0.5). Conclusion To some extent, the cup sign and split sign on CT reflect the biologic character of AMLs, and the signs are helpful in making the specific diagnosis of AML combined with other imaging manifestations.

Objective To investigate the effect of nuclear factor-?B (NF-?B), NF-?B-inducing kinase (NIK) and I-?B in basic fibroblast growth factor (bFGF) promoting gene expression and signal transduction of tenocyte NF-?B. Methods Tenocytes isolated from rabbits were divided into 3 groups with 8 dishes: no bFGF (Group A), 2 ng/ml bFGF (Group B) and 10 ng/ml bFGF (Group C). Cells in all dishes were cultured for 5 days. The effect of bFGF on tenocytes proliferation was examined by means of growth curve analysis. The mRNA was isolated after 5 days and the gene expressions of NIK,IKK? and IKK? induced by NF-?B investigated by reverse transcription-polymerase chain reaction (RT-PCR). Results The growth curve moved forward with the dosage increase of bFGF. Gene expressions of NF-?B,NIK, I?B kinase (IKK)? and IKK? were 0.4? 0.2 , 0.4 ? 0.1 , 0.3 ?0.1 and 0.2?0.1 respectively in the Group B and 1.8?0.5,1.0?0.3, 0.8 ? 0.2 and 1.5 ? 0.4 in the Group C. Gene expressions were all up-regulated in the Groups B and C posterior to adding of bFGF. Conclusions bFGF stimulates tenocyte proliferation and up-regulates gene expression of NF-?B,NIK,IKK? and IKK?, as indicates that the signal transduction of promoting tenocyte proliferation by bFGF may be through NF-?B pathway.

BACKGROUND:For the treatment of Achil es tendon rupture, peripheral ankle autologous tendon displacement is the traditional method in clinic, while the source of autologous tendon is limited, has damage to the donor site and has to pay with the normal power and stable structure. Al ogenic tendon has the advantages of rich sources, easy to obtain, no damage to the normal structure of the host, and can maintain its original biological structure. OBJECTIVE:To evaluate the clinical effect of tendon al ograft transplantation on the repair of Achil es tendon rupture. METHODS:Thirty cases of acute and old Achil es tendon rupture and four cases of chronic rupture with 2-5 cm deficiency were treated from August 2008 to June 2011. The cases were treated with tendon al ograft transplantation, and short leg cast was used to fix the limb after transplantation. Functional exercises were commenced at 4 weeks after cast removal. The clinical treatment results were evaluated by Arner-lindholm criteria. RESULTS AND CONCLUSION:The mean hospital stay was about 12.5 days. Twenty-five cases were fol owed-up for 1-3 years after transplantation and no rupture recurred. According to Arner-lindholm criteria, excel ent was in 25 cases, good in 3 cases, fair in 2 cases, and the excel ent and good rate was 92%. Ankle joint function was recovered to the normal level. Three cases had adhesion between Achil es tendon and adjacent tissue that had impact on the ankle dorsiflexion, and there was no significance decrease in foot pedal force. Two cases had rejection that healed after symptomatic treatment. One case had less flap margin necrosis and incision infection that healed after dressing and adjacent flap coverage. Incisions of al patients were healed at discharge. The results show that tendon al ograft transplantation has satisfactory effect for reaping the Achil es tendon rupture which is a recommended treatment option. But the long-term effect needs further observation.

It is usually a challenge to repair the abdominal wall defect to general surgeons. With developing of materials science, the use of mesh provides a novel method of primary closure of abdominal wall defects in this set-ting. Recently , biological mesh has been reported to reconstruct abdominal wall successfully. This review is to in-troduce the recent status and progress on its biological characteristics,animal experiments and clinical Study.

Objective To investigate the clinical efficacy of rhubarb acupoint sticking joint shuganjieyu diet in the treatment of chronic functional constipation patients with depressive anxiety.Methods 120 patients of chronic functional constipation with depression anxiety were selected,they were randomly divided into control group and obser-vation group,60 cases in each group.The patients in the control group were given promoting gastrointestinal motility drugs mosapride capsules,and orally given laxatives rhubarb with sodium bicarbonate.The patients in the observation group were treated with topical rhubarb acupoint,and orally given medicated shuganjieyu diet.7 days for a course of treatment,the patients were treated for four courses.The clinical efficacy of the two groups,defecation interval and fecal nature,SAS,SDS scale score changes and quality of life (PAC -QOL)scale score changes before and after treatment and adverse reactions during treatment were recorded.Results The total effective rate of the observation group was 90.00%,which of the control group was 91.67%,the difference between the two groups was not significant (χ2 =0.32,P >0.05).Before treatment,the bowel movement and stool ratings between the two groups had no statis-tically significant differences (t =0.23,0.33,all P >0.05).After treatment,the two points of the two groups were significantly decreased,but the differences between the two groups were not significant (t =0.18,0.41,all P >0.05).Before treatment,the SAS,SDS scale scores between the two groups had no statistically significant differences (t =0.78,0.69,all P >0.05).After treatment,the SAS,SDS scores of the two groups were significantly decreased, which of the observation group decreased more significantly than those of the control group (t =4.18,4.72,all P <0.05).Before treatment,the PAC -QOL scale scores for each dimension level had no statistically significant differ-ences (t =0.16,0.21,0.42,0.20,all P >0.05).After treatment,the dimensions of the two groups showed a decline trend,and those of the observation group decreased more significantly than the control group (t =2.10,3.56,2.76, 2.34,all P <0.05).In the control group during the treatment,2 cases of diarrhea,three cases of dry mouth,the patients were improved after given symptomatic treatment.No serious adverse event occurred during therapy in the observation group.Conclusion Rhubarb acupoint joint shuganjieyu diet in the treatment of chronic functional constipation patients with depression anxiety has significant clinical effect,which can significantly improve patients'depression and anxiety scores,quality of life,and without significant adverse reactions,it is worthy of clinical applica-tion.

