Objective To promote more understanding of bone metastasis and reduce the misdiag-nostic rate of bone metastatic tumor.Methods The mechanism of skeletal metastasis,the spreading pathway of tumor to bone,its frequency and distribution of skeletal metastasis,as well as relative frequency of primary malignant tumor,clinical features,diagnosis and differential diagnosis with bone metastastic tumor were re-viewed.Five misdiagnosed cases as bone metastasis were presented.Results Five cases of patients were ob-tained post-longer time of follow-up examination,ranging from24to96months(average57.6months).Case1was carcinoma of lung,and case2carcinoma of prostatic gland,both were living and well.Case4and case5were tuberculosis of lumbar spine,their conditions were stable and satisfied.A lesion of lum-bo sacral disc in case3was found and diagnosed as infection and kept stable without any back and extremities pain since first attack of disease.The causes of misdiagnosis were analyzed.Conclusion Meticulous review of the history and clinical features as well as proper explanation of the supplemental data from plain X-ray,bone scintigraphy,CT and MRI findings are essential for diagnosis of majority of bone metastatic tumor.Al -though such new imaging devices(as bone scintigraphy,CT and MRI )possess a high sensitivity for early detection of bone metastasis,yet with a poor specificity,hence orthopaedic surgeon have to catch hold of proper understanding about new imaging techniques.In difficult and doubtful cases,the bone biopsy under CT guiding may be needed,the radioisotopic Hawkeye system and diffusion weighted MR imaging are rec-ommended for differential diagnosis of senile acute benign(e.g.osteoporosis)and malignant (e.g.metastasis)vertebral body com pressive fracture.

Objective:To explore therapeutic effect of neuromuscular electrical stimulation combined swallowing training in dysphagia after stroke.Methods: A total of 86 stroke patients during recovery period were selected.According to random number table, they were randomly and equally divided into pure training group (received swallowing training based on rehabilitation treatment and nursing care) and combined training group (received neuromuscular electrical stimulation based on routine training group).Therapeutic effects, scores of video fluorography (VFG) and swallowing quality of life (SWAL-QOL) questionnaire before and after treatment were compared between two groups.Results: After treatment, total effective rate of combined training group was significantly higher than that of pure training group (95.35% vs.69.77%, P=0.006).Compared with pure training group after treatment, there was significant rise in VFG score [(5.74±1.86) scores vs.(6.88±2.32) scores], and significant reduction in SWAL-QOL score [(762.66±27.22) scores vs.(648.22±29.62) scores] in combined training group, P=0.025, 0.001 respectively.Conclusion: Compared with swallowing training alone, neuromuscular electrical stimulation combined swallowing training possesses better therapeutic effects, which is better for recovery of swallowing function.

Objective To investigate the correlation between the arterial compliance and insulin resistance in the prehypertensive people.Methods 30 healthy persons,36 prehypertensive persons and 46 hypertensive patients were measured Cl and C2 using CVProfilor DO-2020 and determined insulin sensitivity with HOMA-IR.Results Adjusted for the age and the course of disease,C1 and C2 decreased in hypertensive patients compared with that of the healthy and prehypertensive people(P<0.05);C2 decreased in prehypertensive people compared with the healthy groups(P<0.05).HOMA-IR increased in hypertensive patients and prehypertensive people compared with the healthy groups(P<0.05).There was significant correlation between HOMA-IR and C2 in prehypertensive people.Conclusion Small arterial compliance decrease and insulin resistance can be found with negatively correlation in prehypertensive people.

The expressions of matrix metalloproteinnse-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1) ,and NF-κB in 157 cases of papillary thyroid cancer and 30 cases of papillary thyroid tumors were detected by immunohistochemistry and in situ hybridization. The expressions of MMP-9 and NF-κB protein and mRNA in papillary thyroid cancers were significantly higher than those in benign tumors (all P <0.01), and increased according to the pathological grading (P<0.01). The expressions of MMP-9 and NF-κB protein and mRNA in papillary thyroid cancers with cervical lymph node metastasis were higher than those without metastasis (both P <0.01). The expressions of TIMP-1 protein and mRNA appeared an opposite direction of MMP-9 expression.

Aim To study whetger there is positive express in situ hybridization of L-form DNA or Staphylococcus aureus in laryngocarcinoma cell. Methods 20 cases of expressnon of L-form DNA of Staphylococcus aureus in laryngocarcinoma karyon were detected with nucleic acid in situ hybridization. Results 60% cancer karyon, cytoplasm display positive signal of Staphylococcus aureus L-form DNA. Positive rate of Staphylococcus aureus L-form antigen is 75% with immunohischemical (s-p) stainipg. The rate is 70% with gram staining. Conclusion Staphylococcus aureus L-form DNA had get into laryngocarcinoma ceells, is great possibly to integrate into host ce11, and influence hyperplasis and canceration of cell from gene level. Staphylococcus aureus and its L-form infection have possibly close relation to happen and development of laryngocarcinoma.

Epidemiological studies indicated that dietary tiber was inversely associated with stroke risk.Epidemiological studies have confirmed that increased dietary fiber intake can reduce the risk of stroke.Animal experiments and clinical studies have shown that dietary fiber intake may reduce the incidence of stroke by reducing vascular risk factors,such as hypertension,diabetes,dyslipidemia,and obesity.The direct mechanism of increased dietary fiber intake reducing stroke risk remains to be further studied.Clinicians should pay attention to the important role of dietary fiber,guide the patients with stroke and individuals at risk of stroke to increase consumption of fiber-rich fruits and vegetables.

