BackgroundAdenoid cystic carcinoma is a malignant tumor originating from lacrimal gland epithelium with high recurrence rate and mortality because of its invasiveness. Although surgery, radiotherapy and chemotherapy are used clinically,the curative effect is not enough satisfied. ObjectiveThis study was to provide an experimental basis for clinical application of 125 Ⅰ seeds interstitial brachytherapy. MethodsHuman ACC-2 cell links were transplanted subcutaneously in the back of 30 SPF BALB/C nude mice to establish the ACC model,and 25 of these mice with suitable sizes of tumor were selected and randomly divided into the G1 (0. 4 mCi 125 Ⅰ ), G2 (0. 6 mCi 125 Ⅰ ) ,G3(0. 8mCi 125 Ⅰ ) ,and G4( 1.0mCi 125 Ⅰ ) groups according to the different therapeutic radioactivity treatments,with 5 nude mice for each group,and a 125 Ⅰ seed without radioactivity was used in 5 mice as the control group. The dimensions of the tumors were measured at 2-day intervals and the inhibition rates of tumors were calculated. Nude mice were killed 14 days later by the broken neck method,and the amount of apoptosis and necrosis as well as the maximum effective radius of tumor to 125Ⅰseed were detected under the transmission electron microscope and routine pathological examination. ResultsFourteen day after operation, the dimension of tumors was (3713.19±243.23)mm3 in the G0 group;while in the G1 ,G2 ,G3 and G4 groups,the dimensions of tumors were (3113.35±316.54) mm3,(2635.85±261.21) mm3, (2538.37±312.16) mm3 and(1686.28±231.65) mm3,respectively, showing a significant decrease in comparison with the Go group( P＜0. 05 ). The tumor inhibitory rates in the G1 ,G2,G3 and G4 group were(20. 11±3.09)％, (36. 18±2.54)％ ,(40. 83±4. 17)％ ,and(66. 63±5.34)％ ,with an obvious elevation with the increase in the dose of 125 Ⅰ ( F=120. 240,P=0. 000). Correlative analysis showed that the intensity of radioactivity from 125Ⅰhad a positive correlation with tumor inhibitory rate (r =0. 653,P =0. 008 ). The maximum effective radius were ( 5.2 ±0.5 ) mm, ( 6.4 ±0. 7 ) mm, ( 7.4 ±0.4 ) mm, and ( 8.2 ±0. 5 ) mm in the G1 ,G2, G3 and G4 groups, with the considerable differences among them (F=29. 22, P=0. 000). Radioactivity of 125 Ⅰ exhibited positive correlation with the maximum effective radius ( r =0. 609, P =0. 004). Conclusions125 Ⅰseed implantation brachytherapy can inhibit the growth of the transplanted ACC in BALB/C nude mice by suppressing the proliferation of tumor cells. It is a safe ,feasible and effective method to treat adenoid cystic carcinoma.

Objective To discuss the value of holmium laser lithotripsy combined with choledochoscopy in the treatment of complicated common bile duct stones.Methods Under choledochoscopy,200 ?m fibre holmium laser lithotripsy of common bile duct stones was performed.The settings on the laser were 1.0 J and 10 Hz.The choledochoscope was used to access the common bile duct stones.The stones were fragmented and then extracted with irrigation or by using a basket. Results The stones were successfully removed in all the 17 cases.The duration of operation was 10~50 min(mean,20 min).Out of the 17 cases,there were 8 cases of primary closure of the common bile duct,6 cases of T-tube drainage, and 3 cases of stone removal via drainage passage.No bile duct bleeding or biliary leakage occurred after operation.Follow-up was conducted in 16 cases for 6~15 months(mean,10 months).B-ultrasonography or magnetic resonance cholangiopancreatography found no recurrent or residual stones,or bile duct stricture.Conclusions Holmium laser lithotripsy combined with choledochoscopy in the treatment of complicated common bile duct stones has advantages of minimal invasion,rapid recovery,satisfactory lithotripsy effects,simplicity of performance,and high reliability.

