Objective To investigate the expressions of tenascin(TN)and microvessel density(MVD) in esophageal squamors cell carcinoma.Methods The experessions of TN and MVD were observed by immunohistochemiccal methods in 91 cases of esophageal carcinoma and 47 cases of ono-esophageal carcinoma.Results ①The expression of tenascin in esophageal cancer was much high than that in t he normal tissue(t=12.331,P＜0.01).②Over expression of TN was related to th length(F=12.373,P＜0.01),the invasion(F=11.039,P＜0.01),the lymphatic metastasis(F=6.882,P=0.01)and the pathologic trade(F=5.060,P=0.003)of cancer.③The expression fo MVD in the esophageal carcinoma tissues was stonger than that in the nonesophageal carcinoma tissues(t=6.023,P＜0.01).④Over expression of NVD wsa related to the length(F=9.033,P＜0.01),the lymphatic metastasis(F=12.429,P＜0.01)and the pathologic grade(F=5.717,P＜0.01)of cancer.⑤The positive expressions of TN and MVD were associated(P=0.001).Conclusion TN;s voerexpressions may be a biological marker in esophageal squamous cell carcinoma..It was associated with the expression of MVD.The levels of TN and NVD were useful molecular markers for evaluating malignancy degree and lymph node metastasis of esopageal carcinoma.

Belief in and rejection of a relationship of occlusion and temporomandibular joint (TMJ)condyle-fossa position with normal and abnormal function are still contentious issues.Clinical opinions can be strong,but support in most published data (mostly univariate)is problematic.Distribution overlap,low sensitivity and specificity are a common basis to reject any useful prediction value.Notwithstanding,a relationship of form with function is a basic tenet of biology.These are multifactor problems,but the questions mostly have not been analysed as such.This review moves the question forward by focusing on TMjoint anatomic organisation as the multifactor system it is expected to be in a closed system like a synovial joint.Multifactor analysis allows the data to speak for itself and reduces bias.Classification tree analysis revealed useful prediction values and usable clinical models which are illustrated,backed up by stepwise logistic regression.Explained vari-ance,R2 ,predicting normals from pooled TMJ patients was 32.6%,sensitivity 67.9%,specificity 85.7%;37% versus disc displacement with reduction;and 28.8% versus disc displacement without reduction.Significant osseous organisational differences between TMjoints with clicking and locking suggest that this is not necessarily a single disease continuum.However,a subset of joints with clicking contained char-acteristics of joints with locking that might contribute to symptom progression versus resistance.Moderately strong models confirm there is a relationship between TMJ osseous organisation and function,but it should not be overstated.More than one model of normals and of TMde-rangement organisation is revealed.The implications to clinical decision-making are discussed.

Objective To investigate the intensity modulated radiation therapy (IMRT) planning optimization method to reduce the additional dose resulting from megavoltage cone-beam CT (MVCBCT) imaging for nasopharyngeal carcinoma IMRT treatment. Methods MVCBCT images collection process was simulated using XiO treatment planning system. The mean doses of MVCBCT ( DMVCBCT ) were calculated in gross tumor volume ( GTV), clinical target volume ( CTV ) and risk at organ or tissue using 27. 4 cm× 27.4 cm portal radiation 8 MU,5 MU (A,C) and 27.4 cm× 15.0 cm portal radiation 8 MU,5 MU (B,D). The dose correct factor of MVCBCT (CFMVCBCT) according to IMRT TPS and DMVCBCT ,but CFMVCBCT plus MVCBCT imaging process for radiotherapy planning optimization. The paired t-test was play for A∶ B,C∶ D,A∶ C,B∶ D of DMVCBCT. Results The DMVCBCT and CFMVCBCT of A, B, C, D were 7. 78,5. 78,4. 88,3.55 cGy ( A∶ C, t =24.41,P＜0.01) and 0.993 -0.997 in GTV,with 7.88,6.95,4.88,4.38 cGy (A∶ B,A∶ C,B∶ C,t=3. 85, -31.82, -8.52, all P＜0. 01) and 0.992 -0.996 in CTV1 ,with 8.28,6.67,5. 17,4. 17 cGy (A ∶B,A∶C,B∶C,B∶D,t=6.41 -18.24,all P＜0. 01) and 0.991 -0.996 in CTV2;with 6.88,5.00,4.28,3. 50 cGy ( A∶ B, A∶ C,t = 2. 83,11.03, all P ＜ 0. 05 ) and 0. 989 - 0. 995 in spinal cord, with 7.88,7. 38,4. 95,4. 62 cGy and 0. 984 -0. 990 in left parotid, with 8. 67,0. 28,5. 33,0. 28 cGy and 0. 963 -0. 999 in left optic nerve,with 9. 17,0.22,5.72,0. 17 cGy and 0.821 -0.997 in left eye lens,with 6.95,2. 17,4. 38,1.38 cGy and 0. 987 -0. 997 in brain stem, with 7.78,0.45,4. 95,0. 28 cGy and 0. 978 -0. 999 ( A ∶ B,A∶ C,B∶ C,B∶ D for five organ or tissue,t =5. 06 -335. 16 ,all P ＜0. 01 ) in optic chiasm. Conclusions The MVCBCT imaging process resulted in radiation doses to patient. The impact of MVCBCT image acquired dose on IMRT treatment plan for NPC was eliminated by a compensation method.

