Objective To detect the expression of apoptotic inhibitor gene Livin in different esophageal epithelial lesions and to analyze the relation between the expression of Livin with pathologic characteristics. Methods The expressions of Livin mRNA were detected by real-time fluorescence quantitative PCR in 40 patients with different esophageal epithelial lesions including normal, atypical hyperplasia, carcinoma in situ and invasive carcinoma. Results The expression of Livin was progressively increased from normal to invasive carcinoma. Conclusion The expression of Livin is significantly related to the progression of esophageal cancer. The detection of Livin by real-time fluorescence quantitative PCR may be a reliable means for early diagnosis of esophageal cancer.

Objective To observe the clinical efficacy and safety of Reduning injection combined with pip-eracillin sulbactam in the treatment of community acquired pneumonia(CAP).Methods 122 cases with CAP were randomly divided into treatment group and control group by digital table method.The two groups were given piperacil-lin sodium and sulbactam sodium 3.75g,once every 12 hours,course 7 -10d.The treatment group was treated with Reduning injection,20ml/d treatment for 7 -10d.The clinical symptoms of the two groups before and after treatment, the total number of white blood cells(WBC)and C reactive protein(CRP)to resume normal time were observed. Results The effective rate was 94.91% in the treatment group and 80% in the control group,the difference between the two groups was statistically significant(χ2 =10.286,P <0.05).The treatment group was significantly shorter than the control group in controlling fever and cough symptoms(all P <0.05).3 months after treatment,the WBC and CRP recovery to the normal rate of the two groups had statistically significant differences (χ2 =2.880,3.926,all P <0.05).No obvious toxic side effects and adverse reactions were observed in the two groups.Conclusion Reduning injection combined with piperacillin sodium and sulbactam sodium in the treatment of CAP can alleviate the clinical symptoms of fever.This method has good clinical curative effect and high safety.It can be used as an effective method for treatment of CAP.

Objective To detect the expression of apoptotic inhibitor protein Livin in different esophageal epithelial lesions and to analyze the relation between the expression of Livin with pathologic characteristics. Methods The expressions of Livin mRNA and Livin protein were detected by real- time fluorescence quantitative PCR and western blot in 40 patients with different esophageal epithelial lesions including normal, atypical hyperplasia, carcino-ma in stiu and invasive carcinoma. Results The expressions of Livin mRNA were progressively increased from nor-mal to invasive carcinoma( 1.00 ± 0. 00,2.26 ± 0.79,7.24 ± 1.06,12.21 ± 2.47 ). There was statistical signifi-cance in Livin mRNA expression among carcinoma in stiu and invasive carcinoma and normal tissues ( P < 0.05 ). Conclusion The expression of Livin is significantly related to the progression of esophageal cancer,which may be a new target for diagnosis and gene treatment of esophageal carcinoma.

Objective To investigate the inducing effect of acitrotin on the growth and apoptosis of human cutaneous squamous cell carcinoma cell line SCC13 and on caspases expression.Methods Human cutaneous squa-mous cell carcinoma cell line SCC13 was treated with five different concentrations of acitrefin [5×10-7,1×10-6,5×10-6,1×10-5,5×10-5mol/L].Cell proliferation was evaluated by MTT assay.Apoptosis was assessed by en-zyme-linked immunosorbent assay.The cell cycle was assessed by flow cytometry.The protein expressions of caspase-8 and caspase-9 were examined with Western blot.Results Acitretin inhibited the growth ( F = 83.64,96.34 and 123.17, respectively on the first, third and fifth day)and induced the apoptosis of SCC13 cells(F=74.45,107.37,and 64.28, respectively on the first, third and fifth day) in a dose- and time-dependent manner(P<0.05).Acitretin altered cell cycle distribution of SCC13 cells as compared with controls, the G1-phase population increased by 77.66% 72 hours after acitretin treatment, while the control increased only by 63.55%.An active fragment of caspase-8 occurred following 12 hours treatment of acitretin on SCC13 cells, whereas the caspase-9 active fragment occurred 24 hours after acitretin treatment, which increased time-dependently (P<0.01).Conclusion Acitretin plays an important role on the growth inhibition and apoptosis of cutaneous squamous cell carcinoma cells, which may be affected through both Fas receptor way and mitochondria way.

