Objective To detect the methylation status of CDH1 3 gene promoter in colon cancer by using methylation-specific polymerase chain reaction(MSP)technique.Method The tissue specimens from 32 cases of colon cancer(observation group),and 12 cases of normal colon tissues(control group)were examined,the methylation of CDH13 gene promoter was detected by MSP.Result The methylation of CDH13 gene promoter was detected in 19 cases(59.4％,19/32)in observation group,1 case(8.3 ％,1 / 12)in control group,there was statistical significance between two groups(P =0.002).Conclusion Frequency of the methylation of CDH13 gene promoter is apparently higher in colon cancer tissues than that in normal colon tissues,it reveals that CDH13 gene promoter may contribute significantly to the development of colon cancer.

Objective: To observe the expression of osteopontin (OPN) in the giant cell tumor of bone (GCTB) and to discuss its clinical significance. Methods: OPN expression was examined in 77 GCTB samples by En Vision™ two-step immunohistochemical method. And the expression was compared between patients with different clinical and pathological data; the implied clinical relevance was also analyzed. Results: The positive expression rate of OPN in the GCTB was 76.6%; only weak expression was noted in the normal bone tissues. The expression in the invasive GCTB was significantly higher than that in the non-invasive ones(95.5% vs 69.1%, P=0.013). The expression rate of OPN increased with the increase of Campanacci stages of GCTB, and significant difference was found between different stages(P=O.019). The recurrence status, gender, age, surgery types, duration of illness or site of tumor were not associated with the positive rate of OPN. Conclusion: OPN is highly expressed in GCTB tissues, and the expression is associated with the invasiveness and the Campanacci stages of GCTB.

Objective:To explore the influence of liquid for post-operative irrigation on the effect of ESS.Method:192 cases with chronic sinusitis and/or nasal polyps of groupIIstageII who had undergone the ESS from September,1998 to June,1999 and completed a3-month follow-up were divided randomly into 3 groups to accept 3 different kinds of irrigation liquid.The evaluation of curative effect was according to the index of HaiKou ESS-97.Result:The curative effect of Herba Houttuyniae group was better than the other two.Conclusion:The post-operative care is important and the irrigation liquid can affect the effect of ESS.

Objective To evaluate the urethra lengthening technique in the management of stricture of the external orifice and navicular fossa of urethra. Methods From June 1995 to April 1999,15 cases of severe stricture of the external orifice and navicular fossa of urethra were treated by the urethra lengthening technique and the therapeutic effect was evaluated. Results The patients have been followed up for 3～36 months with a mean of 21 months.Satisfactory results with normal voiding and good apearence of the penis have been observed in all but 2.Slight stricture of the external orifice has been noted in 2 patients and has been relieved after 3～6 times of urethral sounding. Conclusions Urethra lengthening technique yields a high success rate with consistant normal voiding and is compliant with the normal anatomy and physiology of the urethra.

Objective: To study the correlation between serum N terminal pro brain natriuretic peptide (NT-proBNP) concentration and mean pulmonary arterial pressure (mPAP) in patients with congenital heart disease (CHD). Methods: According to mPAP level, a total of 62 CHD patients undergoing transcatheter closure were divided into non- pulmonary artery hypertension （PAH）CHD group (n=26), CHD + mild PAH group (n=17), CHD + moderate PAH group (n=12) and CHD + severe PAH group (n=7). Another 20 healthy subjects in the same period were selected as healthy control group. The changes of serum NT-proBNP concentration was compared among all groups before, 24h and three months after operation. Correlation between NT-proBNP concentration and mPAP was analyzed before transcatheter closure. Results: Compared with healthy control group, there was significant rise in serum NT-proBNP level in all CHD groups before operation, and it significantly elevated along with mPAP increased [healthy control group (34.0±16.8) pg/ml vs. CHD non-PAH group (68.0±20.2) pg/ml vs. mild PAH group (116.7±43.5) pg/ml vs. moderate PAH group (273.1±64.2) pg/ml vs. severe PAH group (326.5±50.2) pg/ml, P<0.01? all]; linear correlation analysis indicated that serum NT-proBNP concentration before operation was positively correlated with mPAP in 62 CHD patients (r=0.604, P=0.002). On 24h after transcatheter closure, NT-proBNP concentration was significantly higher than before operation in all groups, but it possessed significant difference only in non-PAH CHD group [(98.9±22.1) pg/ml vs. (68.0±20.2) pg/ml, P<0.05]. NT-proBNP concentration was significantly lower than before operation in all CHD groups after three months (P<0.01? all). Conclusion: Serum NT-proBNP level rises along with pulmonary arterial pressure increased in patients with congenital heart disease, which could be used as an index judging severity of pulmonary artery hypertension and prognosis in these patients.

The clinical thought is the core and the foundation of clinical ability.The logical teaching strengthens the students'clinical thought most directly and effectively.Through the thought training,the inference thought training and the basic thought rule training the medical students' clinical thought ability can be effectively strengthened.

