Type 2 diabetes(T2DM) is the collective result of insulin resistance in both muscle and liver andβ cell function failure. Traditional pharmaceutical therapy fails in ceasing progressive decline in β cell function. Bariatric surgery has been widely accepted as an efficient measure to treat diabetes. However, the prevalent standards mainly based on body mass index can not meet the demand for promoting remission rate. Related factors should be included in prediction of post-operative remission, like end-point setting, T2DM status, biochemical index, and operative method etc. The combination of these factors can be used to benefit more patients with diabetes.

Objective To explore the effects of TMPRSS2 promoted suicide gene CD-5-FC combined with phytochemicals on the proliferation and apoptosis of prostate cancer (PCa) specific cell-line 22RV1.Methods From March 2016 to October 2016 TMPRSS2-VISA-CD/UPRT'vector was used to deliver pro-drug 5-FC (5-Fluorocytosine) in to PCa specific cell-line 22RV1.Transfection effect was verified by Western-blotting.5-FC,5-FU (5-Fluorouracil) and four phytochemicals epigallocatechin gallate (ECGC),Genistein,Daidzein,and Equol were selected in this study.MTS assay was performed to select dosages,which can kill 10％-40％ of 22RV1 cells,from their pre-set drug concentrations,respectively.According to their select concentrations,either 5-FC plasmid or 5-FU in combination with one of four phytochemicals were added in 22RV1 cells in orders,and then cultured them together.Besides,these four phytochemicals were added in 22RV1 cells individually regarding their selecting concentrations and cultured at the same time.Cell viability was detected by MTS assay on 24hrs,48hrs and 72hrs.Comparing the cell killing rates between the combination groups and each single drug groups on cell-line 22RV1.Results TMPRSS2-VISA-CD/UPRT'plasmid with 5-FC was transfected on PCa specific cell-line 22RV1 successfully.The most obvious transfection occurred on 48hrs.The selected concentration of the pro-drug 5-FC were 83.32 μmol/L and 833.20 μmol/L,5-FU were 76.87 mol/L and 768.70 μmol/L.The concentrations of four phytochemical agents were 2.00 μmol/L,10.00 μmol/L and 20.00 μmol/L.In term of the cell killing numbers,results showed that the combination treatment of 83.32 μmol/L 5-FC/ 76.87μmol/L 5-FU and 10.00 μmol/L/20.00 μmol/L four phytochemicals compared with 10.00 μmol/L/20.00 μmol/L single treatment of four phytochemicals,respectively,there was no significant difference (P ＞0.05),while the combination treatment of 833.20 μmol/L 5-FC/768.70 μ mol/L 5-FU and 2.00 μmol/L/10.00 μmol/L four phytochemicals compared with 2.00 μ mol/L/10.00 μmol/L single treatment of four phytochemicals,respectively,there was a significant difference (P ＜ 0.05).In addition,this study proved that 83.32 μmol/L 5-FC and 76.87 μmol/L 5-FU,833.20 μmol/L 5-FC and 768.70 μmol/L 5-FU reached the same cell killing effect,and there was no statistical difference (P ＞ 0.05).Thus the suicide gene transfection was successful,and its function was the same as the effect of cytotoxic drugs.Conclusions This study has proved that this plasmid with 5-FC suicide gene system can be successfully and efficiently transfected into PCa cells 22RV1.As the pro-drug of 5-FU,5-FC got similar treatment effect with 5-FU,and inhibited cell proliferation.There was no synergistic reaction of enhancing cell apoptosis after combined phytochemical drugs EGCG,Genistein,Daidzen,Equol with suicide gene therapy on 22RV1 cell-line.

OBJECTIVE:To establish a diazotize solution-spectrophotometry for the determination of bilirubin in zhenhuang oral liquid.METHODS:The solution to be determined was added with diazotize solution and the absorbability was detected at a detective wavelength of533nm.RESULTS:The calibration curve was linear for bilirubin at the range of1.07～8.56?g/ml(r=0.9999).The average recovery of loading sample was100.2%(RSD=0.73%).CONCLUSION:The method is simple,reproducible,cost-effective and suitable for the determination and quality control of bilirubin in zhenhuang oral liquid.

