Lymph node metastasis of malignant tumor is a complex pathological process closely related to tumor lymphangiogenesis. With tumor growth, some growth factors of lymphatic vessels are secreted and new lymphatic vessels are formed around or inside the tumor. Then, the tumor cells invade the lymphatic vessels, follow the lymph flow into every lymph node station, and gradually form the lymph node metastasis. Normal cells are in a relatively stable internal environment. Cell proliferation, differentiation, and apoptosis, as well as secretion and expression of related factors, occur in accordance with the normal process. However, the balance is broken with tumor growth and progression. A gradual formation of a suitable external environment for the tumor growth, namely, the tumor microenvironment, occurs. And the pathological and physiological characteristics of tumor microenvironment, which contains numerous lymphangiogenic growth factors and inflammatory conditions, hypoxia, acidic microenvironment, and high interstitial fluid pressure, promote tumor lymphangiogenesis and formation of tumor lymph node metastasis.

Objective:To design ultrasonic atomization device making use of disposable water cup, to improve ventilation therapy in clinical application.Methods: The design take advantage of working principal of ultrasonic atomization, do a simple interface compatible work to the disposable water cup, the water cup can realize the ability of medicine atomization treatment, collecting the water when not do atomization; the water cup access into the ventilator pipe, to test the influence between the atomization and ventilator function.Results: The disposable water cup realized ultrasonic atomization successfully, and shows no influence between the atomization and ventilator self-function.Conclusion: The design has made some simple improvement of the disposable water cup on the structure, proposed a new way of ventilator atomization practically and economically.

Objective To explore the expression changes in SHIP1 gene in patients with chronic granulocytic leukemia (CGL), healthy volunteers and the K562 cells (one of human CGL cell lines), and to explore the effects of BCR/ABL expression in K562 cells on the SHIP1 gene by blocking the BCR/ABL expression in K562 cells with a specific siRNA. Methods The expression levels of SHIP1 mRNA in leukocytes of the patients with CGL, healthy controls and K562 cells were assessed with RQ-PCR. In addition, K562 cells were divided into three groups: control group (untreated), non-specific interference group (treated with non-specific siRNA), and specific interference group (treated with specific siRNA to block BCR/ABL gene). RQ-PCR and Western blotting were employed to examine the expression level of mRNA and protein (P210 and P145) of BCR/ABL and SHIP1 genes. Results The mRNA expression of SHIP1 in CGL patients and K562 cells was significantly lower than that of the healthy controls. The expression of BCR/ABL gene was down-regulated, while SHIP1 gene up-regulated, in the specific interference group. No statistical significant difference was found between the non-specific interference group and the control group. Conclusions The mRNA expression of SHIP1 is lower in patients with CGL than in the healthy control. The specific siRNA can block the expression of BCR-ABL and further suppress the expression of SHIP1.

Background and purpose: It was reported that Sonic Hedgehog (SHH) signaling pathway was involved in carcinogenesis and progression of various tumor types. This study was designed to observe the expression of Shh and Gli2 in SHH signaling pathway in hepatocellular carcinoma (HCC) and to study the relationship between the expression of Shh and Gli2 and different clinicopathlogical characteristics, and further to explore the clinical significance. Methods: We studied 30 HCC tissues and 10 normal liver tissue slices using immunochemistry for the expression of Shh and Gli2, 10 fresh HCC tissues, adjacent-tumor tissues and 2 HCC cell lines HepG2, Huh7 by using RT-PCR for the mRNA expression of Shh and Gli2. Results: Immunochemistry showed in 30 HCC tissue slices,the positive ratios of the components of SHH signaling pathway Shh, Gli2 were 63.3% (19/30) and 66.7% (20/30), respectively. Expression of Gli2 was significantly correlated with the pathological grade and the tumor invasion in hepatic portal vein (P=0.017 and P=0.024). Shh and Gli2 did not express in normal liver tissue. RT-PCR showed Shh and Gli2 were detected as positive in both HCC tissues and lines. The expressions of Shh mRNA and Gli2 mRNA were higher in HCC than in adjacent-tumor tissues (P<0.05). The expressions of Shh mRNA and Gli2 mRNA were higher in Huh7 than in HepG2 cell lines, but no significant difference was found between them (P>0.05). Conclusion: The expressions of Shh and Gli2 were elevated in HCC, which indicated that SHH signaling pathway may be involved in human HCC carcinogenesis. The study may be useful for treatment of HCC.

