Objective:To explore the clinical effect of four oral vitamins [vitamin E (Vit E) +folic acid (FA)+ vitamin B2 (Vit B2) + vitamin B12 (Vit B12)] combined with FE complex enzyme rash on the recurrent oral ulcer (ROU) and on the serum inflammatory factors levels.Methods:126 cases with ROU in our hospital from January 2014 to February 2016 were selected as research objectives and randomly divided into two groups.FE complex enzyme was provided to the control group,while FE complex enzyme and four Vietnam (Vit E+FA+Vit B2+Vit B12) were given to the observation group.The local efficacy,long-term efficacy,serum inflammatory factor levels before and after treatment as well as the incidence of adverse drug reactions were recorded and compared between two groups.Results:Compared with the control group,the pain index was significantly decreased on 30th treating day in the observation group(P＜0.01),and the average ulcer period was shorten (P＜0.01).After being treated for 6 months,the overall effective rate was 95.2％ in the observation group,which was significantly higher than that of the control group (81.0％,P＜0.05).The serum TNF-α and IL-17 levels on the 30th treating day was significantly lower in both groups after treatment than those before treatment (P＜0.01),but the serum 1L-2 level was significantly increased (P＜0.01),and the improvement of each above inflammatory factors in the observation group were more significant than those of the control group (P＜0.01).No significant difference was found in the incidence of adverse reactions between two groups (P＞0.05).Conclusions:Four oral Vietnam combined with FE complex enzyme could promote the ulcer wound healing,reduce the pain,regulate the body to promote/anti-inflammatory factor balance and improve the long-term efficacy in the treatment of patients with ROU with high safety.

Objective To explore the determinant factors influencing the constituent parts of radiological examination in severe trauma patients so as to provide scientific basis for optimized strategy of radiological examination. Methods A prospective study was carried out from April to July 2010 in a tertiary hospital. Clinical data of 60 severe trauma patients admitted to emergency department and ICU were recorded. The type, number and site of trauma under radiological examination were described and compared among different stages of treatment. The correlation between number of radiological examinations and age, number of injured site, injury severity score (ISS), Glasgow Coma Scale (GCS), ICU stay and overall length of hospital stay were analyzed. Results (1) The majority of radiological examinations in 60 patients were radiography and CT, with a corresponding median number of 6.0(3.0～ 11.0, IQR)and 10.0(8.0 ～ 13.8, Qr) times per patient. (2) The numbers of radiography examinations requested in emergency room, emergency ICU and general ward were quite approximately equal (x2 =4.043 ,P =0. 132), while CT examinations were mainly requested in emergency room and emergency ICU (x2 = 20. 274 , P < 0. 001). (3) The numbers of radiological examinations requested for different sites of injury were quite significantly different between radiography and CT during different stages of treatment (x2 = 114.609, 75.932, P < 0.01). (4 ) The number of CT scan requested was positively correlated with number of injured site, ISS, ICU and overall length of hospital stay (r =0.273,0.369,0.523,0.417,all P <0.05). Conclusions The sum of radiological examinations in severe trauma patients was great mainly in radiography and CT, and CT was more predominantly requested. The number of CT scans examinations was positively correlated with severity of injury and length of ICU stay. Further study is warranted to optimize radiological examination in severe trauma patients.

Objective:To investigate the relationship between serum carcinoembryonic antigen (CEA) and the predictive value of epidermal growth factor receptor (EGFR) mutations in non-small cell lung cancer patients, as well as to analyze further EGFR muta-tions and CEA levels affecting patient survival. Methods:From March 2009 to March 2011, a total of 387 cases were treated in the Lung Cancer Department in Tianjin Cancer Hospital. Preoperative CEA tumor marker and postoperative EGFR gene mutation were used for routine detection. The influence of CEA tumor marker on EGFR mutation and its relationship with the prognosis were ana-lyzed further. Results:A total of 168 cases involved EGFR mutations, the incidence of which is more frequent in women, non-smokers, adenocarcinoma patients, and patients below 60 years old (P<0.05). This study also determined that EGFR mutation was related with tu-mor markers and chemosensitivity indicators. Elevated Cyfra21-1, SCC, and ERCC1-positive are more common in wild-type patients (P<0.05). However, abnormal CEA was more common in EGFR mutation patients (P=0.015). The rate of EGFR gene mutations signifi-cantly increased as the serum CEA level increased. Serum CEA levels were divided into three groups (<5, 5-20, and>20). The positive rates of EGFR mutations were 40.1%, 47.5%and 66.6%(P=0.003). Logistic regression analysis determined that CEA levels are inde-pendent factors in predicting EGFR mutations and independent prognostic factors in patients with non-small cell lung cancer. Conclu-sion:Serum CEA levels can independently predict the prognosis of resected non-small cell lung cancer patients, which is has a close re-lationship with EGFR mutations.

