Limb salvage surgery with comprehensive treatment is the standard care for soft tissue sarcoma in the limbs and trunk. Marginal status is a key factor in determining the quality of surgical treatment, as well as in guiding the selection of adjuvant therapies. The goal of surgery is to obtain an appropriately negative margin, although no consensus exists regarding the adequate thickness of normal tissue cuff. With the development of auxiliary treatments, surgery for soft tissue sarcoma is becoming less extensive. Marginal resection combined with adjuvant therapies may be necessary to preserve limb functions when the tumor is close to critical vessels, nerves, or bones. When preparing the preoperative plans, additional considerations should include histologic type, location, presence of barriers, and response to adjuvant therapies.

Sentinel lymph node biopsy has a very important function in the accurate staging, diagnosis, and treatment of malig-nant melanoma. The operational technique of sentinel lymph node biopsy (SLNB) has been basically mature, but its indications remain unclear, especially for thin melanomas. Adequate evidence to show that SLNB combined with a complete lymph node dissection can prolong the survival of patients with metastasis is unavailable. Given the low incidence of malignant melanoma in the country, the use of SLNB has not been extensively investigated in China and the relevant methods are outdated. This review summarizes the current ap-plication of SLNB in cutaneous malignant melanoma by analyzing related studies conducted in recent years.

Sarcomas are tumors of mesenchymal origin that account for approximately 1%of human cancers. There are at least 60 dif-ferent subtypes of soft tissue sarcoma (STS). However, most tumor types are highly malignant tumors that lack an optimal therapeutic agent. Although gastrointestinal stromal tumor (GIST) responds well to imatinib, other types of STSs remain challenging because of their heterogeneous genetic and clinical features and poor prognosis. In recent years, the field of molecular targeted therapy has pro-gressed rapidly. Patients with advanced disease can receive individualized treatment to improve their quality of life. This review focus-es on the targeted therapies that have been evaluated for advanced non-GIST STS. Other promising novel therapeutic agents that are currently in the early phases of investigation are also presented.

Biliary tract malignant tumours do not have any special symptom or physical sign in early stages.It is easy to be delayed for diagnosis and it is often very serious when the disease was diagnosised.With the development of technology of molecular biology,the biliary tract malignant tumours' diagnosis in molecular biology has been made some progresses,and it is expected to be possible to diagnose and treat the diseases in early stages.

Objective To study the clinical features and treatment of multiple schwannomas (neurilemmomas). Methods 9 patients with multiple schwannomas treated with surgery from 1975 to 1999 were reviewed retrospectively. Results In 7 of the 9 cases of schwannomas, the number of tumor lesions was seen more than that diagnosed preoperatively. All the patients had surgical resection; 5 had enucleation and 4 had tumors excised with the invovled nerve. Recurrence occured in 4 patients. Conclusion Because of the difficulty in predetermination of the exact lesional number, thoroughly preoperative examination including MRI is nessesary. Enucleation is recommended to those tumors involving important nerves. There is a high rate of recurrence.

