Nitrogen-containing bisphosphonates exert antitumor activity through induction of apoptosis or inhibition of proliferation, invasion and migration in tumor cells, inhibition of angiogenesis and promotion of immune surveillance. Animal models show that bisphosphonates delay visceral metastasis progression. Both ABCSG-12 and ZOFAST trial have demonstrated that Zoledronate reduced breast cancer recurrence risks. Bisphosphonates are synergistic with a variety of chemotherapeutics, and sequential dosing is more effective, which may be attributable to increased uptake of bisphosphonates by tumor cells after pretreatment with chemotherapeutics. Metronomic administration of bisphophonates after chemotherapy provides bisphosphonates the promising antineoplatic potential.

Objective To investigate the association of human papilloma virus (HPV) typing and p53 expression with radiosensitivity in patients with cervical cancer.Methods A total of 80 patients with cervical cancer from 2014 to 2016 were enrolled,and among these patients,40 had stage Ⅰ B+ Ⅱ A disease and 40 had stage Ⅱ B +ⅢA disease.HPV genotype was identified and p53 expression was measured.All the patients underwent external and internal pelvic irradiation alone,and the correlation between short-term therapeutic effect and HPV typing/p53 expression was analyzed.The chi-square test or the Fisher's exact test was used for statistical analysis,and Spearman rank correlation analysis was also performed.Results The radiotherapy-insensitive (stable disease+progressive disease) group had higher p53 positive rates than the radiotherapy-sensitive (complete response+partial response) group (stage Ⅰ B+ Ⅱ:100％ vs.80.0％,P=0.044;stage Ⅱ B+ⅢA:100％ vs.90.0％,P=0.013).The expression of p53 was negatively correlated with radiosensitivity (r =-0.427,P =0.000).In the radiotherapy-insensitive group of patients with stage I B + Ⅱ and Ⅱ B +Ⅲ A,the rate of HPV multiple infections was higher than that of single subtype infection (65.0％/95.0％ vs.35.0％/5.0％,P=0.004 and 0.003),while in the radiotherapy-sensitive group,the rate of single subtype infection was higher than that of multiple infections (85.0％/60.0％ vs.15.0％/40.0％,P=0.004 and 0.003).The highest detection rate of HPV16 was 66.3％ in all patients,and the highest detection rate of HPV18 was 60.0％ in the radiotherapy-insensitive group.Conclusions High expression of p53 is associated with radioresistance in patients with cervical cancer.Patients with HPV muhiple infections have poor radiosensitivity,and HPV16 is the most common subtype in dual infection.Among patients who do not achieve remission after radiotherapy,HPV multiple infections with HPV18 as the main pathogen has the highest detection rate.

Objective:To explore the rules of acupoint sticking therapy based on data mining technology for the treatment of angina pectoris of coronary heart diseases, and to provide a reference for guiding acupoint selection and rational use of Chinese medicine.Methods:To search for the clinical research literature of acupoints for the treatment of angina pectoris of coronary heart diseases from China Academic Journal Database (Wanfang Data), China National Knowledge Resources Database (CNKI), China biomedical literature service system (SinoMed) and Chinese science and technology journal database (Chongqing VIP) dated from January 31, 2020. Using Microsoft Excel 2016, SPSS Statistics 21.0, and SPSS Modeler 14.2 statistical software as tools to conduct association analysis and cluster analysis on those acupoints and Chinese medicine.Results:A total of 102 acupoints application prescriptions were included, involving 38 acupoints. The top 5 frequently used acupoints were Danzhong (RN17), Neiguan (PC6), Xinshu (BL15), Zusanli (ST36), and Zhiyang (DU9). The top 5 acupuncture were Neiguan (PC6)- Sanyinjiao (SP6), Xinshu (BL15)- Geshu (BL17), Danzhong (RN17)- Geshu (BL17), Danzhong (RN17)- Jueyinshu (BL14), Danzhong (RN17)- Geshu (BL17) and Xinshu (BL15). There are 102 prescriptions of applied medicines with 88 kinds of Chinese medicine. The top 5 frequently used Chinese medicines were Chuanxiong Rhizoma, Borneolum Syntheticum, Salviae Miltiorrhizae Radix et Rhizoma, Olibanum, Santali Albi Lignum, the top three drug pairs were Chuanxiong Rhizoma- Cinnamomi Cortex, Allii Macrostemonis Bulbus- Trichosanthis Fructus, Olibanum- Myrrha. Conclusion:The commonly used single points to treat angina pectoris of coronary heart disease are Danzhong, and usually combined with Neiguan and Xinshu, and the acupoints along the Urinary Bladder Meridian of Foot- Taiyang are used frequently; the Chinese medicines are mainly used for activating blood circulation, genenrally reflects the therapeutic principle of removing blood stasis, dredging collaterals and relieving pain.

