Objective:To investigate the correlation among prognostic nutritional index (PNI), clinical features, and adverse reac-tions after adjuvant chemotherapy of gastric cancer patients who underwent radical gastrectomy. Furthermore, this study aimed to clari-fy the predictive and prognostic significance of PNI in patients who underwent gastrectomy for gastric cancer. Methods:This study re-viewed the medical records of 148 patients with gastric cancer who underwent gastrectomy. The PNI value was calculated by serum al-bumin concentration (g/L)+5 × lymphocyte count (×109/L). The receiver operating characteristic (ROC) curve and Youden index were used to determine the cut-off value of the PNI. Survival curves were described by Kaplan-Meier method and compared by Log-rank test. The univariate and multivariate analyses were performed with the Cox proportional hazard model to identify the prognostic factors. Re-sults:The mean values of the PNI in<65 years old patients (P<0.01), T1 and T2 stages of tumor (P<0.01), and negative lymph node (P=0.013) were significantly higher than those without such factors. Patients with higher PNI had significantly lower rates of postoperative complication and adjuvant chemotherapy adverse reactions than those with lower PNI (P<0.01). When the PNI value was 52.08, the Youden index was maximal, with a sensitivity of 66.7%and a specificity of 34.3%. The overall survival rate in the high PNI group was higher than that in the low PNI group (P<0.01). The univariate and multivariate analyses showed that preoperative carcinoembryonic antigen level (P=0.018), tumor depth (P=0.010), intravascular cancer embolus (P=0.010), time to initiation of chemotherapy after sur-gery (P=0.034), and the PNI value (P=0.015) were independent factors in predicting overall survival rate. Conclusion:The PNI value was a simple and useful tool to predict the prognosis and the incidence of adjuvant chemotherapy adverse reactions of gastric cancer pa-tients after radical gastrectomy.

Objective:To evaluate the potential value of indocyanine green combined with methylene blue and methylene blue alone in the detection of sentinel lymph nodes (SLN) in breast cancer.Methods:The clinical data of 118 patients with early breast cancer from November 2016 to October 2018 in Dalian Central Hospital Affiliated to Dalian Medical University were retrospectively analyzed. Among them, 62 patients underwent SLN biopsy under methylene blue (methylene blue group, 160 SLN), and 56 patients underwent SLN biopsy under indocyanine green combined with methylene blue (combined group, 190 SLN). After SLN biopsy, patients underwent grade Ⅰ and Ⅱ axillary lymph node dissection.Results:There was no significant difference in the positive lymph node rate and accuracy rate between 2 groups ( P>0.05); the SLN dyeing rate and SLN biopsy positive rate in combined group were significantly higher than those in methylene blue group: 97.9% (186/190) vs. 93.1% (149/160) and 28.4% (54/190) vs. 18.1% (29/160), and there were statistical differences ( P<0.05); the false negative rate in combined group was lower than that in methylene blue group: 5.3% (3/57) vs. 14.7% (5/34), but there was no statistical difference ( P>0.05). Conclusions:In breast cancer patients, the dual -tracing method of indocyanine green combined with methylene blue is better than using methylene blue alone in identifying SLN and predicting the status of axillary lymph nodes, and it has a tendency to reduce the false negative rate.

