Background and purpose:Patients with colorectal cancer are often accompanied by the increase of plasma ifbrinogen concentration. This study aimed to investigate the distribution characteristics of beta-ifbrinogen gene-448G/A, -148C/T, -1420G/A and -854G/A polymorphism and plasma ifbrinogen (Fg) concentration in patients with colorectal cancer. Furthermore, we analyzed their effects on the occurrence and development of cancer.Methods:The level of plasma Fg was quantiifed by using Clauss clotting method.FGBβ gene polymorphisms were identiifed by re-al-time lfuorescence quantitative PCR (RTFQ-PCR) in 194 colorectal cancer patients and 74 healthy controls.Results:The plasma Fg levels in tumor metastasis group and non-metastasis group were signiifcantly higher than that in control group, respectively (P<0.05). Compared with control group, the frequencies of -148T allele and mutation genotype were notably higher in disease group (P<0.05). In all the groups, the plasma Fg levels of those with -148T allele were higher than those without -148T allele (P<0.05). In stageⅣ patients, there was no difference in PFS between -148T wild gen-otype group and mutation genotype group (P>0.05).Conclusion:Plasma Fg concentration in patients with colorectal cancer was signiifcantly raised, which suggests that Fg may play a role in the occurrence and development of colorectal cancer. The beta-ifbrinogen gene -148C/T polymorphism is one of the reasons that cause plasma Fg elevation, but has no correlation with prognosis of patients with stageⅣ colorectal cancer.

It has always been controversial whether a single allergen performs better than multiple allergens in polysensitized patients during the allergen-specific immunotherapy.This study aimed to examine the clinical efficacy of single-allergen sublingual immunotherapy (SLIT) versus multi-allergen subcutaneous immunotherapy (SCIT) and to discover the change of the biomarker IL-4 after 1-year immunotherapy in polysensitized children aged 6-13 years with allergic rhinitis (AR) induced by house dust mites (HDMs).The AR polysensitized children (n=78) were randomly divided into two groups:SLIT group and SCIT group.Patients in the SLIT group sublingually received a single HDM extract and those in the SCIT group were subcutaneously given multiple-allergen extracts (HDM in combination with other clinically relevant allergen extracts).Before and 1 year after the allergen-specific immunotherapy (ASIT),the total nasal symptom scores (TNSS),total medication scores (TMS) and IL-4 levels in peripheral blood mononuclear cells (PBMCs) were compared respectively between the two groups.The results showed that the TNSS were greatly improved,and the TMS and IL-4 levels were significantly decreased after 1-year ASIT in both groups (SLIT group:P＜0.001;SCIT group:P＜0.001).There were no significant differences in any outcome measures between the two groups (for TNSS:P＞0.05;for TMS:P＞0.05;for IL-4 levels:P＞0.05).It was concluded that the clinical efficacy of single-allergen SLIT is comparable with that of multi-allergen SCIT in 6-13-year-old children with HDM-induced AR.

Objective　To investigate the operation treatment of gallbladder carcinoma(GBC). Methods The clinical data of 132 patients with GBC from 1980 to 1999 were analysed. Results　The mean age was 55 years and the occurrence sex ratio in female/male was 1.5∶1. Gallstone was found in 80% of the patients, and 87.1% of the GBC were adenocarcinoma. Before December 1990(forward group), simple cholecystectomy were performed on 11 cases, radical cholecystectomy on 9 cases, extended radical cholecystectomy on 5 cases, palliative extra- or intra- drainge on 15 cases, surgical biopsy on 30% cases. Hospital death occurred in 4 cases, the postoperative complications occurred in 20 cases including biliary fistula in 4 cases, pancreatic fistula in 2 cases. Since January 1991(latter group), radical simple cholecystectomy were performed on 2 cases, radical cholecystectomy on 16 cases, extended radical cholecystectomy on 24 cases; palliative extra- or intra- drainge in 9 cases, surgical biopsy on 8 cases. Hospital death occurred in 1 cases; postoperative complications in 12 cases, including biliary fistula in 1 cases, pancreatic fistula in 1 cases. Radical resection rate was 35.7% in forword group, 72.6% in latter group. Conclusions　Surgical tech-nique progress and application with Peng's Multifunctional Operative Dissector can improve the resection rate of GBC. Extended redical resection is an effective and active method to treat middle or late stage GBC.