Objective To evaluate the prospective electrocardiograph (ECG)-gated 128-slice spiral CT angiography in the diagnosis of complex congenital heart disease and airway abnormality in children.Methods Eighty children with congenital heart disease received prospective (n =40) or retrospective ECG-gated 128-slice spiral CT angiography (n =40).All of the patients underwent ultrasound cardiogram (UCG) within one week before CTA exmination.The image quality and the effective radiation dose were statistically analyzed using independent samples t test and x2 test.The surgical results were taken as the diagnostic standards,and the preoperative prospective and retrospective CT angiography data were compared with UCG results using x2 test.Results The effective dose of prospective ECG-gated CT angiography[(1.00 ± 0.26)mSv] was reduced by 86％ as compared with the retrospective ECG-gated CT angiography[(7.37 ± 0.52) mSv] (t =69.296,P ＜ 0.01).Image quality was graded 0 in none patients,graded 1 in 2 patients who underwent prospective ECG-gated CT angiography,graded 2 in 8 and 1 patient who received prospective and retrospective ECG-gated CT angiography respectively,and graded 3 in 30 and 39 patients who underwent prospective and retrospective ECG-gated CT angiography,respectively.There was no significant difference in image quality between prospective and retrospective ECG-gated CT angiography (x2 =0.044,P ＞ 0.05).The definitive diagnosis of extracardiac vascular anomalies was made in 98.3％(59/60) of patients by using prospective and retrospective ECG-gated CT angiography,which were significantly superior to UCG results[(76.7％ (46/60),76.7％ (45/59),respectively] (x2 =13.144,12.644,P ＜ 0.01),and there was no significant difference in the definitive diagnosis between prospective and retrospective ECG-gated CT angiography (x2 =0.001,P ＞ 0.05).The definitive diagnosis of the cardiac/large-vessel malformations was made in 100％ of the patients by both prospective and retrospective ECG-gated CT angiography,and there was no significant difference between 128-slice spiral CT angiography results and UCG results [97.2％ (35/36),97.3％ (36/37),respectively] (x2 =1.014,0.001,P ＞0.05).In the cardiac malformations,the definitive diagnosis by prospective and retrospective ECG-gated CT angiography was 88.7 ％ (47/53) and 92.5 ％ (49/53),and there was no significant difference between 128-slice spiral CT angiography results and UCG results [98.1％ (52/53),98.1％ (52/53),respectively](x2 =3.824,1.889,P ＞ 0.05),and no significant difference in the definitive diagnosis was observed between prospective and retrospective ECG-gated CT angiography (x2 =0.442,P ＞ 0.05).In addition,the 128-slice spiral CT angiography detected airway abnormality in 9 cases who underwent prospective or retrospective ECG-gated CT angiography.Conclusion The prospective ECG-gated 128-slice spiral CT angiography exhibits great application value in the preoperative diagnosis of complex congenital heart disease,which helps to develop surgical program and evaluate surgical risks.

Objective To master the epidemic situation and control effect of schistosomiasis in Yugan County,Jiangxi Prov-ince. Methods The data of the schistosomiasis prevalence in human and cattle as well as Oncomelania hupensis snail status were collected and the change trends were analyzed in Yugan County from 2008 to 2012. Results The schistosome infection rates of residents in Yugan County have declined every year since 2008,and currently,the prevalence of schistosomiasis was at a low lev-el. No acute schistosomiasis case was found during the past 5 years. In 2012,the infection rate of bovine was above 1%in 88 en-demic villages,and the area with schistosome infected snails was 10 hm2. Conclusion In order to achieve the goal of schistosomi-asis transmission control in the whole county in 2015,the comprehensive control measures based on infection source control should be strengthened.

Objectives To monitor the residents prevalence of endemic arsenism in the disease affected areas in Inner Mongolia, so as to provide feasible suggestions for control of arsenism in the future. Methods Monitoring data were obtained from the Project of Endemic Disease Prevention Granted by Central Government in 2010 - 2012, and the conditions of arsenism patients from 38 endemic arsenic villages were analyzed among different year, age and gender. Results The detection rate of arsenism of the 38 surveillance villages was 7.38%(517/7 004) in 2010, 7.10%(482/6 784) in 2011 and 6.62% (431/6 514) in 2012. The arsenism patients of mild;moderate and severe cases from 2010 to 2012, accounted for 74.47% (385/517), 74.27% (358/482), 75.17% (324/431); 16.83% (87/517), 16.60% (80/482), 15.78% (68/431) and 8.7% (45/517), 9.13% (44/482), 9.05% (39/431), respectively. For skin lesions, the detection rates of keratosis, pigmentation and depigmentation from 2010 to 2012, were 8.08%(566/7 004), 7.90%(536/6 784), 7.77%(506/6 514);3.27%(229/7 004), 3.29%(223/6 784), 2.87%(187/6 514) and 6.68% (468/7 004), 6.63% (450/6 784), 5.82% (379/6 514), respectively, showed a declining trend. It also showed a declining trend with age, and the patients were mainly 40 years old people and older, and the highest detection rate was in the 60- 70 years old group[15.54%(143/920)、14.72%(135/917)、13.36%(136/1 018)]. For gender distribution, the detection rate of the three years was higher in male than female [male 8.24%(300/3 639), 7.99%(283/3 542), 7.71%(260/3 372);female 6.45%(217/3 365), 6.14%(199/3 242), 5.44%(171/3 142),χ2=8.24, 8.77, 13.54, all P〈0.01]. Conclusion There is no big change of arsenism conditions in 2010-2012, with a slight declining trend.

