Tumor cells can secrete various cytokines which can enhance the activity of osteoclast in the bone microenvi?ronment, and osteoclast can promote the release of many growth factors buried in bone matrix which would promote the growth and invasion of tumor cells. Thus, a‘vicious cycle’of bone destruction is developed in the bone metastatic microenvironment. Bone metastatic microenvironment facilitate this‘vicious cycle’, while it also provides potential targets for the treatment of bone metas?tases. Osteoprotegerin, receptor activator of nuclear factor?κB and its ligand system are the typicality of molecular targets. Bone metastasis can promote the secretion of RANKL and the expression of OPG. The disbalance of RANKL/OPG is an important induc?ing factor for bone destruction. Many studies have shown that transforming growth factor?βwhich is produced by osteoclast plays an important role in mediating‘vicious cycle’. Src family tyrosine kinase, endothelin A receptor, matrix metalloproteinase, and ca?thepsin K are the potential targets of bone metastasis. Pharmacologic agents such as denosumab, can inhibit the‘vicious cycle’of bone metastasis. In addition to suppress bone destruction by Pharmacologic agents, they also can produce direct antitumor effect. They can delay the occurrence of skeletal related events, prolong the overall survival, and play an important role in patient ’s quali?ty of life at last. Patients with bone metastasis have already benefited from systemic molecular targeted therapies, and further re?searches would be of great importance in improving patient therapeutically selections and enhancing the effect.

The incidence of spine metastasis is increasing due to the aging demography and improvement of cancer diagnosis and treatments.Spine metastasis is one of the serious complications of advanced cancers,and its treatment should pay attention to patients' quality of life and consider interdisciplinary cooperation.Expected life span can guide doctors to select the appropriate treatment for spine metastasis patients,and various scoring systems have been developed.We elicited relevant literatures in WanFang,CNKI,PubMed and Embase databases.Articles aiming at developing model for spine metastasis or describing the clinical effectiveness and pitfalls of the existed systems were included.As a result,48 articles were carefully reviewed.In this review,thosc scoring systems were stratified into two groups:Traditional scoring systems,which were published before or in 2005,including original/revised Tokuhashi scoring systems,Tomita scoring system,Bauer scoring system,Linden scoring system,and Sioutos scoring system;and new scoring systems,which were designed during the last three years,including Lei & Liu scoring system,Bollen scoring system,Rades scoring system,Oswestry spinal risk index (OSRI),and Katagiri scoring system.The usefulness of the traditional scoring systems has been validated by many studies.However,the applicability of those scoring system were controversial due to improvement of cancer treatment and survival period in recent years.Although the improvement of life span was considered,those new scoring systems have not penetrated into clinical routine because of the lack of validation.Currently,which system has the highest accuracy rates still remains unclear.Next generation of scoring systems should take into account the practicality and reliability at the same time.In this review,we introduced above mentioned scoring systems,described the validity and limitation of those scoring system,and suggested the future directions of next generation of scoring systems.

Objective To synthesize a quantum dot (QD) to recognize glioma cells for imaging and photodynamic therapy. Methods By one-pot aqueous approach, near infrared-emitting CdTe was produced. After detection of its physicochemical characterizations, RGD was conjugated. Emission images were observed with confocal microscopy. To test its toxicity, CdTe-RGD with various concentrations was separately added into U251 and 3T3 cells for incubation in dark circulation. To test its photodynamic effect, U251 and 3T3 cells were then irradiated for 5 ~ 60 min using 632.8 nm laser. Results The QD (Φ = 3.75 nm, PL peak wavelength =700 nm, PLQY=20%) achieved was a spherical crystal with excellent monodispersity. Under confocal microscope , U251 cells were visualized but 3T3 cells not. In dark circulation, the survival rates of both U251 and 3T3 cells were above 85%. After laser irradiation, the survival rate of U251 cells decreased to (37 ± 1.6)%with the increasing of irradiation time and CdTe-RGD concentration. Conclusion With good physicochemical characterization and low toxicity, CdTe-RGD could be applied in biomedical imaging and photodynamic therapy of gliomas.

