In recent years,it has been reported that the osteopontin attracts great attention for its roles in tumor growth and metastasis.In many tumors,osteopontin plays an important role in promoting tumor growth,metastasis and enhancing adhesion and migration abilities.In particular,in hepatocellular carcinoma,osteopontin has very satisfactory sensitivity and specificity in early diagnosis and is relatively effective on prognosis prediction.Suppression osteopontin expression will inhibit liver cancer growth and metastasis,indicating that the osteopontin stays a new target for liver cancer treatment and possesses intangible clinical potential.

Objective To analyze the influence of total thyroidectomy (TT) on quality of life of patients with nodular goiter with iodine deficiency.Methods 70 patients who received TT in the hospital from June 2014 to July 2015 were randomly divided into two groups, 35 cases in each.Control group received subtotal thyroidectomy and observation group received total thyroidectomy.The situation of operation, thyroid function, therapeutic effects and quality of life in two groups were compared.Results Operation time and hospital stays of observation group were significantly longer than that of control group (P<0.05);There was no significant difference in intraoperative bleeding volume and curative effective rate between the two groups;Before surgery, there was no significant difference in thyroid function between the two groups;After surgery, thyroid function of both two groups decreased compared with pre-operation, but there was no significant difference;There was significant difference in VAS and health description system scores between the two groups.Conclusion TT in treatment of patients with nodular goiter with iodine deficiency has significant clinical efficacy with high cure rate and less complication, and it can improve quality of life of patients, which is beneficial to postoperative recovery and worthy of generalization in clinical application.

Objective To evaluate the predictive value of morphology of superficial depression in estimation of histology and invasive depth in colorectal neoplasia by using magnifying chromo-endoscopy.Methods Flat or depressed and sessile eolorectal lesions which were indicated for endoscopic mucosal resection (EMR) were consecutively collected. Depressed lesions were classified into type 1 (star-like) and type 2 (round) according to the morphology of depressive areas in the colorectal neoplasia with magnifying ehromoendoscopy. The relationship between morphologic classification with histology and invasive depth was studied with reference to pathological diagnosis after EMR. Results Ninety lesions including 25 sessile and 65 flat were resected with EMR. Lesions with central depression (54. 4%,49/90) were more likely to have high-grade dysplasia (HGD) or cancer than those without ( 51.0% vs. 17. 1%,P＜0. 001 ). Depressive lesions of type 2 were more susceptible to have HGD or cancer than those of type 1 (89. 5% vs. 26. 7%,P＜0. 001 ). The overall accuracy of depression morphology for distinction between lesions of superficial submueosal (m-sm1) and deep submucosal (sm2-sm3) invasion was 83. 7% (41/49). Conclusion The morphology of superficial depression on colorectal neoplasia is highly correlated with the histology and invasive depth,which facilitates the EMR treatment.

Objective To investigate whether gemcitabine (GEM) could enhance radiosensitivity of human non-small cell lung cancer cells and its related mechanism.Methods Clonogenic assay was used to analyze radiosensitivity enhancement by GEM on p53 mutant human lung adenocarcinoma cell line 973.Alterations of cell cycle distribution and apoptosis were measured by flow cytometry.Results Mild radiosesitizing effect was observed when 10 nmol/L GEM was administrated before or after irradiation.Marked radiosesitizing effect was demonstrated when 100 nmol/L GEM was administrated before or after irradiation, with much stronger effect of pre-irradiation GEM treatment.Mutation of p53 gene affected cell cycle redistribution and cell apoptosis, but had no relationship with radiosensitivity enhancement of GEM.Conclusions 100 nmol/L GEM could significantly enhance radiosensitivity of human lung cancer cells.However, this effect may not be associated with p53 gene mutation, cell cycle redistribution or cell apoptosis.

