Lymph node metastasis is the main prognostic factor of endometrial cancer patients.As the metastasis of early endometrial cancer patients is very low,it remains a controversy whether these patients are necessary to undergo conventional lymphadenectomy and a challenge to confirm the scope of lymph node dissection.We intend to demonstrate the application of lymphadenectomy in patients with early endometrial cancer via the impact of lymphadenectomy on the prognosis of these patients.The risk factors for lymph node metastasis of endometrial cancers were analyzed to explore its value in the surgical option.Furthermore,the guidance of sentinel lymph node in surgical staging and prognostic prediction of early endometrial cancer was explored to clarify the applied condition and scope of lymphadenectomy in these patients.

Stem ceils transplantation is one of the potential therapeutic strategies for Alzheimer's disease (AD). Many animal models following stem cell transplantation showed improvement in memory and cognitive function. However, the pathological changes in AD, such as arnyloid beta deposits, negatively affect the survival and differentiaition of stem cells. Stem cells transfectcd with neprilysin or administration of phenserine could at-tenuate these adverse effects. Genetic modification of stem cell by over expression of neurotrophic factors could attenuate the adverse effects not only on stem cells but also on degenerative neurons. Further investigation on how to overcome the adverse effects of phathological factors in AD on stem cells and maximize the therapeutic effects of stem cells would support the hope for introduction of stem cells transplation into clinical application.

Objective:To evaluate the effects of smokeless tobacco extract(ST) on number,morphology,ultrastructure and proliferation of human gingival fibroblasts(HGFs) on titanium in vitro.Methods:HGFs on titanium were cultured in the presence of ST at various concentrations.The cell changes in the morphology and ultrastructure were examined by scanning electrical microscope(SEM).The growth and attachment of the cells were measured by MTT method.Results:The size of the cells became smaller gradually and their shapes changed from spindle type to oval or round when the concentrations of ST increased.Ultrastructure showed that pseudopod decreased in number,the growth and attachment were dose-dependently inhibited.Conclusion:ST can change number,morphology and ultrastructure of HGFs on titanium,they can inhibit the cells growth,suggesting ST may play a pathological role on implant-gingiva interface.

Objective To evaluate the clinical diagnosis of gastric stromal tumors and the safety and feasibility with laparoscopic wedge resection.Methods The clinical data of diagnosis and treatment were retrospectively analyzed in 43 cases diagnosed as gastric stromal tumors by endoscopyic ultrasonography.Results Thirty-six cases were successful by laparoscopic surgery success rate being 83.7%.Endoscopic ultrasonography diagnosis rate was 69.0%.The positive rate of CD117 and CD34 in postoperative diagnosis of gastrointestinal stromal tumor wasl00%.The mean post-operative hospital stay was 5 days.Conclusion Endoscopyic ultrasonography can be selected as a main method for clinical diagnosis of gastric stromal tumors and laparoscopic resection was safe and feasible.

Objective To undenstand the effects of performing the project of water and environmental sanitation (WES) on the environmental sanitation in countryside. Methods In the WES project-performed counties, the densities of fly and maggot, and the odor complains in household latrines were investigated, the status of peasants' hygienic knowledge and personal sanitary behavior and habits, and satisfaction at the sanitary latrines were investigated by means of a unified questionaire in 8 latrine-improved villages and one latrine-unimproved village (control village). Results The densities of fly and maggot and the oder complains in household improved latrines were all significantly lower than those in control household latrines. In the WES project-performed villages, higher levels of hygienic knowledge, better sanitary behavior and habit were observed in peasants compared with those in control village. 94.0% of the peasants in latrine-improved households satisfied the sanitary latrines. Conclusion Performance of WES project rose the whole level of the environmental sanitation in rural area.

