Objective To evaluate the effect of duration of subcutaneous injection on the extent of bruising at injection sites among patients receiving low- molecular weight heparin. Methods Randomized clinical trials and quasi-experimental within-subject design that assessed the effect of subcutaneous duration on the bruising of injection sites were selected in Cochrane library, JBI evidence-based practice medical and nursing database, PubMed biomedical information retrieval platform, Medline general medical literature retrieval database. RevMan5.3 software was used to analyze the data after quality assessment, and data extraction were made for eligible trials. Results A total of 9 trials were included. The results of Meta-analysis supported the 30 s duration injection technique on reducing the rate of bruising of injection sites than 10 s duration injection technique (odds ratio was 0.34,95%confidence interval 0.25-0.47, P<0.01).While it was failed to support the effect on reducing the bruising area 48 and 72 hours after injection (P > 0.05). Conclusions Increasing the length of low-molecular weight heparin subcutaneous injection can reduce the rate of bruising. While it could not effectively reduce the area.

Objective To observe the effect of smoking cessation intervention combined with salmeterol and fluticasone pro‐pionate powder for inhalation on chronic obstructive pulmonary disease (COPD) patients with clinical symptoms and pulmonary function .Methods Totally 78 male long‐term smoking cases were randomly divided into control group(n= 40)and observation group(n=38) .The control group was treated with the ophylline sustained‐release tablets ,shah mette lo fluticasone;observation group received smoking cessation intervention .The smoking rate ,symptoms ,acute exacerbation ,life score and lung function (FEV1 ,FEV1/FVC) ,adverse reactions of two groups were observed .Results Two groups of symptoms were all improved ,but the observation group was better (P<0 .05) .FEV1 ,FEV1/FVC ,acute exacerbation ,scores were improved ,but the observation group was better(all P<0 .05);quit rates in the observation group was better than that of the control group(P<0 .05);and did not found adverse reactions .Conclusion The effect of smoking cessation intervention combined with salmeterol and fluticasone propionate powder for inhalation efficacy in the treatment of COPD is distinct ,can improve the pulmonary function and symptoms .

Objective To evaluate the diagnostic accuracy of intraoperative frozen section in breast neoplasms and to improve the diagnostic accuracy rate,to promote closer communication betwen clinicians and ~pathologists ,mutually increase an understanding of frozen sections, and thus decrease the rate of misdiagnosis. Methods The diagnostic reports of intraoperative frozen sections and paraffin sections of 590 cases with breast neoplasms taken in the recent 8 and a half years were analyzed retrospectively. Results 586 cases (~99.32 %) of intraoperative frozen sections were diagnosed correctly and 4(0.68%) were misdiagnosed. In the 4 misdiagnosed cases,2 cases of infiltrating ductal carcinoma were misdiagnosed as benign lesions,due to questionable quality of the slides,and 2 cases of lobular cystic sarcoma were misdiagnosed as fibroadeuoma,due to removal of insufficient specimen.Conclusions The chief causes of misdiagnosis and delayed diagnosis of frozen sections are specimen limitations,varied morphology of the lesions,and quality of the frozen sections.When there is familiarity with the main aspects of diagnosis and differential diagnosis of breast pathology and enhancement of communication between the surgeon and pathologist,then frozen section of breast masses is an accurate and reliable method of investigation.

Objective To investigate the expressions of cell phenotypes CD_8 and CD_(28) of peripheral blood lymphocytes in patients with colorectal cancer. Method CD_8 and CD_(28) of cell phenotypes were measured by flow cytometry in 50 patients with colorectal cancer (cancer group) and 30 nontumorous patients (control group). Results The expression of CD_8 in cancer group was significantly higher than that in control group [(32.24±8.38)% vs (22.18±7.55)%](P < 0.01). CD_(28) and CD_8~+/CD_(28)~+ were much lower than those in control group [(52.03±10.94)% vs (60.60±7.98)%,12.18±4.28 vs 16.38±4.94](P<0.01). CD_8~+/CD_(28)~+ in Dukes D stage patients were significantly lower than that in Dukes B stage patients (P<0.05). CD_(28) and CD_8~+/CD_(28)~+ in lymph node metastasis patients were much lower than those in lymph node negative patients (P < 0.01). CD_(28) and CD_8~+/CD_(28)~+ in serosa involved patients were lower than those in no serosa involved patients (P < 0.01). Conclusions The expressions of cell phenotypes CD_8 and CD_(28) of peripheral blood lymphocytes in patients with colorectal cancer are closely related to biological characteristics of the tumor. The assays of cell phenotypes CD_8 and CD_(28) might be useful for evaluating the immunal statement and prognosis of patients with colorectal cancer.