Objective To evaluate the guiding role of capsule endoscopy (CE) in choosing the access route of double-balloon enteroscopy (DBE) for small bowel diseases. Methods Patients with complete CE and with small bowel diseases confirmed by DBE were enrolled. The lesion location found on CE was represented by the time index, which was the ratio of access time from pylorus to lesion over access time from pylorus to ileocecal valve. Based on our previous retrospective evaluation, oral approach was selected when the index was ≤0. 6, otherwise the anal access would be chosen. Accuracy of time index predicting DBE access rout was evaluated. Results Data of 60 patients undergoing both CE and DBE were evaluated. All lesions detected by CE were confirmed by DBE, with 41 via oral route and 19 via anus. Based on the time index with threshold of 0.6, the accuracy of selecting the insertion route of DBE was 100%. Conclusion DBE is an effective approach to confirm CE results. In patients with complete small bowel investigation by CE, the insertion route for DBE can be reliably indicated with time index based on the CE results.

目的观察脑血管病康复治疗的临床疗效。方法将244例急性脑血管病患者随机分成康复治疗组和药物治疗组各122例,药物治疗组给予常规药物治疗,康复治疗组在药物治疗的基础上实施康复治疗,疗程30天。治疗前后分别用简式FMA和改良Barthel指数评定患者的运动功能和日常生活活动能力(ADL)。结果康复治疗组患者运动功能和ADL的改善程度明显好于药物治疗组(P<0.01)。结论急性脑血管病在药物治疗的基础上,早期实施康复治疗可明显提高患者的运动功能和ADL。

Objective To evaluate the correlation of ADC values on 3.0 T MR with the pathological grades in pT1b clear cell renal cell carcinoma(CCRCC).Methods Conventional MR images,ADC values and Fuhrman pathological grading of pT1b CCRCC were performed in 30 patients.Grade Ⅰ and Ⅱ were defined as low-grade group; grade Ⅲ and IV were defined as high-grade group.The differences of ADC values among four different pathologic grades were compared with a one-way analysis of variance. The comparison of ADC values of two different grade groups was performed with t test,and the ROC curve was performed to evaluate the diagnostic efficacy of ADC value. Correlation between pathological gradings and ADC values was assessed with Spearman rank correlation analysis. Results ( 1 ) The mean ADC value of grading Ⅰ ( 10 patients ), Ⅱ ( 8 patients ),Ⅲ ( 7 patients ),IV ( 5 patients ) was ( 0.94 ± 0.11 ) ×10-3 mm2/s,(0.82 ±0.13) × 10-3 mm2/s,(0.68 ±0.09) × 10-3 mm2/s,(0.59 ±0.03) × 10-3 mm2/s,respectively.Significant differences of ADC values among the four grades were present (F =16.422,P =0.000 ).( 2 ) The mean ADC value of the low-grade group was significantly higher than that of the high-grade group(t =5.738,P =0.000).Sensitivity and specificity of diagnosing the low-grade group was 88.9％ and 83.3％ respectively.There was a negative correlation between pathological grading and ADC value ( r =-0.807,P ＜ 0.05). Conclusions The ADC values of pT1b CCRCC have close correlation with pathological gradings.They can be used to predict the degree of tumor malignancy preoperatively and guide surgical planning.

Objective To study the expressions of hypoxia inducible factor (HIF)-1 and angiopoietin (Ang)-2 in repeated gastrointestinal bleeding due to vascular malformation, and the efficacy of treatment with thalidomide. Methods Twenty-five patients with repeated gastrointestinal bleeding due to vascular malformation confirmed by capsule endoscopy or enteroscopy were collected and 18 subjects without severe diseases were served as controls. Ten patients with gastrointestinal vascular malformation, who received 25 mg of thalidomide 4 times daily for 4 months and were followed up for at least one year, were also enrolled. The serum samples from all participauts were detected for expressions of HIF-1 and Ang-2 using enzyme-linked immunosorbent assay (ELISA).The expressions of HIF-1 and Ang-2 were compared between angiodysplasia group and control group.The expressions of HIF-1 and Ang-2 were comparatively evaluated before and after treatment with thalidomide in treatment group. Results The expressions of HIF-1 and Ang-2 in vascular malformation group [( 113. 84 ± 26. 66 ) ng/ml and ( 652. 11 ± 140. 39) ng/ml, respectively] were significantly higher than that of control group [(43.28±17.30) ng/ml and (265.60±53.88) ng/ml,respectively, P=0. 000]. The expression of HIF-1 was positively associated with that of Ang-2. (r=0. 700, P= 0. 000). There was no difference in expressions of HIF-1 and Ang-2 before and after treatment with thalidomide (P=0. 498 and =0. 136, respectively). However, significant reduction of Ang-2 [(113. 80±73. 60) ng/ml(P=0. 003)] was found in 8 effectively treated patients after thalidomide treatment. Conclusions HIF-1 and Ang-2 might play an important role in the formation of vascular malformation. The extent of Ang-2 reduction after thalidomide treatment may be helpful in evaluating its efficacy or prognosis.

