experimental group used the CTPA combined with V/Q imaging to evaluate the pulmonary embolism absorption ,to guide the end point of anticoagulant therapy and to evaluate the recurrence rate of pulmonary embolism at the end of 1-year treatment. But in control group ,only CTPA was used to guide the treatment and then the recurrence rate in 2 groups was compared. Results The anticoagulant treatment course of experimental group was(5.90 ± 1.80) months,which was significantly longer than that of control group(3.57 ± 1.09)months(P<0.05). The recurrence rate of experimental group was significantly lower than that of control group(7.5%vs. 22.8%)after 1-year treatment (P<0.05). However,there was no significant difference between 2 groups(8.75%vs 3.80%)in the rate of bleed-ing during anticoagulation therapy (p>0.05).Conclusions CTPA combined with V/Q imaging to guide the end point of anticoagulant therapy for pulmonary embolismhas important clinical value in reducing the recurrence rate of pulmonary embolism.

BACKGROUND:The research and development of scaffold materials is the key to tissue engineering, as the scaffold can provide a stable external environment for cell growth.OBJECTIVE:To summarize the clinical advances in tendon tissue engineering materials.METHODS:We searched CBM, CNKI, CSTJ and PubMed database for relevant articles published from January 2004 to May 2016. The keywords were tissue engineering, tendon injuries, biological scaffold, tendon healing in Chinese and English, respectively.RESULTS AND CONCLUSION:The commonly used tissue engineering tendon materials include natural polymer materials, biological derivatives, synthetic materials and composite materials. Natural polymer materials retain the three-dimensional network structure of the normal tissue, with good biocompatibility but poor mechanical properties and degradation speed. Synthetic polymer materials present with good mechanical properties and biodegradability, but have low hydrophilicity and poor cell adhesion capability. Composite materials as an effective combination of the two above-mentioned materials exhibit a certain potential in clinical practice. Biological derivatives come from organisms, and have a net structure and biomechanical properties most similar to the human body after appropriate treatment. Additionaly, these derivatives also have the normal physiological activity and functions, which are considered as the future development direction of biomedical materials.

Objective:To clarify the relationship between epidermal growth factor receptor (EGFR) mutations and the clinicopathologic features of primary lung adenocarcinomas in Xinjiang.Methods:The mutations of EGFR gene at exons 18 -21 in 59 cases (including 15 cases of Uighur and 44 cases of Han) of lung adenocarcinoma tissues,which were obtained from surgical resection,were detected by amplifica-tion refractory mutation system (ARMS)method.And the relationships among mutations,race and clini-copathologic features were analyzed.Results:The frequencies of EGFR mutations in lung adenocarcinoma were 20% for Uighur,which was lower than that in Han (54.5%),P <0.05.The deletion mutations at exon 19 were seen in 2 of 15 Uighur cases and 9 of 44 Han cases.EGFR mutations were present,inclu-ding exon 21 L858R in one Uighur case and 12 Han cases,exon 18 G719X in two of 44 cases of Han, exon 21 L861Q in one of them.On histological type,the frequencies of EGFR mutation in alveolar pre-dominant adenocarcinoma was 71% (22 /31),which was higher than both that in solid predominant and mucinous carcinoma (6.7%,20% respectively).According to statistic analysis,EGFR mutations were without correlation with the patient’s gender,age,location,gross type,smoking status and lymph node metastasis(P >0.05).EGFR mutation was more frequent in well-differentiated cancer,mainly in acinar carcinoma,while poorly differentiated adenocarcinoma and mucous adenocarcinoma were lower.Conclu-sion:There was a difference of EGFR mutation in primary lung adenocarcinoma between Uighur and Han in Xinjiang,perhaps reflecting ethnic genetic variation,which is worth further analyzing.EGFR mutation was commonly detected in well or middle differentiated adenocarcinoma,mainly in acinar carcinoma.

OBJECTIVETo search for an effective therapy for chronic fatigue syndrome (CFS).

METHODSEighty-five cases of CFS were treated with massage and pressing of Back-shu points, combined with pressing acupoints on the head. The therapeutic effect was observed.

RESULTSAfter treatment of 3 courses, 26 cases were markedly effective, 52 cases were effective, and 7 cases were ineffective, with a total effective rate of 91.8% and a markedly effective rate of 30.6%.

CONCLUSIONPressing acupoints and massage can effectively improve clinical symptoms of the patient with chronic fatigue syndrome.

