Objective To know the pollution status and the cytotoxicity of PM2.5 in Hangzhou,Zhejiang.Methods PM2.5 was collected in the center of Hangzhou city in spring and summer in 2005,the weighting method was used for PM 2.5 collection.WI-38 cell line was used as the target and the cells were treated with PM2.5 at different doses.The cytotoxicity of PM2.5 was tested by cloning efficiency.Results According to the Air Quality Standard for PM2.5 of U.S.EPA(issued in 1997),it was showed that the rates exceeding standard of PM2.5 concentration in spring and summer were 96.7% and 90.0%,respectively,but the rates were 33.3% and 20.0% compared with the standard newly issued in 2006.WI-38 cell survival rate was 100%,99.6%,96.2%,85.0%,73.8%,54.6% and 100%,97.0%,96.9%,88.0%,83.0%,64.7% respectively when treated with PM2.5 in spring and in summer of 0,25,50,100,200,500 ?g/ml.There was a significant difference except 25 ?g/ml and 50 ?g/ml in summer.Conclusion There is an obvious PM2.5 pollution in Hangzhou,which is heavier in spring than in summer,the cytotoxicity of PM2.5 in the polluted air may be higher.

Cancer stem cell(CSC)plays a very important role in the genesis、relapse、metastasis and drug resistance of cancer.Traditional chemotherapeutics may kill a large part of malignant cells,but it has little effect on scanty CSC.It is enough for the relic CSC to make cancer relapse and metastasis.Targeted therapy aimed directly at CSC is the only way to cure cancer fundamentally.The specific biologic character of CSC is helpful for studying and developing targeted therapy to CSC.

?Proliferative diabetic retinopathy ( PDR ) is a group of disease characterized by neovascular disease complication of diabetes mellitus. Neovascular diseases of eye are one of the major causes of blindness of the world. Recent studies showed that vascular endothelial growth factor ( VEGF) and pigment epithelium-derived factor ( PEDF ) are now accepted as the key cytokine in the development of diabetic retinopathy. Recent progress in the investigation of VEGF and PEDF of PDR are summarized in this review.

Objective To compare the efficacy of internal fixation with non-operative treatment of traumatic flail chest combined with sternal fracture.Methods A retrospective review was made on 102 patients with traumatic flail chest combined with sternal fracture treated from January 2007 to January 2014.There were 71 patients in operation group and 31 patients in non-operation group.Operation group was allocated to pure titanium rib plating (Group Ⅰ,22 cases),porous titanium screw fixation (Group Ⅱ,20 cases),and nickel-titanium memory alloy sternal rib plating (Group Ⅲ,29 cases).Rib traction was performed in non-operation group.Clinical results and incidence of complications were compared between the two groups.Results At 24 and 72 hours,operation group was superior over non-operation group with regard to HR [(100.4 ± 9.5) times/min vs (105.2 ± 10.1) times/min,(92.1 ± 9.9) times/min vs (102.1 ± 9.2) times/min],MAP [(97.7 ± 14.5) mmHg vs (91.0 ± 13.3) mmHg,(112.5 ± 15.2) mmHg vs (93.1 ± 13.8)mmHg] and CVP [(7.8 ±3.7)cmH2O vs (9.4 ±3.8)cmH2O,(6.2 ±2.9)cmH2O vs (9.1 ±3.2) cmH2 O] (P ＜ 0.05).Duration in ICU [(5.1 ± 0.8) days vs (9.3 ± 1.1) days],ventilation time [(4.5 ±1.0)days vs (8.2 ± 1.4)days],hospitalization time [(14.6 ±3.5)days vs (23.3 ±4.4)days] and incidence of complications were significantly lower in operation group than in non-operation group (P ＜ 0.05).Two months after discharge,tidal volume (VT) [(0.52 ±0.04)L vs (0.40 ±0.03)L],inspiratory capacity (IC)[(1.99 ±0.45)L vs (1.22 ±±0.33)L],forced vital capacity (FVC) [(3.52 ±0.51)L vs (2.44 ±0.42)L],total lung capacity (TLC) [(5.41 ±0.82)L vs (3.72 ±0.56)L] and forced expiratory volume in one second (FEV1) [(2.80 ± 0.43) L vs (1.95 ± 0.50) L] showed significantly better results in operation group than in non-operation group (P ＜ 0.05).Operation time,intraoperative bleeding and daily drainage volume were (38.8 ±9.2)min,(43.5 ±7.6)ml and (10.9 ± 1.1)ml in Group Ⅱ versus (62.5 ± 10.1)min,(100.0 ± 10.5) ml and (26.8 ±3.1)ml in Group Ⅰ and (49.3 ±9.6)min,(61.4 ±8.3)min and (19.8 ±1.6)ml in Group Ⅲ (P ＜ 0.01).Conclusion For traumatic flail chest combined with sternal fracture,the internal fixation should be done as early as possible so as to reduce incidence of complications.Relatively,porous titanium screw fixation has better clinical outcome.