Objective to investigate the emotional state and childhood trauma among users of amphetaminetype-stimulants under compulsory seclusion rehabilitation in Shaoxing.Methods A cross-sectional design was conducted on 140 users of ATS in Shaoxing compulsory isolation drug rehabilitation center,collecting general information using homemade questionnaires.Using the Patient Health Questionnaire (PHQ-9),Generalized Anxiety Disorder Scale (GAD-7) and Mood Disorder Questionnaire(MDQ) to investigate the emotional state of users of ATS.The Childhood Trauma Questionnaire (CTQ) was applied to explore the childhood trauma experiences of users of ATS.Results Among the 140 users of ATS,84 (60％) users had emotional problems,24 users (17.14％) of anxiety disorder,22 users (15.72％) of depression,27 users (19.28％) of depression and anxiety disorder.66 users (47.1％)experienced at least one childhood trauma.The most common childhood trauma is the physical neglect,60 users (42.9％),followed by emotional neglect in 23 users(16.4％),again sexual abuse in 18 users (12.9％),emotional abuse and physical abuse is relatively fewer.Conclusion Among users of ATS under compulsory seclusion rehabilitation,emotional problems is prevalent.Proper emotional intervention and treatment in users of ATS would promote their mental health,thereby reducing the re-use of ATS,better return to society life.

Choroidal thickness and its relevance with retinal disease has been widely studied in recent years,as choroid is an important source of retina blood supply.Diabetic retinopathy (DR) studies have been focused on retinal vascular injury and related circulatory disorders for a long time,however recent studies have found that choroidal blood vessels are also affected by diabetes,including the thickness changes.The choroidal thickness of diabetic patients is thinner than normal.There is no conclusive conclusion about choroidal thickness and the severity of DR lesions,as the choroid thickness results are determined by multiple factors,including diseases,ocular conditions (choroidal vascular status,ocular axial length,refractory errors and other eye parameters),systemic factors (age and sex) and measurement methods.Therefore,it is necessary to calibrate the ocular and extra-ocular factors affecting choroidal thickness when trying to further clarify the relationship between the choroidal thickness and DR.

Objective To investigate the clinical efficacy of surgical treatment for stage Ⅳ gastric cancer after conversion therapy.Methods The retrospective cohort study was conducted.The clinicopathological data of 50 stage Ⅳ gastric cancer patients who were admitted to the First Affiliated Hospital of Dalian Medical University between January 2012 and June 2016 were collected.All the 50 patients who were diagnosed with single distal metastasis underwent chemotherapy.After chemotherapy,21 patients with operation indication receiving gastrectomy (R0 or R1 resection) were allocated into the conversion surgery group and 29 without operation indication continuing to chemotherapy were allocated into the chenotherapy group.Patients received S-1 + oxaliplatin or S-1 + docetaxel regimen.Patients underwent open distal or total gastrectomy.Observation indicators:(1) response assessment of chemotherapy (complete remission,partial remission,stable disease and progressive disease),grading of of adverse reactions;(2) intra-and post-operative situations of conversion surgery group:operation procedures,intraoperative situations (operation time,volume of blood loss,number of lymph node dissected and surgical margin) and postoperative situations (complications and duration of hospital stay);(3)comparison of follow-up and survival between the 2 groups;(4) prognostic factors analysis affecting stage Ⅳ gastric cancer patients.Follow-up using outpatient examination,correspondence and telephone interview was performed to detect postoperative survival of patients up to September 2016.Survival time was from operation to the last follow-up or death.Measurement data with normal distribution were represented as x±s.Comparison of count data and univariate analysis were done using the chi-square test.Ordinal data were analyzed by the nonparametric test.The survival rate was calculated by the Kaplan-Meier method,and the Log-rank test was used for survival analysis.Multivariate analysis was done using the COX regression model.Results (1) Response assessment of chemotherapy:of 50 patients,24 received S-1 + oxaliplatin regimen and 26 received S-1 + docetaxel regimen.Twenty-one patients in the conversion surgery group underwent chemotherapy,with negative peritoneal metastasis,N2 and below of lymph node metastasis (No.16 lymph node disappeared or reduced),invasive depth ＜T4b and narrowing or disappeared hepatic metastasis.A median preoperative chemotherapy cycle was 4.2 cycles (range,2.0-9.0 cycles).Chemotherapy reaction of 21 patients:15 had partial remission and 6 had stable disease.Twenty-nine patients without operation indication in the chemotherapy group didn't receive surgery.The median cycle of first-line chemotherapy was 5.5 cycles (range,2.0-10.0 cycles).Chemotherapy reaction of 29 patients:13 had partial remission,11 had stable disease and 5 patient had progressive disease.Chemotherapy adverse reactions of 50 patients:26 had reduced white blood cells (WBCs),including 6 with grade Ⅲ-Ⅳ of adverse reactions;29 had reduced neutrophils,including 12 with grade Ⅲ-Ⅳ of adverse reactions;18 had anemia,including 6 with grade Ⅲ-Ⅳ of adverse reactions;12 had reduced platelets,including 2 with grade Ⅲ-Ⅳ of adverse reactions;27 had apositia,including 5 with grade Ⅲ-Ⅳ of adverse reactions;7 had stomatitis;9 had diarrhea;3 had elevated serum creatinin;4 had hand-foot syndrome;3 had abnormal sensory nerve.There was no chemotherapy-related death.(2) Intra-and post-operative situations of conversion surgery group:of 21 patients in the conversion surgery group,8 underwent radical total gastrectomy + D3 lymph node dissection,6 underwent radical distal gastrectomy + D3 lymph node dissection and 7 underwent radical distal gastrectomy + D2 lymph node dissection (including 4 combined with resection of hepatic metastatic tumors and 1 combined with radiofrequency ablation of hepatic metastatic tumor).Operation time,volume of blood loss,number of lymph node dissected and recovery time of gastrointestinal function of 21 patients were (216±31)minutes,(128±52)mL,31±8 and (3.0± 0.7)days,respectively.There were 17 patients receiving R0 resection and 4 receiving R1 resection (3 with positive gastric margin and 1 with positive hepatic margin).There was no death.Seven of 21 patients with complications were cured by conservative treatment,including 2 with pancreatic fistula,1 with intra-abdominal hemorrhage,1 with intestinal obstruction,1 with pneumonia,1 with intra-abdominal infection and 1 with wound infection.Duration of hospital stay of 21 patients was (13.0±3.0) days.(3) Comparison of follow-up and survival between the 2 groups:50 patients were followed up for 6-46 months,with a median time of 24 months.The 3-year cumulative survival rates in the conversion surgery and chemotherapy groups were respectively 33.3％ and 6.9％,with a statistically significant difference between the 2 groups (x2 =7.678,P＜0.05).Results of further analysis showed that R0 resection of 17 patients and R1 resection of 4 patients in the conversion surgery group were respecgtively (25.3±2.8)months and (8.3±0.9)months,with a statistically significant difference between the 2 groups (X2=16.242,P＜0.05).(4) Prognostic factors analysis affecting stage Ⅳ gastric cancer patients:results of univariate analysis showed that T stage,N stage,response assessment of chemotherapy,surgery after chemotherapy and degree of tumor radical resection were related factors affecting prognosis of stage Ⅳ gastric cancer patients (X2 =5.288,12.645,25.581,8.372,12.001,P＜0.05).Results of multivariate analysis showed that R1 resection after conversion therapy was an independent risk factor affecting prognosis of stage Ⅳ gastric cancer patients (HR=14.021,95％ confidence interval:1.928-10.938,P＜0.05).Conclusion Radical resection after conversion therapy can increase survival rate of stage Ⅳ gastric cancer patients,and R1 resection after conversion therapy is an independent risk factor affecting poor prognosis of stage Ⅳ gastric cancer patients.

