Metabonomics is a novel subject which develops after genomics,transcriptomics and proteomics.With its unique advantage,metabonomics has been used widely in screening diagnostic biomarker in a variety of tumors.At present,some diagnostic biomarkers are found in tissue,serum samples,urine samples and stool specimens of gastrointestinal cancer patients by metabonomics,which maybe helpful for the early diagnosis and individualized treatment of gastrointestinal cancer.

Phospholipase A2 (PLA2) is consisted of a large group of enzymes,which can hydrolyze Sn-2 ester bond of the phospholipids and have different structures and functions.According to the latest related researches,many subtypes of PLA2 express abnormally in a various of tumors and have a close relationship with cancer proliferation,apoptosis,invasion,metastasis and prognosis.Different subtypes have different effects on neoplasms.PLA2 can supply a new insight on cancer therapy.

Intra-arterial chemotherapy (IAC) is an interventional treatment for retinoblastoma (RB) which infuses the chemotherapeutic agents through ophthalmic artery using microcatheters to control the tumor.Compared with systemic chemotherapy,IAC could significantly increase the globe salvage of advanced and recurrent RB without serious adverse event.Due to the absence of systemic absorption after IAC,no longer effectively kill tumor cell,which have potential danger to leads to inadequate elimination extraocular tumor cells.The most common systemic complications following IAC is myelosuppression;local ocular toxicities include eyelid edema,delacrimation,blepharoptosis,vitreous hemorrhage,retinal artery obstruction.During the last 10 years of clinical application,IAC become one of first-line treatment for intraocular RB.However,at present,there is still a lack of randomized controlled multicenter studies and long-term follow up of IAC.

A simple analytical method by means of on-line solid phase extraction followed liquid chromatography-tandem mass spectrometry ( SPE-LC-MS/MS) was developed for the simultaneous quantitation of 4 endocrine disruptors ( triclosan, triclocarban, bisphenol A and nonylphenol) in dairy products. Infant formula and milk samples were dissolved in acetic acid buffer and hydrolyzed by β-glucuronidase/arylsulfatase. Acetonitrile was used as the extract. Then, the mixture was freeze-centrifuged for 10 min and the supernatant was diluted with water, and analyzed via on-line SPE-LC-MS/MS. The sample extracts were concentrated by an Xbridge C8 cartridge and separated on a BEH C18 column with a gradient mobile phase of methanol and water; then analyzed by triple quadrupole mass spectrometry. Mass acquisition was conducted under negative electrospray ionization mode. Quantification was performed by isotopic internal standard calibration. Acceptable linearity (R2>0. 99) was achieved over the range of 0. 005-5. 0 μg/L, with limits of quantification of 0. 03-1. 0μg/kg. Average recoveries of four target compounds (spiked at three concentration levels) ranged from 80. 2%-106. 7%,with relative standard deviation less than 15%. Due to its rapidity, simplicity, and high sensitivity, the method is suitable for the analysis of endocrine disruptors in dairy products. It has been applied in the analysis of raw milk and milk products collected in Beijing. As a result, nonylphenol was found with a high detectable frequency.

Objective To evaluate the clinical results of uncemented fully porous-coated long femoral stems in treating Vancouver type B2 periprosthetic femoral fracture following hip arthroplasty.Methods A retrospective analysis was made on 12 patients (12 hips) with Vancouver type B2 periprosthetic femoral fracture treated using the uncemented fully porous-coated long femoral stem prosthesis combined with cerclage fixation with steal-wire or titanium cable devices from February 2006 to January 2013.There were 5 males and 7 females,aged average 69.8 years (range,62 to 79 years).The status of primary arthroplasty was uncemented bipolar hemiarthroplasty in 2 patients and total hip arthroplasty in 10 patients (2 cement and 8 cementless femoral stems).At the final follow-up,Harris hip score for clinical evaluation,Beals and Tower's criteria for radiological evaluation,and complications were recorded.Results There were no intra-operative complications such as femoral perforation and femoral fracture.All patients were followed up for mean 38 months (range,24-72 months).At the last followup,mean Harris hip score was 87.2 points (range,50 to 100 points).All fractures healed at average 16 weeks (range,12-28 weeks).All the 12 hips showed prosthesis stability despite there was one femoral stem subsidence of 3 mm.One patient slipped and sustained another periprosthetic fracture (Vancouver type B1) at postoperative 4 months and was treated successfully with locking plate and cables.According to the Beals and Tower's criteria,there were 10 excellent,1 good and 1 poor results.Final follow-up revealed no complications of deep vein thrombosis,dislocation and prosthesis loosening.Conclusion Uncemented fully porous-coated long femoral stems provide good primary stability that promotes fracture healing and offers a reasonable treatment of Vancouver B2 femoral periprosthetic fracture.

Charcot-Marie-Tooth (CMT) disease is the most common monogenic peripheral neuropathy with high clinical and genetic heterogeneity.With the development of orphan drugs for different genotypes of CMT,the use of standardized scales is essential for assessing the therapeutic effect of drugs and the natural course of the disease.At present,there are different types of outcome measures for assessing the severity of dysfunction,therapeutic effect,quality of life and prognosis of CMT patients.In this article the CMT-related assessment scales which are commonly used in clinical practice are reviewed.

