Objective To determine the value of oxygenation index in assessing the outcome of mechanical ventilated patients with acute respiratory distress syndrome (ARDS).Methods From September 2008 to September 2013,patients meeting the Berlin definition of ARDS were evaluated in this retrospective study.Data included oxygenation index (PaO2/FiO2) on day before,and day 1 and day 3 after mechanical ventilation.The levels of PaO/FiO2 on day before and day 1 after mechanical ventilation were compared between 28-day survivors and non-survivors.Results There were 236 patients meeting the criteria of the Berlin Definition for diagnosis and treated with mechanical ventilation.The mean score of APACHIE Ⅱ and sequential organ failure assessment (SOFA) at the beginning were (19.1 ± 3.0) and (10.8 ±2.5),respectively,while oxygenation index on day before mechanical ventilation was (150.3 ± 62.6) mmHg.According to the hypoxemia grade,patients were divided into mild (n =36),moderate (n =122) and severe (n =78) ARDS,and their levels of PaO2/FiO2 were (80.1 ± 8.1),(162.3 ± 19.9) and (261.6 ± 22.3) mmHg,respectively.There were 92 non-survivors and 144 survivors.No obvious difference in oxygenation index of non-survivors among on day before、and day 1 and day 3 after mechanical ventilation.There was statistically significant difference in oxygenation index between on day before and day 1 after mechanical ventilation in survivors (P ＜ 0.05).Compared with the survivors,the score of APACHE Ⅱ,SOFA,and oxygenation index on day 3 were associated with increased mortality in the non-survivors,respectively (P ＜ 0.05).In respect to the mortality,the cut-off point of score of oxygenation index set at ＜ 180 mmHg on Day 3,an area under the receiver operating curve (AUC) was 0.749 with statistically significance (P ＜ 0.05),leading to sensitivity 61.7％ and specificity 93.2％.The relationship between prognosis and antibiotic resistance did not have statistically significance.Conclusions Data of oxygenation index on early phage of ARDS may be valuable to predict the outcome.A strong predictor of adverse outcome in such conditions was the score of oxygenation index on Day 3 ≤ 180 mmHg.

Objective To investigate the diagnosis and treatment of bilateral thyroid carcinoma(BTC).Methods Clinical data of 68 cases with BTC from July 2001 to July 2008 were analyzed retrospectively.Results All patients underwent surgical treatment.22 cases received total thyroidectomy and bilateral functional neck dissection,30 cases received total thyroidectomy and unilateral functional neck dissection,14 cases received total thyroidectomy and lymph node dissection of Ⅵ area,2 cases received palliative resection.12 cases received proper radioactive 131I therapy after operation.Postoperative complications occured in 16 cases,including 5 cases with transient recurrent nerve paralysis,1 case with permanent injury of recurrent laryngeal nerves received trachea incision,1 case with tracheomalacia and asphyxia,6 cases with convulsion caused by hypocalcemia,1 case with permanent hypoparathyroidism,2 cases with chylous fistula(one was cured by saturing and ligaturing and the other by conservative treatment).Low echo solid or cystic solid nodules in thyroid were found by preoperative ultrasonic scan in all cases,in which 38(55.88%)cases were associated with gravel calcified lesion in thyroid nodules.The diagnosis was comfirmed by needle aspiration biopsy(NAB)in 42 cases preoperatively and 64 cases(94.12%)by frozen section intraoperatively.63(92.64%)cases were followed up postoperatively for a period from 6 months to 5 years,all 5 cases with recurrence and/or metastasis had tumor-free survival after reoperation except for 1 case with undifferentiated cancer died on the 6th month after operation.Conclusions Total thyroidectomy and lymph node dissection is essential to the treatment of BTC.Gravel calcified lesion revealed by preoperative high frequency ultrasonagraphy is an important characteristic for preoperative diagnosis of thyroid cancer.