Objective To evaluate the methods of diagnosis and treatment of thyroid disease with concomitant focal lymphocytic thyroiditis(FLT), and explore the reasons for its confused with Hashimoto′s disease(HD).Methods During the recent 25 years, 207 patients underwent surgical trearment for pathologically diagnosed HD.Among this group, 143 cases of HD with other concomitant thyroid disease were retrospectively analysed.Results Of the 143 cases, 57 cases were found to have thyroid disease with concomitant FLT, and this was 27.5%(57/207) of the total HD group, or 39.9%(57/143) of the group with thyroid disease and concomitant HD.Intraoperative pathologic section revealed that focal lymphocytic infiltration was positive in 87.7%(50/57) of cases. The postoperative hypothyroidism occurrence rate was 19.3%(11/57), of which, 7 cases(7/57, 12.3%) were subclinical hypothyroidism.Conclusions The character of pathologic changes of thyroid disease with FLT and with HD was different. Intraoperative pathologic section can be helpful in the diagnosis of this condition and can have important significance as a guide to the scope of (surgical) resection of the thyroid gland.

Objective To study the expression changes of?-catenin in the hair follicle before and after GasderminA3 gene mutation.Methods Using SP immunohistochemical staining,RT-PCR,Western blotting to detect the expression of?-catenin in the hair follicle in GSDMa3 mutant and C57BL/6(B6) mice on postnatal 11(anagen) ,16(early catagen) ,18(late catagen) and 24 d(telogen) respectively.Results The expression of?-catenin is gradually weakened from 11 d to 24 d in GSDMa3 mutation mice and B6 mice,but stronger expression was found in GSDMa3 mutation mice than in the B6 mice at different time points.In anagen,?-catenin was expressed in the inner and outer root sheath and hair matrix cells,with stronger expression in GSDMa3 mutant mice than in B6 mice.In catagen,?-catenin was mainly expressed in the outer root sheath and hair matrix cells,with more stronger expression in GSDMa3 mutant mice than in B6 mice.In telogen,?-catenin was expressed in the outer root sheath cells in the mutant mice while little in the hair follicle in B6 mice.Conclusion GSDMa3 gene affects the hair follicle growth and development,probably through regulating the expression of?-catenin.

Objective To accurately investigate the characteristic and effective of occlusive devices in ventricular septal of defect (VSD) by using stereo 3D echocardiography. Methods Six patients with VSD were included who were undergone the defect closing operation with Amplatzer occluder device. Stereo 3D echocardiography was performed to show 3DE imaging appearance after the operative procedure. Results Stereo 3D echocardiography were performed after the procedure of implanting occluder device. It was clear to show the location of the occluder and the space relationship of each parts. Conclusions The appearance,location and space relationship of occluder could be seen clearly by stereo 3D echocardiography after implanting occluder device. Compare with 2D, real-time 3D echocardiography, stereo 3D echocardiography could provide more veracious information about heart structures and the therapeutic devices for clinical use.

Objective To investigate the natural course and treatment of adult liver hemangioma (ALH).Methods The records of ultrasonography of 2422 patients with ALH were retrospectively reviewed.Results The patients were between 16 and 69 years of age (mean age 42,9± 11.4) with a male to female ratio of 1 ∶ 1.02 (1197/1225).The prevalence rate gradually increased with age after 30 years old.The highest prevalence rate occurred between 40-69 years.ALH was most commonly 1.1-3 cm in size,located in right liver with a solitary lesion.ALHs were bigger and were seen earlier in females than males.Concurrent illness was also more common in females than males.1427 patients had 3 to 8 repeat sonographies.At a follow-up of 42.7±9.5 months,1351 patients had no change in the ultrasonographic pattern or number of haemangiomas.Increasing in size of the lesions was demonstrated in 76 patients.154 patients received operation or interventional treatment.Conclusions The prevalence rate of ALH rose with age.Female sex hormones might accelerate ALH enlargement but they did not induce the formation of ALH.Most ALH remained stable in size and in patterns.Attention should be paid to rule out other illnesses in patients with ALH and with symptoms.

