Objective To study the tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) expressed in invasive pituitary adenomas (IPA). Methods The expression of TNF-α and IL-6 were observed with immunohistochemstry (SP approach) in tissue from 40 cases of non-invasive pituitary adenomas (NIPA) and 40 cases of IPA. Results The expression of both TNF-α and IL-6 was significantly increased in the IPA tissues compared with those of NIPA (P<0.05). Conclusion TNF-α and IL-6 may play a role in the occurrence and development of IPA.

Objective To explore the causes and preventive measures of symptomatic intracranial hemorrhage in 217 patients with acute cerebral ischemic stroke treated with local intra-arterial urokinase. Methods From February1999 to June 2004, 217 patients were treated for acute ischemic stroke with local intra-arterial urokinase in our hospital. Factors associated with symptomatic intracranial hemorrhage of intra-arterial thrombolysis were analyzed by Stepwise logistic regression to identify some factors relating the prediction symptomatic intracranial hemorrhage. Results Symptomatic intracranial hemorrhage occurred in 8 cases (3.7%). Predictors of the symptomatic intracranial hemorrhage were the elevated systolic blood pressure before therapy (odds ratio, 1.096; 95% CI, 1.006 to 1.194) and urokinase (UK) treatment (odds ratio , 1.068; 95% CL, 1.053 to 1.247). Risk of secondary symptomatic intracranial hemorrhage was increased with elevated systolic blood pressure. Other factors like age, initial treating time, NIHSS, diabetes and collateral circulation did not predict the symptomatic intracranial hemorrhage respectively. Conclusions Predictors of symptomatic intracranial hemorrhage after local intra-arterial infusion of urokinase for acute ischemic stroke were the elevated systolic blood pressure before therapy and urokinase (UK) treatment.

[Objective] To investigate the expression of MICA mRNA and protein in osteosarcoma and give a more comprehensive understanding to its immune evasion.[Methods] RT-PCR was used to analyze MICA mRNA in 11 osteosarcoma tissues and 5 osteosarcoma cell lines.MICA expression was examined in 66 paraffin-embedded osteosarcoma tissues and 6 paraffin-embedded normal bone tissues by immunohistochemistry,and MICA protein in 9 fresh osteosarcoma tissues was detected by Western blot too.MICA surface expression was estimated by flow cytometry.[Results] Nine of eleven (81.8%) osteosarcoma specimens and all of the five cell lines consistently expressed MICA mRNA.Up-regulation of MICA expression was found in osteosarcoma (34/66,51.6%),compared with normal bone tissues (0/6,0%).The cell lines Saos-2,MG63,and HOS showed positive surface MICA expression,while the U2OS and OS732 showed very limited expression.[Conclusion] MICA mRNA and protein predominantly expressed on osteosarcoma tissues and cell lines.

Objective To investigate the effects of in situ venous arterialization on extensive artery obliterans occlusion of the lower extremity. Methods Lumbar sympathetic ganglionectomy and one stage in situ arterialization of the great saphemous vein were performed in 104 ischemic limbs of 88 patients with extensive arterial occlusion. Results Eighty-two of 104 limbs were followed-up from 6 months to over 6 years. The intermittent claudication, night pain improved in all cases, with satisfactory wound healing and no swelling of the lower limbs. Conclusions Arterial blood flow through venous conduit improves and reconstructs the blood circulation of the ischemic limbs.

Objective To explore the common causes of epilepsy and the etiologic characteristics in different age groups of patients with epilepsy.Methods A retrospective survey was made in 5572 epilepsy patients in Epileptic Center of Guangdong 999 Brain Hospital from January 2003 to December 2009.According to the diagnostic criteria published in 2005 from ILAE,all the diagnoses of 5572 cases were made by epileptic specialists.Based on history,cranial MRI or CT and pathologic data,causes of epilepsy were classified into idiopathic,symptomatic and cryptogenic epilepsy.The cases of symptomatic epilepsy were further arranged into different categories in different age grades,such as head trauma,perinatal injuries,infection in central nervous system, cerebral vascular disease, brain tumor, disorders of cortical development,neurocutaneous syndrome and others.The cases with febrile seizures and family history were collected,and positive ratio of febrile seizures and family history were contrasted in different categories of cases by Kruskal-Wallis test ( nonparametric test ).Results In 5572 cases,66 were idiopathic,2834 symptomatic,2672 cryptogenic,and the ratio of these causes was 1％,51％,48％ respectively.Among 2834 cases of symptomatic epilepsy,822 were head trauma,497 were perinatal injuries,360 were infection in central nervous system,249 were brain tumor,150 were cerebral vascular disease,135 were disorders of cortical development,62 were neurocutaneous syndrome and 559 were others. In brief,head trauma,perinatal injuries,infection in central nervous system,brain tumor and cerebral vascular disease were top 5 causes of symptomatic epilepsy. Hippocampal sclerosis was found in 744 cases in those of eryptogenic epilepsy.The importance of febrile seizures( idiopathic:15.2％ ( 10/66 ),symptomatic:6.5％ ( 185/2834 ),cryptogenic:9.4％ ( 250/2672 ) ; x2 =181.393,P =0.000 ) and family history ( idiopathic:83.3％ ( 55/66 ),symptomatic:1.1％ (31/2834),cryptogenic:0.4％ (12/2672) ; x2 =68.354,P =0.000) was statistically different in different causes of epilepsy.Febrile seizures was the most frequent in cases with hippocampal sclerosis than those with other causes,and family history was the most frequent in neurocutaneous syndrome in symptomatic cases.Perinatal injurics was thc first causc in cases of infancy and childhood,head trauma was the top one in those of juvenile and adulthood,and cerebral vascular disease was the main cause in senile cases. Conclusions In the whole epileptic cases of 5572, 1％ was idiopathic,51％ was symptomatic,and 48％ cryptogenic. The main causes of them were head trauma,perinatal injuries,infection in central nervous system,brain tumor,and cerebral vascular disease.

