Metastasis is the main cause of the high mortality of lung cancer. Research is currently underway to understand metastasis at molecular level. Many molecular markers have been shown to participate in metastasis, including thymidylate synthase, angiogenesis lymphangiogenesis-related factors, cell adhesion molecules, extracellular matrix metalloproteinases, cytokines, and metastasis-associated genes. Elucidating the molecular mechanism of metastasis will help improve the early diagnosis and treatment of lung cancer.

[Objective] To observe the effect of medical ozone on cartilage in the model of osteoarthritis(OA)to explore its therapeutic mechanism.[Method] Forty healthy adult SD rats were randomly divided into five groups :A(group normal)、B(group model)、C(group air),D(group O2~O3 35 ?g/ml)and E(group O2~O3 70 ?g/ml)(n=8 in each group).The OA model was duplicated by performed anterior eruciate ligament transection(ACLT)and partial meniscectomy of 1/3 inside.Air was injected into joints of group C,according to concentration different,which O2~O3 35 ?g/ml and O2~O3 70 ?g/ml were respectively injected into joints to D and E group every other day,every time 1～1.5 ml,and after a week injected again.After the model was successfully made,the condylar cartilage of femur was excised after 4 weeks for the observation by transmissive microscope of HE staining.Mankin's index was recorded.At the end of the experiment,douche fluid of the diseased joints were obtained for the measurements of superoxide dismutase(SOD)and malondialdehyde(MDA).[Result]The OA model in B group founded obviously degenerative changes under microscopy,resulting in mostly blue and green color destaining of Masson staining at superficial cartilage.The activity of SOD in the douche fluid of the diseased joints degraded and the quantity of MDA in the serum in the OA model group increased.The Mankin's index in the group D was significantly higher than that in the group B、 C(P

Objective Based on the liver biopsy samples in the past 10 years, this study aimed to investigate the incidence of fatty liver, the relationship among fatty liver and other underlying liver diseases, the clinical and pathological characteristics and the risk factors of fatty liver. Methods In the total 658 cases of liver biopsy from 1988 to 1997, there were 71 cases of fatty liver, among them 68 cases were nonalcoholic fatty liver. Matched by sex and age, 155 cases of non fatty liver cases were taken as control. All cases had had the tests of liver function, blood lipid profile, blood glucose and hepatitis virus markers. Liver biopsy samples were investigated by pathologists. Results The incidence of fatty liver among all the liver biopsy cases was 10.8%. The patients' ALT, AST, TB and CB levels in fatty liver group were significantly lower than in non fatty liver group ( P

The subject of clinical medicine contains abundant humanism educational material.When students start the clinic learning and contact with the patients for the first time,clinical teacher should endeavor to cultivate medical students' humanistic spirit in clinical practice.The paper discussed how to merge humanistic spirit into medical clinic teaching by illustrating the gynecology and obstetrics teaching.

Objective To investigate the radiation pollution level of radon and ? radiation in air in different type of buildings. Methods 22 different type of rooms were selected and common measuring methods and REM-2 Radon exhalation rate apparatus and FD-125 Rn-Th measuring instrument were used. Results It indicated that the indoor radioactive contamination mostly root in the exhalation of soil and building material, secondly outdoor radon and ? radiation, water and the wall contributed little. Conclusion The results of the present paper have laid a foundation for the further study on the effect of radiation on human health and the protective technique.

Background and purpose:Postoperative sore throat (POST) is one of the common complaints of patients after radical thyroidectomy. Tracheal intubation is the main cause of POST. This study compared the effect of intubation with visual endoscopy and general laryngoscope on POST in patients undergoing radical thyroidectomy. Methods:One hundred patients (18-60 years, ASAⅠ-Ⅱ) undergoing elective radical thyroidectomy were randomized into two groups:patients in group A (n=50) were intubated with visual endoscope while patients in group B (n=50) were intubated with general laryngoscope. Endotracheal tube cuffs pressure was maintained at 20mmHg in all patients. Visual analogue scale (VAS) and Bruggrmann comfort scale (BCS) were recorded at the time points of 1, 6 and 24 h after extubation. Results:Compared with group B, the incidence of POST in group A was signifcantly reduced (42%vs 64%, P=0.027). The VAS of group A was lower than that of group B (3.05±1.56 vs 4.25±1.30, 3.05±1.56 vs 4.01±1.98, 2.72±1.77 vs 3.31±1.12) (P<0.05). The BCS of group A was higher than that of group B (0.99±0.46 vs 0.69±0.30, 1.95±0.47 vs 1.51±0.58, 2.82±0.87 vs 2.31±0.72) (P<0.05). Conclusion:Using visual endoscopic intubation can reduce the incidence of the POST in patients undergoing radical thyroidectomy.

