Objective To compare the Chinese 2008, 1992 and 2002 UICC (International Union Against Cancer) staging System for nasopharyngeal carcinoma and find out the reasons for the changes in the new Chinese 2008 staging system. Methods From Apr. 2007 to Dec. 2008, 285 naive patients with pathologically proved NPC, but without metastasis, received standard enhanced MRI scans of the nasopharynx and neck. Based on MRI imaging data and clinical information, clinical stage was classified according to the Chinese 2008, Chinese 1992 staging system and 2002 6th UICC staging system,respectively. Comparisons were made between Chinese 2008 and 1992 staging system, and between Chinese 2008 and 2002 UICC staging system by χ2 test. Results As a result of deleting some details of the old staging system, Chinese 2008 staging system is easier to grasp. With Chinese 2008 staging system, the number of cases in stage T1 to T4 are 66, 84, 72,63, respectively; those in stage N0 to N3 are 12,48,169,56; the number of cases in clinical stage Ⅰ -Ⅳ are 5,30,141 and 109. With 2002 6th UICC staging system, the number of cases in stage T1 to T4 are 66, 83, 55,81; those in stage N0 to N3 are 26,50,201,8;the number of cases in clinical stage Ⅰ -Ⅳ are 6,40,153 and 86. With Chinese 1992 staging system, the number of cases in stage T1 to T4 are 62,91,71,61; those in stage No to N3 are 26,189,61,9; the number of cases in clinical stage Ⅰ -Ⅳ are 6, 110, 98 and 71. Comparing with the staging results of Chinese 1992 staging system, many cases showed different stage based on Chinese 2008 system including 12 cases (4.21%) inT stage (3 up-staging and 9 down-staging), 217 cases (76.14%) in N stage (216 up-staging, most rise I stage, and 1 down-staging), 123 cases (43. 16% ) in clinical stage ( 121 up-staging and 2 down-staging). Comparing with the staging results of 2002 UICC staging system, 35 cases ( 12. 28% )changes in T stage (8 up-staging and 27 down-staging), 77 cases (27. 02% ) changes in N stage (all upstaging, most rise 1 stage), 74 cases (25. 95% ) changes in clinical stage (54 up-staging and 20 downstaging) based on Chinese 2008. Comparing the constituent ratio of T, N and clinical staging results separately, statistical differences were found between Chinese 2008 and Chinese 1992 staging system in N0,N1, N2, N3, clinical stage Ⅱ , Ⅲ, Ⅳ. Statistical difference was also found in N0, N2, N3, clinical stage Ⅳ between Chinese 2008 and 2002 UICC staging system. χ2 test results show that there is N0 significant difference of T stage constituent ratio among the 3 staging system ( χ2 = 6. 916, P = 0. 329 ), but the difference of N stage and clinical stage constituent ratio are significant( χ2 = 275. 169 and 84. 515, P ＜0. 0125). Conclusion Chinese 2008 Staging System for nasopharyngeal carcinoma is based on MRI, with clear definition to some anatomical location, after deleting some details in the old stage system, it's easier to use. The most obvious change for Chinese 2008 Staging System is the up-staging in N staging,which leads to the changes in clinical stage and constituent ratio of stage result.

ObjectiveTo investigate the prognostic factors of non-small cell lung cancer (NSCLC) after resection.MethodsClinical data of 131 NSCLC patients who underwent resection were reviewed and divided into chemotherapy group(86 cases) and non-chemotherapy group(45 cases) according to the treatment method.Survival rate was calculated by Kaplan-Meier method.The prognosis was analyzed by Cox proportional hazards model.ResultsThe median survival time (MST) of squamous cell carcinoma (76 cases),bronchial alveolar cell carcinoma( 8 cases),adenocarcinoma( 35 cases ),adenosquamous carcinoma (12 cases) was 60,54,34,24 months respectively (P＜0.05).For the patients of stage Ⅰ B,the MST of chemotherapy group and non-chemotherapy group was 75 and 76 months respectively(P ＞ 0.05 ).Multivariate analysis showed that tumor size,T stage,N stage,chemotherapy were independent prognostic factors (P =0.080,0.002,0.000,0.029).Conclusions Squamous cell carcinoma and bronchial alveolar cell carcinoma have better prognosis than adenocarcinoma,adenosquamous carcinoma.For the patients of stage Ⅰ B,the survival time can't be prolonged through platinum-based chemotherapy.Tumor size,T stage,N stage,chemotherapy are independent prognostic factors.

