Objective To assess the role of the combination of Helicobacter pylori (H.polyri)antibody detection and serum pepsinogen (PG) examination (ABC method) in risk prediction of gastric cancer.Methods From July 2014 to July 2015,a total of 320 patients underwent gastroendoscopy examination because of stomach discomfort were enrolled.According to the results of serum H.polyri antibody test,PG Ⅰ and PG Ⅰ/PG Ⅱ ratio (PGR),patients were divided into four groups:group A was both H.polyri and PG negative,group B was H.polyri positive and PG negative,group C was both H.polyri and PG positive,group D was H.polyri negative and PG positive.The incidence rates of gastric cancer were compared among the groups.PG positive was defined as PG Ⅰ ≤70 μg/L and PGR≤3.0.And according to the results of gastroendoscopy examination and histopathology,the levels of gastrin 17,PG Ⅰ,PG Ⅱ and PGR of different atrophic regions with different pathological changes and atrophic degree were compared.Chi-square test and analysis of variance were performed for statistical analysis.Receiver operating characteristic(ROC) curve was used to calculate the optimal cut-off value of serum PG Ⅰ and PGR in gastric cancer diagnosis.Results Among the 320 patients,there were 159 patients in group A,124 patients in group B,23 patients in group C and 14 patients in group D,respectively.The incidence of gastric cancer in group A,group B,group C and group D were 0.63％ (1/159),4.03％ (5/124),13.04％ (3/23) and 3/14,respectively.The incidences of gastric cancer in group C and D were much higher than those in group A and B (x2 =11.700 and 21.900,both P＞0.01).Among the 320 patients,there were 179 cases in non-atrophic gastritis group,129 in atrophic gastritis group and 12 in gastric cancer group.The PG Ⅰ and PGR levels of gastric cancer group were (46.84 ± 24.07) μg/L and 3.21 ±1.45,which were lower than those of atrophic group ((100.09±48.15) μg/L and 9.78±7.32) and nonatrophic group ((103.97 ± 44.72) μg/L and 13.09 ± 9.05),and the differences were statistically significant (F=12.460 and 30.290,both P＜0.01).The PGR level of severe atrophy group was 5.62±3.00,which was significantly lower than those of moderate atrophy group (10.04 ± 6.08) and mild atrophy group (11.61±4.05).And the PGⅡ level of severe atrophy group was (18.85±10.54) μg/L,which was much higher than those of moderate atrophy group ((14.63 ± 11.19) μg/L) and mild atrophy group ((10.88 ± 7.41) μg/L),and t he differences were statistically significant (F=8.057,P＜ 0.01;F =3.374,P=0.021).The gastrin 17 level of antrum atrophy group was 2.16 pmol/L (1.12 pmol/L to 4.15 pmol/L),which was lower than those of gastric body atrophy group (4.49 pmol/L,1.88 pmol/L to 18.71 pmol/L) and whole gastric atrophy group (6.18 pmol/L,2.63 pmol/L to 17.82 pmol/L),and the differences were statistically significant (H=13.408,P＜0.01).The optimal cut-off values of PG Ⅰ and PGR for the diagnosis of gastric cancer were 66.7 μg/L and 4.45.Conclusions ABC stratification has certain value in gastric cancer screening in China,however,it still needs improvement.For patients with digestive symptoms,PG Ⅰ ≤ 66.7 μg/L and PGR ≤4.45 can be considered as high risk of gastric cancer and suggested to receive gastroendoscopy examination.

Objective To investigate the expression of osteopontin in colorectal cancer and hepatic metastatic cancer and its clinical significance.Methods The expression of osteopontin in 76 cases of colorectal cancer tissues,30 para carcinoma normal mucosa,liver metastatic tumor tissues in 16 patients was examined by immunohistochemical SP staining method.Results The expression rates of osteopontin in normal mucosa,colorectal cancer tissues and liver metastatic cancer tissues were 6.7％ (2/30),69.7％ (53/76),75.0％ (12/16) respectively.The expression rates of osteopontinin colorectal cancer and liver metastatic cancer was significantly higher than those in the normal mucosa (respectively x2 =34.273,23.014,all P ＜ 0.001).The expression of osteopontin was related to infiltration depth,lymph node metastasis,and distant metastasis (respectively x2 =14.347,6.577,7.278,5.537,all P ＜ 0.05).There was no significant difference in the sex and age.Kaplan-Meier survival analysis showed that patients with osteopontin positive had poor prognosis compared with osteopontin negative patients (P ＜ 0.001).Conclusions The expression of osteopontin is closely related to the invasion and metastasis of colorectal carcinoma,a hopeful indicator for the prognosis of colorectal cancer.