OBJECTIVE:To evaluate the economic efficiency of three oral administration schemes in treatment of benign prostatic hypertrophy(BPH).METHODS:73patients with BPH were divided into three groups:group A,Pule’an,group B,Alfuxosin hydrochloride,group C,Finasteride.Data was evaluated using the pharmacoeconomic cost-effectiveness analysis. RESULTS:The effective rates in the group B and group C were higher than that in group A,the effective rate in group B was comparable to that in group C.The cost-effectiveness ratios of A,B,C were1.30,1.80,4.36,respectively.Using sensitivity analysis,the cost-effectiveness ratios were1.17,1.62,3.92,respectively.CONCLUSION:Among the three schemes,scheme B was the best one.

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Neoplasms, Germ Cell and Embryonal ; diagnosis ; drug therapy ; pathology ; Ovarian Neoplasms ; diagnosis ; drug therapy ; Testicular Neoplasms ; diagnosis ; drug therapy

Objective To study the diagnosis and treatment of the model of multidisciplinary team treatment on hepatoblastoma in children.Methods Retrospective analysis of treatment and long term follow-up of 16 patients with hepatoblastoma(8 cases were boys,8 cases were girls;aged 3 months to 11 years old,average age was 2 years old) during Aug.1998 to Jan.2006 in Shanghai Children's Medical Center.Special in multidisciplinary team treatment,preoperative evaluate and operation.Results The morbility locum of 8 cases were in right liver lobe,8 cases were in left liver lobe.Fifteen cases of the clinical presentation were abdominal mass,1 case was peritonitis.According to International Society of Pediatric Oncology(SIOP) Pretext staging system,43.7%(7/16)cases were stage Ⅱ,43.7%(7/16)cases were stage Ⅲ,12.5%(2/16)cases were stage Ⅳ.In 7 cases of stage Ⅱ,6 cases were accepted tumor total resection,1 case was accepted emergency surgery because tumor was fracture.Patients were given ICE protocal.In 7 cases of stage Ⅲ,6 cases were able to undergo delayed tumor resection following open biopsy and subsequent treatment with chemotherapy 2-3 courses.One case gave up treatment because its had poor response to chemotherapy.In 2 cases of stage Ⅳ,1 case was received liver transplantation due to poor respond to chemotherapy.One case was not received any treatment.In 7 cases of stage Ⅱ,6 cases were alive,1 case died,3-year free survival rate was 100%(4/4).In 7 cases of stage Ⅲ,5 cased were alive,3-year free survival rate was 75%(3/4).Two cases of stage Ⅳ all died.Conclusions Surgery play a very important role in the treatment of hepatoblastoma in children.Chemotherapy has improved the resectability of the tumor.Multidisciplinary team treatment is an effective model for diagnosis and treatment on childhood hepatoblastoma.

Objective To evaluate the influencing factors for hypocalcemia after total thyroidectomy in thyroid carcinoma.Methods 650 patients with thyroid carcinoma undergoing total thyroidectomy from Jun.2009 to Dec.2011 were followed up and analyzed retrospectively.The relativity between persistent hypocalcemia and the following criteria were studied:age, sex, primary tumor stage, initial thyroid treatment, neck dissection cen-tral compartment dissection, inadvertent parathyroidectomy, and thyroid caspsular dissection.χ2test was used to analyze the statistical correlation between hypocalcemia after total thyroidectomy and the other clinical factors. Multiple logistic regression analysis was used to identify the multivariate correlation of clinical factors and hypocal-cemia after total thyroidectomy. Results Persistent hypocalcemia was found in 112 out of 650 patients (17.2%).Advanced stage(OR=2.121,95%CI 1.140-3.947,P=0.018),bilateral central compartment dis-section(OR=1.852,95% CI 1.199 -2.863,P =0.006),failure to use thyroid caspsular dissection(OR =2.307,95%CI 1.208-4.405,P=0.011)and IPE(OR=1.580,95%CI 1.029-2.427,P=0.037)were inde-pendent predictive factors for hypocalcemia after total thyroidectomy.Conclusions It has high incidence of persis-tent hypocalcemia in patients with andvanced-stage thyroid carcinoma after going total thyroidectomy.Thyroid caspsular dissection method, proper indications for bilateral central compartment dissection, and reducing IPE can help to reduce the incidence of persistent hypocalcemia and improve the life quality of patients after going thyroidectomy.

Objective To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) with scissors knife in difficult cases.Methods A total of 36 sessions of ESD in 34 patients were performed from May 2010 to May 2012 with application of new scissors knife.The complications and followup outcomes were recorded.Results All lesions were removed successfully with an en bloc resection rate at 91.7％.Delayed bleeding occurred in 2 patients (5.6％),and both of them were cured sucessfully with endoscopy.No perforation happened and the average hospitalization time was 5 days.Follow-up endoscopy performed 6 or 12 months after ESD in 6 patients revealed no recurrence or residual lesions.Other patients are under follow-up now.Conclusion The scissors knife is easy to manipulate,which can ensure the safety and efficiency of ESD.