With the low-dose spiral computed tomography (LDCT) widely applied in screening for early-stage lung cancers recently, positive rates of Ground-Glass Opacity (GGO) are gradually increased. Many professional researchers believe GGO has a close relationship with the early-stage lung adenocarcinoma, consequently, qualitative diagnosis and early treatment of GGO plays a signiifcant role in improving the diagnostic and survival rates of patients with early-stage lung cancer. Since relative imaging diagnosis, location methods and surgical approaches of GGO have been reported a lot by domestic and overseas researchers, our reviews would mainly focus on the diverse research progress of molecular biology of GGO in the past several years.

OBJECTIVE:To improve automatic outpatient pharmacy drug delivery system in our hospital,and to promote the efficiency of automatic drug delivery. METHODS:The outpatient pharmacy automation system of our hospital was introduced in terms of main structure,working process and application. The work efficiency,safety and error were compared between automatic drug delivery mode and manual drug delivery mode. Drug delivery machine was improved to increase the rate of drug delivery. RE-SULTS:The outpatient pharmacy automation system of our hospital included 2 boxed drug delivery machine and 1 drug dispensing machine,etc. Compared with manual drug delivery mode,automatic drug delivery mode improved drug delivery efficiency,health security and use security,and reduced drug delivery error. Through adjusting the time setting and step of drug delivery of gearing in drug delivery machine,idle time of transmission equipment was utilized effectively,and the quantity of delivered prescriptions was increased,increasing from 220 to 320 each hour. CONCLUSIONS:The reasonable improvement of outpatient pharmacy auto-mation system makes outpatient pharmacy automation system play a bigger role,and further optimize resources.

Objective To evaluate the nutrition intervention on advanced colorectal cancer chemotherapy patients quality of life. Methods 70 colorectal cancer patients (NRS 2002 score was more than or equal to 3 points) with chemotherapy from January 1st, 2013 to June 31th, 2014 were collected. The patients were randomly divided into intervention group (35 patients) and the control group (35 patients). The intervention group received personalized recipe which was developed by a team containing nurse specialist, chief psychiatrist, family members and patients themselves. The control group was treated with a normal diet guidance. The two groups of patients when they were treated after the second days of the first admission (before intervention), the end of the 6th courses of chemotherapy and the 12th courses of chemotherapy were evaluated by the European Organization For Research and Treatment Quality of Life Questionnaire-C30 (EORTC QLQ-C30). Nutritional indicators and the total life condition of the two groups at different time were compared. Results There were 5 cases off in the intervention group and the control group respectively. After the 12th courses of chemotherapy, the intervention group serum albumin (ALB) and the mean serum prealbumin (PAB) were improved 4.10 and 74.14; and the control group were-0.09 and-0.08, there were significant differences between the two groups (t=3.202, 3.623, P<0.05).The total quality of life of the intervention group was 25.87 points while the control group was 35.13 points, there was significant difference between the two groups (t=3.321, P<0.05). The intervention group got the total health status was (72.28 ± 20.97) points after the intervention, and before the intervention was (56.67 ± 14.08) points. Meanwhile the total health status was statistically significant (t=7.01, P<0.05). Conclusions There is a significant nutritional improvement in colorectal cancer patients with chemotherapy after nutritional therapy leading by nurse specialist, which is worthy of application.

Objective To compare the short-term follow-up cu ra tive effect of primary total hip replacement (THR) in treating fresh and old fem oral neck fractures. Methods Double follow-ups with an in terval of 13 months were performed in patients with femoral neck fractures under going THR in our department from January 1997 to October 1999. Results After a follow-up for 37-62 months (mean 44 months), we obtained f ull data of 47 patients [41-77 years old, (61.8?5.22) years old] with preoperative Harris score of 28.40?10.14 and postoperative score of 85.20?7. 91. The Harris score of patients with fresh femoral neck fractures (FFNF) incr eased from 21.60?8.73 preoperatively to 82.50?9.81 postoperatively〔at age of (63.50?5.53) years〕 and that of patients with old femoral neck fracture (O FNF) from 37.70?13.50 to 90.63?5.79, [at age of (58.90?7.81) years]. Of 47 patients, only one case had dislocation once within six weeks postoperative ly during function exercise and recovered after manual reduction. Another one wi th excellent function evaluation was given again internal fixation three years a fter THR because of femoral shaft fracture and obtained satisfactory recovery. N o complications were found in other patients. The mean Harris score in patients with OFNF was significantly higher than those with FFNF ( P