Objective To explore effect of daily clearance and improvement mode application in man-agement of clinical nursing responsible group. Methods 200 patients from hand and foot surgery department of our hospital between January to June, 2007 were included into the control group, and 200 patients who were in hospital between July to December, 2007 were included into the experimental group. Then quality of care and satisfaction of patients were compared respectively between the two groups to study application effect of daffy clearance and improvement mode. Results After six months application of daily clearance and improvement mode, significant difference was seen in the two groups. Condusions Application of daffy clearance and improvement mode in management of clinical nursing responsible group is an effective method in nursing supervision.

Objective The aim of this study was to explore the effect of androgen deficiency on serum hormone levels, visceral fat accumulation and inflammatory gene expression in miniature pigs fed a high-fat diet ( HFD) . Methods Sexually mature male Chinese Wuzhishan miniature pigs were divided into three groups ( animals/group) as follows:intact male pigs ( SHAM) , castrated male pigs ( CAS) and castrated male pigs plus testosterone treatment ( CAS+T) . The pigs were fed a HFD diet for 12 weeks. Serum levels of testosterone and leptin were measured and visceral fat were dissected and weighted. qRT?PCR was performed to determine the mRNA expression levels of lipogenic, lipolysis and inflammation relat?ed genes. Results (1) Serum testosterone levels were significantly decreased but serum leptin levels were significantly in?creased in the castrated pigs. These effects were recovered after testosterone treatment. ( 2 ) Visceral fat percentage was significantly increased in the castrated pigs, and testosterone treatment reduced the increased visceral fat in the castrated pigs. (3) Castration and testosterone treatment had no significant effects on the expression levels of lipogenic genes (FAS and ACC) and lipolysis genes (HSL and ATGL) in pigs fed a HFD. (5) Castration significantly induced the expressions of inflammatory genes including Leptin, CD68, CCL16, CCL23 and SAA, and testosterone treatment recovered the expres?sions of the above genes in the castrated pigs. Conclusions Castration?induced testosterone deficiency promotes visceral fat accumulation and upregulates the expression levels of inflammatory genes in miniature pigs fed a HFD. Moreover, tes?tosterone treatment ameliorates castration?induced visceral fat accumulation and inflammatory response in HFD?fed pigs.

Objective To investigate the influence of a multifaceted stroke telehome-care (THC) on extremities function, activities of daily living (ADL) and quality of life in stroke patients with hemiplegia. Methods A total of 52 stroke survivors in department of neurology were randomized to the THC intervention or usual care. The patients in the control group received conventional care, while those in the intervention group were additionally given a THC program over 3 months. The THC intervention includes motor imagery and adaptive strategies. Data collection was undertaken using the Fugl-Meyer Motor Assessment Scale (FMA), the Barthel Index (BI), the Stroke Impact Scale (SIS) at baseline, 3 months, and 6 months. Results At baseline, the scores of FMA, BI, and SIS in the intervention group were 53.62 ± 23.52, 54.04 ± 17.44, 179.96 ± 28.51, and while the scores of the control group were 50.96 ± 19.52, 49.46 ± 15.09, 169.23 ± 28.48. There were no pre-existing differences on any scale between the two groups (t=0.443, 1.012, 1.358, P > 0.05). At 3 months, the scores of FMA, BI, SIS in the control group were 53.54 ± 17.45, 50.77 ± 14.47, 76.19 ± 27.78, and were significantly lower than 78.38 ± 12.54, 74.62 ± 11.22, 228.54±22.63 in the THC group (t=5.895, 6.641, 7.449,P<0.01). At 6 months, the scores of FMA, BI, SIS in the control group were 57.88±17.89, 59.08±13.85, 183.92±26.56, and were significantly lower than 90.58 ± 9.60, 86.54 ± 9.88, 252.19 ± 20.10 in the THC group (t=8.211, 8.233, 10.451, P < 0.01). Conclusions A telehome-care program that provide distance training and education of disabled persons resulted in greater improvements in physical functioning, ADL and quality of life.