Background:Esophagogastric variceal bleeding is a severe and commonly seen complication of portal hypertension in patients with liver cirrhosis. Prevention of rebleeding remains an important issue in the management of patients suffered from the disease. Aims:To evaluate the efficacy and safety of percutaneous transhepatic variceal embolization(PTVE) combined with partial splenic embolization(PSE)for treatment of esophagogastric variceal bleeding in patients with liver cirrhosis. Methods:Ten liver cirrhosis patients with esophagogastric variceal bleeding were prospectively selected and treated by PTVE combined with PSE. The blood flow of portal system was measured by Doppler ultrasonography pre- and post-operatively;meanwhile peripheral blood cells were counted. A 1-2-year follow-up was carried out and the rebleeding and procedure-related complications were recorded. Results:The postoperative inner diameter of main portal vein,as well as the blood flow velocity of main portal vein and splenic vein were significantly reduced as compared with those before operation(P < 0. 05). Three months after operation,the peripheral white blood cell and platelet were still significantly higher than those before operation(P < 0. 05). During 1-year follow-up,rebleeding appeared in 2 patients,one of them was found having main portal vein thrombosis developed,and was treated by endoscopic esophageal variceal ligation because the gastric varices was not as evident as ever. The rebleeding rate and incidence of portal system thrombosis after the PTVE-PSE procedure was 20. 0% and 10. 0%,respectively. Conclusions:PTVE combined with PSE seemed efficient for alleviating portal hypertension,and might be recommended as a safe and effective interventional therapy for liver cirrhosis patients with esophagogastric variceal bleeding.

Objective To evaluate the therapeutic effects and safety of transcatheter arterial sclerosing embolization (TASE) combined with oral Propranolol in infantile huge hemangiomas.Methods A total of 76 infants with huge hemangioma were treated by TASE.All patients received oral Propranolol based on their weight.The follow-up and efficacy evaluation were performed from the last treatment.And the complications were analyzed.Results Seventy-six cases underwent 95 case-times of TASE totally.The success rate of puncture technique was 100％ (95/95).All patients were divided into 5 levels (0-Ⅳ levels) based on the curative effect of the follow-up,including 6 cases (6/76,7.90％) of level Ⅰ,19 cases (19/76,25.00％) of level Ⅱ,23 cases (23/76,30.26％) of level l,and 28 cases (28/76,36.84％) of level Ⅳ.The total effective rate was 100％ (76/76).There was no serious complications,and the curative effect was stable during the follow-up.Conclusion TASE combined with oral Propranolol in infantile huge hemangiomas is effective with less invasiveness and fewer complications.

Objective To analyze the electrophysiological characteristics of Charcot-Marie-Tooth (CMT) disease 1A,1X,2A and myelin protein zero (MPZ)-related CMT in Chinese patients.Methods Baseline electrophysiological data from 36 CMT1A patients,78 CMT1X patients,31 CMT2A patients and 10 MPZ-related CMT patients in the Third Xiangya Hospital and Xiangya Hospital of Central South University during 2004-2018 were analyzed.Electrophysiological recordings were taken from the upper limbs (median nerve,ulnar nerve) and lower limbs (tibial nerve,peroneal nerve).Demyelination in different nerve segments was assessed by measurement of distal motor latency,motor nerve conduction velocity (MNCV),sensory nerve conduction velocity and F-wave latency,and calculation of conduction block,terminal latency index (TLI) and modified F ratio (MFR);Axonal degeneration was assessed by measuring compound motor action potential (CMAP) and sensory nerve action potential.The relationship between the gender,age at onset,duration,Overall Neuropathy Limitation Scale (ONLS) score and indexes of peripheral nerve electrophysiology was statistically analyzed.Results The peripheral nerves of CMT1A patients were characterized by uniform demyelination and axonal degeneration.MNCV ((21.39± 6.72) m/s) and CMAP amplitude (2.40 (3.50) mY) of median nerve of CMT1A patients were decreased.The peripheral nerves of CMT1X patients were also characterized by uniform demyelination and axonal degeneration.MNCV (35.20 (6.77) m/s) and CMAP amplitude (2.60 (3.79) mY) of median nerve of CMT1X patients were decreased.CMT2A patients showed axonal degeneration of the peripheral nerves and CMAP amplitude ((4.75 ±2.38) mV) of median nerve of CMT2A patients was decreased.The electrophysiological data in MPZ-related CMT patients demonstrated variability.The TLI and MFR for the median and ulnar nerves in these four subtypes were normal.MNCV (r=0.423,P=0.025) of median nerve in CMT1A patients was positively correlated with age at onset.MNCV (r=0.782,P=-0.013) of median nerve in MPZ-related CMT patients was positively correlated with age at onset.CMAP amplitude (r=0.652,P＜0.01) of median nerve in CMT2A patients was positively correlated with age at onset.Demyelination and axonal degeneration in male CMT1X patients were relatively more severe than those in female patients,and MNCV (Z=-3.300,P＜0.01) and CMAP amplitude (Z=-3.960,P＜0.01) of median nerve,MNCV (Z=-2.56,P=0.011) and CMAP amplitude (Z=-2.311,P=0.048) of ulnar nerve of male patients were lower than those of female patients.The ONLS score of CMT1A (r=-0.494,P＜0.01),CMT1X (r=-0.596,P＜0.01) and CMT2A patients (r=-0.494,P=0.012) was inversely associated with CMAP amplitude.Conclusions The electrophysiological characteristics of CMT1A,CMT1X,CMT2A and MPZ-related CMT are different.Electrophysiological examinations are the basis of clinical classification and could provide guidance for further genetic testing and diagnosis.CMAP amplitude may serve as an objective index to assess the severity of functional disability in CMT patients.