Objective: To investigate the application of one stage otoptasty for congenital atresia of the external acoustic canal and malformations of the middle ear and the auricle. Method: patients with the ear malformations were given surgical reconstruction of one stage otoplasty. The auricle was reconstructed with the rib which was encapsuled with the superthin temporal flap. According to the malformations of the middle ear in patients, Ⅰ style tympanoplasty and Ⅲ style tympanoplasty were carried out respectively. All patients were performed myringoplasty with temporal fascia and reconstructed the external acoustic canal with full thickness skin-grafting. Result:A long term follow-up (4～6 years)demonstrated that 11 ears were survival of which 8 ears figuration were ideal. The hearing improvement was observed in all patients. Conclusion:one stage otoplasty is effective for treatment of the congenital malformations of the external and middle ear.

Objective To investigate the expression of miR-21 and PDCD4mRNA in colorectal cancer and their correlation with clinicopathological characteristics,to elucidate relationship between PDCD4and miR-21 in vivo.Methods Expression of RNA (including miR-21and PDCD4mRNA) and PDCD4 protein were detected respectively by quantitative real-time reverse transcriptase-PCR and SP immunohistochemical staining in 43 cases of colorectal carcinoma and corresponding normal mucous membrane tissue.Results In colorectal carcinoma,expression of miR-21 was higher than that of the control ( P ＜ 0.05 ),and expression of PDCD4mRNA lower than the control ( P ＜ 0.05 ).Expression of miR21 was associated with lymph node metastasis and clinical stages ( Ⅰ + Ⅱ,Ⅲ + Ⅳ ) ( P ＜ 0.05 ).On the other hand,no significant differences were observed regarding sex,tumor site,size,local invasion,distant metastases,clinical stages( Ⅰ,Ⅱ ) (P ＞ 0.05 ).Expression of PDCD4mRNA was associated with local invasion,clinical stages ( Ⅰ,Ⅱ ) ( P ＜ 0.05 ).While no significant differences were found concerning sex,site,size,lymph node metastasis,distant metastases,clinical stages( Ⅰ + Ⅱ,Ⅲ + Ⅳ ) ( P ＞ 0.05 ).miR21 levels was negatively correlated with PDCD4 expression including nuclear and nuclear and cytoplasmic put together (P ＜ 0.05 ),in contrast to PDCD4mRNA and PDCD4 expression in cytoplasmic ( P ＞ 0.05 ).Conclusions ( 1 ) Abnormal expression of PDCD4 mRNA and miR-21 correlate with prognosis in colorectal cancer.(2) miR-21 suppress translation of PDCD4mRNA by binding to the 3'-untranslated region (3'-UTR)of target PDCD4mRNA.