Obj ectiev The purpose of this study is to assess the impact of bone metastasis on survival in non-small cell lung cancer(NSCLC),Which were treated with gefitinib for more than 6 months,and to identify the prognostic factors of patients with NSCLC presenting bone metastasis .Methods We compared the overall survival(OS), progression-free survival(PFS),1-year2,-year and 3-year survival rates between two cohorts based on bone metastasis ,as well as the prognostic factors in the patients with bone metastasis .Results In total, 76 patients were included in the study ,in which there are44 patients with no bone metastasis and32 patients with bone metastasis.The cohorts were similar in OS (19.000 ±3.317 months vs.26.000 ±2.121 months,P =0.625)as well as PFS (14.000 ±1.843 months vs.16.000 ±1.411 months,P=0.328).The 1-year survival rate was 63.6%in no bone metastasis cohort,but was increased to 96.9%in the other cohort.The survival rates at 2 years(34.1%vs.56.3%,P=0.054)and 3 years(18.2%vs.18.4%,P=0.950)were similar.The univa-riate analysis showed that a worse prognosis was more likely existed in elderly patients ( aged >60 years) and with pulmonary progression ,whereby factors including gender ,pathology s,moking index ,brain metastases ,bone related events and the application of radiotherapy ,bisphosphonates might not be independently associated with the surviv -al late.Analysis of multiple variables indicated a favorable prognosis for patients with no pulmonary progression . Conclusion This retrospective study shows that bone metastasis may not shorten the survival in patients whose pulmonary lesion was controlled by gefitinib .On the contrary ,pulmonary progression may be more likely the cause of death in patients with bone metastasis .Non suggestion is given to discontinue gefitinib when the bone metastasis appears.

Objective To observe the effect and toxicity of gemcitabine and S-1 in treatment of metastatic triple-negative breast cancer.Methods In this study,41 cases of metastatic breast cancer were treated in the General Hospital of Shenyang Military Region between Jun.2010 and Dec.2012.The median age was 55 years old.The pathological diagnosis of these patients was triple-negative breast cancer.All patients were given gemcitabine 1000 mg/m2 intravenously on the 1st and 8th day,and 60 mg S-1 from the 1st day to the 14th day orally for every cycle.There were 21 days for each cycle.All patients accepted at least 2 cycles of chemotherapy and once effect evaluation.Results 41 cases were diagnosed as metastatic triple-negative breast cancer,with the failure of second-line treatment.The median age was 55 years.All cases were followed up until death.All the 41 cases were administrated for more than 2 cycles,among whom,there were 0 case of complete response(CR),16 cases (39.0％)of partial response(PR),14 cases(34.1％) of stable disease(SD),and 11 cases(26.8％) of progressive disease(PD).The disease control rate was 73.1％ (30/41).In this study,median progression free survival(mPFS)was 7.9 months.The rate of digestive toxicity and marrow suppression was 24.4％ and 55％ respectively.No patient stopped treatment because of severe toxicities.Conclusion The chemotherapy regimen of gemcitabine and S-1 is effective in treatment of metastatic triple-negative breast cancer,and the toxicity could be tolerated.

