OBJECTIVE: In this study, we have detected the expression of STC2 protein in laryngeal cancer and The safe incisal margin by immunohistochemical staining, to evaluate its correlation with clinical features and the prognosis value in laryngeal squamous cell cancer. METHOD: Eighty-one paraffin-embedd specimens of patients who underwent surgery for laryngeal cancer were collected. Clinical data, including date of birth, gender, tumor subsite, tumor stage, RT, and survival status have been recorded. The samples including laryngeal cancer tissues and the safe incisal margin were analyzed for the expression of STC2 protein by immunohistochemical staining. We analyzed the correlations with STC2 expression level and clinical data with software SPSS 18. 0. RESULT: (1)fifty-six cases in 81 cases (69. 1 %) are positive. In 30 cases of the safe incisal margin tissues, STC2 is not expressed, which shows statistically significant differences between the two groups (P<0. 05). (2)Overexpression of STC2 in laryngeal cancer were correlated with the tumor clinical stage and N stage, T stage, tumor site location and histological grade (P<0. 05), but not with genderor age (P> 0. 05). (3)The result showed that the 3-year survival rate is 74. 1%, according to the survival analysis by STC2, STC2 positive group has poorer outcome versus the negative group. (4)The clinical stage displayed the independent value in predicting the tumor prognosis of laryngeal cancer (P<0. 05), not the expression level of STC2. CONCLUSION Overexpression of STC2 in laryngeal cancer patients is correlated with poor outcome, which means STC2 positive group has poorer prognosis than the STC2 negative group.
Carcinoma, Squamous Cell ; metabolism ; mortality ; Glycoproteins ; biosynthesis ; Head and Neck Neoplasms ; metabolism ; mortality ; Humans ; Intercellular Signaling Peptides and Proteins ; biosynthesis ; Laryngeal Neoplasms ; metabolism ; mortality ; Prognosis ; Squamous Cell Carcinoma of Head and Neck ; Survival Analysis ; Survival Rate

Objective To evaluate the effects of controlled heart rate (HR) on the nasal mucosa blood flow (NMBF) during nitroglycerin (NTG)-induced controlled hypotension in the patients undergoing endoscopic sinus surgery.Methods Seventy-two ASA physical status Ⅰ or Ⅱ patients of both sexes,weighing 49-85 kg,with body mass index ＜ 30 kg/m2 and Lund-Mackay score between 7 and 15,scheduled for elective endoscopic sinus surgery,were randomly divided into 2 groups (n =36 each) using a random number table:NTG group (group N) and NTG-induced controlled hypotension combined with esmolol group (group E).Controlled hypotension was induced with continuous iv infusion of NTG at 1-3 μg· kg-1 · min-1 before surgery,and MAP was maintained at 70％ of baseline value until the end of surgery.In group E,when MAP was decreased to 70％ of baseline value,esmolol was infused intravenously at 20-100 μg· kg-1 · min-1,the consumption was adjusted according to the HR,and the HR was maintained at 60-70 beats/min until termination of controlled hypotension.Before induction of anesthesia (T0),after topical anesthesia (T1),at 15,30 and 45 min of controlled hypotention (T2-4),and at packing hemostasis at the end of surgery (T5),HR,stroke volume (SV) and cardiac output (CO) were recorded.NMBF was monitored at T1-T4.Blood samples were drawn from the radial artery and jugular blub at T1-T5 for blood gas analysis.Arteriovenous blood O2 difference (Da-jvO2) and cerebral O2 extraction rate (CERO2) were calculated.The quality of the surgical field in terms of blood loss was rated by the same attending surgeon.Results Compared with group N,HR,SV and CO at T2-T5,NMBF at T2-T4 and the volume of blood loss in the surgical field was significantly decreased in group E (P ＜ 0.01).There was no significant difference in Da-jvO2 and CERO2 between the two groups (P ＞ 0.05).Conclusion Controlled HR (60-70 beats/min) can reduce the NMBF during nitroglycerin-induced controlled hypotension in the patients undergoing endoscopic sinus surgery without causing tissue hypoperfusion.

Objective: To explore the clinical effect of valsartan combined with indapamide in the treatment of hypertension. Methods: In our hospital in 2012 August ~ 2013 August treatment of 280 cases of hypertensive patients, all patients had drug withdrawal for 2 weeks. Were randomly divided into observation group 100 cases and control group 1, control group 2 of the 90 cases, control group 1 given valsartan, control group 2 given indapamide, the observation group were given valsartan combined with indapamide, were treated for 8 weeks. Results:three groups of patients before treatment, the blood pressure were not significantly different, after the treatment, the observation group decreased blood pressure was significantly higher than that in control group, the total efficiency had significant difference (x2=6.472, P<0.05). Conclusion:Valsartan combined with indapamide in the treatment of hypertension has fast acting, high curative effect, long duration, few adverse reactions, is the ideal choice for the treatment of hypertension, is worth the clinical promotion and application.