Objective To investigate the effects of interventions on psychological stress factors of nurses in the emergency department of general hospital. Methods Symptom checklist 90(SCL-90)was used for investigation. The corresponding interventions were conducted based on the found problems. Results The mental health of the nurses in general hospital emergency department was worse than that of the general population. Each factor score, the total average score and the number of items after intervention had significant difference than that before intervention respectively. The incidence rate of top 10 symptoms was significantly decreased after the intervention than that before. Conclusions Implementation of comprehensive intervention can significantly improve the mental health of the nurses in emergency department of general hospital.

Objective To explore the fixation method of tibial helical plate for treatment of proximal and middle one-third of humeral fractures and evaluate the clinical outcome. Methods A review was performed on 15 patients with proximal and middle one-third of humeral fractures treated by tibial helical plate from May 2004 to February 2009. There were 10 males and five females, at age range of 19-65 years ( average 38.0 years). The surgical method was summarized and the shoulder function evaluated.Results The follow-up lasted for 7-24 months (mean 13 months) , which showed bony union in all patients, with mean union time of 4.7 months. There was no implant loosening or failure. According to Neer 's criteria, the result was excellent in seven patients and good in six, with excellence rate of 86.7%.Conclusions Open reduction and internal fixation using tibial helical plate is simple and effective for treatment of proximal and middle one-third of humeral fractures.

Objective To investigate the relationship between level of serum tumor necrosis factorα (TNF-α) and interleukin-12 (IL-12) and the antitumor effects of cantharidin sodium vitamin B6.Methods Forty advanced non-small cell lung cancer patients aged 30 to 80 were divided into experimental groups [paclitaxel + cisplatin (TP program) and sodium cantharidate vitamin B6] and control group (only TP program).Peripheral blood was drawn in the day of admission and the seventh day,the level of serum TNF-α and IL-12 were detected by method of enzyme-linked immunosorbent assay (ELISA),the results were analyzed.The World Health Organization (WHO) anticancer drugs in acute and subacute toxicity grading criteria were used to grade the chemotherapy side effects.Results The level of serum TNF-α and IL-12 were no significant difference on admission.After chemotherapy,serum TNF-α and IL-12 of experimental group was significantly higher than control group (P ＜ 0.000 and P ＜ 0.037,respectively).The serum TNF-α and IL-12 of experimental group had upward trend after chemotherapy.After 3 months of treatment,the remission rate was 85.7％ in experimental group,significantly higher than 57.8％ in the control group (P ＜ 0.05).White blood cells,and platelets decrease in the experimental group were significantly reduced than the control group (P ＜ 0.001 and P ＜ 0.009,respectively),and there are no significant difference in nausea and vomiting reaction between experimental and control groups.Conclusions The antitumor effects of cantharidin sodium vitamin B6 might be related to the high level of serum TNF-α and IL-12,cantharidin sodium vitamin B6 in combination with chemotherapy in patients can reduce white blood cell and platelet decline after chemotherapy.

Objective To investigate the relationship between blood vessel invasion (BVI) and clinicopathologic features and prognosis in patients with gastric cancer,and analyze related factors affecting the prognosis of patients.Methods The clinicopathological data of 206 patients with gastric cancer who were admitted to the Nanjing Hospital Affiliated to Nanjing Medical University from January 2007 to December 2010 were retrospectively analyzed.The BVI of surgical tumor specimens in all patients was detected by immunohistochemical staininng.All the patients were followed up via outpatient examination and telephone interview up to March 2014.The count data were analyzed using the chi-square test.The survival curve was drawn by Kaplan-Meier method.The survival analysis and univariate analysis were done using the Log-rank test,and multivariate analysis was done using the COX regression model.Results The BVI rate of 206 patients was 27.67％ (57/206).The BVI rate of tumor tissues,tumor differentiation,perineural invasion,T stage,N stage and TNM stage in all patients with gastric cancer were compared,showing significant differences (x2=14.396,9.569,15.579,43.453,30.732,P ＜ 0.05).After operation,188 patients were followed up for 6.0-60.0 months (median,34.0 months),with the follow-up rate of 91.26％ (188/206).Among 188 patients with follow-up,the median survival time and 5-year cumulative survival rate in patients with BVI and with negative BVI were 32.4 months and 19.6％,40.7 months and 42.0％,respectively,with a significant difference in the survival of patients (x2 =9.364,P ＜ 0.05).The results of univariate analysis showed that the diameter of tumor,tumor differentiation,perineural invasion,BVI,T stage,N stage and TNM stage were factors affecting the prognosis of patients with gastric cancer (x2=9.241,17.486,11.243,9.364,27.666,216.745,49.887,P ＜ 0.05).The results of multivariate analysis showed that the diameter of tumormore than 5 cm,BVI,stage T4,stage N3 and stage Ⅲ were independent risk factors affecting the prognosis of patients with gastric cancer (HR =0.502,0.456,0.052,0.001,0.735; 95％ confidence interval:0.334-0.754,0.289-0.720,0.004-0.664,0.000-0.006,0.159-3.398,P ＜ 0.05).Conclusions BVI in patients with gastric cancer is associated with the progression of tumors.The diameter of tumor more than 5cm,BVI,stage T4,stage N3 and stage Ⅲ are independent risk factors affecting the prognosis of patients with gastric cancer,and BVI may be a predictor of poor prognosis of patients with gastric cancer.