Talents are core competitiveness of a hospital.In view of the nature of long and slow development cycle of medical talents,Wuxi No.2 People' s Hospital has innovated aTalent-tree program.This program develops talents by categories and stages,in the model oftree root-tree trunk-tree crownto fit different stage needs of these people.The program features a categorized education mode to establish hierarchical individualized plan for the whole career.The hospital has explored a special pathway for talents development,for the purpose of providing talents to ensure sustainable and innovative growth of the hospital.

Objective To investigate the effect of Galangin on migration and invasion in gliomas and explore the possible mechanism.Methods (1) After treating the glioma lines U87 and U251 with 0,10,20 and 40 μmol/L galangin for 24 h,CCK-8 was performed to detect the cell viability;wound healing assay and Transwell assay were used to detect the cell migration and invasion,respectively;protein expression of transforming growth factor (TGF) β was detected by Western blotting.(2) The second experiment was divided into control group,20 μmol/L galangin treatment group,TGFβ over-expression group and 20 μmol/L galangin+TGFβ over-expression group;the cells in the control group and 20 μmol/L galangin treatment group were transfected with empty-vector plasmids;cells in the TGFβ over-expression group and 20 μmol/L galangin+TGFβ over-expression group were transfected with TGFβ plasmids,and 24 h after the transfection,the cells in the 20 μmol/L galangin treatment group and 20 μ mol/L galangin+TGFβ over-expression group were added 20 μmol/L galangin;24 h after that,wound healing assay and Transwell assay were used to detect the cell migration and invasion,respectively;TGF β protein expression was detected by Western blotting.Results (1) As compared with cells from the 0,10 and 20 μmol/L galangin group,the cells from 40 μmol/L galangin group had significantly lower cell viability (P＜0.05).Cells from the 0,10 and 20 μmol/L galangin group had significantly decreased wound healing percentage,significantly decreased cell number reaching to the lower chamber,and statistically decreased TGFβ protein expression in sequence (P＜0.05).(2) U87 and U251 cells from the TGFβ over-expression group,control group,20 μmol/L galangin+TGFβ over-expression group and 20 μmoll/L galangin treatment group had successively decreased wound healing percentage,decreased cell number reaching to the lower chamber,and decreased TGFβ protein expression (U87 cells:1.63±0.21,1.00±0.00,0.78±0.05 and 0.43±0.08;U251 cells:1.98±0.20,1.00± 0.00,0.86±0.06 and 0.29±0.04),with significant differences (P＜0.05).Conclusion Galangin inhibits the glioma migration and invasion through TGFbβ down-regulation.

Objective To explore the role of phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) signaling pathway in early brain injury after subarachnoid hemorrhage (SAH) and its possible mechanism in rats. Methods Ninety healthy male SD rats were randomly divided into 5 groups (n=18) according to the random number table, namely sham-operated group, SAH group, vehicle control group, SAH+PI3K/Akt pathway agonist group (group A), and SAH+PI3K/Akt pathway inhibitor group (group I, n=18). Rat SAH models of the later 4 groups were established by intravascular puncture; rats in the vehicle control group, group A, and group I were given 10μL dimethyl sulfoxide (DMSO), insulin-like growth factor (IGF-1, 1μg/10 μL), and Ly294002 (25μg/10μL) solution, respectively, before model making. After 24 h of intravascular puncture, modified Garcia nerve function scale was used to evaluate the motor function, dry-wet weight method was used to detect the water content of the brain tissues, and immunofluorescence staining was employed to observe the β-amyloid precursor protein (β-APP)/ βtubulin III positive expressions in the subcortical white matter, and Western blotting was employed to detect theβ-APP, and total (t)-and phosphorylated (p)-PI3K and Akt protein expressions in the brain tissues; one month after modeling, HE staining was used to observe the changes of cell structure after cerebral edema. Results As compared with the sham-operated group, SAH model group had significantly lower modified Garcia nerve function scale scores, significantly increased brain water content, significantly larger number ofβ-APP/βtubulin III positive cells, statistically increasedβ-APP protein expression, and significantly increased t-PI3K, and t-Akt protein expressions (P<0.05). As compared with the SAH model group, group A had significantly higher modified Garcia nerve function scale scores, significantly decreased brain water content, significantly smaller number of β-APP/ βtubulin III positive cells, statistically decreasedβ-APP protein expression, and significantly increased p-PI3K and p-Akt protein expressions (P<0.05). As compared with group A, group I had significantly lower modified Garcia nerve function scale scores, significantly increased brain water content, significantly larger number ofβ-APP/βtubulin III positive cells, statistically increasedβ-APP protein expression, and significantly decreased p-PI3K and p-Akt protein expressions (P<0.05). HE staining showed serious morphological damage. Conclusion PI3K/Akt signaling pathway plays an important role in early brain injury after SAH in rats;early stimulation of PI3K/Akt signaling pathway activation can alleviate early brain injury after SAH, and the mechanism may be related to regulation of axonal injury in white matter after SAH.

