Objective The patients with non-small cell lung cancer ( NSCLC) are still at risk of brain metastasis after surgi-cal treatment.The study was to investigate the clinical characteristics and the risk factors for postoperative brain metastasis in patients with NSCLC in order to provide references for prophylactic cranial irradiation ( PCI) . Methods The clinical and prognostic data of 213 patients with NSCLC in our department of oncology from February 2008 to February 2012 were retrospectively analyzed.The occur-rences of postoperative brain metastasis in NSCLC patients with different characteristics were observed.Cox model was used to investi-gate the risk factors for postoperative brain metastasis in patients with NSCLC. Results The overall cumulative rate of brain metasta-sis was 23.9%(51/213) and the rates of brain metastasis at 1-year, 2-year, 3-year after surgery were 6.1%, 14.1%, 22.5% re-spectively.Univariate analysis showed that the rates of postoperative brain metastasis in NSCLC patients with different ages, histological types, tumor stages and CEA levels were statistically significant (P<0.05).Cox regression showed that adenocarcinoma (HR=2.00, 95%CI:1.11~3.64), lung cancer stageⅢ(HR=3.70, 95%CI:1.67~8.25) and high CEA (≥5.0μg/L)(HR=3.16, 95%CI:1.60~6.25) were risk factors for postoperative brain metastasis in patients with NSCLC.The survival time in NSCLC patients with brain metastasis was remarkably lower than that in patients without brain metastasis (P<0.05). Conclusion The NSCLC pa-tients with adenocarcinoma, III stage disease, or high CEA are more likely to develop brain metastasis after surgery, which should be the focus of PCI.

Objective To evaluate operative efficacy in regional pancreaticoduodenectomy with mesenteric-portal vein resection and graft reconstruction using iuternal jugular vein for pancreatic head carcinoma.Methods From Jan 2000 to Jan 2003,6 patients with pancreatic head tumors and mesenteric- portal vein involvement underwent regional pancreatieoduodenectomy with mesenteric-portal vein reseetion and vascular reconstruction using internal jugular vein.Results Surgery was successful in all 6 patients. Postoperative pathology revealed that mesenteric vein or portal vein were invaded by tumor in all cases. Survival time ranged from 17 to 49 mouths.The median survival was 23.4 months.Two cases have survived over 3 years and one of them was alive 49 months postoperatively without recurrence.Conclusion The regional pancreaticoduodenectomy with tumor invaded mesenteric-portal vein resection and graft reconstruction by using internal jugular vein renders a longer survival in metastasis-negative patients of pancreatic head adenocarcinoma.

Objective To investigate the possible protective effects of hydrogen sulfide (H2S) on rats with multiple organ dysfunction syndrome (MODS). Methods NaHS was taken as a donor of H2S. Forty Sprague-Dawley rats were divided into 5 groups with 8 rats in each group:sham group,MODS 12 h model group,MODS 24 h model group,NaHS protection 12 h and 24 h groups. The content of superoxidase dismutase (SOD),malondialdehyde (MDA),glutathione peroxidase (GSH-Px),alanime transaminse (ALT),creatine kinase (CK) and creatinine (Cr) in serum were measured,respectively. The histopathological changes in the heart,liver,lung,kidney and small intestine were observed. Results The serum content of SOD and GSH-Px was significantly higher in protected H2S groups (P

Objective To investigate the clinical effects of gastric bypass( GBP) on type 2 diabetes mel-litus(type 2 diabetes mellitus, T2DM)patients with different body mass index(BMI).Methods T2DM patients undergoing GBP from Sep.2012 to Jul.2013 were divided into 2 groups:obese group( BMI≥28 kg/m2 , 16 ca-ses)and overweight group(BMI<28 kg/m2,21 cases).Changes of fasting plasma glucose(FPG), insulin resist-ance index(HOMA-IR)and insulin stimulation release(INS), C peptide release, BMI, glycosylated hemoglobin ( HbA1c) at 3 and 6 months after surgery were observed.Results INS and C peptide improved 3 months after surgery(P<0.05),and they were close to normal at 6 months after surgery.HbA1c significantly decreased 3 months after surgery compared with that before surgery( P<0.05) and it was close to normal at 6 months after sur-gery.Patients in obese group had significantly declined weight 3 months after surgery compared with that before surgery, and reached the steady state 6 months after surgery.15 cases(93.7%) in the obese group had BMI<25 kg/m2 , and the difference had statistical significance ( P<0.05 ) .Patients in the overweight group had their weight declined but no statistical difference was found(P>0.05).Blood sugar in the obese group decreased with different degrees at 3 and 6 months after surgery.The effective rate was 92%for the obese group and 78%for the overweight group.The overall effective rate was 90%.Conclusion GBP has significant therapeutic value for T2DM patients with different BMI, especially for patients in obese group, which is worth of clinical promotion.