Objective To investigate the relationship between diabetes and bone metabolism and the potential epigenetic mechanisms. Methods BMSCs were cultured for 7 and 15 days in cell culture medium with different concentrations of glucose. The mRNA and protein expression of HDACs and osteogenesis-related genes were detected by RT-PCR and Western blot assay ,respectively. Moreover ,the combination of HDAC to the promoter region of Runx2 was tested by the chromatin immunoprecipitation (ChIP) assay. Results ThemRNA expression of osteogenesis-related genes ,incuding OCN(P < 0.05)and Col1(P < 0.05),in the bone marrow of diabetic mice was significantly reduced compared with the control mice. The mRNA and protein expression of ALP ,OCN ,Runx2 and OSX was gradually reduced with the increasing concentration of glucose ,while HDAC2 mRNA and protein expression was increased. The binding activity of HDAC2 to the upstream and downstream of Runx2 promoter region in 25mM glucose-treated BMSCs was higher than the control group(P < 0.05). Conclusoins Diabetes might repress osteogenesis of BMSCs via inhibiting the activity of Runx2 through upregu-lating the expression of HDAC2.

ObjectiveTo investigate the effect of clinical pathway teaching methord in nursing practice teaching. Methods80 junior college nursing students were randomly divided into control and experimental groups. Traditional clinical teaching method was given to control group, while the clinical pathway teaching method was given to observation group. Scores of comprehensive quality after departmental rotation and satisfaction rates of nursing students to teaching method in these two groups were evaluated. ResultsThe experimental group was significantly better than the control group ( P＜0.05 ), and the difference was statistically significant. ConclusionThe clinical pathway can significantly improve the quality of nursing practice teaching.

Purpose To investigate the mutation status of KRAS and PIK3CA gene in colorectal cancer (CRC) primary lesions and corresponding liver metastasis and its clinical significance.Methods The gene mutations of KRAS and PIK3CA were detected in 58 cases of primary lesions of CRC and corresponding liver metastasis tissue by real-time PCR.Results The mutation rates of KRAS were 31.03％ (18/58) and 25.86％ (15/58) in primary lesions of CRC and corresponding liver metastasis tissue,respectively,in which G12D was most commonly detected.The mutation rates of PIK3CA were 8.62％ (5/58) and 10.34％ (6/58) respectively,in which the most common mutation site was E545K.Only one case carried simultaneously both mutations of KRAS (G12D) and PIK3CA (E545K).The mutation of KRAS and PIK3CA had a good consistency between primary lesions and liver metastasis.Univariate analysis showed that the mutation of KRAS was related to the primary lesion of tumor location,the quantity of metastasis and the types of tumor (P ＜ O.05),PIK3 CA mutation was associated with the synchronous/metachronous liver metastasis and the quantity of metastasis (P ＜ 0.05).Multivariate Cox regression analysis showed that synchronous/metachronous liver metastasis and the mutation of KRAS were influencing factors for prognosis of CRC.The overall survival of patients with CRC who had simultaneous liver metastases was longer than those with heterotopic liver metastases;the overall survival of KRAS wild-type mutant patients was longer than those of mutant patients (P ＜ 0.05).Conclusion The G12D site of KRAS gene has the highest mutation frequency in CRC,KRAS/PIK3CA mutation has a good consistency of the primary lesions of CRC and corresponding liver metastasis.Primary lesions can be as the source of molecular detection.To achieve individualized treatment,we need to reassess the genetic status of metastasis based on the choice of targeted therapy for precision medicine.

