Objective To study the changes rule of serum procalcitonin (PCT) and PCT clearance rate (PCTc) in patients with severe craniocerebral injury complicated with pulmonary infection and analyze the values of PCT and PCTc in the patients' therapeutic effect and prognosis.Methods A retrospective controlled analysis was conducted, the clinical data of 58 patients with severe craniocerebral injury complicated with pulmonary infection admitted into the Department of Neurology of the Forth Hospital of Tianjin from December 2012 to December 2016 were collected, and within 24 hours after definite diagnosis (before treatment) and after treatment for 1, 3, 7 days, the levels of PCT and percentages of PCTc were measured by rapid semi quantitative method. According to the therapeutic results of treatments, including antibiotics, airway management, nutritional support, etc., the patients were divided into an effective group and a deteriorative group. The changes rule of levels of serum PCT and percentages of PCTc before treatment and 1, 3, 7 days after treatment were dynamically evaluated. The receiver operating characteristic curve (ROC curve) was drawn and the area under the ROC curve (AUC) was calculated, and the sensitivity, specificity and diagnostic accordance rate of the combined treatment were assessed.Results Of 58 cases 32 (55.2%) after active treatment had promising therapeutic results or better prognosis (effective group), and the disease situations in 26 patients (44.8%) were deteriorating(deteriorative group). With prolonged treatment in effective group, the serum level of PCT was decreased gradually, while the deteriorative group showed a tendency firstly decreased and then increased, reaching to the valley on the 1st day after treatment, on the 3rd day beginning to increase and reaching the peak on the 7th day; the levels of PCT in effective group were significantly lower than those in deteriorative group at each time point after treatment on 1, 3, 7 days (μg/L: 1 day was 2.67±0.77 vs. 3.24±0.90, 3 days was 1.38±0.63 vs. 3.31±0.85, 7 days was 0.61±0.16 vs. 3.82±1.05, allP < 0.05); The PCTc rates in the effective group were significantly higher than those in the deteriorative group at each time point on 1, 3 and 7 d [1 day was (17.53±9.94)% vs. (12.31±7.55)%, 3 days was (60.34±13.55)% vs. (8.31±4.69)%, 7 days was (82.47±15.11)% vs. (-5.82±9.60)%, allP < 0.05]. After treatment for 3 days, 7 days, the AUC of PCT were 0.532 and 0.688, and the diagnosis cut-off values were 2.42 and 1.86 respectively; on 1, 3, 7 days after treatment, the AUC of PCTc were 0.529, 0.547, 0.775, and the diagnostic cut-off values were 15.67, 35.94 and 70.55 respectively. Further the final outcome was recognized as the gold standard: after treatment for 7 days, the PCT sensitivity was 80.1%, specificity 75%, the coincidence rate 77.6%; 7 days after treatment, the sensitivity of PCTc was 92.3%, the specificity 87.5%, the coincidencerate 89.7%.Conclusion The dynamic observations on serum PCT and PCTc have relatively good evaluation values on the therapeutic effect and prognosis of patients with severe craniocerebral injury complicated with pulmonary infection.

Studies on nitrogen metabolism in rats and dogs during acute radiation damage were made, the main results being shown as follows:1. Rats given 630 r whole body radiation showed marked decrease of food intake, but their body weight losses exceeded substantially those of non-radiated rats in pair feeding group. As compared with the latter, the former had more excretion of urinary nitrogem and negative nitrogen balance in the 1st and 2nd day following the exposure of X-ray.2. Four adult male dogs were selected as experimental animals. After irradiation of 430 r,the daily intake of protein and calories were decreased and correspondingly the excretion of total nitrogen,urea nitrogen and amino nitrogen became increased, especially in the 1st and 2nd day.3. Three groups of dogs were fed to low, moderate and high protein diet respectively. Their nitrogen balance were different but normal, however, after irradiation of 400 r the nitrogen balances in the low protein diet group became negative whereas that in the moderate or high protein diet group in general was slightly positive.

Objective To investigate the role of Ki-67,c-myc,p53 in human in esophageal cancer.Methods 25 specimens of human esophageal cancer as observe group and 25 adjacent normal specimens as control group were selected.Expressions of Ki-67,c-myc,p53 protein were detected by immunohistochemical staining.Results Protein expressions levels of Ki-67,c-myc and p53 in human esophageal cancer were significantly higher than those in control group 5.0,2.0,3.0 vs 1.0,0.5,0.3,respectively (all P ＜ 0.05).The expression level of Ki-67 protein in high differentiation group were significantly lower than that of moderate and low differentiation group (3.0 vs 6.0,P ＜ 0.05).In human esophageal cancer specimens,the expression level of Ki-67 protein was positively correlated with that of c-myc (P ＜ 0.05).Conclusion The expressions of Ki-67,c-myc and p53 are higher in esophageal cancer,which are increased with the higher differentiation.Ki-67,c-myc and p53 proteins may be taken as potential markers in human esophageal cancer.