Objective To investigate the protective effect of GSH on lung injury in rats with severe acute pancreatitis(SAP) and investigate the mechanism of severe acute pancreatitis associated lung injury. Methods Fifty-four Spragwe Dawley rats were randomly divided into three groups: control group, model(SAP)group and herbal group. Rats in model group and herbal group were induced pancreatitis by retrograde injection of 5% sodium taurocholate into the pancreatobiliary duct. Animals were killed at 3h, 6h, 12h after injection. The serum amylase was examined at 3h, 6h, 12h after injection. Pulmonary tissue fluid content was measured.The expression of pulmonary TNF-α mRNA and LIF mRNA was detected by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR). Results The serum level of amylase was lowered significantly in herbal group in comparision with that in model group (P<0.05) and pulmonary tissue fluid content in herbal group was reduced compared with model group (P<0.05). Similarly, the level of pulmonary TNF-α mRNA and LIF mRNA expressions was both significantly reduced in herbal group compared with model group (P<0.05). LIF mRNA was not examined in normal control group. Conclusion Treatment with GSH can prevent lung injury of rats with SAP.

Objective To evaluate the extra-anatomic bypass surgery for aorto-iliac occlusive disease in the elderly. Methods From January 2005 to December 2008,33 elderly patients/39 limbs (age ranged from 70 to 87 years, mean 76.0 ± 3.0 years) with aortoiliac occlusive disease were retrospectively analyzed. According to Fontaine classification, there were 5 phase Ⅱ b cases (7 limbs), 22 phase Ⅲ cases (26 limbs), and 6 phase Ⅳ cases (6 limbs), all cases were with TASC C, D lesions. Results These 33 cases/39 limbs were tr eated with a variety of bypass, including axillobifemoral bypass (6 cases/12 limbs) ,axillofemoral bypass ( 20 cases/20 limbs ), femorofemoral bypass ( 7 cases/7 limbs ). Intermittent claudication improved in 5 cases, rest pain disappeared in 22 cases, and ulcers healed in 6 cases after operations. The mean ABI increased from 0.29 ± 0.11 to 0.66 ± 0.13 ( t = 2.69, P ＜ 0.05 ). All limbs were salvaged and there was no perioperative mortality within 30 days after operations. Postoperative complication rate was 9.1%. Patients were followed up for a median of 12 ±5 months (range, 6 to 28 months), primary patency rate was 89.7% (35/39), secondary patency rate was 94.9% (37/39), limb salvage rate was 92.3% (36/39). After dischargement the mortality was 6.1% (2/33) with one dying of myocardial infarction and another one of malignant tumor (gastric cancer). Conclusions Extra-anatomic bypass for aorto-iliac occlusive disease in the elderly is feasible, safe and effective, and the cardiopulmonary dysfunctions are the major risk factors for perioperative complications.

Protein phosphatase 2A (PP2A) is a major serine/threonine phosphatase involved in many signaling pathways associated with cell growth and proliferation, and it also regulates many cellular processes. With an in-depth exploration of PP2A in the process of cell activity, especially malignant tumors, the association between PP2A and hepatocellular carcinoma (HCC) has attracted more and more attention in recent years; however, there is still a controversy over whether PP2A can promote or inhibit HCC. This article reviews the research advances in the mechanism of action of PP2A as a tumor factor in the regulation of HCC and target therapy.

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors. Due to the insidious onset, poor prognosis, and lack of specificity of HCC, most patients have reached the advanced stage at the time of diagnosis. Conventional treatment methods, such as surgical resection, liver transplantation, radiotherapy, and chemotherapy, have limited therapeutic effects and fail to bring significant benefits to patients. With the improvement of science and technology and medical level in recent years, targeted therapy drugs have gradually entered people’s vision due to the breakthroughs in the treatment of HCC and thus bring new hope to patients with advanced HCC. Targeted drugs have attracted wide attention due to good molecular selectivity, targeted killing of tumor cells, and protection of normal tissue. This article reviews the research advances in targeted therapy for HCC.