Objective To explore the clinical application value of serum amyloid protein(SAA) and C reactive protein(CRP)in early diagnosis of hand‐foot‐mouth disease(HFMD)in children .Methods The serum/plasma levels of CRP and SAA in 81 children with HFMD(HFMD group)and 125 healthy children(healthy control group)were detected by using dot immunogold filtration as‐say .Data including white blood cell (WBC) count ,levels of CRP and SAA were obtained and analyzed .And diagnostic efficacies of these indicators were evaluated by using receiver operating characteristic (ROC) curve .Results The serum levels of SAA and CRP and WBC count in HFMD group were significantly higher than those in healthy control group ,and all had statistically significant differences(P<0 .05) .The area under the ROC curve(AUC) of SAA(0 .921) was higher than that of CRP(0 .728) ,SAA/CRP ra‐tio(0 .846) and WBC count(0 .721) for diagnosing HFMD ,there were statistically significant differences(P<0 .05) .Compared with CRP ,WBC count and SAA/CRP ratio ,SAA had better diagnostic efficacy .Conclusion As a new biomarker of infections ,SAA can effectively diagnose HFMD early and provide more sensitive reference to clinicians for early diagnosis ,which might be worthy of clinical application widely .

Objective To know how large platelets influnece the platelet count difference of the optical and impedance methods so as to provide the support for the reasonable application of optical method and effectively increasing the accuracy of platelet count.Methods 132 blood routine specimens with normal RBC parameters were anaylzed by both electrical impedance and optical methods with the Sysmex-XE5000 fully automativ hematology analyzer.The data were divided into the large platelet group and the normal platelet group according to the platlet-large cell ratio(P-LCR)results.The RBC and platelet parameters were compared be-tween the two groups with the unpaired t-test and the platelet count results detected by the optical and electrical impedance methods were compared within group with the paired t-test.Results The extremely significant differences of platelet parameters existed be-tween the two groups.The P-LCR,MPV,PDW and IPF % of the large platelet group were significantly higher than those of the normal platelet group,but the RBC parameters had no obvious difference.The significant difference of the platelet count also existed between the electrical impedance and optical methods in the large platelet group(P <0.05 ),the platelet count results detected by the electrical impedance method was on the low side,but the normal platelet group had no significant difference.Conclusion P-LCR increase is related with the increase of immature platelet.The electrical impadence method conducts the differentiation according to the granular size,which is easy to exclude the large platelel with larger volume and leads to reduce the platelet count results.There-fore,when P-LCR is increased,the optical method should be adopted in conducting the platelet count for avoiding the false reduce caused by the electrical impedance method.

Objective To investigate the reference ranges of peripheral white blood cells (WBC) and five classification parame‐ters among 13 442 apparently healthy children to provide reference for clinical diagnosis .Methods A total of 13 442 apparently healthy children aged from 1 month old to 5 years undergoing the health physical examination in the healthcare department of the Guangzhou Municipal Women and Children Medical Center were chosen according to the healthy children screening standard and the exclusion standard of hematological diseases ,infection diseases and drug administration history .The WBC analysis and its parame‐ters detection were performed by using the Sysmex XS‐800i automatic blood cell analyzer .Results WBC and its five classification parameters were not accorded with the normally distribution .By the Mann‐whitney test ,no statistically significant differences in WBC ,BASO# and NEU # were detected between different genders of children (P> 0 .05) ,while the differences in LYM # , MONO# and EOS# had statistical significance(P<0 .001) ,in which the LYM # level in females was significantly higher than that in males ,while the MONO# and EOS# levels in females were lower than those in males ;By the Kruskal‐Wallis test ,WBC and five classification parameters had statistically significant differences among different age groups (P<0 .001) .The parameters of WBC ,LYM # ,MONO# and EOS# were decreased with age increase ,while NEU # was constantly increased with age increase and BASO# was decreased with age increase before 4 years old .Conclusion All factors such as gender ,age should be The inde‐pendent reference rangesl of WBC parameters among children aged from 1 month old to 7 years old should be formulated on the ba‐sis of fully considering the factors such as gender ,age .

