MicroRNAs (miRNAs) are a group of multifunctional regulators which plays crucial role in physiological and pathological processed ranging from development,differentiation and apoptosis to stress responscs.Over 50 ％ miRNAs are located in the tumor-associated region or the fragile chrosomal regions which are susceptible to amplification,deletion or translocation during the process of tumor onset and development.More recently,the new publications indicated that the miRNAs broaden the insight for the mechanism research of tumor metastasis and the applications of miRNAs in carcinoma diagnosis.The article focuses on the mechanism by which some miRNAs are deregulated in lung cancer,the clinical potential of these molecules as the diagnosis and prognosis biomarkers and the future of miRNAs to be potential therapeutic drugs.

Objective To compare the influence of radiotherapy,chemotherapy and radiation combined with chemotherapy in the treatment of patients with non-small cell lung cancer on the state of EGFR gene mutation.Methods 328 patients with non-small cell lung cancer were selected.On the basis of the condition of the patients,they were treated with radiation therapy,combination treatment with chemotherapy and radiation.And according to the different treatment methods,they were divided into chemotherapy group (112 cases),radiotherapy group (108 cases) and radiation combined with chemotherapy group(108 cases).Before and after treatment,the plasma EGFR mutations situation was detected and analyzed.Results Before treatment,the plasma EGFR mutation rates in the chemotherapy,radiotherapy,radiation combined with chemotherapy group were 34.82％ (39/112),31.48％ (34/108),32.41％ (35/108),which were significantly higher than 20.54％ (23/112),18.52％ (20/108),19.44％ (21/108) after treatment(x2 =5.709,4.840,4.725,all P ＜ 0.05).The frequency of the mutant EGFR gene in the patients after chemotherapy was 20.5％ (23/112),which was significantly lower than 34.8％ (39/112) before chemotherapy,the difference was statistically significant(x2 =5.709,P ＜ 0.05).After radiotherapy,the frequency of the mutant EGFR gene in the patients was 18.5 ％ (20/108),which was significantly lower than 31.5 ％ (34/108) before radiotherapy,the difference was statistically significant(x2 =4.840,P ＜ 0.05).After chemoradiation therapy,the frequency of the mutant EGFR gene in the patients was 19.4％ (21/108),which was significantly lower than 32.4％ (35/108) before chemoradiation therapy,the difference was statistically significant (x2 =4.725,P ＜ 0.05).Conclusion Radiotherapy,chemotherapy and radiation combined with chemotherapy in the treatment of non-small cell lung cancer can affect the state of EGFR gene mutation,which has significant decline.

Objective To investigate clinical effect of surgery combined with the rehabilitation treatment for the patients with burn scar contracture on hand,to provide a reference for clinical treatment.Methods 60 cases of hand burn scar contracture patients were selected,according to the digital table they were divided into control group and observation group(n =30 cases),which was underwent surgery in both groups.The control group was treated based on out -patient routine hand exercise methods,while a heated therapy,compression therapy and other profes-sional rehabilitation exercises were performed in the observation group.TAM in patients and ADL were compared. Results The observation group after treatment TAM score was (198.67 ±21.08)point,which was significantly higher than (144.43 ±16.65)point,the difference was statistically significant (t =8.476,P =0.000).Manicure, taking food,combing,brushing teeth,washing face,clothing,shoeing ADL scores in the observation group after treatment were (3.26 ±0.51)point,(3.56 ±0.55)point,(3.68 ±0.72)point,(3.38 ±0.68)point,(3.61 ±0.52)point, (3.55 ±0.61 )point and (2.57 ±0.47)point,which were improved significantly better than those of the control group,the differences were statistically significant (t =4.524,P =0.024;t =5.041,P =0.011;t =4.924,P =0.019;t =4.442,P =0.027;t =5.136,P =0.010;t =5.347,P =0.008).Conclusion Clinical effect of surgery combined with professional rehabilitation on hand burn scar contracture is good,and it is worthy of clinical application.