Objective To screen out probable lynch syndrome (LS) associated endometrial cancer (EC) by investigating the expression of mismatch repair (MMR) protein in EC, and to analyze the disease traits combined with clinicopathologic characteristics. Methods The expressions of MSH2, MSH6, MLH1 and PMS2 were detected by using immunohistochemistry (IHC) in 443 EC patients. Results In 443 EC patients, 328 cases (74%) with all MMR proteins expression were classified as sporadic EC, and 115 cases (26%) cases with loss expression of at least one MMR protein were regarded as probable LS. MMR-deficient cases mostly showed a loss of MLH1/PMS2 expression (42%), followed by the absence of MSH2/MSH6 (23%), MSH6 (17%), PMS2 (17%) and MSH6/MLH1/PMS2 (3%). Compared with the sporadic EC group, obesity was not found in probable LS group (body mass index<28 kg/m2) (P=0.040), and high tumor grade was common (P=0.012); There was no significant difference between the two groups in age, the incidence of diabetes or hypertension, family history of cancer or histological type, tumor location, the International Federation of Gynecology and Obstetrics (FIGO) stage, myometrial invasion, lymph node metastasis, lymphatic or vascular invasion (all P> 0.05). A higher tumor grade was more common in the MSH6 and PMS2 deficient groups. Conclusions Compared with sporadic EC, the absence of obesity, a high grade tumor are more common in probable LS cases.

Objective:To explore the prognostic value of quantitative plaque analysis and coronary CT angiography (CCTA) derived fractional flow reserve (CT-FFR) in evaluating plaque progression (PP).Methods:A total of 118 consecutive patients who underwent serial CCTA examinations in Affiliated Hospital of Jiangnan University from December 2013 to December 2017 were retrospectively enrolled. There were 37 patients in the PP group and 81 patients in the non-PP group. All patients′ CCTA images were quantitatively analyzed using plaque analysis software. The quantitative analysis parameters included stenosis degree, plaque length, total plaque volume, calcified plaque volume, non-calcified plaque volume, minimum lumen area, remodeling index(RI) and plaque burden. Plaque progression was defined as plaque burden change rate>1%. CT-FFR analysis was performed using cFFR software and the CT-FFR value was measured at 2-4 cm distal to the coronary lesion. Baseline parameters between the two groups were evaluated using Students t-test, U-test, chi-square test. The logistic regression model was conducted to evaluate the relationship between CCTA derived parameters and PP. Receiver operating characteristic curve analysis with the areas under the curve (AUC) was used to determine the predictive performance of different CCTA parameters. Results:Compared with the non-PP group, the patients were older( t=2.391, P=0.018), the prevalence of hyperlipidemia was higher(χ2=4.550, P=0.033), and the proportion of statins use was lower (χ2=4.764, P=0.029) in the PP group. The PP group showed greater coronary stenosis, smaller minimum lumen area, larger plaque volume and non-calcified plaque volume, larger remodeling index and lower CT-FFR value on baseline CCTA (all P<0.05). Logistic regression analysis demonstrated that RI(OR=2.714, 95%CI:1.078-6.836)and CT-FFR (OR=2.940, 95%CI:1.215-7.116) were independent predictors of PP. The model based on CCTA stenosis degree, quantitative plaque features and CT-FFR (AUC 0.83, 95%CI: 0.75-0.90; P<0.001) was significantly better than the model based on CCTA stenosis degree (AUC 0.62, 95%CI: 0.52-0.70, P=0.049) and the model based on CCTA stenosis degree and quantitative plaque characteristics (AUC 0.77, 95%CI: 0.68-0.84, P<0.001). Conclusions:Compared with the prediction model derived on stenosis degree, plaque quantitative markers and CT-FFR can improve the prediction value of PP.RI and CT-FFR were important predictors of PP.