Objective To evaluate the safety and efficiency of robot assisted surgery guided by damage control orthopaedics(DCO) in polytraumatised patients with pelvic ring injuries.Methods A retrospective review of the pelvic fracture database was performed.Twenty-six patients who had sustained a pelvic fracture from September 2012 to December 2015 were suitable for robot-assisted minimally invasive internal fixation.They were 17 men and 9 women,aged from 23 to 58 years (average,42.6 years).Their Injury Severity Score(ISS) ranged from 20 to 31 points (average,21.3 years).According to Tile classification,6 cases were type B2,3 type B3,9 type C2 and 8 type C3.Guided by DCO,the vital signs were stabilized by all means and the fractures treated by simple and temporary external fixation before the pelvic and other fractures were managed by the robot-assisted minimally invasive internal fixation.Demographics,times to operating room (TOR),time from acute stabilization to late definitive internal fixation (TAL),time for bone union,type of robot-assisted surgery for major fractures,length of stay (LOS),postoperative complications and mortality were recorded.The outcomes of the pelvis were evaluated at the final follow-up according to the Matta criteria.Results Of the 26 patients,robot-navigated percutaneous screwing was conducted with 23 sacroiliac screws in 19,with 9 ramus pubicus screws in 9,with 6 supraacetabular screws in 4,and with 4 both-column screws in 2 cases.TOR averaged 2.7 times,TAL 5.9 days,LOS at ICU 2.1 days,ICU admission rate 46.2％ (12 of 26),hospital LOS 7.3 days,and time for pelvic bone union 79.0 days.None patients had postoperative complications related to the pelvic fracture and no one died.According to the Matta criteria at the final follow-ups,8 cases were excellent,11 good,5 fair and 2 poor,yielding an excellent and good rate of 73.1％.Conclusion Robot-navigated minimally invasive surgery plus DCO is effective,time saving and safe treatment for polytraumatised patients with pelvic ring injuries.

Objective:To discuss the surgical techniques and clinical value of pure laparoscopic radical nephroureterectomy without changing patient’s position in the treatment of upper tract urothelial carcinoma(UTUC).Methods:The clinical data of 28 patients, who underwent pure laparoscopic radical nephroureterectomy with single patient’s position in the treatment of UTUC , were collected and analyzed, including 16 males and 12 females, with the median age of (68.3±9.7)(45-80)years.There were 20 renal pelvic carcinoma and 8 ureteral carcinoma with preoperative clinical TNM stage of T l-T 3N 0M 0. Among them, 9 tumors were located in right side, while 19 in left side. With the patient in a contralateral oblique position at 50°-70°. , an additional instrument hole is added at the midpoint between the umbilicus and pubic symphysis, besides the classical four holes. Nephrectomy was carried out routinely after the pneumoperitoneum was built, and then the ureter was dissected all the way down to bladder wall. The bladder was closed with 3-0 absorbable barbed suture following the bladder cuff being incised.The specimen were retrieved through the extended incision of the lower abdomen trocar or through vagina if suitable. There was no need to change patient’s positioning during operation. Results:All surgical procedures were successfully performed without conversion to open surgery. There was no serious bleeding or other operation related complications. The mean operative time was (136.3±48.7)(70-270)min, while the estimated blood loss was (46.3±38.3)(10-200)ml. The mean postoperative drainage volume (287.3±196.6)(30-910)ml, while the mean postoperative drainage time was 3.2(1-5)d. Their intestinal function recovered 1.5(1-4) d postoperatively. Their average postoperative hospital stay was(6.1±1.7)(3-12)d.Pathological results showed urothelial carcinoma in all cases, including 21 high grade and 7 low grade. Lymphovascular invasion was found in 7 cases of high-grade urothelial carcinoma. All the surgical margins were negative. The median follow-up was(9.2±4.8)(1-12)months, and there was neither tumor recurrence nor distant metastasis.Conclusions:Compared with the traditional operation method, single posture pure transperitoneal laparoscopic radical nephroureterectomy have the advantages of standardized operation method, simple procedure, less trauma, less bleeding and quick postoperative recovery. It is a safe and effective minimally invasive technology for the treatment of UTUC.

AIM: To establish a HPLC-QqQ-MS with multiple reaction monitoring (MRM) method for pharmacokinetics and tissue distribution study of ribavirin by oral and respiratory administration. METHODS: The experiment established a high-sensitivity LC-MS analytical method for the detection of ribavirin, and the linearity, specificity, recovery, accuracy, and precision were investigated. The established methods were used to investigate the pharmacokinetics and tissue distribution of the oral and respiratory administration methods. RESULTS: The concentration of drugs in the blood through respiratory tract administration is higher, and the drug absorption is faster. Respiratory tract administration C