Objective To explore the effectiveness of our self-designed 3D printing relay template in the treatment of malunion of irregular intra-articular ankle fractures.Methods From October 2013 to October 2015,our self-designed 3D printing relay template was used in 14 patients with severe malunion of intra-articular ankle fracture to assist their intra-articular osteotomy.They were 10 males and 4 females,with an average age of 40.5 years (from 34 to 59 years).Thin slice CT scan was preformed preoperatively for all the ankles involved.The computer fictitious tibial and fibular models for location and osteotomy navigation templates were acquired from the data of CT scan after processing,design and reconstruction by software.After the navigation templates which fit the size of solid ankle were printed by a 3D printer,they were sterilized and reserved.The guide plates were used in turn during operation.The irregular malunited bone blocks in the posterior malleolus were completely resected along the osteotomy template.After fracture reduction,the bone blocks were stabilized with internal fixation.Fracture union time was recorded.Scores of visual analogue scale (VAS),American Orthopaedic Foot and Ankle Society (AOFAS) and the short form-36 (SF-36),ankle ROM and complications were also recorded at the final follow-ups.Results The 14 patients obtained an average follow-up of 28.6 months (from 14 to 35 months).Bony union was achieved after an average of 3.7months (from 3 to 6 months).At the final follow-ups,on average,VAS score (2.2 ± O.8),AOFAS ankle and hindfoot score (81.1 ± 6.8),SF-36 score (82.5 ± 5.2),dorsal extension (27.5 ° ± 2.5°),and plantar flexion (24.2° ±6.3°) were significantly improved compared with the preoperative values (6.3 ± 1.8,43.1 ± 12.0,37.6 ± 9.9,14.1° ± 3.8° and 14.4° ± 3.9°,respectively) (P ＜ 0.05).No implant failure,soft tissue complications or post-traumatic arthritis occurred during the follow-up.Conclusion Since our self-designed 3D printing relay templates for osteotomy can accurately position the fracture lines of the distal tibia via limited incision and invasion,they help a lot in precise osteotomy and anatomical reduction of malunited intra-articular ankle fracture,preventing incidence of traumatic arthritis.

Aim To observe the effect of pyrimidine dithiocarbamate (PDTC) on the variance of disc morphology and the expressions of TNF-α, MMP-9 in the cervical disc in cervical dynamic equilibrium rat models, and to investigate the roles of PDTC in the process of intervertebral disc degeneration and the mechanism involved.Methods Fifty-four SD rats were divided into three groups randomly, then the dynamic equilibrium rat model was established by cutting the nuchal superficial and deep muscle of the rats.The dynamic equilibrium rats with PDTC solution intraperitoneal injection after operations were defined as PDTC group (group A), the models with saline intraperitoneal injection after operations as saline group (group B), the rats of fake operation with saline intraperitoneal injection as blank group (group C), and the animals were sacrificed in batches 10 weeks, 12 weeks, 16 weeks respectively after operation.The C5, C6 vertebrae and C5/6 discs were harvested, and the disc morphology was observed.TNF-α, MMP-9 mRNA expressions were detected by q-PCR and protein expression was observed by Western blot.Results Compared with the saline group, the morphology of disc in PDTC group was destructed slightly and fiber ring arranged orderly.TNF-α, MMP-9 gene and protein expressions had no obvious changes (P>0.05) in blank group (group C) at each time point.The expressions of IL-6, MMP-9 mRNA increased with time in group B, but the amount increased fast firstly, and slow lately, reaching peak in 12 weeks.The expression of TNF-α, MMP-9 protein became steady in group B from 10 weeks compared with other time points(P>0.05).TNF-α, MMP-9 genes and proteins expression decreased obviously in PDTC group (group A) compared with saline group (group B) (P<0.01) at each time point, but higher than blank group C(P<0.01) at each time point.Conclusions TNF-α and MMP-9 are important inflammatory factors involved in rat cervical disc degeneration, PDTC relieves the degeneration of rat cervical disc by reducing the expression of TNF-α and MMP-9 via disturbing the NF-κB signal pathway probably, and PDTC may become potential medicine for disc degeneration.

