Spinal giant cell tumor of bone (GCTB) is a kind of primary benign bone tumors in the spine. It is rich in blood supply,aggressive,and easily recurring and lung metastasizing. So the benign GCTBs of the spine remains a challenge to treat.This article reviews the therapeutic methods in spinal GCTBs,including surgery,radiation therapy,arterial embolization. The treatment for the tumor with lung metastasis is also covered in this review. It is established that En bloc resection with wide margins is the most effective method to spinal GCTBs. To eliminate the residual tumor cells,adjuvant radiation should be done when complete resection is not available. Arterial embolization can be used to treat the huge sacral GCTBs.For those with lung metatasis,they can be controlled by lobectomy and /or chemotherapy.

Objective To explore the application of experienced teaching method in the teaching of Fundamentals of Nursing.Methods The feasibility and validity of experienced teaching method was evaluated by expounding the utilization and result of role-play method and practice experienced method.Results The experienced teaching method received good result and proved appropriate in the teaching of Fundamentals of Nursing.Conclusion The experienced teaching method overcame the disadvantages of mere traditional teaching method and aimed at the improvement of quality and ability of students.It contributed to developing the critical thinking ability and other abilities of students.

Objective To investigate the protective effect of pentoxifylline (PTX) on bile duct in grafts against ischemia-reperfusion (IR) injury and its potential mechanisms in the animal model of OLTx in miniature swines. Methods After PTX was added to the preservation solution and administrated through hepatic artery, changes of blood flow, activity of ATPase, apoptosis of epithelial cells, and pathomorphology of the bile duct were investigated in the animal model of OLTx in miniature swines. The animals were divided into IR, IR+NS, and IR + PTX groups. Results The results showed that the incidence of biliary necrosis was significantly lower in IR+PTX group than that in IR and IR +NS groups. When compared with those in IR and IR +NS groups, GGT and ALP levels, numbers of apoptosis cells, and scores of pathomorphology were significantly decreased in IR+PTX group, while blood flow, activity of Na +-K +ATPase, Ca 2+ -ATPase of bile duct in grafts were significantly elevated. Conclusion These results suggest that PTX has multiple antagonistic effects against IR injuries of the bile duct. The effects of PTX on bile duct of grafts against IR injuries are possibly correlated with the improvement of the microcirculation, preservation of the ATPase activity of the bile duct, and suppression of the apoptosis of the bile duct cells.

Objective To study the association between platelet distribution width (PDW) and other indexes in coronary heart disease (CHD) patients with heart failure (HF).Methods Five hundred and ninety-one CHD patients with HF were divided into control group with their NT-proBNP＜300 ng/L (n=228),mild HF group with their NT-proBNP=300-3000 ng/L (n=191),and severe HF group with their NT-proBNP＞3000 ng/L(n=172).Their blood and echocardiographic parameters were recorded.Results The PDW was significantly shorter in 3 groups after treatment than before treatment (0.129±0.031 vs 0.133±0.027,0.133±0.030 vs 0.141± 0.029,0.139±0.028 vs 0.148±0.029,P＜0.05,P＜0.01),and was significantly longer in mild HF group and severe HF group than in control group and in severe HF group than in mild HF group after tgreatment (P＜0.05,P＜0.01).Multivariate stepwise regression analysis showed that PDW was positively associated with NT-proBNP and LAD (P=0.001,P=0.000) and negatively associated with LVEF (P=0.003).Conclusion PDW increases with the severity of HF in CHD patients and can thus play an auxiliary role in assessing the severity of their HF.

Objective To evaluate the usefulness of diffusion-weighted MR combined with routine T2 WI in finding the possible residual foci in uterine cervical cancers after radical chemo-radiation therapy.Methods This was a retrospective study including 25 consecutive cervical cancer patients who received hysterectomy after radical chemo-radiation therapy.All of them underwent MR examinations post-chemoradiation and just before operation.Images of T2 WI alone and those of T2 WI combining DWI were evaluated respectively by 2 senior radiologists,in order to decide whether there were residual tumors.ADC values were also measured.Taking the post-operation pathological results as the gold standard,the accuracies,sensitivities and specificities of T2 WI alone,T2 WI combining DWI,and ADC values were all calculated.Results In those 25 patients,9 were found with foci of residual cancer in operative pathology,while no cancer cells were found in the other 1 6 patients.The accuracy,sensitivity and specificity in finding the positive residual cancer using T2 WI alone were 56.0%,77.8% and 43.8%,comparing with 72.0%,66.7% and 75.0% in T2 WI combining DWI.The accuracy and specificity increased with statistical significance after combining DWI (P =0.01 6 for accuracy,P =0.031 for specificity),while the sensitivity decreased but did not reach statistically significant level (P =0.099).No difference in ADC values was found.Conclusion DWI can be used as a supplementary sequence in finding the existence of residual tumors of cervical cancer after radical chemo-radiation therapy.Routine T2 WI combing DWI increased the specificity and accuracy,but still facing the risk of decreasing sensitivity.

