Objective To study the correlation between blood lactic acid level and PCIS scroing system.To study the relationship between dynamic lactic acid monitoring indexes and prognosis of critical patients.Methods Differences of mortality,incidence of MODS and shock,PCIS score between two groups were compared.The patients were divided into 3 groups by PCIS score to compare pathogenetic conditions prognosis, then to study the were divided into death group and survival group by the hospital prognosis. Differences of their lactic indexes and other clinical indicators which reflected organ/system status were compared, prognostic-significant lactic indexes were selected by mu fti-variable logistic analysis. Results Patients with elevated lactic acid level had more incidence of shock and MODS, higher PCIS scores and higher mortality, the differences had statistical significance compared with the normal lactic acid group. There were significant linear correlation between ICU lactic acid level, peak lactic acid level and PCIS scores respectively. For the patients with elevated lactic acid level, peak lactic acid level, 12h lactic clearance had significant correlation with prognosis. Conclusion PCIS scoring system had a significant linear correlation with lactic acid level. For the patients with elevated lactic acid level,peak lactic acid level,12h lactic clearance were good indicators to evaluate patients' prognosis.

Objective To compare the effectiveness,safety and related clinical indicators between simple drainage treatment and drainage treatment combined with intrathoracic urokinase for children with parapneumonic pleural effusion(PPE).Methods Twenty-nine in patients with PPE given pleural effusion drainage in the First Affiliated Hospital of Zhengzhou University from January 2013 to December 2015 were selected as research subjects,who were divided into a simple group and an urokinase group based on whether intrathoracic urokinase was injected or not.The total number of hospital stay,the total drainage volume,the total number of catheter days,the total cost,the days with fever,efficient rate,operation rate and security of the patients were retrospectively analyzed between two groups.Results The intrathoracic days of hospital stay [M(P25,P75)] of urokinase group[19(11,30) days]were less than those of simple group[30(21,38) days],and the difference was significant (Z =-2.545,P =0.011);the total drainage volume[M(P25,P75)] of the urokinase group [430 (175,1 308) mL] was more than that of the simple group [110 (10,325)mL],and the difference was significant (Z =-2.811,P =0.005);the total number of catheter days [M (P25,P75)] of urokinase group [9 (7,19) days] was less than that of the simple group [20 (10,30) days],and the difference was significant (Z =-2.020,P =0.043);the total cost [M(P25,P75)] of the urokinase group [20 000(10 000,30 000)RMB] was less than that of the simple group [40 000 (30 000,50 000) RMB],and the difference was significant (Z =-2.631,P =0.009);the days with fever between urokinase group and the simple group was not significant (Z =-0.820,P =0.412).The urokinase group had a higher cure rate[76.9％ (10/13 cases)] and a lower surgical rate [23.1％ (3/13 cases)] compared with those of the simple group[18.7％ (3/16 cases),81.3％ (3/16 cases)],and the difference was significant (x2 =9.814,P =0.003).Conclusions Intrapleural urokinase therapy as an adjuvant treatment of PPE is simple and convenient,economic,higher efficiency,lower risk,which can be used as an effective clinical solution such disease.

Objective To evaluate the feasibility and safety of hand-assisted laparoscopic one-stage operation for colorectal cancer with single hepatic metastasis.Methods The clinical data of 6 patients of colorectal cancer with single hepatic metastasis treated with hand-assisted laparoscopic one-stage operation between Aug 2009 and Mar 2010 were analyzed retrospectively.Result Procedures were completed successfully in all cases and there was no conversion to open surgery.The mean operation time was (183 ±45) min,the mean blood loss in operation was (165 ±70) ml,the mean time to intestinal function recovery was (69.4 ± 10.5) h,and the average length of stay was (9.5 ±3.2) d.There was no major intraoperative or postoperative complications.All the patients received chemotherapy and up to 30 months follow-up found good condition in all but one dying of widespread intraabdominal tumor metastasis.Conclusions Handassisted laparoscopic one-stage operation for colorectal cancer with hepatic metastasis is feasible and safe.

Editor's note: The research on effective constituents of traditional Chinese medicine is one of the crucial areas of basic research of traditional Chinese medicine. It is also a research hotspot which gains widespread attention and active application of projects of national natural science funds in the discipline of traditional Chinese medicine. In 2013, the National Natural Science Foundation of Chinese traditional medicine in the application code H2803 in the research field of effective constituents of traditional Chinese medicine , the direction of gener-al project , Youth Science Foundation and the regional Science Foundation project application 449 , which accept-ed 425 . In this paper , the general situation of the application and approved projects of national natural science funds in the research field of effective constituents of traditional Chinese medicine in 2013 has been introduced. The research strategies and plans of the approved projects have been summarized , and the problems of the ap-plications have been also analyzed .