Objective To analyze the clinical and pathological features of breast cancer in patients over 80 years old, to discuss the individualized treatment plan and further to provide foundation for clinical treatment . Methods Data of 58 breast cancer patients over 80 years old were retrospectively analyzed .They were treated from Jun.2008 to May.2014 and the diagnosis was confirmed by pathology after surgery .They were followed up by telephone.Results Among the 58 cases, invasive cancer accounted for 94.8%(55/58), in which triple-negative breast cancer accounted for 29.1%(16/55), and human epidermal growth factor receptor 2(HER2)pos-itive breast cancer accounted for 7.2%( 4/55 ) .Stage III breast cancer accounted for 24%( 14/58 ) .67.2%(39/58)patients underwent breast resection , 55.2%(32/58)patients underwent axillary treatment , 17.2%(10/58)patients received chemotherapy , and 51.7%(30/58) patients received endocrine therapy .Seven cases had recurrence and 3 cases died of the disease .Conclusions Breast cancer in elderly patients has its special clinical and pathological features .It has longer course , relatively late stage , and more complications .It has higher pro-portion of triple-negative breast cancer and lower proportion of positive HER 2.Elderly breast cancer patients are less tolerant to chemotherapy , thus surgery and endocrine therapy are the main treatment .

Objective To evaluate the quality control standard and check system of clinical using of antibiotics based on the change of the constituent ratio of antibiotics. Methods In this retrospective study, we compared consumption of the ten mostly prescribed antibiotics, constituent ratio of national essential drugs, antibiotics utilization ratio and antibiotics use density between the third quarter of 2012 and that of 2013. Results Compared with 2012, the usage of antibiotics was reduced by 39.91%, and the usage of national essential drugs rose by 71.46%, whereas the consumptions of cefoxitin, aztreonam, cefminox were reduced by 84.56%, 89.99%, and 56.52%, respectively, in 2013.The consumptions of cefazolin, cefuroxime, ceftriaxone rose by 36. 39%, 363. 50% and 24. 06%, respectively. The amount of used antibiotics was reduced by 35. 41%, and the application frequency of antibiotics was reduced by 36.62%. Conclusion The establishment, running and implement of the quality control standard and check system of clinical using of antibiotics make constituent ratio of antibiotics used in the first people's hospital of Jining City more reasonable, which will help to promote the rational use of antibiotics in clinic.

Objective To evaluate the effect of Angio-Seal vascular closure device by the femoral artery hemostasis.Methods Relative literature was searched by computer,according to the inclusion and the exclusion criteria,which were analyzed by RevMan5.2 software.Results A total of four studies of randomized controlled trial were brought into this research,the total sample size was involved in 3 191 cases,the sample size of the intervention group and the control group respectively was 1 583 and 1 608.The analysis results showed,Angio-seal vascular closure device can significantly shorten the time of hemostasis after femoral artery interventional therapy in patients and the limb braking time.The sensitive analysis results showed that the results stability were high and the conclusions were reliable.Conclusions Application of Angio-seal vascular closure device can significantly shorten the interventional therapy in patients with bleeding time and braking time.

A new modified inside-out repair technique of arthroscopic meniscal repair for peripherally torn menisci is described. Under arthroscopic control, after conventional inside-out technique using meniscal repair set using outside-in technique with 18-gauge needle, horizontal mattress sutures of absorbable monofilament(PDS 2-0) were placed across the tom site and tied over the capsule or fascia. Nearly all portions of meniscus were possible with this technique except most posterior and anterior portions. As this is the modification of inside-out technique, neurovascular complications could be avioded. The problem of outside-in technique, knot irritation inside joint could be avoided also because the knot is outside of the joint.
Fascia ; Joints ; Needles ; Sutures