AIM:To evaluate the efficacy and safety of methazolamide in treating refractory uveitic macular edema.METHODS: Retrospective self-controlled study was designed.A total of 15 patients (20 eyes) with refractory uveitic macular edema which used methazolamide as adjuvant therapy were enrolled in Shanghai First People`s Hospital from January 2015 to June 2016.The changes of central macular thickness (CMT) and best corrected visual acuity (BCVA) were observed at baseline and 2, 4, 8wk after treatment.We also focused on the incidence of complications and relapse.RESULTS: The CMT was 445.95±154.10μm, 338.83±138.34μm, 251.50±40.20μm, 244.90±35.68μm at baseline, 2, 4 and 8wk after treatment, respectively.The differences among them were statistically significant (F=15.467, P<0.05).The BCVA (log MAR) were 0.40±0.17, 0.28±0.21, 0.19±0.20, 0.18±0.21 at baseline, 2, 4 and 8wk respectively, with a significant difference among them (F=5.208, P<0.05).When the cumulative dose reached to 700mg and 1400mg, no one had methazolamide-related complications;and when it came to 2800mg, 5 patients (33%) had methazolamide-related complication.After the withdrawal of methazolamide 1wk, 1 and 3mo, 3 patients (20%), 5 patients (33%) and 8 patients (53%) relapsed, respectively.CONCLUSION: Methazolamide is beneficial in improving macular edema and vision in 4wk.When the cumulative dose is more than 1400mg, we need pay attention to the complications.After discontinuing methazolamide for 1wk, macular edema relapsed in some patients, and more than half of patients recurred after 3mo.So the patients should be followed closely in 3mo after withdrawal of methazolamide.

Background and purpose: With the increase of aging population, elderly patients (age ≥70 years) with esophageal squamous cell carcinoma occurred more and more. However, few studies have focused on elderly esophageal squamous cell carcinoma patients. This study aimed to assess the outcomes and prognostic factors for elderly patients with esophageal squamous cell carcinoma treated after deifnitive chemoradiotherapy. Methods:We retrospectively analyzed 53 patients (age≥70 years) with esophageal squamous cell carcinoma and treated with deifnitive radiotherapy with or without chemotherapy from Fudan University Shanghai Cancer Center from Mar. 2009 to Dec. 2011. Results:Median age was 74 years. Twenty-nine patients underwent radiotherapy, 24 patients underwent radiochemotherapy. 1-, 2-, 3-, and 5- year survival was 62%, 44%, 33% and 19% respectively. Grade 2 and above acute radiation-induced esophageal toxicity and radiation pneumonitis occur rate was 6% and 9% respectively. No treatment-related deaths occurred and no patients experienced any grade 4 and above toxicities. Multivariate analysis identiifed treatment modality, tumor site and smoking history as independent prognostic factors for overall survival. Conclusion:Radiotherapy may be an acceptable treatment option for elderly patients with esophageal squamous cell carcinoma. In appropriately selected patients, concurrent chemotherapy could bring a better overall survival.

Objective To evaluate the role of mierosurgery in surgical treatment to urethrocutaneous fistula after urethroplasty in hypospadias and improve surgical results.Methods From 1999 to 2006,44 urethrocutaneous fistulae (more than 3mm in diameter) after urethroplasty for hypospadias in 33 patients were repaired with different skin flaps.For example,Thiersch technique,urthroplasty,etc.Microsurgical tech- nique was employed in every case.Results The success rates of different procedure were 84.8% (28/33) for Thiersch technique,100% (11/11) for urethroplasty respectively.The total success rate was 88.6%(39/ 44).Conclusion It's just application of skin flap for repairing of big or complex urinary fistula after hypos- padias surgery.The application of microsurgical technique can increase success rate.It is necessary to excise scar and partial urethra for hypospadias fistula combined with urethral structures,cicatricial eontracture and in- curvation of penis.Rich blood-supply,low tension and atraumatic technique are all very important to improve surgery success rates of urinary,fistula after hypospadias repair.