Objective: The aim of this study is to investigate the clinical factors in association with venous thromboembolism (VTE) in patients with lung cancer, and to provide evidence for prevention and therapy of VTE. Methods: Clinical information of 2 053 patients with lung cancer definitely diagnosed by cytology or pathology between July 2008 and June 2010 was retrospectively analyzed. VTE wasconfirmed by chest spiral computed tomography (CT), pulmonary arteriography and colorful Dopplerultrasound. The clinical factors including age, gender, pathological type, operation, clinical stage,body mass index, co-morbidity and platelet count as well as D -dimer, interleukin-1 (IL-1) and tumornecrosis factor (TNF) were considered as the potential VTE-related factors. Results: Of 2 053 patients,89 (4.34%) were confirmed with VTE. The incidence rates of VTE in patients with adenocarcinoma andnon-adenocarcinoma were 5.65% (58/1 027) and 3.02% (31/1 026), respectively, and the difference wasstatistically significant (P £?0.003). The incidence rate of VTE in stage I-III A lung cancer patients was significantly lower than that in stage IIIB-IV lung cancer patients [1.48% (10/677) vs 5.74% (79/1 376); P<0.001]. In patients with stage I-IIIA undergoing surgical operation or not, the incidence rates of VTE were 1.55% (10/645) and 0% (0/32), respectively (P=0.044). Significant difference of incidence rate of VTE was also found between the patients with and without co-morbidity [6.73% (56/832) vs 2.70% (33/ 1 221); P<0.001]. The incidence rates of VTE in patients with normal levels of platelet count, D -dimer,IL-1 and TNF were 3.72%, 0.31%, 2.44% and 3.27%, respectively; whereas, the incidence rates in patients with increased levels of these measurements were 6.26%, 19.91%, 10.26% and 7.74%, respectively; the differences between two groups were all significant (P<0.05). Logistic multivariant regression analysisrevealed that the clinical factors of adenocarcinoma, operation, co-morbidy and high levels of D-dimer,IL-1 and TNF in blood were associated with increased risk of VTE (P<0.05). Conclusion: Adenocarcinomais the most common pathological type in lung cancer patients with VTE. The risk factors of VTE include operation, co-morbidity and high levels of D -dimer, IL-1 and TNF in blood. Copyright© 2011 by TUMOR.

Objective To study the diagnosis and treatment of choledocholithiasis in patients with low left and right posterior hepatic duct confluence.Methods Clinical data of 12 patients suffering from cholelithiasis with a low confluence of the left and right posterior hepatic ducts admitted between January 2000 to June 2013 were retrospectively analyzed.Results Of the 12 cases,the left and right posterior hepatic ducts joined between 2 cm below hilus hepatis and the superior border of the duodenum in 8 cases,below the superior border of the duodenum in 4 cases.Seven cases had a low confluence of the right and left hepatic ducts,and 5 cases had right posterior duct low confluence.As for bile duct stricture:the opening stricture at the junction of the right and left hepatic ducts were found in 4 cases,the opening stricture in the right hepatic ducts were found in 3 cases,the opening stricture of the left hepatic duct were found in 2 cases.There were left and right bile duct stones in 7 cases,right intrahepatic bile duct stones in 3 cases,left intrahepatic bile duct stones in 2 cases.Cystic duct joined the right hepatic duct in 5 cases,left hepatic duct in 2 cases.Seven cases with a low confluence of the right and left hepatic ducts were with double T tube drainage; five of low right hepatic duct confluence were treated by T tube drainage.The right posterior branch of hepatic ducts were injured in four cases and right hepatic duct was injured in one.Conclusions Low confluence of left and right posterior hepatic ducts often leads to misdiagnosis during surgery of cholelithiasis.Magnetic resonance cholangio-pancreatography or endoscopic retrograde cholangiopancreatography was helpful before cholecystectomy to avoid iatrogenic injury of biliary tract.