With the recent understanding of cancer biology, physiopathology, and cancer genetics& genomics, new treatments and methodologies are constantly developed, including on the development and application of molecular targeted drugs for cancer therapy have been widespread concerned.Antibody-based drugs targeting over-expressed oncogenes or other functional proteins in cancer with its high specificity, less side-effects and significant clinical efficacy became rapidly the hot-spot of anti-tumor drug research.Currently, there are already more than 20 of anti-tumor antibody-based drugs approved for clinical application, and achieved remarkable results.This article summarizes the development and current situation of monoclonal antibody-based drug research for cancer therapy, as well as their anti-tumor mechanism of action.At the same time summarizes the new advances in cancer research in the field of monoclonal antibody drugs made,and its prospects as well as shortcomings were outlined.

Objective To analyze the distribution of multiple myeloma (MM) literature in Chinese periodicals and to find out the core periodicals about MM.Methods Periodical literature that involved with MM in the article titles from January 2008 to December 2014 on the Wanfang medical database was collected and searched.Bibliometric method was used to analyze journal date and journal distribution.Results 456categories of periodicals had published literature about MM.The number of articles about MM published in the top 10 journals was more than 30,accounting for 27.00 ％ of all published MM literature,which were highly effective core journals.The number of articles about MM published in the top 3 journals was more than 100,accounting for 15.59 ％ of all published MM literature.The number in Journal of Leukemia & Lymphoma had reached 187,accounting for 6.43 ％ of the total.Conclusions The core journals about MM provide the key approach to help MM medical personnel to select useful information efficiently.Furthermore,the core journals are not only the significant gist for authors who plan to contribute their articles to relevant MM periodicals,but also the necessary reference tools for medicine workers who engage in basic and clinical research and teaching.

