Objective To evaluate the impact of pathologic parameters and lymphatic mierometastasis on 5-year disease-frtee survival in patients with stages Ⅰ and Ⅱ colorectal cancer.Methods Surgical operation was performed in 126 patients with stage Ⅰ and Ⅱ colorectal cancer.Sixteen (range,10-28)lymph nodes were harvested in each specimen and immunohistochemical staning was performed. Theimpact of pathologic parameters and lymphatic micrometastases in survival was estimated by KaplanMeier.Results The mean follow up time was 64.11 (range,64-106) months. Multivariate analysisrevealed that lymphatic vessel invasion and depth of tumor invasion were correlated with positive CEA in lymph node,and unrelated with clinical pathologic factors.There was no significant difference between pathologic parameters and five year disease-free survival rates. The five-year diseasse-free survival rates was 75.4 percent in CEA negative patients,68.2 percent in patients with isolated tumor cells,and 46.2 percent in patients positive for micrometastasis.There was no significant difference in 5 year disease-free survival between CEA negative patients and patients with isolated tumor cells (P=0.245).However,the5-year disease-free survival was lower in patients positive for micrometastases compared to CEA negativepatients (P=0.003).Conclusions The presence of micrometastases in patients with stages Ⅰ and Ⅱ colorectal cancer may result in poor prognosis and high recurrence,and adjuvant chemotherapy will bejustified and effective.

Objective To investigate the relationship between gastrin expression and the development of coloreetal neoplasm and cell proliferation.Methods 15 samples of normal coloreetal mucosal tissue,21 samples of coloreetal adenomas and 70 samples of colorectal cancer were selected for evaluation of the expression of gastrin and Ki67 with immunohistochemieal method.Results In normal colorectal mucosal tissues.colorectal adenomas and coloreetal cancer,the positive rates of gastrin expression were 0.28.6%and 25.7%,respectively-which were signff-ieantly hisher in coloreetal cancer and adenomas groups than in the normal colorectal mucosal tissues(P<0.05).But there was no significance between colorectal cancer and adenomas(P>0.05).The positive expression rate of Ki67 with the obove samples were 40.0%,76.2%and 82.8%-respectively,with statistical results identical with results of gastrin(P<0.05).There was significant correlation between gastrin and Ki67[P<0.05).Conclusion Gastrin and Ki67 are highly expressed in eolorectal neoplasm.Gastrin miight play an important role in the carcinogen-esis and development of colorectal neoplasm,and might promote tumor cell proliferation.

Objective To evaluate the prognostic impact of a wide spectrum of pathologic parameters in a consecutive series of homogenously treated and well-characterized patients with stage Ⅰ and Ⅱ colorectal cancer, and to investigate the prognostic value of lymph node occult disease (micrometastasis) in disease-free survival rate detected by immunohistochemistry with epithelial membrane antigen and carcinoembryonic antigen. Methods The study included 126 patients operated on by a single surgeon for stage Ⅰ and Ⅱ colorectal tumors. The postoperative follow-up was performed for 64 to 106 months. At least 10 lymph nodes were harvested and examined in all the specimens. The prognostic value of 10 pathologic parameters, including lymph node occult disease (micrometastasis) detected by immunohistochemistry was investigated. Results Multivariate analysis identified lymphatic vessel invasion (absent or present;P=0.009) in lymph node positive and negative by immunohistochemistry. The five-year disease-free survival rates were 78.7%, 65.5% and 43.8% for the lymph node negative, isolated tumor cells and micrometastasis groups, respectively. There was significant difference between the lymph node negative and micrometastasis groups (P=0.005). However, the difference between the lymph node negative and isolated tumor cells groups was not statistically significant (P=0.144). Conclusions We propose that for patients found micrometastasis in lymph node with high-risk stage Ⅰ and Ⅱ colorectal cancer, adjuvant therapies are justified and effective.