An analysis method was developed for the determination of free and bound fractions of polybromi-nated ethers (PBDEs) and tetrabromobisphenol A (TBBPA) in sediment. The free PBDE and TBBPA were extracted with acetone/hexane ( 1:1) mixed solvent,and the bound fraction was released from the sediment by saponification reaction at 80℃. PBDEs and TBBPA were separated via adjusting pH; PBDEs were determined by GC-negative chemical ionization (NCl)-MS after cleaned up by multilayer silica column,and TBBPA was derivative before pre-separated by acid silica column and finally determined by GC-EI-MS. All of the target compounds were quantitative by internal standard method. The limits of detection of eight low bromina-ted congeners (BDE28,-47,-66,-100,-99,-154,-153 and -183),deca-BDE ( BDE209),and TBBPA were 0.6 - 12.5 pg/g,172 pg/g and 4. 2 pg/g,respectively;This method is reliable and stable. The recoveries of all compounds were ranged from 74% to 106% and the relative standard deviations were below 10%. This method is suitable for the measurement of different forms of PBDEs and TBBPA in sediment under reliable quality assurance and quality control.

Objective To compare the impact of propofol and sevoflurane on thermoregulation in children undergoing orheopaedic surgery.Methods Sixty-eight children scheduled to undergo ortho-paedic surgery were randomly allocated to receive propofol (group P)and sevoflurane(group S)anes-thesia,34 cases in each group.Tympanic temperature was recorded 5 minutes before (T0 )and 5 min (T1 ),1 5 min (T2 ),30 min (T3 ),45 min (T4 ),60 min (T5 ),75 min (T6 ),90 min (T7 ),105 min (T8 )and 120 min (T9 )after anesthesia.Total fluid intake,duration of surgery,duration of anesthe-sia,the incidence of hypothermia,and the incidence of shivering were also recorded.Results Com-pared with T0 ,in both groups body temperature declined at T1-T8 .There was no difference between the two groups in total fluid intake,duration of surgery,duration of anesthesia and the incidence of shivering.Compared with group P,children in group S had a higher incidence of hypothermia(8 vs 1). Children in group S had lower temperature,which had statistical significance at T7 and T8 (P <0.05). Conclusion The core temperature of children undergoing orthopaedic surgery showed a trend of in-crease after the first fall in the surgery.Compared with propofol,sevoflurane anesthesia is more likely to lead to the incidence of hypothermia in children undergoing orthopaedic surgery in 90 min after in-duction of anesthesia.

Objective To observe the effect of dynamic articulars panning external fixation combined with limited internal fixation for distal radius comminuted fracture.Methods 100 comminuted distal radius fractures patients during September 2014 and September 2014 in our hospital were selected and randomly divided into control group and research group,50 cases in each group.Patients of the control group accepted conventional manual reduc-tion combined with plaster external fixation,patients of the research group accepted dynamic articulars panning exter-nal fixation combined with limited internal fixation treatment.Curative effect,the palm inclination angle and feet were compared between the two groups.Results (1)After surgical treatment and rehabilitation therapy,15 patients in the control group achieved optimal degree,28 cases in the research group achieved optimal degree(P =0.086);9 cases in the control group were the poor degree;only 2 patients in the research group were poor degree(P =0.025).Statistical analysis showed that two differences were statistically significant,(P <0.05).(2)After 3 months,the palmar tilt of patients in the control group was (6.5 ±2.2)°,while that of the research group was (8.5 ±2.5)°(t =4.25,P <0.000 1 );The average ulnar deviation of control group was (12.3 ±4.3)°,and that of the research group was (15.6 ±6.6)°(t =2.96,P =0.003 8).In a word,the average palmar tilt and ulnar deviation of the research group were greater than those in the control group,the difference showed statistically significant.6 months later,the average palmar tilt of the control group patients was (6.2 ±2.3)°,that of the research group was (8.8 ±2.5)°(t =5.41, P <0.000 1 );the ulnar deviation of the control group was (12.1 ±4.1 )°,and that of the research group was (16.3 ±4.4)°(t =4.93,P <0.000 1),the difference was statistically significant.Conclusion Dynamic articulars panning external fixation combined with limited internal fixation for the treatment of distal radius comminuted fracture effect is significant,which is worthy of clinical promotion.

