OBJECTIVE: To investigate the situation and future trend of use of drugs in this hospital after medical re- form.METHODS:Using the principle of sequencing analysis of DUD system of drug,we analysed the data of drug consumption in our hospital during the period 1999-2000.RESULTS: The policy of medical reform has affected the component ratio of drugs used, the consumption of peroral drugs being increased.The incidence of cardiovascular diseases was high in this re- gion.CONCLUSION:Most of the drugs used after medical reform were those assigned in medical insurance,which will improve the rationality and effectiveness of medication.

Objective To evaluate the accuracy of high-aensitivity C-reactive protein (hs-CRP) in the prediction of perioperative cardiovascular accidents (CVAS) in patients with diabetes mellitus. Methods Ninetyone type 2 diabetic patients undergoing elective non-cardiac surgery were divided into 3 groups according to their blood concentrations of hs-CRP: low-concentration group ＜ 1.0 mg/L ( group Ⅰ , n = 9); median-concentration group 1.0-2.9 mg/L (group Ⅱ ,n= 16) and high-concentration group 3.0-10.0 mg/L (group Ⅲ ,n =66). Risk factors for perioperative CVA were analyzed using Spearman rank correlation analysis. Various risk factors including sex, age, ASA physical status, BMI, NYHA claasification, smoking history ,preoperative ECG changes, duration,treatment and complications of diabetes mellitus, hypertension and blood lipids were correlated with perioperative CVA. The risk factors of which P values were less than 0.05 would enter the binary logistic regression analysis to stratify CVA-related risk factors. Area under the ROC curve was used to analyze the accuracy of the risk factors in prediction of perioperative CVA. Results The incidences of perioperative CVAs were 0, 31% and 35 % in Ⅰ ,Ⅱ and Ⅲ groups respectively. It was determined by Spearman rank correlation analysis that preoperative ECG,NYHA classification, age, preoperative cardiovascular color doppler ultrasound, blood hs-CRP concentration and ASA classification of physical status were important risk factors ( P ＜ 0.05 or 0.01 ). Binary logistic regression .malysis indicated that preoperative ECG, NYHA classification and age were highly related to perioperative CVA (P ＜0.05 or 0.01).The area under ROC curve of preoperative ECG, NYHA classification, age and blood hsCRP concentration was 0.855, 0.755, 0.702 and 0.605 respectively. Conclusion The accuracy of blood concentration of hs-CRP in prediction of perioperative CVA in patients with diabetes mellitus is lower than that of the preoperative ECG, NYHA classification or age.

Objective To study the arthroscopy-assisted minimally invasive treatment of chondromalacia patella. Methods The clinical data of 140 patients with chondromalacia patella, with a mean age of 51.9 ± 5.71 years ( range, 41 to 62 years), undergoing surgical or Non-surgical treatment in our hospital from June 2005 to December 2008 were analyzed. In non-surgical group, 72 cases (96 knees) underwent intra-articular injection of sodium hyaluronate and other non-surgical treatment. In surgical group, 68 cases (84 knees) underwent variorus Arthroscopy-Assisted minimally invasive surgery, according to the extent of the patella cartilage injury and the situation of the patellofemoral joint. Joint functional exercise were carried out after operations. Regular follow-up were done after leaving hospital. Lysholm scoring system was used to evaluate the clinical effects. Judet's evaluation criteria was used to evaluate the improvement of range of motion. Results In non-surgical group, the knee function have been improved 24. 82%. In surgical group the knee function have been improved 35.37%. At the postoperative and final follow-up, the effect in surgery group was significantly better than non-surgical group. Conclusion For the chondromalacia patella with Ⅱ, Ⅲ class cartilage injury, minimally invasive arthroscopic surgery is a good treatment method, which can reduce pain, improve function, slow down the progress of the disease, and improve the quality of life of patients.

