Currently,the treatment of bone metastases is quite limited,and the effect is not significant.It is a tempting but difficult task to find valid therapy.The recent research on bone microenvironment,including the osteoblasts,osteoclasts and tumor cells et al,may provide new targets and methods for the treatment of bone metastases.

Objective To investigate infection status and distribution characteristics of human immunodeficiency virus (HIV)infection among voluntary blood donors in Xiangyang area in 2009-2014,and provide evidence for re-cruiting blood donors from low-risk population. Methods Blood specimens of 326 856 voluntary blood donors in Xiangyang area between January 2009 and December 2014 were detected anti-HIV with enzyme linked immunosor-bent assay(ELISA),positive specimens in HIV screening were performed confirmatory testing,epidemiological analysis was conducted on the positive detection results.Results 41 (0.13‰ )voluntary blood donors were con-firmed positive for HIV in Xiangyang area,positive rate among each year was significantly different (χ2 =27 801.87,P<0.01). Except marital status and infection routes,difference in positive rates among donors of dif-ferent gender,age,area,occupation,educational attainments,and number of blood donation were all significantly different(all P<0.01). Among HIV-infected voluntary blood donors,87.80% were male,41.46% and 31.71%were aged between 18-25 and 36-45 respectively,56.10% were through heterosexual transmission,and 43.90%were through male homosexual transmission. The percentage of workman and public service personnel infected with HIV were high,accounting for 21 .95% and 17.07% respectively,60.97% of confirmed positive HIV were from city area,56.10% only received junior middle school/technical secondary school education,65.85% of HIV-infec-ted persons were infected at the initial donation.Conclusion In order to ensure blood safety,blood center should in-crease publicity efforts,carry out health consultation before blood donation,and recruit blood donors from low-risk populations,nucleic acid detection should be carried out to shorten HIV detection window period.

Interleukin-17 (IL-17) is a newly discovered proinflammatory cytokine in recent years. It has wide biological activities; therefore it may be one of the important factors in the occurrence and development of certain diseases. The article mainly reviews the current situation of the study on the related roles of IL-17 in nervous system diseases.

Objective Analyze the causes of the conversion from off-pump coronary artery bypass (OPCAB) to on-pump coronary artery bypass grafting (ONCAB), in order to improve the operative survival rate. Methods From January 2000 to December 2003, 1952 patients underwent OPCAB. 29 patients (1.49%) required conversion from OPCAB to ONCAB. The causes of conversion included ventricular fibrillation in 5 cases, and hypotension in 24 cases. 26 patients received CABG under CPB. 8 patients under aortic cross clamping, and 3 patients needed only CPB support. Results The mean number of grafts was 2.9?0.6. 9 patients died, postoperatively with a mortality rate of 31.03%. In patients with the perioperative blood pressure lower than 80/40?mm?Hg, the mortality rate was 47.6%, and in patients with blood pressure higher than 80/40?mm?Hg, the mortality rate was 8.33% (P=0.043). No one with duration of hypotension less than 15min died, the mortality of the patients with hypotension times more than 15min was 42.86% (P=0.029). In the death group, all the patients had more than three vessel disease and severe vessel stenosis or occlusion. The mortality was hither in female patients. Conclusion Patients converting from OPCAB to ONCAB had a higher mortality. The severity and lasting time of hypotension is closely correlated with the mortality rate. The high risk factors included the surgeons with less OPCAB experience, the patients with more than three vessel diseases and severe coronary stenosis or occlusion, and female patients. The indication of OPCAB must be strictly controlled. Hypotension and severe ventricular fibrillation occurred during OPCAB must be corrected and eliminated immediately.