Objective To examine the effect of ultrasonic debridement combined with continuous skin stretching to repair refractory infective wound bed.Methods From January 2016 to July 2016,we treated 15 cases of chronic,refractory infective wound beds using ultrasonic debridement combined with skin stretching technique.Results All the 15 (100％) cases were cured without necrosis of the stretched skin edges.Conclusions Ultrasonic debridement combined with continuous skin stretching is an appropriate technique for repairing the refractory wound bed in the patients who are older,in poor general condition,or poor condition of local skin and soft tissue,or have poor postoperative effect,or surgical contraindication or at higher risk of surgery.

The recently introduced real-time three-dimensional color Doppler flow imaging (RT-3D CDFI) technique provides a quick and accurate calculation of regurgitant jet volume (RJV) and fraction. In order to evaluate RT-3D CDFI in the noninvasive assessment of aortic RJV and regurgitant jet fraction (RJF) in patients with isolated aortic regurgitation, real-time three-dimensional echocardiographic studies were performed on 23 patients with isolated aortic regurgitation to obtain LV end-diastolic volumes (LVEDV), end-systolic volumes (LVESV) and RJV, and then RJF could be calculated. The regurgitant volume (RV) and regurgitant fraction (RF) calculated by two-dimensional pulsed Doppler (2D-PD) method served as reference values. The results showed that aortic RJV measured by the RT-3D CDFI method showed a good correlation with the 2D-PD measurements (r = 0.93, Y = 0.89X + 3.9, SEE = 8.6 mL, P < 0.001); the mean (SD) difference between the two methods was--1.5 (9.8) mL. % RJF estimated by the RT-3D CDFI method was also correlated well with the values obtained by the 2D-PD method (r = 0.88, Y = 0.71X + 14.8, SEE = 6.4%, P < 0.001); the mean (SD) difference between the two methods was--1.2 (7.9) %. It was suggested that the newly developed RT-3D CDFI technique was feasible in the majority of patients. In patients with eccentric aortic regurgitation, this new modality provides additional information to that obtained from the two-dimensional examination, which overcomes the inherent limitations of two-dimensional echocardiography by depicting the full extent of the jet trajectory. In addition, the RT-3D CDFI method is quick and accurate in calculating RJV and RJF.
Aortic Valve Insufficiency/*ultrasonography ; Echocardiography, Doppler, Color ; Echocardiography, Three-Dimensional

Stereoscopic three-dimensional echocardiography(S-3DE) is a novel displaying technology based on real-time 3-dimensional echocardiography (RT-3DE). Our study was to evaluate the feasibility and efficiency of S-3DE in the diagnosis of atrial septal defect (ASD) and its use in the guidance for transcatheter ASD occlusion. Twelve patients with secundum ASD underwent RT-3DE examination and 9 of the 12 were subjected to transcatheter closure of ASD. Stereoscopic vision was generated with a high-performance volume renderer with red-green stereoscopic glasses. S-3DE was compared with standard RT-3D display for the assessment of the shape, size, and the surrounding tissues of ASD and for the guidance of ASD occlusion. The appearance rate of coronary sinus and the mean formation time of the IVC, SVC were compared. Our results showed that S-3DE could measure the diameter of ASD accurately and there was no significant difference in the measurements between S-3DE and standard 3D display (2.89+/-0.73 cm vs 2.85+/-0.72 cm, P>0.05; r=0.96, P<0.05). The appearance of coronary sinus for S-3DE was higher as compared with the standard 3D display (93.3% vs 100%). The mean time of the IVC, SVC for S-3DE monitor was slightly shorter than that of the standard 3D display (11.0+/-3.8 s vs 10.3+/-3.6 s, P>0.05). The mean completion time of interventional procedure was shortened with S-3DE display as compared with standard 3D display (17.3+/-3.1 min vs 23.0+/-3.9 min, P<0.05). Stereoscopic three-dimensional echocardiography could improve the visualization of three-dimensional echocardiography, facilitate the identification of the adjacent structures, decrease the time required for interventional manipulation. It may be a feasible, safe, and efficient tool for guiding transcatheter septal occlusion or the surgical interventions.