Objective To explore the expression and significance of HDGF and ADAM9 in esophageal cancer.Methods HDGF and ADAM9 expression in 113 patients with esophageal cancer (78 males and 35 females) with ages ranging from 28 to 87 years,averaged (61.2 ± 8.6) years,were analyzed by SP immunohistoehemical staining.Results The positive rates of HDGF and ADAM9 in esophageal cancer (78.8％ and 68.1％ respectively) were significantly higher than those in normal tissue(all were 30％).ADAM expressions were not correlated with age,sex,tissue types,lymph nodes metastasis,location and tumor size (P ＞ 0.05) ;the positive expression rate of HDGF and ADAM9 was related to differentiation,PT stages,and 5-year survival rate (P ＜0.05).HDGF was correlated with PT stage.Conclusion The expressions of HDGF and ADAM9 in esophageal cancer tissues were more higher than normal esophageal tissues,this means they could promote the development of tumor cells transformation,multiple and moving,and may be an useful tool for providing information about the targeted therapy and prognosis.

Objective To characterize the expressions of androgen receptor (AR) and estrogen receptor (ER) in penis skin of patients with congenital hypospadias. Methods Dorsal prepuce, ventral prepuce, and urethral plate were harvested from 30 patients with congenital hypospadias. The expressions of AR and ER in epidermal cells and dermal fibroblasts were assessed respectively by automated immunohistochemistry. Image Pro plus 6.0 was used to analyze the optical density (OD) value of AR and ER in different parts of epidermal cells and dermal fibroblasts. Results AR and ER were located mainly in nucleis of the squamous basal cells and prickle cells, and were also found in nucleis of subcutaneous fibroblast cells. The expression of AR was lower in epidermis of urethral plate than that of dorsal prepuce and ventral prepuce (P<0.05), but no significant difference was detected in dermal fibroblasts. The expression of ER was higher in epidermis of dorsal prepuce than that of urethral plate and ventral prepuce (P<0.05). The dermal expression of ER in fibroblast cells was increased successively in dorsal prepuce, ventral prepuce and urethral plate (P<0.05). Conclusion Lower expression of AR in urethral plate may contribute the development of hypospadias. Disorder of ER in dermal fibroblast cells of prepuce may play an important role in hypospadias.

[Summary] The characteristics ot clinical data and relevant inspection (quantitative sensory and electrophysiological studies) in 5 patients hospitalized with acute painful neuropathy following rapid glycaemic control with insulin from 2010 to 2012 in our hospital were analyzed.The results showed that 5 patients were all males,aged 31-49 years,with lower body mass index,and diagnosed as latent autoimmune diabetes of adults (LADA) or type 2 diabetes.Glycaemic control was poor before application of insulin.When insulin was used,the hyperglycemia was rapidly corrected in a short time,with recurrent episodes of hypoglycemia during insulin treatment.The painful neuropathic symptoms appeared within 2-4 weeks after application of insulin,and were relieved partially or completely after 2-6 months.Neuropathic symptoms manifested as tingling and tenderness,with worsening during night and after insulin injection.The neuropathic symptoms were not significantly alleviated after application of neurotrophic drugs such as methycobal,protogen,and prostaglandin.These patients often suffered from severe anxiety.Nerve electromyogram examination showed slowed or normal motor conduction velocity of tibial and fibular nerves,and normal feeling threshold.

Objective To study the safety of transfusion of itraconazole through PICC and to evaluate the effect of different amount of blood transfusion before and after the infusion. Methods Patients were recruited from January 1, 2014, until December 31, 2015, in the Hematology hematopoietic stem cell transplantation ward. Thiry-two patients were recruited in the control group. Ninety patients wererecruited in the experience group. They were randomly assigned to three groups with 30 cases each, extracting different amounts of itraconazole before infusion, back phlebotomize in group A, B, C respectively was 10.0, 0.5, 1.0 ml. Comparing the phlebitis and obstruction after ten days from the transfusion day on. Results Catheter obstruction was not observed in any case. There was a significant difference between control group (21.9%,7/32) and observation group (0) regarding the incidence of phlebitis (χ2=21.157,P < 0.05). No statistical difference was noted among the observation groups regarding the incidence of phlebitis (P>0.05). Conclusions Drawing a small amount of blood volume before itraconazole injection through PICC can effectively avoid the drug-induced catheterobstruction. What′s more, transfusion through PICC can significantly reduce the incidence of phlebitis compared with peripheral infusion.

