The semi-extended infrapatellar intramedullary nailing of distal tibia fractures: a randomized clinical trial.

BACKGROUND: Malalignment is a common event during the intramedullary nailing (IMN) of distal tibia fractures (DTFs). Although it is reported that the semi-extended IMN techniques such as suprapatellar (SP) and parapatellar (PP) approaches may be superior in preventing malalignment, the application of these techniques is concerning owing to the intra-articular involvement. We thus developed an extra-articular semi-extended infrapatellar (SEIP) approach which utilizes the infrapatellar (IP) space while maintaining the knee in a semi-extended position. However, there are no studies on the safety and efficacy of SEIP in treating DTFs. Therefore, in this study, the SEIP technique was examined, particularly in terms of the potential alignment improvement of DTFs, and this technique was compared with the traditional hyperflexed infrapatellar (HFIP) procedure. MATERIALS AND METHODS: This randomized clinical trial (RCT) compared IMN malalignment while correcting extraarticular and nondisplaced intra-articular DTFs between April 2018 and June 2021 using the HFIP and SEIP techniques at a level I trauma center in China. The study participants were clinically and radiographically examined for at least 12 months of follow-ups. Intraoperative fluoroscopy time, operation time, blood loss, hospitalization duration, functional ankle score, and complications were assessed as well. RESULTS: Among the 88 recruited participants, 45 (51%) underwent traditional HFIP IMN and 43 (49%) underwent SEIP IMN. Malalignment occurred in 9 patients (20.0%) from the HFIP cohort and in 2 patients (4.7%) from the SEIP cohort (P value = 0.030). In addition, the SEIP IMN technique significantly reduced the intraoperative fluoroscopy time, operation time, and improved the postoperative ankle function compared to the HFIP IMN technique. However, the intraoperative blood loss, hospitalization duration, infection, delay union, and nonunion remained the same between the two cohorts. CONCLUSIONS: In summary, we demonstrated that the SEIP IMN provides markedly enhanced alignment of extraarticular and nondisplaced intra-articular DTFs compared to the traditional HFIP IMN procedure. The described technique represents an effective option for IMN of DTFs. LEVEL OF EVIDENCE: Level 2. Trial registration The Chinese Clinical Trial Registry, ChiCTR2100043673. Registered 26 February 2021, retrospectively registered, http://www.chictr.org.cn/showprojen.aspx?proj=122263.

Removing a suprapatellar intramedullary nail via a suprapatellar approach: a retrospective cohort study.

BACKGROUND: Over the last 20 years, suprapatellar (SP) intramedullary nailing has gained considerable attention for treating tibia fractures and is believed to improve fracture alignments, decrease anterior knee pain, and facilitate intraoperative fluoroscopy. However, it is associated with various concerns, including the need to make another infrapatellar (IP) incision to remove the nail. AIMS: This study was aimed at developing a new technique for the removal of SP tibial nails through an SP approach using a cannulated extraction system. The efficiency of the novel SP approach was compared to that of the traditional IP approach for the removal of SP tibial nails. PATIENTS AND METHODS: This was a retrospective cohort study from a prospectively collected clinical registry. The data for 69 consecutive patients who received surgery to remove a previous SP intramedullary nail using an SP approach (n = 30, SP cohort) or an IP approach (n = 39, IP cohort) were analyzed. Intra-operative evaluations included intraoperative blood loss, operation time, and changes in the surgical procedures. At six months follow-up, post-operative Lysholm knee score, visual analog scale (VAS) score, and the active range of motion (ROM) of the affected knee and complications were assessed. RESULTS: Patients in the SP cohort exhibited an increased post-operative Lysholm knee score (ß, 2.6; 95% confidence interval [CI], 0.6 to 4.6; P = 0.012), decreased post-operative VAS score (ß, - 0.7; 95% CI, - 1.1 to - 0.2; P = 0.004), and increased operation time (ß, 9.8 minutes; 95% CI, 5.7 to 14.0 minutes; P < 0.001) compared with those treated with the IP approach after adjustment for baseline characteristics. There were no statistically significant differences in blood loss, post-operative ROM, or complications between the two cohorts. CONCLUSIONS: Compared with the IP technique, the SP approach for the removal of an SP tibial nail was independently associated with an increased post-operative Lysholm knee score and decreased VAS score, although the surgery was longer in duration. The novel technique offers a reliable and minimally invasive option for the removal of an SP tibial nail.

