ObjectiveTo study the curative effect and safety of low dose of urokinase (UK) combined with low molecular heparin calcium.MethodsSixty-four cases of sudden cardiac arrest patients were divided into treatment group and control group by random digits table with 32 cases each.Two groups were given cardiopulmonary resuscitation according to the 2005 international guide for cardiopulmonary resuscitation and emergency cardiovascular care.Early in the recovery,the patients in treatment group were pumped in vein with low dose of UK(200 000 U) and injected subcutaneous with low molecular heparin calcium (4100 U ) in 30 minutes.The rate of return of spontaneous circulation (ROSC),survival rate longer than 24 hours and 30 days in two groups and patients dying of bleeding or bleeding conditions in treatment group were observed.ResultsThere were 11 cases (34.4％) of ROSC in control group,and compared with 20 cases (62.5％) in treatment group,there was significant difference (P＜0.05).There were 5 cases (15.6％) of survival longer than 24 hours in control group,and compared with 13 cases(40.6％) in treatment group,there was significant difference (P ＜ 0.05 ).There were 2 cases (6.2％) of survival 30 days in control group,and compared with 8 cases (25.0％) in treatment group,there was significant difference (P＜ 0.01 ).Nobody had subcutaneous bleeding or other organ hemorrhage in control group.But there was I patient who had subcutaneous limited ecchymosis in the injection site in treatment group.The difference of fibrinogen before and after treatment in treatment group was statistically significant(P ＜ 0.01 ),but there was no significant difference in prothrombin time and platelet count before and after treatment in treatment group (P ＞ 0.05).ConclusionsIt is safe and effective in cardiopulmonary resuscitation with low dose of UK combined with low molecular heparin calcium.

ObjectiveTo investigate the expression of CXCR4 and CD133mRNA in primary lesion of primary gastric adenocarcinoma and the relation with clinicopathological features,and to explore the correlation of CXCR4 and CD133.MethodsThe primary lesion of primary gastric adenocarcinoma and normal tissues adjacent to gastric cancer were obtained from 50 patients.The diction of CXCR4 and CD133 protein expression was detected by the immunohistochemical staining,and the relative gray scale values of CXCR4 and CD133mRNA by semi-quantitative RT-PCR (Fisher' s exact probability method).Their relationship with clinicopathological features was also investigated ( Spearman relation analysis).ResultsThe positive rates of CXCR4 and CD133 protein in gastric cancers were 76.0％ and 66.0％ respectively,which were significantly higher than that in normal tissues adjacent to gastric cancer ( 16.0％ and 10％ ; P =0.000,P =0.000).The increment of relative gray scale values of CXCR4mRNA was associated with the larger tumor diameter,the later TNM stage and the occurrence of lymphatic metastasis( P ＜ 0.05 ).And the larger diameter of tumor,the later TNM stage were associated with the higher relative gray scale values of CD133mRNA (P ＜0.05).The levels of the relative gray scale values of CXCR4 mRNA and CD133mRNA were positively related(r =0.453,P ＜ 0.01 ).ConclusionsThe higher expression of CXCR4 and CD133mRNA correlateswith tumour diameter,TNM stage and lymphatic vessel invasion. The relative gray scale values of CD133mRNA increase with the increment of the relative gray scale values of CXCR4.

Objective To investigate the application value of modified early warning score (MEWS) for assessment of patients in pre hospital first aid.Methods For patients with MEWS method in 3 478 cases of pre hospital first aid,scored in 0-4,5-9 and ≥ 10 points.Analysis of the relationship between the distribution and severity in patients with different grades,and tracing the fate and the condition of patients after admission.Results In MEWS patients with low 0-4 points was divided into pre hospital first aid,accounted for 69.18％ (2 406/3 478),severe cases accounted for 2.58％ (62/2 406); MEWS 5-9 accounted for 21.54％ (749/3 478),severe patients increased to 37.92％ (284/749); MEWS ≥ 10 points accounted for only 9.29％ (323/3 478),severe patients increased to 87.00％ (281/323).MEWS scores higher ratio in patients with severe more,MEWS 5-9 points,severe patients with MEWS ≥ 10 points 0-4 critical patients proportion (P ＜ 0.01).MEWS 5-9 points,≥ 10 points patients admitted to a specialist ward and intensive care units treatment compared with MEWS 0-4 points patients increased significandy (P ＜ 0.01),the mortality rate was also significandy increased (P ＜ 0.01).Conclusion The MEWS method in pre hospital first aid to early warning of potential in critically ill patients,the higher score,the more serious condition,the higher mortality rate.

