Objective To evaluate the efficacy of transarterial interventional therapy (TAIT) in treating patients with metastatic liver cancer, and to investigate the factors influencing the prognosis of patients. Methods From January 1997 to June 2000, 470 patients with metastatic liver cancer had undergone TAIT 1231 times in the Cancer Hospital of the Chinese Academy of Medical Sciences. The clinical data of the patients were retrospectively analyzed. The short-term and long-term efficacy and the side effect of TAIT were assessed. The potential factors influencing the prognosis of the patients were determined by Cox regression analysis. Results Complete remission was observed in 94 patients, and partial remission in 143. The total effective rate was 50.4% (237/470). The median survival time was 13.5 months. The O. 5-, 1-, 2-, 3-, 5-year survival rates were 86.4%, 66. 8%, 35.6%, 16.9%, 7.3%, respectively. No severe complication occurred. The factors influencing the prognosis of the patients were: the resection of the primary tumor, blood supply of the tumor, multiple metastases of liver cancer, thrombus in the portal vein, adjuvant chemotherapy after TAIT, tumor originated from breast cancer, tumors invading multiple lobes, concurrent metastasis in other sites (X2= 17. 322, 12. 593, 8.721, 8.573, 8.492, 7. 838, 5. 623, 5. 463, P < 0.05). Conclusions TAIT is an effective palliative therapy for metastatic liver cancer which cannot be resected. The factors mentioned above influence the prognosis of patients after TAIT.

Background Ex-PRESS glaucoma drainage device implantations have been clinically applied worldwide.In China,50 type and 200 type of Ex-PRESS glaucoma drainage devices are used for different types of open angle glaucoma.However,whether the clinical outcomes are similar between 50 type and 200 type of Ex-PRESS glaucoma drainage devices are not elucidated.Objective This study was to compare the therapeutic efficacy and security of Ex-PRESS implantation between PS0 type and P200 type of Ex-PRESS glaucoma drainage devices for open angle glaucoma Methods A randomized,parallel-group trial was designed,and written informed consent was obtained from each patient prior to entering in the cohort.Eighty eyes of 69 patients with various types of open angle glaucoma were included from March 2012 to April 2013 in Wuhan General Hospital of Guangzhou Military Command.The patients were randomized into 2 groups according to randomized digital table.The P50 type Ex-PRESS glaucoma drainage device was implanted in 40 eyes of 35 patients in the P50 group,and P200 type was implanted in 40 eyes of 34 patients in the patients of the P200 group.The disease composition,best corrected visual acuity (BCVA) recovery time,theoretical hospitalization days,lowing intraocular pressure (IOP) range and postoperative complications were compared between the two groups.Results The average lowing-IOP ranges of the P50 type group and P200 type group were (21.19±11.22) and (24.35±12.27) mmHg,respectively,with an insignificant difference between them (t =-1.201,P＞0.05).The theoretical hospitalization days and BCVA recovery time in the of P50 type group were (3.65±0.92) days and (2.85±0.95)days,and those in the P200 type group were (4.90±0.81) days and (3.40± 0.96) days,showing significant decreases in the P50 type group (t =-6.444,P＜0.01 ;t =-2.584,P＜ 0.05).The incidence of postoperative complications were 6.06％ and 25.00％ in P50 type group and P200 type group,respectively,with a significant difference between the two groups (.x2 =9.800,P＜0.05).Conclusions Although P50 and P200 Ex-PRESS implantation provide a similar effect in lowing IOP,P50 type Ex-PRESS implantation can restore BCVA more rapidly and lessen complications in comparison with P200 type Ex-PRESS implantation in the early postoperative stage.

With the quick development of information network,a new disease-Internet Addiction has been paid more and more attention,and how to prevent and cure it has become one important problem that need to be resolved.At present,the rate of Internet Addiction among medical students is rising year by year,so we should make a united effort to prevent and control Internet Addiction among medical students.This article tries to explore how to prevent and control medical students'Internet Addiction from the point of view of law and ethics and expect to prevent them form being patients of Internet Addiction and help them thrive promptly.

