Background and purpose: Uveal melanoma (UM) is the most common primary intraocular malignancy in adult. Due to a high tendency for early metastasis the treatment of UM is very difficult. This study aimed to explore an effective approach for the treatment of patients with UM, we designed a strategy that combined HtrA2 gene therapy and radiation therapy. Methods:pIRES-Egr1-Omi/HtrA2 (pEgr1-HtrA2) recombinant plasmids were constructed and transfected into human UM cells (OCM-1) in vitro. The transfected cells were exposed to irradiation. HtrA2 mRNA and protein levels were detected by qRT-PCR and Western blot respectively. Assays that evaluated the apoptosis inducibility caused by HtrA2 gene therapy combined with radiation was performed by lfow cytometry. Followingly, the effects of HtrA2 overexpression on the in vitro radiosensitivity of uveal melanoma cells were investigated by clonogenic formation assay. The in vivo effects of HtrA2 gene therapy combined with radiation therapy were evaluated in different groups. Results:The recombinant plasmids could be successfully transferred into OCM-1 cells and transfection of pEgr1-HtrA2 plasmids combined with radiotherapy caused dramatically elevation of HtrA2 compared with non-irradiation cells in mRNA and protein levels, which was associated with increased apoptosis.Furthermore, we observed that the transfection of pEgr1-HtrA2 could significantly enhance radiosensitivity of OCM-1 cell in vitro. In mice bearing xenograft tumors, pEgr1-HtrA2 combined with radiation therapy signiifcantly inhibited tumor growth compared with the other treatment groups (P<0.05). Conclusion:Our ifndings indicate that radiation-inducible gene therapy may have potential to be a more effective and speciifc therapy for uveal melanoma because the therapeutic gene can be spatially or temporally controlled by exogenous radiation.

Objective:To evaluate the effects of maxillomandibular advancement and contrarotation in the treatment of severe com-plicated multilevel obstructive sleep apnea/hypopnea syndrome (OSAHS).Methods:1 2 patients (all males,aged 26 to 56 years) with severe complicated multilevel OSAHS were treated by orthognathic surgery methods of maxillomandibular advancement and cont-rarotation and followed up for 6 -1 2 months.Results:After surgery the symptoms of all patients,such as snoring,waking up be-cause of stoke and streaming with sweat,disappeared or were ameliorated remarkably.The AHI index declined from 51 -70 before operation to 0 -3 after operation.While sleeping,their blood oxygen saturation augmented from 30% -70.1 % presurgically to 93%-99% postsurgically,and their average blood oxygen saturation increased from 60% -72% presurgically to 95% -99% postsurgi-cally in all 1 2 patients.Conclusion:Orthognathic surgery method of maxillomandibular advancement and contrarotation is effective in the treatment of severe complicated multilevel OSAHS.

Objective To summarize the anesthesia management and surgical characteristic of modified extended Morrow procedure in treating hypertrophic obstructive cardiomyopathy (HOCM). Methods This retrospective study was conducted in 139 patients (male 83 and female 56)aged from 1 1 to 66 years.They underwent general anesthesia by high dose intravenous fentanyl or sufentanyl combined with propofol infusion and low concentration sevoflurane inhalation.The surgeons chose ap-propriate surgical procedures,including modified extended Morrow procedure,or combined with mi-tral valve repair (replacement)and coronary artery bypass grafting,etc.All patients received intraop-erative transesophageal echocardiography (TEE ) or epicardial echocardiography monitoring. Results There was no death case in hospital.All patients were hemodynamically stable and there were no malignant adverse events such as ventricular fibrillation during perioperative period.70 (50.4%)of patients automatically recovered to cardiac rhythm after aortic unclamping,and 1 1 (7.9%)of patients needed temporary pacemaker due to atrioventricular block.Cardiopulmonary by-pass (CPB)were weaned off successfully without positive inotropic drugs in 103(74.1%)of patients, while others 36(25.9%)needed low dose dopamine,epinephrine or norepinephrine to maintain hemo-dynamics stable.The CPB time was (142 ± 5 1 )min and the time of aortic clamping was (96 ± 37 ) min.Blood protection was used in all patients and 129 (92.8%)of the patients didn’t receive any blood product.Conclusion Modified extended Morrow procedure was a safe and effective surgical pro-cedure for treatment of HOCM.Experienced teamwork was essential to achieve satisfactory clinical results.The key points of anesthesia management were administration of appropriate preoperative drugs,maintaining adequate anesthesia depth,appropriate preload and afterload,heart rate and rhythm.Intraoperative TEE monitoring was the golden standard for guiding and evaluating the effec-tiveness of the surgical procedures.Meanwhile protection of myocardium,lung,brain and blood can help to obtain satisfactory clinical outcomes.

