Objective: To study early diagnosis and treatment of multi-primary esophageal cancer and esophageal and cardiac double primary cancer. Methods: The data of 71 cases patients of multi-primary esophageal, double primary esophageal and cardiac cancer were collected. The diagnosis was made by dye staining through gastroscopy and X-ray. Pathological examination after operation was analyzed. Results: 14 patients were diagnosed by X-ray(14/71), 69 by endoscopy (69/71), 54 early foci and 6 early stage patients were found. All of them were operated. The resection rate is 100% with no operative death. 3-year survival rate was 40 5%. Conclusion: Routine X-ray examination of esophagus or stomach, and esophageal dye-staining and/or biopsy through endoscopy are important measures for early diagnosis of multi-primary cancer or esophageal and double primary cardiac cancer prompt surgery is advised.

Objective To investigate the effect of benazepril on expression of connective tissue growth factor(CTGF)gene in kidney of diabetic rats and renal lesion.Methods Forty Wistar rats were randomly divided into control group(CON),diabetic group(DM) and diabetic rats treated with benazepril(DM+B) group.After benazepril was orally administered(15 mg?kg~(-1)?d~(-1))to the diabetic rats for 12 weeks,serum creatinine(Scr) and blood urea nitrogen(BUN) levels,urinary protein excretion(UAER)and angiotensin Ⅱ(AngⅡ) contents in renal cortex were determined.CTGF mRNA expression in the renal cortex was detected by RT-PCR.Immunohistochemstry was used to examine the expressions of fibronectin(FN) and type Ⅳ collagen(Col Ⅳ) in glomeruli.Results At the end of the experiment,UAER in DM group(12.92?3.56 mg?24 h~(-1)) was significantly higher than that in CON group(2.74?1.09 mg?24 h~(-1))(P