Background and purpose:With the development of the three-dimensional (3D) science, minimally invasive technology is going into the 3D period. While 3D laparoscope system has been widely accepted by surgeons because of its better visual effect and safer operations compared to traditional laparoscope system, this study aimed to evaluate the feasibility of 3D thoracoscope system in minimally invasive surgery for the treatment of thoracic diseases. Methods: A total of 96 cases of thoracic diseases were accomplished with KARL STORZ 3D thoracoscope during Mar. 2014 to Oct. 2014, including 33 cases of lobectomy, 2 cases of segmentectomy, and 10 cases of wedge resection of pulmonary tumor, 27 cases of mediastinal tumor, 20 cases of esophageal tumor and 4 case of esophageal achalasia. The data of operative time, bleeding volume, postoperative chest tube drainage and hospital time and postoperative complications were counted. Results: All the operations were completed successfully, without conversion to open surgery. All the operations cost 30 to 237 min. The operation of local resection lasted 30 to 120 min, with an average of 52 min, the operation of pulmonary lobectomy lasted 63 to 122 min, with an average of 75 min;the operation of mediastinal tumor resection lasted 35 to 125 min, with an average of 77 min;and the operation of esophageal diseases lasted 57 to 237 min, with an average of 189 min. The bleeding volumes were 2 to 85 mL, 15 to 72 mL, 30 to 186 mL and with the average of 50 mL, 47 mL, 118 mL in pulmonary, mediastinal and esophageal operations respectively. The time of postoperative chest tube drainage of each surgery was 1 to 5 days after pulmonary operations, 1 to 3 days after mediastinal operations, and 2 to 6 days after esophageal operations. The postoperative hospital time of pulmonary operation was 2 to 10 days, with an average of 6.3 days;the time of mediastinal operation was 3 to 6 days, with an average of 4.2 days;and the time of esophageal operation was 4 to 19 days, with an average of 13.3 days. No complications and tumor recurrence or metastasis were observed during the followed 3 months. Conclusion: 3D thoracoscope system not only preserves the minimally invasive advantage of video-assisted thoracoscopic surgery (VATS), it can also provide high-definition and stereoscopic vision and better sense of depth which facilitate the operation more precise and safer, thus operation time becomes shorter. Besides, 3D system possesses the advantage of natural vision similar to open surgery, thus it has an easier and shorter learning curve.

OBJECTIVETo design a kind of internal fixation device to treat the syndesmosis injury.

METHODSThe elastic syndesmosis hook plate is made of medical stainless steel alloy, which is consisted of locking or common screw fixing hole of the tibial side for the head, tridentate fork like arc anatomical fibula side plate for the tail and serpentine elastic connecting body. By reduction of the joint of the lower tibia and fibula, the steel plate tail is fixed at the side of the fibula and the head is fixed at the side of the tibia for fixing the symphysis.

RESULTSThe design of elastic syndesmosis hook plate is reasonable, and the operation is convenient. There is no need to penetrate the substantia ossea and the plate has elastic micro-movement feature, the problem of internal fixation breakage and loosening is avoid in huge degree, so it is safe and reliable.

CONCLUSIONThe elastic syndesmosis hook plate is a new type medical apparatus of internal fixation of the symphysis, which is worthy of clinical popularization and application.

BACKGROUND:Bone morphogenetic protein-2 (BMP-2) is a key to bone formation and repair.However,it has some disadvantages such as easy to lose and degrade and difficult to sustain continuous effect.OBJECTIVE:To study the preparation and properties of silk fibroin/chitosan/nano-hydroxyapatite (SF/CS/nHA) scaffold loading BMP-2.METHODS:After silk degumming,dissolution and purification,2％ SF solution was obtained.BMP-2 was dissolved in 2％ CS solution,and then fully mixed with equal volume of SF solution and proper amount of nHA.At last,the SF/CS/nHA scaffold loading BMP-2 was prepared using freeze-drying method as experimental group.The SF/CS/nHA scaffold was soaked in the BMP-2 solution as control group.The scaffold porosity was measured by Archimedes method,the surface morphology of the scaffold was observed by scanning electron microscope,the compressive strength was measured by universal testing machine.Scaffolds in the two groups were soaked in PBS,and the release of BMP-2 was measured by ELISA method at different time points.RESULTS AND CONCLUSION:(1) The scaffolds in the two groups had irregular porous structure,interconnected pores and uneven pore wall.There was no significant difference between the two groups in mean pore diameter,porosity and maximum compressive strength.(2) On the 1st day,the release rate of BMP-2 was 4.63％ in the experimental group,and the release curve increased slowly.After 28 days,the release curve of BMP-2 was transferred to the plateau stage.But in the control group,the release rate of BMP-2 on the 1stday was 58.84％,and it was a significant initial burst release.The release curve increased rapidly,and was transferred to the platform stage on the 10th day.The release rate of BMP-2 release was significantly different between the two groups at days 1,2,4,10 (P ＜ 0.05).These results show that the SF/CS/nHA scaffold loading BMP-2 could sustainably and slowly release BMP-2.