Objective:To discuss the effect and significance of reasonable medication review mode for intravenous medical advice on the platform of pharmacy intravenous admixture service( PIVAS) . Methods:The effect of prescription review interference in intrave-nous drugs on the platform of PIVAS was studied through analyzing irrational prescriptions before and after the performance of PIVAS for 25 departments in our hospital. Results:The real-time review and interference procedure for intravenous transfusion was established, which could significantly increase the percentage of reviewed medical advice and the correction rate of irrational medical advice, and re-duce the percentage of irrational medical advice. The medical advice review quality was also increased, which could guarantee the med-ication safety in patients. Conclusion:The real-time review and interference procedure for intravenous transfusion on the platform of PIVAS can significantly improve the rational medication level of intravenous drugs and avoid the hidden danger of irrational medical ad-vice to the maximum extent to ensure the medication safety in patients, which is also beneficial to the provision of medication service and new platform establishment for the development of clinical pharmacy in hospitals.

OBJECTIVE:To compare the clinical efficacy and safety of salmeterol-fluticasone alone versus fluticasone propio-nate combined with montelukast sodium in the treatment of children with moderate persistent asthma. METHODS:275 children with moderate persistent asthma were randomly divided into inhaled corticosteroids(ICS)+ long acting β2 receptor agonist(LABA) group (139 cases) and ICS+ leukotriene receptor antagonists (LTRA) group (136 cases). ICS+LABA group was given Salmeter-ol-fluticasone powder inhalant,1 inhalation,bid;ICS+LTRA was given Fluticasone propionate inhalation aerosol,bid+Montelu-kast sodium chewable tablet 5 mg,before bedtime,qd. Both groups received more than 12 weeks of treatment. Body indexes of 2 groups were observed after treatment,such as asthma control degree,asthma score,the percentage of peak expiratory flow(PEF) in estimated value,aberration rate of PEF,the levels of eosinophi cationic protein(ECP)and leukotrienes E4(LTE4)in peripheral blood,the times of taking short acting β2 receptor agonist (SABA) during treatment,asymptomatic days,compliance,the inci-dence of ADR,etc. RESULTS:Total effective rate of ICS+LABA group(86.33%)after 4 weeks treatment was higher than that of ICS+LTRA group(58.09%),with statistical significance(P<0.05);that of ICS+LABA(99.28%)after 12 weeks treatment was higher than that of ICS+LTRA group (98.53%),without statistical significance (P>0.05). The day and night asthma score of 2 groups decreased significantly and the percentage of PEF in estimated value increased significantly after treatment,there was statisti-cal significance compared to before treatment(P<0.05). There was no statistical significance in above indexes between 2 groups af-ter treatment(P>0.05). The levels of ECP and LTE4 decreased significantly in 2 groups after treatment,there was statistical signif-icance compared to before treatment(P<0.05);those of ICS+LTRA group decreased significantly compared to ICS+LABA group, there was statistical significance between 2 groups(P<0.05). There was no statistical significance in the aberration rate of PEF af-ter treatment,the times of taking SABA,asymptomatic days,compliance and the incidence of ADR between 2 groups during treat-ment(P>0.05). CONCLUSIONS:Salmeterol-fluticasone alone versus fluticasone propionate combined with montelukast sodi-um in the treatment of children with moderate persistent asth-ma both have good therapeutic efficacy and safety,while thelatter one has stronger inhibition effect on ECP and LTE4,and to control asthma symptoms more rapidly.

Objective To compare the efficacy and safety of icotinib therapy alone versus icotinib combined with thoracic radiotherapy for the treatment of advanced non-small cell lung cancer (NSCLC) patients with an activating epidermal growth factor receptor (EGFR) gene mutation.Methods A total of 83 patients with advanced NSCLC harboring an activating EGFR gene mutation was enrolled in this study.All the patients were randomly divided into 2 groups.Patients in group A (n =41) received thoracic radiotherapy (prescribed at 60-66 Gy) combined with icotinib (three times per day,125 mg once).Patients in group B (n =42) were given icotinib therapy alone (three times per day,125 mg once).Treatment was continued until disease progression or unacceptable toxicity or death.The primary end points were median progression-free survival (mPFS) and 12 month-PFS rate.The secondary end points included objective response rate (ORR),disease control rate (DCR) and adverse events.Results With a median follow-up of 18.2 months,mPFS was 15.2 months (95％ CI:12.2-17.4) in group A and 13.2 months (95％ CI:10.8-14.9) in group B (x2 =4.29,P=0.036).PFS rates of 12 months for group A and group B were 70.3％ and 61.2％,respectively.The ORR were 78.0％ vs.57.1％ (x2 =5.16,P =0.028),and the DCR were 95.1％ vs.92.9％ (P＞0.05) in groups A and group B,respectively.No grade 3-4 adverse events was observed in both groups except the rashes (4 cases in each group).Besides,10 patients had grade 1-2 radiation-related pneumonitis and 15 patients suffered grade 1-2 radiation-related oesophagitis in group A.Conclusions In advanced NSCLC patients with an activating EGFR gene mutation,the combination of thoracic radiotherapy and icotinib had achieved an improvement on ORR and PFS with good tolerance.Clinical trial registration Chinese clinical trial registry,ChiCTRINR-16010262.