Objective To investigate the factors and rate of the forming of the collateral feeding arteries from inferior phrenic artery(IPA) in hepatocellular carinoma(HCC).Methods IPA was demonstrated on angiographs in 137 patients with HCC during transcatheter arterial chemoembolization(TACE),TACE was performed through diaphragmatic inferior artery(DIA) super setectively.Results Of 137 cases,21 cases underwent TACE through DIA(15.3%),of them 2 cases were recurrent after surgical operation(9.5%),3 cases had the tumor receive blood supply from IPA at first TACE(14.3%) and 16 cases were occured after TACE tow and more times(76.2%).Conclusion Collateral branches originated from IPA are important feeding arteries in HCC,TACE of IPA can be performed with a high success rate without major complications.

Building a better performance evaluation system for public hospitals is key to the ongoing health reform. To this end, Beijing Municipal Administration of Hospitals reformed the performance evaluation system of public hospitals in Beijing based on its experiences during 2012 to 2014. This reform integrates the target tasks,day-to-day performance,personalized performance,Party and people management performance,and mandatory plan performance as one evaluation integrity,forming a new public hospitals’performance evaluation system of multi-dimension and multi-level.This approach can effectively integrate diversified performance management objectives and overcome key difficulties in performance management,assisting further promotion of the approach,facilitating government objectives in managing the medical sector,promoting healthy development of hospitals,and exploring how to deepen the public hospital reform in terms of separating ownership from operations.

The role of public hospital performance evaluation has become a roadblock for the current reform of public hospitals.By summarizing the performance evaluation of Beijing municipal hospitals in recent three years,the authors systematically introduced the practice of Beijing Municipal Administration of Hospitals in establishing a public hospital performance evaluation mechanism.In addition,the paper introduced the achievements of the Administration in the evaluation methods of public hospital evaluation,governmental responsibilities in hospital governance,guidance of hospitals’orderly development,and positive interactions between the government and hospitals.This way the paper provided useful references for guiding the hospitals back to public service nature,positive interactions, refined management of hospitals and better performance management.

Objective Examination and evaluation of employee satisfaction index in the hospital performance evaluation.Methods Stratified sampling,field survey and telephone survey were used in customizing a questionnaire for two surveys in July and December 201 5 respectively.Results The standardized score of employee satisfaction was 86.252±1 5.1 53,and the lowest score was found in the canteen environment and food quality.Conclusion Employee satisfaction is found as good overall,and targeted measures are recommended to improve insufficiencies for better employee satisfaction.

BACKGROUND:Bone marrow stem cell transplantation can improve heart function and prevent ventricle remodeling.At present,the adult bone marrow stem cells used for transplantation primarily included bone marrow mononuclear cells (BM-MNCs) and mesenchymal stem cells (MSCs),and endothelial progenitor cells.The curative effects and precise mechanisms of transplantation of various bone marrow stem cells remain unknown.OBJECTIVE:To compare the effects of transplantation of autologous BM-MNCs and MSCs via the coronary artery on ventricle remodeling subsequent to acute myocardial infarction (AMI). DESIGN,TIME AND SETTING:Randomized controlled animal experiment performed at the Center for Clinical Research,Hebei Provincial People's Hospital,Electron Microscope Room,Hebei Medical University between March 2005 and December 2006.MATERIALS:Thirty-six male Jizhong pigs,were randomly divided into 4 groups:control group (n = 6),infarct model group (n = 10),BM-MNC group (n = 10),and MSC group (n = 10).METHODS:Porcine autologous BM-MNCs were isolated by gradient density centrifugation,and MSCs were obtained by adherence method.Prior to transplantation,both BM-MNCs and MSCs were colloidal gold labeled.Except the infract model group,pigs in the other 3 groups were developed into AMI models by oppressing the left anterior descending branch with balloon catheter.Ninety minutes after modeling,(6.0±1.3)×107 autologous BM-MNCs and (4.5±2.1)x 107 MSCs were respectively transplanted into pigs in the BM-MNC group and the MSC group via the coronary artery and cultured for 28 days.MAIN OUTCOME MEASURES:Observation of pathological changes of cardiac muscle tissue by light and electron microscope;Examination of cardiac function by ultrasonograph;Detection of the number of blood vessels and apoptotic myocardial cells,and expression of nuclear factor-κB (NF-κB) and troponin Ⅰ and its correlation to cardiac function by immunohistochemistry;Detection of mRNA expression of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) in the cardiac tissue as well as its correlation to cardiac function by reverse transcription-polymerase chain reaction (RT-PCR).RESULTS:In the MSC group,there was proliferation of a great deal of blood vessels as well as growth of abnormal cell masses around the coronary vessels,while the BM-MNC group exhibited the "budding" of many capillary vessels.Prior to transplantation,cardiac function indices were basically similar among each group (F = 1.550,P＞0.05).Twenty-eight days after transplantation,left ventricular ejection fraction was significantly lower in the control,BM-MNC,and MSC groups than in the infarct model group (F = 5.30,P＜0.05),while endocardial fractional shortening was significantly higher (F = 10.67,P＜0.01).Compared with the infarct model group,the number of blood vessels in the infarct zone and infarct border zone was increased in the BM-MNC group (F=29.56-34.87,P＜0.01) and had no apparent change in the MSC group.In the BM-MNC and MSC groups,apoptotic myocardial cells in the infarct zone and infarct border zone were significantly reduced (F=14.31-35.34,P＜0.01 ) and troponin I expression rate was significantly increased (F=19.05,P＜0.01 ),as compared with the infarct model group.In addition,NF-κB positive rate in the infarct border zone was significantly lower in the BM-MNC and MSC groups than in the infarct model group (F=19.05,P＜0.01).VEGF gene expression level in the infarct border zone was significandy higher in the BM-MNC group than in the infarct model group and MSC group (F = 49.41,P＜0.01).bFGF gene expression level in the infarct border zone was significantly higher in the MSC group than in the infarct model and BM-MNC groups (F=4.71,P＜0.01).LVEF was negatively correlated to myocardial cell apoptosis rate and NF-κB level (r=-0.441 1,P＜0.05;r=-0.579 6,P＜0.01 ).LVEF was positively correlated to number of blood vessels,VEGF and bFGF expression (r=0.775,P＜0.01;r=0.565 1,P＜0.05;r=0.573 5,P＜0.05).CONCLUSION:Transplantation of both autologous BM-MNC and MSC via coronary artery can improve the condition of left ventricular remodeling subsequent to myocardial infarction.The improvement of cardiac functions is related to the increase of blood vessels,VEGF and bFGF expression,the decrease of myocardial cell apoptosis and NF-κ B level in cardiac muscle tissues after stem cell transplantation.BM-MNC transplantation better promotes blood vessel proliferation and VEGF expression in the cardiac tissue but produces worse effects on bFGF gene expression than MSC transplantation.

