Multicellular spheroid (MCS) can simulate many aspects of the in vivo physiological and pathological conditions in many aspects,better reflect the in-vivo behavior of cells in tumors.So it's increasingly accepted as a valuable tool for evaluating the efficacy of therapeutic intervention including chemotherapy,radiotherapy,immunotherapy and combined therapy.Various spheroid co-culture approaches have been presented to study heterologous cells interaction in solid tumors.The present review briefly introduces the methodology and applications of MCS with focus on the up-to-date information.

OBJECTIVE: To study the changes of serum vascular endothelial growth factor (VEGF) and beta 2-microglobulin levels before and after radiotherapy in 58 patients with nasopharyngeal carcinoma (NPC), and to elucidate the clinical significance of VEGF and beta 2-microglobulin test before radiotherapy. METHODS: Serum VEGF level was measured by sandwich ELISA in 58 patients with NPC and 24 healthy individuals, and the serum beta 2-microglobulin was assayed with time-resolved fluoroimmunoassay. RESULTS: The serum VEGF level in patients with NPC was (174.0+/-130.0) ng/L, higher than (134.1+/-66.6) ng/L of the healthy subjects, but the difference was not significant (P>0.05). The serum VEGF level was higher in T4 and IV a patients with NPC. No significant differences in the levels of serum VEGF were found among various N classifications in the patients with NPC. Patients with the serum VEGF level higher than 267.3 ng/L (mean+2 s of the serum VEGF level in the healthy individuals) had a shorter metastasis-free survival time (P<0.05). Although the patients with high beta 2-microglobulin level had a shorter survival time, the difference was not significant. CONCLUSION: The NPC patients with high serum VEGF level have a poor prognosis.

Objective To investigate the pathogenesis of avascular necrosis of the femoral head(ANFH) and to observe the effects of uhrashortwave diathermy treatment of ANFH through animal experiments.Methods A total of 30 New Zealand white rabbits were randomly divided into three groups:a control group,a model group,and a diathermy group.All the groups were injected with horse serum and methylprednisolone to induce ANFH.The path- ological effects were observed.Results The amount of osteoblast in the model group was significantly less than in the control group,while in the diathermy group it was significantly increased compared with the control group.The a- mount of osteoclast in the model and diathermy groups was significantly higher than in the control group,and in the diathermy group it was significantly more than in the model group.The thickness of femoral head cartilage in the mo- del and diathermy groups was reduced compared with the control group,while it was thicker in the model group than in the diathermy group.The empty cartilage cell lacunae ratios of the model and diathermy groups were significantly higher than for the control group,and the diathermy group showed significant degradation compared to the model group.The density of blood vessels under the cartilage in the model group was significantly less compared with the control group,while in the diathermy group it was significantly increased compared with the control group.The width of bone trabeculae in the model and diathermy groups was significantly less compared with the control group,while they were significantly wider in the diathermy group compared with the model group.The diameters of fat cells in the model and diathermy groups were increased compared with the control group,while they were significantly smaller in the dia- thermy group compared with the model group.The adipocyte area rates in the model and diathermy groups were signifi- cantly elevated compared with the control group,and rates in the model group were significantly elevated compared with the diathermy group.Conclusion Ultrashortwave diathermy is an effective treatment for early stage ANFH.

Objective To understand the epidemic trend and drug susceptibility of pathogenic bacteria in children with lower re-spiratory tract infection to provide the basis for clinical rational drug use.Methods The sputum culture specimens in these two hospitals during 2013 were performed the pathogenic bacterial culture and the drug susceptibility test respectively.The results were conducted the comparative analysis.Results 6124 strains of bacteria were isolated from the children lower respiratory tract sputum specimens in our hospital during 2013,including 5 121 strains of Gram negative bacteria,accounting for 62.7%,which were domina-ted by Haemophilus influenzae,Klebsiella pneumoniae,Escherichia coli,Bauman Acinetobacter and Pseudomonas aeruginosa;Gram positive bacteria were 2734 strains,accounting for 33.5%,the top two were Streptococcus pneumoniae and Staphylococcus aureus;311 strains of fungi,accounting for 3.8%,and Candida albicans was predominant.1600 strains of bacteria were isolated from the lower respiratory tract sputum specimens in Nanjing Brain Hospital during 2013,including 1 134 strains of Gram negative bacteria, accounting for 70.9%,which were dominated by Klebsiella pneumoniae,Escherichia coli,Pseudomonas aeruginosa and Acinetobact-er Bauman;296 strains of Gram positive bacteria,accounting for 18.5%,Staphylococcus aureus was predominant;170 strains of fungi,accounting for 10.6%,Candida albicans was predominant.The sensitive drugs to Gram-negative bacilli were piperacillin /tazobactam and imipenem,while the sensitive drugs to Gram-positive bacilli were linezolid and vancomycin.Conclusion The Gram negative bacteria are the main pathogens of lower respiratory infection in children,and strengthening bacterial culture and drug re-sistance monitoring is necessary for rational use of antibacterial drugs.

