Objective To investigate the correlation between the expression of vascular endothelial growth factor-C(VEGF-C) and lymph node metastasis in gastric cancer. Methods The expression of VEGF-C was detected in 30 pairs of fresh primary gastric cancers and their adjacent normal tissues from the same patients by semi-quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) and immunohistochemistry. Automated image analyzer was used to quantify VEGF-C expression, which was reflected by positive index (PI). Results VEGF-C was highly expressed in gastric cancer cells,whilst its expression was undetectable in adjacent normal tissues. VEGF-C expression was higher in lymph node metastasis group(PI=1.345?0.079) and lymphatic invasive(PI=1.315?0.037) group than that in no-metastasis group(PI=1.156?0.045) and no-invasive group (PI=1.154?0.043)(P

OBJECTIVE:To investigate the characteristics and related factors of drug-induced hyperkalemia,present preven-tive measures and provide reference for the rational drug use. METHODS:46 literatures of individual cases and group cases of drug-induced hyperkalemia publicly reported in domestic medical journals from 1979 to 2014 were collected and analyzed statistical-ly,including 66 cases. RESULTS:66 cases with drug-induced hyperkalemia were mainly involved in cardiovascular drugs and im-munosuppressants. Most of them were improved after drug withdrawal and symptomatic treatment,and 2 cases died. CONCLU-SIONS:Drug-induced hyperkalemia are potentially dangerous. It is necessary to be vigilant,prevent and control timely and reduce the incidence of severe adverse reactions.

Objective To investigate the influence of zoledronic acid injection on body temperature of patients with primary osteoporosis.Methods A total of 142 patients with primary osteoporosis who received intravenous zoledronic acid treatment in Peking university people's hospital during 2013-2014 were enrolled in this study.The body temperature before and after intravenous zoledronic acid treatment were recorded and analyzed with SPSS 17.0 software.Results The patients'body temperature at different time points after intravenous zoledronic acid treatment was significantly different (P =0.000).Prophylactic use of NSAIDs could significantly reduce patients' body temperature at the second day after intravenous zoledronic acid.Conclusion NSAIDs can be given orally on the same day of intravenous injection of zoledronic acid,and continued for three days.

Objective To study the role of OIf-1/EBF associated zinc finger protein (OAZ),a transcription factor encoded by a positional systemic lupus erythematosus (SLE) candidate gene,in the function of mesenchymal stem cells (MSC) of SLE patients by silencing this gene.Methods OAZ mRNA levels of bone marrow MSC obtained from 5 SLE patients and 5 healthy controls were detected by real-time PCR.Bone marrow MSC obtained from 6 SLE patients were incubated with specific siRNAs for 3 days,then cells were harvested for OAZ measurement,Idl-3 and CCL2 mRNA levels were tested by real-time PCR,and levels of CCL2 were detected in culture supernatants using ELISA.Differences between groups were analyzed using t-test or MannWhitney test.Results ① OAZ mRNA levels of bone marrow MSC were significantly elevated in SLE patients (0.013±0.016) compared to healthy controls (0.001±0.000,P=0.009).② After OAZ silencing,the expression levels of OAZ,Id1,Id2 and ld3 mRNA were significantly decreased (△Ct 10.3±0.7,15.2±1.6,8.1±1.4,10.5±0.6 vs 8.7±0.7,14.1±1.2,7.1±1.5,9.8±0.6) (P all ＜0.05).③ Both the expression levels of CCL2 mRNA (△Ct 2.2±1.1 vs 3.0±1.1 ) and the levels of CCL2 protein in culture supernatants [(341±29) pg/ml vs (304±19) pg/ml] were significantly increased in OAZ silencing group comparing to those in the control group (P all ＜0.05).Conclusion OAZ gene expression is significantly elevated in bone marrow MSC of SLE patients.OAZ may affect autoantibody production in SLE patients by regulating CCL2 expression.

