Objective To investigate the predictive value of metabolic tumor volume (MTV) in angiogenesis and hematoge‐nous metastasis of patients with colorectal cancer .Methods Totally 108 patients with colorectal cancer from January 2011 to De‐cember 2015 were enrolled into the study and divided into metastasis group (n=42) and non‐metastasis group (n=66) according to whether combining with hematogenous metastasis .All patients received 18 F‐2‐fluoro‐D‐glucose positron emission tomography/com‐puted tomography (18F‐FDG PET/CT) before operation ,then used the PET VERA software to automatically calculate MTV ac‐cording to the 40% of standard uptake value max(SUVmax ) as the threshold .The blood vessels were identified with CD34+ immu‐nohistochemical staining ,then measured the microvessel density (MVD) .The clinical pathologic data ,SUVmax ,MTV and MVD were compared between metastasis group and non‐metastasis group .The area under the receiver‐operating characteristic curve (AUC) was performed to evaluate the predictive value of MTV on hematogenous metastasis .Results SUVmax ,MTV and MVD in metastasis group were significantly higher than that in non‐metastasis group (P<0 .05) .There were significant differences in MTV and MVD among patients with different T stage (P<0 .05) .Pearson correlation analysis results showed that MTV was positively correlated with MVD (r=0 .636 ,P<0 .001) ,and there was no significant relationship between MTV and SUVmax (r= 0 .161 ,P=0 .096>0 .05) ,MVD and SUVmax (r=0 .179 ,P=0 .064>0 .05) .AUC of MTV was 0 .736 ,and the best threshold value was 15 .016 cm3 ,whose sensitivity ,specificity ,positive predictive value ,negative predictive value and Youden index were 83 .3% ,63 .6% , 59 .3% ,85 .7% and 47 .0% respectively .Conclusion Compared with SUVmax ,MTV of colorectal cancer is associated with angio‐genesis and hematogenous metastasis ,so as to predict the prognosis of colorectal cancer ,which is worthy of clinical application .

Objective To investigate the esthetic effect of anterior ultra-thin veneers which were fabricated from heat pressed IPS e.max press ingots of high translucency.Methods The whole 62 anterior teeth of 12 patients,who wanted to receive aesthetic restorative treatment,were invloved in the study.Grooves with 0.5 mm depth were marked at the center of the labial face by the use of spherical diamond burs with 1 mm in diameter.At the cervix of the teeth,the design of 0.3 mm shallow concave shoulder was adopted.IPS e.max HT ingots of different color were chosen to be hotpressed; the straining technique was used on the marginal ridge and incisor ridge of the ultra thin veneers after they had been carefully trimmed.Subsequently,the restorations were bonded with Variolink Veneer resin cement.After a short-term follow-up for 3 years,a modified USPHS criterion was used to evaluate the esthetic effect.Results The thickness of the ultra-thin veneers fabricated by heat pressing was 0.3-0.5 mm,marginal integrity of the veneers was perfect and fitted well with the marginal finishing line of the abutment,and then the translucency of veneers was high.There was no edge discoloring after the veneers were used for 6 months to 3 years,and they might produce an excellent chameleon effect by mixing the color of adjacent teeth and gums,and appeared a surface morphology of natural enamel after carefully carved.In the short-term clinical observation,none of the 62 veneers fractured or fell off; there was no case of dentin hypersensitivity.Conclusions Ultra-thin veneers fabricated from IPS e.max Press ingots have the following advantages,a simple operating procedure,high mechanical strength,and satisfactory esthetic effect.

