Mesenchymal chondrosarcoma originated in the primitive mesenchymal tissue .It usually devel-ops in the short bones such as hand ,foot and body bone ,while extremeIy rare in the orbit .We report a case of mesenchymal chondrosarcoma of the orbit which is confirmed by pathology .

Objective To construct secreting type human TRAIL(shTRAIL) gene vector pcDNA3.1-HRE/Egr1-shTRAIL mediated by hypoxia/radiation double sensitive promoter,and observe the effect of hypoxia and radiation on shTRAIL.Methods HRE upper and lower strands were gotten by chemical synthesis,double strands HRE was gotten by PCR;pMD19T-Egr1 was digested by SacⅠ and Hind Ⅲ,then Egr1 was obtained,pshuttle-shTRAIL was digested by Kpn Ⅰ and BamH Ⅰ,then shTRAIL was obtained;HRE/Egr1 double sensitive promoter mediated shTRAIL expression vector pcDNA3.1-HRE/Egr1-shTRAIL was constructed by gene recombination technique,it was identified correctlly by enzyme digestion,PCR and sequencing.A549 cells were divided into normal,hypoxia(0.1%),irradiation(6 Gy) and hypoxia + irradiation groups.Results After enzyme digestion by BamH Ⅰ and Sma Ⅰ,the fragments which lengthes were 1284 bp and 4 998 bp,2 292 bp and 3 990 bp were obtained;the vector was amplified by PCR with Egr1 and shTRAIL primer,the products which lengthes were 469 bp and 820 bp were obtained;pcDNA3.1-HRE/Egr1-shTRAIL was sequenced,the result was same to designed,this demonstrated that the construction was right.The vectors were transfected into A549 cells of adenocarcinoma of lung,the expression levels of shTRAIL mRNA and protein were increased after treated with hypoxia and radiation,it had statistically significant differences compared with normal group(P

Objective To preliminarily explore the delineation of clinical target volume in intensity-modulated radiotherapy for para-aortic lymph node metastases in patients with gynecological malignancies.Methods A retrospective analysis was performed on 56 gynecological tumor patients with para-aortic lymph node metastases who were admitted to our department from January 2010 to September 2016.The number and distribution of metastatic para-aortic lymph nodes were determined by imaging method.Results A total of 108 positive para-aortic lymph nodes were found in the 56 patients,with 1-4(mean,2) positive para-aortic lymph nodes per patient.The mean diameter of positive para-aortic lymph nodes was 2.3 cm (1.2-4.0 cm).A total of 20 metastatic lymph nodes (19%) were located at the L4 level,38(35%) at the L3 level,44(41%) at the L2 level,and 6(5%) at the L1 level.There were 71 metastatic lymph nodes (66%) at the left side of the para-aortic region,20 metastatic lymph nodes (19%) between the abdominal aorta and the vena cava,and 17 metastatic lymph nodes (15%) at the right side of the inferior vena cava.Conclusions For patients with gynecological malignancies,nodal contouring for the para-aortic region should not be defined by a fixed circumferential margin around the vessels.The left side of the para-aortic region should be covered adequately;the upper target should be extended up to the renal artery,and needs to be further extended for patients who have nodal involvement near the renal arteries and veins.

Objective:To analyze the relationship among smoking, levels of homocysteine (Hcy), cystatin C (CysC), C reactive protein (CRP) and coronary heart disease (CHD) onset in young people.Methods:A total of 152 patients, who received selective coronary angiography because of chest pain in our hospital, were enrolled, and all subjects were <45 years old.According to examination results, they were divided into CHD group (n=100) and non-CHD group (n=52).Clinical data were analyzed in both groups, and Logistic multi-factor regression analysis was used to analyze independent risk factors for CHD in young people.Results:Compared with non-CHD group, there were significant rise in percentages of men (30.8% vs.65.0%), smoking (46.1% vs.68.0%) and hypertension (34.6% vs.51.0%), levels of CysC[(0.85±0.16) mg/L vs.(1.34±0.28) mg/L], CRP [(1.26±0.85) mg/L vs.(6.93±0.85) mg/L] and Hcy[(7.16±1.16) mol/L vs.(20.85±2.16) mol/L],P<0.05 or <0.01;multi-factor Logistic regression analysis indicated that male, hypertension, smoking, Hcy, CysC and CRP were risk factors for CHD in young people (OR=1.34~3.42, P<0.05 or <0.01).Conclusion:Male, smoking, total cholesterol, homocysteine, Cys C and C reactive protein are risk factors for CHD in young people.Therefore, these risk factors should be eliminated, or its risk should be reduced.