OBJECTIVE:To provide reference for the further implementation of national essential medicine system of township hospitals. METHODS:5% township hospitals in a province were collected as sample by using random cluster sampling method, and statistics,comparison and evaluation was made by issuing questionnaires to get health resources distribution status,health ser-vice status and income and expenditure status before(in 2009 and 2010)and after(from 2011 to 2013)the implementation of na-tional essential medicine system of township hospitals. RESULTS:Totally 46 township hospitals were surveyed and totally 46 ques-tionnaires of township hospitals were recycled. Average number of beds in township hospitals increased from 15.1 beds in 2009 to 19.4 beds in 2013. Average annual outpatients increased from 11 200 in 2009 to 16 100 in 2013,and average number of hospital discharge increased from 644 in 2009 to 924 in 2013. The proportion of government financing to total income increased from 25.9% in 2009 to 47.1% in 2013,proportion of drug income to the total income decreased from 54.9% to 29.7%,drug profit rate decreased from 25.5% to 3.7%,and proportion of township hospital under deficit decreased from 17.4% to 4.3%. Average time that residents see a doctor in township health center increased from 0.47 in 2009 to 0.74 in 2013,and cost of average hospitaliza-tion and outpatient drugs decreased from 805 to 718 and 28.1 to 24.1,respectively. CONCLUSIONS:The implementation of nation-al essential medicine system has no negative effect on outpatient service,but first inhibits then promotes the inpatient services. Na-tional essential medicine system has effectively cut down the financial burden of drugs,but it has no effect on total health burden. It is difficult to realize the excessive rapid rise of health ex-pense by the single implementation of essential medicine sys-tem,and it needs comprehensive reform,collaboration and in-teraction of medicine and health to effectively relieve the prob-lem of“expensive ill”.

OBJECTIVETo compare the clinical outcomes of anterior cervical decompression plus sublevel fusion and posterior cervical laminoplasty in treating multilevel cervical spondylotic myelopathy.

METHODSThe clinical data of 56 patients with multilevel cervical spondylotic myelopathy were retrospectively analyzed from July 2009 to June 2012. There were 32 males and 24 females, aged from 42 to 79 years old with an average of (56.9 +/- 12.8) years. All patients had the typical clinical features of cervical spondylotic myelopathy,radiological evidences, and courses of disease were from 2 months to 16 years with an average of (10.6 +/- 3.2)years. Of them,34 patients were treated with anterior cervical decompression plus sublevel fusion (anterior fusion group) and 22 patients with posterior cervical laminoplasty (posterior laminoplasty group). JOA score and radiological data were used to evaluate the clinical results:

RESULTSNo complications about nerve and blood vessel was found and the patients were followed up from 24 to 36 months with an average of 28.6 months. In anterior fusion group, the cervical anterior column height was significantly increased and the anterior cervical curvature angle was significantly decreased at 2 weeks after surgery (P < 0.05). In posterior laminoplasty group, there was no significant difference in above items between preoperative and postoperative at 2 weeks,final follow-up. Postoperative at 2 weeks and final follow-up, there was significant difference in anterior cervical curvature angle between two groups (P<0.05). Postoperative JOA score had obviously improved in all patients, at 3 months after operation and final follow-up, anterior fusion group was better than that of posterior laminoplasty group (P < .05).

CONCLUSIONThe anterior sublevel fusion can effectively restore cervical anterior column height, and compared with the posterior cervical laminoplasty, it can obviously improve the spinal cord function. It is an effective method for the multilevel cervical spondylotic myelopathv.

Adult ; Aged ; Case-Control Studies ; Cervical Vertebrae ; diagnostic imaging ; surgery ; Decompression, Surgical ; Female ; Humans ; Laminectomy ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Radiography ; Retrospective Studies ; Spinal Cord Diseases ; diagnostic imaging ; surgery ; Spinal Fusion ; Spondylosis ; diagnostic imaging ; surgery

Breast Neoplasms ; metabolism ; pathology ; Female ; Humans ; Insulin-Like Growth Factor Binding Protein 5 ; biosynthesis ; genetics ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; RNA, Messenger ; biosynthesis ; genetics ; Tumor Cells, Cultured

