Osgood-Schlatter disease (OSD) is a common strain disease in adolescents, which is more common in youth sports enthusiasts, athletes and soldiers. The clinical manifestations of OSD are typical, and the diagnosis can be made based on the medical history, physical examination and knee X-ray examination, but it needs to be differentiated from other diseases that may cause anterior knee pain. The risk factors of OSD development include males, 12-15 years of age in males and 8-12 years of age in females, high body mass index, skeletal-muscular anatomical variants, and large amount of exercise, etc. OSD is a self-limited disorder that gradually resolves as the skeleton maturates. Most patients do not need treatment or can also be treated with conservative methods such as exercise therapy, medications and physical therapy, but may be left with sequelae that affect motor function and quality of life. Clinical attention should be paid to it adequately. If the conservative treatment is ineffective, active operation should be performed. The principle of operation is to remove bone fragments and reconstruct tibial tuberosity. Common surgical procedures include traditional open surgery and arthroscopic surgery. Arthroscopic surgery, with its advantages of minimally invasive and rapid recovery, is currently advocated as the best surgical procedure, but the mid- and long-term efficacy is unclear.

Objective:Due to the low contrast between tumors and surrounding tissues in CBCT images, this study was designed to propose an automatic segmentation method for central lung cancer in CBCT images.Methods:There are 221 patients with central lung cancer were recruited. Among them, 176 patients underwent CT localization and 45 patients underwent enhanced CT localization. The enhanced CT images were set as the lung window and mediastinal window, and elastic registration was performed with the first CBCT validation images to obtain the paired data set. The CBCT images could be transformed into" enhanced CT" under the lung window and mediastinal window by loading the paired data sets into cycleGAN network for style transformation. Finally, the transformed images were loaded into the UNET-attention network for deep learning of GTV. The results of segmentation were evaluated by Dice similarity coefficient (DSC), Hausdorff distance (HD) and the area under the receiver operating characteristic curve (AUC).Results:The contrast between tumors and surrounding tissues was significantly improved after style transformation. The DSC value of cycleGAN+ UNET-attention network was 0.78±0.05, HD value was 9.22±3.42 and AUC value was 0.864, respectively.Conclusion:The cycleGAN+ UNET-attention network can effectively segment central lung cancer in CBCT images.

Endothelial cell injury is a major contributor to cardiovascular diseases.The 2,3,5,4’-Tetrahydroxystilbene-2-O-β-D-Glucoside (TSG) contributes to alleviate human umbilical vein endothelial cells (HUVECs) injury through mechanisms still know a little. This study aims to clarify the TSG effects on gene expression (mRNA and microRNA) related to oxidative stress and endoplasmic reticulum stress induced by H2O2 in HUVECs. We found that TSG significantly reduced the death rate of cells and increased intracellular superoxide dismutase activity. At qRT-PCR, experimental data showed that TSG significantly counteracted the expressions of miR-9-5p, miR-16, miR-21, miR-29b, miR-145-5p, and miR-204-5p. Besides, TSG prevented the expression of ATF6 and CHOP increasing. In contrast, TSG promoted the expression of E2F1. In conclusion, our results point to the obvious protective effect of TSG on HUVECs injury induced by H2O2, and the mechanism may through miR16/ATF6/ E2F1 signaling pathway.

Endothelial cell injury is a major contributor to cardiovascular diseases.The 2,3,5,4’-Tetrahydroxystilbene-2-O-β-D-Glucoside (TSG) contributes to alleviate human umbilical vein endothelial cells (HUVECs) injury through mechanisms still know a little. This study aims to clarify the TSG effects on gene expression (mRNA and microRNA) related to oxidative stress and endoplasmic reticulum stress induced by H2O2 in HUVECs. We found that TSG significantly reduced the death rate of cells and increased intracellular superoxide dismutase activity. At qRT-PCR, experimental data showed that TSG significantly counteracted the expressions of miR-9-5p, miR-16, miR-21, miR-29b, miR-145-5p, and miR-204-5p. Besides, TSG prevented the expression of ATF6 and CHOP increasing. In contrast, TSG promoted the expression of E2F1. In conclusion, our results point to the obvious protective effect of TSG on HUVECs injury induced by H2O2, and the mechanism may through miR16/ATF6/ E2F1 signaling pathway.