Objective To explore the sensitivity of contrast-enhanced ultrasound (CEUS) and ultrasonic elastography(UE) in detecting different sizes of thyroid papillary carcinoma.Methods 64 cases of thyroid papillary carcinoma were divided into two groups according to the diameter size(group 1,≤1 cm;group 2,＞ 1 cm) and examined by the contrast-enhanced ultrasound and elastography,then the features were analyzed and the sensitivity for detecting of the two methods in different groups were compared.Results The sensitivity for detecting in CEUS was higher than in UE,which had significant difference between two methods.CEUS and UE were valuable for detecting and they had no difference in sensitivity for detecting in group 1.There was a significant difference in sensitivity for detecting between two methods in group 2.Conclusions Both CEUS and UE were valuable in diagnosis of thyroid papillary carcinoma and the sensitivity for detecting in CEUS is higher than in UE in group 2.

Objective To explore how clinical pharmacists exert their effects in drug therapy.Methods The pharmaceutical practice of clinical pharmacist participating in the treatment of one case of warfarin related nephropathy (WRN) was reported.Early identification of warfarin associated nephropathy and early treatment were necessary and the anticoagulant regimen was optimized.Pharmaceutical education was conducted by clinical pharmacist.Results With guidance by clinical pharmacist,the psychological burden of the patient was reduced,the patient compliance was improved,and the patient understanding of adverse drug reactions was increased.Conclusion Clinical pharmacists involved in clinical treatment practice is conducive to timely detecting and treating patients with adverse drug reactions,and improving the level of drug treatment.

BACKGROUND:Periosteal cel s have been used in bone repair, but whether nucleus puplousus cel s co-cultured with autologous periosteal cel s can differentiate into osteoblasts in spinal fusion is rarely reported. OBJECTIVE:To isolate nucleus puplousus cel s and periosteal cel s so as to observe the osteogenic ability of nucleus puplousus cel s co-cultured with periosteal cel s or not. METHODS:Type II col agenase digestion method was used to isolate and purify nucleus pulposus cel s, which were confirmed by toluidine blue and immunohistochemical staining. Periosteal cel s were isolated histological y and cultured in complete medium, and cel surface antigens CD90, CD105 were identified by immunofluorescence staining. According to the experimental needs, the cel s were assigned into two groups. Nucleus pulposus cel s and periosteal cel s were co-cultured by osteogenic induction medium in the experimental group. Nucleus pulposus cel s in the control group were cultured alone in osteogenic induction medium. Cel morphology was observed by inverted microscopy, and cel proliferation was detected by cel counting kit-8. The osteogenic differentiation indexes of cel s in each group were measured using alkaline phosphatase staining, alizarin red staining, and type I col agen immunohistoehemical staining. The expression of osteopontin was tested by western blot assay. RESULTS AND CONCLUSION:CD105 and CD90 expressions of the periosteal cel s were positive. Nucleus puplousus cel s were positive for toluidine blue and col agen type II immunohistochemical staining. The proliferative ability of nucleus puplousus cel s was significantly higher in the experimental group than the control group at days 1, 3, 5, 7, 9. After 2 weeks of induction, the cel s were positive for alkaline phosphatase staining, alizarin red staining, and type I col agen immunohistoehemical staining, but the experimental group showed higher positive expressions than the control group (P<0.05). The expression of osteopontin was also higher in the experimental group than the control group. These findings indicate that nucleus puplousus cel s possess osteogenic ability, but have lower proliferative ability in vitro. After co-culture with periosteal cel s, the proliferative ability of nucleus puplousus cel s can be increased. Under osteogenic induction, nucleus puplousus cel s co-cultured with periosteal cel s have good compatibility and adhere with each other, which have stronger osteogenic ability than cel s cultured alone.