Objective To evaluate the role of serum homocysteine (HCY) in diabetes mellitus(DM ) complicating proliferative diabetic retinopathy (PDR) .Methods 174 patients with DM were selected and divided into PDR ,non‐PDR(NPDR) and non‐dia‐betic retinopathy (NDR) groups .The serum HCY level was detected .Results Serum HCY levels in the PDR ,NPDR and NDR groups were (18 .20 ± 5 .60) ,(14 .40 ± 6 .70) and ,(12 .10 ± 6 .80)μmol/L respectively ,which was highest in the PDR group (P<0 .05) .Conclusion HCY could result in PDR generation possibly by injuring the retinal blood vessels .

Pancreatic enzyme replacement therapy is given to manage pancreatic exocrine insufficiency (PEI) in cystic fibrosis (CF) and following pancreatectomy, total gastrectomy or chronic pancreatitis. The article reviews on aspects of pancreatic enzyme replacement therapy containing the assement of pancreatic exocrine function, the pathogenesis of exocrine pancreatic insufficiency, pancreatic enzyme preparations and their efficiency, dosing of pancreatic enzymes, enteral nutrition and pancreatic enzyme replacement, the modulation of pancreatic exocrine and adverse reactions to pancreatic enzyme.

China ; Dyslipidemias ; prevention & control ; Guidelines as Topic ; Humans

Objective To introduce the method and to evaluate the therapeutic effect of collagenase chemonucleolysis for treatment of cervical disc herniation.Methods 92 patients with cervical herniated discs were selected from January 2002 to December 2004.The procedure was guided by DSA and the puncture was defined from C_(6~7) or C_7-T_1 extradural cavity.Collagenase(1200~2400 u) was injcted in the herniated extradural cavity through the micrcatheter.Results The procedure of 88 cases was successful.80 cases were followed up from 6 to 12 months.The effect showed that 70 cases(87.5%) were excellent or good.No serious complication occurred.Conclusion The method of collagenase chemonucleolysis for treating cervical disc herniation is safe and effective,it can be used in clinic.

Background Studies showed that microRNA (miR)-375 suppresses the growth,apoptosis,migration and adhesion of tumor cells,and it plays a regulation to the changes of vascular endothelial growth factor (VEGF) in tumor tissue to arrest neovascularization.However,whether miR-375 intervenes the formation of new blood vessel in eyes is unelucidated.Objective This study was to explore the effects of miR-375 on human retinal capillary endothelial cells (HRCECs) function induced by hypoxia.Methods HRCECs were cultured using IMDM and divided into normal control group,CoCl2 model group,CoCl2 +miR-375 mimic group,CoCl2 +miR-375 mimic control group,CoCl2+miR-375 inhibitor group and CoCl2 +miR-375 inhibitor control group,and hypoxia cell models were created by adding 200 μmol/L CoCl2.MiR-375 and frizzled 4 (FZD4) small interfering RNA (siRNA) were transfected into the cells by 50 nmol/L miRNA lipidosome for 48 hours.The proliferation of the cells was detected by MTT assay;migrated number of the cells was examined by Transwell chamber assay;ELISA was employed to detect the concentrations of VEGF and VE-cadherin in the medium;the expression of β-catenin,cyclinD1,matrix metalloproteinase-2 (MMP2) and VEGF proteins were analyzed by Western blot;tube length of vessel formation was evaluated by Matrigel assay.Cultured cells were divided into normal control group,CoCl2 model group,CoCl2 +mock group and CoCl2 + FZD4 siRNA group,the relative expression of FZD4,a miR-375 targeted gene,was detected by luciferase reporter.Results The relative expression of miR-375 mRNA was significantly increased in the CoCl2 +miR-375 mimic group compared with the CoCl2 + miR-375 mimic control group and reduced in the CoCo2 + miR-375 inhibitor group compared with the CoCo2 + miR-375 inhibitor control group (t =-19.237,8.764,both at P＜0.01),with a higher transfected efficacy for miR-375.The cell proliferative fold,migrated cell number,VEGF and VE-Cadherin contents in the medium and the tube length were significantly different among the CoCl2 model group,CoCl2 +miR-375 mimic group,CoCl2 +miR-375 mimic control group,CoCl2 +miR-375 inhibitor group and CoCl2 +miR-375 inhibitor control group (F =24.324,26.776,14.113,19.225,15.040,all at P＜0.001),and those in the CoCl2 +miR-375 mimic group were evidently reduced in the CoCl2 +miR-375 mimic group compared with the CoCl2 +miR-375 mimic control group,while those in the CoCl2 +miR-375 inhibitor group were considerably elevated in comparison with the CoCl2 +miR-375 inhibitor control group (all at P＜0.01).The expressions of β3-catenin,cyclinD1,MMP2 and VEGF protein were significantly different among the normal control group,CoCl2 model group,CoCl2 +miR-375 mimic group,CoCl2+miR-375 mimic control group,CoCl2 +miR-375 inhibitor group and CoCl2 +miR-375 inhibitor control group (F=11.753,13.283,16.770,10.334,all at P＜0.001).In addition,the cell proliferative fold,migrated cell number and the tube length were significantly increased in the CoCl2 model group and CoCl2+mock group,and those in the CoCl2+FZD4 siRNA group were decreased in comparison with the CoCl2 +mock group (all at P＜0.05).Conclusions MiR-375 inhibits the growth,migration and tube formation ability of HRCECs in hypoxic status probably by regulating the activation of Wnt pathway via directly targeting FZD4.

