Objective To investigate the effect of telephone call follow-up on compliance with opening-mouth exercises among nasopharyngeal carcinoma(NPC)patients with radiotherapy-induced difficulty in opening mouth.Methods Sixty four nasopharyngeal carcinoma patients undergoing radiotherapy were randomized into control group(n=31)and observation group(n=31).The former group was given health education and instructions for functional exercises of opening mouth at discharge and regular return visits after discharge,and the observation group received regular telephone call follow-ups by an appointed nurse besides the same treatment as in the control group.The two groups were compared in regard to the compliance with the exercises of opening mouth and the incidences of difficulties in opening mouth at the first and second years after discharge. Results The compliance of the observation group was significantly higher that in the control group(P<0.01).The incidences of difficulties in opening mouth in the observation group were significantly smaller than that in those of the control at the first and second years after discharge(P<0.01). Conclusion Telephone call follow-ups are effective in the improvement of compliance of functional exercises in NPC patients with radiotherapy-induced difficulty in opening mouth,the reduction of the incidence of mouth-opening problems and the improvement of their quality of life.

Objective　To investigate the surgical management of a gun shot wound of blood vessels and immersied, and evaluate its primary effect. Methods　100 rabbits were divided randomly into simple wounded group(SWG,n=50) and seawater immersion group(SIG,n=50).F emoral arteries were impacted by 0.38 gram steel spheres with velocity of 600 ～800 meters per second fired by 7.62 mm rifle. Animals in SIG were immersed in artificial seawater (pH 8.2～8.4, salinity 25.4,temperature 21℃) for 60 min, o f which those in SWG were spared. Grossly injuried artery was excised and restor ation of blood flow was reconstructed by end-to-end anastomosis or reversed au togenous venous grafting or cryopreserved arterial allografting. At 24 h,7,1 4,21 days after operation, blood flow was examined by Doppler ultrasonic detecti on and part of anastomotic sites and graft were collected for pathological obser vation. Results　In completely transected injury, the patency in SIG was 80.00%,while that in SWG was 86.67% in the first 3 weeks. In arterial c ontused injury ,patency in SIG was 86.67%,and that in SWG was 82.35% at the same time. Thrombosis occurred mostly in the first postoperative week. Atypical endo thelial cells were found at the anastomosis sites in the first postoperative week, and the anastomosis sites were lined with endothelium in 3 weeks postopera tively. Conclusion　Early curative effect could be obtained. Whe n grossly injuried artery is excised and followed by a routine surgical procedur e in the treating gunshot wounds immersed in seawater.

Biomarkers, Tumor ; metabolism ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; metabolism ; pathology ; Humans ; Lung Neoplasms ; drug therapy ; metabolism ; pathology ; Oncogene Proteins, Fusion ; chemistry ; metabolism ; Protein Kinase Inhibitors ; therapeutic use ; Pyrazoles ; therapeutic use ; Pyridines ; therapeutic use ; Pyrimidines ; therapeutic use ; Smoking

Objective To review the clinical features of fulminant myocartitis,in order to provide assistance to the clinical management.Methods The clinic data of 183 patients with viral myocarditis,including 153 cases of acute myocarditis and 30 cases of fulminant myocarditis admitted in our hospital during January 2008 and Dec 2012 were retrospectively analyzed.The age of onset,interval after virus infect,initial symptoms,auxiliary examination,treatment,and turnover were compared in the study.Results The average onset age of fulminant myocartitis and acute myocarditis were similar [(22.3 ± 7.6) vs.(26.2 ± 12.6) years,P =0.105 5].There was a significant difference between the two gourps in the rate of patients with a explicit history of virus infection [30.0％ (9/30) vs.78.4％ (120/153),x2 =28.3,P ＜0.001],the average interval after virus infect [(3.1 ±2.2) vs.(7.0 ±3.80) d,P＜0.001] and the length of hospital stay [(12.1 ± 6.9) vs.(6.9 ± 4.50) d,P ＜ 0.001].Chest congestion (101/153,66.0％),feebleness (76/153,49.7％),fluster (74/153,48.4％) are the most onset symptoms of acute myocarditis,while chest congestion (24/30,80.0％),shortness of breath (14/30,46.7％),feebleness (13/30,43.3％) in flunimant myocarditis.Advanced A-V block (19/30,63.3％),cardiogenic shock (18/30,60.0％),ventricular arrhythmia(16/30,53.3％),Adams-Stokes syndrome(8/30,26.67％) and acute renal failure (8/30,26.7％) were the most complications of flunimant myocarditis.Temporary pacemaker (11 cases),extracorporeal memberane exygenator (7 cases) and intra-aortic balloon pump (7 cases) were applied in critical patients.In acute phase,21 cases were cured,9 cases was dead of cardiogenic shock and ventricular(27,30.0％).Two dead cases applied with ECMO because of delay.After leaving hospital,1 case was implanted permanent pacemaker,2 cases became chronic myocarditis and required hospitalization repeatedly.Conclusions The fulminant myocarditis has a rapid onset,most of which has no prodrome of virus infection or a shorter interval than acute myocarditis.Timely and effective mechanical circulatory support is critical for fulminant myocarditis.