Objective To explore the clinical significance of platelet count increasing in patients with ovarian malignant tumor . Methods 80 cases of ovarian malignant tumor patients ,80 patients with ovarian benign tumor and 80 cases of healthy women were enrolled in the study as group A ,B ,C respectively .The group A was divided into FIGOⅠ group(n=30) ,and FIGOⅡ and above group(n=50) .Platelet count was detected by using fully automatic blood cell analyzer and the serum CA125 concentrations were also measured for all the groups .Results The platelet count and CA125 concentrations in group A were higher than group B and group C(P< 0 .05) .The positive rate of platelet increasing and serum CA125 were also higher than group B and group C(P<0 .05) .There were significant differences between FIGOⅠ group and FIGOⅡ and above group in platelet count and CA125 concen‐trations .Conclusion Ovarian malignant tumor complicated with increased platelet count is common in patients of advanced stage . The increased platelet count could indicate the malignant degree of ovarian malignant tumor .

Objective To explore the effects of empowerment education model on glycemic control and self-management behavior of community patients with diabetes. Method A total of 120 diabetics from 2 different communities were set as the observation group and control group. The control group was treated by routine medications and health education and the observation group was intervened with empowerment education model. After intervention for 6 months, the patients′blood glucose index and the diabetes self-management behavior were assessed and compared by scale of the diabetes self-care activities (SDSCA) between the two groups. Result By the end of the study, the glycemic index and SDSCA score in the former group were both significantly decreased than those in the control group (P<0.05), indicating the patients in the experiment group had better glycemic control and self-management behaviors compared with those in the control group. Conclusions Empowerment education model can arouse the internal motivation of patients to change their behaviors from passive to active acceptance in the health education. Empowerment education model can enhance diabetes patients′self-management conduct and the glycemic level.

Objective To explore the impact of NaF · EDTA-K2 on blood lipids measurement in pregnant women , determine whetherthe empty-stomach plasma for OGTT could be used as substitute for serumin blood lipids analyses.Methods Fastingplasma with NaF · EDTA-K2 and serumfrom 100 pregnant women werecollected,andconcentration of CHO,TG, HDL,LDL,apoA1 and apoB were tested with Hitachi 7 600 automatic biochemical analyzer.Data were analyzed by SPSS 19.0 software.Results The concentrations oflipids and lipoproteins with NaF · EDTA-K2 were slightly lower than those of serum.There were statistical significances between the means of CHO , HDL, LDL, apoA1 and apoBof two groups ( P<0.05) except TG.Correlation coefficients of the six analyteswere CHO 0.968, TG 0.995, HDL 0.979, LDL 0.991, apoA1 0.692, apoB 0.846respectively.Standard Error of Estimate for plasma were: CHO 0.281, TG 0.094, HDL 0.077, LDL 0.112, apoA1 0.230, apoB 0.111 respectively.The modified coefficients were 1.08 for CHO, HDL and LDL, 1.14 for apoA1 and 1.07 for apoB.Conclusion NaF· EDTA-K2 negatively biased the blood lipidsmeasurement of CHO , HDL, LDL, apoA1 and apoB in pregnant women,yet lipids concentrations in plasma with NaF · EDTA-K2 were closely related to those in serum , which may be used to predict the bloodlipidslevel of pregnant women afterajusted.