Abundant clinical and basic studies in recent years reported the high association of Wnt/β-catenin signaling pathway with the incidence and development of multiple neurological disorders. In order to improve the attention about the relationship between Wnt/β-catenin signaling pathway and neurological disorders, and to provide new therapy target, this article reviews the research progress on the relationship between wnt/β-catenin signaling pathway and Parkinson′s disease, Alzheimer′s disease, epilepsy, multiple sclerosis and myasthenia gravis.

Objective The aim of this study was to identify macrophage related genes(MRGs)in liver cancer and construct a prognostic risk prediction model for liver cancer.Methods The liver cancer scRNA-seq data from the GEO database were down-loaded to identify genes specifically expressed in macrophages as MRGs.The GO and KEGG functional enrichment analyses on MRGs were conducted.In the TCGA-LIHC dataset of the TCGA database,multiple random sampling single factor Cox regression for single-factor Cox regression,LASSO regression,and multivariate Cox regression analyses were employed to identify MRGs for liver cancer prognosis prediction,and a liver cancer prognostic prediction model was constructed.Results The results obtained 8 major cell types,including those containing macrophages through clustering using scRNA-seq data from the GEO database.The proportion of macrophages in the immune microenvironment of liver cancer was significantly higher than that of normal tissues(P=0.016),and genes such as SPP1,RNASE1,and MMP9 were highly expressed.Multiple metabolic pathways,including purine metabolism,citric acid cycle,and drug metabolism cytochrome P450 were activated in liver cancer-associated macrophages.This study identified 777 MRGs from liver cancer scRNA-seq(LogFC＞0.25,P＜0.05),which mainly involved in functions such as actin binding and regula-tion of immune receptor activity.Seven MRGs,including ATP1B3,ATP6V0B,HBEGF,KLF2,NR1H3,RAB10,and SPP1 were select-ed from the 169 stable prognostic genes(P＜0.05)for the construction of the prognosis model.The AUC values for the 1,3,and 5-year survival outcomes of the model in the TCGA liver cancer cohort were 0.791,0.791,and 0.751,respectively.In the validation ICGC cohort,they were 0.614,0.682,and 0.688,respectively,demonstrating good predictive performance.In liver cancer patients with high prognosis risk scores,the expression of macrophages M0,neutrophils,and regulatory T cells was higher(P＜0.05),and im-munosuppression and immune activation coexisted.Conclusion Liver cancer MRGs can serve as potential biomarkers for predicting the prognosis of liver cancer patients.These liver cancer MRGs are mainly associated with actin binding,immune receptor activity,and infiltration of various immune cells.

OBJECTIVES: The effects of hormone replacement therapy on the survival rate of female lung cancer patients are still controversial. The Meta-analysis aims to systematically evaluate the effect of hormone replacement therapy on the survival rate of female lung cancer patients. METHODS: Retrospective studies regarding the effect of hormone replacement therapy on female lung cancer patients' survival rate were searched from the database of Embase, Cochrane, Pubmed, CNKI, Wanfang, and Weipu. The Meta-analysis was conducted with Stata 12.0 software. test was used to analyze the heterogeneity among included studies. The analysis was conducted by randomized model. Egger's test and Begg's test were used to assess the publication bias. RESULTS: Five retrospective studies were included, involving 2 582 female patients with lung cancer. There were 1 054 cases of female lung cancer with hormone replacement therapy and 1 528 cases of female lung cancer without hormone replacement therapy. No publication bias was observed among these studies. The sensitivity analysis result showed that the overall results were stable. Meta-analysis showed that compared with patients without hormone replacement therapy, patients with hormone replacement therapy had an increased survival time for 5 years (ES=0.346; 95% CI 0.216 to 0.476; <0.001). CONCLUSIONS Hormone replacement therapy improves 5-year survival in female lung cancer patients. Female lung cancer patients with menopausal syndrome can use hormone replacement therapy properly under their doctors' suggestion.
Female ; Hormone Replacement Therapy ; Humans ; Lung Neoplasms ; drug therapy ; Retrospective Studies ; Survival Rate

