Objective To investigate the contents of cytokeratin fragment 21-1 (CYFRA21-1),cancer antigen-153(CA153) and neuron-specific enolase (NSE)in patients wuth lung cancer. Methods 60 cases with lung cancer using single and combined determination serum CYFRA21-1, CA153 and NSE levels by radioimmunoassay (RIA). Results The contents of CYFRA21-1 ,CA125 and NSE in lung cancer were significantly higher than the control group(t = 2.811,2.845,2.901,2.795,2.759,2.811,2. 852,2.799,2. 816, all P ＜ 0. 01); The content of CYFRA21-1 in squamous cell carcinoma were higher than that small cell undifferentiated carcinoma(t = 2. 214, P ＜0. 05) ;The content of NSE in squamous cell carcinoma group were lower than small cell undifferentiated carcinoma (t = 2.312,P ＜ 0.05) ;The content of CA125 in adeno-carcinoma were higher than the higher squamous cell carcinoma scales cancer(t = 2. 177, P ＜ 0. 05); The positive rate of combined detection of CYFRA21-1 + CA153 + NSE (86. 4%)was significantly higher than the single test(x2 =3.786,P ＜0.05) ;The combined detection of sensitivity and negative predictive value was significantly higher than single detection (x2 = 3. 846,3. 877, all P ＜ 0. 05).Conclusion The combined determination could make up for missed diagnosis, and had some clinical value.

In recent years,gut microecology has attracted increasing attention because of its close relationship with the development and pro-gression of various liver diseases and associated complications.The impairment of liver function can disturb gut microecology,whereas the imbalance in gut microecology in turn promotes the aggravation of liver diseases.This paper reviews the relationship between gut microecolo-gy and various liver diseases,and discusses the role of modulating gut microecology in the treatment of liver diseases.A new idea is provided for the prevention and treatment of liver diseases based on the modulation of gut microecology.

SUMMARY Breastfeeding has been recognized as the most natural and nutritious way of feeding babies . Besides the nutritional , immunological and emotional benefits , breastfeeding promotes a healthy stomatog-nathic system .First of all, the nutrients and minerals in maternal milk are easy to be absorbed by the infants, which contributes to the mineralization of the teeth , and suppress the propagation of bacteria on the teeth.Though the jury is still out on whether breastfeeding can prevent Early Childhood Caries (ECC), it is definite that we should pay attention to feeding at night and the oral hygiene of the babies . Secondly , the method of feeding is closely bound up with the development of dentition and jaw .Breast-and bottle-feeding involve different orofacial muscles , which possibly have different effects on the harmo-nic growth of maxilla and dental arches .Meanwhile , breathing , swallowing and mastication should be developing in harmony , and differences exist in the learning of the coordinated movement between breast feeding and bottle feeding children .Bottle feeding had been proved to be closely related with the non-nutritive sucking habits which can cause malocclusion .At last, it should be pointed out that breast fee-ding should be the only feeding source in the first 6 months of life, then supplementary foods should be added .And prolonged bottle feeding should be avoided .We can see that breast feeding is definitely good for the infants , but the reality is not optimistic in our country .

OBJECTIVE:To systematically review the efficacy of α-lipoic acid versus epalrestat in the treatment of diabetic pe-ripheral neuropathy(DPN),and provide evidence-based reference for clinic. METHODS:Retrieved from CJFD,CBM,VIP,Wan-fang Database and PubMed,randomized controlled trials(RCT)about α-lipoic acid versus epalrestat in the treatment of DPN were collected,and the study was screened by inclusion and exclusion criteria. Meta-analysis was performed by using Rev Man 5.3 soft-ware after data extraction and quality evaluation by Cochrane software. RESULTS:Totally 6 RCTs were enrolled,involving 408 pa-tients. Results of Meta-analysis showed,compared with epalrestat,there were no significant differences in the total effective rate [RR=0.98,95%Cl(0.84,1.15),P=0.81],motor nerve conduction velocity [median nerve:MD=1.02,95%Cl(-1.10,3.14),P=0.34;common peroneal nerve:MD=0.23,95%Cl(-1.11,1.58),P=0.73] and sensory nerve conduction velocity [median nerve:MD=1.10,95%Cl(-0.39,2.59),P=0.15;common peroneal nerve:MD=0.95,95%Cl(-1.47,3.36),P=0.44] in α-lipoic acid group. CONCLUSIONS:The efficacy of α-lipoic acid is similar to epalrestat in the treatment of DPN,as well as the motor nerve conduction velocity and sensory nerve conduction velocity of median nerve or common peroneal nerve.