OBJECTIVETo evaluate the effect of annular electrode lacrimal duct reconstruction in improving the safety and efficacy of nasolacrimal duct stent implantation for treatment of nasolacrimal duct obstruction.

METHODSThis randomized clinical trial was performed to compare the efficacy, success rate of intubation, time used for stent implantation, intraoperative pain, and extubation-assciated complications between nasolacrimal stent implantation with and without annular electrode lacrimal duct reconstruction.

RESULTSA total of 119 eligible patients were enrolled in this trial. The total curative rate at 6 months of follow up after extubation was 70.9% (83/117) in these patients, and was significnatly higher in pateinets with lacrimal duct reconstruction than in those without [80.6% (54/67) vs 58.0% (29/50); χ(2)=7.093, P<0.05]. The total success rate of stent implantation was 98.3% (117/119) in all the patients initially enrolled, and two patients experienced failure of stent implantation and were excluded; the success rate was signfiicantly higher in patients initially enrolled in the lacrimal duct reconstruction group (χ(2)=6.282, P<0.05). The median time required for intubation was shorter in lacrimal duct reconstruction group (12 s vs 33 s; Z=-36.722, P<0.05). The intendity of intraoperative pain was comparable between the two groups (t=0.833, P=0.405). The total rate of puncta injury was 43.6% (51/117) in these patients and similar between the two groups (χ(2)=1.459, P=0.227). The total rate of extubation difficulty was 9.4% (11/117) in all the patients, and was lower in lacrimal duct reconstruction group [4.5% (3/67) vs 16% (8/50); χ(2)=4.463, P<0.05]. Stent breakage in extubation occurred in 4.3% (11/117) of the patients with similar rates between the two groups (χ(2)=2.964, P=0.085). Spearman bivariate correlation analysis showed that the time required for intubation was inversely correlated with the treatment efficacy (r=-0.584, P<0.05) and positively with the occurrence of extubation difficulty (r=0.491, P<0.05); extubation difficulty was inversely correlated with the curative effect (r=-0.511, P<0.05).

CONCLUSIONAnnular electrode nasolacrimal duct reconstruction can increase the safety and efficacy of nasolacrimal duct stent implantation for treatment of nasolacrimal duct obstruction.

Dacryocystorhinostomy ; methods ; Electrodes ; Humans ; Intubation ; Lacrimal Duct Obstruction ; Nasolacrimal Duct ; surgery ; Pain ; Reconstructive Surgical Procedures ; methods ; Stents ; Treatment Outcome

Objective To investigate the setup error for nasopharyngeal carcinoma (NPC) patients with poor compliance using kV cone-beam computed tomography,and to calculate the expansion margin from the clinical target volume (CTV) to planning target volume (PTV).Methods In 45 NPC patients from 2013 to 2015,the setup error,95％ confidence interval (CI)-1 for random error,and PTV-1 value were calculated.Moreover,in 16 NPC patients with poor compliance based on five verifications (random error not within 95％ CI-1),the setup error,95％ CI-2 for random error,and PTV-2 value were calculated.For the 16 special patients,PTV-1 and PTV-1 combined with PTV-2 were used to develop the plan-1 and plan-2,respectively.The dosimetric difference between plan-1 and plan-2 was evaluated.Results Both PTV-1 and PTV-2 had the largest expansion margin in the y direction.The CTV of plan-1 could not meet the requirement of the prescription dose after the setup error was introduced.Compared with plan-1,the V95％ and D95 values for the CTV of plan-2 were increased by 6.26％ and 4.43％,respectively.The D01 value was significantly larger in plan-2 than in plan-1 (P=0.005),which,however,met the clinical requirement.Conclusions In patients with poor compliance,the dose to target volume can be effectively elevated and the normal tissue can be spared from damage when PTV-1 combined with PTV-2 is selected as expansion margin.