Objective:To investigate the clinical characteristics of choledocholithiasis com-bined with periampullary diverticulum and influencing factor for difficult cannulation of endoscopic retrograde cholangiopancreatography (ERCP).Methods:The retrospective case-control study was conducted. The clinical data of 1 920 patients who underwent ERCP for choledocholithiasis in 15 medical centers, including the First Hospital of Lanzhou University, et al, from July 2015 to December 2017 were collected. There were 915 males and 1 005 females, aged (63±16)years. Of 1 920 patients, there were 228 cases with periampullary diverticulum and 1 692 cases without periampullary diverticulum. Observation indicators: (1) clinical characteristics of patients with choledocholithiasis; (2) intraoperative and postoperative situations of patients undergoing ERCP for choledocholithiasis; (3) influencing factor analysis for difficult cannulation in patients undergoing ERCP for choledocholithiasis. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M(range) or M( Q1, Q3), and com-parison between groups was conducted using the Wilcoxon rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test or Fisher exact probability. The Logistic regression model was used for univariate and multivariate analyses. Results:(1) Clinical characteristics of patients with choledocholithiasis. Age, body mass index, cases with complications as chronic obstructive pulmonary disease, diameter of common bile duct, cases with diameter of common bile duct as <8 mm, 8?12 mm, >12 mm, diameter of stone, cases with number of stones as single and multiple were (69±12)years, (23.3±3.0)kg/m 2, 16, (14±4)mm, 11, 95, 122, (12±4)mm, 89, 139 in patients with choledocholithiasis combined with periampullary diverticulum, versus (62±16)years, (23.8±2.8)kg/m 2, 67, (12±4)mm, 159, 892, 641, (10±4)mm, 817, 875 in patients with choledocholithiasis not combined with periampullary diver-ticulum, showing significant differences in the above indicators between the two groups ( t=?7.55, 2.45, χ2=4.54, t=?4.92, Z=4.66, t=?7.31, χ2=6.90, P<0.05). (2) Intraoperative and postoperative situations of patients undergoing ERCP for choledocholithiasis. The balloon expansion diameter, cases with intraoperative bleeding, cases with hemorrhage management of submucosal injection, hemostatic clip, spray hemostasis, electrocoagulation hemostasis and other treatment, cases with endoscopic plastic stent placement, cases with endoscopic nasal bile duct drainage, cases with mechanical lithotripsy, cases with stone complete clearing, cases with difficult cannulation, cases with delayed intubation, cases undergoing >5 times of cannulation attempts, cannulation time, X-ray exposure time, operation time were 10.0(range, 8.5?12.0)mm, 56, 6, 5, 43, 1, 1, 52, 177, 67, 201, 74, 38, 74, (7.4±3.1)minutes, (6±3)minutes, (46±19)minutes in patients with choledocholithiasis combined with periampullary diverticulum, versus 9.0(range, 8.0?11.0)mm, 243, 35, 14, 109, 73, 12, 230, 1 457, 167, 1 565, 395, 171, 395, (6.6±2.9)minutes, (6±5)minutes, (41±17)minutes in patients with choledocholithiasis not combined with periampullary diverticulum, showing significant differences in the above indicators between the two groups ( Z=6.31, χ2=15.90, 26.02, 13.61, 11.40, 71.51, 5.12, 9.04, 8.92, 9.04, t=?3.89, 2.67, ?3.61, P<0.05). (3) Influencing factor analysis for difficult cannulation in patients undergoing ERCP for choledocholithiasis. Results of multivariate analysis showed total bilirubin >30 umol/L, number of stones >1, combined with periampullary diverticulum were indepen-dent risk factors for difficult cannulation in patients with periampullary diverticulum who underwent ERCP for choledocholithiasis ( odds ratio=1.31, 1.48, 1.44, 95% confidence interval as 1.06?1.61, 1.20?1.84, 1.06?1.95, P<0.05). Results of further analysis showed that, of 1 920 patients undergoing ERCP for choledocholithiasis, the incidence of postoperative pancreatitis was 17.271%(81/469) and 8.132%(118/1 451) in the 469 cases with difficult cannulation and 1 451 cases without difficult cannula-tion, respectively, showing a significant difference between them ( χ2=31.86, P<0.05). In the 1 692 patients with choledocholithiasis not combined with periampullary diverticulum, the incidence of postopera-tive pancreatitis was 17.722%(70/395) and 8.250%(107/1 297) in 395 cases with difficult cannula-tion and 1 297 cases without difficult cannulation, respectively, showing a significant difference between them ( χ2=29.00, P<0.05). In the 228 patients with choledocholithiasis combined with peri-ampullary diverticulum, the incidence of postoperative pancreatitis was 14.865%(11/74) and 7.143%(11/154) in 74 cases with difficult cannulation and 154 cases without difficult cannulation, respectively, showing no significant difference between them ( χ2=3.42, P>0.05). Conclusions:Compared with patients with choledocholithiasis not combined with periampullary divertioulum, periampullary divertioulum often occurs in choledocholithiasis patients of elderly and low body mass index. The proportion of chronic obstructive pulmonary disease is high in choledocholithiasis patients with periampullary diverticulum, and the diameter of stone is large, the number of stone is more in these patients. Combined with periampullary diverticulum will increase the difficult of cannulation and the ratio of patient with mechanical lithotripsy, and reduce the ratio of patient with stone complete clearing without increasing postoperative complications of choledocholithiasis patients undergoing ERCP. Total bilirubin >30 μmol/L, number of stones >1, combined with periampullary diverticulum are independent risk factors for difficult cannulation in patients of periampullary diverticulum who underwent ERCP for choledocholithiasis.