Objective To study the expressions and significances of leptin,estrogen and estrogen receptor (ER) in pulmonary squamous carcinoma and adenocarcinoma.Methods The expressions of leptin and estrogen receptor were detected in 58 cases of lung adenocarcinoma and 63 cases of pulmonary squamous cell carcinoma and 50 cases of normal lung tissue samples by immunohistochemical menthod,the levels of estrogen were also detected in patients with venous blood at the same time.Comparison of differential expression of leptin,estrogen and estrogen receptor in lung adenocarcinoma and lung squamous cell carcinoma,normal tissues,and explore their relationships with lung adenocarcinoma.Results Leptin,estrogen and estrogen receptor positive rates in lung adenocarcinoma group were 65.5％,36.2％ and 58.6％ respectively,and 33.3％,15.9％,30.2％ in lung squamous cell carcinoma group.There were a statistical difference between the two groups (x2 =4.324,P＜0.050;x2 =5.372,P ＜0.050;x2 =5.718,P ＜0.050).In the normal control group the positive rates were 24.0％,4.0％ and 0 respectively,and there was a statistical difference compared with lung adenocarcinoma group (x2 =7.126,P ＜0.010;x2 =9.683,P＜0.005;x2 =22.308,P ＜0.005).In lung adenocarcinoma group,leptin,estrogen and estrogen receptor positive rate have no relationships with tumor stage (x2 =0.001,P=0.950;x2 =0.061,P =0.900;x2 =0.178,P=0.750) and primary tumor size (x2=0.023,P=0.900;x2 =0.001,P=0.950;x2 =0.001,P=0.950).Conclusion Leptin,estrogen and ER were expressed highly in adenocarcinoma of lung tumor.The expressions of leptin,estrogen and ER may associated with the carcinogenesis,development and clinical type of adenocarcinoma of lung.

OBJECTIVE:To explore the idea and method of post-marketing safety reevaluation of TCM injection in our hospi-tal. METHODS:In case-control study,salvianolate for injection was chosen for practice. 1 000 patients with stable angina receiv-ing Salvianolate for injection in our hospital during May 2012-Oct. 2013 were selected as subjects. The occurrence of ADR/ADE were observed and Logistic regression analysis was conducted by using SPSS 20.0 software. RESULTS:The incidence of ADR/ADE was 0.6%,and rare(0.1%-1%). The ADR/ADE were general and mainly manifested as erythra(66.67%). Skin and its ap-pendants were main organs involved in ADR(66.67%). Logistic regression analysis showed that gender,drug combination and age are risk factors of ADR/ADE. CONCLUSIONS:The post-marketing safety reevaluation of TCM injection not only make up for the deficiency of pre-marketing safety evaluation of TCM injection and find out potential delayed and severe ADR/ADE and drug inter-action,but also provide reference for rational drug use in the clinic and guarantee the safe and rational drug use.

Objective:To study the phenotypes of T cell in patients with Hashimoto thyrioditis (HT) and to analyze its relationship with the impairment of follicles, so as to provide evidence for clinical diagnosis and treatment. Methods: Totally 136 HT specimens were obtained by fine needle aspiration biopsy (FNAB) and were divided morphologically(L, P, O type). The serum parameters (TPOAb, TGAb, TSH) were tested, and 20 cases with nontoxic goiter were taken as control. Immuno-histochemical assay was performed with 60 specimens and FCM (Flow cytometry ) was used to study 23 specimens. The T cell infiltration and the distribution of CD3+ . CD4+ . and CD8+ T cells were compared between all types of HT tissues. The correlationship between the atrophic degree of follicle with T lymphocytes infiltration and phenotype was analyzed. Results: It was found that L type (n = 58) and P type (n = 28) had more serious follicle atrophy than that of O type (n = 20) (P

Objective To investigate the expression level of monocytes ATP-binding cassette transporter A1(ABCA1) stimulated by oxidized low-density lipoprotein (ox-LDL) in patients with coronary heart disease (CHD) for exploring the mechanism of ABCA1 in the pathogenesis of atherosclerosis (AS). Methods Human monocytes of patients in CHD group (n=42) and normal control group (n=40) were isolated by density gradient centrifugation with separating medium (1.077). ABCA1 was labeled by immune reaction PE fluorescence, then the expression of ABCA1 before and after being incubated with the ox-LDL (30mg/L) for 24 hours was investigated by flow cytometer, and the changes in ABCA1 expression were observed. The differences between the two groups and the correlation between ABCA1 expression and blood lipids were analyzed. Results The high-density lipoprotein cholesterol (HDL-C) and apolipoprotein A1 (apoA1) levels in CHD group (1.15?1.40 and 1.19?0.17, respectively) were significantly lower than that in control group (1.36?0.40 and 1.34?0.22, respectively, P0.05). Conclusions ABCA1 expression in the patients with CHD may be inhibited by high concentration of ox-LDL. The lowered expression of ABCA1 and the abnormal lipids spectrum may decrease the reverse cholesterol transport (RCT), and contribute to the development of AS and CHD.