Objective To compare the influence of radiotherapy,chemotherapy and radiation combined with chemotherapy in the treatment of patients with non-small cell lung cancer on the state of EGFR gene mutation.Methods 328 patients with non-small cell lung cancer were selected.On the basis of the condition of the patients,they were treated with radiation therapy,combination treatment with chemotherapy and radiation.And according to the different treatment methods,they were divided into chemotherapy group (112 cases),radiotherapy group (108 cases) and radiation combined with chemotherapy group(108 cases).Before and after treatment,the plasma EGFR mutations situation was detected and analyzed.Results Before treatment,the plasma EGFR mutation rates in the chemotherapy,radiotherapy,radiation combined with chemotherapy group were 34.82％ (39/112),31.48％ (34/108),32.41％ (35/108),which were significantly higher than 20.54％ (23/112),18.52％ (20/108),19.44％ (21/108) after treatment(x2 =5.709,4.840,4.725,all P ＜ 0.05).The frequency of the mutant EGFR gene in the patients after chemotherapy was 20.5％ (23/112),which was significantly lower than 34.8％ (39/112) before chemotherapy,the difference was statistically significant(x2 =5.709,P ＜ 0.05).After radiotherapy,the frequency of the mutant EGFR gene in the patients was 18.5 ％ (20/108),which was significantly lower than 31.5 ％ (34/108) before radiotherapy,the difference was statistically significant(x2 =4.840,P ＜ 0.05).After chemoradiation therapy,the frequency of the mutant EGFR gene in the patients was 19.4％ (21/108),which was significantly lower than 32.4％ (35/108) before chemoradiation therapy,the difference was statistically significant (x2 =4.725,P ＜ 0.05).Conclusion Radiotherapy,chemotherapy and radiation combined with chemotherapy in the treatment of non-small cell lung cancer can affect the state of EGFR gene mutation,which has significant decline.

Objective To observe the clinical effects of early use of neuromuscular blocking agents (NMBA) in patients with severe sepsis and acute respiratory distress syndrome (ARDS).Methods A prospective study was conducted.96 patients with severe sepsis and ARDS admitted from July 2012 to September 2013 to intensive care unit (ICU) of Liuzhou People's Hospital in Guangxi Zhuang Autonomous Region were enrolled and divided into severe ARDS group (n=48) and moderate ARDS group (n=48) according to the Berlin definition of ARDS.Then patients in each group were randomly divided into treatment group (n =24) and control group (n=24).All patients with diagnosis in accordance with the 2008 international septic shock and severe sepsis treatment guidelines were provided with comprehensive treatment and mechanical ventilation on the basis of analgesia and sedation.The patients in treatment group were given a loading dose of vecuronium during mechanical ventilation,started with 0.l mg/kg up to 0.05 mg ·kg 1 ·h 1 for continuous intravenous infusion for 24-48 hours.The acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score,sequential organ failure assessment (SOFA),arterial oxygenation index (PaOfFiO2),central venous oxygen saturation (ScvO2),arterial blood lactate (Lac),C-reactive protein (CRP) levels of two groups were compared before treatment and 48 hours after treatment,and 21-day mortality rate was finally compared.Results In moderate or severe ARDS group,there were no statistically significant difference in APACHE Ⅱ score,SOFA score,PaO2/FiO2,ScvO2,Lac and CRP before treatment between two groups.APACHE Ⅱ score,SOFA score,PaO2/FiO2,ScvO2,and Lac 48 hours after treatment were significantly improved in severe ARDS group compared with control group [APACHE Ⅱ score:16.58 ± 2.41 vs.19.79 ± 3.52,t=3.679,P=0.010; SOFA score:12.04 ± 2.17 vs.14.75 ±3.26,t=3.385,P=0.010; PaO2/FiO2 (mmHg,1 mmHg=0.133 kPa):159.31 ±22.57 vs.131.81 ± 34.93,t=3.239,P=0.020; ScyO2:0.673 ± 0.068 vs.0.572 ± 0.142,t=3.137,P=0.030; Lac (mmol/L):3.10 ± 1.01 vs.4.39 ± 1.72,t=3.161,P=0.030],while the value of CRP (mg/L) showed no significant difference (180.91 ±37.14 vs.174.66 ± 38.46,t=0.572,P=0.570).21-day mortality in treatment group was significantly lower than that in control group [20.8％ (5/24) vs.50.0％ (12/24),x2=4.463,P=0.035].In moderate ARDS group,each of the above clinical parameters were improved in both groups expect for CRP at 48 hours after treatment,but the indexes showed no statistically significant difference between two groups (all P＞0.05).21-day mortality rate in the treatment group was slightly lower than that in the control group which showed no statistically significant difference [16.7％ (4/24) vs.25.0％(6/24),x2=0.505,P=0.477].Conclusion The early use of NMBA treatment of patients with severe sepsis and severe ARDS cannot only improve the severity but also reduce 21-day mortality.