Objective : The polishing effects of different compositions of chairside polishing systems on polyetheretherketone (PEEK) were compared to provide a reference for the rational selection of polishing systems for this material in clinical settings. Methods : A total of 108 specimens were made from ShushijieTMPEEK crown and bridge materials, Bio-PAEK® dental PEEK, and BioHPP® PEEK. Thirty-six specimens of each material were randomly divided into 6 groups on average based on their polishing technique: OptiDisc®, Super-Snap® Rainbow Technique Kit, VITA ENAMIC®Clinical Polishing Set, Sof-LexTM Diamond Polishing System, Visio.lign Finishing Kit for Composite Veneers, and CERAMAGE Polishing Kit, LavaTM Ultimate ceramic and VITA ENAMIC ceramics were set as the control groups, and 6 specimens were made in each material, polished by Sof-LexTM Diamond Polishing System and VITA ENAMIC® Polishing Set clinical, respectively, according to the manufacturers’ suggestions. The surface roughness (Ra value and Sa value) and gloss of each set were measured. The surface morphologies of the polished specimens were observed by scanning electron microscopy. Results : Surface roughness (Ra value and Sa value) and gloss were mainly influenced by the type of polishing system, and they varied between PEEK material types. The Sof-LexTM Diamond Polishing System produced the highest surface roughness and the lowest gloss values for PEEK materials, while the Super-Snap® Rainbow Technique Kit, Visio.lign Finishing Kit for Composite Veneers and CERAMAGE Polishing Kit resulted in low surface roughness values. The Visio.lign Finishing Kit for Composite Veneers and CERAMAGE Polishing Kit exhibited high gloss values. Polishing paste particles were observed embedded on the surfaces of the PEEK materials polished by the Visio.lign Finishing Kit for Composite Veneers; the surfaces of specimens polished by the CERAMAGE Polishing Kit were smooth, without polishing paste particle residue. Using the same polishing system, the best polishing results were obtained with BioHPP® among the PEEK materials tested. The surface roughness values of the three tested PEEK materials polished by the CERAMAGE Polishing Kit were similar to those of the LavaTM Ultimate ceramic and VITA ENAMIC ceramic, but the gloss was higher than that of both. Conclusion CERAMAGE Polishing Kit was recommended for polishing all three tested PEEK materials, achieving a good polishing effect, with similar surface roughness and higher gloss characteristics comparable to those of polished computer-aided design and manufacturing (CAD/CAM) resin-matrix ceramics.