Objective To conduct a retrospective study about drug-induced hyperthermia (DIH) based on DIH data obtained in medical practice,and elucidate the relationship between DIH incidence and antibacterials overuse.Methods To investigate successively the medical records of inpatients from orthopaedics department in Fudan university affiliated Jinshan hospital at two different periods,and data of DIH cases were extracted to perform a comparative study.The period for 229 effective cases of group Ⅰ was from Feb.1 to Apr.30,2011,before significant improvement on antibacterials use.The period for 342 effective cases of group Ⅱ was from Jul.1 to Sep.30,2012,after the effective enforcements of regulation on antibacterials use.Inclusion criteria for DIH were:①an oral temperature ≥37.6 ℃ since postoperative day 4,②no evidence of infection,③a time relationship between fever and the administration of causative drugs:a fever occurring with drug administration and disappearing after drug cessation within 3 days,④no other causes for the fever,⑤oral temperature ≤ 37.6 ℃ until leaving hospital.Exclusion criteria for DIH were listed below:①possible pathological fever,e.g.,in cancer,②hospitalization within 3 days,③no surgery,④severe trauma,for example,visceral or central nervous system injury.Results All causative drugs were for injection.By comparison,duration of antibacterial administration is significantly shorter in group Ⅱ than in group Ⅰ (1.7 ± 1.7 vs.4.6-± 1.8days,P ＜ 0.01),and total DIH incidence and antibacterials related DIH incidence were significantly lower in group Ⅱ than in group Ⅰ (7.3％ vs.30.1％,1.5％ vs.25.3％,both P ＜0.01).Conclusion DIH incidence is related with drug type especially with antibacterials overuse,and changed with drug program.DIH was more serious for injection of antibacterials than injection of traditional Chinese medicine.Decrease of antibacterials usage is positively associated with the decreased DIH incidence.Safe medication should begin from safe usage of antibacterials.

Objective To study the structural features and characteristics of a novel gene Schistosoma japonicum 79(Sj79), and observe its effect of RNA interference(RNAi),so as to provide the experimental basis for its further function study and mechanism study of anti reproductive development of schistosome. Methods The gene structure and characteristics of Sj79 were analyzed by bioinformatics methods. Then the expressions of Sj79 messenger RNA(mRNA)during the different develop?mental stages of schistosome were analyzed and the effects of RNAi silencing were observed by the soaking method. The tran?scriptional levels of Sj79 after RNAi were detected by real time PCR. Results The open reading frame of Sj79 contained 696 base pairs with an exon structure. The gene had obvious stage specificity,and its transcriptional level in mature female worms was the highest. After soaking for 3 d,the Sj79 mRNA level[(41.0 ± 12.3)%]in the siRNA?1 group with low dosage(20 nmol/L) was lower than that in the siRNA?NC group[(103.2 ± 14.4)%],the difference was statistically significant(t=3.28,P<0.05). When with high dosage(200 nmol/L ),both the Sj79 mRNA levels in the siRNA?1 group[(15.8 ± 10.9)%]and siRNA?2 group [(11.1 ± 8.8)%]were significantly lower than that in the siRNA?NC group[(100.1 ± 6.3)%](t=13.44,27.84,both P<0.01). After soaking for 7 d,only the Sj79 mRNA levels in the siRNA?1group[(43.4 ± 4.5)%]and siRNA?2 group[(62.5 ± 5.4)%]with low dosage were lower than that in the siRNA?NC group[(100.4 ± 5.2)%],and the differences had statistical sig?nificance(t=8.33,5.07,both P<0.01). Conclusion Through this study,we have improved the mRNA sequence and genom?ic information of Sj79 gene,and understood its structural features,as well as selected out two effect fragments siRNA?1and siR? NA?2 which will provide the basic evidences for the further study on egg laying interference of the female adult worm of schisto?some in vitro.

Objective:To explore the efficacy of apatinib combined with S-1 capsule in the treatment of patients with advanced recurrent and metastatic esophageal cancer.Methods:A total of 140 patients with advanced esophageal cancer were selected as test subjects from January 2017 to January 2019 in Shandong Tai′an Cancer Prophylaction-Therapeutic Hospital. These patients were randomly divided into observation group (72 cases) and control group (68 cases) using random number table method. The patients in the observation group were treated with oral apatinib combined with S-1 chemotherapy, and the patients in the control group was only given S-1 chemotherapy. The short-term and long-term efficacy and adverse reactions of the two groups were observed.Results:The objective remission rates of the observation group was 38.9% (28/72), higher than that in the control group (22.1%, 15/68), with a statistically significant difference ( χ2=4.655, P=0.031). The disease control rate of the observation group was 88.9% (64/72), higher than that in the control group (61.8%, 42/68), and there was a significant difference between the two groups ( χ2=13.993, P<0.001). The median progression-free survival of the observation group and the control group was 5.9 months and 2.7 months respectively, the median overall survival was 14.8 months and 7.9 months respectively, and there were significant differences between the two groups ( χ2=5.477, P=0.026; χ2=6.083, P=0.014). The adverse reactions of the two groups were mild, grade 1-2, mainly including fatigue, leukopenia, hand-foot syndrome, hypertension and proteinuria, with incidences of 59.7% (43/72), 50.0% (36/72), 8.3% (6/72), 12.5% (9/72), 9.7% (7/72) in the observation group, and 51.5% (35/68), 57.4% (39/68), 17.6% (12/68), 4.4% (3/68), 4.4% (3/68) in the control group, there were no significant differences between the two groups ( χ2=0.965, P=0.326; χ2=0.760, P=0.383; χ2=2.708, P=0.100; χ2=2.919, P=0.088; χ2=0.794, P=0.373). Conclusion:Apatinib combined with S-1 is effective, safe and tolerable in the treatment of recurrent and metastatic esophageal cancer.