A capillary electrophoretic method was developed for the separation of enantiomers of naphthylgly-cidic ether(NGE). Several cyclodextrins(CDs) were applied as the chiral selectors and it was found that the ionic modified highly sulfated cyclodextrin(HS-β-CD) could give satisfactory enantioselectivity. In addition,the effects of the pH value of the buffer system,the concentration of the HS-β-CD,capillary temperature and the running voltage on the chiral separation were investigated systematically. The result showed that under the optimized conditions of pH 2. 5,20 mmol/L H_3PO_4-triethanolamine buffer containing 2% highly sulfated cyclodextrin ( HS-β-CD) at capillary temperature 20℃ in the reversed polarity voltage of - 18 kV,the enantiomers of naphthylglycidic ether were baseline separated. This method is simple,precise and can be applied to the chiral separation of naphthylglycidic ether enantiomers and determination of enantiomers excess(ee,% ).

Objective To investigate the relation between the expression of MICA/B in lung cancer cells and the mediastinum lymph node metastasis. Methods The samples of the lung cancer tissue as test group and the healthy tissue beside lung cancer as control group from 30 cases of patients with lung cancer were collected, and the expression of MICA/B on lung cancer cells surface were detected by flow cytometry.All patients were divided into three groups(N0, N1, N2) according to the state of lymph node metastasis, and the expression of MICA/B was analyzed among the three groups. Results The expression level of MICA/B in test group was significantly higher than that in control group[(0.3788±0.2398) %, (0.1908±0.1760) %] (P ＜0.01),however the MICA/B expression level between N0 and N1 or between N1 and N2 was not statistically different (P＞0.05), while that between N0 and N2 had statistical difference (P＜0.05). Conclusion The expression level of MICA/B on surface of lung cancer cells is high, and the MICA/B as ligand of NKG2D may play an important role in the tumor immune response. The expression of MICA/B in mediastinum metastatic lymph node from lung cancer is remarkably increased and the prognosis of patients with lymph node metastasis is poor. MICA/B could be considered as a marker of mediastinum lymph node metastasis.

Objective:To analyze the wall thickness of C-shaped canals in permanent mandibular second molars.Methods:40 ex-tracted permanent mandibular second molars with C-shaped root were collected from native Chinese and were scanned by micro-CT scan-ner.The specimens were reconstructed three-dimensionally by software Mimics 10.01.The roots were sliced from cemento-enamel junc-tion (CEJ)to apex with 1 mm intervals.The cross-sectional root canal configurations were classified into 5 types according to the Fan's Classification.The minimum buccal wall thickness (MBWT),minimum lingual wall thickness(MLWT)and their locations,as well as the wall thickness at the mesial and distal reference sites were detected.Two-way ANOVA and post hoc LSD-t tests were used to com-pare the mean thickness at 4 sides.Results:Among 370 cross-sections of 40 C-shaped roots,C1,C2 and C3 canals were observed on 126(34.1%),46 (12.4%)and 160 (43.2%)sections respectively.Except at the 10 mm level,the mean MLWT was always lower than MBWT;and the MLWT and MBWT were always lower than the wall thickness at the mesial and distal reference sites.The differ-ence was statistically significant (P <0.05)along the root length above the 12 mm level.The MBWT of the C2 and C3 canals was more likely located at the mesial region,and the MBWT of the C1 and the MLWT of C1,C2 and C3 was more frequently located at the center region.Conclusion:The lingual wall of C-shaped canal in mandibualr second molars was the thinnest zone among four sides,and care should be taken during root canal instrumentation and post space preparation to avoid perforation.

