Objective To observe the sensitivity ofastrocytoma to chemotherapeutic drugs, in order to explore the drug selection using chemosensitivity testing in vitro on astrocytoma. Comparing different WHO grade astrocytoma to chemotherapeutic drugs sensitivity differences,providing the basis data for clinical treatment. Methods The astrocytoma cells were seperated and cultured in vitro from 142 tumor tissues by glioma resection, including 55 cases of low-grade astrocytoma (WHO grade Ⅰ , Ⅱ) and 87 cases of high-grade astrocytoma (WHO grade Ⅲ, Ⅳ). The proliferation inhibition and chemosensitivity of tumor cells to 11 drugs were investigated by using MTT method. Results There were 54.93% (78/142) patients recommended chemotherapeutic drug in 142 cases. The percentage was 41.82%(23/55) in the low-grade astrocytoma, and 63.22% (55/87) in the high-grade astrocytoma respectively. Teniposide,carboplatin,vincristine as the sensitive drugs were similar in different WHO grade astrocytoma. Conclusions The chemosensitivity testing could be used to filtrate sensitive drugs to clinical chemotherapy. The action is more prominent in high-grade astrocytoma than in low-grade astrocytoma. There is no difference in the choice of sensible drugs among different WHO grade astrocytoma.

Objective To explore the similarities and differences in endoscopic and pathological characteristics between elderly and non-elderly patients with Barrett esophagus (BE). Methods Three hundred and seventy-one cases with BE were divided into elderly group (n=254) and nonelderly group (n=117). The detection rate, endoscopic findings and pathological changes were assessed. Results The detection rate of BE was 2.9% in the elderly, and 0. 9% in the non-elderly(χ2 =127.8, P＜0.01). The 112 cases (44.1%) of the elderly had reflux symptoms, and so did 87cases (66.7%) of the non-elderly (χ2 =55.9, P＜0.01). The detection rate of BE in the two groups was increased year by year from 2004 to 2008. The detection rate of ring pattern was significantly higher in elderly group than in non-elderly group (28.7% vs. 10.3%, χ2=14.5, P＜0.01). Nonelderly patients had higher rate of island pattern than elderly patients (59.5% vs. 71.7%, χ2=4.7,P＜0.05). There were significant differences in the rate of specialized intestinal metaplasia between elderly and non-elderly patients (42.1% vs. 27.4%, χ2=6.9, P＜0.01). The difference in low and medium grade intraepithelial neoplasm between the two groups had statistical significance (21.3% vs.11.1%, χ2=4.9, P＜0.05). There were two cases with adenocarcinoma in elderly group, but no case was found in non-elderly group. The detection rate of H. pylori was comparable between elderly group and non-elderly group (35.5% vs. 40.9%, χ2=0.40, P＞0.05). Conclusions The elderly patients have the 3.2 times higher detection rate of BE than non-elderly patients. The detection rates of specialized intestinal metaplasia and intraepithelial neoplasm are higher in elderly group than in nonelderly group.

Objective　To evaluate therapeutic effect and opportunity of laser in situ keratomileusis(LASIK) for treatment of hypermetropia.Methods　Three hundred and ninety hypermetropia eyes were treated with LASIK using solid excimer laser instrument(made in Novatec Corporation, USA),and were reexamined at 1,3,6 and 12 months after LASIK.Results　Therapeutic effect of LASIK was more remarkable, stable and reliable, that of other methods in treating +2.00～+10.00D hypermetropia and astigmatism, and the rate and degree of refraction regression were small. The diopter has been stable in 6～12　months after LASIK. Diopter of 87 percentage of all eyes≤+2.00D, and 61 percentage≤+1.00D. LASIK had shorter recovery time, more gently operation reaction, more remarkable droping of diopter than other methods. Elevation of vision was remarkable after LASIK. Elevation of vision of amblyopia children who were treated with LASIK was quicker and more remarkable after treatment of amblyopia than that of other amblyopia children who were not treated with LASIK.Conclusion　At present, LASIK is the best therapeutic method to treat hypermetropia.

