Objective To study the correlations between personality characteristics and life quality of rectal cancer patients.Methods A total of 91 rectal cancer patients were enrolled in the study.Preoperative questionnaire-based survey was conducted for investigation of personality characteristics and life quality using Eysenck personality questionnaire-revised,short scale for Chinese (EPQ-RSC) and European organization for research and treatment,quality of life questionnaire-core 30 (EORTC QLQ-C30).The correlations between personality characteristics and life quality were analyzed.Results The scores on the personality characteristics of rectal patients were significantly higher than norms (all P＜0.05).In addition,the scores on constipation,diarrhea and economic difficulties were higher than the norms (all P＜0.05).In contrast,the patients with introverted personality were subject to irritability and depression.The score on function was more than 70％.And the total score on health was 61％.The scores on symptoms and dimensions were all less than 40％.The psychoticism was negatively related with role function,extraversion and emotional function were both positively related with general health but negative with fatigue,loss of appetite and diarrhea.The nervosity was negatively related with general health,emotional function and social function,but positively related with fatigue,pains,insomnia,anorexia,financial difficulties.The lie was positively related with role function (all P＜0.05).Conclusion This study suggests that targeted psychological intervention will be beneficial for improving the life quality of rectal cancer patients through preoperative analysis of personality characteristics.

Objective To investigate the mechanism,injury characteristics,and early interventions of bilateral femoral shaft fracture.Methods Twenty-five cases of bilateral femoral shaft fracture treated between December 2009 and June 2012 were enrolled in the study.Eighteen patients were males and 7 were females with mean age of 31.2 years (range,17-40 years).Nineteen cases were injured due to traffic accidents and 6 due to the hit by heavy objects.There were 47 sides with closed fracture and 3 sides with open fracture.Intramedullary nailing was performed at 32 sides and plate fixation was used at 18 sides.ISS,blood routine,some blood biochemical items,blood or plasma use,and hospitalization days were measured.Results ISS was (14.6 ± 5.2) points.Preoperative readiness time and hospital stay were (10.1 ± 3.7) days and (28.9 ± 8.4) days respectively.After hospitalization,measured values were (3.0 ± 0.4) × l012/L for red blood cells,(86.0 ± 13.5) g/L for hemogIobin,(47.0 ± 10.6) g/L for total protein,(31.4 ± 6.5) g/L for albumin,(124.1 ± 95.1) U/L for aspartate aminotransferase,(114.2 ± 107.1) U/L for alanine aminotransferase,and (1 848.7 ± 1 044.8) U/L for creatine kinase with significant differences from the reference ranges (P ＜ 0.05 or 0.01).Amount of blood transfused for 23 cases was (1 444.4 t 726.5) ml and plasma transfused for 19 cases was (305.6 ± 98.3) ml before operation.Volume of intra-and post-operative blood transfusion was (2 005.7 ± 1 153.1) ml.Conclusions Stabilization of vital signs predominates the early treatment of bilateral femoral shaft fracture.After the condition is stable,intramedulary nailing or plating can be performed concurrently.

Gastroesophageal reflux disease( GERD)is caused by dysfunction of lower esophageal sphincter( LES), which allows the contents of stomach and duodenum to reflux into esophagus. Currently,medical and surgical therapies are the main treatment for GERD,but patients need to take life-long acid suppression and the surgical treatment has the risks of potential side effects. Endolumenal therapy as a minimally invasive approach to GERD can safely and effectively relieve the symptoms of GERD,especially Stretta radiofrequency procedure,transoral noninvasive fundoplication( TIF ) and LinX reflux management system. This article reviewed the advances in study on endolumenal therapy for GERD.

Regarding the fact that there is a huge gap between higher education of assistive technology in China and the social need, the authors discussed about the necessity of developing China's higher education of assistive technology, by discussing about the fact that assistive technology becoming an independent subject, society's need for leaders and designers in the field of assistive technology, the need to develop assistive technology theories and knowledge, the important meaning of developing higher education of special education to support the independent living of persons with disability and opening potential market, the successful example of America's assistive technology and higher education of it being in the leading place.