Nitrogen is an essential nutrient for yeast cells on ethanol fermentation. In order to reveal the promoting mechanisms of organic nitrogen sources on the ethanol fermentation by yeast, Saccharomyces cerevisiae, laser tweezers Raman spectroscopy and single-cell analysis techniques were used to monitored the kinetic of intracellular bio-macromolecules of individual cells during fermentation with urea, yeast extract, ammonium nitrate or ammonium sulfate as the sole nitrogen source. Major results from this work were as follows. (1) Organic nitrogen sources had a promoting effect on the ethanol fermentation, the fermentation with urea and yeast extract reached the maximum concentration of ethanol in 14-18 h. ( 2 ) There were no apparent lag phases for the RNA synthesis of yeast cells cultured with urea and yeast extract. The averaged Raman intensity of yeast cells at peak of 782 cm-1 in the early stage of fermentation was stronger than that of cultured with ammonium nitrate and ammonium sulfate. The maximum was about 1. 9-2. 1 times of the initial intensity for urea or yeast extract, but 1. 2-1. 4 times for ammonium nitrate and ammonium sulfate. (3) The secondary structure of proteins of partial cells cultured with yeast extract was dominated byβ-sheet, while cells cultured with other nitrogen sources were dominated by α-helix absolutely. These results bring us the conclusion that the improving effect of organic nitrogen sources such as urea and yeast extract on ethanol fermentation by Saccharomyces cerevisiae may be due to that the organic nitrogen sources can shorten the lag phase of yeast cells, promote the RNA synthesis, and promote the transcription and expression of related genes.

Objective To report our self-designed guide module for placement of posterior column lag screws in anterior-posterior column acetabular plate using CT reconstruction data.Methods The CT scan data of 50 normal adult pelves were collected from February 2012 to April 2013,involving 30 males and 20 females with an average age of 46.4 years(range,from 25 to 69 years).The data were imported into Mimics 10.01 software for reconstruction of semi-pelvic models.Virtual cylindrical implants were placed intraosseously in both the left and the right posterior columns.The perpendicular distance (OP) from the insertion point O of the virtual cylindrical implant to the arcuate margin (P) and the distance (PI) from the point P to the point I,the crosspoint of the extension line of the ischial ramus and the arcuate margin were measured respectively.The angle (∠φ) between the direction of screws and the plane of guide module and the angle (∠θ) between the direction of screws and the long axis of guide module were also measured respectively.Results The average length of PI was 0.98 ± 0.13 cm,with 1.08 ± 0.22 cm in females and 0.95 ± 0.27 cm in males.The difference between genders was not statistically significant (P ＞ 0.05).The average length of OP was 1.09 ± 0.26 cm,with 1.06 ± 0.29 cm in females and 1.12 ± 0.24 cm in males.The gender difference was not statistically significant either (P ＞ 0.05).The mean value of ∠ φ was 55.43° ± 3.64°,with 55.33° ± 4.00° in females and 55.50° ±3.43° in males.The difference between genders was not statistically significant (P ＞ 0.05).The ∠θ value in females was 39.21 ° ± 2.45° and 35.58° ± 2.31 ° in males.The gender difference was statistically significant (P ＜ 0.05).Conclusions In design of the guide module,the nail holes should be located about 1 cm away from both the posterior edge and the medial edge,the angle between the screw direction and the module plane should be approximately 39° in females and 35° in males,and the angle between the screw direction and the long axis of the module approximately 55°.

Objective To investigate clinical manifestations and clinical diagnosis and treatment and pathological and immunohistochemical features in gastrointestinal stromal tumors. Methods The clinical data of fifty-two cases with gastrointestinal stromal tumors were collected, whose clinical diagnosis and treat-ment and pathological features were retrospectively analyzed from January 1995 to December 2007. Results All patients received operation therapy, only forty-five cases with complete surgical resection. The immu-nohistochemical staining showed that the cases with CD117 positive accounted for 100% (52/52) and CD34 positive accounted for 88.5% (46/52). Conclusions Surgery was necessary for all patients, especially complete surgical resection. Gastrointestinal stromal tumors were poor in preoperative diagnosis, which diag-nosis was based on the immunohistochemical staining of the tumor tissue. CD117 and CD34 tumor markers may help to diagnose gastrointestinal stromal tumors.