BACKGROUND:Ischemia/reperfusion (IR)injury during the pancreas transplantation can cause numerous postoperative complications, among which,secondary pancreatitis can cause small intestinal mucosal injury and result in severe Consepuence.OBJECTIVE:To observe the protective effect of ischemic preconditioning (IPC) on small intestinal mucosal barrier after pancreas transplantation in rats.DESIGN:Randomized controlled animal trial.SETTING:Department of Gastrointestinal Surgery,Xijing Hospital,Fourth Military Medical University of Chinese PLA.MATERIALS:This trial was done in the Laboratory of Gastrointestinal Surgery,Xijing Hospital,Fourth Military Medical University of Chinese PLA between September 2001 and April 2004.Eighty-three male SD rats were involved in this trial.METHODS: Forty-seven rats were randomly chosen to prepare diabetic rat models by penile-intravenous injection of 65 mg/kg streptozotocin.Thirty-six successful model rats were randomized into 3 groups,with 12 in each group:IR group,donor IPC(DIPC)group and recipient with two hindlims IPC(RIPC)group.Twelve of the remaining 36 normal rats served as control group,and the other 24 rats were used as donors.Laparotomy was conducted only in control group,and pancreas transplantation was conducted in the other 3 groups In DIPC group,the splenic vessels of donors were blocked for 5 minutes and reperfused for 5 minutes twice before obtaining pancreas from donor;In the RIPC group, blood flow of two hindlimbs of recipients was blocked for 5 minutes and reperfused for 5 minutes before reperfusing the pancreas of donor,and this procedure was repeated 3 times.IR group was untouched.MAIN OUTCOME MEASURES:① On the 5th day after operation,6 rats were randomly chosen from each group to detect small intestinal permeability[expressed with plasm fluorescent-isothiocyanate-dextran(FITC-dextran)concentration]and absorption function(expressed with plasm xylose concentration).② On the 5th day after operation.blood was taken from the left 6 rats in each group to detect serum tumor necrosis factor-α(TNF-α) and nitric oxide(NO)level as well as superoxide dismutase(SOD)and amylase activity.Ileal mucosal tissue was taken to detect wet weight of small intestinal mucosa,the height and width of microvilli,malonaldehyde(MDA)level and myeloperoxidase(MPO)activity.At the same time,mesenteric lymph node,liver and splenic tissue were taken to perform bacterial culture.Bacterial translocation was observed.RESULTS:After supplement,72 rats were involved in the result analysis.①Plasm FITC-dextran concentration of IR group were higher than that in control group,DIPC group and RIPC group,respectively(P＜0.01).②Plasm xylose concentration in the IR group was lower than that in the control group,DIPC group and RIPC group,respectively(P＜0.01).③Bacterial translocation rate in the IR group was higher than that in the control group,DIPC group and RIPC group,respectively(P＜0.01).④Small intestinal mucosal injury degree in the IR group was lower than that in the other 3 groups(P＜0.01).⑤Small intestinal MPO activity and MDA level in IR group were significantly higher than those in the other 3 groups(P＜0.01). Serum SOD activity and NO level were lower but amylase activity and TNF-α 1evel were higher in the IR group as compared with the other 3 groups(P＜0.01).CONCLUSION:IPC of two hindlimbs in both donor and recipient can protect small intestinal mucosal barrier and reduce bacterial translocation rate after pancreas transplantation in rats.