BACKGROUND: Connective tissue growth factor (CTGF) has very strong regulative effect on the differentiation and proliferation of renal cells as well as the synthesis and degradation of extracellular matrix. Its abnormal expression plays a key role in the process of fibrous degeneration of various renal diseases including diabetic nephropathy.OBJECTIVE: To observe the protective effect ofjiedu tongluo baoshen gelatin capsule on renal disease in rats with diabetes mellitus and its effect on the expression of renal CTGF mRNA.DESIGN: A randomized controlled experiment taking animals as subjects.SETTING: Institute of Traditional Chinese Medicine, Changchun College of Traditional Chinese Medicine; Department of Pathology, Institute of Regenerated Medical Sciences, Jilin University MATERIALS: Totally 46 Wistar rats, of clean degree, male and female in half, weighing 150 to 200 g, were used in the experiment. Jiedu tongluo baoshen gelatin capsule was provided by Preparation Room, Traditional Chinese Medicine Hospital of Jilin Province (Batch No. 2002101, composed of Renshen, Huangqi, Shengdi, Gouqizi, Zhimuv Digupiv Huanglian,Zhenhua, Jinyinhua, Dahuang, Danshen, Yimucao and so on, 0.25 g/pill)and benazepril (Provided by Beijing Nuohua Pharmaceutical Company,Batch No. 01046) were used in the experiment.METHODS: This experiment was carried out in the Department of Pathology, Institute of Regenerated Medical Sciences, Jilin University from May 2002 to January 2003. ① Totally 46 Wistar rats used in the experiment were randomly divided into 4 groups: normal control group (n=10), model group (n=12), benazepril-treated group (n=12) and traditional Chinese medicine-treated group (n=12).Rats of normal control group were intraperitoneally injected of natrium citricum buffer solution of same volume; Rats of other groups were intraperitoneally injected of 50 mg/kg streptozotocin which was dissolved by 0.1 mol/L citric acid buffer solution before use(pH 4.2). Seventy-two hours after modeling, venous blood was collected from the tails to measure the levels of fasting blood glucose and urine glucose.Blood glucose ≥ 16.7 mmol/L and urine glucose over 卅 suggested diabetic models were successful. Rats of benazepril-treated group were performed intragastric administration of benazepril suspension of 15 mg/(kg·d);Rats of traditional Chinese medicine-treated grou p were performed intragastric administration ofjiedu tongluo baoshen gelatin capsule suspension of 5 g/(kg ·d); Rats of normal control group and model group were performed intragastric administration of the same volume of running water on each morning, once a day, 12 weeks in total. ② Levels of blood glucose,urea nitrogen, serum creatinine and urinary albumin excretion rate were measured 12 weeks after administration; Level of angiotensin Ⅱ of renal tissue was measured with radioimmunoassay; Levels of renal fibronectin and type Ⅳ collagen protein expression were measured with immunohistochemical method; Connective tissue growth factor gene expression of renal cortex was measured with reverse transcription-polymerase chain reaction and renal histological observation was also performed. ③ Analysis of variance was used in the intergroup comparison.MAIN OUTCOME MEASURES: Biochemical index of blood and urine,level of angiotensin Ⅱ of renal tissue, pathological morphology, expression of fibronectin and type Ⅳ rabbit anti-rat collagen protein and expression of connective tissue growth factor mRNARESULTS: Five, four and three rats died in the process of experiment respectively in model group, benazepril-treated group and traditional Chinese medicine-treated group, finally, 10,7,8 and 9 rats entered the stage of result analysis respectively in normal control group, model group, benazepril-treated group and traditional Chinese medicine-treated group. ① The ratio between body mass and renal mass was significantly higher in the model group than in the normal control group (P ＜ 0.05),but was significantly lower in the benazepril-treated group and traditional Chinese medicine-treated group than in the model group (P ＜ 0.01). ② Fasting blood glucose was significantly higher in the model group than in the normal control group (P ＜ 0.01),but was significantly lower in the traditional Chinese medicine-treated group than in the model group and benazepril-treated group (P ＜ 0.01). ③ Levels of urea nitrogen, serum creatinine, creatinine clearance, urinary albumin excretion rate and angiotensin Ⅱ of renal tissue were significantly higher in the model group than in the normal control group (P ＜ 0.01), but significantly lower in the benazepril-treated group and traditional Chinese medicine-treated group than in the model group (P ＜ 0.05-0.01 ). ④Pathomorphological change of renal tissue was very severe in the model group,but very mild in the benazepril-treated group and traditional Chinese medicine-treated group. ⑤Fibronectin and type Ⅳ rabbit anti-rat collagen protein expression were significantly higher in the model group than in the normal control group (P ＜ 0.01), those were significantly lower in the benazepril-treated group and traditional Chinese medicine-treated group than in the model group, but higher than normal control group (P ＜ 0.01). ⑥Expression of CTGF mRNA of renal cortex of model group was 2.65 times that of normal control group. Expression of CTGF mRNA of benazepriltreated group and traditional Chinese ine-treated group was decreased by 23.68% and 26.32%, respectively (P ＜ 0.05 or 0.01).CONCLUSION: Jiedu tongluo baoshen gelatin capsule has protective effect on diabetic nephropathy, which might be implemented by reducing the level of angiotensin Ⅱ of renal tissue and down-regulating the expression of CTGF mRNA of renal cortex of rats with diabetes mellitus, so as to reduce the deposition of extracellular matrix.

Objective To explore the fixation method of tibial helical plate for treatment of proximal and middle one-third of humeral fractures and evaluate the clinical outcome. Methods A review was performed on 15 patients with proximal and middle one-third of humeral fractures treated by tibial helical plate from May 2004 to February 2009. There were 10 males and five females, at age range of 19-65 years ( average 38.0 years). The surgical method was summarized and the shoulder function evaluated.Results The follow-up lasted for 7-24 months (mean 13 months) , which showed bony union in all patients, with mean union time of 4.7 months. There was no implant loosening or failure. According to Neer 's criteria, the result was excellent in seven patients and good in six, with excellence rate of 86.7%.Conclusions Open reduction and internal fixation using tibial helical plate is simple and effective for treatment of proximal and middle one-third of humeral fractures.

