Objective: To study the relationship between different patterns of invasion and extracapsular spread in lymph node metastasis from squamous cell carcinoma of tongue. Methods: Pattern of invasion described by Anneroth was used to evaluate the malignance grade of tongue cancer and immunohistochemical and HE staining were used to detect the extracapsular spread in successive cases of tongue cancer with radical neck dissection. Results: Lymph node metastasis was observed in 0/5 of the cases with pattern I invasion,3/8 pattern II,5/6 pattern III and 1/1 pattern Ⅳ. Extracapsular spread occurred as totally or partly replacement of the lymph node by the tumourcells. The tumour cells infiltrated between lymph nodes, perinodal fibroadipose tissue or sternocleidmastoid muscle in the form of cell cluster or isolated cell. Conclusion: Pattern of invasion is a significant factor for evaluating the malignance grading of tongue cancer. Radical neck dissection should be used to treat the tongue cancer with pattern III or IV invasion.

ObjectiveTo observe the effects of anti-neurohormone drugs on ventricular remodelling and the plasma concentrations of neurohormone of patients with different grade heart function after myocardial infarction.MethodsAccording to ejection fraction of patients,103 consective patients with myocardial infarction were divided into two groups:normal heart function group:ejection fraction ranged from 50% to 70%.Abnormal heart function group:ejection fraction was less than 50%.All patients were given the same beta-receptor blocking agent and angiotensin-converting enzyme inhibitor and then were followed up 6 months.Heart function and the plasma concentrations of neurohormone were compared before and after anti-neurohormone drugs were given;at the same time,changes of heart function and the plasma concentrations of neurohormone were compared in statistical aspect between two groups.ResultsThe improvement of heart function and change of the plasma concentrations of neurohormone were significantly different in statistics before and after drugs were used.Besides,the patients with different grade heart function had significantly different changes of heart function and plasma concentrations of neurohormone.ConclusionAnti-neurohormone drugs can significantly reduce the level of the plasma neurohormone,improve heart function and inhibit heart remodeling.What’s more,there are better treatment effects in patients with heart failure.

The Scientific Development Concept provides significant guidance for the discipline construction.This thesis discusses how to embody the scientific development concept in accelerating the all-round construction of disciplines in our unit from the aspects of general target,approaches and talents cultivation.

Objective To evaluate the follow-up diagnostic value of 3 T magnetic resonance angiography (MRA) after intracranial aneurysm coil embolization.Methods The databases such as PubMed,EMbase,Cochrane Library,CBM,CNKI and VIP were retrieved.According to the inclusion criteria of diagnostic tests,the diagnostic tests of the follow-up diagnostic value about MRA were screened after intracranial aneurysm coil embolization.The methodological quality included in the studies was evaluated using QUADAS items and the meta-analysis was conducted using Meta-Disc 1.4 software.The receiver operating characteristic curve was drawn and the area under the curve was calculated.The residual sensitivity and specificity diagnosed by MRA after intracranial aneurysm embolization were evaluated.Results A total of 6 studies were included,including 253 patients.The pooled sensitivity and specificity in 3 T MRA diagnosing residual intracranial aneurysms were 0.915 (95％ confidence interval [ CI]0.850 - 0.959) and 0.847 (95％ CI 0.787 - 0.896) respectively.The area under the receiver operating characteristic curve was 0.951,Q =0.892.Conclusions 3 T TOF MRA can be used as an effective and feasible imaging follow-up method after embolization of intracranial aneurysms,however,because of the methodological limitations,the high-quality research is needed to further validate the application value of the MRA during follow-up after intracranial aneurysm embolization.