Objective:To investigate the effects of titanium spcimens with different surface character on the proliferation and mRNA expression of IL-6 and Cbfα1 in osteoblasts.Methods:Titanium surface was treated by smooth pretreatment(PT),sandblast and acid etch(SLA)and anodic oxidation(AD)respectively.The morphology and the elements analysis of the spcimens were inspected and detected by SEMand EDS.The surface contact angle was measured by contact angle meter.MC3T3-E1 cells were cultured on the titanium surface and cells cultured on tissue culture plate were served as the control group.The proliferation was measured by MTT assay.The mRNA expression of IL-6 and Cbfα1 was quantified by RT-qPCR.Results:The sample surface in PT group showed scrat-ches,in SLA group showed multiple three dimensional structure,in AD group exhibited porous structure.The elements of the sample surface of group PT,SLA and AD were Ti,Ti/Al and Ti/O respectively;the contact angles were 54.47°±3.33°,75.42°±8.32° and 38.91 °±4.00°respectively(P<0.05).The cells in AD group showed higher proliferation than those in PT and SLA groups(P<0.05).In AD group IL-6 mRNA expression decreased and Cbfα1 mRNA increased more than in PT and SLA groups(P<0.05). Conclusion:Titanium spcimens treated with AD may promote cell proliferation,decrease IL-6 mRNA expression and increase Cbfα1 mRNA expression in MC3T3 cells.Implats treated with AD might have some advantages in early osseointegration.

BACKGROUND:Studies have confirmed that nicotine affects the activity of osteoblasts, osteoclasts, fibroblasts and erythrocytes.
OBJECTIVE:To study the nicotine effects on osseointegration and the expression of osteoprotegerin and bone morphogenetic protein 2 after implantation of dental implants with surface treatment by sandblasting or acid etching.
METHODS:Twenty-four Sprague-Dawley rats were randomly assigned to two groups and received daily injections for 2 weeks as folows: Nicotine 2 mg/kg twice for experimental group, saline solution for control group. Then the titanium implants with surface sandblasting or acid etching were implanted into the tibiae folowed by continuous nicotine or normal saline injection. At weeks 2 and 4 after implantation, the implants and surrounding bone tissue were prepared for CT, X-ray and hematoxylin-eosin staining examinations to evaluate bone healing and expression levels of bone-related genes were measured by quantitative RT-PCR.
RESULTS AND CONCLUSION: Compared with the control groups, the degree of osseointegration and the expression of osteoprotegerin and bone morphogenetic protein 2 in the experimental groups were decreased significantly (P < 0.05), except that the expression of bone morphogenetic protein 2 in the experimental group with acid etching was not significantly reduced. In addition, the expression of bone morphogenetic protein 2 in the experimental group with acid etching was higher than that in the experimental group with sandblasting at 2 weeks after implantation (P < 0.05). The X-ray and CT show that the quantities of new generation bone and the degree of bone mineralization of the sandblasting group were significant lower than those of the acid etching group under the intervention of nicotine. Hematoxylin-eosin staining showed that the activity and quantity of osteoblasts around the implants down-regulated significantly, but acid etching-treated implants showed better outcomes than sandblasting-treated implants.

The study was aimed to examine the prevalence of depression in patients with Parkinson's disease (PD) and identify its features. A total of 131 out-patients, diagnosed as having idiopathic PD in accordance with the United Kingdom Parkinson's Disease Society Brain Bank criteria, were interviewed with questionnaire and evaluated by Mini-Mental State Examination (MMSE), Unified Parkinson's Disease Rating Scale (UPDRS), Hohen &Yahr staging (H&Y staging) and Hamilton Rating Scale for Depression (HRSD). Patients were divided into three groups in terms of HRSD score: depression group, sub-threshold depression group and non-depression group. The clinical variables and symptom profiles were obtained and compared among the three groups. The results showed that 27 patients (20.6%) fell into the depression group, 71 (54.2%) into the sub-threshold depression group, and 33 (25.2%) into the non-depression group. There were no differences in age, gender or tremor score among the groups (P>0.05). Significant differences were found in duration of PD, UPDRS score, rigidity score and H&Y stage between the sub-threshold depression group (or the depression group) and the non-depression group (P<0.05). Moreover, the clinical variables in the subthreshold depression group had the trend of increasing with the severity of PD and their values were similar to those in the depression group. Anhedonia, feeling of incapability, sleep disturbance, gastrointestinal symptoms and depressive moods were most common in the depression group. And these symptoms also were more common in the other two groups. It is concluded that depression and sub-threshold depression are common in PD and share similar clinical features. Furthermore, subthreshold depression might be the prodrome of depression and may develop into depression as the condition progresses.

