According to the ultrasonic manifestations of the gall bladder before laparoscopic cholecystectomy(LC),including size,morphology,wall thickness,presence or absence of gallstone,congenital anomaly of biliary duct,surrounding adhesion and state of common bile duct,tbe patients Werc dividcd into 4 groups:A.Most suitable for LC,B.Sitable for LC,C.Relatively suitable for LC. D.Not suitable for LC.This provided clinicians the basis for patient selection.Comparing with the sur.gical findings,the coincidence rate of B-mode ultrasonography was 97.8%.Preoperative B-mode ul-trasonography of gall bladder has significant clinical value to relieve the patients from pain,decrease the operative risk and conversion rate of LC.

Objective To explore factors associated with incision infection in elderly patients undergoing general surgery and thus provide a basis for its clinical prevention.Methods Retrospective clinical data of 2985 elderly patients who underwent routine surgical operation after admission to the Department of General Surgery from Feb.2009 to Dec.2013 were analyzed.Patients with incision infection following surgery were assigned into the infection group,while patients without incision infection served as the control group.Single factor analysis and multivariate Logistic regression analysis were conducted to identify factors responsible for incision infection.Results There were 91 cases with incision infection,constituting a rate of 3.0％.Compared with the control group,patients in the infection group showed an older average age [(67.3±5.8) years vs.(63.0± 5.6) years,t=1.906,P＜0.05],a longer average operating time [(2.13±0.26) hours vs.(1.87±0.24) hours,t=10.149,P＜0.001],and a longer average incision length [(8.14±2.62) cm vs.(7.59±2.14) cm,t=2.396,P＜0.01].In addition,compared with the control group,more patients in the infection group received prophylactic antibiotics (74.7％ vs.83.3％,x2 =4.819,P=0.032),exhibited malnutrition (20.9％ vs.10.0％,x2 =11.418,P=0.001),and had diabetes mellitus (11.0％ vs.5.1％,x2 =5.968,P=0.015).Therefore,independent risk factors for incision infection included age (OR=1.89),operating time (OR=3.32),nutritional status (OR=2.08) and diabetes mellitus (OR=3.18).Conclusions A few risk factors may contribute to incision infection.Clinicians should take necessary preventive measures accordingly to minimize its occurrence.

Objective To study the effect of serum leptin in “two hits” of nonalcoholic fatty liver disease (NAFLD).Methods Fasting serum leptin(LEP) ,malondialdehyde(MDA) ,hyaluronic- acid(HA) ,type Ⅲ procollagen ( PCⅢ), laminin ( LN), and type Ⅳ collagen ( Ⅳ-C ) were detected in 43 simple nonalcoholic fatty liver( NAFL ) patients ,41 NASH patients and 40 healthy subjects. Insulin resistance was estimated by HOMA value and its relatio nship with leptin level in NAFLD was analyzed. The severity of lipid peroxidation was estimated by MDA and its relationship with leptin level in NAFLD was analyzed. The relationship of serum fibrosis markers with leptin level in NAFLD also was analyzed. Results Serum leptin, HOMA value in NAFLD were higher than those of healthy controis. MDA,PC Ⅲ 、Ⅳ-C 、LN 、HA in NASH were higher than those of healthy controls or simple NAFL patients. ,HOMA value, in NAFLD positively correlated with leptin. MDA, PC Ⅲ、 Ⅳ-C 、LN、HA in NASH positively correlated with leptin. Conclusion Serum leptin closely correlated with insulin resistance which results in “First hit” of NAFLD. There was certain relationship of leptin with “Second hit” of NAFLD. Leptin should be one of the factors which result in liver fibrosis.

Purpose To detect the expressions of stress induced phosphoprotein 1 (STIP1) and estrogen receptor-α(ER-α) in papil-lary thyroid carcinoma and to analyse the relationship between STIP1 and ER-α. Methods 54 cases of paraffin-embedded tissues of papillary thyroid carcinoma, 18 cases of papillary thyroid carcinoma with lymph node metastasis, 15 cases of Hashimoto’ s thyroiditis, 10 cases of adjacent normal thyroid tissue were collected. The expressions of STIP1 and ER-αwere detected by immunohistochemistry, and the relationship between the expressions and clinicopathological features of papillary thyroid carcinoma was analyzed. Results The expression of STIP1 and ER-α in papillary thyroid cancer group ( 55. 6% and 44. 4%) were higher than that of normal thyroid group (10% and 0) and Hashimoto’s thyroiditis group (8. 3% and 0, all P<0. 05). STIP1 expressions was related to lymph node metastasis ( P<0. 05 ) , while ER-α expression was related to gender, TG-Ab and the merger of nodular goiter, but not related to lymph node metastasis (P>0. 05). The expressions of STIP1 and ER-α in papillary thyroid carcinoma were not related to patients’ age , tumor location, number of tumors, tumer size, invasion of capsule, the concomitant Hashimoto’ s thyroiditis and TPO-Ab ( all P>0. 05). And the expressions of STIP1 was not related to gender, TG-Ab and the merger of nodular goiter (all P>0. 05). A positive correlation was found between the expressions of STIP1 and ER-αin thyroid papillary carcinoma (P<0. 05). Conclusion STIP1 and ER-α in papillary thyroid carcinoma may be related with lymph node metastasis.