Comparison between infrapatellar and suprapatellar approaches for intramedullary nailing for the fractures of the tibial shaft.

INTRODUCTION: This study aimed to compare the outcomes at the clinical and functional levels of suprapatellar (SP) and infrapatellar (IP) approaches for intramedullary nailing in treating tibial shaft fracture. METHODS: Patients who underwent tibial shaft fracture intramedullary nailing by the SP approach or IP approach in a trauma center were retrospectively reviewed. The demographics, intraoperative fluoroscopy time, operation time, blood loss, irrigation volume, postoperative X-ray alignment, and complications of patients were compared between the two groups under different approaches. Lysholm knee score, visual analog score (VAS), and incidence of anterior knee pain (AKP) were assessed 1 year after surgery. RESULTS: The study finally included well-documented 81 patients (38 SP versus 43 IP). The SP group exhibited significantly shorter intraoperative fluoroscopy time than that of the IP group (81.7 ± 14.5 s vs. 122.0 ± 24.3 s, P < 0.001). Both aspects recorded a precise reduction of the fracture: angulation (2.1 ± 1.2° vs 3.1 ± 1.5°, P < 0.05) and translation (0.6 ± 0.8 mm vs 1.4 ± 1.5 mm, P < 0.05) in the coronal plane in the SP group. However, the sagittal plane recorded no such change (P > 0.05). The Lysholm knee score was higher in the SP group than that of the IP group (87 ± 8 vs. 80 ± 15, P < 0.05). The SP group displayed an evidently lower average VAS score than that of the IP approach group (0.3 ± 0.8 vs 1.3 ± 1.4, P < 0.001). Six cases (16%) in the SP group and 16 cases (37%) in the IP group experienced AKP 1-year post-operation (P < 0.05). As far as complications are concerned, neither group showed any significant difference (P > 0.05). CONCLUSION: Compared with the IP approach, the application of intramedullary nailing through the SP approach in treating tibial shaft fractures can effectively shorten the intraoperative fluoroscopy time, correct coronal plane angulation and translation deformity, reduce the incidence of AKP and improve postoperative function.

Semi-extended intramedullary nailing of the tibia using an infrapatellar approach: a retrospective cohort study.

PURPOSE: The semi-extended tibial intramedullary nailing method would enable easier and improved reductions for tibial fractures as well as facilitate fluoroscopic imaging; however, its in-articular nature remains controversial. The aim of this study was to compare the clinical and functional outcomes of the semi-extended infrapatellar (SEIP) approach and hyper-flexed infrapatellar (HFIP) approach for intramedullary nailing to treat tibial shaft fractures. METHODS: This study involved the retrospective analysis of the medical records of patients with tibial shaft fractures that were fixed through either the SEIP approach or the HFIP approach of intramedullary nailing and who were admitted to a level 1 trauma centre. The minimum patient follow-up period was 12 months and the clinical and functional outcomes were estimated at the 12-month visit. RESULTS: Of the 80 patients whose medical records were analyzed, 40 (50%) underwent SEIP nailing and the remaining 40 (50%) underwent the traditional HFIP nailing. Compared with the HFIP group, patients in the SEIP group had a higher Lysholm knee score (median, 92 [interquartile range, 88-95] vs median, 88 [interquartile range, 81-92]; p = .01), a shorter intra-operative fluoroscopy time (median, 93 [interquartile range, 78-105] s, vs median, 136 [interquartile range, 110-157] s; p < .001), and operation time (mean, 88.1 [SD, 17.8] min vs mean, 98.7 [SD, 19.3] min; p = .01). The VAS score was significantly lower in the SEIP group (median, 0; interquartile range, 0-0) than in the HFIP group (median, 0; interquartile range, 0-2) (p = .03). There were two cases (5%) in the SEIP group and 10 cases (25%) in the HFIP group of moderate AKP (p = .03). Meanwhile, there was no significant difference in malalignment, nonunion, delayed union, infection, and other complications, as well as SF-36 physical and mental scores. CONCLUSION: We found that the SEIP approach to tibia intramedullary nailing was superior to the HFIP approach based on the intra-operative and post-operative outcomes. Thus, this novel technique provides an infrapatellar option for semi-extended tibial nailing.

LncRNA UCA1 Affects the Cell Proliferation, Migration, Invasion and Apoptosis of Hepatic Carcinoma Cells by Targeting MicroRNA-193a-3p.

