Objective To comprehensively evaluate the relationship between murine double minute 2 (MDM2) gene promoter SNP309 T＞G polymorphism and the susceptibility of gastrointestinal cancer.Methods The China National Knowledge Infrastructure (CNKI),WanFang database,SpringerLink database and PubMed were retrieved to get all case-control research literatures (2005-2012) on the relationship of MDM2 gene SNP309 T＞G and gastrointestinal cancer susceptibility.Meta-analysis with RevMan 4.2 was used to combine OR values of the relationship between SNP309 T＞G and gastrointestinal cancer susceptibility.A sensitivity analysis and tested publication bias were made with all selected literatures' data.Results A total of 17 domestic and foreign qualified papers were included in this study.Twenty case-control studies including 5 183 cases and 6 660 controls were identified for the present meta-analysis.A significant association was detected between the MDM2 SNP309 T＞G polymorphism and gastrointestinal cancer risk.The meta-aualysis showed that the combined odds ratio (OR) for GG genotype was 2.23 (95 ％ CI =1.73-2.89,P ＜ 0.01) compared with that for TG + TT genotypes.There was no statistical significance for the evaluation of publication bias.Conclusion The GG genotype of MDM2 SNP309 may increase gastrointestinal cancer risk in Asians.

Objective To compare dose distribution in gamma knife radiotherapy plan, conformal radiotherapy(CRT)plan and intensity modulated radiotherapy(MRT)plan for patients with small mass in lung, and evaluate their characters. Methods Fourteen patients with small mass in lung participated in the study. Gamma knife radiotherapy plan(plan 1), CRT plan(plan 2)and IMRT plan(plan 3)were made for each mass. The planning target volume(PTV)and the dose include 95% PTV were consistent.Conformal index(CI), homogeneity index(HI), lung V5 ,V10 ,V20 ,V30 and the max dose of esophagus and spinal cord were analyzed. Paired samples t-test was used for comparison between each two plans. Results The CI of the plan 1,2 and 3 were 0. 58,0. 46 and 0. 63, respectively. CI of the plan 1 ＞ that of the plan 2 (t= -3.95,P =0.000),plan 3 ＞ plan 2(t = -6.01 ,P =0.000),plan 1 =plan 3(t =1.64,P =0.116);HI of the plan 1,2 and 3 were 1.66,1.10 and 1.07 respectively. HI of the plan 1 ＞ plan 2 ,plan 1 ＞ plan 3(t= -20.52,21.41 respectively, both P=0. 000),plan 2 = plan 3(t= -1.08,P=0.294). The wholelung V5 ,V10 ,V20 and V30 were 10.0% ,5.6% ,2. 4% and 1.2%, respectively, in plan 1 ;20. 2% ,13. 4%,6. 9% ,3.0%, respectively, in plan 3; and 26. 5%, 18. 0%, 11.4% and 4. 6%, respectively, in plan 2.The V5, V10, V20 and V 30 of the plan 1 ＜ in plan 2(t = 9. 68,8. 41,5. 45,5. 14, all P = 0. 000), the V5,V10,V20 and V30 of the plan 1 ＜ in plan 3(t=7.58,8.95,6. 15,4.78, respectively, all P=0.000),the V5 ,V10, V20andV30 oftheplan2 ＞ inplan3(t =9. 71,5. 91,4. 13,3.91, respectively, allP =0.000).The max dose of esophagus in plan 1 ,2 and 3 were 24.93 ± 21.54, 31.90 ± 18. 75, 29. 19 ± 23.09 Gy,respectively, plan 1 ＜ plan 2(t = -2. 71 ,P=0.013),plan 1 = plan 3(t = - 1.49,P =0. 152),plan 2 =plan 3(t = 1.35, P = 0. 193). The max dose of spinal cord in plan 1,2 and 3 were 12.07 ± 10. 67,17.70 ±11.35 and 8.92 :± 10. 04 Gy, respectively, plan 2 ＞ plan 1 ＞plan 3(t = -2. 38,2. 29,4. 83,P=0. 1027,0.033,0.000);All three plans of each mass meet the needs that the max dose of the esophagus≤60 Gy and the max dose of spinal cord ≤40 Gy. Conclusions The dose of the normal lung was lower, but the HI and the max dose of spinal cord were higher in Gamma knife radiotherapy plan than those in the CRT and the IMRT plan of the small mass in lung.