Objective To compare the mast cells' property and the level of pelvic pain, urgency and frequency (PUF) scale in urinary bladder between interstitial cystitis (IC) patients and controls.Methods Eighteen cystoscopy biopsy specimens of interstitial cystitis patients and 12 controls were stained with 0.5% toluidine blue and immobilizated with Osmic Acid. Then the mast cells were observed and counted with light microscope and transmission electron microscope. The PUF scale and the number of mast cells between the 2 groups were compared. Results The mast cell's number of the interstitial cystitis samples(28-76 pieces/mm2) was significantly higher than that of the non IC persons' bladder tissues(7-15 pieces/mm2) (Z=3.927,P＜0.01). 75.3% mast cells were in a state of being activated degranulation. The PUF scale of IC patients( 17-35 scores)was significantly higher than that of the non IC persons' (0-8 scores) (t=14.736,P＜0.01). The PUF scale of the patient group did not have a linear IC relation with the mast cell's infiltrated number among the specimens (rs=-0.618,P=0.601). Conclusions Mast cell infiltration may be one of the characteristic pathological manifestations of IC. The association of mast cell infiltration and the PUF scale may be a new diagnosis criteria for IC.

Objective To compare the continuous subarachnoid block with ropivacaine or sufen?tanil either alone or in combination for labor analgesia. Methods Ninety nulliparous parturients who re?quired labor analgesia voluntarily, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, aged 23-35 yr, with a body height of 155-170 cm, were included in this study. When regular uterine contrac?tion appeared, labor analgesia was performed in the first stage of labor. The parturients were divided into 3 groups ( n=30 each ) using a random number table: ropivacaine group ( group R ) , sufentanil group (group S), and combination of ropivacaine and sufentanil group ( group RS). The spinal catheter was placed at L3,4 interspace. In group R, ropivacaine was given as an initial bolus of (0.6 mg∕ml) 5 ml fol?lowed by an infusion of 0.2 mg∕ml after the analgesia pump was connected. In group S, sufentanil was given as an initial bolus of (1.6 μg∕ml) 5 ml followed by an infusion of 0.2μg∕ml after the analgesia pump was connected. In group RS, the mixture of ropivacaine 0. 3 mg∕ml plus sufentanil 0. 8 μg∕ml was given as an initial bolus of 5 ml, followed by an infusion of the mixture of ropivacaine 0. 1 mg∕ml plus sufentanil 0.1 μg∕ml after the analgesia pump was connected. The analgesia pump was programmed to deliver a 5 ml bolus dose with a 15 min lockout interval, background infusion at a rate of 5 ml∕h, and the total volume of 100 ml in the three groups. The analgesia pump was connected at 30 min after the initial bolus was given, and the infusion was stopped at 2 h after delivery in the three groups. Visual analog scale ( VAS) scores were maintained ≤3. VAS scores were recorded before analgesia and at 5, 10 and 30 min after the initial bolus was given. The interval and duration of uterine contraction were recorded before analgesia, in 0-30 min, 30-60 min and 90-120 min of analgesia periods, and in the second stage of labor. The development of nausea and vomiting, pruritus, lateral episiotomy, assisted vaginal delivery, cesarean section, and post?dural puncture headache and requirement for oxytocin were recorded. Apgar scores at 1, 5 and 10 min after birth were recorded. Results The Apgar score of the newborn was more than or equal to 7 at 1, 5 and 10 min after birth in the three groups. Compared with the value before analgesia, the interval of uterine contraction was significantly prolonged, and the duration of uterine contraction was significantly shortened in the 0-30 min of analgesia period in group R ( P<0.05) , and no significant change was found in the inter?val and duration of uterine contraction in each analgesia period in S and RS groups ( P>0.05) . Compared with group R, the VAS scores were significantly increased at 5 and 10 min after the initial bolus was given, the interval of uterine contraction was significantly shortened, and the duration of uterine contraction was significantly prolonged in S and RS groups, and the incidence of pruritus was significantly decreased in group S ( P<0.05 or 0.01) . Compared with group S, the incidence of pruritus was significantly decreased ( P<0.01) , and no significant change was found in the VAS scores at each time point and interval and du?ration of uterine contraction in each analgesia period in group RS ( P>0.05) . Conclusion Continuous sub?arachnoid block with combination of ropivacaine and sufentanil provides better efficacy for labor analgesia than ei?ther alone.