Objective To screen and validate differentially expressed microRNAs in human degenerative nucleus pulposus cells (NPCs) and to predict their target genes,and to investigate the role of JNK pathway in degenerative intervertebral disc disease.Methods Eight degenerative nucleus pulposus tissues were harvested from 8 patients (6 males and 2 females) with lumbar degenerative disease,and three normal nucleus pulposus tissues were harvested from 3 patients (3 males) with lumbar fracture,intraoperatively.Differentially expressed microRNAs were screened by microRNA microarray analysis and validated by real-time qPCR.Target genes of highly expressed microRNAs were predicted by analyzing information from data bases:MicroCosm v5,TargetScan 5.1 and microRNA.org.Signal pathways associated with the target genes were analyzed,and qPCR was used to validate the screening results.Results Twenty differentially expressed microRNAs were identified.The microRNA-513a-5p and microRNA-494 were highly expressed in degenerative nucleus pulposus tissue,which was corresponding to the verification results,and the ratio was 2.222 2 and 2.948 5,respectively.Target genes of microRNA-513a-5p and microRNA-494 were MKK4 and JunD,respectively.MKK4 and JunD were both involved in JNK signaling pathway and located in upstream and downstream of this pathway,respectively.Conclusion In human degenerative nucleus pulposus cells,microRNA-513a-5p and microRNA-494 are highly expressed microRNAs,whose target genes are MKK4 and JunD,respectively.Both MKK4 and JunD are involved in JNK signaling pathway.These results indicate that JNK pathway may play important role in the pathogenesis of degenerative intervertebral disc disease.

Objective:To solve the problems in intensity-modulated radiation therapy (IMRT) planning, such as large labor cost and high dependence on the experience of physicists and great inconsistency in the quality of plan, and to discuss an unsupervised automatic treatment planning procedure of IMRT.Methods:The eclipse scripting application programming interface (ESAPI) within the Eclipse treatment planning system (TPS) 15.6 and optimization parameters tree search algorithm (OPTSA) were used to emulate and realize the whole planning process. Interacted with the TPS through ESAPI, relevant dosimetric parameters were input and output. The OPTSA evaluated the plan qualities based on dosimetric parameters of the targets and organs at risk (OARs) and iteratively adjusted the optimization objective parameters to achieve a progressively improving IMRT plan. In order to verify the effectiveness of the automatic planning, twenty historical rectum cancer cases were selected from the clinical database, and the dose distribution and specific dosimetric parameters were compared between the plans generated by the OPTSA and the manual plans under the same constraints.Results:All the auto plans have met clinical requirements. Furthermore, 90% and 10% of the auto plans were deemed as clinically improved and equally compared with the manual plans, respectively. The average CI for the PTV was 0.88 and 0.80 for the auto and manual plans respectively. Compared with the manual plans, the mean doses of all the OARs in the auto plans were reduced by 11% in average. The average elapsed time of automatic planning and manual planning was (28.15±3.61) and (36.7±4.6) min, respectively.Conclusions:The plans created by the proposed algorithm have been shown to be at least as good as the manual plans. In addition, this method can shorten the labor time in plan designing while ensuring the plan quality and consistency of the plan.

Objective To investigate the effect of tension stress on the changes of mRNA expression of interleukin-17B (IL-17) and inducible nitric oxide synthase (iNOS) in rat discs.Methods Sixty-four female Sprague-Dawley rats were randomly divided into 4 groups:sham (S),tail-suspended (TS),tail-suspended with needle puncture (TSNP) and single needle puncture (SNP) groups.Tail-suspension device made rats of TS group and TSNP group hindlimb suspended,which exerted tension force on the coccygeal vertebrae disc;and aseptic needle puncture on the tail disc between the seventh and eighth coccygeal vertebrae (Co7/Co8)of TSNP,SNP group induced the inflammatory environment.The discs were harvested 4 weeks later.Measurements included gross observation,histological observation and real-time quantitative reverse transcription-polymerase chain reaction (RT-qPCR) analysis.Results Gross and histological examination found that varying degrees of degenerative changes in the annulus and nucleus in TS,SNP and TSNP groups,but not in the S group.RT-qPCR results showed that the mRNA of IL-17B and iNOS were significantly higher in the TSNP and SNP groups than that in the S group.The values of 2-△△Q were 12.99 and 8.12 in TSNP groups,and the 2-△△Q values of SNP group demonstrated 22.49 and 14.98 compared to S groups.Sole application of tension stress brought by the tail-suspension slightly enhanced the expression of IL-17B and iNOS,the values of 2-△△Q were 1.22 and 1.49,which didn't reach a statistically significant change.Compared with SNP group,the mRNA expression of IL-17B and iNOS in TSNP groups were shapely decreased,the values of 2-△△Q were-9.50 and -6.86 respectively.Conclusion Relatively low magnitude tension stress might play a key role in anti-inflammatory process and the relief of discogenic pain.