Objective To explore the correlation between anti-thyroid autoantibodies and hepatitis C virus (HCV) infection. Methods Four hundred and sixty-two samples with positive thyroid peroxidase antibody (TPOAb) and (or) thyroglobulin antibody (TgAb) were collected. Three hundred and eighty age and gender matched subjects with negative TPOAb and TgAb were selected as controls. The anti-HCV antibody was examined in all the cases using the third-generation enzyme-linked immunosorbent assay (ELISA), HCV RNA qualitative examination was examined further in those who had positive anti-HCV antibody. Meanwhile, 195 subjects with hepatitis C, 150 healthy subjects and 150 subjects with hepatitis B were tested for thyroid-related markers. The data were analyzed by independent-sample t test and chi square test. Results The HCV infection rate in 462 thyroid autoantibodies positive subjects was 1.30% and 0.53% in 380 thyroid autoantibodies negative subjects. There was no significant difference of the HCV infection rate between two groups (X2=1.322, P>0.05). In the subjects with hepatitis C, 30.8% were TPOAb positive, 30.8% were TgAb positive, which were significantly different from those of healthy subjects and subjects with hepatitis B (X2=21.496,X2=30.454;P<0.01). Conclusions HCV infection rate does not increase in subjects with abnormal thyroid autoimmunity. However, positive rate of thyroid autoantibodies increases in subjects with hepatitis C, which suggests that thyroid-related markers should be examined in hepatitis C patients.

Objective To describe the characteristics of and emergency treatment for and outcomes of critical ill children with 2009 influenza A caused by H1N1 virus strain. Method A prospective observational study of 3 pediatric patients with severe influenza A of H1N1 virus strain complicated with acute respiratory distress syndrome (ARDS) from November to December 2009. Results The H1N1 virus strain was confirmed by using realtime reverse transcription polymerase chain reaction (Real-time RT-PCR). Two patients survived and one died. Fever and cough were the onset symptoms. The systemic responses to influenza A at first were relatively mild. The tragic deterioration occurred all of a sudden with cyanosis all over the lips and dyspnea. The roentgenography showed bilateral multiple tabular pulmonary effusion and diffuse opaque shadows. The length of time required to confirm the diagnosis of ARDS from the symptom onset was 4 to 6 days. All patients were severely hypoxic with the ratio of PaO2 to 0.7-0.9 fraction of inspired oxygen (FiO2) to be 70- 100 mmHg at admission to PICU. In order to avoid injury to the lung, the protective ventilation strategy was carried out with low tidal volume (6 mL/kg) and adequate pressure,and conservative fluid management. Conclusions The H1N1 strain influenza virus A is characterized by pyrexia, cough and other respiratory symptoms in the early stage of critically ill children. In a few days, cough increased along with a sudden burst of cyanotic lips and shortness of breath, highly suggesting ARDS. Timely oxygen therapy and respiratory support, conservative fluid management, and the prophylaxis of secondary infection may be the essential measures. More clinical data are needed to clarify the critical features and to evaluate the emergency therapy for H1N1 influenza A in critically ill children.

Objective:To optimize the parameters of the equation of sagittal craniofacial structures with different classes of malocclusion using genetic algorithms(GAS), and to explore the rules .Methods:A total of 240 patients with average angle malocclusion aged 8-18 years old were divided into three groups: Angle Class Ⅰ(n=79), Angle Class Ⅱ(n=76)and Angle Class Ⅲ(n=85) groups.In each group 10 cases were randomly selected as the test samples, the rest as the experimental samples.The cephalometric analysis was performed on all the patients'' cephalograms, and the results of Ba-N,Ba-A,Ba-S,S-Ptm,Ptm-A,Ba-Ar,Ar-Go,Go-PoG,Ba-PoG and N-S-Ar were analyzed by two independent samples t-test and One-Way ANOVA. The relevant influencing factors of craniofacial structures were found.The parameters of the equation was optimized to obtain the relevant equations using GAS.The predicted values of the optimized equation were compared with the measured values.Results:There were no significant differences in sex between Angle Class Ⅰ, Class Ⅱ and Class Ⅲ groups(P> 0.05);when the men and women with the same type were combined,the Ba-A,Ptm-A,Ar-Go,and Ba-PoG had statistically significant differences between Angle Class Ⅰ, Class Ⅱ, and Class Ⅲ groups (P<0.05).The correlation analysis results showed that in Angle Class Ⅰgroup:Ba-A was positively correlated with Ba-N (r=0.683),Ptm-A was positively correlated with Go-PoG (r=0.738), Ar-Go was positively correlated with Ba-PoG (r=0.833), and negatively correlated with Go-PoG (r=-0.560) and Ba-PoG was positively correlated with Go-PoG (r=0.669);in Angle class Ⅱ group,Ba-A was positively correlated with Ba-PoG and Ba-N(r=0.884,r=0.883), Ptm-A was positively correlated with Ba-A (r=0.742),Ar-Go was positively correlated with Ba-PoG (r=0.401)and negatively correlated with Go-PoG (r=-0.317) and Ba-PoG was positively correlated with Ba-A and Go-PoG(r=0.883,r=0.488);in Angle Class Ⅲ group,Ba-A was positively correlated with Ba-N and Ba-PoG(r=0.891,r=0.829),Ptm-A was positively correlated with Ba-A (r=0.807)and negatively correlated with Ba-S (r=-0.404),Ar-Go was positively correlated with S-Ptm (r=0.548) and Ba-PoG was positively correlated with Ba-A (r=0.829).The equation of sagittal craniofacial structure with different occlusal classes was established by GAS.In Angle Class Ⅰgroup:Ba-A(mm)=10.963 9+0.859 8×Ba-N,Ptm-A(mm)=6.897 6+0.557 0×Go-PoG,Ar-Go(mm)=-2.548 2+0.511 8×Ba-PoG-0.5272×Go-PoG,Ba-PoG(mm)=17.515 6+1.021 3×GO-POG;in Angle Class Ⅱ group:Ba-A(mm)=-2.121 3+0.567 6× Ba-PoG+0.513 2× Ba-N,Ptm-A(mm)=13.788 7+0.349 4×Ba-A,Ar-Go(mm)=2.447 7+0.368 8×Ba-PoG-0.427 9×Go-PoG,Ba-PoG(mm)=-7.140 2+0.751 3×Ba-A+0.295 4×Go-PoG;in Angle Class Ⅲgroup:Ba-A(mm)=3.281 0+0.545 3×Ba-N+0.394 4× Ba-PoG,Ptm-A(mm)=3.535 8+0.63 1×Ba-A-0.614 2×Ba-S,Ar-Go(mm)=-9.002 1+1.004 3×S-Ptm,Ba-PoG(mm)=-2.091 2+1.057 5×Ba-A.There were no significant differences between the predicted values of GAS and the measured data (P> 0.05), and the error was small.Conclusion: The optimal relation equation of craniofacial structure of sagittal malocclusion is established by GAS with the quantitative regularity.