In recent years,a considerable number of epidemiological investigations and animal studies have confirmed that metabolic diseases, such as obesity,type 2 diabetes mellitus and metabolic syndrome, have adverse effects on brain functions,inducing mood disorders and cognition impairment. Brain dysfunctions induced by obesity and related complications are associated with numerous central abnormalities,involving brain shrinkage and neurotrophic function impairment,brain insulin resistance, brain oxidative stress,and brain leptin resistance,as well as dysfunctioned dopamine motivation and the reward system. Moreover,these brain dysfunctions are mediated by several peripheral factors, such as triglycerides/free fatty acids,proinflammatory cytokines,and corticosterone/glucocorticoid. On the other hand,metabolic disturbances correlated with emotional-cognitive disorders are evident,but the mechanisms remain obscure. Because of the drawbacks of animal models, the majority of researches focus on the impact of mental stress on the metabolism of lipid and glucose. The interrela?tionship between metabolic diseases and brain functions has become one of the hot spots for research. In this review,we mainly discussed the potential mechanisms underlying mood disorders and cognition impairment induced by obesity and related complications.

Objective:To observe the effects of veno-venous extracorporeal membrane oxygenation (VV-ECMO)combined with prone position ventilation (PPV) on oxygenation index (PaO 2/FiO 2), respiratory compliance (Crs) and vasoactive inotropic score (VIS) in severe acute respiratory distress syndrome (ARDS) patients. Methods:Eighteen patients with severe ARDS requiring VV-ECMO support in Liuzhou People's Hospital from June 2018 to April 2020 were selected for retrospective analysis, and 8 patients among of these cases received PPV after VV-ECMO. The differences in PaO 2/FiO 2, VIS and Crs before and 1, 2 or 3 days after treatment were compared between VV-ECMO group and VV-ECMO combined with PPV group, as well as the differences in these indices before PPV and 2 hours after PPV daily in VV-ECMO combined with PPV group. The incidence of adverse events in two groups were also observed. Results:Before treatment, there was no significant difference in PaO 2/FiO 2, Crs between two groups. Over time, PaO 2/FiO 2 and Crs increased and VIS decreased in both groups. Compared with before treatment, there were statistically significant differences in PaO 2/FiO 2 and VIS from 1 day after treatment [PaO 2/FiO 2 (mmHg, 1 mmHg = 0.133 kPa): VV-ECMO group was 197.75±39.80 vs. 75.57±7.44, VV-ECMO combined with PPV group was 255.20±31.92 vs. 68.24±11.64; VIS: VV-ECMO group was 5.51±3.72 vs. 10.20±7.10, VV-ECMO combined with PPV group was 6.73±3.32 vs. 14.50±2.48, all P < 0.05], up to 3 days after treatment [PaO 2/FiO 2 (mmHg): VV-ECMO group was 231.96±32.76 vs. 75.57±7.44, VV-ECMO combined with PPV group was 285.61±19.40 vs. 68.24±11.64; VIS: VV-ECMO group was 2.26±1.90 vs. 10.20±7.10, VV-ECMO combined with PPV group was 2.13±1.55 vs. 14.50±2.48, all P < 0.05], and the PaO 2/FiO 2 1 day and 3 days after treatment in VV-ECMO combined with PPV group were significantly higher than those in VV-ECMO group (mmHg: after 1 day of treatment was 255.20±31.92 vs. 197.75±39.80, after 3 days of treatment was 285.61±19.40 vs. 231.96±32.76, both P < 0.05). Before treatment, Crs of VV-ECMO combined with PPV group was significantly lower than that of VV-ECMO group (mL/cmH 2O: 17.91±0.82 vs. 20.54±1.26, P < 0.05). From 1 day after treatment, the Crs in VV-ECMO combined with PPV group was significantly higher than that before treatment (mL/cmH 2O: 21.20±1.50 vs. 17.91±0.82), the peak value was (24.93±2.18) mL/cmH 2O on 3 days after treatment, however, there was no significant difference between the two groups (all P > 0.05). In VV-ECMO combined with PPV group, compared with before PPV treatment, the PaO 2/FiO 2 and Crs of 2 hours after PPV treatment in 1, 2 and 3 days were significantly rose, and it reached the highest level in 3 days [PaO 2/FiO 2(mmHg): 285.61±19.40 vs. 189.91±28.34, Crs (mL/cmH 2O): 24.93±2.18 vs. 23.35±1.45, both P < 0.05]; the VIS was only increased in 2 hours after PPV treatment on the first day than before (6.73±3.32 vs. 6.38±3.22, P < 0.05). There were no related serious adverse events happened after PPV treatment. Conclusions:The combination of PPV during VV-ECMO could further increase PaO 2/FiO 2, improve hypoxemia and implement further protective lung ventilation to reduce the potential hazards during mechanical ventilation. In addition, no serious adverse events were observed in this study, suggesting PPV is safe during VV-ECMO.