Objective To compare the diagnostic value of 3.0T and 1.5T magnetic resonance diffusion weighted imaging (DWI) in lymph node metastasis of gastric cancer. Methods Preoperative magnetic resonance examination was performed on 50 patients with gastric cancer by using Siemens 1.5T and 3.0T superconducting magnetic resonance imaging system, and the outcomes were compared with postoperative pathological results. The sensitivity, specificity and accuracy of the diagnosis in lymph node metastasis of gastric cancer were analyzed statistically. The apparent diffusion coefficient (ADC) values of lymph nodes were also evaluated for 1.5T and 3.0T magnetic resonance DWI. Results The sensitivity, specificity and accuracy of the diagnosis on lymph node metastasis of gastric cancer by 1.5T magnetic resonance DWI were 79.4 %, 81.4%and 80.0%, respectively, and the corresponding percentages of 3.0T magnetic resonance DWI were 84.6%, 79.7%and 83.1%. The accuracy rate of 3.0T magnetic resonance DWI was slightly higher than that of 1.5T in the diagnosis of lymph node metastasis of gastric cancer (χ2=5.451, P=0.020), but there were no significant differences in the sensitivity and specificity between the two groups (both P> 0.05). The accuracy rate of 1.5T magnetic resonance DWI in the diagnosis of lymph node metastasis of gastric cancer was less effective than that of the pathological diagnosis (χ2=7.410, P=0.007), but there was no significant difference between 3.0T magnetic resonance DWI and pathological diagnosis (χ2=2.450, P=0.120). The mean ADC values of metastatic and non-metastatic lymph nodes detected by 1.5T magnetic resonance DWI were (1.036 ±0.203) × 10-3 mm2/s and (1.476 ± 0.215) × 10-3 mm2/s (t= 6.813, P< 0.001), meanwhile, the corresponding values detected by 3.0T magnetic resonance DWI were (1.154 ± 0.183) × 10-3 mm2/s and (1.502 ± 0.264) × 10-3 mm2/s (t= 5.991, P< 0.001). The coincidence of the two methods for ADC value was favorable. Conclusions The diagnostic effect of 3.0T magnetic resonance DWI on lymph node metastasis of gastric cancer is better than that of 1.5T. ADC value provides a reliable imaging quantitative indicator for the determination of metastatic lymph nodes in gastric cancer, which plays a significant role in the clinical treatment options and prognosis of patients.

Objective To evaluate the effect of remifentanil on Toll-like receptor 2 (TLR2) mRNA expression during renal ischemia-reperfusion (Ⅰ/R) in rats.Methods Fifty-four male Sprague-Dawley rats,weighing 200-250 g,were randomly divided into 3 groups (n=18 each) using a random number table:sham operation group (group S),Ⅰ/R group and remifentanil group (group R).Renal Ⅰ/R injury was produced by clamping the bilateral renal arteries for 45 min followed by reperfusion in Ⅰ/R and R groups.Bilateral renal arteries were only exposed but not clamped in group S.Remifentanil 1.0 μg · kg-1 · min-1 was infused via the tail vein starting from 15 min before ischemia until 30 min of reperfusion in group R,while the equal volume of normal saline was given instead in S and Ⅰ/R groups.The animals were sacrificed at 15 min before ischemia and 6 and 24 h of reperfusion,and the renal specimens were obtained for examination of the pathological changes (with light microscope) and for determination of the contents of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) (by ELISA) and expression of TLR2 mRNA (by RT-PCR) and cell apoptosis (by double staining and flow eytometry).The apoptotic rate was calculated.Results Compared with group S,TLR2 mRNA expression was significantly up-regulated,and the contents of TNF-α and IL-6 and apoptotic rate were increased at 6 and 24 h of reperfusion in Ⅰ/R and R groups.Compared with group Ⅰ/R,TLR2 mRNA expression was significantly down-regulated,and the contents of TNF-α and IL-6 and apoptotic rate were decreased at 6 and 24 h of reperfusion in group R.The pathological changes were significantly attenuated in group R as compared with group Ⅰ/R.Conclusion The mechanism by which remifentanil reduces renal Ⅰ/R injury is related to down-regulation of TLR2 expression and decrease in TLR2 activity and inhibition of inflammatory responses in renal tissues and cell apoptosis in rats.

Objective To study the pharmacokinetics difference of levofloxacin polymorphs in rats, evaluate the advantageous medical polymorph,and explore the effects of different polymorphs on clinical medicine. Methods Four crystal forms of levofloxacin were administered intragastrically to rats,and high performance liquid chromatography( HPLC)was used to measure the contents of levofloxacin in rat plasma. The pharmacokinetic parameters were calculated and compared Results After a single oral dose,the peak plasma concentration(Cmax)of crystal forms ofⅠ,Ⅱ,ⅢandⅣof levofloxacin was 6. 984,9. 692,9. 405,6.424 mg·L-1;the time to peak(tmax)was 0.6,0.9,1.0,1.0 h;the half-life(t1/2)was 4.207,2.97,4.857,1.695 h;theareaunderthecurve(AUC0→12h)was31.478,42.385,32.406,31.636mg·h·L-1. Conclusion Thereisnostatistically significant difference in pharmacokinetic parameters. However,compared with other crystal forms,plasma concentration of crystal form II is higher and maintained longer. Therefore,crystal form II of levofloxacin is an advantageous polymorph for medicine.