A total of 4 patients with renal cancer were admitted to our hospital from October 2006 to September 2015 in a familial renal cancer family. Among the 4 patients, 1 patient showed unilateral multiple clear cell carcinoma, 1 patient showed bilateral multiple clear cell carcinoma, and 2 patients showed bilateral multiple chromophobe cell carcinoma. No mutation of VHL or FLCN gene was found in all patients by genetic analysis.

Objective To study the application of regional localization method in the thoracoscopic resection of small pulmonary nodule.Methods Sixty-eight cases of small pulmonary nodules were located by applying the small pulmonary nodules regional localization method,and the clinical effect was intraoperatively observed.The ROC curve was used to find the best node for the nodule maximum diameter and minimum distance from the pleural.Results The once successful localization was obtained in 65 cases with the success rate of 95.6％.The best node of the maximum diameter of small pulmonary nodules was 1.0 cm,and the shortest distance from the pleura was 1.3 cm.Conclusion The regional localization method in the thoracoscopic resection of small pulmonary nodule has high accuracy.

Objective To prepare the polybutylcyanoacrylate nanoparticles (PBCA-NPs) loaded brain derived neurotrophic factor (BDNF) gene as the gene delivery system and explore their expressions in rat brain tissues so as to observe the influence of PBCA-NPs in BDNF expression.Methods PBCA-NPs were prepared by emulsion polymerization method.Surface of PBCA-NPs was surveyed by transmission electron micrograph (TEM) and zeta potentials of PBCA-NPs were determined with laser grain analyzer.The PBCA-NPs surface was modified by cationic surfactant cetyltrimethylammonium bromide (CTAB).The eukaryotic expression vectors PPEGFP-BDNF were constructed;after verification by double enzyme digestion and sequencing, pPEGFP-BDNF was packaged by PBCA-NPs.Forty-eight male SD rats were randomly divided into blank-control group, PBCA group, pPEGFP-BDNF group and PBCA-PEGFP-BDNF group (n=12), and Feeney's method was used to induce craniocerebral injury models in these rats, and then, one mL normal saline, PBCA-NPs, PEGFP-BDNF plasmids and PBCA-PEGFP-BDNF plasmids were given to the above groups.Seven d after that, peripheral brain tissues of right injury brain tissues were chosen;expressions of BDNF gene were detected by pathological examination, real time-PCR and Western blotting.Results Nps with even size and smooth surface were successfully obtained, holding the high zeta electric potential ([62.23±2.15] ％).The new constructed vectors were confirmed by restricted enzyme and sequencing.Real time-PCR indicated significant difference of BDNF mRNA expressions among the four groups (F=112.668, P=0.000);as compared with that in the other three groups, the BDNF mRNA expression in the PBCA-PEGFP-BDNF group was significantly higher (P＜0.05).Western blotting indicated significant difference of BDNF protein expressions among the four groups (F=66.629, P=0.000);as compared with that in the blank group and PBCA group, the BDNF protein expression in the PEGFP-BDNF group was significantly higher (P＜0.05), and that in the PBCA-PEGFP-BDNF group was significantly higher than the other three groups (P＜0.05).Conclusion PBCA-NPs could be a good vector and provide a new way for gene therapy of craniocerebral injury.

Objective:To evaluate a new imaging sign, named" bilateral water sign" (BWS), which can evaluate the neurovascular compression of primary trigeminal neuralgia (TN).Methods:A prospective study was conducted on 85 primary TN patients admitted to our hospital from March 2017 to March 2019. All patients accepted magnetic resonance 3D-T2W-DRIVEN sequence examination and multiplanar reconstruction (MPR) for post-processing. The sequential nerve (low signal)-cerebrospinal fluid (high signal)-vessel (low signal)-cerebrospinal fluid (high signal)-nerve (low signal) signs on the recombination plane were named as "BWS". The sensitivity, specificity, positive predictive value and negative predictive value of BWS in evaluating the neurovascular compression were calculated respectively, by combining with intraoperative situation of microvascular decompression (MVD).Results:In 85 TN patients, 46 patients (54.12%) had BWS. The sensitivity was 57.14%, the specificity was 75.00%, the positive predictive value was 95.65% and the negative predictive value was 15.38%. There was a statistically significant difference in the degree of neurovascular compression between patients with and without BWS ( P<0.05); and degree of neurovascular compression was severer in patients with BWS. Conclusion:BWS can evaluate the relation of neurovascular compression in TN patients and suggest the degree of neurovascular compression.