Background The afferent signals of proprioceptor in extraocular muscles play an important role in controlling eye position and conjugate movement. Palisade ending in the extraocular muscles is the main source of proprioceptive information, and its abnormalities in structure and function may be associated with the occurrence of nystagmus. Objective This study was to observe the changes of palisade ending in the extraocular muscles of patients with congenital nystagmus ( CN) and discuss the probable mechanism. Methods Modified Kestenbaum procedure was performed on 10 patients with CN, and the extraocular muscle samples were collected during the operation. Normal extraocular muscle samples were obtained from the enucleated eyeballs after ocular wound. The ultrathin sections of extraocular muscles were prepared and double-staining by uranyl acetate and lead citrate. The morphological changes of the palisade ending of extraocular muscles were examined under the transmission electron microscopy. Written informed consent was obtained from each subject before surgery. Results The ultrastructure of palisade ending in the extraocular muscle of CN subjects showed the different degrees of alterations. The mild changes included the collapse and disconnection of external capsules and the nonhomogeneous electron-dense substracts. The degeneration and dissociation of myelin in nerve endings, swelling and vacuolation of mitochondria were also exhibited. Myeloid body was found in axon. In the severe patients,the necrosis of Schwann' s cells,dissolve of axon and disappear of capsules were seen. Conclusion The palisade ending of extraocular muscle in the patients with CN are obviously abnormal in comparison with normal one. These alterations are probably associated with the etiology and pathogenesis of CN.

Objective: To explore the application of grid health education model in improving college students health literacy. Methods: The clustered stratified random sampling method was used among the pre-formative education freshmen in a Xi-an university, with 1 123 students randomly selected totally. The intervention group (578) received health literacy education based on grid health education model, while the control group (545) receuved the original health education model. The effect of gird model of health education on health literacy was compared between two groups of college students after one-semester intervention. Results: Insufficient health literacy was found among freshmen participants in Xi an(17.12%, 17.61%); health literacy on prevention and treatment of chronic diseases (15.92%, 16.70%) was significantly lower than the national average level of urban residents(22.73%). Health literacy of the two groups of college students was significantly improved(47.75%, 27.71%, χ 2=20.50, 5.47, P<0.05). The grid health education model had significant effects in improving health literacy among college students, except for health literacy on safety and emergency(P<0.05). Conclusion Health literacy of college students is insufficient compared to that of urban residents in China. Grid model of health education model is superior to conventional health education model, which is in line with the requirements of health education in colleges in the new era.

Background Research demonstrated that alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid GluR2 (AMPA-GluR2) is associated with amblyopia.It has been shown that levodopa and cytidine diphosphate choline can improve visual function of amblyopic children,but the mechanism is unclear.Objective This study was to explore the possible effects of levodopa and cytidine diphosphate choline on amblyopia.Methods Monocular deprivation (MD) animal models were created in 60 2-week-old SD rats by monolateral eyelid suturing and observed for 31 days and reared in natural light together with 15 other matched normal healthy SD rats.The models were randomly divided into the MD group,levodopa group,cytidine diphosphate choline group and normal saline control group,with 15 rats for each group.40 mg/kg of levodopa,80 mg/kg of cytidine diphosphate choline,I ml normal saline were given to the rats,respectively,for 28 consecutive days.Expressions of the AMPA-CluR2 protein and AMPA-CluR2 mRNA in the rat visual cortex were detected by immunohistochemistry,Western blot and real-time fluorescence quantitative PCR.Use of the animals followed the Regulations for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission.Results The expression values of the AMPA-GluR2 protein (AMPA-GluR2/β-actin) and AMPA-GluR2 mRNA (2-△△Ct) were significantly lower in the MD group than those of the normal control group (protein:0.32 ± 0.02 vs.0.64 ± 0.05,t =13.287,P＜0.05 ;mRNA:0.30±0.01 vs.0.84±0.03,t=38.184,P＜0.05).Those in the levodopa group were significantly increased in comparison with the normal saline solution group (protein:0.59 ±0.04 vs.0.33 ±0.03,t =11.628,P＜0.05 ; mRNA:0.71±0.06 vs.0.33 ±0.02,t =13.435,P＜0.05).The expression values of the AMPA-GluR2 protein and AMPA-GluR2 mRNA were significantly increased in the cytidine diphosphate choline group compared with the normal saline solution group (protein:0.52 ± 0.04 vs.0.33 ± 0.03,t =8.497,P ＜ 0.05 ; mRNA:0.48± 0.04 vs.0.33 ± 0.02,t =7.500,P＜0.05).Conclusions AMPA-GluR2 is associated with the plasticity of visual development.Levodopa and cytidine diphosphate choline may improve visual function by down-regulating the expression of AMPA-GluR2 in the visual cortex.