Objective To investigate the clinical value of inflammation-related factors [white blood cell count,erythrocyte sedimentation rate (ESR),and C-reactive protein] in predicting delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.Methods The aneurysmal subarachnoid hemorrhage in 217 cases according to whether the occurrence of delayed cerebral ischemia were divided into 2 groups:delayed cerebral ischemia (DCI) group (n =69) and non DCI group (n =148).A retrospective analysis of 217 cases of patients was performed with inflammation-related factors,and its relationship with clinical prognosis of patients with DCI was also analyzed.Results The inflammation-related factors (WBC count,erythrocyte sedimentation rate,and C-reactive protein) in DCI group were significantly higher than those in non DCI group with a statistically significant difference (P ＜ 0.05).The follow-up results showed that there were 33 patients died,12 cases of plant survival,and 12 patients with severe disability in DCI group,which had a statistically significant difference relative to non DCI group (P ＜ 0.05).Spearman analysis showed that there was a significantly negative relationship between inflammation-related factors (white blood cell count,ESR,C-reactive protein) and glasgow prognostic score (GOS) in DCI group(r =-0.877,-0.683,-0.841,P ＜0.05).Conclusions The inflammation-related factors can be used as one of method to predict delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.

Spontaneous complete thrombosis with parent artery occlusion of giant intracranial aneurysms is rare.We report a patient with a rare giant vertebral artery aneurysm with spontaneous complete thrombosis and parent artery occlusion,and review the related literature,discuss its incidence,clinical presentation,pathogenesis,diagnosis,and treatment.

Objective To investigate the efficacy of combining ultrasonic with three-dimensional imaging guided microwave ablation in treating large hepatocellular carcinoma.Method The clinical data of 262 patients with large unresectable liver cancer who were admitted to the Air Force General Hospital from Jan 2011 to Jun 2014 were retrospectively analyzed.Of these patients,136 underwent transcatheter arterial chemoembolization (TACE),and the remaining 126 patients underwent combined ultrasonic with three-dimensional imaging guided microwave ablation (MWA).The AFP levels,tumor ablation rate,postoperative complication rates and survival rates between the two groups were compared.Result There were significant differences in the AFP levels in the two groups before and after surgery (P ＜0.05),but no significant differences were found between the 2 groups (P ＞ 0.05).A significant difference was also observed on tumor ablation rate.In the MWA group,11 patients (8.73％) developed complications,while 21 patients (15.44％) in the TACE group developed complications,(P ＜ 0.05).The 3-month,9-month,1-year,2-year and 3-year survival rates were 99％,95％,81％,70％ and 57％ in the MWA group,and 98％,94％,63％,36％ and 28％ in the TACE group.There were significant differences in the 1-year,2-year and 3-year survival rates,but no significant difference were observed in the 3-month and 9-month survival rates.Conclnsion Combined ultrasonic with three-dimensional imaging guided microwave ablation increased the rate of tumor ablation and prolonged the survival time of patients with large hepatocellular carcinoma.

Objective To investigate the autophagy and apoptosis in acute myelogenous leukemia U937 cell induced by Sirolimus.Methods U937 cells were subcultured, and blank control group(normal) and Sirolimus treated groups(12 h, 24 h,48 h) were established.The Sirolimus treated groups were treated by 2 μmol/L concentration of Sirolimus for 12 h,24 h and 48 h, respectively.The cell morphology of U937 cells treated by Sirolimus was observed after 12 h,24 h and 48 h.The survival rate of cells was detected by cell counting kit-8 method.Cell apoptosis was detected by flow cytometry using Annexin V-FITC/PI double labeled.Real-time PCR was used to detect the level of mRNA expression in autophagy specific protein maker mictotubule-associated protein light chain 3 (LC3)-Ⅱ in different treated times by Sirolimus.Sirolimus LC3 protein expression levels after treatment were detected by Western blot method.Results Under inverted microscope, the cell number of Sirolimus treatment group reduced gradually after 12 h ,24 h and 48 h culture, volume of cells became smaller, cells got ruptured, and the nucleus pycnosis and cellular debris increased.With the extension of time, U937 cells survival rate was falling, and there was statistical differences compared with those of the control group(P =0.031).With Sirolimus treatment, U937 cells after 12 h,24 h and 48 h, U937 cell apoptosis rate increased, and there were statistically significances, compared with those of the control group (P =0.027).With Sirolimus treatment U937 cells after 12 h,24 h and 48 h,LC3-Ⅱ mRNA expression and protein expression were down-regulated compared with those of the control group, and there were statistically significances (P =0.029).Conclusions Sirolimus can induce autophagy and apoptosis in U937 cells.Autophagy protein LC3-Ⅱ in gene and protein expression levels were lowered, and LC3-Ⅱ may play an important role in regulating the leukemia cell autophagy.