Objective:To explore the clinico-pathological characteristics and risk factors affecting prognosis in elderly patients with gastric cancer.Methods:A retrospective study was used to retrospectively analyze 2386 patients with gastric cancer undergoing radical surgery in Surgery Department of the Fourth Hospital of Hebei Medical University from 1 January 2012 to 1 January 2015.Patients aged 70 years and older were screened so as to analyze clinical characteristics and influencing factors for the prognosis.Results:A total of 2386 patients with gastric cancer were divided into the elderly group aged 70 years and older(342 of 2386 cases, 14.3%). There were statistically significant differences between the two groups in gender, number of concomitant diseases, NRS2002 score, PG-SGA score, tumor location, tumor diameter, histological type, Borrmann classification, tumor invasion depth staging(pT), lymph node metastasis staging(pN), the anatomic extent of tumor staging(TNM, pTNM), and Lauren classifications( P<0.05). The 981 of 2386 cases(41.4%)had postoperative complications, accompanied by 413 cases(17.3%)of surgery-related complications and 568 cases(24.0%)of non-surgery-related complications.A multivariate logistic analysis showed that the number of preoperative co-existing diseases ≥ 2 was an independent influencing factor for postoperative complications in elderly gastric cancer patients( HR=4.478, 95% CI: 1.121-7.918, P=0.006). The 5-year OS and DSS was 21.10% and 62.73% in the ≥70 years gastric cancer group, and was 54.1% and 70.0% in the <70 years gastric cancer group, respectively.The difference in the 5-year OS between the two groups was statistically significant( P<0.05), while the difference in the 5-year DSS between the two groups was not statistically significant( P>0.05). Multivariate analysis by the Cox proportional hazard model showed that the independent risk factors for the prognosis of elderly patients with gastric cancer included the low-undifferentiated histological type of the tumor( P=0.004), the depth of tumor invasion pT stage of pT4a-pT4b( P=0.007), lymph node metastasis( P=0.034), tumor pTNM stage ⅢA-ⅢC( P=0.002)and vascular tumor thrombus( P=0.034). Conclusions:Elderly patients with gastric cancer have many preoperative co-existing diseases, which increases the risk of postoperative non-surgical complications.Therefore, we should focus on the peri-operative management of their comorbid diseases so as to improve the safety and efficacy of surgery.The advanced age is not the independent risk factors for the prognosis.

Objective:To investigate the clinically relevant factors of progressive disease (PD) after neoadjuvant therapy for locally advanced gastric cancer.Methods:From Jun 2011 to Mar 2016, 569 patients with locally advanced gastric cancer(cT3/4N0/+ M0) admitted to the Fourth Hospital of Hebei Medical University were retrospectively analyzed .Results:All 569 patients completed neoadjuvant therapy, 59 patients (10.4%) had PD. Univariate analysis showed that tumor size (χ 2=10.091, P=0.001), pathological type (χ 2=4.110, P=0.043), Borrmann type (χ 2=91.941, P=0.001), pre-treatment cT stage (χ 2=7.980, P=0.005) were associated with PD after neoadjuvant therapy for gastric cancer. The results of multi-factor regression analysis showed that pathological type, Borrmann type, pre-treatment cT stage were independent factors influencing the occurrence of PD after neoadjuvant therapy for advanced gastric cancer. The overall survival and progression-free suruival time of patients with PD is significantly shorter than that of patients without PD . Conclusion:The pathological type, Borrmann typing and pre-treatment cT stage are the influencing factors for the occurrence of PD after neoadjuvant treatment in advanced gastric cancer, and the prognosis of PD patients is poor.

Objective:To investigate the risk factors of pancreatic fistula after radical resection of gastric cancer, and to establish a risk prediction scoring model for pancreatic fistula.Methods:The clinico-pathological data of 312 patients with gastric cancer admitted to the Fourth Hospital of Hebei Medical University from January 2019 to January 2020 were retrospectively analyzed. Multiple factor logistic regression model was used to analyze the risk factors of pancreatic fistula after radical resection of gastric cancer, and a risk prediction scoring model based on the risk factors was established. Hosmer-Lemeshow test was used to detect the goodness of fit of regression equation, and receiver operating characteristics (ROC) curve was used to evaluate the distinction degree of regression equation.Results:Among 312 patients with gastric cancer, 27 cases (8.65%) had pancreatic fistula after radical resection of gastric cancer. Multiple factor logistic regression analysis showed that male patients ( OR = 5.312, 95% CI 1.532-18.420, P = 0.008), age ≥ 60 years old ( OR = 4.928, 95% CI 1.493-16.250, P = 0.009), preoperative diabetes mellitus ( OR = 3.062, 95% CI 1.091-8.589, P = 0.034), lesion location in the gastric body-gastric antrum ( OR = 3.121, 95% CI 1.052-9.251, P = 0.040), intraoperative omental bursa resection ( OR = 6.209, 95% CI 2.084-18.478, P = 0.001), intraoperative lymph node dissection at D2+ station ( OR = 3.114, 95% CI 1.044-9.281, P = 0.042), intraoperative combined organ resection ( OR = 5.063, 95% CI 1.473-17.400, P = 0.010), preoperative TNM stage Ⅲ ( OR = 4.973, 95% CI 1.189-20.792, P = 0.028) were independent risk factors for pancreatic fistula after radical resection of gastric cancer. A risk prediction equation of pancreatic fistula after radical resection of patients with gastric cancer was established: P = -8.619+1.670X 1+1.595X 2+1.119X 3+1.138X 4+1.826X 5+1.136X 6+1.622X 7+1.604X 8; factor X was set as a binomial assignment (0 or 1); X1-X8 were listed as follows respectively: gender (the male was 1), age (≥60 years old was 1), preoperative diabetes history (yes was 1), lesion location (gastric body-gastric antrum was 1), intraoperative resection of omental bursa or not (yes was 1), intraoperative lymph node dissection at D2+ station or not (yes was 1), intraoperative combined organ resection or not (yes was 1), preoperative TNM stage (stage Ⅲ was 1). The goodness of fit of regression equation was high ( P = 0.395). The area under the curve of ROC by using risk prediction scoring model to judge pancreatic fistula was 0.916 (95% CI 0.872-0.960, P<0.01). The probability of pancreatic fistula in patients with score ≥ 5 was 40.90%, and the probability of pancreatic fistula in patients with score < 5 was 3.35%. Conclusions:The occurrence of pancreatic fistula after radical resection of gastric cancer is closely related to a variety of risk factors. By establishing a risk prediction scoring model for pancreatic fistula after radical resection of gastric cancer, it is helpful to effectively identify patients with high risk of pancreatic fistula after radical surgery during the perioperative period.