ObjectiveTo explore the expression of miR-130b and RUNX3mRNA in human gastric carcinoma and the clinical significance. MethodsThe expression of miR-130b and RUNX3mRNA were detected by RT-PCR in 40 cases of gastric carcinoma and corresponding normal mucosa tissue. The expression of RUNX3protein was determined by immunohistochemistry SP method. ResultsThe expression of miR-130b was significantly up-regulated in gastric carcinoma than that in the adjacent normal gastric mucosa tissues (2.18 ± 3.75 ) vs.( 2.59 ± 3.45 ),P ＜ 0.05 ; The expression of RUNX3mRNA in gastric carcinoma tissues was significantly lower than that in adjacent normal gastric mucosa tissues( 8.76 ±2.82) vs.( 7.58 ± 2.87 ),P ＜ 0.05.The expression of miR-130b and RUNX3mRNA were positively correlated with lymph node metastasis and clinical stage ( P ＜ 0.05 ) ; No significant association was found between the expression and age,gender,tumor size,distant metastasis and depth of tumor invasion ( P ＞0.05 ).The expression of miR-130b was negatively correlated with RUNX3 protein expression in nuclei and cytoplasm (P ＜ 0.05 ).ConclusionsAbnormal expression of miR-130b and RUNX3mRNA correlates with prognosis of gastric carcinoma; Decreased RUNX3 protein expression may contribute to tumourigenesis.

Objective To investigate the relations between p53 and K-ras gene mutation in portal venous blood of gastric carcinoma patients and cancer metastasis. Methods p53 and K-ras gene mutation was detected with PCR-SSCP technology in 62 cases of gastric carcinoma. Results p53 and K-ras mutation rate were 39% and 34% in portal venous blood, but only 8% and 4. 8% in peripheral blood; The rate of gene mutation in p53 and K-ras were 24% and 22% in patient without liver metastasis, 92% and 77% in patient with liver metastasis; The rate of gene mutation in p53 and K-ras in portal venous were 39% and 34% before surgical exploration, but 56% and 63% after exploration. The rate of positive detection of the mutation was significantly (P

Magnetic resonance imaging (MRI) data of 87 patients with suspected cervical posterior longitudinal ligament (PLL) rupture,who underwent cervical spine surgery in Luoyang Orthopedic Hospital from January 2015 to September 2017,were analyzed retrospectively.The criteria of MRI diagnosis for PLL rupture were the low signal image of the PLL on the posterior margin of the vertebral body,the discontinuity or continuous interruption,or the local highlighting signal on the T2 weighted image.According to intraoperative findings,the diagnostic accuracy of MRI for PLL rupture was examined.Among 87 patients,31 cases were diganosed as PLL rupture by preoperative MRI;and 38 cases were confirmed by intraoperative exploration,of whom 30 were diagnosed with MRI,and 8 were missed by MRI.The accuracy,sensitivity and specificity of MRI in the diagnosis of ruptured PLL were 0.90,0.79 and 0.98 respectively.MRI has a good diagnostic efficiency in PLL rupture,which can be used for preoperative investigation.

Objective To investigate the relationship between p27 gene methylation and pathology of colorectal carcinoma. Methods p27 gene methylation promotor region and p27 protein expression were detected respectively by methylation specificity polymerase chain reaction and immunohistochemical staining SP in 106 cases of colorectal carcinoma and each adjacent normal mucous membrane tissue and 22 cases of colorectal adenoma tissue. Results The positive expression rate of p27 gene methylation was statistically different in colorectal carcinoma tissue compared with normal mucous membrane and colorectal adenoma tissue (P＜0.05). Their positive expression rate were 59.4% (63/106), 18.2% (4/22) and 3.8%(4/106) respectively in colorectal carcinoma tissue,colorectal adenoma and normal mucous membrane tissue (P ＜ 0. 05). p27 gene methylation in poorly differentiated group was significantly higher than that in welldifferentiated group (48.0% vs. 24. 7%, P ＜0. 05), in Dukes-A + B stage group was significantly lower than that in Dukes C + D stage group(20. 0% vs. 41.2%, P ＜ 0. 05 ), and it was higher in lymph nodes metastases group than that in lymph nodes negative group(41.5% vs. 23. 1%, P ＜0. 05), that in positive serosa infiltration group was higher than negative serosa infiltration group(32. 5% vs. 24. 1%, P ＞ 0. 05 ).Conclusions Methylated p27 gene protein expression in colorectal carcinoma was significantly higher than normal mucous membrane and colorectal adenoma tissue. The methylation rate of p27 gene in colorectal carcinoma was significantly associated with tumor differentiation, invasive depth, Dukes stage, lymph node metastasis.