Objective:To establish the quantitative relationship equation of the crantiofacial vertical points in the skeletal classⅡ malocclusion patients with various vertical types by using genetic algorithms method,and to express the measured values in the patients with different gender with the same formula.Methods:A total of 155 skeletal class Ⅱ malocclusion patients without treatment,aged from 10 to 18 years old,were selected and divided into high-angle group(n=50),average-angle group(n=58),low-angle group(n=47);5 samples were randomly selected in each group as the test samples,the rest as the experimental sample.The cephalometic radiographs were performed and measured.The relevant influencing factors of craniofacial structure were ensured.The genetic algorithm was used to optimize the equation parameters to obtain the correlation equation.The error between the predicted value and the measured value was compared.Results:The various parameters had no significant differences between different gender in high-angle,average-angle and low-angle groups(P>0.05);then the men and the women with same type were combined,most of the indicators had statistically significant differences between three groups (P<0.05).The correlation analysis results showed that there was a positive correlation between age and Ans-U1(r=0.470),there was a positive correlation between N-Me and Ans-Me(r=0.964);for Ans-U1 ,there was a positive correlation with Ans-Me(r=0.805)and negative correlation with facial angle;there was a positive correlation between N-Go and N-Me (r=0.926);for L1-Me,there was a positive correlation with Ans-Me(r=0.898)and negative correlation with the angle of Go(r=-0.468)in high-angle group. In average-angle group,there was a positive correlation between age and N-Me (r=0.531);for Ans-U1,there was a positive correlation with Ans-Me(r=0.878)and negative correlation with the facial angle(r=-0.262);for Ans-Me,there was a positive correlation with N-Me(r=0.920), negative correlation with N-Ans(r=-0.560)and negative correlation with Ar-Go(r=-0.652);for N-Go,there was a positive correlation with S-Go(r=0.867), positive correlation with N-Ans(r=0.252)and positive correlation with L1-Me(r=0.754).For S-Ar,there was a positive correlation with S-Go(r=0.671), negative correlation with Ar-Go(r=-0.250),and positive correlation with L1-Me(r=0.552).In low-angle group,for age,there was a positive correlation with S-Go(r=0.602), negative correlation with the angle of Go(r=-0.346),and positive correlation with L1-Me(r=0.576);for N-Me,there was a positive correlation with Ans-Me(r=0.869),and positive correlation with N-Go(r=0.859),and negative correlation with the facial angle(r=-0.177);for N-Ans,there was a positive correlation with N-Me(r=0.605) and negative correlation with Ans-U1(r=-0.113);for Ans-Me,there was a positive correlation with N-Me(r=0.869),positive correlation with the facial angle(r=0.070),and positive correlation with Ans-U1(r=0.785);for N-Go,there was a positive correlation with N-Me(r=0.859)and positive correlation with S-Go(r=0.829).The quantitative relationship equations of the crantiofacial vertical points in skeletal class Ⅱmalocclusion patients with various vertical types in each group were established by using genetic algorithms.In high-angle group:Age=5.883 6+0.269×Ans-U1,N-M=22.026 6+1.494 5×Ans-Me,Ans-U1=34.959 4+0.454 5×Ans-Me-0.409 7×Facial angle,N-Go=-4.588 2+0.472 4×N-Me,L1-Me=-12.590 5+0.5322×Ans-Me+0.124 3×∠Go.In average-angle group:Age=-2.944 1+0.146 8×N-Me,Ans-U1=18.917+0.476 4×Ans-Me-0.230 2×Facial angle,Ans-Me=-0.620 5+1.014 5×N-Me-0.974 1×N-Ans-0.057 6×Ar-Go,N-Go=1.631 1+0.897 8×S-Go+0.919 7×N-S+0.168 8×L1-Me,S-Ar=-1.823 1+0.845 3×S-Go-0.867 0×Ar-Go+0.202 4×L1-Me.In low-angle group:Age=11.740 6+0.152 7×S-Go-0.169 9×∠Go+0.252 5×L1-Me,N-Me=61.153 0+0.964 3×Ans-Me+0.628 6×N-Go-0.689 2×Facialangle,N-Ans=-4.949 2+1.065 8×N-Me-2.316 5×Ans-U1,Ans-Me=-25.180 0+0.418 4×N-Me+0.280 3×Facial angle+0.477 6×Ans-U1,N-Go=8.684 2+0.409 9×N-Me+0.403 3×S-Go.There was no significant difference between the predicted values of equation established with genetic algorithms and the measured data (P>0.05).Conclusion:The quantitative relationship equation of the crantiofacial vertical points in the skeletal class Ⅱmalocclusion patients with various vertical types established with genetic algorithms may show the vertical quantitative relationship and predict the growth to a certain degree.