Objective:To determine the relationship between injury risk and alcohol drinking. Methods:Totally 531 patients (age≥18 years) who were treated for the ifrst time and came to the emergency room within 6 h atfer the injury were included. hTe American National Institute of Health questionnaire was used to investigate the trauma type, intentional injury, drinking before the injury, drinking volume, and drinking history in the past years and so on. hTe case-crossover method was used to analyze the data and relationship between alcohol drinking and injury.Results:Compared with the non-drinkers, subjects who drank alcohol 6 h before the injury had a higher risk of intentional injury (OR=2.79, 95%CI: 1.61–4.84). Male, drunken, patients with positive alcohol test results were more likely to suffer from intentional injury. Compared with the non-drinkers, victims who drank alcohol 6 h before injury had a higher risk of injury in traffc accidents (OR=2.41, 95%CI: 1.29–4.51). Compared with the non-drinkers, subjects who drank alcohol 6 h before injury had a higher risk of injury (OR=11.86, 95%CI: 5.48–25.65). Subjects who drank more than 6 standard drinks of alcohol 6 h before injury had much higher risks than non-drinkers (OR=24.52, 95%CI: 5.84–102.86). Conclusion:Alcohol drinking before injury is associated with increased the risk of trauma, intentional injury and injury related to traffc accidents.

Objective To exPlore the efficacy of nutritional interVention in Patients with chronic obstructiVe Pulmonary disease (COPD) and malnutrition risks. Methods From Jan. ,2008 to Dec. ,2012,829 COPD Patients with NRS2002 score≥3 in Qinzhou Second PeoPle's HosPital were enrolled in this study. Patients were randomized into control grouP (254 cases) and treatment grouP (575 cases) by random numerical table of SPSS 13. 0 statistic software. Patients without contraindication to enteral nutrition were giVen enteral nutrition suPPort,while those with contraindication to enteral nutrition were giVen Parenteral nutrition suPPort. Patients in the treatment grouP receiVed intensiVe suPPort with fortified nutrition,whereas Patients in the control grouP receiVed routine nutrition treatment. All other treatment methods were the same between the two grouPs. TelePhone follow_uP lasted for 3 years in both grouPs after discharge. Patients in the treatment grouP with NRS2002 score≥3 were giVen guidance on nutrition food intake. No nutrition guide was giVen to the control grouP. Times of acute attack,times and duration of mechanical Ventilation,mortality rate,and NRS2002 score three years after the treatment were comPared between the two grouPs. Data were analyzed by multi_factor Logistic regression analysis to understand the nutritional factors of COPD Patients affecting their mortality rate. Results After 3 years of follow_uP,times of acute attack,times and duration of mechanical Ventilation were lower in the treatment grouP than in the control grouP. Mortality rate was significantly lower in the treatment grouP (0. 696%) than the control grouP (4. 724%). After treatment,NRS2002 score was PositiVely correlated with mortality rate of COPD Patients with malnutrition risks. Conclusion For the COPD Patients with malnutrition risks, actiVe nutritional interVention can imProVe their nutrition status ( lower NRS2002 score) ,increase the number of resPiratory muscles to alleViate anoxia,enhance cellular immune function, and thus imProVe their Prognosis.

Objective To investigate muli-leaf collimator (MLC)-defined small field output factors calculated by the treatment planning system (TPS), and to study the measuring method of small field output factors verified by 0.015 cc PinPoint ionization chamber.Methods Eight medical accelerators for intensity-modulated radiation therapy (IMRT) were investigated in Henan province, and TPS-calculated output factors for various small fields (6 cm ×6 cm,4 cm ×4 cm,3 cm ×3 cm and 2 cm ×2 cm) were compared with published values recommended by IAEA.If the relative deviation was more than ± 3％ for the 2 cm ×2 cm field size and ±2％ for the fields of 6 cm ×6 cm, 4 cm ×4 cm and 3 cm ×3 cm, which was beyond the scope of IAEA allowed, the output factors will be measured and verified using 0.015 cc PinPoint ionization chamber and Unidos electrometer.Results TPS-calculated small field output factors for eight medical accelerators were compared with published values.The relative deviation of small field output factors for five pieces of equipment, which accounted for 62.5％ of the total, met the IAEA's requirement, while the other three, which accounted for 37.5％ of the total, did not.After measuring with PinPoint ionization chamber, the results from only three pieces of equipment met minimum IAEA's requirement.Conclusions MLC-defined small field output factors calculated by TPS for some medical accelerators in Henan need to be measured and corrected using micro-ionization chamber, and the measured values could be taken as the basis of radiation treatment planning.