Objective The aim of this study was to investigate the masculinizing effects of progesterone ( PRO) exposure at different concentrations on the morphology of female mosquitofish (Gambusia affinis).Methods Immature female G.affinis individuals were put into static water with 0.5, 5, 50 and 500 nmol/L progesterone (n=56), respective-ly.In addition, control group and parallel groups were set up .After 42-day-long exposure, we measured four main indexes of the G.affinis:the body length, body weight, morphological changes in the anal fin 3rd fin and the 14, 15 and 16 verte-bral ribs.We also observed the state of ovarian development .Results The body lengths (BL) of experimental groups ex-posed at concentration of 50 and 500 nmol/L progesterone for 42 d showed significant differences , respectively ( P<0.01 for both), when compared with those of the control group .The body weights (BW) of experimental groups exposed to pro-gesterone at all concentrations were significantly or very significantly decreased (P<0.05 or P<0.01).Only the proges-terone at 5 nmol/L concentration showed significant effect on the body health index (CF) (P<0.05).The section number (FJ) of the anal fin 3rd fin, the section length (FL)and the widest portion width (FW)in the experimental groups had sig-nificant difference (P<0.05), respectively, showing significant changes in morphology after the exposure to 500 nmol/L progesterone .However , there was no significant difference between the values resulted by progesterone in other concentra -tions (P>0.05).When exposed to 500 nmol/L PRO, the L, D and L:D values of the 14th, 15th and 16th vertebral ribs of the female G.affinis had very significant difference ( P<0.01 for all ) , respectively , indicating significant changes of morphological masculinization .Histological examination revealed that the developmental status of the ovaries of G.affinis in the experimental groups were to different degrees inhibited , and the nuclei appeared swelling in stage II and III oocytes . Conclusions The results of this study indicate apparent masculinizing effects of progesterone on immature female mosquit -ofish.

Objective To investigate the expression and the clinical significance of meningioma-association protein（MAC30）mRNA and protein in colorectal carcinomas.Methods MAC30 was immunohistochemically examined in 130 primary tumours,73 distant normal mucosa specimens and 34 lymph node metastases from rectal cancer patients＇paraffin embedded blocks.MAC30 mRNA expression was detected by RT-PCR in primary tumors,adjacent and distal normal mucosa of 50 rectal cancer patients underwent colectomy.Results MAC30 cytoplasmic expression level in colorectal primary tumors and lymph node metastases was significantly higher than that in distant normal mucosa.MAC30 mRNA expression was upregulated in primary tumor,and the expression level was related to the histologic type of the tumor.Three-year survival rate of the colorectal carcinomas patients with strong expression of MAC30 was significantly lower than that of the patients with weak MAC30 expression（P 0.05）.Conclusion MAC30 overexpression might be involved in the development of colorectal carcinomas and seemed to be a prognostic factor.

Objective To evaluate the clinical significance of rearrangements during transfection of papillary thyroid cancer (RET/PTC) 1,3 in fine needle aspiration (FNA) specimen from regional thyroid nodules by FQ-PCR.Methods Two hundred and eighty-five FNA samples were collected from patients with thyroid nodules during January 2012 to January 2013.RET/PTC1,3 rearrangements were detected with FQ-PCR.Results The frequencies of the RET/PTC1 and RET/PTC3 rearrangements in 285 FNA samples were 17.2％ (49/285) and 1.4％ (4/285),respectively.During 21.7 months of follow-up,19 (40.4％,19/47) RET/PTC1 positive patients were confirmed to have papillary thyroid carcinoma(PTC) after operation.In the patients with RET/PTC1 rearrangement PTC was found in Thy5 and Thy4 groups.In Thy 2 group,22.6％ cases with RET/PTC1 rearrangements developed PTC as compared with 3.2％ cases without it(x2 =6.667,P＜0.01).In addition,8.5％ (4/47) RET/PTC1 rearrangements emerged in benign lesions.Conclusions It is convenient and reliable to detect RET/PTC1,3 rearrangements by FQ-PCR using FNA samples.RET/PTC1 rearrangement frequently occurs in PTC,however it would be detected in benign lesions occasionally.