Objective To evaluate the clinical efficacy and safety of endoscopic mucosal resection (EMR) assisted with magnifying chromoendoscopy in treatment of colorectal neoplasms. Methods Patients who met criteria for EMR including appropriate flat or depressed type and sessile lesions were enrolled. The association of morphology of colorectal lesions with histopathology was observed and the accuracy of estimation of invasive depth by magnifying chromoendoscopy was evaluated. Results Ninety lesions of 81 patients were reseeted by EMR (25 being sessile and 65 being flat or depressed). The histological results revealed low-grade dysplasia (LGD) in 58 lesions, high-grade dysplasia (HGD) in 20 lesions, and adenocarcinoma in 12 lesions. The average size of lesions was (1.4±0.5) cm in HGD, (1.6±0.5) cm in cancer and (1.0±0.4) cm in LGD with no significant difference (P> 0.05). It was shown that the flat and depressed lesions were more likely to be HGD or cancer as compared to sessile lesions, but with no statistical difference [41.5 % (27/65)vs. 20.0% (5/25), P= 0.084]. Moreover, the lesion with central depression was more likely to be HGD or cancer as compared to those without depressed surface [51.0% (25/49) vs. 17.1 % (7/41), P<0.01)]. The accuracy of estimating invasive depth by magnifying chromoendoscopy was 97.8% (86/90). Complete resection was confirmed histologically in 95.8% (88/90) of all lesions. Conclusions Colorectal lesions of depressed and flat types with central depression are more likely to be malignant. Estimation of invasive depth of colorectal neoplasia by magnifying chromoendoscopy in EMR treatment makes it more effective and safer.

Objective To observe and investigate the therapeutic effect of thalidomide on gastrointestinal bleeding of angiodysplasia.Methods Eighteen patients with recurrent gastrointestinal bleeding of angiodysplasia were treated with thalidomide 100 mg daily for 4 months.Median follow-up time was 16.7 months.The changes of clinical setting and serum.vascular endothelial growth factor(VEGF)and tumor necrosis faetor-α(TNF-α)level between pre-therapy and post-therapy were compared.Results The clinical setting of patients in post therapy was significantly better than that in pre-therapy.The overall symptom score,the median bleeding frequency and median transfusion volume of patients after therapy was significantly lower than those before the therapy[(15.000±3.630)vs(5.330±3.325),(11.220±6.404)vs(1.000±1.237),(1422.22±1556.601)ml vs(100.00±240.098)ml,respectively,all P＜0.01],while median hemoglobin was obviously higher than that before the therapy[(5.950±1.656)g/ml vs(9.533±2.278)g/ml,P＜0.01].Serum VEGF and TNF-α levels decreased obviously after the therapy(118 pg/ml vs 58 pg/ml,116 pg/ml vs 34 pg/ml,P＜0.01).Conclusions Thalidomide can suppress the serum VEGF and TNF-α levels of the patients with recurrent gastrointestinal bleeding of angiodysplasia,then play a significantly role in preventing the rebleeding in patients with recurrent gastrointestinal bleeding of angiodysplasia.