Ovarian epithelial carcinomas are the most common lethal gynecological malignancies. Ovarian carcinomas are divid-ed into Types I and II based on different morphologies, genetic alterations, and biomarker expression. Low-grade micropapillary serous carcinoma are Type I tumors. Type I tumors are slow growing, generally confined to the ovary at diagnosis, and with better prognosis. These tumors develop from well established precursor lesions that are termedborderlinetumors. Type 1 tumors are genetically stable and are characterized by mutations in a number of different genes including KRAS, BRAF, PTEN, and beta-catenin. Type II tumors are rapidly growing and highly aggressive neoplasms, for which well defined precursor lesions have not been described. They may arise in the fimbrial epithelium of the oviduct with advanced stage, more aggressive behavior, and worse prognosis. High-grade serous carcino-ma belongs to Type II tumors. This group of tumors has a high level of genetic instability and is characterized by TP53 mutation. Hence, ovarian cancer comprises a heterogeneous group of tumors with distinctly different histological characteristics, molecular genet-ic features, and clinical course.

Objective To report a new surgical approach (modified anconeus flap approach) in which the anconeus and part of triceps are reflected in the treatment of distal intercondylar humerus fracture (AO type C).Methods To design the modified anconeus flap approach,the anatomy of the distal tendon of the triceps brachii and the anconeus was studied using 15 cadaveric adult specimens (30 sides).The new surgical approach was compared with the triceps-reflecting anconeus pedicle (TRAP) approach in terms of the area of exposure at the distal humeral articular surface.Furthermore,the new surgical approach was applied in 16 patients who had been treated for intercondylar humerus fracture (AO type C) from May 2005 to May 2013.The clinical outcomes were evaluated using the Mayo elbow performance score (MEPS) and Broberg-Morrey scoring systems.Results The blood supply and innervation of the anconeus was interrupted minimally during incision along the radical edge of triceps tendon.The area of exposure at the distal humeral articular surface provided by the part triceps and anconeus reflecting approach and the medial humerus approach was 42.66％ ± 0.03％ at the elbow flexion from 0° to 50°.This was significantly smnaller than that provided by the TRAP approach (46.11％ ±0.03％) (P ＜0.05).Of the 16 patients,15 obtained complete follow-ups from 6 months to 4 years(average,16.5 months).The mean MEPS at the last follow-up was 90.5 points (range,from 82 to 93 points),with 10 excellent and 4 good cases and one poor case.The Broberg & Morrey score system showed 11 patients with no articular cartilage degeneration (level-0),3 patients with level-1 degeneration,and 2 patients with level-2 degeneration.Conclusion The modified anconeus flap approach proposed in the present study provides clear surgical vision and needs no olecranon osteotomy or olecranon dissection or ablation of the major triceps brachii tendon for intercondylar humerus fractures,thereby leading to early active motion and satisfactory clinical outcomes.

0.70,cluster in two pairs of medicines are similar. Conclusion:It's reliable to cluster analysis the TCM by regarding the element contents as the character of these medicines. The larger the correlation coefficient is,the more similar the nature,flavor and efficacy of the medicines are,which suggested that trace element contents were closely related to(have much to do with) the flavor,nature and efficacy. The study provides method for the cluster relationship among TCM.

Objective:To provide a retrospective analysis of the levels of occupational external exposure of radiation workers in Hubei province from 2009 to 2018 in a way to prevent and control its risks.Methods:The external individual doses were surveyed for 50 070 radiation workers between 2009 and 2018 by the effort of the Hubei Provincial Center for Disease Control and Prevention. Under the relevant national standards, the external radiation doses to radiation workers were conducted by using TLDs.Results:The average annual collective effective dose to radiation workers in a 10 years period was 1.93 man·Sv, the median of average annual effective dose of 0.14 mSv ( P25- P75: 0.06-0.30 mSv), and the average annual effective dose of 0.40 mSv. The annual effective doses received by 46 562 workers were less than 1 mSv, accounting for 92.99% of the total monitored workers. The annual effective dose varied dependent on occupational categories, showing a year-by-year decline trend and staying at a low level after 2012. The relative high radiation doses were seen in nuclear medicine and interventional radiology in medical applications, non-destructive testing and well logging in industrial applications, and other types of radiation applications. Conclusions:The average annual effective dose decreased year in a by year manner and kept at a low level. This indicated that the radiological protection measures taken during the 10 years ensure the health of workers. The continuous monitoring result suggest that much more attention should be paid to such categories workers as nuclear medicine, interventional radiology, non-destructive testing, well logging and others through improving radiation protection measures.