Objective To explore methods of quickly identifying loopholes in medical quality management and to improve medical quality by means of analyzing low-risk death cases.Methods Two rounds of analysis of 1 14 low-risk death cases of hospitals in Beijing in 2012 in terms of data quality and medical procedures,in an effort to identify problems and to verify the feasibility and accuracy of the method through interaction with other data.Results Totally 585 760 inpatients were discharged in 2012 from 21 hospitals,of whom 1 5 1 1 93 being low-risk cases.Such cases included 1 14 low-risk death cases, accounting for 0.01 9% of the total discharged,and 0.075% of low-risk discharged cases.Analysis of these medical records found 50 cases of problematic diagnosis (43.86%),45 cases of possible defects in diagnosis and treatment (39.47%),39 cases of missing items of secondary diagnosis (34.21%),and 28 cases of missing items of surgery/operation (24.56%). Some of the abovementioned cases had overlapping mistakes.Conclusion Analysis of low-risk death cases can help focus among massive data of medical records,problems of diagnostic and therapeutic insufficiency,pinpointing common problems in medical service and improving medical quality and fine management of hospitals.

To investigate the effect of Cornu Cervi Oral Liquid (mainly composed of Cornu Cervi, Fructus Psoraleae, Herba Epimedii, Fructus Corni, Fructus Ligustri Lucidi and Lignum Aquilariae Resinatum) in reversing myocardial fibrosis in rats with congestive heart failure caused by pressure overload and to explore its mechanism. Thirty six male Wistar rats were randomly allocated to mimic operation group (Group A), model group (Group B) and Cornu Cervi Oral Liquid group (Group C). Rat models of congestive heart failure were induced by constriction of abdominal aorta. Left ventricular mass index(LVMI) was observed; contents of collagen type Ⅰ and Ⅲ in left ventricular cardiac muscle were detected by immunohistochemical method and their mRNA expression by RT PCR; and plasma levels of angiotensin Ⅱ (AngⅡ), atrial natriuretic factor (ANF) and serum aldosterone (ALD) level were measured by radioimmunoassay method. LVMI, contents of collagen type Ⅰ and Ⅲ and their mRNA expression, levels of plasma and myocardial AngⅡ, plasma ANF and serum ALD were higher in Group B than those in Group A (P0 05).[Conclusion]Cornu Cervi Oral Liquid is effective in reversing myocardial fibrosis in rats with congestive heart failure caused by pressure overload and its mechanism may be related to the decrease of contents of collagen type Ⅰ and Ⅲ and their mRNA expression, levels of plasma and myocardial AngⅡ, plasma ANF and serum ALD.

Objective To detect the PTEN gene mutation and loss of heterozygosity(LOH) on chromosome 10q in oligodendrogliomas. Methods The entire PTEN coding sequence of the 9 exons were screened by 9 different PCR reactions and followed by denaturing gradient gel electrophoresis(DGGE) and direct sequencing for detecte mutation.Microsatellite markers with fluorochrome on 10?q amplified by PCR were used to detecte LOH by PAGE on an automatic sequencer and analyzed with the Gene Scan program in 55 oligodendrogliomas and mixed oligodendrogliomas. Results The PTEN gene somatic mutations were detected in 2 tumors,one case that carried a PTEN mutation deletion T base in position 20 resulting stop codon moved to 347.Another case was a A to C transition at the codon 139 resulting in changeing from Leu to Phe.Twenty\|three of 55(42%) cases were observed the loss of heterozygosity(LOH) on chromosome 10?q.Fifteen of 55 cases allelic loss were detected on loci D10S 541 which located in the PTEN gene region at 10?q 23\^3 .Twelve of 55 cases were detected totaled LOH on 10?q.Conclusion\ The PTEN gene mutation is rare,loss of allelic 10?q is frequente in oligodendrogliomas,especially in high\|grade oligodendrogliomas.It could indicate that LOH on 10?q has an enhance effect in tumor progression,and chromosome 10?q harbors additional tumor suppressor genes in oligodendrogliomas.\;[

ObjectiveTo explore the pathological effect of Anti-stenosis No.1 which had effect of vivid Qi and promoting blood flow,eliminate sputum and circulating collaterals on restenosis after carotid artery angioplasty in experimental rats.Methods48 rats were randomly divided into the blank group,the hyperlipid group,the small-dose group and the large-dose group.Restenosis model in carotid artery after angioplasty was built by high-dose cholesterol diet and three times balloon injury.Chinese herbs were administered for three months.Lumen area,intimal area,media area and intimal area/media area in the restenosis region were calculated.ResultsLumen area and intimal area were very more significantly changed in the hyperlipid group,the small-dose group,and the large-dose group compared to the blank group(P<0.01).Media area and intimal area/media area were very more significantly changed in the hyperlipid group and the small-dose group compared to the blank group(P<0.01).There was no significant difference in the large-dose group.Compared to hyperlipid group,lumen area significantly increased in the large-dose group(P<0.01)),intimal area significantly decreased in the small-and large-dose groups(P<0.05),and media area significantly decreased in the large-dose group(P<0.01).There was a significant difference in media area between the small-and large-dose groups(P<0.05).ConclusionAnti-stenosis No.1 can significantly inhibit restenosis by inhibiting intimal and media hyperplasty,and the effect is dose dependent.