OBJECTIVE/BACKGROUND: Hepatic carcinoma (HCC) is the fourth lethal cancer in the world, but its relationship with lncRNA urothelial cancer-associated 1 (UCA1)/microRNA-193a-3p axis remains unclear, so this study would explore the relationship. METHODS: A real-time polymerase chain reaction (RT-PCR) assay was carried out to quantify lncRNA UCA1 and microRNA-193a-3p in HCC tissues and cells, and relevant overexpression or inhibition vectors were constructed to analyze the influences of lncRNA UCA1 and microRNA-193a-3p on HCC cells. A Transwell assay was used to measure invasion and migration of HCC cells, and a Western blot assay to quantify protein biomarkers of apoptosis, invasion, and migration, a MTT assay to determine cell viability, a flow cytometry to detect cell cycle, and a dual-luciferase reporter gene assay to analyze the correlation between lncRNA UCA1 and microRNA-193a-3p. RESULTS: LncRNA UCA1 was increased in HCC, while microRNA-193a-3p was decreased. Down-regulated lncRNA UCA1 could up-regulate microRNA-193a-3p, and down-regulated lncRNA UCA1 or up-regulated microRNA-193a-3p would strengthen cell apoptosis and weaken cell migration, invasion, and proliferation. Furthermore, lncRNA UCA1 could negatively regulate microRNA-193a-3p by binding to it. CONCLUSION: LncRNA UCA1 promotes malignant hyperproliferation of HCC cells by repressing microRNA-193a-3p.

A comparison of the use of a suprapatellar Chinese Aircraft-shaped Sleeve System versus suprapatellar intramedullary nailing for tibial shaft fractures: Outcomes over a one-year follow-up.

INTRODUCTION: This study aimed to investigate the effectiveness and safety of the Chinese Aircraft-shaped Sleeve (CASS) system on the clinical outcomes of tibial intermedullary nailing using a suprapatellar approach for the treatment of tibial fractures in a cohort of adult Chinese patients over a minimum one-year follow-up. METHODS: After institutional review board approval, skeletally mature patients with Orthopaedic Trauma Association (OTA) type 42 tibial shaft fractures were randomized into either a SP approach using CASS group or a conventional SP approach group after informed consent was obtained. The operations were performed by a single senior orthopaedic surgeon according to group assignments. A group of 33 patients were treated using the CASS system and the other group of 34 patients were treated using a conventional SP approach. Both groups fully complied with research requirements and completed 12 months of follow-up. Magnetic resonance images (MRI) were obtained for the evaluation of the patellofemoral joint (PFJ) and residual debris preoperatively, as well as one week and 12 months postoperatively. Radiographs were used to assess alignment and union, visual analog scores (VAS) were used to assess anterior knee pain, and range of motion (ROM) and the Lysholm knee scoring scales were used for evaluating the operated knee at the 12-month follow-up. RESULTS: Differences in cartilage lesion changes observed by MRI between the two groups were statistically significant (P = 0.030 at 1 week postoperatively; P = 0.025 at 12 months postoperatively). No significant differences were evident with respect to debris residue, malalignments, nonunion, VAS, ROM and Lysholm knee scoring scale with the exception of stair climbing (P = 0.02). CONCLUSION: Based on the data of this one-year clinical follow-up study, the SP approach using the CASS system offers the potential to benefit patients suffering from tibial shaft fractures, who will be treated with intramedullary nailing especially for smaller patients.

Clinicopathological Presentation and Management of Penile Schwannoma.

INTRODUCTION: Patients with penile schwannoma are rare and usually with variant presentations. No evidence-based clinical guideline exists for diagnosis or treatment. To put schwannoma into differential diagnoses of benign soft tissue lesions in the penis is important. AIM: To analyze and categorize clinical, histopathological, and radiological presentations and apply possible explanation on several fields of penile schwannoma. METHODS: We collected the English literature through the PubMed database of the National Library of Medicine up to October 2019. A newly diagnosed case in Chang Gung Memorial Hospital, Taiwan, was also included. This study categorized lesion locations into the penile body or shaft, glans, or penile root, dorsal or ventral. MAIN OUTCOME MEASURE: The main outcome measure was to demonstrate clinical, pathological, ultrasonography, and MRI manifestations of penile schwannoma and perform immunohistochemistry staining that has not been performed among penile schwannomas. RESULTS: We collected 40 cases. Data were arranged in tables. Clear descriptions were added on several fields of penile schwannoma in detail in Discussion. CONCLUSION: Penile schwannomas are mostly located at the penile shaft and dorsum of the penis. Dyspareunia is the most reported complaint for sexual dysfunction. This study is the first study in the world to document the expressions of calretinin, SOX10, glial fibrillary acid protein, D2-40 (podoplanin), and cytokeratin AE1/AE3 in penile schwannoma and claims magnetic resonance imaging and pathologic presentations of penile schwannomas are synonymous with schwannomas from head to toe. The current patient may be the first to present with penile schwannoma with schwannomatosis. Huang LC, Wang HZ, Chu YC, et al. Clinicopathological Presentation and Management of Penile Schwannoma. Sex Med Rev 2020;8:615-621.