Objective To evaluate the value of acoustic radiation force impulse (ARFI) elastography in assessment of nonalcoholic fatty liver disease (NAFLD) and hepatic fibrosis in rats.Methods Models with various degrees of NAFLD severity were conducted in 110 rats by feeding high fat emulsion.The right liver lobe of rat models were processed and embedded in a fabricated gelatin solution to measure the shear wave velocity (SWV) by ARFI.And the other liver lobes were used for histologic assessment.Based on NAFLD activity score (NAS),the final pathologic NAFLD diagnosis were considered as normal group (NAS=0),simple steatosis (SS) group (1≤NAS≤2),borderline (3≤NAS≤4) group and nonalcoholic steatohepatitis (NASH) group (NAS≥5).The diagnostic accuracy of the SWV parameters in evaluating NAFLD severity and fibrosis stages was studied using ROC curves.Results The difference of SWV values among normal group,SS group,borderline group and NASH group was statistically significant (F=31.53,P＜0.001).Taking SWV≥ 2.54 m/s as the diagnostic standard to differentiate normal rats from rats with SS,and SWV≥2.90 m/s to differentiate SS from NASH in rats,the area under ROC curve (AUC) was 0.922 (95％CI [0.871,0.973],P＜0.001) and 0.882 (95％ CI [0.807,0.956],P＜0.001) respectively.The sensitivity and specificity were 93.5 ％ and 100 ％ for differentiating normal and SS groups,83.3 ％ and 84.2 ％ for differentiating SS and NASH groups.Taking SWV≥3.48 m/s as cutoff to predict fibrosis (≥F2 stage),the AUC was 0.963 (95％CI [0.909,1.000],P＜0.001),the sensitivity was 92.9％ and the specificity was 97.6％.Taking SWV≥3.61 m/s as cutoff to predict severe fibrosis (≥F3 stage),the AUC was 0.997 (95％CI [0.990,1.000],P＜0.001),sensitivity was 100％ and specificity was 98.9％.The same high validity was maintained as in the prediction of cirrhosis (F4 stage) with the cutoff as SWV≥4.50 m/s,and the AUC was 0.993 (95％CI [0.982,1.000],P＜0.001),the sensitivity was 100 ％ and the specificity was 96.8％.Conclusion ARFI elastography is a promising method for differentiating the different severity of NAFLD and staging the degree of hepatic fibrosis with NAFLD in rat models.

The study was to observe the therapeutic effect of HJ-1 NO--HFJV respirator on treating pulmonary edema caused by seawater drowning. Seawater was infused into the rabbit's lung to establish the animal model of pulmonary edema caused by seawater drowning(PE-SWD). Then the animals were divided into three groups: simple PE-SWD model as control group, treat group(animal model treated with HFJV respirator and four medicines) and HFJV respiratior plus NO group. Pao2, Sao2 and pH were measured by the blood-gas analyzer. The survival time and seawater drowing-respiratiory distress syndrom(SW-RDS) were observed. The results showed that Pao2, Sao2 in NO group were remarkably higher than that of PE-SWD control group, and the survival time was longer than that of medicine treated group and the incidence of SW-RDS decreased to zero. We assume that HJ-1 NO-HFJV respirator is efficient on treating pulmonary edema.
Animals ; Disease Models, Animal ; High-Frequency Jet Ventilation ; instrumentation ; Near Drowning ; complications ; Nitric Oxide ; therapeutic use ; Pulmonary Edema ; etiology ; therapy ; Rabbits