Objective:We aimed to explore the clinical features, computed tomography (CT) findings, treatment, and prognosis of bronchopulmonary carcinoid. Methods:Clinical data of 31 patients with primary carcinoid tumor of the lung were retrospectively re-viewed. The prognostic factors were analyzed via Cox univariate and multivariate analyses. Results: Clinical symptoms included coughing or expectoration in 17 of the 31 cases, hemoptysis or blood-stained sputum in 7 cases, and chest pains or shortness of breath in 8 cases. Six cases were asymptomatic. The CT scans showed round or oval nodules with clear boundaries, and enhancement CT scans indicated mild, homogeneous enhancement. Immunohistochemistry results revealed the positive expression rates of synaptophy-sin (Syn), chromogranin A (CgA), and neuron-specific enolase (NSE) were 90.3%(28/31), 87.1%(27/31), and 90.3%(28/31), respec-tively. Therapy and prognosis results were as follows:28 of the total number of patients underwent surgery, among which 3 underwent postoperative adjuvant therapy, 2 received chemotherapy; and only 1 refused treatment. The 1-year overall survival rates were 100%(18/18) and 92.3%(12/13), whereas the 3-year survival rates were 94.4%(17/18) and 69.2%(9/13) in the typical and atypical carcinoid cases, respectively. Cox univariate analysis results revealed that lymphatic metastasis (P=0.02), tissue types (P=0.017), TNM stage (P=0.005), and therapies (P=0.01) were the prognostic factors. Cox multivariate analysis results showed that lymphatic metastasis (P=0.032) and tissue types (P=0.002) were the independent prognostic factors. Conclusion:Compared with other lung cancers, the bron-chopulmonary lung carcinoid has no special clinical manifestation in clinical and radiographic images. The diagnosis was mainly based on histopathology results. Surgery was the main and effective treatment, whereas chemotherapy and radiotherapy showed unsatisfactory results. The overall prognosis was satisfactory. However, the atypical carcinoid was inferior to the typical carcinoid in terms of progno-sis. Pathological typing and lymph node metastasis were significant prognostic factors.

Objective To study the clinical features,treatment methods and clinical outcomes of acute tibialis posterior tendon rupture.Methods Using [(posterior tibial tendon) OR (tibialis posterior tendon)] AND (rupture OR injury OR disruption OR trauma OR tear) as the search words,we searched the PubMed database to retrieve the 19 articles involving 24 cases of acute tibialis posterior tendon rupture.The injury mechanisms,X-ray manifestations,operational findings,treatment methods and clinical outcomes were analyzed.Results The mechanisms of the fracture-related tibialis posterior tendon rupture included motor accident (50.0％,12/24),falling from a height (41.7％,10/24) and sports injury (8.3％,12/24).The tendon rupture was mostly complicated with malleolar fracture (91.7％,22/24),especially the pronation type (70.8％,17/24).Direct suture of the tendon was adopted in 91.7％ of the cases (22/24).Favorable outcomes were achieved in 95.5％ of the cases (21/24).Conclusions Acute tibialis posterior tendon rupture is mostly seen in high-energy medial malleolus fracture.The mechanism of the rupture might be tendon distraction or bone flake incision.Early operation can lead to favorable outcomes.

Objective To investigate the effect of labetalol in treatment of severe preeclampsia clinical effect.Methods The control group of severe preeclampsia patients received routine clinical treatment,the study group were treated with labetalol,two groups of patients with severe preeclampsia were treated for 7 d.Results After treatment,the two groups of DBP,SBP,HR,and 24 HUP were significantly lower than before,the study group improved the above indicators better(P<0.05).The study group of patients with severe preeclampsia premature delivery rate,postpartum hemorrhage rate,neonatal asphyxia rate(10.20%,8.16%,6.12%)were significantly lower than the control group(28.57%,34.69%,20.41%)(P<0.05).Conclusion The application of conventional therapy combined with labetalol can significantly improve the hypotensive effect of severe preeclampsia,is conducive to the protection of maternal physical and mental health and life safety.

Objective To evaluate the efficacy of using dual laser system in off clamp nephronsparing surgery.Methods We used dual laser system in the patients who underwent off-clamp NSS between Jan 2016 and Apr 2016 in our institution.There were 16 males and 8 females with average age of 49 years.Mean tumor size was 1.9 cm (range 0.8-3.2 cm).The mean R.E.N.A.L.score was 3.8 (range 3-6).The mean Zhongshan score was 3.5(range 3-5).The mean ZⅡ(zero ischemia index)was 1.6(range 1-4).The Evolve Dual (980 nm/1 470 nm) laser system set at 60 W in continuous mode was used.Results Offclamp NSS was successfully performed in 22 patients except for renal artery occlusion in 2 case.Mean operative time was 74 min(range 50-100 min);The average estimated blood loss was 52.9 ml(range 10-200 ml);Mean postoperative drainage was 65.4 ml(range 20-150ml);Mean postoperative hospital stay was 5.2 days (range:4-7days).No severe post-operative complication was found.The mean pre-and postoperative serum creatinine levels were 76.2 μmol/L(range:48-112μ mol/L) and 81.5μ mol/L(range:54-122 μ mol/L) with no significant difference(P ＞0.05).The postoperative pathology indicated that 20 cases of clear cell carcinomas,3 cases of chromophobe renal cell carcinomas,one case of papillary carcinoma.Conclusions Dual laser system can be used in off clamp nephron-sparing surgery safely and effectively.