Recombinant human epidermal growth factor (rhEGF, 20 ng/ml) and Genistein (740 μmol/ml) were added to the cells from 12 cases of human pituitary tumors and co-cultured in vitro. The 3H-thymidine uptake of tumor cells was measured by scintillation counter and tyrosine kinases activity was detected by using immunocytochemical method. The results showed that 3H-thymidine uptake and tyrosine kinases activity were increased in 10 out of 12 cases of human pituitary tumor by EGF and both declined by Genistein. It was suggested that EGF had a strong mitogenic effect on majority of pituitary tumors. Genistein could abolish the effects of EGF promoting the proliferation of the tumor cells, inhibit the growth of the tumor and might be useful in pituitary tumor treatment.

Objective:To explore the mechanism of growth factor autocrine stimulation in human pituitary tumors. Method: Immunohistochemical analyses of EGF、TGF-αand EGFR were studied on paraffin-embeded sections of 30 pituitary tumors. Results: Expression of EGFR and its ligand EGF、TGF-αhas a variable stained cells intensity,density and type. EGFR and the ligands expressed in majority of pituitary tumors.Conclusion:The EGF autocrine stimulation exists in pituitary tumors,and tyrosine kinases inhibitors may be useful for pituitary tumors treatment.

Objective To understand the status of comprehensive health function impairment in elderly patients with rheumatoid arthritis, and to explore its influencing factors. Methods A total of 80 elderly patients with rheumatoid arthritis were enrolled in the first Affiliated Hospital of Kunming Medical University from December 2014 to October 2016. The quality of life SF-36 score was used to measure the physical health, mental health, daily activities and social health to assess the overall health status of patients. The factors influencing the comprehensive health function of the patients were analyzed by univariate analysis and multivariate linear regression analysis. Results The univariate and multivariate analysis showed that the low level of education, general occupation, marital misfortune, poor economic condition and self-treatment expense were the risk factors affecting the comprehensive health function in elderly patients with rheumatoid arthritis ( P<0.05). Conclusion Elderly patients with rheumatoid arthritis have problems of the functions of daily life, physical health, mental health and social health. To alleviate the high medical costs, improve the level of medical treatment, improve the people 's health and education level and maintain a good mood are the key to improve the overall health in patients with rheumatoid arthritis.

Objective To investigate the role of autophagy in radiation-induced death process of human esophageal squamous carcinoma Eca-109 cells.Methods Esophageal carcinoma cell line Eca-109 was divided into 6 groups of control,5 mmol/L 3-Methyladenine treatment,10 mmol/L treatment,6 Gy irradiation,irradiation + 5 mmol/L drug,and irradiation + 10 mmol/L drug.Some cells were transferred with GFP-LC3 plasmid and the changes of autophagosome were obserred.After each treatment,the expression of autophagy marker LC3B was measured by Western Blot,cell viability was detected by MTT,morphological characteristics of apoptosis cells were stained with a fluorescein of Hoechst 33342 and the percentage of apoptotic cells and cell cycle distribution were measured by flow cytometry.Clonogenic survival were used to evaluate the cell radiosensitivity.Results Autophagy level was increased after radiation,and the LC3B Ⅱ expression and LC3B Ⅱ/LC3B Ⅰ ratio were significantly decreased by autophagy inhibitor 3-Methyladenine (F =25.64,P ＜ 0.05).The number of autophagosome fluorescent foci were significantly increased in the GFP-LC3 transfected cells after radiation,but reduced by 3-Methyladenine (F =127.36,P ＜ 0.05).Compared with radiation alone group,autophagy inhibition combined with radiation significantly decreased cell viability (F =129.54,P ＜ 0.05) and colony formation,increased apoptosis and the percentage of G2/M-phase cells.Conclusions 3-Methyladenine enhances the radiosensitivity of esophageal squamous carcinoma Eca-109 cells,suggesting that inhibition of autophagy could be used as an adjuvant treatment of radiotherapy in esophageal squamous carcinoma.

Objective To evaluate the effect of immune fluorescence chromatography on glycosylated hemoglobin (HbA1c). Methods The precision of immune fluorescence chromatography was evaluated with samples of 6.0% and 8.0% fixed value. Group of High performance liquid chromatography (HPLC) as control, HbA1c for 200 samples of EDTA-K2 anti-coagulated whole blood were detected by immune fluorescence chromatography to synchronous blinded trial. Results As to the precise of immune fluorescence chromatography in the samples of 6% and 8%, values of coefficient of variation were 5.1% and 5.3%, respectively. The linear regression equation of immune fluorescence chromatography and HPLC was Y=-0.110+1.021X and the correlation coefficient was 0.982. 6.0% and 8.0% as the cut-off value, kappa values were 0.950 (P < 0.001) and 0.922 (P < 0.001), respectively. Conclusion Immune fluorescence chromatography and HPLC is consistent with detection of HbA1c, which can be used for clinical detection of HbA1c.