BACKGROUND:Lower cervical anterior transpedicular screw technology combines the advantages of the anterior and posterior surgery;therefore, the pressure releasing and reconstruction problems can be solved via one time anterior surgery, whereas, the difficulty and risk of the operation are increased. However, the three-dimensional (3D) printing assembly navigation template improves the safety and accuracy of screw placement. OBJECTIVE:To explore the feasibility and accuracy of 3D printing assembly navigation template in lower cervical anterior transpedicular screws and compare it with free hand pedicle screw placement. METHODS:Lower cervical spine specimens of six adult (2 males, 4 females, average age 58.5 years old ranged from 53 to 64 years) corpses were equal y and randomly divided into two groups. Group A underwent free hand pedicle screw placement. Groups B (lower cervical anterior transpedicular screws assisted by personalized 3D printing combined navigation template):Three cadaveric lower cervical spines were examined using CT and data in DICOM format were recorded. After data were processed using software Mimics for 3D model reconstruction, computer-assisted design of optimum trajactory for lower cervical (C3-C7) anterior transpedicular screws placement was worked out and made into a dril template, where the surface was created as the inverse of anterior surface of cervical vertebra. The dril template was materialized in a 3D printing and used to place the screws. Subsequently, CT scan was performed to evaluate the screw orientation and acceptability. RESULTS AND CONCLUSION:(1) Thirty screws were inserted in Group A. The pedicle perforation was classified by CT, Grade 1:22 screws, Grade 2:6 screws, Grade 3:2 screws;insertion rate was acceptable (Grades 1-2):28 (93%). Thirty screws were inserted in Group B. The pedicle perforation was classified by CT, Grade 1:25 screws, Grade 2:4 screws, Grade 3:1 screw;insertion rate was acceptable (Grades 1-2):29 (97%). There were no statistical y significant differences in the rate of acceptable insertion and orientation between two groups (P>0.05). (2) These results suggested that 3D printing combined navigation template consisted with dril hole cap and screw hole, with functions of double direction. Compared with the traditional method, personalized 3D printing combined navigation template can be used simply.

BACKGROUND:At present, the main purpose of treatment for degenerative scoliosis is to relieve symptoms, surgicaly correct scoliosis, restore balance and function of the spine, but what kind of techniques is superior has been controversial. OBJECTIVE:To systematicaly assess the clinical effectiveness and safety of short fusion versus long fusion for degenerative scoliosis. METHODS:The databases such as China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Scientific Journals Database, WanFang Database, The Cochrane Library, PubMed, and EMbase published before May 2015 were electronicaly searched to colect the trials about the short fusion versus long fusion for degenerative scoliosis. Meta-analysis was performed by using RevMan 5.3.4 software. RESULTS AND CONCLUSION: Eleven studies were included, with 533 patients, including 272 cases in the short fusion group and 261 cases in the long fusion group. Meta-analysis results showed that: compare with short fusion group, long fusion group had better improvement of spine Cobb angle (P < 0.000 01) and lordosis angle (P < 0.000 01). No differences were found in the coronal imbalance (P=0.06) and lateral slippage (P=0.24) between the two groups. No significant difference was detected in Japanese Orthopaedic Association score (P=0.93), Visual analogue scale score (P=0.22), and Oswestry Disability Index score (P=0.13) between the two groups. The postoperative complications (P=0.000 6) and the rate of reoperation (P=0.03) were higher in the long fusion group than those in the short fusion group. The incidence of adjacent segment disease has no difference between the two groups (P=0.81). These findings suggest that long fusion is better than short fusion in improvement of the deformity of spine, but incidence of postoperative complications and the rate of reoperation are higher than those in the short fusion group. Comprehensive consideration should be given to the selection of a fixed fusion scheme.

OBJECTIVE:To systematically review the effect of CYP2C19 genetic polymorphism on lansoprazole pharmacoki-netics,and provide evidence-based reference for clinical individualized medication of lansoprazole. METHODS:Retrieved from PubMed,EMBase,Web of science,Cochrane Library and CJFD,retrospective studies about the effect of CYP2C19 genetic poly-morphism on lansoprazole pharmacokinetics were collected,Meta-analysis was performed by Rev Man 5.2 software after data ex-tract and quality evaluation. RESULTS:Totally 11 retrospective studies were included,involving 200 patients. The gene type in-cluded homozygote express metabolizers (EM),heterozygous express metabolizers (HEM) and slow metabolizers (PM). Results of Meta-analysis showed CYP2C19 polymorphism significantly affected cmax,AUC,t1/2,tmax and CL/F. The cmax and AUC in group PM were higher than group HEM and group EM;CL/F in group EM was higher than group HEM and group PM;t1/2 in group PM was higher than group HEM and group EM,while there was no significant difference in the t1/2 between group HEM and group EM;tmax in HEM and group PM were higher than group EM,while there was no significant difference in the tmax between group PM and group HEM. CONCLUSIONS:CYP2C19 genetic polymorphism shows obvious effect on lansoprazole pharmacokinetics, which is the key factor for causing efficacy of lansoprazole and individual differences among adverse reactions,and clinic should take into account individualized dose regimen of lansoprazole.