Objective To provide an effective and convenient microsurgical method for ischemic necrosis of femoral head in children (Perthes disease) Method Basing on anatomic study, two periosteal flap pedicled with anterior superior iliac and anterior inferior iliac branches of lateral femoral circumflex vessel transposition was designed for the treatement of Perthes disease Result Eleven patients were performed with this method, and the average period of follow up was 2 1 years (range 1～3 5 years) The good and excellent rate was 82 percent Conclusion The operative method can not only provide with plenty of blood supply,but also increase osteogenic ability of the femoral head So, it is an effective method for the treatment of Perthes disease

Objective To explore the influence factors of hidden blood loss during the treatment of femoral intertrochanteric fractures with percutaneous compression plate( PCCP) in elder patient. Methods The data of 136 patients with intertrochanteric fracture in our hos-pital from March 2009 to March 2012 treated with percutaneous compression plate were retrospectively analyzed,the effect of age,fracture type,preoperative aspirin,internal diseases on perioperative hidden blood loss, and different haemoglobin ( HGB) levels in patients with dif-ferent distribution were analyzed. Results The mean hidden blood loss volume was 499 mL,which accounted for 92. 54% of the total blood loss. The mean HGB decline was 11 g/L. The rate of on admisson haemoglobin level lower than 80 g/L was 6. 62% in AO type A2. 3 and A3 groups,and the rate of postoperative haemoglobin level lower than 80 g/L was 14. 70%. The average hidden blood loss for AO type A2. 3 (862 mL) and A3 (698 mL) were higher than those for AO types A1 (430 mL),A2. 1 (450 mL) and A2. 2 (415 mL) (P<0. 05). Multi-variate linear regression analysis showed that comminuted fracture and preoperative aspirin treatment were independently associated with in-creased perioperative hidden blood loss. Conclusion It indicated that the overt blood loss was fewer for PCCP operation. Intertrochanteric fracture was the main reason for substantial perioperative hidden blood loss. Types A2. 3 and A3 intertrochanteric fracture were early predic-tive factors of postoperative haemoglobin level lower than 80 g/L in elderly patients.

We created the multi-media network-based teaching platform in emergency and critical care medicine teaching and unified the advantages of the network technique,multimedia technique and information commons,to build up a new place for all kinds of persons to learn the emergency and critical care medicine in any time or any places,and to build up a teaching re-source library of emergency and critical care medicine by the digital image processing technique, streaming media technique and database technique.

Objective:To observe the effects of Yikunjing capsules on the bone histomorphometry indexes and the serum Interleukin-6 (IL-6) level in mice with osteoporosis.Methods:60 cases ofC57 female mice were randomly divided into 5 groups,such as model group (equal volume of normal saline),estrogen group (nilestriol,0.25 mg/kg),Yikunjing capsules high dose group (1.44 g/kg),Yikunjing capsules medium dose group (0.72 g/kg) and Yikunjing capsules low dose group (0.36 g/kg),sham group (equal volume of normal saline) were treated with sham operation.The mice in each group was intragastrically administrated for 70 days.Enzyme linked immunosorbent assay (ELISA) was used to detect the serum IL-6 level.The bone histomorphometry index were detected with BI-2000 Medical Image Analysis System.And the Number of blood vessels in distal femoral metaphysis of each group was measured by CT.Results:Compared with the sham group,the width and area of trabecular bone,the thickness of cortical bone,area of trabecular bone,the number of osteoblasts,the bone mineral density and the number of blood vessels in model group were significantly reduced(P＜0.05),while the number of osteoclasts and serum IL-6 level were significantly increased (P＜0.05).Compared with the model group,above indexes in estrogen group,Yikunjing capsules high,medium,low dose group were improved (P＜0.05),and the effect of Yikunjing capsules high dose group and estrogen group was almost the same (P＞0.05).Conclusion:Yikunjing capsules can rectify the bone histomorphometry indexes reduce the serum IL-6 level and increase the number of blood vessels in mice with osteoporosis,and intragastrically administrating 1.44 g/kg Yikunjing capsules could get the better effect.

Objective To observe the changes of apoptosis and caspase 3 activity in cardiomyocytes of rats at different time points after transient ischemia and the effects of caspase 3 inhibitor Ac DEVD CHO on reperfusion injury Methods A total of 122 rats were divided randomly into 3 groups: IR group, IR+Ac DEVD CHO group and sham group The ischemic samples were observed at 30 min after ischemia followed by reperfusion at 1, 3, 6, 12 and 24 h The apoptotic cardiomyocytes, the activity of caspase 3 and the myocardial infarction area were determined by TUNEL method, fluorescent assay and TTC dyeing method, respectively Results Apoptosis index(AI) of cardiomyocyte and caspase 3 activity changed in a time dependent manner Highest AI and caspase 3 were found after reperfusion at 12 h The myocardial infarction area in group IR kept increasing during the period of reperfusion AI and caspase 3 activity were positively correlated with the myocardial infarction area( P