Background and purpose: Epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) is of advantage in treating non-small cell lung cancer (NSCLC) patients with EGFR mutations. However, their clinical effects vary individually. This study aimed to evaluate whether the EGFR ligand, plasma transforming growth factor α (TGF-α), could act as a predictor for the EGFR-TKI treatment e?ciency in NSCLC patients with EGFR mutations and the association between TGF-α and prognosis in these patients. Methods: Seventy-five NSCLC patients with EGFR gene positive mutation were included in the current study from May 2012 to Jul. 2014 in Ruikang Hospital A?liated to Guangxi University of Chinese Medicine. Plasma TGF-α was measured using enzyme-linked immunosorbent assay (ELISA) in all of the patients before EGFR-TKI treatment. The radiographic evaluation was performed 2 months after the therapy. The association between TGF-α and clinical outcome and its prediction e?ciency were determined, followed by the further analysis of the association between TGF-α and overall survival (OS) as well as progression-free survival (PFS). Results: After EGFR-TKI treatment, there were 20 patients with partial response (PR), 25 with stable disease (SD) and 30 with progression disease (PD) in all 75 NSCLC patients harboring EGFR positive mutation. The disease control (DC) rate reached 60%. Patients in PD group presented statistically significant higher plasma TGF-αthan patients in the DC group (P<0.01). Multivariate COX model indicated that smoking status, lymph node metastasis and plasma TGF-α levels were independent risk factors for prognosis in these patients. The ROC analysis revealed that baseline plasma TGF-α showed good prediction e?ciency [area under the curve (AUC)=0.926] and the cut-off point of TGF-α was 16.75 pg/mL. Higher level of TGF-α (≥16.75 pg/mL) was associated with smoking history, clinical stage, lymph node metastasis and clinical outcome of the patients (P<0.05). In comparison to patients with low TGF-α, the patients with high TGF-α concentration presented significantly reduced median OS and PFS (log-rank P<0.05). Conclusion: Higher plasma TGF-α (≥16.75 pg/mL) had a predictive role in EGFR-TKI resistance and poor prognosis.

This study was conducted to investigate the paclitaxel loaded by hydrazone bonds in poly(ethylene glycol)-poly(caprolactone) micelles (mPEG-PCL-PTX) on proliferation and apoptosis of human lung cancer A549 cells and its possible mechanisms of anti-tumor activity. The cell proliferation was measured with MTT assay. Flow cytometry were used to analyze the cell cycle. The cell apoptosis was analyzed using Hoechst/P staining. The expression levels of apoptotic genes expression in the mitochondrial apoptosis pathway were detected by RT-PCR and Western blotting, respectively. The mPEG-PCL-PTX could inhibit the proliferation of A549 cells and promote the apoptosis. The Bax, caspase-3 protein expression were increased while Bcl-2 protein expression was decreased in A549 cells. Results showed that the polymer containing hydrazone bond is non-toxic in vitro, the mPEG-PCL-PTX micelles can inhibit the proliferation and induce the apoptosis of A549 cells. Key words: paclitaxel; micelle; A549 cell; proliferation; cell cycle; apoptosis

Objective:To investigate the efficacy and toxicity of oxaliplatin reintroduction combined with raltitrexed as second-line che-motherapy after the first-line oxaliplatin-based chemotherapy in advanced colorectal cancer patients. Methods:The 48 evaluable pa-tients with advanced colorectal cancer following disease progression prior to the first-line chemotherapy were treated with oxaliplatin and raltitrexed (raltitrexed 3 mg/m2 ivgtt d1, oxaliplatin 100-130 mg/m2 ivgtt d1, q21d). All 48 patients were divided into two groups:Group A, non-oxaliplatin-based regimens as the first-line chemotherapy, 20 cases;Group B, oxaliplatin-based regimens as the first-line chemotherapy, 28 cases. Each group was evaluated every two cycles. Results:The response rates (RR) of Groups A and B were 30.0%(6/20) and 32.1%(9/28), the disease control rates (DCR) were 80.0%(16/20) and 75.0%(21/28), the median progression free survival time (mPFS) was 6.5 and 7.0 months, and the median overall survival time (mOS) was 10 and 13 months, respectively. No statistical sig-nificance was observed between the two groups in their RR, CR, mPFS, and mOS (P=0.264, 0.514, 0.713, 0.788), respectively. The most common adverse effects observed wereⅠ-Ⅱgrades of bone marrow suppression, aminotransferase abnormality, and digestive toxici-ties. The incidence of neurotoxicity (Ⅰ-Ⅱgrades) between the two groups was similar. Conclusion:Instead of irinotecan combined with raltitrexed, oxaliplatin reintroduction combined with raltitrexed for second-line chemotherapy after the first-line oxaliplatin-based chemotherapy in advanced colorectal cancer patients is feasible.