BACKGROUND:Supination maneuver is mainly used for reduction of radial head subluxation in children, but recently, pronation maneuver has also achieved good results in the treatment of radial head subluxation. OBJECTIVE:To objectively evaluate the efficacy of pronationversus supination maneuvers for the reduction of radial head subluxation by using Meta-analysis. METHODS:PubMed, Cochrane Central Register of Controled Trials (CENTRAL), EMbase, the ISI Web of Knowledge databases, VIP, CNKI, CBM and Wanfang were searched from database establishment to December 2014 for colecting the randomized controled trials (RCTs) about pronationversus supination maneuvers for the reduction of radial head subluxation, and the references of those RCTs were also searched by hand. After study selection, assessment and data extraction were conducted by two reviewers independently. Meta-analyses were performed by using the RevMan 5.2 software. RESULTS AND CONCLUSION:Five studies involving 436 patients were included. The results of Meta-analyses showed that: compared with the supination maneuvers group the pronation maneuvers group had a higher rate of successful reduction at the first attempt [RR=1.17, 95%CI (1.08, 1.28),P=0.000 3] and lower rate of failed reduction [RR=0.25, 95%CI(0.09, 0.65),P=0.005]. There was no significant difference in the rate of successful reduction at the second attempt [RR=1.39, 95%CI (0.75, 2.58),P=0.30]. Based on the results of systemic assessment, the level of evidence assessed by the GRADE system showed that the outcome indicators of the rate of successful reduction at the first attempt and rate of failed reduction were graded as intermediate level; the outcome indicator of the rate of successful reduction at the second attempt was graded as low level. For the poor quality of the original studies, a prudent choice is suggested; and more highly-quality, large-sample studies are needed.

BACKGROUND:Many studies concern the comparison of micro-titanium plate fixation and suture suspension fixation during cervical posterior expansive open-door laminoplasty, but the sample size of many studies has limitations. There is lack of objective evaluation on advantages and disadvantages of micro-titanium plate.
OBJECTIVE:To systemicaly evaluate the efficacy and safety of micro-titanium plate fixationversus suture suspension fixation in cervical posterior expansive open-door laminoplasty.
METHODS: English and Chinese randomized controled trials were searched by two reviewers. They retrieved the Cochrane Central Register of Controled Trials (CENTRAL), PubMed, EMbase, the ISI Web of Knowledge Database, CNKI, CMB, VIP and Wanfang database for randomized controled trials addressing micro-titanium plate fixationversus suture suspension fixation in cervical posterior expansive open-door laminoplasty published from database foundation to March 1, 2015. The references were also searched by hand. Meta-analyses were performed by using the Rev-Man 5.3 software, provided by the Cochrane Colaboration.
RESULTS AND CONCLUSION: A total of 9 studies involving 642 patients were included. The results of meta-analyses showed that: (1) safety: There were no significant differences between the two groups in operation time [SMD=-0.02, 95%CI (-0.57, 0.54),P=0.95 > 0.05], and intraoperative blood loss [SMD=0.07, 95%CI (-0.26, 0.40),P=0.69 > 0.05]. (2) Efficacy: compared with suture suspension fixation, Japanese Orthopaedic Association Scores were higher [SMD=0.26, 95%CI (0.10, 0.42),P=0.001 < 0.05], the angle of the opened laminae was bigger [SMD=0.25, 95%CI (0.02, 0.48),P=0.04 < 0.05], cervical curvature was better [SMD=0.46, 95%CI (0.27, 0.65),P < 0.000 01], and incidence of axial symptoms was lower [RR=0.40, 95%CI(0.29, 0.56),P< 0.000 01] after micro-titanium plate fixation. These findings suggest that during expansive open-door laminoplasty for treatment of cervical spondylosis, micro-titanium plate fixation and suture suspension fixation can obtain good clinical outcomes. However, Japanese Orthopaedic Association Scores were higher and the angle of the opened laminae was better in micro-titanium plate fixation than in suture suspension fixation. Micro-titanium plate fixation could effectively prevent loss of cervical curvature and reduce the incidence of axial symptoms. For the poor quality of the original studies and smal sample size, a prudent choice is suggested. More high-quality large-sample studies are needed for further verification.