Objective To investigate the role of heparin binding epidermal growth factor-like growth factor(HB-EGF)in active psoriasis vulgaris.Methods HB-EGF mRNA and protein were detected by hy-bridization in situ and immunohistochemistry in normal skin tissues,lesional and non-lesional psoriatic skin of progressive stage.Results In normal skin tissues,the stain of HB-EGF mRNA and protein was located in the basal layer of epidermis(100.00%)and there was only a little expression in the suprabasal layers(16.67%).Focal overexpression was found in the suprabasal layers of non-lesional and peri-lesional psoriat-ic skin(88.00%,80.00%respectively);however,there was no HB-EGF mRNA protein expression in the superabasal layers of the central part of psoriatic lesions(0),and nearly no expression in the basal layer(4.00%).Conclusion HB-EGF may play an important role in the pathogenesis of early psoriasis.

Purpose To identify the role of tyrosine kinase receptor Axl for anti-apoptosis which was induced by cisplatin (DDP) and methotrexate (MTX) chemotherapy and to analyze the relationship between P-Axl and apoptosis-related proteins in osteosarcoma.Methods Osteosarcoma cell lines MG63,143B and U2OS were used in apoptosis assays,Axl siRNA transfection,cytotoxicity assays,cell cycle analysis,etc.A total of 41 cases of osteosarcom patients were included for immunohistochemistry of EnVision two-step staining and clinico-pathological relative analysis.TUNEL assay was performed in ten cases for apoptosis detection.Results Among the osteosarcoma cell lines,Gas6/Axl could obviously protect tumor cells from apoptosis induced by DDP and MTX (P ＜ 0.05).Axl siRNA transfection enhanced cell apoptosis,whereas Gas6 prone to function upon previous knockdown by Axl siRNA.Among the 41 cases,the positive rate of P-Axl,BCL-2,and Bax was 85.4％,70.7％,and 36.6％,respectively.In contrast,the positive rate of them was 22.2％,11.1％,and 11.1％ in osteofibrous dysplasia,respectively.The expression levels of these apoptosisrelated factors were significantly higher in osteosarcoma than in osteofibrous dysplasia (P ＜ 0.05).Through clinico-pathological analysis,there were significant relationships between the survival status and BCL-2 or Bax expression (P ＜ 0.05).Pearson correlation analysis demonstrated that BCL-2 was positively correlated to P-Axl with statistical significance (r =0.842,P ＜ 0.0001).By Cox univariate analysis,BCL-2 or Bax was correlated with the patients' prognosis.TUNEL assay also demonstrated that P-Axl high expression inhibited apoptosis in osteosarcoma tissues.Conclusion Gas6/Axl protects osteosarcoma cells from the apoptosis induced by DDP and MTX chemotherapy and inhibits apoptosis in osteosarcoma tissue,possibly through the regulation of apoptosis-related protein BCL-2.

Objective:To explore the metabolic outcomes of type 2 diabetes patients with different durations after 1 year treatment under the standardized metabolic disease management model.Methods:(1)From September 2017 to September 2018, 345 type 2 diabetes patients in the Standardized Metabolic Management Center(MMC) of Shanghai General Hospital were recruited and included in this research. They were divided into newly-diagnosed type 2 diabetes(duration≤1 year) and long-term groups(duration>1 year). The general characteristics, blood pressures, glycemic levels, lipids levels, control rates and comprehensive compliance rates(blood glucose, pressure and lipids all reached targets) were compared at baseline between 2 groups.(2)All patients underwent one year standardized management, and metabolic indicators mentioned above and control rates at the time were compared as well.Results:(1) At baseline, compared with long-term group, patients in newly-diagnosed type 2 diabetes group were younger ( P<0.01), and 2 h blood glucose level after glucose loading were higher [(15.20±5.26 vs 13.68±4.94) mmol/L, P<0.01]. (2) After one year standardized management, body weight, blood pressure, glucose and lipids metabolism in all patients were significantly improved. Compared with patients in long-term group, newly-diagnosed type 2 diabetes patients achieved better glycemic level [fasting blood glucose(6.27±1.56 vs 7.63±2.08) mmol/L, P<0.01; glycated hemoglobin(6.33±0.96 vs 7.23±1.37) %, P<0.01] , and had higher HOMA-β [(74.01±56.45 vs 40.17±37.07) %, P<0.01]. The glycemic control, blood pressure and blood lipids control rates in both groups increased significantly in one year. Comprehensive compliance rate of the whole patients increased from 5.80% to 24.06%. The metabolism indexes of the newly-diagnosed type 2 diabetes group were better than those of the long-term group[comprehensive compliance rate: (24.73% vs 17.18%, P=0.087, glycemic control rate(84.62% vs 53.37%, P<0.01)]. Conclusion:Standardized metabolic disease management promoted the overall improvement in blood glucose, blood pressure, and lipids levels in type 2 diabetes patients, especially in terms of blood glucose and those of the newly-diagnosed type 2 diabetes. In the future, we should focus on the early diagnosis and treatment of type 2 diabetes, actively promote the MMC model and stress the integrated management of blood glucose, blood pressure, and blood lipid levels. We should pay more attention to the long-term patients, to improve their awareness and treatment compliance.