OBJECTIVE:To study curative effect of the combination of cyclosporine A,mycophenolate mofetil,anti-thymocyte globulin,interleukin-11 and short-term methotrexate as acute graft-versus-host disease(aGVHD) prophylaxis on HLA-matched unrelated donor or HLA-mismatched related donor allogenic peripheral blood stem cell transplantation(Allo-PBSCT).METHODS:Thirteen patients with haematological malignancies who underwent HLA-matched unrelated donor or HLA-mismatched related donor Allo-PBSCT with the combination of cyclosporine A as aGVHD prophylaxis at Haikou Municipal People's Hospital from September to November 2008 were selected,including 7 of unrelated donor,3 of haplotype transplantation,and 3 of 1-locus mismatched.The conditioning regimen was performed at 7 days prior to transplantation,with cyclosporine A 5-10 mg/(kg?d),12 hours per time with twice per day.From day 7 prior to transplantation,mycophenolic acid was intravenous drip once per day,then 2.5 mg/(kg?d) antithymocyte globulin at days 5-2 prior to transplantation,1.5 mg/d interleukin 11 was subcutaneous injected at day 2 prior to and 10 days after transplantation,followed by intravenous drip 15 mg/m2 amethopterin at day 1 and 10 mg/m2 at days 3,6,11 after transplantation.The drug doge was reduced and stopped gradually after 3-6 months,which could be prolonged for haplotype grafter.Recombinant human granulocyte colony-stimulating factor was injected subcutaneously at day 3 prior to transplantation,and PBSCT was collected at days 4 and 5 after medication,which was infused to patients with subclavian vein at the same day.In total(7.82-9.11)?108/kg mononuclearcell and(2.9-7.7)?106/kg CD34+ cells were infused.RESULTS:Hematopoiesis was rebuilt in all patients with 46.15%(6/13) aGVHD incidence rate,including 8 %(1/13) of Ⅲ-Ⅳ aGVHD.Up to April of 2009,all patients live and work as normal except one patient who can not visit public places.CONCLUSION:The combination of cyclosporine A,mycophenolate mofetil,anti-thymocyte globulin,interleukin-11 and short-term methotrexate is effective in the prevention of aGVHD.

Objective Through two nationwide sero-epidemiological survey programs on hepatitis B virus (HBV),hepatitis B markers in Yunnan province were compared between the findings in 2014 and in 2006.Results were used to understand the HBV epidemic status in Yunnan province and to estimate the efficiency of measures on prevention and control of the disease.Methods People at the age of 1-29 years were sampled from 6 counties of the National Disease Surveillance sites in Yunnan province,by multi-stage random sampling method.Demographic information was collected by questionnaire,and 2-4 ml serum sample was taken to detect HBsAg,anti-HBs,anti-HBc,HBeAg and anti-HBe,by ELISA method.Results were logged-in the database and analyzed by SPSS 17.0.Results Between the two studies,no statistically significant differences were observed on the overall HBV infection rates and the positive rates of HBsAg,HBeAg,anti-HBe,anti-HBc.Positive rate of anti-HBs in 2014 was significantly higher than that in 2006.The main two combination profiles of hepatitis B markers were through the fifth model which was positive only for anti-HBs and the sixth model which was negative for all markers in 2006,and the same in 2014.Detection rate through the fifth profile in 2014 was significantly higher than the rate in 2006,while the detection rate of the sixth profile in 2014 was significantly lower than the one in 2006.When analyzing the differences in the same age group,between the two surveys,results showed that the positive rate of anti-HBs in 2014 was significantly higher than that in 2006,in both the10-14 and the 15-19 years-old groups.Positive rate of anti-HBc in the 20-29 year-olds in 2014 was significantly lower than the one of 2006.The positive rates of HBsAg in the age groups of 1-4,5-14 and 15-29 were 1.12％,1.61％ and 1.25％ respectively,in 2014.Conclusion Prevention and control measures on HBV seemed in great progres.However,more effective prevention and control measures should be taken continually among people under the age of 15,in Yunnan province.

Objective:To explore the effect of combined orbicularis muscle double stitch operated on blepharoplasty.Methods:A total of 90 patients, 79 females and 11 males, aged 18-49 years, were treated by using combined orbicularis muscle double stitch procedure, that is, to fix upper lifting muscle, to remove partial fat, and to perform blepharoplasty.Results:All 90 cases＇ incisions were healed at the first phase, no obvious swelling and bleeding. Within 3-24 months follow up, all patients＇ upper eyelids were significantly improved. The skin was smoothy when closing eyes, and eyelash was up when opening eyes, and arc was natural and satisfactory.Conclusions:This method can improve the shape of the upper eyelid swelling and get long-lasting and stable physiological eyelid.