Objective To study the Sheng Mai San on the levels of cell factors induced by lipopolysaccharide in acute liver failure rats. Methods The models of chronic liver failure were constructed by injecting CCl4 in the abdomen of rats. The serum levels of lipopolysaccharide and cell factors were determined after treating with LPS and Sheng Mai San for 2 hours. Results The serum level of IL-6［(64.50±18.79)pg/ml vs (4.79±0.57)pg/ml］, ICAM-1［(25100.00±5258.85)pg/ml vs (4215.50±942.79)pg/ml］ and TNF-α［(17.55±2.39)pg/ml vs (10.92±5.02)pg/ml］ was increased by CCl4 (P＜0.05), but there is no effect on the serum level of LPS in rats ［(0.058±0.007)EU/ml vs (0.040±0.002)EU/ml,P＞0.05］. Sheng Mai San can significantly reduce the serum level of IL-6, ICAM-1 and TNF-α in rats with acute liver failure induced by CCl4 ［(17.20±3.12)pg/ml,(9490.00±2725.78)pg/ml,(3.00±1.00)pg/ml,P＜0.05］. After treating with LPS for 2 hours, the serum level of LPS, TNF-α, IL-6, ICAM-1 markedly increased ［(0.501±0.019)EU/ml,(19750.00±9655.17)pg/ml,(5615.00±490.50)pg/ml,(41000.00±589.88)pg/ml,P＜0.01］. Sheng Mai San could reduce the serum levels of LPS, TNF-α, IL-6, ICAM-1 and in rats with chronic liver failure (P＜0.01). Conclusions SD Rats in the state of chronic liver fail-ure, existing serious serum endotoxin, can induce the levels of cell factors by diversification inflammation reaction and. ShengMaiSan can regulating the levels of cell factors in rats with chronic liver failure.

Objective:To explore the spatio-temporal dynamics of brain mechanisms in visual change detection by 256-channel event-related potential (ERP) and low-resolution electromagnetic tomography (LORETA) analyses.Methods：ERP were recorded in 12 healthy participants during performing an S1-S2 matching task.Visual stimuli defined by color and shape.Each trial consisted of two sequentially presented stimuli (S1 and S2),where S2 was either the same as S1,different from S1 in shape only,different in color only,or different in both color and shape.Subjects matched the stimuli according to task demands：attending to color and attending to shape.Result：Change condition elicited change-related positivity (CRP) ranging 135～165 ms.The estimated source regions contributing to CRP were lingual gyrus and cuneus of occipital lobe.N200 was elicited in no change and task-irrelevant change condition ranging 235～275 ms.The source for N200 was in the right temporal fusiform gyrus,middle temporal gyrus and parahippocampal gyrus.In the time window of 240～320 ms,N270 was elicited in all change conditions.The N270 source was localizable to the anterior cingulated cortex and amygdala.Conclusion：In the early stage,CRP reflects the preattentive processing of visual changes.The LORETA result confirms that CRP is generated in the early visual areas.N200 may be related to the active ignored processing of task-irrelevant change.The source for N200 is in the right temporal fusiform gyrus,middle temporal gyrus and parahippocampal gyrus.In the late stage,N270 reflects the advanced processing of visual change in the human brain.The N270 source may be in anterior cingulate cortex (ACC) and amygdala.

OBJECTIVE:To optimize extraction technology of polysaccharides from Stemona tuberosa so as to increase the ex-traction rate and efficiency. METHODS:Anthrone-sulfuric acid method was used for detection. With water and alkaline water (NaOH solution)as the solvent respectively,the effects of decocting method,ultrasound method and microwave method on the ex-traction rate of crude polysaccharide were observed respectively. By carrying out single factor and orthogonal tests,with the extrac-tion rate of crude polysaccharide as the index,the effects of the amount of water,NaOH solution concentration,extraction tempera-ture and extraction time on the extraction of crude polysaccharide by alkaline water ultrasound method were observed to optimize the technology parameters,and verification test was conducted. RESULTS:The alkaline water ultrasound method is superior to oth-er extraction methods,where the optimal technology parameters were as follows as 0.3 mol/L NaOH aqueous solution 30 times as much as the amount of crud drug,ultrasonic processing for 70 min at 50 ℃. The verification tests showed that the average extrac-tion rate of crude polysaccharide was 25.76%(RSD=3.51%,n=6). CONCLUSIONS:The optimal alkaline water ultrasound method can better extract crude polysaccharide from S. tuberosa.

Objective:To analyze the clinico-pathological characteristics, pathological diagnosis, and treatment of rhabdoid tu-mor. Methods:The medical records of four rhabdoid tumor patients that were admitted to the Tianjin Medical University Cancer Insti-tute and Hospital since 2000 were analyzed based on existing literature. Results:In one of the four cases, the tumor originated from the kidney, whereas in the other three, the tumor occurred from extra-renal soft tissues. Histologic analysis revealed that the tumor cells were loosely arranged with diffuse growth, vesicular nuclei, dyed cytoplasm, visible eosinophilic inclusions, and more nuclear fission. The results of immunohistochemical staining showed that the vimentin and epithelial membrane antigen were positive, whereas CK, CD99, CD34, and S-100 were positive at different degrees. MyoD1, Desmin, and INI-1 were negative. Conclusion:Rhabdoid tumor is rare and highly aggressive. It occurs mainly in the kidney and can also be found in other systems. The unique pathological form and im-munohistochemical staining observed on the tumor can be used as reference for diagnosis.