Objective To obtain novel vaccine candidate antigens against Schistosoma japonicum. Methods S. japonicum schistosomula cDNA library was screened by using sera of Microtus fortis that was naturally resistant to schistosomiasis. The positive clones were transformated into Escherichia coli BM25.8, E. coli clones containing the plasmid cultured in LB, and then selected for plasmid extraction, the plasmid DNA was digested by EcoRⅠand Hind Ⅲ, and analysed by agarose gel electrophoresis. The positive clones were also sequenced and the data were analysed through the internet Nucleotide BLAST software of NCBI and Expert Protein Analysis system of GeneRunner and HNN. Results Twelve positive clones were obtained after repeatedly immunoscreening the library and their sizes ranged from 300 bp to 1100 bp. Two novel genes (named as Sj-sMf1 and Sj-sMf2) with complete ORF were obtained. The deduced protein of Sj-sMf1 consisted of 93 amino acids while Sj-sMf2 consisted of 61 amino acids. Sj-sMf1 protein predicted containing one cAMP phosphorylation site and Casein kinase C phosphorylation site, respectively. Sj-sMf1 protein predicted containing one Casein kinase C phosphorylation site and two Protein kinase C phosphorylation sites. Conclusion Two novel genes predictably encoding unknown proteins are obtained from immunoscreening of Schistosoma japonicum schistosomula cDNA library by M. fortis sera.

Objective To lay the foundation for further exploration on parasitifer's defence reaction to pneumolysin through constructing ply gene-deletion strain of Streptococcus pneumoniae and researching on its virulence change. Methods A linker fragment with erm gene in middle and homologous upstream and downstream fragment of ply gene at both sides was prepared by long flanking homology-polymerase chain reaction(LFH-PCR). The linker fragment was transformed into Streptococcus pneumoniae. ply-deficient strain was then screened out from blood plate which contains erythromycin and identified by PCR. ply-deficient strain growth in vitro was observed and virulence change was observed through infecting mouse model. Results PCR results showed that ply gene was replaced completely by erm gene. The ply deficient strain was successfully constructed. The growth of single strain culture medium showed that ply genetic defect made no influence on bacterial's external growth. While in the mice nasal cavity infecting experiment, deficient strain enter into blood after 6 h from infecting which obviously slower than that did wild-type(2 h). And the number of bacteria at each point was much smaller than that of wild-type(P ＜0. 01 ). The mice peritonaeum infecting experiment showed that median lethal time of wild-type was 3 d, while that of deficient strain was 18 d(P＜0. 01). Conclusion It is a good way to completely substitute ply gene using LFH-PCR. ply deletion made no influence on baterial's growth in vitro, but it resulting in reduction of bacterial virulence in vivo.

Objective To investigate the application value of three-dimensional shear wave elastography( 3D-SWE) in diagnosis of malignant and benign breast masses . Methods Sixty-seven patients with total 96 masses diagnosed by ultrasound and verified with surgical pathological analysis were selected . The masses were divided into benign group ( 54 masses ) and malignant group ( 42 masses ) . The quantitative diagnosis was performed using two-dimensional shear wave elastography ( 2D-SWE) and 3D-SWE to evaluate the hardness of the masses . Receiver operating characteristic ( ROC ) curves of 2D-SWE and 3D-SWE were drawn to calculate the sensibility and specificity in diagnosis of breast masses . The qualitative diagnosis was performed according to the elastic color image classification to classify the elastic images of the lesions into type Ⅰ - Ⅳ . Results The quantitative diagnosis:① There were significant differences in Emean ,Emax and SD on planes of 2D-SWE and three orthogonal planes of 3D-SWE between the two groups ( P <0 .05) ;② There was no significant difference in Emean ,Emax and SD of two groups between 2D-SWE and 3D-SWE ( P > 0 .05) ;③ Emean ,Emax and SD on planes of 2D-SWE and three orthogonal planes of 3D- SWE both exhibited high diagnostic performance . However , there was no significant difference in Emean ,Emax and SD between 2D-SWE and 3D-SWE ( P >0 .05) . The qualitative diagnosis of elastic color mode:type Ⅰ and type Ⅱ account for most planes of 2D-SWE and three orthogonal planes of 3D-SWE in benign masses ,while type Ⅲ and type Ⅳ account for most in malignant masses . Among the malignant group ,type Ⅲ on the 3D-SWE coronal planes was significantly more than other three types ( P < 0 .05) .Conclusions For quantitative diagnosis ,2D-SWE and 3D-SWE are both beneficial to differentiate benign from malignant masses ,but there is no difference in diagnostic efficacy ;for qualitative diagnosis ,3D-SWE can provide more diagnostic information than 2D-SWE ,especially on the coronal planes of 3D-SWE .