The multi-campus mode is an important way to give full play to the advantages of public hospitals and promote the expansion of high-quality medical resources and balanced regional layout. The authors summarized the practical experience of the Second Affiliated Hospital Zhejiang University School of Medicine in promoting multi-campus cultural integration, including vertical dimensional initiatives including raising cultural construction to a strategic level, improving the working mechanism of cultural construction, and building a distinctive cultural identity system; horizontal dimensional initiatives including creating equal status and intergroup cooperation conducive to cultural integration, building a variety of forms of the main cultural communication platform, and building a unified and diverse cross-campus communication bridge. Through cultural integration, the internal cohesion of the hospital was enhanced and the influence of the hospital brand was improved. The authors suggested that cultural integration should always be based on the principle of " seeking common ground while preserving minor differences" , focusing on the construction of systems and standards, and focusing on the construction of communication platforms.

Objective To find out if there is any difference in intercondylar fossa width and notch width index (NWI) between tibial intercondylar eminence avulsion fracture and anterior cruciate ligament (ACL) injury.Methods A retrospective study was conducted of the patients who had sought medical attention at Department of Sports Medicine and Adult Reconstructive Surgery,Drum Tower Hospital from June 2014 to May 2018.There were 10 patients with tibial intercondylar eminence avulsion fracture (4 males and 6 females with an average age of 32.7 ± 9.2 years),13 patients with ACL injury (8 males and 5 females with an average age of 31.8 ± 10.9 years) and 22 patients with simple meniscus injury as controls (13 males and 9 females with an average age of 30.9 ± 10.6 years).They all had MRI examination of the knee before surgery.The width of intercondylar fossa and the width and height of bilateral femoral condyles were measured on high resolution images of MRI axial view.NWI was calculated.The 3 groups were compared in intercondylar fossa width and NWI.Results The 3 groups of patients were comparable because there were no significant differences in gender,age,height,weight or BMI between them (P ＞ 0.05).The intercondylar fossa width in the ACL injury group (17.4 ± 3.5 mm) was significantly smaller than that in the avulsion fracture group (20.8 ± 1.1 mm) or in the control group (20.2 ±2.6 mm) (P ＜ 0.05),but no significant difference was detected between the avulsion fracture group and the control group (P ＞ 0.05).NWI in the avulsion fracture group (0.301 ±0.011) was similar to that in the control group (0.280 ±0.039) (P ＞ 0.05) but significantly higher than that in the ACL injury group (0.25 ± 0.05) (P ＜ 0.05).NWI in the ACL injury group was significantly lower than that in the control group (P ＜ 0.05).Conclusions Intercondylar notch stenosis may be a risk factor for ACL injury but may not be associated with tibial intercondylar eminence avulsion fracture.The difference in pathogenesis between tibial intercondylar eminence avulsion fracture and ACL injury may be associated with their difference in NWI.

Osteoarthritis (OA), in which M1 macrophage polarization in the synovium exacerbates disease progression, is a major cause of cartilage degeneration and functional disabilities. Therapeutic strategies of OA designed to interfere with the polarization of macrophages have rarely been reported. Here, we report that SHP099, as an allosteric inhibitor of src-homology 2-containing protein tyrosine phosphatase 2 (SHP2), attenuated osteoarthritis progression by inhibiting M1 macrophage polarization. We demonstrated that M1 macrophage polarization was accompanied by the overexpression of SHP2 in the synovial tissues of OA patients and OA model mice. Compared to wild-type (WT) mice, myeloid lineage conditional Shp2 knockout (cKO) mice showed decreased M1 macrophage polarization and attenuated severity of synovitis, an elevated expression of cartilage phenotype protein collagen II (COL2), and a decreased expression of cartilage degradation markers collagen X (COL10) and matrix metalloproteinase 3 (MMP3) in OA cartilage. Further mechanistic analysis showed thatSHP099 inhibited lipopolysaccharide (LPS)-induced Toll-like receptor (TLR) signaling mediated by nuclear factor kappa B (NF-κB) and PI3K-AKT signaling. Moreover, intra-articular injection of SHP099 also significantly attenuated OA progression, including joint synovitis and cartilage damage. These results indicated that allosteric inhibition of SHP2 might be a promising therapeutic strategy for the treatment of OA.