Objective To investigate the clinical and X-ray characteristic findings of the cystic and expansive bone metastasis.Methods The clinical and X-ray findings of the cystic and expansive bone metastasis in 35 cases were analysed with the literaturereviewed.There were 21 males and 14 females,the age ranged from 35 to 70 years with average of 52 years.Results The bone metastasis was found 1~10 years after primary tumor diagnosed in 29 cases befor primary tumor diagnosed in 5 cases and the primary tumor did not know in one case.The primary neoplasmes included nasopharyngeal carcinoma in 10,lung carcinoma in 9,renal carcinoma in 5,breastcarcinoma in 4,thyroid carcinoma in 3,hepatic carcinoma,prostatic carcinoma,esophageal carcinoma and primary focus unknown in onerespectively.The metastatic lesions localized in the long bone in 20 cases,ribs in 4,pelvis in 4,vertebrae body in 2,scopula in 2,clavicle,metacarpal and skull in one respectively.There were 16 cystic destruction,9 expansive destruction,10 both cystic and expansive.The marginated lesions were in 27 and 8 unclear in outline of lesion was in 8.There were distruction in the bony cortex with soft tissue in 7,and sclerosis in outline of lesion in 11 and bone crest and spot clacification inside the lesions in 6.Conclusion The time of metastases occured of cystic and expansive bone metastases is depended on the differentiating degree of primary tumor cell its developmental speed.

Objective To explore the feasibility of laparoscopic common bile duct exploration without T-tube drainage.Methods A to-tal of 37 patients who were addmitted into our hospital from May 2014 to August 2015 with common bile duct stones were analyzed.Among these patients,22 cases were given T-tube drainage while the other 15 cases were not.The operation time,hospitalization expenses,anal ex-haust time,postoperative hospitalization time,bile leakage rate and the satisfaction of patients after surgery in the two groups were observed. Results In the non-T-tube group,the anal exhaust time was (1.41 ±0.82)d and the hospitalization time was(4.82 ±1.61)d,which were lower than(3.81 ±1.09 )d and (11.17 ±1.19 )d respectively in the T-tube group,and the differences were statistically significant (P <0.05).The number of bile leakage (0%)in the non-T-tube group was also significantly lower than 31.82% in the T-tube group (P <0.05).The satisfaction rate of patients in the non-T-tube group(100%)was significantly higher than that in T-tube group (50%),and the difference was statistically significant(P <0.05).Conclusion The laparoscopic common bile duct exploration without T-tube drainage is feasible and it can be popularized in clinic.

Objective To detect the expression of matrix metalloproteinase-9 (MMP-9) gene in peripheral blood of patients with oral paraquat (PQ) poisoning and evaluate its predictive value for their prognosis.Methods Thirty-seven cases of oral PQ poisoning admitted to Linyi People's Hospital from January 2013 to June 2014 were enrolled,and they were divided into survival group (26 cases) and death group (11 cases) according to the survival sitnation in 28 days after poisoning;a healthy control group included 10 healthy people selected in the same period.The peripheral blood 3 mL was collected from each PQ patient on the 1st and 3rd day after admission,and in the healthy control group,3 mL peripheral venous blood was obtained under fast on the day for physical examination.The MMP-9 gene expression of peripheral blood mononuclear cells (PBMCs) was detected by reverse transcription-polymerase chain reaction (RT-PCR) methods;the serum MMP-9 concentration was determined by using enzyme-linked immunosorbent assay (ELISA);the serum PQ level was detected by high performance liquid chromatography (HPLC),and the amount of poison orally taken was recorded.The correlations between PQ amount orally taken,serum PQ level and MMP-9 expression were analyzed by Spearman correlation analysis.A receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of peripheral blood MMP-9 level for the 28-day prognosis of PQ poisoning patients.Results After admission the 1 day serum PQ level was (2.60 ± 1.29) mg/L,and the amount of poison taken was 50.0 (7.5,60.0) mL in the 37 patients with oral PQ poisoning.The MMP-9 gene expression level in PBMCs and serum MMP-9 protein level of both PQ poisoning groups were significantly higher than those of healthy control group,and the levels were gradually increased with the extension of poisoning time;the degrees of elevation in death group were more significant [the PBMCs' MMP-9 gene expression (A value):2.84± 1.16 vs.0.95 ± 0.23 on the 1st poisoning day,4.22± 1.75 vs.1.29 ±0.30 on the 3rd poisoning day;serum MMP-9 concentration (μg/L):2791.48± 1 230.88 vs.807.81±279.86 on the 1st poisoning day,4384.21 ± 1 781.97 vs.1 131.14±291.76 on the 3rd poisoning day,all P ＜ 0.05].Correlation analysis showed:there were significant positive correlations of oral PQ amount,serum PQ concentration to the MMP-9 gene expression in PBMCs and serum MMP-9 protein concentration in patients with oral PQ poisoning (all P =0.000).ROC curve analysis showed:the MMP-9 gene expression in PBMCs on the 1st day and the serum MMP-9 content on the 3rd day after admission had predictive value for 28-day prognosis in patients with oral PQ poisoning,and the ROC areas under the curve (AUC) was 0.820 and 0.776 respectively.When the cutoff value of MMP-9 gene expression level on the 1st day after admission was 0.90,the predictive sensitivity and specificity were 80.00％ and 63.64％ respectively;when the cutoff value of serum MMP-9 protein content on the 3rd day after admission was 904.36 μg/L,the predictive sensitivity and specificity were 80.00％ and 72.73％ respectively.Conclusion Oral PQ poisoning can lead to the MMP-9 gene expression in PBMCs and elevation of serum MMP-9 protein level in the body,and the MMP-9 gene expression has predictive value for the prognosis of patients with oral PQ poisoning.

