OBJECTIVE To compare different methods of processing of homograft costal cartilage. METHODS Homograft costal cartilage samples were processesd by three methods-irradiation, freezing, and alcohol fixation-before being inserted into the rabbit nasal dorsum. They were taken out 12 weeks later and evaluated for histological responses under a optical microscope. RESULTS The histological responses consisted of inflammatory cell infiltration, necrosis, vasal responses and fibroplasia. The was a significant different in degree of inflammatory cell infiltration and necrosis in all three groups(P

Objective To evaluate the influence of age factors on etomidate sedative potency.Methods One hundred and fifty (ASA physical status Ⅰ or Ⅱ) patients of both sexes,scheduled for elective operation under general anesthesia,were divided into 3 groups according to age (n =50 each):group Y 18-44 yr,group M 40-64 yr and group O 65-75 yr.Each group was randomly divided into 5 subgroups receiving in'venous etomidate 0.07,0.09,0.11,0.13 and 0.17 mg/kg,respectively.Loss of consciousness was evaluated depending on loss of eyelash reflex within 5 min after intravenous administration.Results ED50 of etomidate inducing loss of consciousness was 0.13,0.11 and 0.09 mg/kg in group Y,M and O,respectively.Compared with that in group Y,ED50 was significantly decreased in group O,however,and showed no significant change in group M.Conclusion Age factors can affect sedative potency of etomidate,which appears greater in the elderly patients.

Because of the specificity of infectious diseases , the the medical ethics education and concepts need to be paid more attention to .During the clinical teaching of infectious diseases , pay attention to teachers′medical ethics accomplishment level of ascension , teaching teachers should play the role of shape model , encourage interac-tion, eliminate the fear and discrimination interns and strengthen medical ethics consciousness and the combination of legal concepts , promote the medical students medical ethics consciousness of the form .

Objective To investigate the accuracy of CTVision image-guided stereotactic body radiation therapy (SBRT) for non-small cell lung cancer (NSCLC).Methods 10 lung SBRT patients were imaged with CTVision before and after irradiation for acquiring and analyzing the three-dimensional set-up error data sets in our department from October 2010 to May 2012.Gross tumor volumes (GTVs) were contoured on pre-and post-SBRT CT sets and combined for generating internal gross tumor volumes (IGTVs).Planning target volume (PTV) margin was calculated,and IGTVs and PTVs were compared for off-line verification of accuracy of SBRT.A paired t-test statistical analysis was conducted with the datasets using SPSS 17.0.Results 80 CT image sets were totally obtained.Setup errors was significant difference before and after radiotherapy in the left-right,superior-inferior and anterior-posterior directions,that were (-0.10±1.30) mmand (-0.15±1.31) mm (P=0.720),(0.18±1.32) mm and (0.18±1.43) mm (P =1.000) and (-0.08 ± 1.19) mm and (-0.13 ± 1.18) mm (P =0.750),respectively.IGTVs of ten patients were smaller than corresponding PTVs (13.53 cm3 and 37.84 cm3,P =0.000).Conclusion Accuracy and safety of SBRT could be verified by imaging with CTVision before and after delivery for non-small cell lung cancer.