Effect of gamma irradiation on carbon dot decorated polyethylene-gold@ hydroxyapatite biocomposite on titanium implanted repair for shoulder joint arthroplasty.

High disappointment rate of the ligament to hard tissue mending after the medical procedure has dependably been a testing issue in rotator cuff repair. Considering the elasticity of carbon dot decorated polyethylene (f-CDs-PE) and osteogenic movement of gold substituted hydroxyapatite (Au@HA) bioceramic, f-CDs-PE-Au@HA biocomposite coatings were created by an electrophoretic deposition method (EPD), the in vivo and in vitro bioactivity and cytocompatibility were researched. The physico-chemical properties of f-CDs-PE-Au@HA biocomposite coatings were characterized using fourier transform infra-red (FTIR) and X-Ray diffractometery (XRD). The morphology of the fabricated biocomposites was analyses via scanning electron microscopy (SEM) and transmission electron microscopy (TEM) methods. With a gamma-irradiation of f-CDs-PE-Au@HA biocomposite coating (BC2), the bond and multiplication of cells on biocomposite coating were improved. The specimen with a f-CDs-PE-Au@HA biocomposite (BC2) demonstrated a most noteworthy alkaline phosphatase activity articulation. The animal model consequences additionally show that the f-CDs-PE-Au@HA biocomposite (BC2) had great bioactive and cytocompatibility, which could develop the association of collagen and the arrangement of ligament and hard tissue. Expansion of the gamma-ray irradiation with f-CDs-PE-Au@HA biocomposite coating (BC2) at the tendon- hard tissue crossing point was exhibited to reinforce the mending entheses, increment hard tissue and tendon development and progress collagen association contrasted and control. The above outcomes have recommended that the progressive, implantable and solid stringy platforms built utilizing EPD extraordinary potential for enlargement of rotator cuff tears-recuperating.

Application of the Chinese Aircraft-shaped Sleeve system in the treatment of tibial shaft fractures using a suprapatellar approach for tibial intramedullary nailing: a randomised controlled trial.

BACKGROUND: The use of the suprapatellar approach for intramedullary nailing has recently become popular for the treatment of tibial fractures. This study aimed to investigate the effectiveness of using the Chinese Aircraft-shaped Sleeve (CASS) system on the clinical outcomes of tibial intermedullary nailing using a suprapatellar approach for the treatment of tibial fractures in a cohort of adult Chinese patients. METHODS: Magnetic resonance images (MRI) of the knee joints of 212 healthy adults with normal lower limb function from May 2011 to May 2015 were obtained from a level I Chinese regional trauma centre. Sixty inpatients at the same trauma centre who underwent treatment for tibial shaft fractures from June 2015 to June 2018 were enrolled. Tibial intramedullary nailing fixation of tibial shaft fractures via the suprapatellar approach was performed with either a CASS system or a conventional sleeve. The measurements of patellofemoral joint anatomy, the surgical time, the assessments of the patellofemoral joint cartilage conditions, and information of residual debris based on arthroscopic analysis were subsequently collected. RESULTS: The mean patellar angle (PA), sulcus angle (SA), sulcus width (SW) and sulcus depth (SD) were 135.40 ± 6.20°, 142.37 ± 5.33°, 33.37 ± 2.73 mm, and 4.29 ± 0.63 mm, respectively. The surgical time until entry reaming commencement and the irrigation time were significantly lower in the CASS group (P < 0.001). The difference in cartilage damage rate between groups was statistically significant (P = 0.031); the difference in residual debris conditions was not statistically significant (P = 0.1967). CONCLUSION: The use of the CASS system could improve clinical outcomes of intramedullary nailing via suprapatellar approach for patients with a small patellofemoral joint space.

[Case control study on Mobi-C cervical artificial disc replacement and anterior cervical decompression MC+fusion for the treatment of cervical spondylosis].