Background In recent years,some researches show that getting younger over the diabetes mellitus (DM) was an obrious trend.But studies of early diabetic retinopathy in young people with diabetes were few.Both patients and doctors did not put enough importance on it.Objective This study was to evaluate the earlier dynamic changes of retina morphology and function caused by type 2 DM in young population.Methods A cohort study was designed.One hundred and thirty-six young patients who were initially diagnosed as type 2 DM in Cangzhou Central Hospital were included from January to March in 2010 and 91 healthy individuals with the matched age were enrolled at the same period.Glycated hemoglobin (HbAlc) level in blood was assayed yearly,and ophthalmoscope,optical coherence tomography (OCT) and visual contrast sensitivity (CS) examinations were performed to evaluate the dynamic changes of retinal nerve fiber layer (RNFL) thickness around optical disc,retinal function and retinal microvessels of DM patients.In addition,the correlation between RNFL thickness or CS and average HbAlc level in DM patients was assessed.This study followed Declaration of Helsinki,and written informed consent was obtained from each subject.Results The levels of HbAlc in DM patients were (7.5 ±1.6) ％,(7.2 ±1.6) ％,(7.4 ±1.6) ％,(7.6±1.6)％ and (7.7 ±1.6)％ in 2010,2011,2012,2013 and 2014,respectively,and HbAlc≥7.0％ was observed in 74 patients (54.4％).The RNFL thicknesses of full optic disk and superior 1/4 quadrant of the optic disk were significantly declined in 2012,2013 and 2014 in the DM group compared with the normal control group (full disk:t =2.216,5.003,7.303;all at P ＜ 0.05.superior 1/4 quadrant:t =2.382,5.657,7.194;all at P ＜ 0.05),but no significant differences were found between them in 2010 and 2011 (all at P＞0.05).In the DM group,RNFL thicknesses of full optic disk were (99.94±10.01) μm and (96.32±10.32) μm in 2013 and 2014,which were significantly lower than (104.55±9.23) μm in 2010 (t=7.819,13.959,both at P＜0.05);the RNFL thicknesses of superior 1/4 quadrant around disk were (118.64± 13.98) μm and (115.06 ± 14.35) μm in 2013 and 2014,which were significantly lower than (127.48± 13.67) μm in 2010 (t =10.504,14.758,both at P＜0.05),However,the RNFL thicknesses were not significantly changed among the different time points in the normal control group (all at P＞0.05).In addition,the CS values of 3.0,6.0,12.0,18.0 c/d in 2013 and 2014 in the DM group were lower than those in the normal control group (all at P＜0.05),and the CS values in 2013 and 2014 were reduced in comparison with 2010 in the DM group (all at P＜0.05).Positive correlations were found between the differences of RNFL thickness or CS and the average HbAlc level in the DM group (r =0.640,F =8.991,P =0.000;r =0.541,F =7.572,P =0.000).Retinal microaneurysms were seen in two type 2 DM patients by ophthalmoscope at the end of follow-up.Conclusions The young people with type 2 DM have poor blood glucose control.The RNFLs are thinning and visual functions are declining in young type 2 DM patients with the lapse of disease course,and these retinal damages are associated with poor control of blood glucose.