Medical model is the product of medical practice and crystallization of the essence of medicine and insights of life based on human being's fights against diseases for ages.Medical practice and medical model change fundamentally with the changing needs of human.being for health,having undergone for example from biomedical model to biopsychosocial(BPS)model.Thanks to perspectives of Epistemology and practice theory,the medical model is nourishing itself with BPS theories and methodologies for sustainable development,helping human being to better understand health and life multi-dimensionally.In such a model,individual hospitals will shift from focusing on disease care to provision of wholesome and sustained health services,while hospital systems will shift from coordination to resources reallocation and vertical integration.Thus the hospitals will gain new perspectives and broader horizon for development in the future.

This paper introduces the principium of data exchange between different information systems by COM technology, and the one between HIS and RIS is taken as an example.

Objective To study the threshold effect of government health expenditure on residents' health.Methods Using threshold panel data model to perform the empirical research.Results There is threshold effect of government health expenditure on residents' health.There are two threshold values.As the increase of the proportion of the government health expenditure to the total fiscal expenditure,it has two changes of the impact on the health of residents.Conclusion The government should increase the health expenditure,and increase the proportion of the government health expenditure to the total fiscal expenditure,but the government should not blindly pursue the high input of health expenditure,focus on the efficiency of health expenditure,and avoid of resource waste.

Objective To sum up the experience of perioperative management of patients with heart transplantation.Methods In recent 3 years 24 cases of dilated cardiomyopathy,4 cases of(serious) valve disease,1 case of serious ischemic cardiomyopathy and 1 case of bi-ventricular assist(received) heart transplantation surgery.The mean by pass time was 75?24 min and the mean aortic clamp time was 72?8 min.Cyclosporine,MMF and prenisodone were adopted as anti-immune(response) strategy and the dose of cyclosporine was adjusted according to the serum concentration.(Intramyocardial) electrograms and tissue Doppler ultrasound technique were used to monitor the(immune) response situation.The myocardial biopsy was performed in case of the suspect of acute(rejection).Results In 5 postoperative deaths,3 cases died of low cardiac output,1 died of infection-(induced) multiple organ failure and 1 case died of serious bleeding.The postoperative complications(included) right heart failure in 6 cases,renal failure in 13 cases,and acute rejection in 4 cases.(Conclusion) The effective prevention and management of complications is the key point of success of heart transplantation.Application of comprehensive monitoring techniques is beneficial to the management of the immune rejection after transplantation.

Objective To analyse the MRI appearances of giant cell tumors of the bone and the relationship with their pathologic bases.Methods Histologic examinations were conducted in 21 cases,and their correlations with the MRI appearances were further evaluated.Results There were 3 cases of the Ⅰ grade,3 cases of the Ⅰ～Ⅱ grade,13 cases of the Ⅱ grade,2 cases of the Ⅲ grade of the giant cell tumors.Most tumors were composed of solid content that presented sligthly low to intermediate signal intensity on T 1WI,sligthly high to high signal intensity on T 2WI.The minority of the tumors were composed of the half of the solid and cystic contents expectively.Specific tumors was mainly composed of cystic content or combined with fluid-fluid level on T 2WI.Soft tissue masses were found in 8 cases.Conclusion The location and their extension into the soft tissue of the tumors can be clearly demonstrated on MR imaging,but there is no relationship between the grades of the tumors and their MRI appearances.