Objective To observe the expression of Interleukin-17 (IL-17) in different types of herniated disc tissue,and to investigate Modic changes in corresponding injured segment and relationship between Modic changes and herniated types.Methods Fifty patients with single level disc herniation were enrolled in this study.According to clinical diagnosis criteria,imaging (CT and MR) examination results,and the view in surgery process the patients were divided into 2 groups:herniation group(35 patients),degeneration group(15 patients).According to MRI,patients were divided into 2 groups:Modic changes group(14 patients),non-Modic changes group (36 patients).The disc tissues were observed by HE staining and immunohistochemical staining,and the expression of IL-17 was detected by using real-time quantitative PCR.Results Pathological examination revealed that there were more granulation tissue and neovascularization in herniation group than in degeneration group.Immunohistochemical result showed that there were more IL-17-positive cells in herniation group than in degeneration group; there were more IL-17-postive cells in Modic changes group than in non-Modic changes group.The expression of IL-17 mRNA in herniation group was 6.7701 times more than that in degeneration group.The expression of IL-17mRNA in Modic changes group was 4.2836 times more than that in non-Modic changes group. Conclusion The herniated disc nucleus pulposus can cause more prominent local inflammation.Autoimmune responses maybe play an important role in pathophysiological mechanisms of Modic changes.

Objective To investigate the possibility of establishing a Modic changes (MCs) animal model,and explore the pathogenesis of MCs through imaging,histology and molecular biology experiments.Methods Fifty four New Zealand rabbits (weight 2.5-3.0 kg,half male and half female) were randomly divided into 3 groups:sham group (n=l8),muscle embedment group (n=18) and NP embedment group (n=18).In NP embedment group,the L4-5 and L5-6 discs were exposed by the lumbar anterolateral surgical approach.A 16 G needle was used to puncture the L5-6 vertebral body close to the epiphyseal plate.The depth of the drilling was approximately 3 mm.A 5 ml syringe was then put into the L4-5 intervertebral disc and extracted the NP,which was injected into the drilled hole of the vertebral body.The muscle embedment group and sham group shared the same operating procedures and drilling methods with the NP embedment group.Some pieces of muscle acquired from paraspinal muscles were put into the drilled hole in muscle embedment group,while nothing was put into the drilled hole in sham group.After that,the bleeding stopping,tissue washing and suture were done in all groups.12 weeks,16 weeks and 20 weeks after the surgery,MRI scan was applied to each group.All the specimens were tested by HE staining,real-time fluorescence quantitative PCR and Western blot to observe the expression of inflammatory cytokines.Results After modeling for 12 weeks,16 weeks and 20 weeks,MRI showed low signal changes on T1WI and mixed high signal in the context of low signal changes on T2WI in the NP embedment group.However,the muscle embedment and sham group showed no significant signal changes.Gross observation and HE staining confirmed that there was abnormal tissue proliferation in the imbed site of the NP embedment group.RT-PCR and Western blot showed high expression of IL-4,IL-17 and IFN-γin the NP embedment group,which were positively correlated with the length of the postoperative period.There was no significant difference between the muscle embedment group and sham group.Conclusion The puncturing of vertebral body close to endplate and putting nucleus into it can create an animal model of MCs.Autoimmune factors may play an important role in MCs.

Objective To compare transdermal penetration of triamcinolone acetonide liposparticles (TAA-LPPs) and TAA-Ethosomes in vitro. Methods The TAA-LPPs and TAA-Ethosomes were produced and the morphology was observed by transmission electron microscope,particle size was detected by laser particle analyzer. The percutaneous permeability in vitro was tested by modified Franz diffusion pools. The amount of penetrated triamcinolone acetonide and the retention in the skin were de-termined by HPLC. Results The shape of TAA-LPPs and TAA-Ethosomes was almost spherical with mean diameter of (99. 9±1. 3) and (105±1. 4) nm, respectively. The cumulative transdermal penetration of TAA-LPPs, TAA-Ethosomess and TAA suspension was (53. 59±4. 40),(87. 03±4. 87),and (30. 54±8. 61) μg·(cm2 ) -1 , respectively . The drug retention in the skin after 32 h was (1. 02±0. 13), (0. 62±0. 08), (0. 55±0. 17) μg·(cm2 ) -1 , respectively. Conclusion TAA-LPPs is better for transdermal administration of triamcinolone acetonide by reducing systemic absorption of the drug.