Acupressure ; methods ; Adult ; Fatigue Syndrome, Chronic ; therapy ; Female ; Humans ; Male ; Middle Aged

The known members of inhibitor of growth (ING) gene family are considered as candidate tumor suppressor genes. ING4, a novel member of ING family, is recently reported to regulate brain tumour angiogenesis through transcriptional repression of NF-?B-responsive genes, induce G2/M arrest by the increased p21 expression in a p53-dependent manner, suppress the loss of contact inhibition and represses activation of the hypoxia inducible factor, which plays an important role in the progression of tumorigenesis. However, seldom studies about ING4 inducing tumor cells apoptosis were reported.The C6 cells (mouse glioma cells) were infected respectively with the blank adenovirus carrying GFP (Ad) and the recombinated Ad-hING4-His, then RT-PCR assay was used to detect the transcriptions of hING4, as well Western-blotting assay was ued to detect the expressions of hING4. The effects of hING4 expression upon C6 cells were observed, and the growth curve was drawed and tumor control rates were calculated. The C6 cells, which were affected by blank Ad and Ad-hING4-His, were respectively observed by LSCM (laser scan confocal microscope) and transmission electron microscope (TEM), detected by flow cytometry; and the genomic DNA of both groups were extracted and electrophoresised in agarose gel to examinate the DNA fragments. The results showed hING4 can significantly inhibit the growth of C6 cells by promoting the cell’s apoptosis, which probably is the first one to prove this property of ING4.The experimental and theoretical foundation for gene therapy for gliomas with ING4 in the future was established.

OBJECTIVETo investigate surgical outcomes of strip nail internal fixation with bone graft in treating tibial plateau fracture.

METHODSFrom May 2012 to May 2014,36 patients with tibial plateau fracture were retrospectively analyzed, including 25 males and 11 females with an average age of 43.5 (ranged from 17 to 65) years old. The time from injury to operation ranged from 3 to 10 days with an average of 5.8 days. All patients were treated with L-shaped and T-shaped strip nail internal fixation with bone graft. It was evaluated by the Knee Functional therapy assessment method of the Special Surgical Hospital of American at final following-up. Varus angle, caster angle and femorotibial angle were recorded and compared at 3 days and 1 year.

RESULTSOperative time was (2.2 ± 0.6) h on average, blood loss was (310.5 ± 36.2) ml on average, hospital stay was (14.8 ± 2.7) days on average. Thirty-six patients were followed up from 12 to 30 months with an average of 18.2 months. Fracture healing time ranged from 4 to 8 months with an average of 6.2 months. The difference is not significant among varus angle, caster angle and femorotibial angle at 3 days and 1 year. According to the knee functional therapy assessment method of the Specialized Surgical Hospital of American, 18 cases got excellent results, 13 good, 4 moderate and 1 poor.

CONCLUSIONStrip nail internal fixation with bone graft for the treatment of tibial plateau fracture could effectively prevent the joint surface from secondary collapse, and achieve anatomic reduction, stable fixation and earlier functional exercise in further to get satisfied clinical effects.

Adolescent ; Adult ; Aged ; Bone Nails ; Bone Transplantation ; Female ; Fracture Fixation, Internal ; methods ; Fracture Healing ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tibial Fractures ; physiopathology ; surgery

OBJECTIVETo explore the correlation of the gene polymorphisms of Toll-like receptor 2 ( TLR2) and TLR4 with the susceptibility and recurrence of condyloma acuminatum (CA).

METHODSUsing Snapshot, we detected the gene polymorphisms of TLR2 597(T/C), 1350(T/C), 15607(A/G), and 2258(G/A) and TLR4 896(A/G) and 1196(C/T) in the peripheral blood of 140 CA patients and 105 HPV-negative controls. We made comparisons between the CA patients and controls as well as between the cases of recurrent CA and those of non-recurrence at 6 months after treatment.

RESULTSThere were 72, 48, and 20 cases of genotype TT, TC, and CC of TLR2 597 (T/C), respectively, in the CA patients, as compared with 71, 31, and 3 cases in the controls. The gene frequency of mutant C was 31. 43% in the patients, significantly higher than 17.62% in the controls (χ2 = 12.04, P < 0.01), and it was 38.68% in the recurrent cases, remarkably higher than 27.01% in the non-recurrent cases (χ2 = 4.16, P < 0.05). There were 74, 49, and 17 cases of genotype TT, TC, and CC of TLR2 1350( T/C), respectively, in the CA patients, as compared with 73, 29, and 3 cases in the controls. The gene frequency of mutant C was 29. 64% in the patients, significantly higher than 16. 67% in the controls (χ2 =11.05, P < 0.01), and it was 36.79% in the recurrent cases, markedly higher than 25. 29% in the non-recurrent cases (χ2 = 4.18, P < 0.05). There were 44, 66, and 30 cases of genotype AA, AG, and GG of TLR2 15607(A/G), respectively, in the CA patients, as compared with 26, 58, and 21 cases in the controls. There was no significant difference in the gene frequencies of mutant G between the two groups (χ2 = 0.33, P > 0.05). No mutant genes of TLR2 2508 (G/A) or TLR4 896(A/G) and 1196(C/ T) were detected in either the CA patients or the controls. Linkage disequilibrium analysis showed a tight linkage between TLR2 597 (T/C) and 1350(T/C) (D' = 1, r2 = 0.93).

CONCLUSIONTLR2 597(T/C) is tightly linked to 1350(T/C), which is correlated with both the susceptibility and the recurrence of condyloma acuminatum.

Aged ; Case-Control Studies ; Condylomata Acuminata ; genetics ; Gene Frequency ; Genetic Linkage ; Genetic Predisposition to Disease ; Genotype ; Humans ; Polymorphism, Genetic ; Recurrence ; Toll-Like Receptor 2 ; genetics ; Toll-Like Receptor 4 ; genetics