Objective To investigate the efficacy and safety of laparoscopic surgery of rectal cancer for different stages of rectal cancer . Methods A retrospective analysis was made on clinical data of 96 cases of rectal cancer from January 2009 to December 2013.Among 42 cases of TNM staged 0-Ⅰ, there were 22 cases of laparoscopic surgery ( laparoscopic group A ) and 20 cases of open surgery ( laparotomy group A ) .Among 54 cases of TNM staged Ⅱ-Ⅲ, there were 20 cases of laparoscopic surgery (laparoscopic group B) and 34 cases of open surgery (laparotomy B group).At the end of follow-up ended in May 2015, the tumor markers, postoperative complications , local recurrence , distant metastasis rate and 1-year and 3-year survival rates were compared in different stages of patients between the laparoscopic surgery and open surgery . Results As compared with the laparotomy group A , the laparoscopic group A had shorter surgery time [(121.7 ±13.5) min vs.(142.4 ±23.5) min, t=-3.530, P=0.000] and less blood loss [(80.9 ±10.6) ml vs.(136.3 ±32.6), t=-7.559, P=0.000].As compared with the laparotomy group B , the laparoscopic group B had less blood loss [(110.3 ±15.3) ml vs.(186.5 ±22.6) ml, t=-12.202, P=0.000].As compared with the laparotomy group A, the laparoscopic group A had significantly reduced distal resection margin distance [(2.3 ±0.6) cm vs. (3.0 ±0.7) cm, t=-3.489, P=0.001].As compared with the laparotomy group B, the number of lymph node metastasis was significantly reduced in the laparoscopic group B (2.7 ±0.4 vs.3.1 ±0.4, t =-3.298, P=0.002).The conversion rate to laparotomy in the laparoscopic group B was 20%.There were no significant difference between the laparoscopic group A and laparotomy group A in local recurrence rate [9.5% (2/21) vs.5.0% (1/20), χ2 =0.000, P=1.000], distant metastasis rate [4.8%(1/21) vs.5.0%(1/20),χ2 =0.000, P=1.000], and survival rate (log-rankχ2 =0.102, P=0.750).There were no significant difference between the laparoscopic group B and laparotomy group B in local recurrence rate [6.2%(1/16) vs.6.2%(2/32),χ2 = 0.000, P=1.000], distant metastasis rate [6.2%(1/16) vs.3.1%(1/32), Fisher test, P=1.000], and survival rate (log-rankχ2 =0.158, P=0.691). Conclusions Laparoscopic radical surgery for TNM stage 0-Ⅰ of rectal cancer has a good effect and safety.The conversion rate to laparotomy in TNM staged Ⅱ-Ⅲrectal cancer patients is still high with relatively high surgical risks , which requires strict preoperative assessment .

[Objective]To evaluate a simple,safty and effective therapeutic option to treate subaxial cervical fracture-dislocation with locked-facet.[Method]With the patients being awake and supervized under X-ray fluoroscopy,the authors used the early and continued closed skull traction-reduction to treate 16 cases of traumatic subaxial cervical fracture-dislocation with locked-facet.Before the beginning of the treatment,all the patients were taken for X-ray plain films and MRI/CT examinations as well as American Spinal Injury Association(ASIA) neurological function grade.The dynamic ASIA neurological function scale and X-ray fluoroscopy examnations were asked during the skull traction–reduction procedures.The average interval from the traumatic events to begin to skull traction–reduction was 31 hours(6-52 hours).The authors would continue the skull traction to maintain the anatomy position as soon as they succeeded in reducing the dislocation with locked-facet,forthmore they would take the anterior operation or combinations with anterior and posterior operations during the best condition.[Result]The MRI scans showed that there were 8 disc hernations and 5 disc disruptions at the dislocation levels before traction–reduction procedures.The ASIA scale were 7 grade C,5 grade D and 4 grade E,respectively.All the 16 cases succeeded in reduction as well as no neurological deterioration occurred.The postreduction MRI scans showed that 2 disc herations had converted to nearly normal disc position and another 4 disc hernations remained unchanged.Accordingly,2 disc disruption remained unchanged and another case had converted to disc hernation.The average traction weight was 19 kg(10~32 kg) and average traction time was 53 minutes(30~135 minutes).[Conclusion]Under the intensive dynamic ASIA neurological function grade and X-Ray fluoroscopy examnations,with the patients being awake and co-operation,the early and continued closed skull traction-reduction and then performing elective anterior or anterior-posterior surgery depending on the patient's overall and local status to treate subaxial cervical fracture-dislocation with locked-facet is safe and effective.