Objective To investigate the the level of red blood cell microparticls in patients with acute coronary syndromes and the correlation with severity of coronary artery disease and with its influencing factors.Methods A total of 140 patients were sdected into our study from Jun 2016 to Feb 2017.All patiens were identified through coronary angiography.There were 108 patients with acute coronary syndromes (ACS) mentioned as experimental group,which including 25 patients with single vessel disease,27 patients with double vessel disease,27 patients with triple vessel disease and 29 cases of multi-vessel disease,and 32 patients of non-coronary heart disease group mentioned as control group.Each patient was fasting and drawn the periheral venous blood after the next day of hospitalized then analyzing blood lipids,blood routine and biochemical indicators.The expression of CD235a in erythrocyte derived microparticles was quantitatively analyzed by flow cytometry.The Gensini score was calculated based on the Results of coronary angiography.Results Compared with the non-CHD group,the levels of red blood cells microparticles (44.37％ ± 15.48％),low density lipoprotein cholesterol (3.18 ± 1.16mg/L),lipoprotein a (215.23 ± 183.10mg/L) and high sensitivity C Protein (19.58 ± 26.94mg/L) were significantly increased,and the difference was statistically significant (P ＜ 0.05).The levels of erythrocyte microparticles and low-density lipoprotein cholesterol in the subgroups of acute coronary syndromes were statistically significant (P ＜ 0.05),with erythrocyte microparticles levels and low-density lipoprotein cholesterol levels (P ＜ 0.05).There was a positive correlation between Gensini score and erythrocyte drived microparticls (β =2.157,P ＜ 0.05),and negatively correlated with high density lipoprotein (β =-15.579,P ＜ 0.05).Conclusion The level of Gensini scores were calculated based on the results of coronary angiography.That in patients with acute coronary syndrome is significantly higher than that in patients with non-coronary heart disease.The level of erythrocyte derived microparticls is closely related to the severity of coronary artery disease.The level of erythrocyte derived microparticls has a high value in predicting the severity of coronary artery disease in acute coronary syndromes.

OBJECTIVETo evaluate the influence of small-dose dexmedetomidine infusion on recovery of patients undergoing vertebral operation.

METHODSSixty ASA I-II patients undergoing vertebral operation were randomly divided into two groups (n=30). In group I, dexmedetomidine infusion was pumped at the rate of 0.5 µg·kg(-1)·h(-1) from tracheal intubation to incision suture, and in group II, 0.9%saline was pumped instead. The mean arterial pressure, heart rate, Riker Sedation-Agitation Scale and Ramesay sedation score were recorded at the time points of autonomous respiration (T1), eye opening (T2), extubation (T3), 1 min after extubation (T4), 10 min after extubation (T5), and 30 min after extubation (T6).

RESULTSThe recovery time of autonomous respiration and eye opening time in group I were significantly longer than those in group II, and the extubation time was significantly shorter in group I (P<0.05). Riker Sedation-Agitation Scale scores in group II were significantly higher than those in group I at T2 and T4, and Ramesay sedation scores in group I were significantly higher than those in group II at T1, T2 and T5 (P<0.05). The mean arterial pressure and heart rate at each time point was significantly lower in group I than in group II (P<0.05), especially at T3 and T4 (P<0.01). In both groups, the mean arterial pressure and heart rate at T3 and T4 were significantly higher than those at rest (P<0.05).

CONCLUSIONSSmall-dose dexmedetomidine infusion can reduce dysphoria and lower the risks during recovery from general anesthesia following vertebral operation.

Adult ; Aged ; Anesthesia Recovery Period ; Dexmedetomidine ; administration & dosage ; pharmacology ; Humans ; Middle Aged ; Spine ; surgery