Methods involved in the treatment of malignant tumor are surgical therapy, radiotherapy, chemotherapy and immunotherapy. Although some effects have been showed in tumor therapy, the limits of single use of those methods can not be avoided. Therefore, combined therapy has been pursued in order to achieve better results. The effects of those combined methods such as chemotherapy combined with cytokine, chemotherapy combined with tumor vaccine, chemotherapy combined with adjuvants have been approved both experimentally and clinically. These results, in some extent, will provide us a new way to fight against tumor.

OBJECTIVE:To study the correlation between the rate of inpatients using antibacterials and the cross-sectional rate of inpatients using antibacterials.METHODS:A cross sectional study was conducted on the use of antibacterials in 1040 inpatients between May 22 and May 23 in 2007.Besides,the discharge case histories of 100 cases were collected randomly for an analysis.RESULTS:Of the total 1 040 inpatients,510(49.04%)used antimicrobials.The rate of inpatients using antibacterials in comprehensive ICU took the lead at 100%,followed by pediatric department(86.05%)and the department of nephrology(84.62 %).The average rate of inpatients using antibacterials in surgery department was significantly higher than in the department of internal medicine(63.52% vs.33.94%).81% of the discharged cases used antibacterials.The irrational use of antibacterials manifested as improper timing of medication,prolonged use of antibacterials for prophylactic purpose etc.CONCLUSION:The proportion of the patients using antibacterials in descending order were inpatients,cross-sectional inpatients and outpatients.It is necessary to tighten control on the rational use of antimicrobials.

Objective To explore the etiology of and timing for operation of acalculous biliary acute pancreatitis(ABAP).MethodsWe retrospectively analyzed the etiology study and treatment experience of 38 cases of ABAP.ResultsThirteen cases underwent a surgery, including 6 early operations for complicated biliary tract infection without morbidity and mortality, 5 middle staged patients (5～14 days after onset of ABAP) underwent surgery because of intraabdominal indications with one postoperative death and 2 late operations for severe acute pancreatitis (SAP) resulted in one postoperative death of sepsis. The total postoperative mortality rate was 15%( 2/13). Four SAP cases were managed conservatively with one death of MOF. The remaining 21 cases of acute edematous pancreatitis (AEP) were cured by nonoperative methods.ConclusionWhereas an early exploration is indicated, when complicated by biliary tract infections, it is judicious to try a conservative therapy first for ABAP patients.

The treatment strategy for infected acute necrotizing pancreatitis is that enables recovery but at the same time limits the morbidity and mortality.The current gold standard remains open necrosectomy.Recent literature contains scattered reports of percutaneous drainage,endoscopic,and laparoscopic approaches to managing patients with this condition.This review addresses the role of minimally invasive approaches and treatment strategy in patients with infected acute necrotizing pancreatitis.

Objective To study the clinical significance of the caudate lobe vein in patients with Budd-Chiari syndrome (BCS) by contrast-enhanced magnetic resonance imaging(MRI).Methods Contrast-enhanced MRI data of 46 patients with BCS, 30 patients with cirrhosis due to hepatitis B virus (HBV) and 49 healthy people in our institution were analyzed retrospectively.The presence and diameter of the caudate lobe vein among the three groups were measured.Among the BCS group, in which the caudate lobe vein could be seen, andpatients were divided into two groups according to disease duration and patency of inferior vena cava (IVC), respectively.And comparative study of diameter between two groups was performed.Results ①The caudate lobe vein was noted in 76.1% of patients with BCS, in 30.0% of patients with cirrhosis due to HBV,and in 36.7% of healthy subjects.The diameter of caudate lobe vein in BCS group was larger than that in both cirrhosis group and healthy group(P<0.01).There was no statistically difference between cirrhosis group and healthy group(P>0.05).②Among BCS group,the caudate vein was shown in 35 patients, with mean diameter of(4.21±1.66)mm.For 35 BCS,the diameter of caudate lobe vein in chronic group was larger than that in acute group(P<0.05).The diameter of caudate lobe vein in IVC obstruction group was larger than that in IVC open group(P<0.05).Conclusion The demonstration of the caudate lobe vein on contrast-enhanced MRI is of great significance in the diagnosis and treatment of BCS.

BACKGROUND: Recently, zirconia ceramic implants have been reported to be used in clinic. Increasing studies on surface treatment of ziconia implants have been done, in order to promote bone-implant osseointegration and increase the success rate of implantation. There are no recognized surface treatment techniques of zirconia implants as yet.OBJECTIVE: To summarize the research progress in surface treatment techniques of zirconia implants.METHODS: The first author searched the CNKI, PubMed and Web of Science databases for relevant articles published from January 2000 to October 2016. The keywords were zirconia or zirconium, implant, surface treatment in Chinese and English, respectively. The search condition was((zirconia or zirconium) AND implant) AND surface treatment. Here,we reviewed the surface treatment techniques of zirconia implants, and introduced the properties, the surface treatment techniques and commercialization of zirconia implants.RESULTS AND CONCLUSION: Totally 23 papers were included in result analysis. Commonly used surface treatment technologies of zirconia implants include sand blasting, acid etching, sandblast and acid-etching, selective filtration etching, laser, ultraviolet and coating. These technologies all contribute to improving the surface activity of the implant,increasing the roughness, and promoting bone bonding to a certain extent.Because of the very limited experiments,further investigations are required to explore the optimum technique for the surface treatment of zirconia implants.