Objective To observe the expression and influence of SH2-B in hepatocarcinoma,and to investigate the molecular mechanisms of canceration in hepatocarcinoma.Methods By using SABC imunohis-tochemistry,the expressions of SH2-B were detected in 27 cases of hepatitis,29 cases of hepatocirrhosis and 47 cases of hepatocarcinoma.Hepatocarcinoma cell (HepG)2 with a low-expressed SH2-B was selected using immunofluorescence assay.There were 3 groups:the transfected group (transfected with pcDNA3.1 -SH2-B), the vector group (transfected with pcDNA3.1 )and the blank group (without transfection).After gene transfec-tion,SH2-B expression was detected by Western blotting;cell proliferation was measured by MTT assay;cell colony was counted by colony formation test;and cell cycle was analyzed by flowcy tometer.Results The posi-tive rate of SH2-B in hepatocarcinoma (95.7%)was significantly higher than 55.2% in hepatocirrhosis (χ2 =1 8.64,P <0.01 )and 25.9% in hepatitis (χ2 =40.01 ,P <0.01 ).After being transfected with pcDNA 3.1 -SH2-B,SH2-B expression dramatically increased in HepG2 cells.After cultured for 48 h,the average optical density value of the transfected group was 1 .1 2 ±0.1 9,obviously higher than 0.45 ±0.1 1 in the vector group (t =-31 .55,P <0.01 ),which indicated that cells proliferation was significantly enhanced after being trans-fected with SH2-B.The cell colony numbers of the transfected group was 1 66 ±1 4,significantly higher than
82 ±8 in the vector group (t =-20.33,P <0.01 )and 78 ±9 in the blank group (t =-1 9.64,P <0.01 ), which indicated that the cell colony numbers increased after being transfected with SH2-B.The S stage cells of the transfected group was (45.7 ±5.8)%,significantly higher than (1 9.4 ±4.7)% in the vector group (t =-20.33,P <0.01 )and (20.5 ±5.1 )% in the blank group (t =-34.69,P <0.01 ),which indicated that SH2-B could enhance promote cell cycle of HepG2 cells.Conclusion The expression of SH2-B in hepatocar-cinoma is high,and it may be involved in the canceration of hepatocarcinoma though promoting cell cycle,cell proliferation and cell transformation.

Objective To investigate the value of copy number variation analysis based on next-generation sequencing (NGS-CNVA) in the genetic analysis of missed abortion chorionic villi. Methods From August 2012 to May 2014, chorionic villi from 74 cases of missed abortion at 6-13 gestational weeks in Haidian Maternal and Child Health Hospital were collected and analyzed by karyotype analysis and NGS-CNVA. The results of the two methods were compared. Results (1) Karyotype analysis was carried out for the villi from the 74 missed abortion patients. Thirty cases were euploid, 26 cases were aneuploid, while 18 cases had structural abnormalities. The resolution of the karyotyping was 320 bands and the average report time was 22 days. (2) All of the 74 samples obtained NGS-CNVA results and the report time was 7-10 days. (3) The NGS-CNVA results of 56 cases were consistent with karyotype. Among them, 28 cases (28/56, 50%) had no copy number variants (CNV), and 19 cases (19/56, 34%)had CNV between 1 Mb and 10 Mb. 9 cases (9/56,16%) had CNV≥10 Mb found by NGS-CNVA, but not found by karyotyping. (4) According to the results of NGS-CNVA, karyotype were reviewed. The reviewed results found 7 cases with CNV<10 Mb and 3 cases with CNV≥10 Mb in 30 cases which got normal karyotype results at the first analysis. (5) Among the 18 cases of structural abnormalities, 6 cases were Robertsonian translocation. Sequencing technology could confirm the specific area of chromosome deletion/duplication in 8 cases, but could not locate them. Conclusions NGS-CNVA has lower failure rate, higher resolution, lower specimen requirement and shorter report time than karyotype analysis when used for the genetic analysis of missed chorionic villi . NGS-CNVA could be a useful genetic analysis method for the missed abortion villi.

Objective To observe the influence of inactive FRMD4A gene′s expression on the biological behavior of tongue cancer CAL-27cell. Methods FRMD4A-siRNA was transfered into CAL-27 cell by lipidosome, to the expression of FRMD4A-siRNA in CAL-27 cell after transfection was detect by qRT-PCR cell proliferation , was checked by CCK-8,the influence of inactive FRMD4A gene on cell cycle distribution of CAL-27 cell was assayed by flow cytometry. Results Compared with the control group, FRMD4A mRNA expression significantly reduced in FRMD4A-siRNA interfering group (94%) and the cell proliferation index decreased(P<0.05). The cell cycle arrested in G1 period (P<0.05). Conclusion FRMD4A-siRNA could effectively inhibit FRMD4A mRNA expression in tongue cancer CAL-27cell, impact the distribution of cell cycle, and reduce cell proliferation.