Objective To study the effects of modified Danggui Beimu Kushen Pills on the expressions of TLR2, TLR4, TLR6, TRAF6 and MyD88 in tumor tissues on MFC gastric cancer bearing mice; To discuss relevant mechanism of action. Methods MFC gastric cancer bearing mice were employed to perform anti-tumor experiment in vivo in this study. A total of eligible 48 mice were randomly divided into model group, DDP positive control group, modified Danggui Beimu Kushen Pills high-dose and low-dose groups, modified Danggui Beimu Kushen Pills high-dose and low-dose combined with DDP groups. The treatment was conducted once a day, and lasted for 14 continuous days. After the last administration of gavage orally treatment, all mice were anaesthetized and killed by cervical dislocation method to obtain tumor tissue completely for further HE staining measure and detection of TLR2, TLR4, TLR6, TRAF6 and MyD88 in tumor tissue with the method of RT-qPCR and immunohistochemistry. Meanwhile, the tumor growth was observed and the general conditions of mice were recorded. Results The model group was rich in tumor cells; the sizes of cells were different; the volume was large; the nucleus was deeply stained and the heterotypic shape was obvious, and the small focal necrosis was seen. The number of tumor cells in each administration group was reduced; the arrangement was loose; the cell volume was significantly reduced, and the nuclear pyknosis was reduced. Cell necrosis significantly increased; the number of interstitial blood vessels decreased; collagen fibers increased, especially in modified Danggui Beimu Kushen Pills high-dose and low-dose combined with DDP groups. Compared with the model group, the expressions of TLR2, TLR4, TLR6, TRAF6 and MyD88 mRNA and protein decreased in each administration group. TLR2, TLR4, TLR6, TRAF6 and MyD88 were lighter and weakly positive expressed in modified Danggui Beimu Kushen Pillshigh-dose and low-dose combined with DDP groups, the protein changes were more obvious Compared with DDP positive control group, modified Danggui Beimu Kushen Pills high-dose and low-dose groups. Conclusion Modified Danggui Beimu Kushen Pills can down-regulate TLR2, TLR4, TLR6, TRAF6 and MyD88 expression of tumor tissue in MFC gastric cancer bearing mice at both mRNA and protein levels to play anti-tumor pharmacology action.

The methylation status of GNAS1 gene in pseudohypoparathyroidism type Ib patients was detected by methylation-specific PGR technique. There was an abnormal methylation of 1A region in all seven PHPIb patients. Loss of exon 1A methylation (imprinting defect) seems to be the cause of PHPIb.

Objective:The aim of this study is to investigate the expression of p53 and PD-L1 in ultrasound-guided core needle biopsy specimens of breast cancer, and to analyze their application value.Methods:Ninety-eight patients who underwent ultrasound-guided coarse needle puncture biopsy and radical operation admitted to our hospital from Aug. 2021 to Sep. 2022 were selected as the study objects. The clinical data of patients were collected, the expression of p53 and PD-L1 in puncture biopsy specimens and radical surgical excision specimens were detected by immunohistochemical experiment, and the consistency was analyzed. Statistical test was used to analyze the relationship between the expression of p53 and PD-L1 and the pathological parameters of patients.Results:In 98 patients, the positive rate of p53 and PD-L1 in core needle biopsy specimens was 48.0% and 55.1%, respectively. The positive rate of p53 and PD-L1 in radical operative specimens was 62.2% and 61.2%, respectively. The concordance rates of p53 and PD-L1 were 63.6% ( κ=0.441, P<0.001) and 65.3% ( κ=0.505, P<0.001) between core needle biopsy specimens and radical operative specimens. Taking the results of radical operative specimens as the standard, the cases with positive expression of p53 and PD-L1 in core needle biopsy specimens were all positive in radical operative specimens, and the specificity was 100%. p53 was determined negative in 25 coarse needle biopsy specimens, however, p53 was positive in radical surgical specimens, and the false negative rate of coarse needle puncture was 49.0 %. PD-L1 was determined negative in 20 coarse needle biopsy specimens, but it was determined positive in radical operative specimens, and the false negative rate of coarse needle puncture was 41.7 %. There was no significant correlation between the consistency rate of p53 and PD-L1 expression and the number of puncture cores, the length of puncture cores, the length of invasive carcinoma and the proportion of invasive carcinoma (all P>0.05). The expressions of p53 and PD-L1 in core needle biopsy specimens were significantly correlated with tumor size, pTNM stage and Ki67 (all P<0.05), but not with age, BMI, family history, histological type or Nottingham histological grade (all P>0.05) . Conclusion:The concordance rates of p53 and PD-L1 expression between ultrasound-guided core needle biopsy specimens and radical resection specimens of breast cancer were 63.6% and 65.3%, respectively, and the specificity of positive detection results were both 100%, which has certain guiding significance for the clinical treatment of breast cancer.