Objective To analyze high risk factors for poor prognosis in the refractory neonatal respiratory distress syndrome(NRDS).Methods A retrospective analysis was conducted at NICU in the Affiliated Hospital of Xuzhou Medical university.The newborns with NRDS,chest radiograph for grades 3 and 4,who required mechanical ventilation and pulmonary surfactant(PS)therapy were recruited from January 2014 to December 2015.According to treatment rusults,they were divided into death group(21 cases)and survival group(25 cases).Data regarding antenatal corticosteroid administration,maternal high risk factors,the basic situation of neonatal in the perinatal period,surfactant applications,the blood routine,albumin,lactate dehydrogenase(LDH),creatine kinase(CK),creatine kinase isoenzyme(CK-MB),blood coagulation function with the first 24 hours after birth were collected and analyzed.Results The frequency of using PS in the death group and the survival group was(2±0.9)times and(1.5±0.6)times,the difference between the two groups was statistically significant(t=2.131,P=0.039).Dangerous placenta previa in death group was 19％(4/21),in the survival group was 0％(0/25),the two groups had statistical differences(x2=5.215,P=0.022).CK in death group was(541.5±399.1)U/L,in the survival group was(345.4±173.3)U/L,the difference between of the two groups was statistically significant(t=2.224,P=0.031).Prothrombin time(PT)in the death group was(23.2±6.3)s,in the survival group was(18.5±3.6)s,there was a significant difference between the two groups(t=3.008,P=0.039).Maternal risk factors of premature rupture of the survival group(38.9％)was higher than that of death group(5.0％),the two groups was statistically significant(x2=4.29,P=0.038).The application of prenatal hormone NRDS newborns were more likely to survive,there was statistical difference between two groups(x2=5.197,P=0.023).Multivariate Logistic analysis showed that PT was an independent risk factor for poor prognosis of NRDS.Conclusion PT is an independent risk factor for poor prognosis of neonatal respiratory distress syndrome.

Objective To investigate the expression of insulin-like growth factor Ⅱ mRNA-binding protein 3( IMP3 ) in transitional cell carcinoma of bladder( TCCB ) and its clinical significance. Methods The IMP3 expressions in 6 normal bladder tissues and 48 TCCB tissues were determined by immunohistochemistry staining, and the relationships between IMP3 expression and gender, age, pathological grading and staging were analyzed statistically. Results The positive expression rate of IMP3 was 62.5% ( 30/48 ) in bladder cancer,which were significantly higher than that in normal control ( 0/6 ) ( P ＜ 0. 05 ). The positive rate of IMP3 expression were significantly lower in superficial TCCB ( 46. 15%, 12/22 ) or early TCCB [ Grade Ⅰ 12. 5%(1/8) ,Grade Ⅱ 60. 0% (12/20) ] than that in invasive TCCB [T2 or above,81.8% (18/22) ] or advanced TCCB [ Grade Ⅲ ,85% ( 17/20 ) ] ( Ps ＜ 0. 05 ). Conclusion IMP3 is a promising biomarker for eraly detection and assessment of the malignancy degree in TCCB.

Objective To elucidate the roles of high mobility group box-1 protein (HMGB1) and myeloperoxidase (MPO) deficiency in evaluating coronary stenosis and the vulnerability of atherosclerotic plaques in patients with coronary heart disease.Methods Totally 50 patients with acute myocardial infarction (AMI),50 patients with unstable angina pectoris (UAP),50 patients with stable angina pectoris (SAP) and 30 patients without coronary heart disease underwent the study.Coronary arteriography (CAG) and intravascular ultrasound (IVUS) were performed to analyze coronary stenosis and plaque characteristics and then gensini score was calculated.Concentrations of HMGB1,MPO and hypersensitive C reactive protein (hsC-RP) were measured by means of enzymelinked-immonosorbent assay (ELISA).Results Concentrations of HMGB1,MPO and hsC-RP were significantly higher in AMI and UAP patients than in SAP paticnts (all P＜ 0.01).IVUS showed that 51.3 ％ (20/39) AMI patients,46.7％ (43/92) UAP patients had soft lipid-rich plaqucs,while 52.9％(46/87) SAP patients had fibrous plaques,only 17.2％(15/87) had soft plaques.AMI and UAP patients had larger plaque burden and vascular remodeling index than did the SAP patients (both P＜0.01).In AMI group,HMGB1 and MPO levels were correlated well with gensini score and remodeling index measured by IVUS,respectively(r=0.54,0.48,allP＜0.05),while in UAP group,HMGB1 and MPO levels were correlated well with gensini score and plaque burden measured by IVUS,respectively(r=0.43,0.56,all P＜0.05).Conclusions HMGB1 and MPO are positively correlated with coronary stenosis,which can be used to predict the severity of ACS.HMGB1 and MPO are associated closely with plaque vulnerability and rupture.