Objective To understand genetic distribution, drug resistance, molecular typing and the epidemiological relativeness between strains of the Shigella boydii virulence. Methods Nine Shigella boydii strains were isolated form stool samples of patients with diarrhea from the Enteric Disease Clinic of the Second Hospital of Tianjin Medical University in June-October 2015. The strains were identified by biochemical test and serum agglutination test. Antibiotics susceptibility test was carried out using the Kirby-Bauer method. Polymerase chain reaction was used for detecting virulence genes. Pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) technique were used to determine the epidemiological relationship between nine Shigella boydii strains. Results There were three subtypes in nine isolated Shigella boydii samples, including one, three and five isolates inⅠ,Ⅱ,Ⅳsubtypes respectively. All of the 9 isolates were multi-drug resistant. The resistant rate of these strains for ampicillin was 100%(9/9), and then the resistant rates of these strains for ceftazidime, streptomycin, gentamicin, trimethoprim/sulfamethoxazole, cefotaxime, ceftriaxone, norfloxacin and levofloxacin were 1/9, 4/9, 4/9, 4/9, 5/9, 5/9, 6/9, 6/9 and 6/9, respectively. All of these strains were sensitive to amikacin, cefperazone-sulbactam and imipenem. The ipaH was carried by all the testing strains, and none of the strains carried the sen, set1A, set1B, ial, virA, icsA and SigA. The detective rates of pic, sepA and sat were 4/9, 5/9 and 7/9 strains, respectively. Nine shigella boydii strains were divided into 8 PFGE types. The similarity between the spectrums of PFGE was 63.21%-100%. Multilocus sequence typing showed that six isolates were belonged to ST648, two isolates were ST131 and one isolate was ST10. Conclusion Nine isolates of Shigella boydii (divided into three subtyping) isolated from our hospital are multi-drug resistant and they have distant relationships, belonging to the dissemination of case.

Objective To analysis the human cytomegalovirus (HCMV)and human T lymphotropic virus(HTLV)infection status in Beijing among voluntary blood donors.Methods Randomly selected 2 010 blood samples from five districts and counties of Beijing City to screen HCMV-IgG,HCMV-IgM and HTLV-Ⅰ/Ⅱ antibody by ELISA method.The positive samples were reexamined two times,two test results of samples were positive that were determined positive by ELISA. HTLV positive samples was confirmed by nested PCR.Results The HCMV-IgM and HCMV-IgG positive rates of Beijing blood donors were 2.19% and 92.59%,screened 1 case of anti-HTLV positive by ELISA method,then confirmed to be neg-ative result by nested PCR.The statistics showed that the HCMV-IgG positive rate female blood donors was higher than male (P <0.05).The positive rates of HCMV-IgM and HCMV-IgG among18~25 years old donors was lowest (P <0.05). Positive rate of HCMV-IgG in college students was lower than other occupation blood donars (P <0.05)and education de-gree was independent of HCMV-IgG,HCMV-IgM positive rates (P >0.05).Conclusion In this investigation,2 010 cases of voluntary blood donors from five districts of Beijing were not found in cases of HTLV infection,HCMV infection was prevalent.

OBJECTIVETo explore the relationship between DNA mismatch repair (MMR) and clinicopathologic features and prognosis in patients with stages II and III colon cancers.

METHODSThe clinical and pathological data of 440 patients with stage II/III colon cancer after radical resection were retrospectively reviewed and analyzed. Immunohistochemical staining was used to assess the expression of MMR proteins (MLH1, MSH2, MSH6 and PMS2), and the correlation between DNA MMR and clinicopathological features and prognosis of colon cancers was analyzed.