Objective:To investigate the orthopedists' cognition on Chinese Osteoarthritis Guideline (2018 Edition).Methods:Questionnaire about Chinese Osteoarthritis Guideline (2018 Edition) was developed and sent to orthopedists via an invitation link to fill out after authorization from Chinese Osteoarthritis Association. The content of the questionnaire included the basic personal information of the physician, the awareness rate of the guidelines, the evaluation of the guidelines, and its application effects. The survey duration was from September 2019 to December 2019. Multivariate logistic regression and linear regression analysis were performed for the guideline awareness rate and comprehensive score, respectively.Results:A total of 628 physicians completed the questionnaire, of which 623 of 628 (99.2%) were available. About 72.4% of the orthopedists knew the guideline. The awareness rate was statistically related to the education of the physicians ( P<0.05). Respondents' overall score for the guideline was 8.39 with methodological score 8.28. A total of 41.2% of orthopedists thought that the guideline was very good compared with the European and American guidelines, and the clinical problem coverage rate was 78.6%. There is a statistically significant difference in the appraisal of the recommendations ( χ2=138.9, P<0.05) . More than 40% of orthopedists believed that the guidelines were of great help to orthopedists and patients, and that the guide could be promoted to the primary hospitals. Conclusion:After one year publication of Chinese Osteoarthritis Guideline (2018 Edition), most orthopedists have understood the present guideline and applied recommendations in clinical practice. However, the guideline need to be further promoted and disseminated in the future.

OBJECTIVE To investigate the effects and mechanism of atractylodin on inflammatory injury of periodontal tissue and alveolar bone loss in periodontitis rats. METHODS A total of 144 SD rats were divided into control group （intragastric and intraperitoneal injection of normal saline）， model group （intragastric and intraperitoneal injection of normal saline）， atractylodin low-dose， medium-dose and high-dose groups （intraperitoneal injection of 6.665， 13.33， and 26.66 mg/kg atractylodin）， metronidazole group （positive control group， intragastric injection of 0.05 g/kg metronidazole， intraperitoneal injection of normal saline）， AMD3100 [stromal cell-derived factor-1 （SDF-1）/CXC chemokine receptor-4 （CXCR4） pathway inhibitor] group （intragastric injection of 1 mg/kg AMD3100， intraperitoneal injection of normal saline）， atractylodin high-dose+AMD 3100 group （intraperitoneal injection of 26.66 mg/kg atractylodin， intragastric injection of 1 mg/kg AMD3100）， with 18 rats in each group. Except for the control group， all other groups of rats were inoculated with Porphyromonas gingivalis to construct a periodontitis model. After successful modeling， they were given relevant medicine or normal saline， once a day， for 4 consecutive weeks. The gingival index of rats was detected； the levels of interleukin-6 （IL-6） and tumor necrosis factor α （TNF-α） in rat serum were also determined； alveolar bone resorption， periodontal histopathologic changes and the number of osteoclasts were detected by methylene blue staining， HE staining and TRAP staining， respectively. The expressions of osteoprotegerin （OPG）， receptor activator of NF-κB ligand （RANKL）， SDF-1 and CXCR4 proteins were determined. RESULTS Compared with the control group， serious pathological injury of periodontal tissue was found in the model group， the gingival index， the levels of IL-6 and TNF- α， alveolar bone absorption value， the number of osteoclasts， and the expression of RANKL protein were all increased significantly （P＜0.05）， while the expressions of OPG， SDF-1 and CXCR4 proteins were decreased significantly （P＜0.05）. Compared with the model group， pathological injury of periodontal tissue in rats was reduced； the gingival index， the levels of IL-6 and TNF-α， alveolar bone resorption value， osteoclast number and RANKL protein expression were decreased significantly， while protein expressions of OPG， SDF-1 and CXCR4 were increased significantly in atractylodin low-dose， medium-dose and high-dose groups and metronidazole group （P＜0.05）. The change trend of corresponding indexes in the AMD3100 group was opposite to the above （P＜0.05）. AMD3100 attenuated the inhibitory effect of high-dose atractylodin on inflammatory response and alveolar bone loss in rats with periodontitis （P＜0.05）. CONCLUSIONS Atractylodin may improve the inflammatory response and alveolar bone loss in periodontitis rats by activating the SDF-1/CXCR4 signaling pathway.