Objective:To explore risk factors for no‐reflow after emergency coronary intervention in aged patients with a‐cute ST elevation myocardial infarction (STEMI) . Methods:According to presence of no -reflow (≤TIMI grade Ⅲwas considered as no-reflow) after operation or not ,a total of 700 aged STEMI patients hospitalized in our hospital during 2010-2013 were divided into no-reflow group (n=190 ,27. 14% ) and reflow group (n=510 ,72. 86% ) . Clinical data , PCI and coronary angiography data were collected ,compared and analyzed between two groups . Results:Compared with reflow group ,there were significant rise in percentages of patients with TIMI grade 0-1 (61.17% vs. 82.11% ) ,coro‐nary collateral blood flow grade 0 (64.12% vs. 74.21% ) ,5 thrombus scores before PCI (58.83% vs. 80.00% );signifi‐cant reduction in systolic blood pressure (SBP) at hospitalization [ (111.2 ± 24.6) mmHg vs. (101.7 ± 25.9) mmHg] in no-reflow group , P<0. 01 all. Multi-factor Logistic regression analysis indicated that SBP<101 mmHg at hospitaliza‐tion ,collateral blood flow grade 0 before PCI and 5 thrombus scores before PCI were risk factors for no‐reflow after emer‐gency PCI (OR=1.006~4.398 , P<0.05 or <0.01) .Conclusion:In aged acute STEMI patients ,those with risk factors for no-reflow after emergency PCI should take corresponding preventive and therapeutic measures in order to improve their prognosis .

Objective To evaluate the impact of chemotherapy compliance on the therapeutic efficacy of induction chemotherapy plus concurrent chemoradiotherapy versus induction chemotherapy plus radiotherapy alone for patients with locally advanced nasopharyngeal carcinoma (NPC). Methods Based on intention to treat analysis (ITT) for 400 patients, 314 patients were analyzed by per protocol (PP) analysis. The patients were divided into induction chemotherapy plus concurrent chemoradiotherapy group (IC/CCRT, 127 patients) or induction chemotherapy plus radiotherapy group (IC/RT, 187 patients). The patients who completed 2 cycles of induction chemotherapy and at least 2 cycles of concurrent chemotherapy in the IC/CCRT group and the patients who completed 2 cycles of induction chemotherapy in the IC/RT group were analyzed. Radiotherapy was given by two-dimensional technique with γ-ray, X-ray and electron beams. The chemotherapy regimen was FUDR plus carboplatin for induction chemotherapy and carboplatin alone for concurrent chemotherapy. Results The follow-up rate was 96.2%. 295 patients were followed to at 3 years. Based on PP analysis, Grade 3/4 toxicity was found in 23.6% of the patients in IC/CCRT group and 13.4% in the IC/RT group (χ~2 =5,50,P=0.019). No grade 4 toxicity was found in the IC/RT group. The median follow-up time was 3.9 years, and no significant difference was found between the two groups in 3-year overall survival (78.1% : 84.6% ;χ~2 = 0. 61, P =0. 435), disease-free survival (74.3 % : 70.1% ;χ~2= 0. 12, P= 0.731), Iocoregional relapse-free survival (89.7% : 89.5% ; χ~2= 0. 10, P= 0.748), or distant metastasis-free survival (78.9%:76.5% ;χ~2=0.05,P=0.825). Conclusions With more severe toxicities, the IC/CCRT regimen does not improve the overall survival in locally advanced NPC patients compared with the IC/RT regimen.

Objective:To investigate the effects of miR-195 on the migration, invasion and epithelial mesenchymal transition (EMT) of human gastric cancer cell line (HGC-27) and its mechanism.Methods:HGC-27 cells were cultured in vitro and they were randomly divided into control group, miR-195 negative control (NC) group and miR-195 mimics (mimics) group; the expressions of miR-195 and SALL4 mRNA were detected by real-time fluorescence quantitative PCR (RT-qPCR) ; The changes in cell morphology of each group were observed under a microscope; the expressions of SALL4, E-cadherin, N-cadherin and Vimentin in HGC-27 cells were detected by Western blot; MTT method was used to detect the change of HGC-27 cell survival rate; the abilities of migration and invasion in HGC-27 cells were detected by scratch test and invasion test (Transwell) ; and the targeting relationship between miR-195 and SALL4 was confirmed by double Luciferase Report.Results:Compared with those in control group and miR-195 NC group, the miR-195 expression level, apoptosis rate and E-cadherin protein expression level of HGC-27 cells in miR-195 mice group were significantly higher ( P<0.05) , the cell survival rate, scratch healing rate, invasion number, SALL4 mRNA and SALL4, N-cadherin, Vimentin protein expression levels were significantly lower ( P<0.05) , the morphology of HGC-27 cells returned to normal, and the epithelial mesenchymal behavior was significantly reduced; in addition, there was a binding site between miR-195 and SALL4 mRNA 3'UTR region, and compared with that in SALL4-3'UTR-WT + miR-195 NC group, the luciferase activity of SALL4-3'UTR-WT + miR-195 MICs group was lower ( P<0.05) . Conclusion:MiR-195 may inhibit the migration, invasion and epithelieal-mesenchymal transition of human gastric cancer cells by targetingly inhibiting the expression of SALL4.