Objective To investigate the effects of recombinant tissue plasminogen activator (rt-PA)intravenous thrombolysis on blood-brain barrier (BBB) permeability,the expressions and the activities of MMP-2 and MMP-9 after cerebral ischemia in rats.Methods A total of 40 adult male Sprague-Dawley rats were allocated into 3 groups:Sham operation group (n =10),middle cerebral artery occlusion (MCAO) group (n =18),and rt-PA thrombolysis group (n =18).A MCAO model was established by using autologous thromboembolism.The sham operation group did not inject any thromboembolus,the MCAO group only made MCAO,and the rt-PA thrombolysis group received intravenous thrombolysis with rt-PA at 3 hours after MCAO.Brain infarct volume was determined by 2,3,5-triphenyl tetrazolium chloride staining BBB permeability was measured by Evans blue dye leakage.The activities and the expressions of MMP-2 and MMP-9 in brain tissue were detected by Gelatin zymography and Western blot,respectively.Results Compared to the MCAO group,the neurological function was improved significantly in the rt-PA thrombolysis group,and the infarct volume was also reduced significantly (t =7.365,P =0.005).However,the hemorrhage score (t =-3.286,P =0.017) and BBB permeability (t =-3.947,P =0.029) were increased significantly.The activities and the expressions of MMP-2 and MMP-9 in the sham operation group were lower.The activities and the expressions of MMP-2 (t =-45.121,P =0.000; t =-11.624,P=0.000) and MMP-9 (t=-71.849,P=0.000; t=-8.992,P=0.000) in the MCAO group were increased and upregulated significantly.Compared to the MCAO group,the activities and the expressions of MMP-2 (t =-28.792,P =0.000; t =-3.809,P =0.013) and MMP-9 (t =-53.506,P =0.000; t =-2.640,P =0.046) in the rt-PA thrombolysis group were increased and upregulated significantly.Conclusions After rt-PA intravenous thrombolytic therapy,the BBB permeability was increased.The activities and the expressions of MMP-2 and MMP-9 were increased and upregulated.MMP-2 and MMP-9 might participate in the increased BBB permeability,and thus inducing hemorrhagic transformation after rt-PA intravenous thrombolytic therapy in rats with cerebral ischemia.

Objective To compare the contents and features of licensed pharmacist qualification examination papers between those in abroad and domestic in order to provide the informations for the reforming the examination in our country.Method The characteristics of licensed pharmacist qualification examination among USA、UK、Australia and China were analysed and compared with classified statistic by using excel software.Results The scene questions are the main type in the three examination papers(＞50％).There were fewer questions examining the memory ability of examinees in abroad examinations,than that of ours.There were one question just had objects of pharmaceutical care (0.18％) in our examination.In the inspection of pharmaceutical knowledge application ability for the practice test(＞60％),covering all aspects of pharmaceutical care; And Chinese licensed pharmacists exam basic no object and pharmaceutical care link information feedback(＞60％),and the others are theoretical knowledge(＞20％).And in the three abroad examinations other common questions were about clinical drug therapy (＞90％),while they were the knowledge of pharmaceutical analysis and pharmaceutics in domestic examination papers (41.97％).Conclusion Licensed pharmacist qualification examination in our country ignored the ability of employing pharmaceutical knowledge and developing pharmaceutical care.The reformation of the licensed pharmacist qualification examination in our country is extremely urgent.

