Objective: To investigate the possible association between codon 2020 polymorphism(Asn2020Ser) of IGF2R gene and the susceptibility to colorectal cancer(CRC) and hepatocellular carcinoma(HCC) in Chinese population. Methods: The IGF2R Asn2020Ser genotypes were determined by TaqMan assay in 345 CRC cases and 670 controls, and in 469 HCC cases and 558 controls. Odds ratios(OR) for cancer and 95% confidence intervals(CI) from unconditional logistic regression models were used to evaluate relative risks. Potential risk factors were included in the logistic regression models as covariates in the multivariate analyses on genotype and cancer risk. Results: The Ser allele of the IGF2R Asn2020Ser polymorphism was significantly associated with decreased risks of CRC and HCC. As compared with Asn/Asn genotype, Asn/Ser,Ser/Ser and Ser-allele carriers (Asn/Ser or Ser/Ser genotype) had significantly decreased risks of CRC, with the decrease being 0.71-fold (95% CI = 0.54-0.94, P = 0.017), 0.64-fold(95% CI = 0.42-0.97, P = 0.036) and 0.69-fold(95% CI = 0.53-0.90, P = 0.008), respectively. A similar decreased HCC risk was also shown, with the decrease being 0.68-fold(95% CI = 0.52-0.89, P = 0.005) for Asn/Ser genotype, 0.78-fold(95% CI = 0.52-1.16, P = 0.212) for Ser/Ser genotype, and 0.70-fold(95% CI = 0.54-0.90, P = 0.006) for Ser-allele carriers, when compared with Asn/Asn genotype. Conclusion: The Ser allele of the IGF2R Asn2020Ser polymorphism is potentially one of the protective factors against CRC and HCC in Chinese population.

Intracranial branch atheromatous disease (BAD) was proposed by Caplan in 1989.It has been widely studied in Japan in recent years.With the application of high-resolution magnetic resonance,BAD has become a hot topic.This article reviews the concept,etiology,pathology,diagnosis and treatment of BAD as well as its relationship with ischemic stroke.

Objective To discuss the value of combining the physiological and operative severity score for enumeration of mortality and morbidity(POSSUM)and acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)in severe acute pancreatitis(sAP).Methods 60 cases of SAP were divided into surgery group(n=15)and non-surgical group(n=45),Non-surgical group was vahde with APACHE Ⅱ score,the surgery group with POSSUM score,decided to continue conservative treatment or surgery treatment,Observation of two ways with the complications and death.Results The rates of compHcafions and death were(0.37±0.08)and(0.27±0.09)in Single-operation group(n=15)higher than(0.76±0.14)and(0.61±0.15)in surgical group(n=11)(t1=3.125,t2=3.211,P＜0.01);APACHEⅡ score of mortality in operation group and non-surgical group were no significant difference(x2=2.28,x2=1.98,P＞0.05);APACHE Ⅱ score were(10.12±6.27)in survival group(n=46)were lower than (25.75±7.90)in death group(n=14)(t=2.525,P＜0.05.Conclusion The score of dynamic APACHE Ⅱ has better effect to judge the timing of surgery,and the score of POSSUM has high value to predict post-operative complications and deaths occurred in patients with severe acute pancreatitis.

BACKGROUND:Tantalum rod implant technology is a new method of early osteonecrosis treatment. Current research on stress distribution before and after tantalum rod implant in different sizes of femoral head necrosis area is few. OBJECTIVE:To analyze the stress distribution before and after tantalum rod implantation in different sizes of necrotic femoral head area using three-dimensional finite element method. METHODS:Three-dimensional finite element models of normal femoral head and necrotic femoral head of 15, 20 and 30 mm diameterwere constructed. Eight measuring points were chosen on two tiers of each necrotic model to detect the stress distribution and its alteration before and after tantalum rod implantation. RESULTS AND CONCLUSION:(1) Stress concentration werefound on every necrotic femoral head, most pronounced on the one with 30 mm lesion. (2) Tantalum implant appeared to reduce the stress concentration generaly. Comparison of the peak points of these models indicated most significant benefit in 15 mm lesion, next in 30 mm lesion, last in 20 mm lesion. (3) Results indicate that larger lesion entails more concentrated stress distribution and more likely to colapse. Tantalum rod implantation can delay the development of necrosis of the femoral head, andismost effective in smal lesion.