ObjectiveTo evaluate the effectiveness of PBL teaching model for medical students in surgery bed side teaching.MethodsThe method of meta-analysis.ResultsFinally,twenty-six documents met the requirement.The resuhs of Meta-analysis showed that,in the aspect of theory improvement for medical students,WMD=6.46,95 ％ CI 为 2.56 ～ 10.36,P＜0.01 ; in the aspect of skill ability improvement,WMD=5.32,95 ％ CI 为 2.47 ～ 8.16,P ＜0.01.ConclusionThe model of PBL teaching could significantly improve the effectiveness in theoretical knowledge and skill ability.

Objective To develop an intelligent assist order system for parenteral nutrition and embed it into hospital information system,so as to facilitate rational prescription of parenteral nutrition.Methods Comprehensive database,knowledge base and control system of parenteral nutrition orders were set up based on production rule.An intelligent assist order system for parenteral nutrition was designed and developed.Individual energy demand of patients were calculated automatically and compared with doctors' orders of parenteral nutrition.Cation concentration was calculated automatically and controlled for the stability of all-in-one parenteral nutrition admixture.Results This system achieved successful and fast calculation of individual energy demand,over-standard warning of total energy,the ratios of carbohydrates to lipids and non-protein calories to nitrogen,ion concentration,and liquid volume.It also controlled the cation concentration,thus avoiding demulsification.Conclusions The intelligent assist order system for parenteral nutrition can solve the problems of energy calculation and ensure the stability of all-in-one parenteral nutrition admixture.As a result,it can improve the utilization of parenteral nutrition in hospital.

Objective To investigate the effects and anti-atherosclerotic mechanism of rosiglitazone on the expression of ATP-binding cassette transporter A1 (ABCA1) and reverse cholesterol transport (RCT) in atherosclerotic rabbits. Methods Twelve rabbits were randomly divided into two groups (6 each): control group (only high cholesterol diet for 6 weeks), rosiglitazone group [high cholesterol diet plus rosiglitazone 0.5mg/(kg?d) for 6 weeks]. ABCA1 expression and [3H] cholesterol efflux rates were evaluated by flow cytometry and liquid scintillation spectrometry, respectively. Enzymatic methods were used to assay serum lipids levels and cholesterol contents in tissues, and the atherosclerotic area of aorta was calculated by professional image analysis software. Results For the rabbits of both control and rosiglitazone group, the serum levels of high-density lipoprotein cholesterol (HDL-C), non-high-density lipoprotein cholesterol (NHDL-C) and apolipoprotein A1 (apoA1) significantly went up when they took their cholesterol rich diet for 6 weeks (P0.05). Compared with control group, the ABCA1 expressions in monocytes, peritoneal macrophages, adipocytes and hepatocytes, as well as the cholesterol efflux rates in peritoneal macrophages, adipocytes and hepatocytes increased significantly (P

Objective: To evaluate the self-developed intelligent assist order system for parenteral nutrition on the control of concentration exceeding standard of positive ions.Methods: The special comments, pharmacist audit and information control were used to intervene the concentration exceeding standard of positive ions in parenteral nutrition orders and the effect of the three intervention methods were evaluated.Results: For the intervention of concentration exceeding standard of positive ions in parenteral nutrition orders, the information control was better than the special comments and pharmacists audit.Conclusion: The intelligent assist order system for parenteral nutrition can solve the problem of concentration exceeding standard and promote the rational application of parenteral nutrition in hospitals.