AIM: To study the dynamic expression of protease - activated receptors - 1 (PAR- 1 ) after intracerebral hemorrhage (ICH) and the influence of Nao Xue Kang Tablet (NXKT) on it's expression. METHODS: 72 Wistar rats were divided into normal group, ICH model groups (ICH, 6 h, 24 h, 3 d, 7 d), Nao Xue Kang groups (NXKT, 6 h, 24 h, 3 d,7 d).ICH models were produced with the induction of collagenase typeⅦ - S, except normal group. Immunohistochemical method was used to detect PAR- 1 protein and RT- PCR technique was used to detect PAR- 1 mRNA in brain tissues around the haematoma at different time points of different groups. RESULTS: PAR - 1 protein and mRNA were mildly positive in normal group. In ICH model groups, intensity of PAR - 1 expression started to increase at 6 h, and further increased at 24 h. PAR - 1 expression reached the peak at 3 d and began to descend. At 7 d the decent was obvious. At 6 h, 24 h, 3 d, and 7 d time points, the PAR-1 protein positive cell number and PAR- 1 mRNA absorbance ratio in ICH model and NXKT groups were significantly higher than those in normal group ( P ＜0.05 or P ＜ 0.01). The PAR- 1 protein positive cell number and PAR- 1 mRNA absorbance ratio in NXKT group were significantly lower than in ICH model group ( P ＜ 0.05 or P ＜ 0.01 ). CONCLUSION: After ICH,PAR - 1 is continuously activated because of the stimulation of thrombin. Action of thrombin after ICH may be mediated by PAR- 1; NXKT may inhibit the activation of PAR- 1, so the praxiology is improved. This may be one of the main mechanisms that NXKT could facilitate the recovery of nervous function.

OBJECTIVE:To prepare adriamycin-loaded PLGA-PLL-PEG nanoparticles,and study its antitumor activity. METH-ODS:PLGA-PLL-PEG with the polymerization of PLGA-PLL and activated polyethylene glycol was used as carrier for adriamy-cin,and adriamycin-loaded PLGA-PLL-PEG nanoparticles were prepared. The shape size,particle size distribution,adriamycin con-tent of nanoparticles were detected,drug loading and encapsulation efficiency were calculated. Cumulative release rate (Q) of nanoparticles and adriamycin within 144 h and its proliferation inhibition rate on breast cancer HeLa cells were compared,and half inhibitory rate (IC50) was calculated. RESULTS:Prepared adriamycin-loaded PLGA-PLL-PEG nanoparticles were regular circular with good dispersion and no adhesion. The average particle size was (136.7 ± 9.3) nm (n=5),average encapsulation efficiency was(76.67±8.63)%,average drug loading was(3.86±0.55)%(n=3). Q12 h of adriamycin had reached 100%;Q12 h of adriamy-cin-loaded PLGA-PLL-PEG nanoparticles was 52.9%,Q144 h was 81.2%. The inhibitory rate of adriamycin-loaded PLGA-PLL-PEG nanoparticles on HeLa cells increased slowly than adriamycin;IC50 were 1.844,0.345 μg/mL,respectively. CONCLUSIONS:Adri-amycin-loaded PLGA-PLL-PEG nanoparticles are prepared successfully,showing good sustained-release effect and more significant inhibitory effect than adriamycin.

AIM: To study the dynamic expression of protease-activated receptors-1 (PAR-1) after intracerebral hemorrhage (ICH) and the influence of Nao Xue Kang Tablet (NXKT) on it's expression. METHODS: 72 Wistar rats were divided into normal group, ICH model groups (ICH, 6 h, 24 h, 3 d, 7 d), Nao Xue Kang groups (NXKT, 6 h, 24 h, 3 d,7 d). ICH models were produced with the induction of collagenase typeⅦ-S, except normal group. Immunohistochemical method was used to detect PAR-1 protein and RT-PCR technique was used to detect PAR-1 mRNA in brain tissues around the haematoma at different time points of different groups. RESULTS: PAR-1 protein and mRNA were mildly positive in normal group. In ICH model groups, intensity of PAR-1 expression started to increase at 6 h, and further increased at 24 h. PAR-1 expression reached the peak at 3 d and began to descend. At 7 d the decent was obvious. At 6 h, 24 h, 3 d, and 7 d time points, the PAR-1 protein positive cell number and PAR-1 mRNA absorbance ratio in ICH model and NXKT groups were significantly higher than those in normal group (P