Objective To analyze the clinical and pathological features of advanced colorectal serrated adenoma(ACSA). Methods The endoscopic and pathological features of 156 cases of ACSA and 121 cases of non-ACSA diagnosed in General Hospital, Tianjin Medical University from January 2010 to March 2016 were retrospectively analyzed and compared.Results ACSA and non-ACSA cases accounted for 56.3%(156/277)and 43.7%(121/277)of all patients with colorectal serrated lesions,respectively. The mean age of ACSA patients was 57.79±13.65 years and 89(57.1%)of these patients were male. There was no significant difference in age and gender between ACSA and non-ACSA patients. A total of 161 ACSA lesions were diagnosed,including 71 sessile serrated adenoma/polyps and 90 traditional serrated adenomas. Among the 161 ACSA lesions,there were 29(18.0%)lesions whose diameter≥10 mm, and 84(52.2%) lesions located in the proximal colon, which were more than non-ACSA(84/161 VS 49/134,P=0.007). ACSA was classified under endoscopy into pedunculated type(20/161),sub-pedunculated type(35/161), sessile type(24/161),flat type(79/161)and laterally spreading tumor(3/161), and the distribution of lesion type was significantly different from non-ACSA(P<0.001). One hundred and sixty(99.4%)ACSA lesions were diagnosed as dysplasia, including 158 low degree dysplasia and 2 high degree dysplasia.Moreover,16 ACSA patients were accompanied with synchronous advanced colorectal neoplasia(sACN), and large serrated polyps(diameter≥10 mm)might have a strong association with sACN(OR=4.35, 95%CI:1.467-12.894, P<0.05). Conclusion ACSA is more common in proximal colon and sub-pedunculated type,sessile type and flat type. ACSA diameter≥10 mm is significantly associated with sACN.

Objective:To better understand the current status of master of public health (MPH) cultivation, establish a better training system, and improve its training quality.Methods:The students and teachers from many universities in Fujian province, as well as the public health workers, were investigated with a questionnaire on the "training model of master of public health", and SPSS 13.0 was used for data processing.Results:The survey results showed that 51.54%(67/130) of the survey respondents liked MPH major, and their understanding of MPH gradually increased with increasing working experience. However, there was no statistical significance in terms of the correlation between the abilities cultivated by the MPH training system and the working years. And 89.23%(116/130) of the survey respondents indicated that the direction of MPH training needed to be further refined, and the net promoter score for the evaluation of the MPH training model was -53.07%.Conclusion:At present, certain achievements have been made in MPH cultivation, and the development of MPH cultivation system needs more in-depth study.

Objective To study the clinical application effect of X-ray computed tomography (DR) and spiral CT in the diagnosis of emergency thoracic and abdominal trauma. Methods A total of 174 patients with emergency thoracic and abdominal trauma admitted in our hospital from November 19, 2016 to November 19, 2017 were enrolled in this study. All patients underwent DR and spiral CT examinations. The pathological diagnosis coincidence rate between the two diagnostic methods and the satisfaction with the diagnostic methods between the two groups was compared. Results In terms of pathological diagnosis, the coincidence rate of spiral CT in subcutaneous emphysema, rib fractures, scapular fractures, clavicle fractures, pulmonary contusion, pleural effusion, pneumothorax, atelectasis, mediastinal emphysema, liver injury, spleen injury, kidney injury, pancreas injury, celiac hemorrhage, mesentery laceration and diaphragmatic injury was 100. 00％. Except for pulmonary contusion, mediastinal emphysema, hematoma and kidney injury and pancreatic injury, the pathological diagnosis coincidence rate of spiral CT in the other chest trauma was higher than that of DR diagnosis, and the difference was statistically significant (P＜0. 05). The patients' satisfaction score of spiral CT diag nosis was significantly higher than that of DR diagnosis(P＜0. 05). Conclusion The spiral CT in the diagnosis of emer gency thoracic and abdomen trauma is better, which can improve the clinical diagnosis of coincidence rate, and is worthy of further recommendation.