Objective:To investigate the regulation of proliferation and differentiation of bone marrow mesenchymal stem cells(BM-SCs)by CKIP-1 in vitro.Methods:BMSCs from CKIP-1 nock out(KO)and wild type(WT)C57 mice were isolated and cultured u-sing adherence method in vitro.BMSCs of the 3rd passage were induced to osteogenic and adipgenic differentiation.Cell proliferation was examined by MTT assay.Cell surface markers were tested by FCM.The osteogenic and adipogenic differentiation was studied by alkaline phosphatase (ALP)staining,alizarin red staining and oil red O staining.Results:The proliferation and cell marke expression of the 2 groups were similar.ALP staining of KO group was strong than that of WT group after osteogenic induction.Alizarin red stai-ning showed that there were more mineralized nodules in BMSCs of KO group than in those of WT group.Oil red O staining of KO mice BMSCs was stronger than that of WT.Conclusion:CKIP-1 deficiency can enhance the osteogenic and adipogenic differentiation without influence on the proliferation of BMSCs.

Objective:To standardize the clinical information of the nose.Methods:Based on the 1034 descriptions on the clinical manifestation of nose in the database of the clinical records of Chinese medicine in the past dynasties,according to the hypothesis of symptomatic unit,the symptomatic units,the second-level clinical characteristics and the limiting factors were summarized in the paper.Results:All the descriptions on the clinical manifestation of nose include 11 symptomatic units,7 second-level clinical characteristics and 1 limiting factor.Conclusion:Comparing with the symptoms in the authoritative works of Chinese medicine,cold-feeling of the nose while breathing was the new fi nding,nares flaring and ozena recorded in the authoritative works were the second-level clinical characteristics of polypnea and rhinorrhoea respectively.Nose diseases,such as nasal eczema,were usually diagnosed by several symptomatic units,so they were not symptomatic units.

Objective To study the state and trends of Kesan disease in Henan province from 2004 to 2009. Methods Surveillance sites were selected: Guxian village of Luoning country from 2004 - 2007, Zuyang town of Lingbao city in 2008, and Shahe village of Lushi country in 2009. All residents of surveillance sites were examined by clinical and electrocardiogram, and suspected patients were inspected by chest X-ray to measure ardiothoracic ratio. Hair and wheat flour samples were collected and selenium levels were detected with hydride generation atomic fluorescence spectrometry. Results From 2004 to 2009, a total of 4034 people were examined.The numbers of chronic and latent KSD patients were 21 and 75 cases,respectively, and the incidence rates were 0.52%(21/4034) and 1.86%(75/4034), respectively . The number of abnormal electrocardiogram was 751 cases, and the incidence rate was 18.62%. The highest proportion of abnormal electrocardiogram was ST-T changes,accounting for 24.63%(185/751), followed by high-voltage, accounting for 18.11%(136/751), and left ventricular accounting for 13.85% (104/751). Sixty-one grain samples were collected and the wheat flour selenium level was averaged 0.034 mg/kg. Thirty hair samples were collected and the selenium median was 0.285 mg/kg. Conclusions The state of Keshan disease is in a steady state in Henna province, but higher rates of abnormal electrocardiogram is a serious problem and should be studied and prevented.

Objective To understand Kaschin-Beck disease(KBD) status in Henan Province and provide the basis for the further prevention and treatment of KBD. Methods Children aged 7 to 12 in 3 villages(Yaodian, Miaowa and Zhuyang) with the same environment such as topography, physiognomy,production mode and living habits in Shan County and Lingbao City were selected to undertake KBD clinical examination in 2008, X-ray examination of right hand and child hair samples and food samples were collected to determine the content of selenium. Selenium was determined using 2,3-Diaminonaphthalene method. Adults who were 16 years or older in 5 counties(Luoning, Lingbao, Mianchi, Shah and Lushi) were selected and examined for KBD. Results One hundred and ninty children aged 7 to 12 were clinically examined and clinical KBD were found, whereas 3 children were diagnosed as KBD by X-ray examination, the positive rate was 1.58% (3/190). All 20 521 adults were clinically examined and KBD prevelance rate was 6.10%(1251/20 521), including degree Ⅰ (3.97%,814/20 521), degree Ⅱ (1.77%, 364/20 521 ), degree Ⅲ (0.36%, 73/20 521). The average selenium contents in hair and food samples were (0.319±0.128)mg/kg and (0.031±0.009)mg/kg, respectively. Conclusions Child KBD in Henan Province is under control or almost under control, whereas the prevalence of adult KBD was relatively serious, which suggested that secondary prevention with the objective of clinically treating KBD patients should be strengthened.