BACKGROUND: Hedgehog signaling pathway is shown to contribute to the osteogenesis of bone marrow mesenchymal stem cells, and to play an important role in regulating the expression of RANKL in osteoblasts. Nowadays, the definite signal transduction pathway has been revealed gradually.OBJECTIVE: To review the research progress of RANKL in osteoblasts that regulated by hedgehog signaling pathway.METHODS: A computer-based online search in CNKI, Google Scholar and PubMed databases was performed with the key words of Hedgehog, osteoblast, BMSCs, PTHrP, CREB, NFAT, RANKL in English and Chinese, respectively.Literatures related to the expression of RANKL in osteoblasts that regulated by the Hedgehog signaling pathway were included initially and 37 eligible articles were extensively summarized for review.RESULTS AND CONCLUSION: The Hedgehog signaling pathway plays an advanced role in the osteogenic differentiation of bone marrow mesenchymal stem cells, and also upregulates intracellular parathyroid hormone related protein, which activates its downstream signaling molecules cAMP response element binding protein and nuclear factor of activated T cells ulteriorly, to promote the expression of RANKL in osteoblasts and increase the differentiation and formation from osteoclast precursor cells to mature osteoclasts.

Objective To evaluate the outcome and safety of endoscopic submucosal dissection (ESD) versus endoscopic mucosal resection (EMR) in the management of esophageal mucosal lesion.Methods The clinical data of 70 patients with esophageal mucosal lesion were analyzed.Twenty-five patients were treated by ESD (ESD group) and 45 patients were treated by EMR (EMR group).The enbloc resection rate,tissue healing resection rate,operation time,complication and recurrence rate were compared between two groups.Results The enbloc resection rate,tissue healing resection rate in ESD group were significantly higher than those in EMR group [60.0％(15/25) vs.48.9％(22/45),48.0％(12/25) vs.40.0％ (18/45)] (P ＜0.05).The local recurrence rate in ESD group was lower than that in EMR group [4.0％ (1/25) vs.20.0％ (9/45)] (P ＜ 0.05).The severe complication such as delayed hemorrhage,perforation,stenosis between two groups had no significant difference (P ＞ 0.05).The operation time in ESD group was (64.3 ±27.1) min,and significantly longer than that in EMR group [(27.6 ± 14.1) min] (P ＜0.05).Conclusions Compare with EMR,ESD has better enbloc resection rate,tissue healing resection rate,and lower recurrence rate.It is more safe and effective in the therapy of esophageal mucosal disease.

ObjectiveTo study the expressions of p75NTR,Bax and Bcl-2 and cell apoptosis in rat cortical neurons following mechanical injury and discuss the mechanism and mutual action way during the apoptosis of rat neurons after mechanical injury.Methods Cortical neuron cultures were prepared from the brain tissues of day 17 rat embryos and were exposed to mechanical injury seven days after seeding.After the traumatic neuron injury models were created,the apoptosis ratio of neurons was tested at several time points.The models were divided into the minor,moderate,severe injury groups according to the injury severity and the control group.The expressions of Bax and Bcl-2 in each group were detected by immunohistochemistry method and that of p75NTR by Western-blot.Combining with cellular apoptosis ratio in each group shown after FCM analysis,the correlation between the expressions of p75NTR,Bax and Bcl-2 and the apoptosis in rat neurons after mechanical injury could be analyzed.ResultsThe apoptosis ratio of the neurons in all the injury groups was obviously higher than that in the control group,with significantly higher apoptosis ratio of the neurons in the severe injury group than the minor and moderate injury groups (P ＜0.05).P75NTR,Bax and Bcl-2 were all expressed in all the injury groups,with statistical differences between groups.The expression of Bax in the severe injury group was significantly higher than that in the minor and moderate injury groups(P ＜ 0.05 ). Conclusions p75NTR expression and Bax/Bcl-2 ratio are closely correlated with neuron apoptosis.The early expression of p75NTR may be one of mechnisms for neuronal apoptosis after neuron injury,when Bax and Bcl-2 may be involved.

Mean platelet volume (MPV) in patients with type 2 diabetes mellitus (DM) and coronary artery disease was increased significantly.In those with acute coronary syndrome,multi-vascular disease,obesity,and highvalue of HbA1C(＞7％),the MPV was much higher.Gisini coronary score,fasting blood glucose,high density lipoprotein cholesterol and HbA1C were the independent predictors of MPV in patients with DM and coronary artery disease.