Objective To analyze the diagnostic value of multi-slice spiral CTin patients with emergency chest pain. Methods 81 patients with chest pain admitted in the Department of Emergency in our hospital from October 27, 2016 to October 27, 2017 were investigated. All patients underwent multi-slice spiral CTexamination. The examination results of multi-slice spiral CTexamination were compared with those of conventional coronary angiography. At the same time, the patient's heart rate and satisfaction during different examinations was compared. Results There were 64 patients with coronary artery stenosis, 9 patients with aortic dissection, 8 patients with pulmonary embolism were detected by multi-slice spiral CT, accounting for 79. 01％, 11. 11％ and 9. 88％ respectively. There were 64 cases of coronary artery stenosis, 10 cases of aortic dissection and 7 cases of pulmonary embolism detected by routine coronary angiography examination, accounting for 79. 01％, 12. 35％ and 8. 64％, respectively. There was no significant difference between the results of the two examination methods (P＞0. 05). There was no significant difference in the level of heart rate between patients with multi-slice spiral CTand those with conventional coronary angiography(P＞0. 05). The patient's satisfaction with multi-slice spiral CTwas 96. 30％, which was significantly higher (P＜0. 05). Conclusion For patients with emergency chest pain, the detection of multi-slice spiral CTis similar to that of routine coronary angiography in the cause of the disease, and has little influence on the patient's heart rate, which is an ideal method for clinical diagnosis of chest pain.

OBJECTIVETo investigate the effect of fuzheng quxie granule (FQG) on immune cells and cytokines in populations with respiratory viral infection.

METHODSFifty-nine patients were randomly divided into 3 groups, that is, 19 patients treated with conventional western medicine (WM) plus FQG in the treated group, 19 patients treated with conventional western medicine alone in the WM group, and 21 patients treated with FQG alone in the TCM group. The levels of T lymphocyte subsets, interleukine-2,4,6,10 (IL-2, IL-4, IL-6, IL-10), tumor necrosis factor-alpha (TNF-alpha), interferon-gamma (INF-gamma) and Th1/Th2 were determined before treatment, and at the end of 1st and 2nd week of treatment respectively.

RESULTSBefore treatment, levels of TNF-alpha, IL-2, IL-6, IL-10 and INF-gamma in all patients were significantly higher than normal range (P < 0.05). After being treated for 1 week, the levels of serum TNF-alpha, IL-6, and IL-10 were significantly decreased in all groups (P < 0.05), serum IL-2 and INF-gamma decreased to the normal level in the WM group, but in the treated and the FQG group by the end of the 2nd week, the two indexes still remained at the rather higher level (P < 0.05). The ratio of Th1 and Th2 in the treated group and the FQG group increased significantly by the end of 2nd week, reached the level higher than that in the WM group and that before treatment (P < 0.05). No significant difference in, T lymphocytes subsets (CD3+ , CD4+ , CD8+) and percentage of B and NK cells before and after treatment was found in all the 3 groups.

CONCLUSIONFQG can positively regulate the immune function of patients with respiratory tract viral infection in certain degree.

Adult ; Aged ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Interleukin-10 ; blood ; Interleukin-6 ; blood ; Killer Cells, Natural ; immunology ; Male ; Middle Aged ; Phytotherapy ; Respiratory Tract Infections ; drug therapy ; immunology ; virology ; T-Lymphocyte Subsets ; immunology ; Tumor Necrosis Factor-alpha ; metabolism ; Virus Diseases ; drug therapy ; immunology

Model informed precision dosing for warfarin is to provide individualized dosing by integrating information related to patient characteristics, disease status and pharmacokinetics /pharmacodynamics of warfarin, through mathematical modeling and simulation techniques based on the quantitative pharmacology. Compared with empirical dosing, it can improve the safety, effectiveness, economy, and adherence of pharmacotherapy of warfarin. This consensus report describes the commonly used modeling and simulation techniques for warfarin, their application in developing and adjusting dosing regimens, medication adherence and economy. Moreover, this consensus also elaborates the detailed procedures for the implementation in the warfarin pharmacy service pathway to facilitate the development and application of model informed precision dosing for warfarin.