Background Studies determined that blue light exposure causes apoptosis of human retinal pigment epithelial (RPE) cells,but its mechanism is still below understood.Objective The aim of this study was to investigate whether or how mitochondrial apoptotic pathway is involved in blue-light induced apoptosis of human RPE cells in vitro.Methods Human RPE cells were isolated from fresh donor eyes and primarily cultured and passaged.The cells were identified with keratin antibody by immunochemistry.Then the cells were the non-light exposed group,simple light-exposed group,light-exposed+nifedipine group,light-exposed+calphostin C group and the light-exposed+phorbol myristate acetate (PMA) group.Human RPE cells in light-exposed group were consequently cultured for 24 hours following the exposure of (2 000±500)lx blue-light for 6 hours,and then the expression levels of bax,bcl-2,bcl-xl in the cells were detected by Western blot to evaluate the effect of blue light on the apoptosis.The cells in the light-exposed+nifedipine group,light-exposed+calphostin C group and the light-exposed+PMA group were treated with the corresponding drugs 1 hour prior to light irradiation and sequently received 6-hour light irradiation and 48-hour culture.The expression of caspase-9 protein in the cells were assayed with Western blot to assess the influence of Ca2+ channel and protein kinase C (PKC) pathway on mitochondria of RPE cells.Results Cultured cells grew well with visible pigment in cytoplasm.The cells showed the positive response for keratin and presented a cobblestone-like appearance.The expression bands of bax,bcl-2 and bcl-xl proteins were clearly visible at the molecular weight of 23 000,26 000 and 30 000 in both non-light exposed group and the simple light-exposed group,and the absorbance values of the cells to bax were elevated,while the absorbance values to bcl-2 and bcl-xl were declined in the simple light-exposed group compared with the non-light exposed group (t =-4.409,P =0.012 ;t =7.575,P =0.002 ; t =6.068,P =0.004).Compared with the non-light exposed group,the absorbance values of caspase-9 were significantly raised in the simple light-exposed group,light-exposed+calphostin C group and the lightexposed+PMA group (P=0.005,0.002,0.000),but no significant difference between the non-light exposed group and light-exposed+nifedipine group (P=0.191).Compared with the simple light-exposed group,the expression level was considerably higher in the light-exposed + PMA group (P =0.005) ; while that in the light-exposed + nifedipine group or light-exposed+calphostin C group was not significantly different (P=0.057,0.643).Conclusions Blue light exposure induces apoptosis of RPE cells by up-regulating the expressions of bax and caspase-9 proteins and down-regulating the expressions of bcl-2 and bcl-xl.The mitochondrial apoptosis pathway and PKC pathway participate in blue-light induced apoptosis of human RPE cells in vitro.

Objective To compare the diagnostic values of 18F-FDG and 18F-FLT PET/CT in patients with suspicious recurrence of glioma after multimodal treatment.Methods A total of 20 patients (13 males,7 females;age range:12-73 years) with glioma who underwent 18F-FDG and 18F-FLT PET/CT due to abnormal enhancement on MRI from January 2012 to June 2015 were enrolled in this retrospective study.According to the pathological or follow-up results,patients were divided into therapy-related benign changes (TRBC) group and recurrent glioma group,the later was subdivided into initial low-grade glioma (LGG) group and initial high-grade glioma(HGG) group.T/NT ratios of 18F-FDG and 18F-FLT between HGG (LGG) group and TRBC group were compared using one-way analysis of variance and the least significant difference t test.ROC curve analysis was conducted to calculate the differential diagnostic efficiency of 18F-FDG and 18F-FLT between TRBC and recurrent glioma.Results A total of 14 patients were proved as recurrent glioma and 6 patients as TRBC.The mean 18F-FDG T/NT ratios of HGG group,LGG group and TRBC group were 2.31±0.86,1.32±0.86 and 1.32±0.64,respectively.The 18F-FDG T/NT ratio of the HGG group was significantly higher than that of the TRBC group(F=3.671,t=-2.471,P＜0.05).The mean 18F-FLT T/NT ratios of HGG group,LGG group and TRBC group were 8.94±3.14,7.18±3.29 and 1.92±1.20,respectively (F=13.301,t values:-5.150 and-2.360,both P＜0.05).The optimal T/NT cutoff values for 18 F-FDG and 18F-FLT PET/CT were 1.62 and 4.58,respectively.The sensitivity,specificity and accuracy of detecting recurrent glioma with optimal T/NT cutoff value were 11/14,5/6 and 16/20 for 18F-FDG PET/CT,and those for 18F-FLT PET/CT were 13/14,6/6 and 19/20,respectively.No significant difference was observed between the diagnostic efficiencies of the two imaging modalities (x2 values:1.167,1.091 and 2.057;all P＞0.05).Conclusion There were no statistical significances between 18F-FDG and 18F-FLT PET/CT on the differential diagnosis of glioma recurrence.