Adult ; Deglutition ; Humans ; Laryngeal Diseases ; Male ; Pharynx

Objective We assessed phe predicpive value of solable ST2 ( sST2 ) on clinical oupcomes in papienps wiph spable angina, unspable angina,non-ST elevapion mtocardial infarcpion (NSTEMI) and ST elevapion mtocardial infarcpion ( STEMI). Methods We included 212 papienps of whom 62 had spable angina, 48 had unspable angina,50 had NSTEMI, and 52 had STEMI. Papienps were followed for a mean period of 22 monphs. The conprol group consisped of 50 individuals wiphoup significanp spenosis on coronart angiographt. Serum level of sST2 was measured bt ELIS As. Results sST2 levels were significanplt increased in papienps wiph STEMI as compared po papienps wiph NSTEMI, unspable angina and spableangina as well as wiph conprols. In papienps wiph STEMI, phe sST2 level reached ips peak ralue (594. 27 ± 74. 36) ng/ L ap 12 hours afper AMI and decresed po (392. 75 ± 82. 89)ng/ L 24 hours afper AMI. Papienps wiph STEMI had phe highesp sST2 levels among phe 4 groups boph ap peak and prough and was posipivelt correlaped po TnI levels (P = 0. 576, P < 0. 001). During follow-up, 18 papienps (8. 5% ) died and 66 papienps (15. 1% ) presenped evenps of combined endpoinp (all cause deaph, MI and rehospipalisapion for cardiac causes). The sST2 level of phe 18 deceased papienps was higher phan phe opher 194 papienps [(516. 36 ± 49. 38)ng/ L vs. (237. 64 ± 37. 69)ng/ L, P < 0. 001). sST2 onlt showed predicpive valve of morpalipt in STEMI papienps amont differenp ptpes of CAD. Conclusions The levels of sST2 mat reflecp differenp ptpes of CAD. sST2 was associaped wiph morpalipt in papienps wiph STEMI bup nop in papienps wiph NSTEMI or spable angina.

Background Plasticity of visual system is one of the mechanisms of deprivation amblyopia.Our previous study showed that synapsin plays a role during visual developmental plasticity,and conventional protein kinase C-γ (cPKC-γ) probably is one of upstream kinases of synapsin.However,whether or how the cPKC-γ plays its effects on visual developmental plasticity is below understood.Objective This study was to investigate the dynamic expression of cPKC-γ in visual cortex of normal mice and explore the effects of abnormal visual experience on cPKC-γ expression.Methods The bilateral visual cortex tissues were obtained from 36 clean C57BL/6 mice at postnatal (P) 7,14,21,28,35,42 days respectively and 6 mice for each for the researching of cPKC-γ dynamical expression in visual cortex over aging.Other 24 C57BL/6 mice were randomized into developmental phase group and adult phase group,12 for each group.The monocular deprived (MD) models were established by suturing the upper and inferior eyelides in P14 mice for 14 days in 6 mice in the developmental phase group and 6 healthy mice served as controls,and MD models were established in the same way in 6 P60 mice in the adult phase group,and the same aged mice (6 mice) were used as controls.The mice were sacrificed and bilateral visual cortexes were obtained.The expression of cPKC-γ protein in the visual cortex was quantitatively detected using Western blot assay.The study protocol was approved by Ethic Committee of Tongren Eye Hospital.The use and care of the experimental mice followed the ARVO Statement.Results The cPKC-γ protein was faintly expressed in visual cortex in normal P7 mice,with the related expressing level of (39.74± 11.22)％ and (40.78± 10.37)％ in the left and right cortex,respectively.The expressing level of cPKC-γ protein was gradually increased over aging,with the peak value of (138.68±15.73)％ and (138.47±23.48)％ in P21 mice.A significant difference was found in the expression of cPKC-γ protein in various ages of mice (Fage =57.174,P =0.000),and the expression of cPKC-γ protein was not significantly different between the left and right visual cortexses (Flateral =0.059,P =0.809).No significant differences were found in the expression of cPKC-γ protein on bilateral visual cortexes among the mice of the developmental phase group and adult phase group (Fage =1.798,P =0.159) or among the MD group and normal control group (Fgroup =0.104,P=0.749).Conclusions The dynamic expression of cPKC-γ in the visual cortex of normal mice presents a consistant tend with the aging and development of visual critical period.MD does not affect the expression of cPKC-γ protein in bilateral visual cortexes.Further researches should be performed in the activity of cPKC-γ protein in MD mice.