Objective To explore the value of free anterolateral thigh flaps in the reconstruction of maxillofacial defects after resection.Methods Patients were recruited from January,2008 to March,2016 in the Department of Oral and Maxillofacial Surgery of Nanjing University.All patients sunder when reconstructive surgery employing anterolateral thigh myocutaneous flaps follow-up of 3 months to 84 months after operation.Results Among 422 cases,survived completely with satisfied configuration,the survival rate was 98.6％.Postoerative vessel thrombosis occurred in flaps,21 patients required operative exploration in the perioperative period including 10 flaps with thrombotic events and 11 flaps with venous thrombosis were complete survival after the salvages,and 6 flaps were failure.The mean follow-up was 36.5 months (range:3 to 84 months).Conclusion The free anterolateral thigh flap is an ideal choice for reconstruction of maxillofacial defects,as it has many advantages such as abundance volume,easily molding and adjusting the thickness,possessing,long vascular pedicle,composition need to be adjusted according to defects,easily concealed donor site,and little donor site complications and malformation.

Objective To explore the clinical efficacy and safety of bevacizumab combined with docetaxel in treatment of advanced cervix cancer.Methods Seventy-five patients with advanced cervix cancer accepted in our hospital from April 2011 to April 2016 were selected and divided into observation group with 43 cases and control group with 32 cases according to different treatment methods.Patients in control group were given docetaxel,and patients in observation group were combined with bevacizumab on the basis of control group.The clinical efficacy,adverse reactions,life quality and pharmacoeconomics of two groups were observed and compared.Results The total efficacy and clinical control rate of observation group were all higher than control group with statistically significance (P ＜ 0.05).The adverse reaction rate of two groups had no difference.Total efficacy of life quality improvement was 83.72％,which was obviously higher than control group 62.50％ with statistically significance (P ＜ 0.05).The average cost of observation group was (83 ± 10) thousands,of control group was (18± 6) thousands.The cost of observation group was obviously higher than control group with statistically significance (P ＜ 0.05).Conclusion Using bevacizumab combined with docetaxel in treatment of advanced cervix cancer has better effect clinical but costs much than docetaxel.We should set on treatment according to patients' own situation.

Objective:To evaluate angioimmunoblastic T-cell lymphoma(AITL) completely, we gave in-depth investigation of histopathological features, specific immunochemical markers, antigen receptor gene rearrangements and in situ hybridization for Epstein-Barr virus (EBV). Methods: 15 cases of typical AITL displayed effacement of the normal lymph node architecture partially or completely, abundance of arborizing high endothelial vessels, infiltration of polymorphic cells and hyperplastic atypical T lymphocytes with or without clear cytoplasm. Clinical characteristics, histological manifestations, and immunohistochemical staining for CD3, CD20, CD4,CD21, CXCL13, CD10, and BCL6 were analyzed. Polymerase chain reaction for immunoglobulin heavy chain (IgH) and T cell receptor ? (TCR?) rearrangements and in situ hybridization for Epstein-Barr virus encoded RNA (EBER-1) were performed.Results: Histologically, we found eight cases with regressed lymphoid follicles, six with absence of follicles and one with hyperplastic follicles with interfollicular lesions. We also found eight cases displaying aggregation of clear cells, four infiltration of large lymphoid cells, five abundant epithelioid histiocytes. CD20 staining showed hyperplasia of large B cells in four cases. CD21 expression exihibited extrafollicular expansion of follicular dendritic cell meshworks in 11 cases (73.3%), partially with a tendency of perivascular distribution. Positive rate for CXCL13 and CD10 are 73.3% and 6.7% respectively. Monoclonal rearrangements of TCR? were detected in 6/15 (40%) of cases, IgH rearrangements in 7/15 (46.7%), of which five were monoclonal, while two oligoclonal. 8 out of 15 cases (53.3%) contained EBV-positive cells. Among the four cases with large B cell proliferation, three were EBV-positive. Conclusion: AITL display great complexity and diversity clinicopathologically. Only when we recognize such diversity, can we reasonably apply and properly evaluate immunochemical markers and molecular techniques, and thus give a correct diagnosis.