Objective To investigate the protective effects of rhein lysinate ( RHL) on cardiac tissue damage in-duced by paraquat in experimental mice , and to clarify its mechanism .Methods In this study mice were assigned to the following three groups: control, paraquat model, and RHL-treated groups.The model of oxidative damage mice was established by intraperitoneal injection of paraquat .RHL-treated group was given RHL ( 50 mg/kg ) by gavage for one week before performing model .The other two groups were given equal volume of distilled water .For making model , paraquat was intraperitoneally injected in the paraquat model and RHL-treated group .The content of MDA was detected by thiobarbituric acid assay .The activities of SOD and GSH-Px were detected by biphenyl three phenolic autoxidation assay and NADPH coupling method respectivly .The pathological profile of cardiac tis-sue was observed by hematoxylin and eosin ( HE) staining and reactive oxygen species was observed by DCFH-DA staining .The change of proteins related to myocardial damage detected by Western blot .Results Compared with control group, the activities of SOD and GSH-Px decreased (P<0.05) and the content of MDA increased (P<0.05) in paraquat model group .However , these changes were attenuated byr RHL treatmen ( P<0.05 ) .The pathologi-cal examination indicated the structure of cardiac tissue was damaged and reactive oxygen species of cardiac tissue was increased after paraquat was given , however , these changes were attenuated after RHL treatmen .It was shown in western blot analysis that compared with control group , the expression of SIRT1 decreased, the acetylation of P53 and the expression of P 53 and P66 increased in paraquat-treated group .These changes were attenuated by RHL treatmen ( P<0.05 ) .Conclusions RHL may attenuate paraquat-induced cardiac injury in mice .

Objective To investigate the effects of rhein lysinate (RHL)on the expressions of TNF-α,IL-6 and NF-κB in the kidney tissue of senescence accelerated mouse prone 10 (SAMP 10)mice.Methods We selected 1 8 male mice (SAMP 1 0 )aged 7 months for the study and randomly divided them into blank control group and groups of different concentrations of RHL;six senescence accelerated mouse resistance 1 (SAMR 1 )served as the young control group.After 6 weeks’ treatment,HE staining was used to detect the pathological changes of the kidney.The expressions of TNF-α,IL-6 and NF-κB at the protein level were detected by immunohistochemistry and Western blotting.Results RHL treatment did not affect the body weight of SAMP 10 mice (P>0.05 ). Compared with SAMR 1 mice, contracted and destroyed renal glomeruli and infiltration of mononuclear macrophages were observed in control SAMP10 mice.However,this pathological process was blocked by RHL (25 mg/kg and 50 mg/kg ) treatments. In addition, the overexpressions of TNF-α, IL-6 and NF-κB and the phosphorylation of NF-κB in the kidney tissue of SAMP 10 mice could be inhibited by RHL treatments (P<0.05). Conclusion RHL inhibits the inflammatory reaction of the kidney tissue,which may be one of the mechanisms by which RHL exerts its kidney-protecting and anti-aging effects.

Objective:To explore the improvement effect of rhein lysinate (RHL)on the insulin resistance in the KK/HlJ diabetes mellitus (DM ) mice induced by streptozotocin (STZ ), and to elucidate its mechanism. Methods:The KK/HlJ diabetic mouse models were made by intraperitoneal injection of STZ (50 mg· kg-1 )and fed with DM diet.A total of 48 mice were divided into normal control group,model group,low dose of RHL group (25 mg·kg-1 )and high dose of RHL group (50 mg·kg-1 ) (n= 12).All the mice were treated for 16 weeks. The levels of fasting glucose (FBG),total cholesterol (TC)and triglyceride (TG)of the mice were measured by glucose oxidase method.HE staining was used to observe the morphology of pancreas tissue of the mice.The insulin level in pancreas islet tissue was detected by immunohistochemistry method.The levels of insulin and of C reactive protein (CRP)in serum and tumor necrosis factorα(TNF-α)and interleukin 6 (IL-6)in liver tissue of the mice were detected by enzyme linked immunosorbent assay (ELISA)method.The expression levels of glycogen synthesis related genes (PI3K,AKT and GSK-3β)phosphorylation were detected by Western blotting method. Results:Compared with model group,the levels of FBG,TG and TC of the mice in low and high doses of RHL groups were significantly decreased (P < 0.05),but there was no significant difference in the insulin level (P >0.05).Compared with model group,the levels of CRP in serum and the levels of TNF-αand IL-6 in liver tissue of the mice in low and high doses of RHL groups were significantly decreased (P <0.01).The HE staining results showed that compared with model group,the islet morphology of the mice in low and high doses of RHL groups was partially restored,and the occasional inflammatory infiltration was observed.The immunohistochemical staining results showed that compared with model group,the brown granular substance in the islets of the mice in low dose of RHL group was significantly reduced,which was disappeared in high dose of RHL group.Compared with model group,the expression levels of glycogen synthesis related genes (PI3K,AKT and GST-3β)phosphorylation of the mice in low and high doses of RHL groups were increased (P <0.01).Conclusion:RHL has improvement effect on the insulin resistance in the KK/HlJ DM mice induced by STZ,and the mechanism may be related to promoting the glycogen synthesis.