Objective To discuss the treatment of cervical cancer in different stages.Methods The treat- ment of 42 cases of cervical cancer in this hospital from January 2000 to December 2005 was analysed,and clinical treatment modalities were analysed too.Results(1)A total of 6 cases of uterine carcinoma in situ received hysterec- tomy plus bilateral salpingo-oophorectomy.(2)A total of 26 cases was inⅠb-Ⅱa stage,of which 15 cases with cer- vical cancer were treated with a simple radical hysterectomy;6 cases of cervical cancer were radiotherapied after radi- cal hysterectomy;7 cases of cervical cancer received radical hysterectomy plus radiotherapy.(3)A total of 10ⅡbⅣstage eases selected radiotherapy and chemotherapy.Conclusion Different treatment should be applied in differ- ent stages of cervical cancer,and the choice for treatment is important for patients' quality of life after treatment. Comprehensive treatment can improve the survival of patients with cervical carcinoma.

Objective To propose a new classification scheme of otitis media (OM). Methods By reviewing current internat ional classification systems of OM, we analyzed their disadvantages and the prog ress made in histopathologic studies of OM, then worked out a new classification scheme to apply it to clinic. Results In current internati onal classification systems of OM, those apparent clinical signs are regarded as main standards of classification. Their main disadvantage is that these signs c annot very well indicate the condition of pathologic and functional changes of i mportant hearing structure areas. We proposed a “Three-stage Scheme” of OM cl assification and applied in 1 160 cases of OM. The accuracy rate of diagnosis w as 82.4% in 348 cases of early-stage OM, 98.4% in 696 cases of chronic OM, and 95.2% in 116 cases of OM sequela. Conclusion The “Three-s tage Scheme” system is scientific, simple and practical. Its accuracy rate of d iagnosis is very high. It plays a guiding role in diagnosis and treatment of OM.

Objective To analyze the demand for home care service and its influential factors among elderly in Tianjin city.Methods A total of 254 residents aged 60 and above from Tianjin city were investigated with a self-designed questionnaireDemand for Home Care Service,Katz index of independence in Activities of Daily Living(ADL) and Lawton Instrumental Activities of Daily Living (IADL) scale.Results The mean score for home care service has been revealed (2.40±0.67),as the ranking demonstrated:public welfare (3.61±1.04),social participation (2.69±1.32),medical service (2.56±0.90),rights safeguard by law (2.37±1.54),mental need (2.26±0.99),and need for daily life care (1.73±0.69).Multiple linear regression analysis showed that income,education level,activity of daily living and the convenience degree of seeking treatment were major factors affecting demand for home care service among elderly,which explained 16.3％ of the variance.Conclusions Oriented by demand,further progress shall be achieved multidimensionally,under which circumstances,individualized service ought to be de-livered.Simultaneously,the vulnerable elderly groups require more attention.

OBJECTIVE: To investigate the pathogenic factors of severe acute pancreatitis (SAP) complicated by hepatic insufficiency, the prognosis and the effective preventive and therapeutic interventions. METHODS: One hundred and fifty-two patients with SAP (from January 2003 to June 2004) were divided into 2 groups, SAP with hepatic insufficiency group and SAP without hepatic insufficiency group. The related factors such as causes of disease, serum biochemical criteria, complications, mortality and course of disease were observed. RESULTS: The concentrations of serum amylase, creatinine and lactate dehydrogenase were all much higher in the SAP with hepatic insufficiency group than those in the SAP without hepatic insufficiency group (P<0.05). The incidences of complications such as acute renal failure, heart failure, gastrointestinal hemorrhage and infection were also higher in the SAP with hepatic insufficiency group than those in the SAP without hepatic insufficiency group (P<0.05). There was no significant difference in mortality between these two groups, but the course of disease in SAP with hepatic insufficiency group was longer than that in the other group (P<0.05). CONCLUSION: The causes of SAP complicated by hepatic insufficiency are related to the imbalance of internal environment and the characteristics of the liver function. To control the biliary tract diseases, intervene with traditional Chinese medicine, recover the intestinal function in time, reduce the damage of pancreatic enzyme, maintain the stability of internal environment and avoid using drugs that can induce liver injury are all important aspects of reducing the incidence of hepatic insufficiency.

