Objective To investigate the therapeutic effect of radial surgery in large cerebral metastatic carcinoma. Methods Adopt three dimensional oriented radial surgery to 15 patients with the biggest diameter of more than 35mm. Observe the variation of clinical symptoms and analysis the change of CT image. Follow up the survival time, complications and the cause of death at the same time. Results Most of the patients got prominent improvement in symptoms. But the imaging change of carcinoma focus was a slow course comparatively. The survival rate in 1 year was 26％ . Conclusion Radial surgery is an effective, simple and safe method in the treatment of large cerebral metastatic carcinoma. It has a good control rate with only slight complications.

OBJECTIVE To evaluate the role ofpreoperative ultrasonograpy in detecting cervical lymph node metastasis. METHODS Medical records between February 1998 and February 2002,consisting of 51 cases (58 sides) of well-differentiated thyroid carcinoma with cervical lymph nodes metastasis, were reviewed. Patients were divided into 2 groups: group 1,34 cervical sides with palpable cervical lymph nodes preoperatively and group 2,24 cervical sides with impalpable nodes but positive for nodal metastasis ultrasonically. All patients underwent modified neck dissection. The preoperative ultrsonographic results and preoperative pathologic findings were compared. RESULTS Of the 58 sides with positive preoperative ultrsonographic results, 53 sides had been demonstrated to have cervical lymph nodes metastasis pathologically. The sensitivity of ultraonography was 91.4 %(53/58). Four patients had developed lateral cervical recurrence during the course of the follow-up, yielding a recurrence rate of 7.5 %. Ultrasonography detected cervical lymph node believed to be uninvolved by physical examination in 39.6 % of patients. The most frequent involvement site was middle neck according to ultrasonography [71.7 %(38/53)] and level Ⅲ according to pathological findings [67.9 %(36/53)]. CONCLUSION Preoperative ultrasonograpy is a basis for detecting cervical lymph nodes metastasis in thyroid cancer patients. It can detect metastatic cervical lymph nodes and their localizations. All thyroid cancer patients should undergo preoperative ultrasonography.

目的：通过检索挖掘多个肿瘤公共数据库中肝细胞癌（hepatocellular carcinoma，HCC）的相关数据，从转录本、蛋白质、基因突变、蛋白相互作用及相应的信号通路和功能富集等不同层面，揭示BRD（bromodomain）蛋白家族与HCC的相关性，探索BRD蛋白家族作为HCC的肿瘤进展及预后判断的潜在生物标志物价值。方法：从UALCAN数据库中获取BRD蛋白家族所有成员在HCC患者组织样本中的mRNA表达数据和患者临床信息并进行相关性分析。从TCGA数据库中获取BRD蛋白家族mRNA表达水平与HCC患者预后的数据并进行相关性分析。从The Human Protein Atlas数据库中获取BRD蛋白家族在HCC组织和正常肝组织中的免疫组化结果并进行对比分析。使用STRING数据库获取BRD蛋白家族的相互作用蛋白网络，并利用CYTOSCAPE软件对获取的相互作用蛋白进行KEGG和GO分析。结果：BRD家族7个成员均在HCC组织中高表达（P<0.01），并且与HCC患者肿瘤分级和临床分期正相关（P<0.01）,同时BRD8和BRD9的低表达提示HCC患者预后较好（P<0.05）。BRD相互作用蛋白主要参与组蛋白乙酰化修饰，并高度富集于HCC相关的信号通路。TP53基因突变HCC患者的BRD1、BRD3、BRD4、BRD7、BRD8和BRD9表达水平显著高于非突变患者（P<0.05）。结论：BRD蛋白家族分子能够作为HCC患者肿瘤分级、临床分期和预后判断的潜在靶标。

Bone marrow stromal cells (BMSCs) are a kind of stem cells with multiple differentiation potential in bone marrow.BMSCs have been widely used in tissue engineering,cell transplantation,gene therapy and organ transplantation,due to their characteristics of wide range of sources,weak immunogenicity weak,easily transfected by exogenous gene,long survival time in the host,multi-directional differentiation,etc.Cerebral ischemia is caused by neurological impairment,which is the most common cause of death and quality-of-life impairments.The clinical manifestations of the patients with cerebral ischemia are motor function failure,sensory dysfunction and abnormal mental consciousness.A large number of studies have reported that BMSCs transplantation has the therapeutic effects of body sensory and motor function recovery,and can treat ischemic stroke.BMSCs transplantation has brought new hope for the clinical treatment of ischemic cerebrovascular disease.In this paper,the recent progress in the study of BMSCs transplantation for ischemic stroke was reviewed.The mechanism,pathways,influencing factors and clinical application of BMSCs transplantation were summarized.