Objective:To investigate the value of 24-hour dynamic electrocardiogram combined with cardiac troponin I (cTnI) in evaluating the radiation-induced heart disease (RIHD) in chest tumor radiotherapy.Methods:From 2015 to 2018, 128 patients with chest tumor who received radiation therapy with/without chemotherapy in the Third People′s Hospital of Linyi were selected to undergo routine ECG examination, 24-hour dynamic ECG examination, cTnI and cardiac color Doppler ultrasound before radiotherapy, 30Gy radiotherapy, 50Gy radiotherapy, after radiotherapy and 3 months after radiotherapy, respectively. The detection rates of 24-hour dynamic electrocardiogram, routine electrocardiogram, cTnI, cardiac color Doppler ultrasound and 24-hour dynamic electrocardiogram combined with cTnI for RIHD were statistically compared. The correlation between glucose level, hypertension and coronary heart disease, combined with chemotherapy, radiation dose and the irradiated area of the heart and the incidence of RIHD was analyzed.Results:The detection rates for RIHD did not significantly differ between 24-hour dynamic electrocardiogram and routine electrocardiogram ( P>0.05), whereas the detection rates for arrhythmia, atrioventricular block, bundle branch block and ST-T changes of 24-hour dynamic electrocardiogram were significantly higher than those of routine electrocardiogram (all P<0.05). The detection rate of 24-hour dynamic electrocardiogram combined with cTnI was significantly higher compared with that of 24-hour dynamic electrocardiogram, routine electrocardiogram, cTnI or cardiac color Doppler ultrasound alone (all P<0.05). There was a significant difference in RIHD before and after radiotherapy ( P<0.05). The incidence rate of RIHD in the radiation therapy combined with chemotherapy group was significantly higher than those in the cisplatin chemotherapy and radiotherapy alone groups, especially in the epirubicin+cyclophosphamide group (45%, all P<0.05). The incidence rate of RIHD was similar between radiotherapy alone and radiotherapy combined with cisplatin chemotherapy (both P>0.05). After radiation therapy, the grade of RIHD was elevated in 40 cases (31.2%). Diabetes mellitus, hypertension, coronary heart disease, radiotherapy combined with chemotherapy, cardiac D mean and cardiac V 40Gy were the independent factors for the occurrence of grade 1-4 RIHD (all P<0.05). Conclusion:The 24-hour dynamic electrocardiogram combined with cTnI is of great value in the detection of RIHD induced by radiotherapy for chest tumors with high detection rate, simple operation and low cost, which is worthy of application in clinical practice.

Objective To analyse the relationship between frailty index(FI)and drug use situation in elderly patients.Methods For the cross-sectional study,data from participants aged 75 and over (n =88,male =46)of Fuxing Hospital.Demographic data,co-morbidity,patients′healthy condition were evaluated by fIrating scale according to Rockwood.Demographics data,co-morbidity and medication compliance (the types and amounts of the drugs)were recorded.Frailty was quantified as deficits accumulated in a frailty index (FI). Individuals were separated into three groups according to FI:frail (0.45≤FI <1 ),pre-frail (0.20

Objective: To establish finite element models of skull, fronto-orbital advancement and fronto-orbital distraction osteogenesis of craniosynostosis, to analyze the mechanical characteristics of skull base and fronto-orbital operation area, so as to guide the later application of tractors. Methods: One 6-year-old male patient with unilateral coronal synostosis was enrolled in October 2015. Three-dimensional (3D) computed tomography (CT) scan of skull was performed. DICOM data was imported into Mimics 17.0 for contour extraction and cranial 3D reconstruction. The skull model was processed by Mimics, Geomagic Studio 12.0, Hypermesh 12.0 and other software to establish a three-dimensional finite element model. The unilateral and bilateral fronto-orbital anterior osteotomy models were simulated respectively. The mechanical analysis was performed at point A in forehead area and point B in temporal area. Three different groups of traction forces were loaded: (1) 50 Newton for point A, 50 Newton for point B; (2) 80 Newton for point A and 50 Newton for point B; (3) 100 Newton for point A and 50 Newton for point B, to obtain the optimized traction force. Results: Stress analysis was performed on established cranial finite element model, as well as unilateral and bilateral fronto-orbital advancement procedures. The stress distribution of the anterior and middle cranial fossae was found to be concentrated. After unilateral fronto-orbital advancement, the stress of anterior cranial fossa, especially the affected side, was decreased. The stress on both side in anterior cranial fossa was decreased after bilateral fronto-orbital advancement. After force was applied to point A and point B, the optimum deviation result at supraorbital notch point, midpoint of supraorbital margin, frontal temporal point and frontal zygomatic suture point in 3D (Deviation result of X value: -29.4%, -20.5%, -8.6%, -9.3%; Deviation result of Y value: 20.9%, 31.5%, 73.0%, 539.4%; Deviation result of Z value: 4.4%, 1.9%, 0.1%, 11.8%) demonstrated the application of traction force can inwardly, downwardly and forwardly move the bone flap. The optimized traction was 80 Newton at point A and 50 Newton at point B by preliminary assessment. Conclusions The finite element analysis of the fronto-orbital advancement can be used for more accurate preoperative simulation, to clarify the influence of fronto-orbital advancement on craniofacial morphology and development, as well as skull base. It also facilitates surgical decision and predicts the postoperative distraction vectors.