ObjectiveTo help physicians improve detection rate of depressive and anxiety disorders by exploring the complaints of gastrointestinal(GI) outpatients with these disorders in the general hospitals.Methods A multicenter cross-sectional study was conducted from May to June in 2007.A total of 1995 subjects from 13 general hospitals in China were screened with the hospital anxiety and depression scale ( HADS ) and patient health questionnaire 15-item (PHQ-15).Meanwhile patients'complaints were recorded.Psychiatrists interviewed subjects scored ≥8 on HADS and made diagnoses by using the mini international neuropsychiatric interview(MINI).There were 323 outpatients diagnosed as depressive or anxiety disorders and 1287 outpatients without diagnosis of depressive or anxiety disorders.The complaints and PHQ-15 sores were compared between these two groups.The logistic regression analysis was used to determine the risk of having depressive or anxiety disorders with the number of complaints as an independent variable.ResultsSome symptoms between two groups were statistically significant,including weakness(34.1％ vs 18.8％ ;χ2 =18.04; P=0.000),fatigue(9.6％ vs 5.7％ ;χ2 =6.58,P=0.010)and insomnia( 7.1％ vs 3.4％ ; χ2 =8.87 ; P =0.003 ).Logistic regression analysis showed that with each additional complaint,the odds for an interview-based diagnosis of depressive or anxiety disorders increased,the odds ratio(OR) was 1.12(95％ CI,1.08 ～ 1.17,P=0.000).In comparison to the outpatients without depressive or anxiety disorders,outpatients with these disorders signifycantly had higher PHQ-15 scores (( 11.12 ± 4.92 ) vs (6.68 ± 4.05 ) ; t =16.84,P =0.000).ConclusionThe GI outpatients with depressive and/or anxiety disorders have worse mental heath and more complaints,compared to patients without these disorders.These results may help physicians to better identify depressive disorders and anxiety disorders.

ObjectiveTo assess the current situation of postgraduates knowledge about medical research design and optimize the curriculum setting of research design.MethodsAn investigation was carried out in the postgraduates of 2011 using questionnaires in a medical university..The questionnaire ineluded basic information of participants and cognition of basic methods of research design.ResultsA total of 473 postgraduates participated in the investigation.Among them,311 systematically learned medical statistics before enrollment,and 275 ( 58.14％ ) once participated in scientific researches.Most of them ( ＞80％ ) knew about the 10 basic methods of research design listed in the questionnaire,but only a few of them were familiar with them,and some even didn't know about the methods.ConclusionWe should pay attention to the culture of scientific research thought in statistical design,strengthen the practice of research design teaching,and the curriculum of research design should be led into undergraduate course.

ObjeclJve To definine the corresponding value to glycated albumin(GA)for a specific target of HbAlc,and to elvaluate the relationship between GA and HbA1c.Methods From Oct.2006 TO Apr.2009, 2 532 subjects were enrolled who accepted oral glucose tolerance test(OGtt)in out-patient department,including 898 with normal glucose regulation,695 with impaired glucose regulation,and 939 with newly-diagnosed diabetes.GA was measured with liquid enzymatic method.HbA1c was measured with high performance liquid chromatography method.The plasma glucose was measured at fasting,0.5 h,1 h,2 h,and 3h after glucose load.The correlation among GA,HbA1c and the other parameters monitored was analyzed.Results (1)The levels of HbA1c and GA in 2 532 subjects were(6.3±1.1)% and(17.9±4.5)%.The ratio of GA/HbA1c was 2.85±0.51.(2)HbAlc and GA were positively correlated with fasting,0.5 h,1 h,2 h and 3 h plasma glucose(r was in 0.567-0.776,atl P<0.01).(3)GA was significantly correlated with HbA1c(r=0.701,P<0.01).Linear regression analysis,using GA and HbA1c summarized by patient(n=2 532),produced a relationship of GA=2.871×HbA1c-0.112.The change in GA per increase of 1% HbA1c was 2.87%.When HbA1c level was 6.5%,the expected value of GA was 18.5%.The sensitivity,specificity,positive predictive value,negative predictive value,and accuracy with GA≤18.5% to predict HbA1c≤6.5% were 82.32%,72.49%,86.48%.65.73%,and 79.19%,respectively.When HbA1c level was 7.0%,the expected value of GA was 20.O%.When HbA1c level was 7.5%.the expected value of GA was 21.4%.Conclusions We initially establish the corresponding value to GA for a specific target of HbA1c and provide the basis for clinical application.