Objective: To explore assessment value of heart rate variability (HRV) of Holter for cardiac autonomic nervous function in patients with acute stroke.Methods: A total of 80 cases with acute stroke treated in our hospital were regarded as stroke group, and another 80 inpatients without cardio-and cerebrovascular diseases were enrolled as control group simultaneously.Holter was used to perform 24h ambulatory heart rate monitoring on two groups, and the results were compared between two groups.Results: Compared with control group, there were significant reductions in standard deviation of normal to normal RR intervals calculated over the 24 h period [SDNN, (129.89±5.42) ms vs.(92.58±4.36) ms], standard deviation of normal to normal RR intervals in all 5 min segments of the entire recording [SDANN, (118.85±5.79) ms vs.(77.36±4.82) ms], root-mean square of differences between successive normal to normal intervals [rMSSD, (27.04±1.18) ms vs.(7.31±1.09) ms] and adjacent normal RR interval difference >50ms stroke accounted for a percentage of 24h total RR interval [PNN50, (8.97±1.48)% vs.(2.62±0.54)%] in stroke group, P<0.01 all;in stroke patients, there were no significant difference in above indexes between cerebral infarction patients and cerebral hemorrhage patients, P>0.05 all.Conclusion: HRV indexes possess significant assessment value for cardiac autonomic nervous function in patients with acute stroke.They can predict patient′s status changes, and help to prevent and identify severe cerebrovascular disease in time.

Objective To explore the application value of INTERGROWTH-21st standard evaluate intrauterine growth restriction (IUGR).We aimed at predicting IUGR with ultrasonic fetal growth measurements.Methods A prospective cohort of singleton pregnancy scanned after 28 gestational weeks was constructed.The Z-score values of growth measurements were calculated using the INTERGROWTH-21st standard.Logistic regression equation was used to establish the prediction formula.Finally,the new formula was compared with the traditional Hadlock method to predict the accuracy of IUGR.We assessed outcomes for consenting participants who attended research scans and delivered at the Obstetrics and Gynecology Hospital of Fudan University.Results A total of 834 patients fulfilling the inclusion criteria were included.After the exclusion of 143 lost cases,565 of control cases and 126 of IUGR cases were obtained.The sensitivity,specificity,positive predictivevalue,negative predictive value,false positive rate and false negative rate of prediction model wererespectively:88.9 ％,85.4 ％,57.7 ％,97.2 ％,14.6 ％,11.1 ％.In contrast,the values of Hadlock wererespectively:81.7％,82.7％,51.2％,95.3％,17.3％,18.3％.Conclusions This study shows aprediction model of IUGR.INTERGROWTH-21st standard improved the diagnostic accuracy of IUGR,especially enhanced the positive predictive value.

Functional Science Lab.Of Jining Medical College has attempted to reform the management system,share the resource,improve the resource utilization,exceed the limits of science,modify the contents of experimental courses,innovate the teaching methods,pay attention to teacher training.Through longtime research and practice,we have gained the significant achievements.