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

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.

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: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.

To investigate the effect of Cornu Cervi Oral Liquid (mainly composed of Cornu Cervi, Fructus Psoraleae, Herba Epimedii, Fructus Corni, Fructus Ligustri Lucidi and Lignum Aquilariae Resinatum) in reversing myocardial fibrosis in rats with congestive heart failure caused by pressure overload and to explore its mechanism. Thirty six male Wistar rats were randomly allocated to mimic operation group (Group A), model group (Group B) and Cornu Cervi Oral Liquid group (Group C). Rat models of congestive heart failure were induced by constriction of abdominal aorta. Left ventricular mass index(LVMI) was observed; contents of collagen type Ⅰ and Ⅲ in left ventricular cardiac muscle were detected by immunohistochemical method and their mRNA expression by RT PCR; and plasma levels of angiotensin Ⅱ (AngⅡ), atrial natriuretic factor (ANF) and serum aldosterone (ALD) level were measured by radioimmunoassay method. LVMI, contents of collagen type Ⅰ and Ⅲ and their mRNA expression, levels of plasma and myocardial AngⅡ, plasma ANF and serum ALD were higher in Group B than those in Group A (P0 05).[Conclusion]Cornu Cervi Oral Liquid is effective in reversing myocardial fibrosis in rats with congestive heart failure caused by pressure overload and its mechanism may be related to the decrease of contents of collagen type Ⅰ and Ⅲ and their mRNA expression, levels of plasma and myocardial AngⅡ, plasma ANF and serum ALD.

Heart rate is the most common index to directly monitor the level of physical stress by comparing the subject's heart rate with an appropriate "target heart rate" during exercise. However, heart rate only reveals the cardiac rhythm of the complex cardiovascular changes that take place during exercise. It is essential to get the dynamic response of the heart to exercise with various indices instead of only one single measurement. Based on the rest-workload alternating pattern, this paper screens the sensitive indices of exercise load from electrocardiogram (ECG) rhythm and waveform, including 4 time domain indices and 4 frequency domain indices of heart rate variability (HRV), 3 indices of waveform similarity and 2 indices of high frequency noise. In conclusion, RR interval (heart rate) is a reliable index for the realtime monitoring of exercise intensity, which has strong linear correlation with load intensity. The ECG waveform similarity and HRV indices are useful for the evaluation of exercise load.
Electrocardiography ; Exercise ; Heart Rate ; Humans ; Monitoring, Physiologic ; Workload

Objective:To investigate the clinical efficacy of intramedullary nailing combined with bone cement in repair of segmental bone defects after tumor resection.Methods:A retrospective analysis was conducted of the 5 patients with malignant bone tumor who had been treated at Department of Orthopaedics, Qiannan People's Hospital from April 2018 to September 2019 for remaining segmental bone defects following limb salvage surgery. They were 4 males and one female, aged from 11 to 55 years (average, 35.4 years). Their defects ranged from 6 to 21 cm (average, 12.3 cm) after tumor resection. By the Karnofsky performance score (KPS) for long-term quality of life, all of them scored less than 50 points. Of them, 3 were treated by interlocking intramedullary nails and bone cement filling, and 2 by elastic intramedullary nails and bone cement filling. In the 2 cases with defects of 21 cm and 13 cm, the fixation was assisted by a plate and an external fixator. Defect length after resection, operation time and intraoperative bleeding were recorded; the efficacy was evaluated by the Enneking functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system, visual analogue scale (VAS), and KPS.Results:All the 5 patients had uneventful surgery, with operation time ranging from 112 to 225 min (average, 154.2 min), intraoperative bleeding from 300 to 500 mL (average, 382 mL), and defect length after resection from 6 to 21 cm. The 5 patients were followed up for 6 to 28 months. Of them, 2 died of disease progression 6 and 7 months after surgery, respectively. According to the Enneking's evaluation, one patient scored 28 points, 2 patients 23 points and 2 patients 21 points, giving a high degree of satisfaction. Their VAS scores 6 months after surgery ranged from 1 to 6, averaging 3.6; their postoperative KPS scores ranged from 60 to 80, averaging 72.Conclusion:In repair of segmental bone defects after tumor resection, intramedullary nailing combined with bone cement filling can relieve pain of patients and lead to satisfactory short-term curative efficacy.

Objective:To evaluate the value of ultrasound-guided transperineal systematic prostate biopsy(SPB)and cognitive fusion multi-parameter magnetic resonance imaging(mpMRI) suspicious transperineal targeted biopsy(CFTB) in the prostate cancer with different serum prostate specific antigen(PSA) levels.Methods:A retrospective analyses were performed in 527 patients with suspected prostate cancer who underwent ultrasound-guided SPB from January 2018 to December 2019 in Shanghai Jiaotong University Affiliated 6th People′s Hospital. According to the PSA levels, they were divided into group A(PSA 4-10 μg/L) and group B(PSA>10 μg/L). All the patients underwent ultrasound-guided SPB, 376 patients with suspicious mpMRI had two additional targeted biopsies. The detection rates of ultrasound-guided SPB and CFTB in prostate cancer were tested by χ 2 test. Compared with pathological results, the sensitivity, specificity, accuracy of two methods were calculated and tested by χ 2 test, and a P<0.05 was defined as statistically significant difference. Results:Prostate cancer was detected in 319 of 527 patients(60.5%). One hundred and three cases of 198 patients in group A were diagnosed as prostate cancer, with an overall detection rate was 52.0%. Among them, ultrasound-guided SPB detected 72 cases of prostate cancer, the detection rate was 36.4%, sensitivity was 67.9%, specificity was 17.7%, accuracy was 26.5%, the detection rate, sensitivity, specificity and accuracy of CFTB were 39.9%, 75.6%, 91.6% and 88.8%, respectively. In this group, there were no statistically significant differences in the detection rate and sensitivity of the two methods in the diagnosis of prostate cancer (χ 2=0.525, 0.005, both P>0.05), and the differences in specificity and accuracy were statistically significant (χ 2=108.340, 79.829, respectively, both P<0.05). Two hundred and sixteen cases of 329 patients in group B were diagnosed as prostate cancer, with an overall detection rate was 65.7%. Among them, 160 cases of perineal prostate cancer were detected by ultrasound-guided SPB, with the detection rate was 48.6%, sensitivity was 78.2%, specificity was 37.6% and accuracy was 49.5%. A total of 189 cases of prostate cancer detected by CFTB, the detection rate was 57.4%, the sensitivity was 89.3%, the specificity was 90.6%, and the accuracy was 90.2%. All the differences were statistically significant in group B(χ 2=5.131, 4.391, 61.339, 38.982, all P<0.05). Conclusions:When PSA is greater than 10 μg/L, CFTB has a higher diagnostic efficiency than SPB.When PSA is 4-10 μg/L, there are no significant differences between the two methods in the detection rate and sensitivity of prostate cancer.