Liver fibrosis is a necessary stage in the development of chronic liver diseases to liver cirrhosis. Liver cirrhosis is the end-stage change of various chronic liver diseases, and early diagnosis of liver fibrosis has an important value in timely treatment and prognosis. At present, liver biopsy, ultrasound, computed tomography, and magnetic resonance imaging are the main diagnostic methods for liver fibrosis and cirrhosis. Liver biopsy is the gold standard for the diagnosis of liver fibrosis and cirrhosis, but its clinical application is limited by invasiveness and sample error. Conventional noninvasive methods cannot meet the requirements for the diagnosis of liver fibrosis and cirrhosis. Therefore, searching for new serological markers for liver fibrosis and cirrhosis has become a research hotspot. Related studies have shown that serum Golgi protein 73 (GP73) can be used as a serum marker for the diagnosis of liver fibrosis and cirrhosis and has high clinical value. This article reviews the commonly used methods for the diagnosis of liver fibrosis and cirrhosis and elaborates on the biological characteristics of GP73 and its value in the diagnosis of liver fibrosis and cirrhosis.

Objective:To study the characteristics of the lens turbidity after long-term exposure to low intensity 635nm laser.Methods:Cluster sampling method was adopted to select 812 employees in a laser leveler workshop in a city of Guangdong Province from January 2014 to December 2018. They were divided into the control group, diffuse reflection (DR) group and direct vision (DV) group for retrospective observation and analysis of lens turbidity. The laser irradiation intensity of each group was investigated, the position and shape of lens opacity were analyzed, and the influencing factors were statistically analyzed with the repeated measurement data of dichotomy.Results:The laser irradiance and radiant exposure of DV group were between 0.72×10 -4 and 9.92×10 -4 mW/cm 2 and between 2.61×10 -2 and 1.53 J/cm 2, respectively. The subjects were mainly diagnosed with lens turbidity lesion, especially for the DV group. Most of lesions occurred in the pole and periphery of the anterior cortex. The lesions exhibited multipoint patterns with greyish white color. The turbidity rates in DV group (before work and work for 1, 2, 3 years) were 0%, 1.99% (8/402) , 4.98% (20/402) and 6.72% (27/402) , respectively, in the order of observation points. The statistical analysis of single factor effect showed that the turbidity rate was higher in DV group and higher in the second year in the DV group ( P<0.01) . Multi-factor analysis of the laser effect on the lens showed that the main effect between groups, between the observation point were statistically significant ( P<0.05) , but no statistical significance in the interaction between group×observation points ( P>0.05) . Conclusion:Lens turbidity lesion can be caused by long-term exposure to low intensity 635 nm laser, so the product safety classification should be strictly strengthened. It is necessary to strengthen the protection of laser photochemical damage in the production process.

Epiphyseal plate injury in children is very common, which can be caused by fracture, infection, malignant tumors, iatrogenic injury or other causes.Growth arrest and angulation or rotation deformity after epiphyseal plate injury would seriously affect the physical and mental health of children.At present, the success rate of bone bridge resection combined with corresponding material filling is super low.The construction of bioactive epiphyseal cartilage using cartilage tissue engineering technology has become a new research direction for the treatment of epiphyseal plate injury in children.Therefore, this review focuses on the current research on the regeneration of epiphyseal cartilage from the perspective of 3 elements of tissue engineering: seed cells, growth factors, and tissue engineering scaffolds.

Objective:To study the characteristics of the lens turbidity after long-term exposure to low intensity 635nm laser.Methods:Cluster sampling method was adopted to select 812 employees in a laser leveler workshop in a city of Guangdong Province from January 2014 to December 2018. They were divided into the control group, diffuse reflection (DR) group and direct vision (DV) group for retrospective observation and analysis of lens turbidity. The laser irradiation intensity of each group was investigated, the position and shape of lens opacity were analyzed, and the influencing factors were statistically analyzed with the repeated measurement data of dichotomy.Results:The laser irradiance and radiant exposure of DV group were between 0.72×10 -4 and 9.92×10 -4 mW/cm 2 and between 2.61×10 -2 and 1.53 J/cm 2, respectively. The subjects were mainly diagnosed with lens turbidity lesion, especially for the DV group. Most of lesions occurred in the pole and periphery of the anterior cortex. The lesions exhibited multipoint patterns with greyish white color. The turbidity rates in DV group (before work and work for 1, 2, 3 years) were 0%, 1.99% (8/402) , 4.98% (20/402) and 6.72% (27/402) , respectively, in the order of observation points. The statistical analysis of single factor effect showed that the turbidity rate was higher in DV group and higher in the second year in the DV group ( P<0.01) . Multi-factor analysis of the laser effect on the lens showed that the main effect between groups, between the observation point were statistically significant ( P<0.05) , but no statistical significance in the interaction between group×observation points ( P>0.05) . Conclusion:Lens turbidity lesion can be caused by long-term exposure to low intensity 635 nm laser, so the product safety classification should be strictly strengthened. It is necessary to strengthen the protection of laser photochemical damage in the production process.