Objective To summarize the nursing methods of Orthofix limb reconstruction system in the treatment of limb long bone defects. Methods Thirty-two patients with long bone defects were collected between January 2012 to January 2015. The patients were all treated with the Orthofix limb reconstruction system and perioperative nursing. Results All the cases were treated by the method for 8 . 5 to 18 . 2 months , averaged 15 . 40 ± 3 . 20 months . The bones extended 4 ~ 21 cm , averaged ( 8 . 06 ± 3 . 06 ) cm . The assessments of bone transport treatment showed 31 cases were excellent and 1 good. Conclusions The limb long bone defects with or without soft tissue defects caused by various causes can be treated by the Orthofix limb reconstruction system. Patients should pay attention to psychological counseling and nutritional support preoperatively. It is important for patients to pay attention to bone transport and functional exercise guidance postoperatively.

OBJECTIVE: To investigate the risk factor,type and characteristic nystagmus of the otolith abnormal migration during diagnosis and treatment for posterior semicircular canal benign paroxysmal positional vertigo (PSC-BPPV). The therapy and prevention is also discussed. METHOD: Four hundred and seventy-nine patients with PSC-BPPV were treated by Epley's canalith repositioning procedures(CRP) from March 2009 to March 2012. We observed otolith abnormal migration complicating during diagnosis and treatment. According the type of otolith abnormal migration, the additional repositioning maneuver was performed. RESULT: The rate of complication was 8. 1%(39/479), with canal conversion in 5.4%(26/479) and primarily canal reentry in 2.7%(13/479). The rate of incidence of conversion to horizontal canal conversion and anterior canal were 4. 8%(23/479)and 0. 6%(3/479) respectively. All the patient was cured in follow up. The risk factors were unappropriated head movement during or after CRP, including another Dix-Hallpike were performed immediately. CONCLUSION To prevent the complications,the pathognostic positioning sequence and angle of head rotation are commenced during CRP. Appropriate short time postural restrictions post-treatment is necessary. Careful observation of nystagrnus variation is crucial to determine the otolith abnormal migration.
Benign Paroxysmal Positional Vertigo ; therapy ; Head ; Humans ; Incidence ; Nystagmus, Pathologic ; etiology ; Otolithic Membrane ; Patient Positioning ; adverse effects ; Semicircular Canals ; Vertigo

ObjectivesTo examine the validity of high-frequency Doppler ultrasound in identifying knees synovitis in patients with rheumatoid arthritis(RA).MethodsNinety-five consecutive patients with active RA were examined withhigh-frequency Doppler ultrasound to examine synovitis signals in knees.Synovial tissue samples of 51 patients were obtained by closed needle biopsy from knees after ultrasound examination.Serial synovial tissue sections were stained with H&E and immunohistochemical staining,and the histopathological synovitis scores were evaluated.The relationship among clinical, histopathological and ultrasound synovitis indexes was analyzed by Spearman's rank order correlation test and receiver operating characteristic curve analysis.ResultsAmong 95 RA patients,the median thickness of synovial membrane in ultrasound was 2.8 mm,the median depth of effusion was 2.7 mm; Doppler signals of synovial blood flow were detected in 82％(78/95 ) of patients and the median semiquantitive grading of synovial blood flow was 1.0.The thickness of synovial membrane and synovial blood flow at Doppler ultrasound correlated positively with histological synovitis score,hyperplasia of the lining layer,and inflammatory infiltration in sublining area (the thickness of synovial membrane:r=0.438,0.424,0.368,respectively; synovial blood flow:r=0.357,0.377,0.347,respectively; all P＜0.05).Although there was no significant difference in clinical synovitis indexes between patients with histologically low-grade and high-grade synovitis,the thickness of synovial membrane and synovial blood flow in ultrasound in patients with histologically high-grade synovitis was significantly higher than those with low-grade synovitis(P=0.001,0.036,respectively).When the thickness of synovial membrane in ultrasound was ≥ 3.9 mm,the specificity of diagnosing the high-grade synovitis was 96.7％ and the sensitivity was 61.9％.ConclusionSynovitis signals at high-frequency Doppler ultrasound correlate with histopathological synovitis,and it might be helpful in evaluating the severity of histopathological synovitis.