Objective To analyze the short-term clinical efficacy of the treatment of ipsilateral femoral intertrochanteric fractures with femoral head necrosis through total hip arthroplasty combined with internal fixation.Methods From January 2011 to June 2014 a total of 28 cases of ipsilateral femoral intertrochanteric fractures with femoral head necrosis were selected,and they were all treated with open reduction and greater trochanter plate fixation combined with total hip arthroplasty.The time of operation, amount of bleeding,time of bone healing of the greater trochanteric fracture,postoperative complications, rate of internal fixation device loosening,incidence of infection,and the Harris score of the hip joint before and after operation were recorded and statistically analyzed.Results The mean operative time was (174.0±27.1)min and the mean blood loss was (530.0±132.0)mL.There were 2 cases of deep venous thrombosis in the lower extremities,and there was no serious complications occured among the remaining cases.All patients were followed up for 12 to 24 months,averagely (16.3±7.0) months.All the 28 patients get bony union of the large trochanter,with the average healing time of (5.0±1.5) months.The preoperative Harris score was (28.0±7.1) points, while it was (86.5±5.3) points after the surgery, and the difference was statistically significant(t=-21.699,P=0.000).At the end of the follow-up,there was no internal fixation device loosening, no cable breakage,and no infection cases.Conclusion Total hip arthroplasty combined with internal fixation for the treatment of ipsilateral femoral intertrochanteric fractures with femoral head necrosis, especially the large trochanteric fractures, were of reliable fracture fixation, good initial stability and good joint function recovery.And it can maintain fracture stability and early recovery of joint function,so that intertrochanteric fractures and femoral head necrosis were treated simultaneously,and its recent clinical results were satisfactory.

Objective:To investigate the predictive value of serum soluble urokinase-type plasminogen activator receptor (suPAR) combined with alpha-fetoprotein (AFP) and model for end-stage liver disease (MELD) score in short-term prognosis assessment of patients with chronic hepatitis B (CHB) related acute-on-chronic liver failure (ACLF).Methods:From January 2018 to May 2020, 66 patients with CHB related ACLF from Fuzhou First People′s Hospital were enrolled. After 90 days of follow-up, the patients with CHB related ACLF were divided into death group and survival group according to the outcome. Meanwhile, 30 patients with CHB were enrolled by simple random sampling method. The differences of serum suPAR in patients with CHB related ACLF and patients with CHB were analyzed. The values of suPAR, AFP and MELD score were compared between death group and survival group in patients with CHB related ACLF. The predictive value of suPAR, AFP, MELD score, Child-Turcotte Pugh score (CTP score) and suPAR combined with AFP and MELD score in the short-term prognosis of patients with CHB related ACLF were analyzed by area under the receiver operator characteristic curve (AUROC). Data were analyzed by two independent sample t test or non-parametric test. Results:The serum suPAR level of patients with CHB related ACLF was (9.6±0.8) ln ng/L, which was higher than that of patients with CHB ((8.0±0.3) ln ng/L). The difference was statistically significant ( t=14.533, P<0.01). The suPAR and MELD score of patients with CHB related ACLF in the death group were (9.9±0.7) ln ng/L and 29.6 (7.1) points, respectively, which were higher than those in the survival group ((9.4±0.7) ln ng/L and 21.0 (5.0) points, respectively). The AFP level in the death group was 45.9 (108.1) μg/L, which was lower than that in the survival group (209.3 (187.1) μg/L). There were significant differences in suPAR ( t=2.895, P=0.005), MELD score ( Z=4.708, P<0.01) and AFP ( Z=3.051, P<0.01) between the death group and the survival group. AUROC of suPAR (0.741, P=0.001), AFP (0.724, P=0.002) and MELD score (0.885, P<0.01) had predictive value for death in patients with CHB related ACLF. The sensitivities of suPAR, AFP, MELD score, CTP score and suPAR combined with AFP and MELD score were 84.6%, 73.1%, 88.5%, 96.2% and 84.6%, respectively, and the specificities were 75.0%, 72.5%, 70.0%, 52.5% and 92.5%, respectively. The AUROC of suPAR combined with AFP and MELD score was 0.871 ( P<0.01), which was higher than that of CTP score (0.793, P<0.01). Conclusions:Serum suPAR is increased in patients with CHB related ACLF. SuPAR combined with AFP and MELD score could apply in the prognostic value for patients with CHB related ACLF.