Objective To investigate the infectious status,etiological spectrum and epidemiological characteristics of rotavirus (group A/B/C),calicivirus (novovirus Ⅰ/Ⅱ,sapovirus),astrovirus and enteric adenovirus in diarrhea cases below 5 years old from 2008 to 2015 in Henan provinces.Methods Totally 2541 stool samples were collected from cases below 5 years old in four sentinel hospitals.All stool specimens were tested for group A rotavirus by double antibody sandwich ELISA method.G/P genotyping of group A rotavirus was determined by nested multiplex PCR.Viral RNA was extracted from all samples and rotavirus (group B/C),calicivirus,astrovirus and enteric adenovirus were detected by two-step reverse transcription-polymerase chain reation (RT-PCR)/PCR.Results One thousand four hundred and twenty-one out of 2 541 samples were positive with a total positive rate of 55 .9%,among which,102 were mixed infection.The isolation rate of rotavirus was 36.0% (914 samples)(group A:785 cases,group B:36 cases,group C:93 cases),calicivirus was 12.1 % (308 samples)(novovirus Ⅰ:64 cases,novovirusⅡ:193 cases,sapovirus:51 cases),astrovirus was 5 .9% (151 samples),enteric adenovirus was 1 .9%(48 samples).The group A rotavirus gene type combinations were composed mainly of G9P[8],G2P[4], G3P[8 ],G1P [8 ]and most cases were identified from September to November and March to May. Novovirus Ⅱ was predominant in calicivirus and most cases were identifed between March and May. Rotavirus or calicivirus infection was mainly among children aged 4—12 months or 3—5 years, respectively.Clinical manifestations included fever,diarrhea,vomiting,dehydration.Gender and region distributions differed according to the types of pathogen.Conclusions Group A rotavirus and novovirus Ⅱare the major viral pathogen in diarrhea cases younger than 5 years old in Henan province.Different viral infections exhibit extinct epidemiologic and clinical characteristics.

Objective:To investigate the effect of antlerbase on the radiation carcinogenesis by observing the effect of antlerbase on the expressions of Notch2 gene and immune function of the mice with thymic lymphomas induced by ionizing radiation.Methods:Ninety BALB/c mice were randomly divided into control group,irradiation group and irradiation combined with drug group (combined group)(n=30).The thymic lymphoma models of mice were made by X-ray irradiation in irradiation group and combined group;after establishing the animal models,the mice in combined group were fed with chow containing antlerbase superfine powder.After 6 months,the whole blood and thymic tissue were taken,then RT-PCR and Western blotting methods were used to detect the mRNA and protein expressions levels of Notch2 gene in the thymic lymphoma tissue;ELISA method was used to detect the serum immunoglobulin (IgG,IgA,IgM)levels and SOD kit was used to detect the serum SOD activities of the tumor mice.Results:The incidences of thymic lymphoma in irradiation group and combined group were 53.33%(16/30)and 36.67% (11/30),respectively.Compared with control group,the expression levels of mRNA and protein of Notch2 gene in thymic lymphoma of the mice in irradiation group were significantly increased (P <0.05);compared with irradiation group,the expression levels of mRNA and protein of Notch2 gene in combined group were decreased (P <0.05);compared with control group,the levels of IgG,IgA,and IgM in serum of the mice in irradiation group were decreased (P < 0.05 ); compared with irradiation group, the levels of IgG, IgM, hemoglobin and the activity of SOD in serum of the mice in combined group were increased (P < 0.05 ). Conclusion:Ionizing radiation can activate the high expression of Notch2 gene and protein and decrease the immune function of mice,it might be one of the mechanisms for the occurrence of radiation carcinogenesis;antlerbase can decrease the incidence of radiation carcinogenesis by inhibiting the expression of Notch2 gene and increasing the immune function of mice,which might play an role in restraining tumor.

Objective:To evaluate the performance of RapidArc technique on cervical cancer patients with various filling status of the bladder. Methods: Conventional fixed field intensity modulation radiated therapy (IMRT) is used as the benchmark. In 10 fe-males suffering from cervical cancer, two CT scans were performed for treatment planning:one with an empty bladder and the other with filled bladder. The prescribed dose was 50 Gy. The images of that with an evacuated bladder and that with filled bladder were planned in the dual-arc RapidArc and the 7-field IMRT, respectively. The implementor of the plan was the Varian TrueBeam linear ac-celerator. Dose-volume histogram was used to evaluate the data from each plan. Results:When the bladder was filled, IMRT and Rapi-dArc homogeneity were 1.05 and 1.04 (P>0.05), respectively. When the bladder was emptied, the homogeneity was 1.04 for both plans (P>0.05). With or without bladder filling, the conformity index was 0.71 and 0.73 for IMRT and RapidArc (P>0.05), respectively. The effect of V30 and V40 (volume for receiving doses of 30 and 40 Gy) on the intestine and the bladder was more favorable in a full than in an empty bladder. No significant difference between the two plans was observed. IMRT exhibited improved V30 on the rectum and on the bladder. RapidArc was much better in terms of monitor unit (MU) and deliver time. Conclusion:No significant differences in the homogeneity and conformity index between dual-arc RapidArc and 7-field IMRT were observed. Filled bladder is better than empty bladder in intestine and bladder protection in both RapidArc and IMRT. IMRT is better on V30 of the rectum and the bladder, whereas RapidArc improved MU and deliver time.