Uncontrolled chronic inflammation plays key roles in the carcinogenesis of hepatocellular carcinoma (HCC). Among the risk factors of HCC, such as chronic viral hepatitis, alcoholic hepatitis, non-alcoholic steatohepatitis and so on, the occurrence and development of uncontrolled chronic inflammation are the core factors of HCC. The damaged or dead hepatocytes generated during the process of chronic inflammation may lead to the activation of immune cells in the liver, resulting in hepatic inflammation. Chronic and prolonged liver inflammation promotes the occurrence of cancer. During this process, different injuries or death patterns of hepatocytes and progression of inflammation caused by activation of different immune cells play different roles in hepatic carcinogenesis, involving multiple pathological or pathophysiological processes such as liver injury, inflammation, and compensatory proliferation, as well as function alteration of various cells, signaling pathways, and regulatory molecules. Further studies on the regulatory mechanisms of hepatic inflammation-induced carcinogenesis are helpful to provide theoretical basis for the intervention of occurrence of HCC. This review focused on the research progress of regulatory mechanisms involved in the hepatic inflammation-induced carcinogenesis.

Objective To explore the regulatory role of calcium activated chloride channel (CaCC) in vascular structural remodeling in pathogenesis of pulmonary arterial hypertension (PAH) induced by high pulmonary blood flow.Method An abdominal aorta and inferior vena cava shunting operation was used to induce high pulmonary blood flow and establish a PAH rat model.Seventy-five SD rats were randomly divided into normal,sham,shunt,niflumic acid (NFA) 1 (0.2 mg/(kg · d)) and NFA 2 (0.4 mg/(kg · d)) groups.There were 15 rats in each group.Pulmonary artery pressure and vascular structural remodeling were measured,arteriole contraction ratio among these groups were compared using vascular tone analysis system,and the electrophysiology of pulmonary artery smooth muscle cell (PASMC) was recorded using patch clamp technology.Differences between multiple groups were compared through variance analysis and that between groups with q test.Result Compared with normal ((14.4 ± 1.3) mmHg,1 mmHg =0.133 kPa) and sham groups ((13.5 ± 2.3) mmHg),mean pulmonary artery pressure in shunt group ((27.4 ± 2.4) mmHg) increased significantly (P ＜ 0.05).Compared with shunt group,mean pulmonary artery pressure in NFA 1 group ((21.2 ± 2.0) mmHg) and NFA 2 group ((22.3 ± 2.0) mmHg) decreased significantly (P ＜ 0.05).Pulmonary vascular structural remodeling including pulmonary artery stenosis presented in shunt group.Compared with normal ((114.3 ± 1.2) ％) and sham ((115.5 ± 1.1) ％) groups,arteriole contraction ratio to 10-5 mol/L phenylephrine in shunt group ((132.6 ± 1.4) ％) increased significantly (P ＜ 0.05).Compared with shunt group,pulmonary vascular structural remodeling alleviated in NFA 1 and NFA 2 groups.Arteriole contraction ratio in NFA 1 group ((126.4 ± 1.3) ％) and NFA 2 group ((124.6 ± 1.0) ％) decreased significantly compared with shunt group (P ＜ 0.05).Patch clamp technique recorded typical CaCC currents.Compared with normal ((32.3 ±2.3) pA/pF) and sham groups ((35.3 ± 1.2) pA/pF),the CaCC current density of PASMC in shunt group ((51.3 ± 2.7) pA/pF) increased significantly (P ＜ 0.05).Compared with shunt group,the CaCC current density of PASMC in NFA 1 group ((40.2 ± 1.5) pA/pF) and NFA 2 group ((42.7 ± 2.2) pA/pF) decreased significantly (P ＜ 0.05).Conclusion CaCC is involved in pulmonary arterial hypertension induced by high pulmonary blood flow through regulating membrane potential.NFA attenuate pulmonary vascular structural remodeling and pulmonarv pressure through decreasing CaCC current density of PASMC membrane.

Objective To explore the application effects of experiential learning theory (ELT) in intern nursing students in spine surgery department.Methods A total of 126 intern nursing students who had been practicing in Spine Surgery Department of the Second Xiangya Hospital of Central South University from February 2016 to January 2017 were selected as the research objects. According to the entry time, all the students were divided into two groups: students who entered department in odd months were allocated into observation group (n=63); and even months entered students were allocated into control group (n=63). Traditional teaching method was applied in the control group, while ELT was used in the observation group. Nursing students' theoretical examination, practical skills, critical thinking ability and communication ability were compared between the two groups.Results The results of nursing students' theoretical examination and practical skills assessment of the observation group were higher than those of the control group, and the difference were statistically significant (P<0.05). The scores of truth seeking, open-mindedness, analyticity, systematicity, inquisitiveness and maturity of judgement and the total score of critical thinking ability in the observation group were all statistically higher than the control group (P<0.05). The total score and scores of each dimensions of communication ability in the observation group were higher than those in the control group, and the difference were statistically significant (P<0.05).Conclusions ELT is helpful in improving nursing students' theoretical knowldge and practical skills, and cultivating the critical thinking ability and communication ability of the nursing students.