Objective To explore the efficacy of saxagliptin in the treatment of failed glycemic control of patients with type 2 diabetes mellitus on the basis of established treatments.Methods 172 cases of failed glycemic control of patients with type 2 diabetes mellitus from June 2013 to December 2014 in department of endocrinology of the first hospital of Ningbo were selected and received health education of 8 weeks, then received saxagliptin on the basis of established treatments for a consecutive treatment of 12 weeks.The HbA1c, fasting blood glucose ( FBG), 2-hours postprandial blood glucose (2hPBG), body mass index (BMI), insulin dosage and adverse event were observed.Results The FBG,HbA1c and 2hPBG after treatment of 12 weeks were significantly lower than those pre-treatment[(7.1 ±2.0)vs.(8.3 ±1.6)mmol/L,(10.2 ±2.3)vs.(15.2 ±2.9)mmol/L,(7.0 ±1.5) vs.(8.0 ±1.7)%], with significant difference (all P <0.05), while there was no significant difference in BMI between pre-and post-treatment [(24.4 ±3.0)vs.(24.9 ±2.7)kg/m2].The insulin dose after treatment of 12 weeks was significantly lower than that pre-treatment[(22.6 ±7.9)vs. (32.3 ±8.2) U/d], with significant difference (P <0.05).There were two patients dropout because of the intolerable digestive tract symptom. Conclusion The adding of saxagliptin could control FBG,2hPBG and HbA1c effectively and decrease insulin dose, without gaining weight in the treatment of failed glycemic control of patients with type 2 diabetes mellitus on the basis of established treatments.

Objective To investigate the expression of autophagy and the effect of complement C5a/C5aR pathway on autophagy induced by renal ischemia reperfusion injury (IRI).Methods MaleWT and C5aR gene knockout (BALB/C background) mice were selected.The model of renal IRI was established by occluding bilateral renal pedicles with microaneurysm clamps.Mice were divided into wild type BALB/C (WT) group and C5aR gene knock out (C5aRKO) group.The pathology of kidney was assessed by HE staining.The levels of BUN and KIM-1 were detected 24 h after reperfusion.The expression of the autophagy-associated protein (LC3 Ⅱ/LC3 Ⅰ and P62) was measured by Western blotting and immunofluorescence.In vitro,human renal tubular epithelial cells (HK2) were cultured.The expression of LC3 in HK2 cells was investigated by immunofluorescence and Western blotting after being treated with recombinant C5a or C5a combined with C5aR antagonist (C5aRA).Results As compared with WT group,the severity of kidney injury was obviously reduced in C5aRKO group (P＜0.05).After ischemia-reperfusion,the expression of autophagy-related protein LC3 gradually increased with the reperfusion time prolonged.The level of autophagy induced by ischemia-reperfusion was significantly reduced in C5aRKO group as compared with WT group (P＜0.05).In addition,the expression of autophagy-related protein LC3 Ⅱ in HK2 cells was increased with the augment of C5a stimulation concentration in vitro.Blockage of C5aR pathway by C5aRA led to a significant decrease in autophagy (P ＜ 0.05).Conclusion Complement C5a/C5aR pathway promotes renal IRI-induced autophagy.

Objective To investigate the effects of Ruangan granule on transforming growth factor-β1(TGF-β1)/Smads signaling pathway in liver fibrosis in rats. Methods A total of 105 Wistar rats were randomly divided into normal control group, model group and colchicine, Dahuang-Zhechong pill group, high-, medium- and low-dose Ruangan granule groups (n=15 in each group). Liver fibrosis was induced by carbon tetrachloride and a high-cholesterol diet. After modeling, the low-, medium- and high-dose Ruangan granule groups were intragastric administrated Ruangan granule mixed suspension 3.6, 7.2, 14.4 g/(kg?d), respectively;Dahuang-Zhechong pill group was administrated with Dahuang-Zhechong pellets mixed suspension of 0.18 g/(kg?d);the colchicine group was intragastric administrated with colchicine mixed suspension of 0.108 mg/(kg?d);and the normal control group and the model group were intragastric administrated with the equal volume of distilled water. All rats were intragastric administrated for 8 weeks. The expressions of TGF-β1, Smad3 and Smad7 proteins in the liver tissue were detected with immunohistochemical staining method. The expressions of TGF-β1, Smad3, Smad7 mRNAs in the liver tussue were detected by RT-PCR. Results The expressions of TGF-β1 (2.59 ± 0.99 vs. 0.43 ± 0.21) and Smad3 (2.56 ± 0.67 vs. 0.41 ± 0.18) proteins and TGF-β1 mRNA (2.25 ± 0.21 vs. 0.71 ± 0.09) and Smad3 (2.34 ± 0.03 vs. 0.78 ± 0.12) mRNAs in the model group were significantly increased than those in the normal control group (all P<0.01). Compared with the model group, the expressions of TGF-β1 (1.12 ± 0.27 vs. 2.59 ± 0.99) and Smad3 (1.05 ± 0.34 vs. 2.56 ± 0.67) proteins in the high-dose Ruangan granule group decreased significantly, the expression of Smad7 increased significantly (2.33 ± 0.62 vs. 0.36 ± 0.18), and the expressions of TGF-β1 (1.09 ± 0.11 vs. 2.25 ± 0.21) and Smad3 (1.10 ± 0.02 vs. 2.34 ± 0.03) mRNAs decreased significantly, the expression of smad7 mRNA (1.18 ± 0.13 vs. 0.38 ± 0.11) increased significantly (P<0.05). Conclusions Ruangan granule can regulate the TGF-β1/Smads signaling pathway via down-regulation of TGF-β1, Smad3 and up-regulation of Smad7 in liver fibrosis in rats.