RESULTSOf the 440 tumor samples tested for DNA mismatch repair status, 90 (20.5%) demonstrated defective DNA mismatch repair and 350 (79.5%) had proficient DNA mismatch repair. Defective DNA mismatch repair (dMMR) was associated with young patients (≤ 60), proximal colon cancer, stage II, poorly differentiated adenocarcinoma and mucinous adenocarcinoma (P<0.05 for all). Among the 440 patients, 126 (28.6%) cases had recurrence or metastasis and 93 (21.1%) died during the median follow-up of 61.0 months. The five-year disease-free survival (DFS) rate was 82.2% among the patients with tumor exhibiting dMMR, significantly higher than that in patients with tumors exhibiting pMMR (68.9%, P=0.02). The univariate and mutlivariate analyses showed that the MMR status is an independent factor affecting 5-year disease-free survival and overall survival (OS) in colon cancer patients (P<0.05 for both).

CONCLUSIONSDefective DNA mismatch repair (dMMR) is associated with patients with proximal colon cancer, stage II and poorly defferentiated adenocarcinoma and mucinous adenocarcinoma. The prognosis for patients with dMMR is better than those with pMMR. dMMR may be a useful biomarker for the prognosis of colon cancer.

Adaptor Proteins, Signal Transducing ; metabolism ; Adenocarcinoma ; genetics ; metabolism ; mortality ; pathology ; Adenocarcinoma, Mucinous ; genetics ; metabolism ; mortality ; pathology ; Adenosine Triphosphatases ; metabolism ; Age Factors ; Analysis of Variance ; Colonic Neoplasms ; genetics ; metabolism ; mortality ; pathology ; DNA Mismatch Repair ; DNA Repair Enzymes ; metabolism ; DNA-Binding Proteins ; metabolism ; Disease-Free Survival ; Humans ; Mismatch Repair Endonuclease PMS2 ; MutL Protein Homolog 1 ; MutS Homolog 2 Protein ; metabolism ; Neoplasm Recurrence, Local ; Nuclear Proteins ; metabolism ; Prognosis ; Retrospective Studies ; Survival Rate

Objective To explore the relationship between DNA mismatch repair ( MMR ) and clinicopathologic features and prognosis in patients with stages Ⅱ and Ⅲ colon cancers. Methods The clinical and pathological data of 440 patients with stage Ⅱ/Ⅲ colon cancer after radical resection were retrospectively reviewed and analyzed. Immunohistochemical staining was used to assess the expression of MMR proteins ( MLH1, MSH2, MSH6 and PMS2 ) , and the correlation between DNA MMR and clinicopathological features and prognosis of colon cancers was analyzed. Results Of the 440 tumor samples tested for DNA mismatch repair status, 90 (20.5%) demonstrated defective DNA mismatch repair and 350 (79.5%) had proficient DNA mismatch repair. Defective DNA mismatch repair ( dMMR) was associated with young patients (≤60), proximal colon cancer, stage Ⅱ, poorly differentiated adenocarcinoma and mucinous adenocarcinoma (P<0.05 for all). Among the 440 patients, 126 (28.6%) cases had recurrence or metastasis and 93 ( 21. 1%) died during the median follow?up of 61. 0 months. The five?year disease?free survival (DFS) rate was 82.2% among the patients with tumor exhibiting dMMR, significantly higher than that in patients with tumors exhibiting pMMR (68.9%, P=0.02). The univariate and mutlivariate analyses showed that the MMR status is an independent factor affecting 5?year disease?free survival and overall survival(OS) in colon cancer patients (P<0.05 for both). Conclusions Defective DNA mismatch repair ( dMMR) is associated with patients with proximal colon cancer, stage Ⅱ and poorly defferentiated adenocarcinoma and mucinous adenocarcinoma. The prognosis for patients with dMMR is better than those with pMMR. dMMR may be a useful biomarker for the prognosis of colon cancer.