Objective:To investigate the correlation between the expression levels of STMN1, BubR1, bcl-2 and Bad and the chemotherapy effect of paclitaxel-containing regimen in patients with esophageal squamous cell carcinoma (ESCC).Methods:The clinical data of ESCC patients who received paclitaxel-containing chemotherapy at Fenyang Hospital Affiliated to Shanxi Medical University from September 2016 to June 2021 were retrospectively analyzed. Among them, 59 cases received maintenance chemotherapy and 27 cases received surgery after 3 courses of neoadjuvant chemotherapy. The expression levels of STMN1, BubR1, bcl-2 and Bad in tumor tissues before chemotherapy were detected by immunohistochemistry. The imaging efficacy after 3 courses of chemotherapy and pathological efficacy after neoadjuvant chemotherapy were evaluated. The imaging efficacy, pathological efficacy and progression-free survival (PFS) were compared between the high expression group and the low expression group of each protein.Results:The proportion of patients with stage Ⅳ (46.3%, 19/41), the proportion of patients with low differentiation (22%, 9/41) and the incidence of lymph node metastasis (95.1%, 39/41) in STMN1 high expression group were higher than those in STMN1 low expression group (17.8%, 8/45; 4.4%, 2/45; 64.4%, 29/45), and the differences were statistically significant (all P < 0.05). The proportion of patients with stage Ⅳ in Bad high expression group was lower than that in Bad low expression group, and the difference was statistically significant ( P < 0.05). In the evaluation of imaging efficacy, the chemotherapy sensitivity rates in STMN1 and BubR1 high expression groups (29.3%, 12/41; 37.9%, 22/58) were lower than those in STMN1 and BubR1 low expression groups (75.6%, 34/45; 85.7%, 24/28), and the chemotherapy sensitivity rate of patients in Bad high expression group (65.9%, 27/41) was higher than that in Bad low expression group (42.2%, 19/45), and the difference was statistically significant (all P < 0.05). There was no statistical correlation between bcl-2 expression and chemotherapy sensitivity rate ( P > 0.05). In the evaluation of pathological efficacy, the proportion of patients with tumor regression grade (TRG) score 0-1 after neoadjuvant therapy in STMN1 high expression group (27.3%, 3/11) was lower than that in STMN1 low expression group (75.0%, 12/16), and the difference was statistically significant ( P = 0.022). There were no statistical differences in the proportions of patients with TRG score 0-1 after neoadjuvant therapy between high and low expression groups of BubR1, bcl-2 and Bad (all P > 0.05). The PFS rate was 15.2% (9/59) for patients received maintenance chemotherapy, and the median PFS time was 6 months. Kaplan-Meier analysis showed that PFS in STMN1 low expression group was better than that in STMN1 low expression group ( χ2 = 12.90, P < 0.001). PFS in BubR1 low expression group was better than that in BubR1 high expression ( χ2 =12.04, P < 0.001). PFS in Bad high expression group was better than that in Bad low expression group ( χ2 =9.69, P = 0.004). There was no statistical difference in PFS between high and low bcl-2 expression groups ( χ2 =1.43, P = 0.320). Conclusions:ESCC patients with low expression of STMN1, low expression of BubR1 and high expression of Bad have better chemotherapy effect after receiving paclitaxel-containing regimen, but there is no correlation between bcl-2 expression and chemotherapy efficacy.