OBJECTIVE: To systematically review the efficacy and safety of taxane, cisplatin, and fluorouracil (Tax-PF) as induction chemotherapy for advanced head and neck cancer. METHOD: Literature about the efficacy and safety of Taxane-cisplatin-fluorouracil as induction chemotherapy for advanced head and neck cancer was retrieved from digital databases of PubMed, Embase, SpringerLink, MEDLINE and the Cochrane Library before February 2015. Data extraction and quality assessment of included studies were conducted by two reviewers independently. Stata 13.0 was then used to perform Meta-analysis. RESULT: A total 7 randomized controlled trials involving 2,702 were included. The 3-year OS rate [HR = 1.14, 95% CI (1.03, 1.25), P < 0.01], 3-year PFS rate [HR = 1.24, 95% CI (1.08, 1.43), P < 0.01], 5-year OS rate [HR = 1.30, 95% CI (1.09, 1. 55), P < 0. 01], 5-year PFS rate [HR = 1.39, 95% CI (1.14, 1.70), P < 0.01] and ORR to chemotherapy [OR = 1.66, 95% CI (1.35, 2.05), P < 0.01] of the patients in the Tax-PF group were statistically superior to those in the PF group. In terms of toxicities, the incidence of febrile neutropenia [OR = 2.36, 95% CI (1.62, 3.46), P < 0.01], alopecia [OR = 8.22, 95% CI (3.99, 16.92), P < 0.01], diarrhea [OR = 1.57, 95% CI (1.05, 2.36), P< 0.05] and leucopenia [OR = 2.79, 95% CI (1.86, 4.21), P < 0.01] was higher in the Tax-PF group than that in the PF group. CONCLUSION The Tax-PF induction chemotherapy improved PFS and OS, and the ORR was better as compared to PF-based therapy regimens at the cost of a higher incidence of adverse events.
Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bridged-Ring Compounds ; therapeutic use ; Cisplatin ; therapeutic use ; Fluorouracil ; therapeutic use ; Head and Neck Neoplasms ; drug therapy ; Humans ; Induction Chemotherapy ; Randomized Controlled Trials as Topic ; Taxoids ; therapeutic use