Objective:To carry out a scoping review on the development process, main forms, main contents and outcome indicators of decision aids for thyroid cancer patients, providing a theoretical basis for future research in China.Methods:The Arksey and O'Malley's methodological framework was used to analyze the literature. Electronic retrieval was conducted in PubMed, Cochrane Library, Embase, Web of Science, CINAHL, China National Knowledge Infrastructure, WanFang Data, VIP, and China Biomedical Database, and the search period was from database establishment to August 21, 2023.Results:A total of 11 articles were included. The forms of decision aids included paper decision support manuals, web-based decision support tools, conversation support tools and so on. The main content was to provide disease knowledge and the advantages and disadvantages of various treatment plans, help patients clarify their values, understand patient preferences, and assist doctors and patients make decisions. Outcome indicators involved treatment choice, medical knowledge, decision conflict, decision regret, decision satisfaction, anxiety and so on.Conclusions:The application of decision aids has a positive effect in thyroid cancer patients. Future research should encourage many people to participate in decision-making in order to improve the quality of decision-making for thyroid cancer patients.

Objective To understand the clinical outcomes of frozen embryo transfer and fresh embryo transfer.Methods A retrospective analysis was conducted on the clinical data of 870 cases receiving embryo transfer at the Reproductive Medical Center of Sun Yat-Sen Memorial Hospital from January 2013 to March 2014,including 577 cases of in vitro fertilization and fresh embryo transfer,118 cases of intracytoplasmic sperm injection and fresh embryo transfer and 175 cases of frozen thawed embryo transfer,to compare the clinical characteristics and outcomes between fresh embryo transfer group and frozen embryo transfer group (the patients who had received unsuccessful fresh embryo transfer).The frozen embryo transfer group was divided into pregnant subgroup and non pregnant subgroup to further comparison.Binary logistic regression analyses was performed to identify the influencing factors of pregnancy.Results The implantation rate and clinical pregnancy rate were significantly lower in frozen embryo transfer group than in fresh embryo transfer group (26.27％ vs.31.98％,P=0.01 and 47.43％ vs.65.18％,P＜0.001).The differences in abortion rate,biochemical pregnancy rate and fetal birth weight had no statistical significance between the two groups (P=0.63,P=0.17 and P=0.33).The difference in age between pregnant subgroup and non pregnant subgroup was statistical significant (30.69 ± 3.37 years vs.32.00 ± 5.09 years,P=0.03),but no significant differences were found in BMI,duration of infertility and basic endocrine between the two subgroups.Binary logistic regression analysis showed that receiving frozen embryo transfer or not (P＜0.001),wife's age (P＜0.001),BMI (P=0.011) and number of top quality embryos (P＜0.001) were influencing factors of pregnancy.Conclusion Lower implantation rate and clinical pregnancy rate was observed in the patients in frozen embryo transfer group,who had received unsuccessful fresh embryo transfer,but no increase of abortion rate,influence on fetal birth weight and adverse pregnancy outcome were observed.

Objective To construct and validate an effective prognostic nomogram for the patients with incidental gallbladder cancer(IGBC).Methods The clinical data of 161 patients with IGBC requiring radical surgery admitted to the First Affiliated Hospital of Xi'an Jiaotong University from May 2011 to October 2022 was analyzed retrospectively.COX proportional risk regression model was used to screen for influencing factors on overall survival(OS)of IGBC.Nomogram was constructed based on independent influencing factors that affected the prognosis of IGBC patients.The concordance index(C-index)and calibration curve were used to validate the performance of the model.Receiver operating characteristic(ROC)curve analysis and decision curve analysis(DCA)were used to validate the predictive accuracy and net benefit of the plotted column chart.Results Univariate COX regression analysis suggested that age,T stage,N stage,M stage,preoperative carcinoembryonic antigen(CEA),preoperative carbohydrate antigenl9-9(CA19-9),preoperative red blood cell volume distribution on width coefficient of variation(RDW-CV),treatment method,and recurrence and metastasis were risk factors which affected the long-term survival of IGBC patients after radical surgery.Multivariate COX regression analysis suggested that T stage,N stage,preoperative CA19-9,preoperative RDW-CV,preoperative AST,treatment methods,and recurrence and metastasis were independent risk factors which affected the prognosis of IGBC patients.The C-index of the constructed prognostic model was 0.872.The calibration plot demonstrated good performance of the Nomogram.ROC curve analysis showed an area under the curve of 0.869,confirming a high sensitivity and specificity.A high net benefit was proven by DCA.Conclusions The constructed Nomogram.can accurately and intuitively predict the survival probability of IGBC patients after radical surgery.