ObjectiveTo evaluate the effects of selective cyclooxygenase-2 inhibitor nimesulide lone and combined with cisplatin on tumor growth,and Ki67 and Caspase-3 expression in lung cancer xenografts in nude mice. Methods The mice were randomly divided into 4 groups:the control group,the nimesulide group,the cisplatin group and the nimesulide combined with cisplatin group. A549 cells were injected into BALB/c nude mice subcutaneously.On the 21st day after treatment tumor tissues were collected,and the xenografts growth were observed. The expression of Ki67 and Caspase-3 were detected by immunohistochemical method.ResultsNimesulide combined with cisplatin could significantly inhibited the xenografts growth compared with nimesulide or cisplatin.The tumor inhibition rate was 44.33％ in the nimesulide group,53.61％ in the cisplatin group and 80.41％ in the nimesulide combined with cisplatin group (P ＜ 0.05).Immunohistochemical analysis showed that the expression rates of Caspase-3 was significantly increased in the nimesulide combined with cisplatin group (67.43 ± 23.57 ) ％,the cisplatin group (48.40 ± 20.37 ) ％,and the nimesulide group (38.65 ± 15.37)％,compared with the control group (27.63 ± 13.03)％ (P ＜ 0.05).The expression rate of Caspase-3 was significantly increased in the nimesulide combined with cisplatin group compared with the nimesulide group or the cisplatin group (P ＜ 0.05 ).The expression rate of Ki67 was significantly decreased in the nimesulide group combined with cisplatin group (24.34 ± 15.90)％,the cisplatin group (40.85 ± 22.47)％ and the nimesulide group (53.33 ± 19.67)％ compared with the control group ( 80.43 ± 16.88 ) ％ ( P ＜ 0.05 ).The expression of Ki67 was significantly decreased in the nimesulide combined with cisplatin group compared with the nimesulide group or the cisplatin group ( P ＜ 0.05 ).Conclusion Nimesulide can inhibit human lung cancer A549 cells xenografts in nude mice growth,Nimesulide enhanced the inhibitory effects of cisplatin.The mechanism may be related to inhibition of tumor cell Ki-67 expression,increased expression of Caspase-3,inhibition of tumor cell proliferation,and inducing tumor cell apoptosis.

Objective To explore the change of 25 hydroxyvitamin D level and its correlation with glucose metabolism and bone mineral density in elderly men with type 2 diabetes mellitus(T2DM).Methods Hospitalized 53 elderly male patients with T2DM (T2DM group) and 51 patients without T2DM (NDM group) were chosen.Blood.biochemical indexes and 25 hydroxyvitamin D level were measured.Bone mineral density of lumbar (L2_4),left proximal femur was measured by dual energy X-ray.Results The serum 25 hydroxyvitamin D level in T2DM group was lower than that in NDM group [(12.38 ±5.12)μg/L vs.(17.35 ± 5.52) μ g/L],and there was significant difference(P＜ 0.05).The serum 25 hydroxyvitamin D level was negatively associated with fasting blood glucose level and glycosylated hemoglobin (r =-0.225,-0.499,P ＜ 0.05).The serum 25 hydroxyvitamin D level was not associated with fasting insulin and homeostasis model insulin resistance index (r =-0.050,-0.082,P ＞ 0.05).The incidence of osteoporosis in T2DM group was higher than that in NDM group [30.19％(16/53) vs.11.76％(6/51)],and there was significant difference (P ＜0.05).The serum 25 hydroxyvitamin D level was positively associated with bone mineral density of femur neck,greater trochanter of femur and Ward triangle(r =0.773,0.762,0.812,P ＜ 0.05).The serum 25 hydroxyvitamin D level was not associated with bone mineral density of lumbar (L2_4)(r =0.116,P ＞ 0.05).Conclusions The prevalence of vitamin D deficiency is found in elderly men with T2DM.Vitamin D level can affect blood glucose control and increase the risk of the occurrence of osteoporosis.Therefore,T2DM patients,especially elderly patients,should be routine vitamin D testing.Vitamin D supplementation to the patients of vitamin D insufficiency in time may be beneficial to glucose metabohsm and the prevention and treatment of osteoporosis.