Objective:To investigate the influencing factors for synchronous colorectal liver metastasis (synCRLM).Methods:The retrospective case-control study was conducted. The clinicopathological data of 3 172 patients with primary colorectal cancer (CRC) who were admitted to the Affiliated Hospital of Qingdao University from January 2010 to January 2016 were collected. There were 1 946 males and 1 226 females, aged (63±12)years, with a range from 21 to 97 years. Observation indicators: (1) general data analysis; (2) clinicopathological data analysis; (3) analysis of influencing factors for synCRLM. Measurement data with normal distribution were represented as Mean±SD. Count data were represented as absolute numbers. The influencing factors for synCRLM were analyzed after excluding missing data of tumor differentiation degree, tumor diameter, pathological T stage and N stage. Univariate analysis was conducted by chi-square test or Logistic regression model. Multivariate analysis was conducted by Logistic regression model. Results:(1) General data analysis: among the 3 172 patients, cases with age ≤29 years, from 30 to 39 years, from 40 to 49 years, from 50 to 59 years, from 60 to 69 years, from 70 to 79 years, and ≥80 years were 15, 82, 342, 774, 965, 759 and 235, respectively. There were 2 972 patients in Qingdao, 172 cases in Yantai and 28 cases in Weihai. Of the 2 972 patients in Qingdao, there were 422 cases in Shinan District, 658 cases in Shibei District, 457 cases in Huangdao District, 144 cases in Laoshan District, 188 cases in Licang District, 205 cases in Chengyang District, 252 cases in Jimo District, 221 cases in Jiaozhou City, 255 cases in Pingdu City, 170 cases in Laixi City. (2) Clinico-pathological data analysis: among the 3 172 patients, there were 1 639 cases of colon cancer including 972 cases with left colon cancer and 667 cases with right colon cancer, 1 533 cases of rectal cancer. There were 2 981 cases of adenocarcinoma, 165 cases of mucinous adenocarcinoma, 10 cases of signet ring cell carcinoma and 16 cases of other types including carcinoid tumor, squamous carcinoma, tubular adenocarcinoma, etc.There were 162 cases with highly differentiated adenocarcinoma, 5 cases with highly-moderately differentiated adenocarcinoma, 2 338 cases with moderately differentiated adenocarcinoma, 80 cases with moderately-poorly differentiated adeno-carcinoma, 396 cases with poorly differentiated adenocarcinoma and 191 cases missing tumor differentiation data. There were 708 cases with tumor diameter <4 cm, 1 957 cases with tumor diameter ≥4 cm and 507 cases missing tumor diameter data. There were 486 cases in T1 or T2 stage of pathological T stage, 2 169 cases in T3 or T4 stage of pathological T stage and 517 cases missing tumor pathological T staging data. There were 1 563 cases in N0 stage of pathological N staging, 1 062 cases in N1 or N2 stage of pathological N staging and 547 cases missing tumor pathological N staging data. There were 2 895 cases without synCRLM and 277 cases with synCRLM. There were 2 799 cases without diabetes and 373 cases with diabetes. There were 2 931 cases without fatty liver and 241 cases with fatty liver. There were 2 989 cases negative for hepatitis B surface antigen (HBsAg) and 183 cases positive for HBsAg. (3) Analysis of influencing factors for synCRLM. Results of univariate analysis showed that gender, tumor location, tumor differentiation degree, tumor diameter, pathological T stage, fatty liver, HBsAg were related factors for synCRLM in primary colorectal cancer ( χ2=7.400, 7.577, 7.111, 4.513, 12.125, 5.686, 5.919, P<0.05), and neutrophils counts, lymphocytes counts, platelet counts, alanine aminotransferase (ALT), aspartate aminotrans-ferase (AST), total bilirubin, γ-glutamyltransferase (GGT), triacylglycerol (TG), total cholesterol (TC), carcinoembryonic antigen (CEA), and CA19-9 were related factors for synCRLM in primary colorectal cancer ( odds ratio=1.101, 0.807, 1.002, 1.017, 1.023, 1.027, 1.012, 0.686, 1.169, 1.007, 1.004, 95% confidence interval as 1.048-1.156, 0.678-0.960, 1.001-1.004, 1.011-1.024, 1.016-1.031, 1.011-1.044, 1.009-1.015, 0.541-0.869, 1.047-1.306, 1.006-1.008, 1.003-1.004, P<0.05). Results of multivariate analysis showed that cases as male, case with positive HBsAg, AST, GGT, TC, CEA and CA19-9 were independent risk factors for synCRLM in primary colorectal cancer ( odds ratio=1.503, 2.492, 1.018, 1.007, 1.301, 1.005, 1.003, 95% confidence interval as 1.038-2.178, 1.443-4.304, 1.003-1.034, 1.003-1.011, 1.112-1.522, 1.003-1.006, 1.002-1.003, P<0.05), and lymphocytes, ALT and TG were independent protective factors for synCRLM in primary colorectal cancer ( odds ratio=0.777, 0.983, 0.602, 95% confidence interval as 0.608-0.993, 0.966-0.999, 0.421-0.862, P<0.05). Conclusion:Cases as male, case with posotive HBsAg, AST, GGT, TC, CEA and CA19-9 are independent risk factors for synCRLM in primary colorectal cancer, while lymphocytes, ALT and TG are independent protective factors for synCRLM in primary colorectal cancer.

Objective To compare the virtual non-enhanced chest CT (VNCT)generated from spectral CT with conventional non-enhanced chest CT in patients with lung disease in terms of CT number accuracy and image quality.Methods A total of 30 patients with lung disease proved by pathology underwent the conventional non-enhanced thoracic CT and contrast enhanced CT with spectral imaging mode in arterial phase (AP)and venous phase (VP).The VNCT images were reconstructed based on the enhanced spectral CT imaging data.The mean CT number,signal to noise ratio (SNR)for the lesions and image quality score were obtained and compared between the true non-contrast CT (TNCT)and the VNCT (including AP and VP)with paired t test.Results The mean±standard deviation for CT number were (38.74±5.17)HU,(39.08±5.07)HU and (38.96± 5.18)HU for TNCT,VNCT at AP and VNCT at VP,respectively, with no statistical difference (P>0.05).All 3 sets of images demonstrated acceptable image quality,even though there were statistically significant differences in the SNR value and image quality score.The mean ± standard deviation values for SNR were 4.74±0.42 with TNCT, 3.79 ± 0.5 1 with VNCT at AP and 3.77 ± 0.39 with VNCT at VP (P <0.05),and the image quality scores were 5.00 ±0.00 with TNCT,4.17±0.65 with VNCT at AP and 4.17±0.53 with VNCT at VP (P<0.05).Conclusion In patients with lung disease,the vir-tual non-enhanced CT images generated from spectral CT provide accurate CT numbers for lesions and acceptable image quality com-pared with the true non-contrast CT.VNCT may be used to replace TNCT to improve work flow and reduce radiation dose.