AIM: To study the effect of nasal mucosal tolerance to E-selectin on cerebral ischemia-reperfusion injury.METHODS: Two different doses(single and booster) of E-selectin or PBS were dropped into membrana mucosa nasi of rats.The middle cerebral artery occlusion(MCAO) model referring to Zea Longa method with modifications was performed 48 h after the last dose of E-selectin or PBS.After 2 h ischemia and 22 h reperfusion,the numbers of CD3+CD4+T-lymphocyte and CD3+CD8+T lymphocyte subgroup in the blood were examined with flow cytometry.Rats were killed,then part of the animals was used to measure the cerebral infarction volume by TTC staining.mRNA expressions of E-selectin,ICAM-1 and lymphocyte function-associated antigen-1(LFA-1) were determined by RT-PCR and activity of SOD was determined by xanthinoxidanse method in ischemic cortex of the other part of animals.RESULTS: The ratio of the numbers of CD3+CD4+T-lymphocytes and CD3+CD8+T-lymphocytes increased in E-selectin single pretreatment group(P

BACKGROUND: Recent studies have proven the existence of the regeneration of central nervous tissue. But abjective results,such as lacked of neurogenesis after injury,also have been found in many experiments. The greatest difficulty in conventional brain transplantation or brain tissue transplantation has been the survival and development of the graft. Additionally,the stability of therapeutic effects and the rehabilitation of brain functions also need confirmation.OBJECTIVE: To investigate an approach to intrathecal injection of neural stem cells(NSCs) in stroke therapy,and observe therapeutic effects and side effects as well,so as to make the evaluation of the safety and feasibility.DESIGN: A confirmative before-after study based on stroke patients.SETTING: A neurology department in a municipal hospital and a microbiology and immunology department affiliated to a university hospital.PARTICIPANTS: From November 2002 to September 2003,26 stroke inpatients in the Neurology Department of Anyang Municipal People' s Hospital were selected. Of all the c ases,3 were diagnosed as acute cerebral hemorrhage,and the other 23 had been suffering strokes for durations ranging from 3months to 30 years,an average of (4.2 ± 6. 6) years. They were 20 male and 6female between the ages from 36 -72 years old,an average of(56.3 ± 12.7)years old. Fifteen of them were ischemic and 11 were hemorrhagic. Nineteen were associated with hypertension,2 with coronary heart disease,4 with diabetes and 4 associated with hyperlipodemia.INTERVENTIONS: On each of the 3 patients with acute cerebral hemorrhage (hematoma volume,35 - 40 mL),a microinvasive intracerebral hematoma puncture was performed,and then a suspension of NSCs were conducted to the stroke by a drainage tube. For the rest of the patients,suspensions were intrathecally administered into the subarachnoid and then flowed to the cerebral surface through cerebrospinal fluid(CSF) circulation. Afterwards,physical therapy(PT),occupational therapy (OT) and speech therapy(ST) were jointly applied to facilitate the rehabilitation of the stroke patients. Therapeutic effects was calculated according to the European stroke scale(ESS) and the Barthel Index(BI) . If ESS index went beyond or equal to 1 score,the case would be defined as effective; otherwise,it would be defined as not effective. Additionally,CT,MRI,EEG,chest x-ray,and blood biochemical variables were also measured.MAIN OUTCOMEMEASURES: Therapeutic effects and side effects were taken as main outcomemeasurements.RESULTS: Of the 23 patients who ntrathecal administration,19had positive therapeutic effect and 4 did not. Post-transplantation ESS was higher than that of pre-transplantation(54. 1 ±21.2 vs 51.4 ±21.1,t = 5.8,P = 0. 000 007 6),while post-transplantation BI also increased significantly as compared with that of pre-transplantation(41.1 ± 31.3 vs 36. 1 ± 32. 1,vasive intracerebral hematoma puncture had successful rehabilitation and regained self-care ability. Of all the patients,4 got a transitory fever and 2felt slight post-operation headache.CONCLUSION: Conclusion can be drawn from the study that stroke patients are ameliorated to various extents after neural stem cell transplantation which has no toxicity or side effects. It shows that neural stem cell transplantation is viable and feasible in improving the motor function and self-care ability in stroke patients.

Thyroid cancer is the most frequent endocrine cancer and its incidence is progressively growing.Bone metastasis is are not uncommon in clinic.The efficacy is limited for patients with single treatment.However,multi-disciplinary combination therapy,combined with thyroid surgery,bone tumor surgery,nuclear medicine could get better outcomes and improve the life quality of the patients.