Objective To investigate the predictive value of red cell volume distribution width RDW),RDW to platelet ratio (RPR),aspartate aminotransferase (AST) to platelet ratio index APRI),fibrosis index based on the 4 factor (FIB-4) and aspartate-alanine aminotransferase ratio (AAR) in assessing esophageal varices (EV) in patients with hepatitis B virus (HBV)-related cirrhosis.Methods Between December 2013 and July 2015,a total of 190 patients with HBV-related cirrhosis and no previous history of endoscopic therapy for EV hospitalized at the Department of Hepatology,Tianjin Third Central Hospital were enrolled.Upper gastrointestinal endoscopy were conducted in all patients to diagnose EV.According to the morphology and degree of EV as well as bleeding risk,patients were categorized into mild,moderate and severe stages.RDW,platelet counts,alanine aminotransferase,aspartate aminotransferase were tested,and RPR,APRI,FIB-4,AAR were calculated.Spearman correlation was used to evaluate the association between EV and these indexes.Receive operating characteristic (ROC) curves were generated and the areas under the curves (AUC) were calculated to assess the performance of these indexes in predicting esophageal varices bleeding (EVB).Results RDW ([16.78±2.27]％),RPR (0.41±0.18),FIB4 (8.99±5.91),APRI (2.09[1.35,2.90]) in patients with EVB were all significantly higher than those ([14.37±1.86]％,t=-7.449;0.19±0.09 [t=-8.132];5.72±3.92 [t=-3.658];1.29 [0.70,2.39;z=-2.996]) without EVB (all P＜0.05).However,AAR had no statistical significance between two groups (t =1.216,P=0.226).Both of EV and EVB had positive correlation with RDW,RPR,FIB-4 and APRI (all P＜0.05) and no correlation withAAR(P＞0.05).RDW (F=9.604),RPR (F=47.530),FIB-4 (F=18.071) and APRI (H=12.320) showed statistically significant differences among patients with different stages of EV (all P＜0.05),whereas AAR showed no difference (F=1.177,P=0.320).The AUC of RPR (0.896) for EVB was highest,followed by RDW (0.824,P＜0.05).AUC of FIB-4 and APRI was 0.690 and 0.642,respectively,with no statistical difference (P＞0.05).The optimal cut-off levels of RDW,RPR,FIB-4 and APRI were 14.450 (sensitivity:88.24％,specificity:64.03％),0.209 (sensitivity:96.10％,specificity:69.10％),6.912 (sensitivity:66.67％,specificity:73.38％) and 1.338 (sensitivity:76.47％,specificity:51.08％),respectively.Conclusions RPR and RDW are closely correlated with EV in HBV-related cirrhotic patients,which are of clinical importance in predicting EVB.Both of them can be used as clinical screening methods and RPR may be superior to RDW.Although FIB-4 and APRI are correlated with EV,their predictive value of EBV are low.

Objective To assess the quality of life (QoL) of rural elderly persons using the health-related dimensions of the EuroQol-5 (EQ-5D) scale to analyze the scale's reliability and validity.Methods A total of 2575 elderly residents of Tongchun rural community in Kaihua county,Zhejiang Province,were surveyed using the instrument EQ-5D,and the visual analogue scale of EQ.They included 1027 with and 1548 without chronic disease.Results The mean total EQ-5D score was 6.49 ± 1.94 for the chronic disease group and 5.15 ± 0.44 for the healthy group.The corresponding average visual analogue scale (VAS) scores were 78.15 ± 17.26 and 91.47 ± 4.37,showing significant differences.About 75％ of the elderly respondents reported no difficulties in their living.There was strong correlation between the EQ-VAS scores and the scores on all the EQ-5D scale dimensions.Conclusion The health-related quality of life reported by the rural elderly using this scale seems quite good.The EQ-5D scale,with the EQ-VAS scale as a part of it,is one useful and effective tool for evaluating the health-related quality of life of the elderly in rural areas.

Objective To evaluate the efficacy and safety of helmet delivered continuous positive airway pressure (Helmet-CPAP)for hypoxemia in airway extubated patients after cardiac surgery.Methods 120 adult patients in ICU from March 2014 to July 2015,who were after cardiac surgery,were enrolled.These patients who suffered hypoxemia within 48 hours after extubation,defined as that PaO2/FiO2 with oxygen mask could not reach 200,were divided into two groups.In the control group high concentration oxygen therapy with mask was delivered,while helmet-CPAP was delivered in the experimental group.Treatment duration was 6 hours.Results Helmet-CPAP significantly improved PaO2/FiO2 (144.35 ± 24.43 vs.201.35 ± 52.97,P ＜ 0.05) and left ventricular ejection fractions(0.5383 ± 0.0844 vs.0.5540 ± 0.0844,P ＜ 0.05).Breathing rate (22.60±5.08 vs.18.53 ±4.13,P＜0.05),heart rate(102.72±17.9 vs.95.15 ±13.79,P＜0.05)and shock index (0.85 ± 0.35 vs.0.75 ± 0.15,P ＜ 0.05) were significantly lower.The rate of using mechanical ventilation (6.67％ vs.28.33％,P ＜ 0.05) and length of ICU stay[41.0(25.0,67.5) hours vs.49.5 (32.5,90.8) hours,P ＜ 0.05] was significantly less than control group.Conclusion Helmet delivered continuous positive airway pressure is an effective and safe treatment for hypoxemia in airway extubated patients after cardiac surgery.