Breast cancer is the most common disease in women worldwide, which not only threatened the women’s survival time, but also inlfuenced their quality of life as well. Within this challenge, it’s important to optimize the current multidisciplinary treatment stratagem for breast cancer. Radiotherapy is one of the most important treatment modality for patients with breast cancer, with the trend to shrink the irradiated volume and shorten the total fraction times in recent years. Intraoperative radiation therapy (IORT) as a fast and convenient procedure has the ability to deliver a high, single-fraction radiation dose to tumor beds with minimal exposure of surrounding tissues (lung, heart, etc.), which could be displaced or shielded right after the tumor removal during the surgical procedure. Right now, IORT has been either integrated as a boost technique in multimodal approaches using postoperative EBRT in the treatment of early breast cancer patients undergoing breast conservation surgery or used as a single dose accelerated partial breast irradiation technique for these patients. This review discussed the rationale of IORT, the beneifts and limitations of IORT, the indication and the clinical results of this procedure, including treatment related side-effects as well in order to provide the preliminary evidence based approach for early breast cancer patients.

Objective To observe the clinical features and treatment outcomes of presumed tubercular retinal vasculitis.Methods This is a retrospective non-comparative interventional clinical research.A total of nine patients (11 eyes) with major presentation of retinal vasculitis were included in this study.Patients first consulted the eye clinic and were diagnosed presumed tubercular retinal vasculitis.The patients,seven males and two females,aged from 19 to 66 years,with an average of 43.89 years.The time interval from symptoms to diagnosis ranged from two weeks to six months with an average of 76.27 days.Visual acuity,slit lamp ophthalmoscopy,fundus fluorescein angiography (FFA),optical coherence tomography (OCT),hematological and tuberculosis related investigations were examined and analyzed.All patients had standard anti-tuberculosis treatment.Treatment outcomes were followed for six to 37 months with an average of 14.11 months.Results Baseline visual acuity ranged from hand movement to 0.8 with an average of 0.28.Among 11 eyes,six presented mild to moderate vitritis,five presented as retinal vein occlusion with no obvious vitirits.Fundus examination showed six cases with retinal hemorrhage,four cases with macular edema,two with macular epiretinal membrane,and two with vitreous hemorrhage.FFA revealed 11 cases with leakage of vessels,11 with nonperfusion area,four with macular edema,three with retinal neovascularization,and two with choroidal lesions.OCT of nine eyes suggested six eyes with retinal edema,three with macular edema,three with macular epiretinal membrane.TST of seven patients were all strong positive.T-SPOT.TB of four patients were all positive.Three of eight patients who had chest X-ray or chest CT were suggested tuberculosis infection.Four to six weeks after the start of anti-tuberculosis treatment,vitritis,exudates,retinal and macular edema subsided.During follow up,inflammation was stable with no recurrence observed.The visual acuity of last follow-up ranged from 0.15 to 0.8 with an average of 0.51.Conclusions The main presentations of presumed tubercular retinal vasculitis are vitritis,retinal vein occlusion,and retinal hemorrhage.Standard anti-tuberculosis treatment can improve inflammation and retinal hemorrhage.

Biomaterials are commonly applied in regenerative therapy and tissue engineering in bone.Generally,nanoparticles interact distinctively with bone cells and tissue,depending on their com-position,size,and shape.Therefore,detailed analyses of nanoparticle effects on cellular functions have been performed to select the most suitable candidates for supporting bone regeneration.This review will highlight potential nanoparticle applications in bone.We found that mesenchymal stem cells (MSCs) display exceptional regenerative potential.The delivery of genetic material with nanoparticulate carriers offers the possibility of overcoming certain disadvantages of standard protein delivery approaches.Moreover,nanoparticles are already clinically applied in cancer treatment.Thus,corresponding efforts could lead to new therapeutic strategies to improve bone regeneration or to treat bone disorders.

Invasion and metastasis are critical determinants on cancer morbidity.Genes and molecules participating in these steps have been demonstrated as potential prognostic factors.Growth factors and their receptors,cell-cycle regulators,cell-adhesion molecules and m trix-degrading enzymes are potentially used as prognostic factors.However,increased understandings for molecular mechanisms underlying carcinogenesis and its implementation in the treatment of gastric cancers have recently been focused on the development and incorporation of targeted agents with chemotherapy.