OBJECTIVETo study the significance of P504s in differential diagnosis between solid pseudopapillary tumor of the pancreas (SPTP) and pancreatic neuroendocrine tumors (PanNET).

METHODSForty-three patients with SPTP and 41 patients with PanNET encountered during the period from 2007 to 2014 were recruited. Immunohistochemical study for vimentin, CD10, chromogranin A, synaptophysin, beta-catenin, CD99 and P504s in SPTP and PanNET was performed. The diagnostic value of P504s in differentiating SPTP from PanNET was analyzed.

RESULTSImmunohistochemical study showed that vimentin, CD10, chromogranin A, synaptophysin and CD99 were expressed both in SPTP and PanNET. All cases of SPTP showed granular cytoplasmic expression of P504s, whereas those of PanNET were negative.

CONCLUSIONP504s is a sensitive and useful marker for SPTP and can be used in the distinction between SPTP and PanNET.

Objective To investigate the treatment strategy for the re-operation patients with gallbladder cancer revealed by pathological results after laparoscopic cholecystectomy .Methods The clinical data in 15 cases of gallbladder cancer found by pa-thology after laparoscopic cholecystectomy in the general surgery department of this hospital during 2009-2013 were retrospective-ly analyzed .Results The pathological results on 3-5 d after laparoscopic cholecystectomy in 15 cases showed gallbladder cancer , tumor located at the gallbladder fundus in 2 cases ,the gallbladder body in 2 cases and gallbladder neck in 9 cases;there were 1 case of severe atypical hyperplasia ,2 cases of high differentiation adenocarcinoma ,9 cases of middle differentiation adenocarcinoma and 3 cases of low differentiation adenocarcinoma ;there were 1 case of Tis ,8 cases of pT Ⅰa ,6 cases of pTⅠb ,and 15 cases of bile tube incisal edge were negative .All 15 cases received re-laparotomy and hepatic duodenal ligament lymph nodes resection on 6-11 d af-ter cholecystectomy ,There were 1 case in the stage 0 ,8 cases in the stage Ⅰa ,5 cases in the stage Ⅰb ,1 case in the stage Ⅲb by TNM classification .The postoperative follow up lasted for 28 -79 months ,the accumulative survival rate was 100% in 1 year , 100% in 2 year ,93% in 3 year ,93% in 5 year .One case of stage Ⅲb was found repeated metastasis obstructive jaundice ,received transcutaneous puncture bile tract drainage and died after 3 months;no postoperative incision implantation metastasis was found . Conclusion Gallbladder cancer found by pathological examination after laparoscopic cholecystectomy is generally in early stage . Therefore ,early conducting the additional hepatic duodenal ligament lymphadenectomy has relatively good prognosis .

Objective To explore the value of pelvic fascia changes after high intensity focused ultrasound (HIFU) ablation of uterine fibroids patients with MRI.Methods The pelvic MRI and clinical data of 283 patients with uterine fibroids after treatment of HIFU were analyzed retrospectively.The total power and irradiation time of HIFU,and the degree of pelvic fascia edema changes were observed.The correlation between age,fibroids location,type,number,volume,total energy,irradiation time of HIFU and the degree of pelvic fascia edema were analyzed.Results Totally 201 patients (201/283,71.02％) had pelvic fascia edema and 59.71％ (169/283) were degree 1 and 2.There was significant difference in the degree of pelvic fascia edema in patients with different fibroids (x2 =27.50,P=0.007).There was no correlation between patients age,number,volume,type of fibroids,nor pelvic fascia edema (all P＞0.05).HIFU energy and irradiation time were positively correlated with the degree of pelvic fascia edema (rs =0.288,0.317,both P＜0.001).Conclusion MRI can observe pelvic fascia edema caused by HIFU treatment of uterine fibroids.HIFU irradiation time,total energy,and location of uterine fibroids location are the main influencing factors.