Thirty-three infants with muscular torticollis were treated by Tuina techniques, and the size of the hardened sternocleidomastoid muscle in the affected side was B-ultrasonographically observed before and after treatment. Results: 27 cases were cured, 5 cases got effectiveness, 1 case failed and the total effective rate was 97.0%; B-ultrasonography, in the palpable cord-like or ovary-like lumps,showed low echo in 28 cases, moderate echo in 2 cases and high echo in 3 cases; there were significant differences in the length, thickness and width of the lumps between before and after treatment, P＜0.01. It is indicated that Tuina is quite effective against infantile muscular torticollis; that ultrasonography can be adopted as an objective item for the evaluation of the clinical efficacy of Tuina in the treatment of infantile muscular torticollis, and it is a simple, convenient and inexpensive method and should be extensively popularized in clinical practice.

Objective Abnormal activation of mitogen-and stress-activated kinase (MSK1) plays an important role in the development of various cancers.This study was to explore the effect of small interfering RNA (siRNA)-mediated MSK1-silencing on the proliferation of human nasopharyngeal carcinoma (NPC) cells and its underlying mechanism.Methods The siRNA vector targeting MSK1 was constructed and transfected into CNE2 cells, and the NPC cell line stably expressing MSK1 was established.Then the cells were divided into a blank control (without transfection of the plasmid), a negative control (with stable transfection of the negative control plasmid), and an experimental group (with stable transfection of the positive recombinant plasmid).The expressions of MSK1 mRNA and protein were detected by real-time quantitative PCR and Western blot, respectively, the proliferation of the cells determined by CCK-8 and colony formation assays, the cell cycles analyzed by flow cytometry, the level of histone H3 phosphorylation at Ser10 examined by Western blot, and The transcriptional activity and expression of the c-jun protein measured by dual-luciferase reporter gene assay and Western blot.Results Compared with the blank control, the inhibition rates of cell proliferation at 48, 72 and 96 hours were significantly reduced in the experimental group (P<0.05), and so were the colony formation ability of the cells (P<0.01) and the expression and transcriptional activity of the c-jun protein (P<0.05).In comparison with the negative control, the experimental group showed significant decreases in the rate of cell growth after 24 hours, the inhibition rates of cell proliferation at 48, 72 and 96 hours (P<0.05), the number of formed colonies ([221.00±20.08] vs [99.67±15.57] / 300 cells, P<0.01), the proportion of S-phase cells (P<0.01), and the expression of the c-jun protein in the CNE2 cells ([100.00±0.00] vs [48.77±10.71] %, P<0.05), but a remarkable increase in the percentage of G0/G1-phase cells (P<0.01).Furthermore, histone H3 phosphorylation at Ser10 was markedly reduced (P<0.01) but no significant change was observed in the expression of the total c-jun protein in the experimental group.Conclusion Knockdown of MSK1 using siRNA can significantly inhibit the growth and proliferation of CNE2 cells, which may be closely related to the decreased phosphorylation of histone H3 and subsequently down-regulated transcriptional activity of c-jun.