Objective To investigate the effect of different delivery modes and related obstetric factors on the short-term function of the pelvic floor.Methods One hundred and twenty healthy primiparae women were interviewed at 6-8 weeks postpartum,with 72 women in the vaginal delivery group and 48 women in the elective cesarean section group.Questionnaire on stress urinary incontinence and measurement of diastolic and contractive function of the pelvic floor muscles by electromyogram(EMG)were used for the evaluation and comparison.Results The prevalence of stress urinary incontinence in the vaginal delivery group and the elective cesarean section group was 21% and 10%(P=0.134),respectively.The values of the right act,right work,and average work surveyed by EMG in vaginal delivery group were significantly lower than those in cesarean section group(right act,12.9?0.8 vs 17.3?1.7,P

Conditions about protoplast preparation and regeneration of Streptococcus zooepidemicus,which could produce hyaluronic acid, were studied , including the concentration of lysozyme, lytic time, different osmotic stabilizers and the preculture under the high osmotic pressure . As a result, the formation and regeneration rate of protoplasts could reach up to 94.6% and 18.5% respectively under the optimum conditions, before the digestion of lysozyme (50U/mL,39℃, 60 min) the strain was cultured for 2 hours in 0.6 mol/L NaCl high osmotic pressure liquid medium containing 1.2% Gly. Among different treatments of various laser power and irradiating time, He-Ne laser which acted for 300 seconds with 40mW /cm 2 caused lethality rate as high as 99.88%. Finally, a mutated strain was gained, whose production of HA is 2.21g/L, just 4.5 times as much as the original strain.

Objective To investigate our early results of robot-assisted esophagectomy (RAE) and present our learning curve experience with the largest study from one-single institution of China.Methods Between November 2015 and April 2017,a series of consecutive patients undergoing RAE at Shanghai Chest Hospital were reviewed.The patients'demographics,operative and postoperative outcomes were demonstrated.Results A total of 154 patients underwent RAE during the study.All patients received Mckeown esophagectomy and extensive thoraco-abdominal two-field lymph node dissection.Of these,122 were male and 32 were female.The mean total operative duration was 179-445 (271.0 ±61.5) min and the operative duration of the thoracic phase was 51-142 (96.7 ± 27.0)min.The mean estimated blood loss was 100 -1 000 (230.4 ±74.4)ml.The pathological results showed that 150 had squamous cell carcinoma,2 had adenocarcinoma,and 2 had small cell carcinoma.The R0 resection was 92.2％.The mean number of lymph node dissection was 11-64 (20.4 ± 8.5) and the lymph node sampling rate along left and right recurrent laryngeal nerve (RLN) were 92.2％ and 88.3％.The morbidity was present in 64 of 154 patients (41.6％).The major complications rate was anastomotic leak (12.3％),and vocal cord paralysis (16.9％).Intensive care unit (ICU) hospital stay time was 0-27 (2.7 ± 3.6) d,the median length of hospital stay was 7-81 (15.8 ± 11.6)days.There was no 90-day mortality.Conclusions RAE is a safe and feasible alternative for treatment of esophageal cancer.RAE can improve the efficacy of lymph node dissection,especially for the lymphadenectomy along recurrent laryngeal nerve.