Objective To explore the value of human epididymis protein 4(HE4),cancer antigen 125(CA125) and the risk of ovarian malignancy algorithm(ROMA) in the diagnosis of ovarian cancer.Methods Electrochemical luminescence and Enzymelinked immunosorbent assay (ELISA) were used to determine the levels of serum HE4,CA125 in 56 patients with ovarian carcinoma,73 cases of ovarian benign tumor and 50 health women,and the ROMA was calculated by HE4 and CA125 levels depending on the menopause state,drawing the receiver operating characteristics(ROC) curve and calculating the area under the curve(AUC).Results The average levels of the HE4,CA125 and the value of the ROMA were (345.33±605.03)pmol/L,(701.46±1 500.30) U/mL,(58.72±31.00) ％ in the ovarian carcinoma group,(53.84± 14.68)pmol/L,(44.25±45.81)U/mL,(10.80± 6.75) ％ in the ovarian benign tumor group,and (46.03±10.26)pmol/L,(17.39±10.64)U/mL,(6.92±3.85)％ in the health control group respectively,compared with the benign tumor group and the health control group,the ovarian carcinoma group were higher in HE4,CA125 and the ROMA value,and the difference were significantly (P＜0.05),whereas compared in the ovarian benign group and the health group,except the CA125 was higher in the benign group and the difference had statistical significance(P＜0.05),the HE4 level and the value of the ROMA had no statistical significance(P＞0.05).The sensitivities of the HE4,CA125 and ROMA were 71.43％,76.79 ％,89.28％,the specificities were 93.15 ％,53.42％,94.52 ％ and the ROC-AUCs were 0.930,0.809,0.937 respectively.When the specificity for the diagnosis of the ovarian carcinoma was 95.00％,the sensitivities of the HE4,CA125 and ROMA were 80.40％,53.60％,83.90％ respectively.Conclusion HE4 and CA125 combined detection to calculate the ROMA can elevate the sensitivity and specificity for the ovarian carcinoma diagnosis.

Objective To evaluate the value of 3.0T MRI diffusion-weighted imaging (DWI)in diagnosis and staging of cervical cancer. Methods A total of 65 cervical carcinoma patients were enrolled and performed T2 WI,DWI and LAVA-Flex dynamic contrast-enhancement before operation.MR images were analyzed by two radiologists to evaluate the staging performance.Results All the cervical cancers were detected in DWI,while three lesions were missed in T2 WI and one lesion was missed in LAVA-Flex dynamic contrast-enhanced MRI.Respectively,the accuracy of staging with DWI,T2 WI and LAVA-Flex dynamic contrast-enhanced MRI was 90.8%,78.5%and 87.7%.Accuracy of DWI was significantly higher than that of T2 WI(P =0.04),while there was no significant difference of accuracy between DWI and LAVA-Flex dynamic contrast-enhanced sequence (P =0.39).Conclusion DWI shows relatively higher accuracy than T2 WI in the staging of cervical cancer which makes it an ideal method to replace LAVA-Flex dynamic contrast-enhanced MRI for exact staging.

Objective To study the application of isokinetic muscle testing in identification of the faked paralysis to provide scientific data for establishing a standard systemof muscle strength in forensic medicine identification. Methods Fifty-seven patients with bone fracture or nerve damage as damaged group and 128 normal subjects pretended paralysis as faked paralyzed group were included in this study. Isokinetic muscle testing was performed on bilateral knees of all subjects in the two groups. The peak torque (PT) and peak torque angle (PTA ) were compared between both sides in each group. The fea-tures of torque-time graph of two groups were classified. Results In the damaged group, the differences of PTbetween two sides of flexors and extensors were statistically significant (P<0.05), while the dif-ferences of PTA were not statistically significant (P>0.05). In faked paralyzed group, the differences of PTand PTA between two sides of flexors and extensors were both statistically significant (P<0.05). The torque-time graph of damaged knee presented mostly as single lead peak, while torque-time graph of the faked paralyzed knee presented mostly as multiple peaks. Conclusion The feature of torque-time graph could be useful to identify the faked paralyzed extremities in forensic authentication.