Objective:To analyze the predictors of poor outcomes after emergency intracerebral thrombectomy based on the characteristics of cerebral angiography.Methods:A total of 146 patients with acute ischemic stroke (AIS) who received endovascular treatment in Loudi Central Hospital from March 2019 to February 2022 were included in the study, and digital subtraction angiography (DSA) was performed on the patients. The patients were divided into a good prognosis group (95 cases) and a poor prognosis group (51 cases) by the modified Rankin scale 3 months after operation. Gender, age, time from onset to visit, time from onset to puncture, proportion of intravenous thrombolysis, occlusion site, treatment strategy, National Institute of Health Stroke Scale (NIHSS) score, core infarct volume, ischemic hypoperfusion volume, collateral circulation classification, and venous drainage status were compared between the two groups score; Logistic regression was used to analyze the risk factors affecting the poor prognosis of patients; Receive Operating Characteristic (ROC) curve was used to analyze the predictive value of collateral circulation classification and venous drainage status score for poor prognosis of patients, and the differences in general data and imaging data were compared between groups with different collateral circulation grades and venous drainage status.Results:Compared with the good outcome group, the time from onset to visit, NIHSS score, core infarct volume, ischemic hypoperfusion volume, the proportion of thrombectomy alone, and collateral circulation classification in the poor outcome group [2 (2, 3) levels. 2 (1, 2) level] and venous drainage score [5 (4, 6) points vs. 6 (6, 8) points] increased ( P<0.05), and the proportion of recanalization grade 2b/3 decreased ( P<0.05); NIHSS score, collateral circulation grade and venous drainage status were predictors of poor outcome within 3 months after mechanical thrombectomy ( OR = 2.51, 1.93, 2.61, P<0.05); collateral circulation grade and venous drainage score predicted mechanical thrombectomy in patients with AIS, the area under curve (AUC) of poor outcome after thrombectomy were 0.714 and 0.829, respectively; the time from onset to visit between patients with poor collateral circulation, moderate and good AIS [(236.95 ± 21.03) min, (250.41 ± 21.32) min, (255.72 ± 20.98 min)], core infarct volume [52 (17, 80) ml, 25 (15.5, 30) ml, 15 (10, 25) ml] and venous drainage scores [5 (4, 6) points, 5 (5, 8) points, 5 (5, 8) points] were significantly different ( P<0.05); time from onset to visit in patients with poor venous drainage, moderate and good AIS (234.81 ± 21.22 min), (256.83 ± 20.88) min, (258.97 ± 21.35) min], core infarct volume [17(13, 45) ml, 26(25, 29) ml, 20 (11, 29) ml] and collateral circulation classification [2 (1, 2) level, 2 (1, 3) level, 2 (2, 3) level] were significantly different ( P<0.05). Conclusions:Collateral grading and venous drainage scores based on DSA imaging were predictors of poor outcomes within 3 months of mechanical arterial thrombectomy in patients with AIS.

Polyetheretherketone(PEEK),as a new biomaterial,has been reported to have more performance studies and clinical application in the field of prosthetics in recent years.This paper reviewes the material research of PEEK from 4 aspects of its mechani-cal properties,processing properties,adhesive properties,and aesthetic properties,and then introduces the current status of its clini-cal application of removable and fixed PEEK oral restorations,respectively.