Objective To investigate the curriculum construction and evaluation of teaching effectiveness of simulation and comprehensive experiment for clinical nursing. Methods Based on the investigation of hospital, taking working progress and working task of nurses as orientation, we constructed the curriculum of simulation and comprehensive experiment for clinical nursing, and unfold in junior class (before clinical practice) for student nurses. The teaching effect was evaluated. Results Unfolding simulation and comprehensive experiment could effectively enhance the nursing students' ability to transform theoretical knowledge into clinical nursing practice, and was favorable to change the role of nurses and improve the satisfaction degree of clinical practice.Conclusions Unfolding simulation and comprehensive experiment for clinical nursing for student nurses before clinical practice is practicable and essential.

Objective:To investigate the relationship between the distance from the upper and lower resection margin and the gastric cancer patients with R0 resection and no distant metastasis.Methods:Retrospective analysis of 281 patients with gastric cancer in our hospital,the relationship between the age,sex,tumor size,tumor size,vascular invasion,lymph node metastasis,TNM stage,type of gastric cancer,tumor location and operation mode was analyzed.To compare the survival time of patients with different upper and lower margins.Results:The increase of the distance from upper resection margin was significantly related to the tumor size＞5 cm,TNM stage,type of gastric cancer,tumor location,and the difference was statistically significant(P＜0.05);The distance of lower resection margin was significantly correlated with tumor size＞5cm,vascular invasion,lymph node metastasis and TNM stage,type of gastric cancer,and the difference was statistically significant (P＜0.05);Themedian survival timein patientsof upper resection marginr□3cm with 48 months of the 5-year follow-up period was significantly higher than that in patients of the resection margin＞3cmwith 46 months (P＜0.001).Themedian survival timein patientsof lower resection margin□3cm with 45 months of the 5-year follow-up period was significantly higher than that in patients of the resection margin＞3cm with 44 months (P＜0.001).Conclusion:Gastric cancer postoperative upper and lower resection margin was significantly related with tumor size,TNM staging factors,and the median survival time of upper and lower resection margin＞5 cm was significantly lower than that of the resection margin3 cm.

Objective To evaluate the reproducibility of normal liver ADC measurements by different respiratory motion compensation techniques. Methods A total of 31 young healthy volunteers who are 20 to 40 years old without any hepatic diseases were selected to research. Each volunteer underwent liver DWI twice in 24 hours with the same parameters and location. The imaging was performed with free-breath(FB), breathhold(BH), rspiratory-triggered(RT)and navigator-triggered(NT)techniques, and the ADC values of the left hepatic lobe and right hepatic lobe (upper, middle and lower) was acquired with two scans. Analysis the the ADC values of various anatomic locations of liver with two-way analysis of variance of randomized block design. Reproducibility of ADCs was assessed with the Bland-Altman method. Analysis of variance and paired-sample t test was used to assess ADCs from both right and left liver lobe among the four techniques. Result The ADC values acquired from the four techniques were significant differences (P<0.01),and the ADC values of the right lobe were less than the left lobe's(P<0.01). It showed a trend to decrease moving from superior to inferior levels in both left and right lobes, and the ADC values among The middle and lower were significant differences (P<0.01). The limit of agreement of ADC of twice imaging among the four techniques were as follow: the right lobe was less than the left lobes, and the breathhold was less the others. As the result, reproducibility in the right liver lobe was better to that in the left and the reproducibility with breathhold was better than the other respiratory motion compensation techniques. Conclusions Both anatomic location and DWI technique influence the liver ADC measurements and their reproducibility. The reproducibility of BH is the best.