Objective To explore the prognostic values of telomerase reverse transcriptase promoter (TERTp) mutation and 1p/19q co-deletion in newly-diagnosed O6-methylguanine-DNA methyltransferase (MGMT) promoter un-methylated/isocitrate dehydrogenase (IDH) wild-type glioblastoma multiform (GBM). Methods A total of 82 patients pathologically newly-diagnosed MGMT promoter un-methylated/IDH wild-type GBM, admitted to our hospitals from March 2016 to November 2018, were included in this study. TERTp mutations (TERTp wild-type and TERTp mutation [C228 mutation and C250 mutation]) in GBM specimens were detected by PCR sequencing, 1p/19q co-deletion in GBM specimens was detected by fluorescence in situ hybridization (FISH), and clinical data, adverse reactions and prognoses of patients with different molecular typing were compared. Results There were 33 patients in the TERTp wild type group with mean age of 48 years, and 49 patients in the TERTp mutation group with mean age of 59 years; the difference of age was significant (P<0.05); there were no statistical differences in gender distribution, Karnofsky performance status (KPS) scores, tumor sites and surgical resection degrees between the two groups (P>0.05). There were 8 patients with 1p/19q co-deletion and 74 patients without 1p/19q co-deletion; no significant differences in above clinical parameters were noted between the two groups. There were no statistically significant differences in the incidences of bone marrow suppression, digestive tract response and fatigue, disease progression rate, or survival rate between patients from TERTp wild type group and TERTp mutation group, and between patients with 1p/19q co-deletion and patients without 1p/19q co-deletion (P>0.05). No significant differences in above clinical parameters, disease progression rate, and survival rate were noted between patients with C228 mutation and C250 mutation (P>0.05). Conclusion TERTp typing and 1p/19q co-deletion status do not have prognostic value in newly-diagnosed MGMT un-methylated/IDH wild-type GBM patients; patients with TERTp mutations have older age than wild-type patients; patients with C250 mutation trend to have higher survival rate than those with C228 mutation.

Objective:To study lncRNA MEG3 expression and its relationship with Th17/CD4+T cells in patients with non-small cell lung cancer(NSCLC)with different pleural effusion severity and prognosis.Methods:A total of 104 NSCLC malignant pleural effusion patients admitted to Quanzhou First Hospital Affiliated to Fujian Medical University from January 2020 to December 2022 were selected as research subjects,and divided into three groups based on amount of pleural effusion,including small amount of pleural effusion group(35 cases),moderate amount of pleural effusion group(42 cases)and large amount of pleural effusion group(27 cases).According to actual development and prognosis of patient's disease,they were divided into good prognosis group(29 cases without recurrence and metastasis)and poor prognosis group(75 cases with recurrence and metastasis).Another 60 patients with benign pleural effusion due to pneumonia who were treated in Quanzhou First Hospital Affiliated to Fujian Medical University at same time were selected as control group.MEG3 expression in pleural effusion of two groups was detected by real-time fluorescent quantita-tive PCR,and peripheral venous blood of subjects was collected.Th17 cell and CD4+T cell ratios of peripheral blood were detected by flow cytometry,and Th17/CD4+T was calculated.lncRNA MEG3 and peripheral blood Th17 and CD4+T levels in each group of patients compared.Logistic regression analysis was used to analyze pleural effusion and prognostic factors in NSCLC.Results:lncRNA MEG3 expression and CD4+T percentage in pleural effusion in NSCLC group were lower than control group,while Th17 percentage and Th17/CD4+T were higher than control group(P<0.05).lncRNA MEG3 expression and CD4+T percentage in large pleural effusion group were lower than small and moderate pleural effusion groups.lncRNA MEG3 expression and CD4+T percentage in modarate pleural effusion group were lower than small pleural effusion group,while Th17 percentage and Th17/CD4+T in large pleural effusion group were higher than small and moderate pleural effusion groups.Th17/CD4+T was higher in small amount pleural effusion group(P<0.05).lncRNA MEG3 expression and CD4+T percentage in poor prognosis group were lower than those in good prognosis group,while Th17 percentage and Th17/CD4+T were higher than good prognosis group(P<0.05).Logistic regression analysis showed that lncRNA MEG3 was a protective factor for NSCLC pleural effusion,and Th17/CD4+T was a risk factor(P<0.05),lncRNA MEG3 was a protective factor of NSCLC prognosis,and Th17/CD4+T was a risk factor(P<0.05).Conclusion:lncRNA MEG3 expression and Th17/CD4+T in NSCLC patients with different pleural effusion severity and prognosis is not same.lncRNA MEG3 is a risk factor for NSCLC pleural effusion and prognosis,while Th17/CD4+T is a risk factor,which can be used as an effective biomarker for pleural effusion severity and progno-sis diagnosis.

According to the pathological characteristics of symptomatic chronic thoracic and lumbar osteoporotic vertebral fracture (SCOVF), the different clinical treatment methods are selected, including vertebral augmentation, anterior-posterior fixation and fusion, posterior decompression fixation and fusion, and posterior correction osteotomy. However, there is still a lack of a unified understanding on how to choose appropriate treatment method for SCOVF. In order to reflect the new treatment concept and the evidence-based medicine progress of SCOVF in a timely manner and standardize its treatment, the clinical guideline for surgical treatment of SCOVF is formulated in compliance with the principle of scientificity, practicability and advancement and based on the level of evidence-based medicine.