OBJECTIVE: To compare the clinical effects and clinical indications between Mobi-C cervical artificial disc replacement (CADR) and MC+ anterior cervical decompression and fusion(ACDF) in treating cervical spondylosis. METHODS: The clinical data of 100 patients with cervical spondylosis treated ACDF or CADR from June 2009 to June 2015 were retrospectively analyzed. There were 53 males and 47 females, aged from 38 to 70 years old. Among them, 50 cases were treated by ACDF (ACDF group), follow-up time was for 22 to 42 months with an average of (32.24±5.20) months;other 50 cases were treated by CADR (CADR group), follow-up time was for 23 to 48 months with an average of (30.40±5.66) months. Odom criterion was used to evaluate the clinical effects in two groups. JOA score, including sensory function, motor function and bladder function was used to assess the spinal cord function. Preoperative and postoperative responsible intervertebral space heights, cervical curvatures were compared by image data between two groups. RESULTS: All incisions obtained good healing and no serious complications were found. At final follow-up, 30 cases got excellent results, 12 good, 8 fair in ACDF group;and 34 cases got excellent results, 10 good, 6 fair in CADR group;there was no significant difference between two groups(u=4.000, P=0.827). At final follow-up, the scores of sensory function and motor function were obviously improved(P<0.05), and bladder function had not obviously recovered (P>0.05) in two groups;and CADR group in the scores of sensory function and motor function were obviously better than of ACDF group(P<0.05). There was no significant difference in preoperative intervertebral space height, cervical curvature between two groups, and at final follow-up both had different recovered. The recovery of CADR group was obviously better than of ACDF group. CONCLUSIONS: CADR can quickly recover normal action for patients and retains the movement. CADR has certain advantages in recovering cervical curvature, improveing sensory function and motor function, but it is not able to completely replace ACDF.

Subunits of human condensins are potential therapeutic targets for cancers.

The main role of condensins is to regulate chromosome condensation and segregation during cell cycles. Recently, it has been suggested in the literatures that subunits of condensin I and condensin II are involved in some human cancers. This paper will first briefly discuss discoveries of human condensins, their components and structures, and their multiple cellular functions. This will be followed by reviews of most recent studies on subunits of human condensins and their dysregulations or mutations in human cancers. It can be concluded that many of these subunits have potentials to be novel targets for cancer therapies. However, hCAP-D2, a subunit of human condensin I, has not been directly documented to be associated with any human cancers to date. This review hypothesizes that hCAP-D2 can also be a potential therapeutic target for human cancers, and therefore that all subunits of human condensins are potential therapeutic targets for human cancers.

[Current researches and prospects of seedling propagation and cultivation modes of Jinxianlian].

In the wake of on-the-spot investigation into Chinese major production bases in Fujian, Zhejiang, Jiangxi, Taiwan, Guangxi and Yunnan provinces, and based on relevant literature, the paper systematically elaborates the current researches of botanical origin, major cultivation type, seedling propagation technique as well as cultivation mode of Jinxianlian. The way of seedling breeding mainly includes aseptic seed culture, in vitro propagation, artificial seed and bioreactor propagation, etc. And the planting model mainly includes protected cultivation modes, bionic wild cultivation modes and pot cultivation modes, etc. Further discussions have also been conducted to tackle significant problems existing in the production process of Jinxianlian, based on personal studies of the authors. It has made considerable contributions for the betterment of Jinxianlian's development and improvement.

[Current status and sustainable development countermeasures of Anoectochilus roxburghii].

The current status of the domestic manufacturing and sales markets of Anoectochilus roxburghii were investigated and analyzed in the study. Some problems in the A. roxburghii industry were revealed and a variety of sustainable development countermeasures were also proposed. The main problems of A. roxburghii industry are the lack of protection for wild resources, the lag in the speed of variety breeding, the insufficient research on the quality systems, the low level of industry and product innovation capability, as well as the relatively low market cognition and brand competence. Therefore, strengthening the protection for breeding resources, establishing a dynamic monitoring system, promoting the variety breeding, constructing a propagation system for improved varieties, enhancing the quality of medicinal herbs, accelerating the adjustment of product structure, upgrading the industry technology, strengthening brand competence and expanding the market, will be the effective methods to realize the sustainable development of A. roxburghii industry.

Microanatomy of the spermatic cords during microsurgical inguinal varicocelectomy: initial experience in Asian men.