Objective We performed a diffusion tensor imaging (DTI) study to explore the value of mode of anisotropy (MO) and other DTI-derived indices in assessing white matter fiber damage with mild to moderate Alzheimer disease (AD) patients. Methods This study was a prospective study. From February 2015 to February 2018, 33 patients with mild to moderate AD according to criteria were prospectively recruited as AD group at the First Affiliated Hospital of Wenzhou Medical University. Twenty healthy age-, sex-matched volunteers were recruited as normoal conctrast (NC) group. All subjects were performed by conventional brain MRI and DTI scans. The MO, anisotropic fraction (FA), mean diffusivity (MD), radial diffusivity (RD) and axial diffusivity (AxD) of white matter fibers were obtained from DTI images after TBSS post-processing. The statistical analyses of DTI indices between AD group and NC group were carried out in Functional MRI Software Library software. Results As compared with NC group, we found 1 cluster with significant decrease FA and increase RD in AD group, the affected fibers involving bilateral anterior thalamic radiation, corticospinal tract, cingulate gyrus, hippocampus, inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, uncinated fasciculus, superior longitudinal fasciculus (P<0.05). The MD value increase(P<0.1) was found to coincide with the decrease of FA and the increase of RD, while no significant increase or decrease in P<0.05. Three clusters of MO increases (P<0.05) accompanying with increases of AxD were found in left anterior limb of internal capsule, bilateral posterior limb of internal capsule, posterior forceps, left centrum semiovale and parietal lobe. Two clusters of MO decreases (P<0.05) accompanying with decreases of FA and increases of RD were found in fornix, forceps, external capsule, centrum semiovale and left frontal lobe. Conclusions The combination of MO with DTI routine tensor indices (FA, RD, MD, AxD) can further reveal the microstructural damage of white matter fibers in AD, especially to crossing-fibers. The abnormalities of MO combined with FA, RD and MD reveal the degeneration of both bundles of crossing-fibers,and the abnormalities of MO combined with AxD reveal that the white matter damage was mainly caused by axon damage of one bundle of cross fibers.

Objective To evaluate the clinical value of enhanced 3D-SPACE-STIR sequence MR in brachial plexus injury post-ganglionic nerve.Methods Eighteen patients with suspected brachial plexus injury were examined by routine MRI,3D-SPACE-STIR sequence and enhanced scan.The position,morphology,signal intensity of the brachial plexus injury and its relation with the proximal and distal portions of the brachial plexus were evaluated by senior radiologists.The image quality of plain and enhanced 3D-SPACE-STIR was evaluated respectively.Results The CNR of plain scan and enhanced 3D-SPACE-STIR sequence images were 32.31+2.98 and 43.66+2.78 respectively and the difference was statistically significant.Plain and enhanced 3D-SPACE-STIR sequences of supraclavicular nerves display rate were 95.0% and 96.1% respectively without having statistically significant difference.However,the subclavicular segment of the brachial plexus showed the displaying rates of 66.7% and 94.4% and the difference was statistically significant.Moreover, the background suppression effect of enhanced scan was better than that of the plain scan.Conclusion Enhanced 3D-SPACE-STIR sequence can clearly show brachial plexus injury,and its image quality is better than that of the plain scan,which can provide important imaging basis for accurate diagnosis of brachial plexus injury.

ObjectiveTo explore the effect of synthesized rehabilitation on detoxification addicts.Methods100 detoxification addicts were randomly divided into the rehabilitation group and control group with 50 cases in each group. Cases of the rehabilitation group were treated with "ten-step" rehabilitation treatment, but that of the control group did not. The rehabilitating treatment included cognitive psychotherapy, behavioral therapy, family treatment, social skill training and etc. The effects of two groups were evaluate with Symptom Checklist-90 (SCL-90) scale.ResultsExcept hostility, other factorial scores of the rehabilitation group including positive items, somatization, obsession, interpersonal sensitivity, depression, phobia, paranoid and psychotic factors were significantly higher than that of the control group (P<0.05～0.01).ConclusionThe synthesized rehabilitation can obviously improve the psychology of detoxification addicts.