Objective To observe theRuangan granule on liver fibrosis in rats liver pathology change, the influence of hepatic function and hepatic fibrosis indexes, and to discusses the mechanism of its action to provide the basis for clinical prevention and treatment of liver fibrosis.Methods A total of 105 Wistar rats were randomly divided into a normal control group, a model group and a colchicines group, and Dahuang-Zhechong pill group, high-, medium- and low-doseRuangan granule groups (n=15 in each group). Liver fibrosis was induced by carbon tetrachloride and a high-cholesterol diet. After modeling, the low-, medium- and high-doseRuangan granule groups were intragastric administratedRuangan granule mixed suspension 3.6, 7.2, 14.4 g/(kg?d), respectively;Dahuang-Zhechong pill group was administrated with Dahuang-Zhechong pellets mixed suspension of 0.18 g/(kg?d); the colchicine group was intragastric administrated with colchicine mixed suspension of 0.108 mg/(kg?d); and the normal control group and the model group were intragastric administrated with the equal volume of distilled water. All rats were intragastric administrated for 8 weeks. HE staining and Masson trichromatic collagen staining were used to observe the pathological changes of liver While the change of AST, ALT, PH, TP and serum HA, LN, C-Ⅳ, PCⅢin blood serum were detected. Results Masson trichromatic collagen staining showed that, the percentage of liver collagen fiber area in rats of theRuangan granule high-dose group was significantly decreased (7.06 ± 1.18) % compared with model group (23.49 ± 1.34) %, colchicine group (11.35 ± 1.83) %, rhubarb worm pill group (15.27 ± 1.22) %,Ruangan granule medium-dose group (14.52 ± 1.75) %, and low dose group (16.08 ± 1.56) % (P<0.05 orP<0.01). Compared with model group,Ruangan granule high-dose group rats serum AST (75.86 ± 5.23 U/Lvs. 157.62 ± 24.04) U/L, the ALT (80.15 ± 5.94 U/Lvs. 160.58 ± 26.47) U/L, PH (52.58 ± 4.98μg/Lvs. 98.66 ± 6.75)μg/L significantly reduced, TP (74.19 ± 3.56 g/Lvs. 51.73 ± 5.92)g/L increased significantly (P<0.01).Ruangan granule high-dose group rats serum HA (277.22 ± 106.34 ng/mlvs. 553.19 ± 172.38 ng/ml), LN (89.82 ± 5.68 ng/mlvs. 134.25 ± 10.64 ng/ml), C-Ⅳ (47.94 ± 8.65 ng/mlvs. 84.18 ± 13.83 ng/ml), PCⅢ (16.53 ± 4.88 ng/mlvs.31.57 ± 5.35 ng/ml) decreased significantly in the model group (P<0.01).ConclusionRuangan granule has obvious effects for resisting liver fibrosis.

The survey aims at probing into the current development of medical instruments in hospitals and computerized quality control,upgrading the competence of hospital engineering departments and guiding the development of medical clinical engineering.Questionnaire surveys were made to the medical engineering departments of 195 hospitals above secondary hospitals in Zhejiang,totaling 1001 professionals.The results indicate significant differences among hospitals of various scales in terms of deployment of medical engineering Professionals,working conditions,and computerized applications,yet a consistency in academic title promotion and training requirements.In this consideration,it is imperative to build the team,maintain consistency in professional certification of medical engineering professionals,build a regular and systematic examination,promotion and certification system,enhance training in professional knowledge and equipment quality control,as well as promoting information and resources sharing.All these efforts are essential for better quality control and management of medical engineering departments,and promoting computerized management of medical instruments.