Objective:To explore the significance of laparoscopic virtual reality simulation training by analyzing the learning curve of laparoscopic cholecystectomy among young general surgeons who had participated in laparoscopic skills training at our hospital.Methods:Fifty young surgeons were divided into two groups, with the intervention group participating in virtual reality simulation training and the control group participating in traditional laparoscopic clinical training. After completion of the training, 30 laparoscopic cholecystectomies were performed under the supervision of highly qualified surgeons with extensive laparoscopic experience. CUSUM analysis was applied to plot the trainees' surgical learning curve based on the completion rate, surgical score and operative time. " x" is the number of surgical cases and " k" is the slope. The value of x when k=0 was calculated and the surgical learning curves and intraoperative scores of the 2 groups of trainees were compared. SPSS 23.00 was performed for t-test and Chi-square test. Results:The intervention and control groups crossed the surgical learning curve at x=19.24±0.39 and x=21.72±0.73 respectively, with significant differences ( P<0.01); the intervention and control groups scored (10.82±2.73) and (9.71±2.69) for gallbladder exposure ( t=4.61, P<0.01), (12.59±3.12) and (8.87±2.99) for gallbladder dissection triangle ( t=6.21, P<0.01), and (10.69±3.38) and (8.80±3.55) for gallbladder dissection ( t=3.10, P<0.01). Conclusions:Virtual reality simulation training can facilitate the translation of basic laparoscopic training skills into clinical skills and can promote the growth of young general surgeons.

Objectives: To explore the expression regulation of type 1 and type 2 (Th1 and Th2) cytokines from serum of coal miners and the evaluation in surveillance of coal workers' pneumoconiosis, 630 coal miners were studied. Methods: A total of 90 male patients diagnosed as coal workers' pneumoconiosis (CWP) in a institute for occupational health and 19 male workers newly diagnosed as CWP patients was chosen as CWP group with simple random sampling method from a coal mine group from January 2013 to December in 2015. 180 male coal miners with abnormal but not diagnosed as CWP were selected as CWP suspected group with simple random sampling methods, meanwhile 180 male coal miners with normal chest X-ray photograph was as dust-exposed group by 1∶1 matched as age. And 161 healthy males accepted pre-employed examination were selected as control group, CWP suspected group, dust-exposed group and control group called as non-CWP group. According to screening test and diagnosis test, the basic information and occupational history of all subjects were collected, and cytokines including IL-1β, IL-8, IFN-γ, IL-6 and IL-10 of serum were detected. Receiver operator characteristic (ROC) curve was used to determine the optimal cutoff value of each cytokine. Area under curve (AUC), the validity and reliability were calculated and judged. Results: The average age of control group, dust-exposed group, CWP suspected group and CWP group were (27.4±5.0) , (43.4±10.7) , (48.2±6.2) , (64.7±7.0) years old, respectively. The median level of IL-1β, IL-8, IFN-γ and IL-6 in cases group (1 638.30, 2 099.49, 815.18,140.32 pg/ml) were higher than that of non-cases group (1 445.57, 1 402.26, 736.38, 95.73 pg/ml) (P<0.05) . The level of IL-8 (1 503.99 pg/ml) in CWP suspected group was higher than that of control group (1 295.67 pg/ml) and dust-exposed group (1 376.94 pg/ml) , but the level of IL-10 (654.08 pg/ml) was lower than that of control group (596.64 pg/ml) . The ratio of IFN-γ/IL-6 ranged from 5 to 8, and the ratio in CWP group (5.87) was lower than that of non-CWP group (7.61) . The IL-6 and IL-8 among the subjects of dust-exposed group in terms of the age distribution of among had reached statistical significance. According to ROC, the cutoff value of IL-1β, IL-6, IL-8, IL-10 and INF-γ reached 1 582.65, 116.53, 1 791.54, 581.08 and 792.69 pg/ml, respectively. The AUC was 0.668, 0.895, 0.859, 0.716 and 0.637, respectively. It was found that IL-6 and IL-8 could be used as biomarkers in detecting CWP, the sensitivity and specificity was 82.6% and 84.6%, 78.0% and 84.8%, respectively; Youden's index was 0.674 and 0.628 and the consistency rate was 84.3% and 83.7%, while Kappa value was 0.55 and 0.52. Conclusion There was Type 1 and type 2 cytokine dysregulation in CWP patients. IL-6 and IL-8 can be used as effective biomarkers to forecast lung injury before X-ray changes.

Objective To explore the characteristics of plantar pressure of ankle joints at different limb laterality and different stress positions. Methods Twenty-three healthy subjects were recruited to perform walking trails. Each subject was tested for plantar pressure in ankle neutral position, ankle inversion and ankle eversion through simple custom-designed walkways and plantar pressure plate. The evaluation indices were peak pressure, contact area, contact time percentage, M/L (ratio of sum of medial plantar peak pressure to sum of lateral peak pressure), A/P (ratio of sum of toe peak pressure to heel peak pressure). Results The peak pressure of the first metatarsus bone in the dominant foot was significantly larger than that in the non-dominant foot, and the peak pressure of the fifth metatarsus bone was significantly smaller than that on the non-dominant foot. The M/L of dominant side was significantly larger than that of the non-dominant side. Except for the peak pressures of the mid-foot and the first toe, there were significant differences in other regions among the three ankle positions. The percentage of contact time in each area during inversion was greater than that in neutral position, and the percentage of contact time of plantar regions during eversion was longer than that in neutral position except the second toe. The M/L in inversion, neutral and eversion position were 1.24±0.46, 1.06±0.26, 0.88±0.25. The M/L of dominant foot was greater than that of the non-dominant foot, and the A/P during inversion and eversion was greater than that in neutral positions. Conclusions The stability of the dominant foot was better than that of the non-dominant foot. The standing stability decreased during inversion and eversion. During inversion, the body shifted inward and forward to maintain the stability. During eversion, the center of gravity shifted outward and forward to maintain the stability.