Objective To observe the effect of intermedin (IMD) preconditioning on cyclin D1, cyclin E and CDKs expression, and explore its role in.promoting kidney tissue regeneration after renal ischemiareperfusion injury. Methods One hundred and forty-four healthy male Wistar rats were randomly divided into four groups: sham operation (S) group, ischemia-reperfusion injury (IR) group, empty plasmid (EP) group and IMD group. In the IR group, after the right kidney was excised, the aorta abdominalis and left renal artery were bluntly dissected in EP and IMD group, empty plasmid and IMD plasmid were transfected into the left kidney using ultrasound-micro-bubble (SonoVue) mediated system, respectively. One week later, renal IRI model was made by clasping the left renal artery for 45 min. After 1, 2, 3, 4, 7 and 14 day of reperfusion, the kidney in each group was collected to detect the expression of cyclin D1, cyclin E, CDK4 and CDK2 by western blot analysis or enzyme-linked immunosorbent assay (ELISA). Results Compared with S group, the expression of cyclin D1, cyclin E, CDK4 and CDK2 was significantly up-regulated in day 1, 2,3, 4, 7 and 14 in IR group. And the above index increased gradually after reperfusion, and reached the peak at day 7 (F=54.92, 69.60, 61.28, 77.38, P＜0.05). While in IMD group, these indexes reached the peak at day 1, then progressively declined, and could not be detected at day 14 (compared with the IR group, F=54.92, 69.60, 61.28, 77.38, P＜0.05). Conclusion IMD preconditioning can up-regulate the expression of cyclin D1, cyclin E, CDK2 and CDK4 in the early phase of renal ischemia-reperfusion injury that may accelerate repair of renal tissue, at least by part, by enhancinge cell proliferation.

Objective To investigate the correlation between immediate postoperative platelet count with liver failure after partial hepatectomy in patients with hepatocellular carcinoma.Methods The clinical data of 71 patients with hepatocellular carcinoma who underwent liver resection at the Hepatopancreatobiliary Surgery Department of Nanjing Drum Tower Hospital from July 2013 to August 2015 were retrospectively analyzed.The clinical diagnosis was confirmed by pathology of the resected specimens.Based on postoperative platelet count within 2 h,the patients were divided into the low platelet count (PLT ＜ 100 × 109/L) group (n =24,33.8％) and the normal platelet count (PLT ≥ 100 × 109/L) group (n =47,66.2％).The correlations between immediate postoperative platelet count with serum indexes including serum alanine aminotransferase (ALT),aspartate aminotransferase (AST),total bilirubin (TBil) and direct bilirubin (DBil) were analyzed,and the incidences of posthepatectomy liver failure was also evaluated in these two groups.Results There was no re-operation and perioperative death in this study.Among the 71 patients,25 patients (35.2％) developed postoperative complications (grade Ⅰ to Ⅲ),and 8 patients (11.3％) suffered from postoperative liver failure (grade A).When compared with the normal platelet count group,the low platelet count group had significantly increased risks of postoperative liver failure (29.2％ vs 2.1％,X2 =11.618,P ＜ 0.05),increased postoperative peaks of ALT,AST,TBil and DBil levels [(462.5 ±135.7)U/L vs (307.9 ± 192.6) U/L,(440.0 ± 163.3) U/L vs (265.8 ± 155.8) U/L,(29.5 ±9.1) μmol/L vs (17.9 ±8.8) μ mol/L,t =3.507,4.385,5.129,P ＜0.05,respectively] and longer normalization time of liver function.Multiple Logistic regression analyses revealed that an immediate postoperative low platelet count was an independent risk factor of posthepatectomy liver failure.Conclusions The platelet count was associated with the incidence of postoperative liver failure after partial liver resection in patients with hepatocellular carcinoma.Patients with an immediate postoperative low platelet count suffered from a high incidence of posthepatectomy liver failure and delayed liver function recovery.