Objective To investigate the expression and clinical significance of the estrogen receptor beta isoforms and survivin in thyroid tumors. Methods The pathological data of 125 patients with thyroid tumors were, collected from june 2003 to june 2007 in our institution, including thyroid carcinoma (86 cases), thyroid follicular adenoma (39 cases) and normal thyroid tissue (10cases). SP immunohistochemistry was used to measure the expressions of ERβ and survivin in the thyroid tumors. Results ERβ not only was detected in the thyroid epithelial cell plasma and nuclear, but also in the stroma. The positive rate of ERβ in cases with thyroid carcinoma, adenoma and normal thyroid tissue were 83.72 %, 51.28 % and 20.00 % respectively. There was significant difference between carcinoma and the adenoma or normal thyroid tissue (P<0.05). The positive rate of survivin in cases with carcinoma, adenoma and normal thyroid tissue were 59.30 %, 17.95 % and 0 respectively. There was significant difference between carcinoma and the adenoma or normal thyroid tissue (P<0.05). The expressions of ERβ and survivin correlated with TNM staging and lymph node metastasis of thyroid carcinoma (P<0.05). Conclusion ERβ may play a role in accelerating proliferation in the occurrence of the thyroid carcinoma. The expressions of ERβ and survivin are related to invasion and metastasis of thyroid carcinoma.

BACKGROUND:Hydroxyapatite/poly-L-lactic acid composite can wel improve the brittleness and mechanical properties of the hydroxyapatite. OBJECTIVE:To study the biocompatibility of hydroxyapatite/poly-L-lactic acid composite biomaterials with periodontal ligament cels. METHODS:Passage 4 human periodontal ligament cels at a density of 5×109/L were cultured with hydroxyapatite/poly-L-lactic acid composite as experimental group, and human periodontal ligament cels cultured alone as control group. Cel proliferation was detected within 7 days of culture; alkaline phosphatase activity was detected at 24, 48 and 72 hours of culture; and type I colagen expression was detected at 72 hours of culture. RESULTS AND CONCLUSION:There was no significant difference in the absorbance value of cels between the two groups at 1-7 days of culture. The alkaline phosphatase activity of cels at 48 and 72 hours was significantly higher than that at 24 hours (P < 0.05) in the two groups, but there was no difference between the two groups. The expression of type I colagen had no difference between the two groups. These findings indicate that the hydroxyapatite/poly-L-lactic acid composite biomaterial has good cel compatibility.

Objective To investigate the value of 18F-FDG PET/CT for differentiating multiple myeloma from bone metastases with undetermined origin.Methods A retrospective study was performed on patients with multiple bone destructions and without extraosseous primary malignant tumor in 18F-FDG PET/CT imaging.A total of 26 patients (12 males,average age 55.4 years) with multiple myeloma and 20 patients (9 males,average age 50.2 years) with multiple bone metastases confirmed by biopsy or histopathology from January 2011 to December 2013 were included into this study.The characteristics of 18F-FDG PET/CT and urine Bence-Jones protein were used to establish the diagnostic criteria.Myeloma was diagnosed if two or more of the following conditions could be satisfied:more than 10 bone lesions,osteolytic or mixed bone destruction,SUVmax＜4.0,and positive urine Bence-Jones protein.Two-sample t test and x2 test were used.Results The average number of bone lesions in multiple myeloma patients was 15.8,which was more than that (7.8) in patients with bone metastases.About 71.8％ (296/412) of bone lesions in multiple myeloma and 28.8％ (45/156) of bone metastases were osteolytic.The percentage of osteolytic lesions was significantly higher in multiple myeloma (x2=87.2,P＜0.05).The SUVmax of bone lesions of multiple myeloma and bone metastases were 3.81 ±2.17 and 5.82± 3.44 (t =8.29,P＜0.05) respectively.According to the diagnostic criteria,the sensitivity,specificity and accuracy of 18F-FDG PET/CT for the differentiation of myeloma from bone metastases were 88.5％ (23/26),85.0％ (17/20) and 87.0％ (40/46).Its diagnostic efficiency was higher than urine Bence-Jones protein (sensitivity:65.4％ (17/26);x2=3.90) and original 18 F-FDG PET/CT evaluation (specificity:10/18,accuracy:64.1％ (25/39);x2 =3.99,6.12) respectively (all P＜0.05).Conclusion Combining the evaluation of structural properties and metabolism on 18F-FDG PET/CT with urine Bence-Jones protein level may provide additional value for the differentiation of multiple myeloma from bone metastases with undetermined origin.