Objective To observe the expression of ITF in colon of mice infected by mouse cytomegalovirus (MCMV) and the in-volvement of ganciclovir(GCV) .Methods Forty-eight BALB/c young mice were randomly divided into blank group ,virus group and GCV group ,each with 8 mice .Mice in virus group and GCV group received injection of 100 μL MCMV virus suspension (TCID50105 .31 /mL) ,and GCV group was given intraperitoneal injection of GCV once a day at the dose of 50 mg/kg from day 0 (24 hours after vaccination of virus ) ,for 14 days .At the same time the virus group and blank group were given the same dose of normal saline as controls .Murine cytomegalovirus loads in livers and colons were measured by PCR .The expression levels of ITF in mRNA in colon were detected by RT-PCR .Results After MCMV injection ,mice in virus group manifested aggressively apparent poor appetite ,less activity ,fur laxly ,unresponsiveness to stimuli ,growth retardation ,body weight not increased .All liver and colon tissue MCMV-DNA PCR electrophoresis of virus group had positive strip ,while the blank group did not .GCV group also showed less bright positive strip when compared with the virus group .Expression level of ITF mRNA was significant higher in GCV group than virus group ,there was statistically significant difference(P<0 .05) .Expression of ITF mRNA in virus group were higher than that in blank group ,there was statistical difference(P<0 .05) .Conclusion ITF is regarded as a fast reaction peptide in the course of mucosa impairments ,so ITF plays a protective role in delayed healing process after acute MCMV infection .

Objective:To investigate the complications of spastic cerebral palsy with selective posterior rhizotomy (SPR).Methods:In the study, 2 593 patients who had undergone SPR from January 2000 to September 2012 were followed-up for at least one year .The complications were classified .Results:Peri-operative complications:pulmonary system complications including bronchial spasm (5 cases, 0.19%) and aspiration pneumonia (4 cases, 0.15%);digestive system complications including abdominal bloa-ting (145 cases, 5.6%) and colic (80 cases, 3.1%);urinary system complications including tempora-ry bladder dysfunction (54 cases, 2.1%) and urinary tract infection (6 cases, 0.23%); peripheral nervous system complications including lower extremity weakness ( 327 cases, 12.6%) and lower extremity sensory disturbances ( 140 cases, 5.4%); central nervous system complications including headache (112 cases, 4.3%) and epileptic seizures (4 cases, 0.15%).None spinal or intracranial in-fection, intraspinal hematoma or intracranial hemorrhage were identified .General surgery complications including back pain (1 382 cases, 53.3%), delay wound healing caused by infection (5 cases, 0.19%) and cerebrospinal fluid leakage (8 cases, 0.31%).Long-term follow-up complications inclu-ding lower limb decreased exercise capacity ( incidence: 7.33%) and lower extremity sensory distur-bance (incidence:5.59%).Urination occurred in only one case and defecation function disturbance with no sexual dysfunction was identified .The incidences of scoliosis , thoracic kyphosis , spondylolisthe-sis and long-term back pain were 7.23%(31/429), 4.2%(18/429), 10.49%(45/429) and 9.72%respectively .Conclusion:SPR is one of the effective and safe surgical treatments for spastic cerebral pal-sy.Valid methods should be applied to reduce the incidence of postoperative complications , such as choosing the appropriate patients , meticulously operating in the surgery , assistance of electrophysiological guidance , reinforcing perioperative management and regular rehabilitation training after operation .