Pancreas transplantation alone(PTA) which dose not popularize in clinical therapy the insulin-dependent diabete mellitus patients who have not occurred end-stage complications,which was resulted in not only the technical but also the sociological and ethnics reasons.There are some reasons to restrict the development of clinical PTA at present.In this article the sociological and ethnics reasons to circumscribe the development of clinical PTA were discussed.

Purpose To explore the feasibility of optimizing monochromatic images in reducing iodinated contrast dose in CT pulmonary angiography (CTPA). Materials and Methods Sixty-eight patients undergoing CTPA were randomly divided into two groups, with half in research group and half in conventional group to evaluate image quality. Research group underwent spectral CT imaging with the injection of 30 ml Omnipaque (300 mgI/ml) and optimal monochromatic images were postprocessed using the software of GSI viewer. Conventional group underwent conventional CTPA with the injection of 80 ml Ultravist (370 mgI/ml). The CT values were measured respectively in the main pulmonary artery, left pulmonary trunk, right pulmonary trunk, left lobe artery and right lobe artery. The contrast noise ratio (CNR) in two groups were calculated, and image quality were subjectively assessed. Results The total iodine intake in research group (9000 mg) was significantly lower than that of conventional group (29 600 mg). CNR in the main pulmonary artery, left pulmonary trunk, right pulmonary trunk, left lobe artery and right lobe artery in research group was significantly higher than that of conventional group (t=2.07-2.71, P<0.05). Subjective image quality scores in research group were also higher than that of conventional group but had no statistical difference (Z=-0.944, P>0.05), while there was a good agreement between the two readers (Kappa=0.8, P<0.05). Conclusion It is possible to reduce iodinated contrast dose using spectral CT imaging and improve the image quality of CTPA.

Objective To investigate the value of application of magnetic resonance imaging (MRI) in diagnosis and treatment of leptomeningeal metastases from malignant solid tumors.Methods A retrospective analysis was conducted depend on the radiological data of 63 patients who had been diagnosed as leptomeningcal metastasis of malignant solid tumors.Results All patients received brain MRI examination.26 patients underwent cervical or lumbar spine MRI examination.The MRI images showed nodular enhancement in the gyri and sulci,leptomeningeal linear enhancement,dura mater thickening and enhancement,ependymal enhancement,intraventricular metastasis,intraspinal metastatic nodules,communicating hydrocephalus,subdural hydroma and negative imaging.Ncuroimages of ependymal enhancenent,intraventricular metastasis and intraspinal implantation metastasis appeared in 5,7 and 9 patients with small cell carcinoma,respectively,which were higher than that of the other pathological types (P =0.002,P =0.009,P ＜ 0.000 1).Seizure occurred in 7 patients after intrathecal chemotherapy,of which 5 patients had pia mater linear enhancement.Among 33 patients treated with radiotherapy combined with intrathecal chemotherapy,3 patients had poor prognosis,of which 2 patients had negative imaging findings.The conditions of 25 patients were improved obviously after treatment,of which 21 patients showed different imaging remission in MRI re-examination.Conclusions The contrast MRI has an important assistant effect in diagnosis of leptomeningeal metastasis of malignant solid tumors.The MRI findings and clinical features are related with the pathological types.The pia mater linear enhancement indicates a high possibility of seizures after inthathecal chemotherapy,and it suggests that the preventive treatment should be given for such patients.MRI is not applicable to evaluate severity,prognosis and curative effect of the disease.