Objective To evaluate the value of spiral CT and 3D reconstruction in diagnosis and treatment of tibial plateau fractures.Methods 25 cases with tibial plateau fractures were examined with plain radiograhs,spiral CT and 3D reconstruction during July,1998 to December,2000.The tibial plateau fractures were classified according to Schatzker′s classification on the X-rays and 3D reconstruction images.On the superior view the tibial plateau fractures were divided into anterior lateral,posterior lateral,anterior medial and posterior medial fractures.Results 3D reconstruction images of 25 plateau fractures were the same as what arthroendoscopy were.25 fractures(including 23 arthroscopic management fractures)were operated under 3D reconstruction guide.No one case was infected.The treatment was valid.Conclusion Spiral CT and 3D reconstruction can offer more accurate classification and complement to new spatial classification of fractures.Also can provide better planning and management for the tibial plateau fractures.

Objectives To evaluate the preliminary effectiveness,investigate the clinical methods and prevent the complications of the epiphysis preservation operation by using custom-made prosthesis in children with distal femoral osteosarcomas.Methods Between August 2012 and July 2013,3 patients (from 8 to 14 years old) who were diagnosed of osteosarcoma underwent tumor segmental resection and epiphysis preservation operation and reconstruction with custom-made prosthesis.Patients were assigned neoadjuvant chemotherapy 1 to 2 cycles.The effect of neoadjuvant chemotherapy was then evaluated by X-ray,CT and MRI.Patients were determined the disease field by MRI,customized prosthesis by computer and had surgery of tumor segmental resection and reconstruction with custom-made prosthesis.All individuals were given appropriate functional exercise after operation,standard chemotherapy after incision healing one week,and long-time follow-ups.Results The operation times were 3 hours,4 hours and 6 hours.The bleeding losses during operation were 300 ml,500 ml and 2200 ml,respectively.The functional scores according to the scoring system of the Musculoskeletal Tumor Society (MSTS) after 12-24 months follow-ups were 24,26 and 13,respectively.And excellent functional results were obtained in short-time follow-ups.1 patient had prosthesis infection and amputation was taken after failing in conservative treatment.Unequal lengths of both lower extremities in 2 patients were less than 2 cm.Conclusion For the pediatric distal femoral osteosarcomas that has surgical indications,a new theory and therapy idea on combination of epiphysis preservation operation with custom-made prosthesis and neoadjuvant chemotherapy and standardized postoperative chemotherapy is suggested.And it has advantages of effective curative effect,easy operation,short operative time and quick recovery.However,long-term outcomes of complications should be observed further.

Objective To investigate the correlation between neuronal injury and the expression of caspase-3 and caspase-activated deoxyribonuclease (CAD) after focal cerebral ischemia-reperfusion in rats, also to study the effect of caspase-3 particular inhibitor. Methods The focal cerebral ischemia model (occluding middle cerebral artery of the rats) was made by using modified inserting thread method and reperfusion after embolizing for one hour. Using HE staining, TUNEL staining and microscopy to observe the morphological changes of ischemic neurons at six different time points including 6,12,24,48 and 72 h, using immunohistochemistry to observe the changes of caspase-3 and CAD protein in two groups (model group and interfere group). Results There was no significant difference between the two groups using HE staining and microscopy. While there was difference of TUNEL staining positive cells in all time points, except 6 h time point; Both the two groups reached the expression peak of caspase-3 in 24 h, and the number was 2. 360± 0. 318 and 0. 804 ± 0. 206 respectively(t' = 10. 039, P < 0. 01), there was statistical significance from 12 h to 48 h between the two groups ; The expression peak time of CAD protein in two groups was 48 h, and the number was 3.061 ± 0. 567 and 0. 812 ± 0. 240 respectively (t' = 8. 960, P < 0. 01), there was statistical significance from 12 to 72 h between two groups. Conclusions Caspase-3-CAD-DNA degradation is one important way of neuronal injury in cerebral ischemia-reperfusion of rats, caspase-3 inhibitor can protect neuron in a certain degree.