The microanatomy of the inguinal spermatic cords has never been reported in Asia. The purpose of this study was to describe the number and relationship of the veins, arteries and lymphatics in the spermatic cord and to clarify the location of the vas deferens in Asian men. Fifty-one patients receiving 79 primary microsurgical varicocelectomies performed by a single surgeon from April 2011 to July 2012 were studied. The number of internal and external spermatic veins, testicular arteries and lymphatic channels preserved during the inguinal microsurgical varicocelectomy were recorded. The relationship between the right and left vascular anatomy during bilateral varicocelectomies was evaluated. The data showed that mean numbers of 1.5±0.9 arteries, 5.6±2.2 spermatic veins and 3.6±1.9 lymphatics were identified during the repairs. The internal spermatic arteries were surrounded by a dense complex of adherent veins in 81.2% of the cases. The external spermatic vein or veins were found in 60.8% of the cases. The vas deferens may be contained within the internal spermatic fascia. The results suggest that the number of veins may be highly variable and less than those reported in the English literature, but there is some similarity in the inguinal microanatomy of the right and left spermatic cords. Further research is warranted to clarify our results.

The immunogenicity of fusion protein linking the carboxyl terminus of the B subunit of Shiga toxin 2 to the B subunit of E. coli heat-labile enterotoxin.

To augment the immunogenicity of the subunit B of Shiga toxin (Stx2e B) produced by Escherichia coli and protect piglets from edema disease in china, a fusion gene was constructed consisting of Stx2e B genetically linked at the N-terminus of the B subunit of heat-labile enterotoxin (LTB) in a translational fusion. After being induced with IPTG, the expressed fusion protein of Stx2e B-LTB was about 8.8% of total proteins, approximately 13 microg/ml of the bacteria culture. The Stx2e B-LTB fusion protein was found to be nontoxic to Vero cells at the dose higher than 1 microg/ml and to mice less than 100 microg/ml. Antibody titer against the fusion protein Stx2e B-LTB was 1:76,800, much higher than that of the recombinant Stx2e B protein (1:12,800) alone. All of the mice immunized with the Stx2e B-LTB fusion protein survived when challenged with a lethal dose (LD) of Stx2e toxin. The results showed that the poor immunogenicity of Stx2e B was overcome by conjugating the stx2e B to ltB. The immunogenicity of the constructed fusion protein Stx2e B-LTB in the present study was highly qualified to protect animals against Shiga toxin produced from Shiga toxin-producing Escherichia coli (STEC). The fusion protein of Stx2e B-LTB could be a candidate for a vaccine against edema disease and post-weaning diarrhea simultaneously in piglets.

[Clinical observation on treatment of 34 advanced gastric carcinoma patients by chemotherapy of DCF regimen combined with Fuzheng Hewei Decoction].

OBJECTIVE: To evaluate the therapeutic and adverse reactions of integrative Chinese and Western medicine (ICWM) for treatment of advanced gastric carcinoma. METHODS: Sixty-six patients with advanced gastric carcinoma were randomized into two groups. Patients in the treatment group (34 patients) received chemotherapy of DCF (docetaxel/cisplatin/5-fluorouracil) regimen combined with Chinese herbal medicine, and patients in the control group (32 patients) were treated with chemotherapy of the same regimen alone. RESULTS: No significant difference between the two groups was found in response rate (55.9% versus 50.0%), clinical benefiting rate (85.3% versus 81.3%) and half year survival rate (82.4% versus 65.6%); but the 1-year survival rate in the treatment group was superior to that in the control group (52.9% versus 25.0% , P < 0.05). As for the adverse reactions, significant difference between the two groups was shown in incidence of leucopenia, nausea and vomiting, mucosa reaction and fatigue, these reactions occurred lesser in the treatment group (P< 0.05). CONCLUSION: Although treatment of ICWM for advanced gastric carcinoma cannot improve response rate, it could alleviate the adverse reactions of the treatment, improve quality of life and prolong the survival rate in patients.

[Degenerate PCR and its application in gene cloning].

Degenerate PCR is introduced in this paper, including what is degenerate PCR, how to design degenerate primers, how to optimize degenerate PCR parameters, how to applying degenerate PCR to obtain full-length gene and which fields can apply degenerate PCR. The limits and recent advances of degenerate PCR are also discussed. Based on this introduction,strategies of gene cloning and applications of degenerate PCR in gene cloning are summarized in brief. Degenerate PCR is a very useful tool for searching and discovering new genes and new members of a protein family.