ObjectiveTo analyze the relationship between the patients' psychological factors and esthetics satisfaction of all-ceramic restoration of anterior teeth.MethodsThe N scales of Eysenck personality questionnaires (EPQ) were filled at the first visit,and the total scores of N scales were calculated.After restorative treatments,the satisfaction questionnaire was used to evaluate the patients' aesthetic satisfaction on material quality,color,geometry,profile,self-confidence,etc,and to analyze the relation between psychological factors and satisfaction of the patients.ResultsThe scores of EPQ N scale of the patients in this study were as follows:Nmax=23,Nmin =3,Navg =9.35±5.714.The patients had high satisfaction with restoration.Aesthetic satisfaction,color and self-confidence were in relation to the N scales scores,satisfaction of color was in relation to sickness suspicion,satisfaction of profile was in relation to enthrallment extent and guilty consciousness,and satisfaction of self-confidence improvement was in relation to anxiety and self-determination.Conclusions The psychologic factor of the patients has some influence on the esthetics satisfaction of all-ceramic restoration of anterior teeth.

Objective To evaluate hepatitis B virus large surfsce protein(LHBs) in monitoring of antiviral treatment.Methods LHBs.HBV serum markers and HBV DNA loads in 46 patients with adefovir dipivoxil(ADV) therapy were monitored for the whole course(60 weeks).Enzyme linked immunosorbent assay(ELISA),time differentiate immunofluoresence assay and real.time polymerase chain reaction(RT-PCR)were performed to detect LHBs,HBV serum markers and HBV DNA loads,respectively.And correlation analysis was also performed.Results Both LHBs and HBV DNA declined during the ADV treatment.and the correlation coefficient was 0.97.but LHBs declined after HBV DNA.There were 20 patients with HBV DNA<5×102/mL at 60th week.in which 8 were LHBs negative;in 14 recurrent patients,the HBV DNA turned to negative and became positive again,3 with negative LHBs;while in 12 patients resistant to the ADV therapy.2 were LHBs negative.Conclusion Dynamic monitoring of LHBs is useful in the evaluation of antiviral treatment.

Objective To investigate the effect of hyperthermia and mild hypothermia on permeability of blood-brain barrier(BBB),activity of matrix metalloproteinase-9(MMP-9)and expression of laminin in rats with severe traumatic brain injury(TBI)so as to explore the mechanism of hyperthermia and mild hypothermia affecting permeability of BBB. Methods A total of 72 healthy adult SpragueDawley rats were randomly divided into four groups,ie,sham operation group(SO group),TBI group,hyperthermia group(HT group)and mild hypothermia group(MH group).The rats were sacrificed at 24hours and the samples of injured brain tissues collected to detect the content of Evans blue(EB),activity of MMP-9 and expression of laminin. Results The content of EB and activity of MMP-9 in HT group were more significantly increased compared with those in TBI group(P<0.05),while the expression of laminin in HT group Was more significantly decreased than that in TBI group(P<0.05).However,the content of EB and activity of MMP-9 in MH group were significantly lower than those in TBI group(P<0.05),while the expression of laminin in MH group was significantly higher than that in TBI group(P<0.05). Conclusions The high activity of MMP-9 can.degrade laminin and increase permeability of BBB after TBI.After TBI,hyperthermia can increase permeability of BBB while mild hypothermia does on the contrary,which may be related to their different roles in changing activity of MMP-9.