Objective To investigate the effects of inhibiting NgR on retinal ganglion cells density and synaptophysin expression of diabetic rat.Methods Thirty-two SD male rats were randomly divided into normal control group,diabetic group,siNgR group and scNgR group,8 rats in each group.Normal control group was given no any treatment.Diabetes model was induced by intraperitoneal injection of 50 mg · kg-1 streptozotocin in diabetic group,siNgR group and scNgR group,and the blood giucose more than 16.7 mmol · L-1 at 72 hours was set as the successfully model.The rats of siNgR group were intravitreally administrated with anti-NgR nucleotide and the rats of scNgR group intravitreally administrated with negative nucleotide.Eight weeks later,HE staining was conducted to detect density of retinal ganglion cell (RGC),immunofluorescence was used to evaluate the expression and distribution of synaptophysin (a marker of synaptic number).Relative expression of NgR and synaptophysin in retina were analyzed by Western blot.Results RGC density in normal control group,diabetes group,siNgR group and scNgR group were (624.33 ± 3.51) mm-2,(420.00 ± 2.65) mm-2,(621.67 ± 1.53) mm-2,(416.67 ± 2.52) mm-2,respectively.There was significant difference among four groups (F =5985.37,P ＜ 0.01).Compared with normal control group,RGC density in diabetes group and scNgR group were obviously decreased (all P ＜0.01),but siNgR group had no obviously change (P ＞ 0.05).The synaptophysin mainly expressed in the inner and outer network layer.Compared with normal control group,the positive expression of synaptophysin in diabetes group and scNgR group were decreased,but siNgR group had no obviously change.The relative expression of NgR in normal control group,diabetes group,siNgR group and scNgR group were (11.26 ±0.02) ％,(19.38 ± 0.10) ％,(11.17 ± 0.02) ％,(19.47 ± 0.31) ％,respectively.There was significant difference among four groups (F =2466.09,P ＜ 0.01).Compared with normal control group,the relative expression of NgR in diabetes group and scNgR group were obviously decreased (all P ＜ 0.01),but siNgR group had no obviously change (P ＞0.05).The relative expression of synaptophysin in normal control group,diabetes group,siNgR group and scNgR group were (35.76 ± 0.15) ％,(25.47 ± 0.36) ％,(35.28 ± 0.12) ％,(25.03 ± 0.75) ％,respectively.There was significant difference among four groups (F =583.70,P ＜ 0.01).Compared with the normal control group,the expression of synaptophysin in diabetic group and scNgR group were decreased increased (all P ＜ 0.01),while there was no significant difference in siNgR group (P ＞ 0.05).Conclusion Inhibiting the expression of NgR in the retina of diabetic rats can help to restore the number of synapses and protect the damaged RGC.

Objective To investigate lymph node metastasis on the middle and lower segment of lⅡ and Ⅲ stage of esophageal squamous cell carcinomas,understand the factors influencing the lymph node metastasis,and provide the basis for the key areas of lymph node cleaning.Methods A retrospective study was made on the specimens of 186 patients who were middle and lower segment of Ⅱ and Ⅲ stage of esophageal squamous cell carcinomas,who had underwent radical operation through left thoracic,thoraco abdominal two field lymph node cleaning.All the cases were patients from April 2010 to December 2013 at the Inner Mongolia Medical University Clinical Medical College of Chifeng.Results A percentage (67.9％) of patients (126/186) was found with lymph node metastasis.A total of 4259 lymph node was dissected,with an averaged cleaning of (22.9 ± 8.1) lymph nodes for each case.A total of 622 lymph nodes (14.6％ =622/4 259) existed metastasis.The rate of mediastinum metastasis for middle and lower segment of esophageal cancer was 56.1％ and 16.5％,respectively.The rate of metastasis to the lower mediastinal lymph nodes was 34.6％ and 54.4％,respectively.The rate of metastasis to the celiac lymph nodes was 23.4％ and 46.8％,respectively.A significant difference was found in the metastasis locations of middle and lower segment of esophageal carcinomas (P ＜ 0.05).The top three locations of lymph node metastasis in the middle segment of esophageal squamous cell carcinomas were the lymph nodes of left artery paraesophageal,carina,and gastric bypass.The top three locations of lymph node metastasis in the lower segment of esophageal squamous cell carcinomas were paraesophageal,cardia,and gastric lymph nodes.The depths of tumor invasion,differentiation,intravascular cancer embolus were statistically significant effect on lymph node metastasis rate (P ＜ 0.05).Tumor location,and lesion length had no significant effect on the lymph node metastasis rate (P ＞ 0.05).Conclusions The lower segment of Ⅱ,Ⅲ stage esophageal squamous cell carcinoma with lymph node metastasis occurs in the lower mediastinal and abdominal lymph nodes.The middle segment Ⅱ,Ⅲ stage esophageal squamous cell carcinoma with lymph node metastasis occurs in the thoracic and abdominal lymph nodes with Jump transfer characteristics.The lymph node cleaning of the mid-dle segment includes the left artery near the stomach,paraesophageal,and carina lymph node.The lymph node cleaning of the lower segment includes paraesophageal,cardia,and gastric lymph nodes.The metastasis rate of vascular tumor thrombus is related to the depth of tumor invasion and differentiation degree.