OBJECTIVE: To determine whether diffusion kurtosis imaging (DKI) is effective in monitoring tumor response to neoadjuvant chemotherapy in patients with osteosarcoma. MATERIALS AND METHODS: Twenty-nine osteosarcoma patients (20 men and 9 women; mean age, 17.6 ± 7.8 years) who had undergone magnetic resonance imaging (MRI) and DKI before and after neoadjuvant chemotherapy were included. Tumor volume, apparent diffusion coefficient (ADC), mean diffusivity (MD), mean kurtosis (MK), and change ratio (ΔX) between pre- and post-treatment were calculated. Based on histologic response, the patients were divided into those with good response (≥ 90% necrosis, n = 12) and those with poor response (< 90% necrosis, n = 17). Several MRI parameters between the groups were compared using Student's t test. The correlation between image indexes and tumor necrosis was determined using Pearson's correlation, and diagnostic performance was compared using receiver operating characteristic curves. RESULTS: In good responders, MDpost, ADCpost, and MKpost values were significantly higher than in poor responders (p < 0.001, p < 0.001, and p = 0.042, respectively). The ΔMD and ΔADC were also significantly higher in good responders than in poor responders (p < 0.001 and p = 0.01, respectively). However, no significant difference was observed in ΔMK (p = 0.092). MDpost and ΔMD showed high correlations with tumor necrosis rate (r = 0.669 and r = 0.622, respectively), and MDpost had higher diagnostic performance than ADCpost (p = 0.037) and MKpost (p = 0.011). Similarly, ΔMD also showed higher diagnostic performance than ΔADC (p = 0.033) and ΔMK (p = 0.037). CONCLUSION: MD is a promising biomarker for monitoring tumor response to preoperative chemotherapy in patients with osteosarcoma.
Bone Neoplasms ; Diffusion ; Drug Therapy ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Necrosis ; Osteosarcoma ; ROC Curve ; Tumor Burden

OBJECTIVE: The relationship between vitamin D and allergic rhinitis (AR) remains unclear. The present study investigated their association by examining serum 25-hydroxyvitamin D (25(OH)D) levels, blood eosinophils, and the expression of vitamin D receptors (VDR) on nasal mucosa in patients with AR. METHODS: A total of 32 patients with persistent AR and 25 controls were enrolled in this study. Serum 25(OH)D levels were detected by enzyme-linked immunosorbent assay, and eosinophils in the peripheral blood were examined by an automated hematology system, while VDR expression on inferior turbinate mucosa was assessed by immunohistochemistry. Furthermore, the correlation of serum 25(OH)D levels with blood eosinophils in persistent AR was analyzed. RESULTS: No significant difference in serum 25(OH)D levels was detected between the AR and control groups (p = 0.371). Interestingly, the serum 25(OH)D levels of the AR group were negatively correlated with blood eosinophil count and its proportion (p = 0.019 and p = 0.010, respectively) even when adjusting confounding factors including age, sex, body mass index, and the season of blood sampling. On the other hand, no significant difference in the expression levels of VDR on nasal mucosa was found between the AR group and the control group (p = 0.231). CONCLUSION: These results suggest that the serum 25(OH)D might be inversely associated with blood eosinophils in patients with persistent AR. However, the relationship between vitamin D and AR still requires further clarification
Body Mass Index ; Enzyme-Linked Immunosorbent Assay ; Eosinophils ; Hand ; Hematology ; Humans ; Immunohistochemistry ; Mucous Membrane ; Nasal Mucosa ; Receptors, Calcitriol ; Rhinitis, Allergic ; Seasons ; Turbinates ; Vitamin D

[Abstract] Objective: To investigate the molecular mechanism of miR-143-3p regulating the proliferation, migration and invasion of colon cancer RKO cells via targeting enhancer of zeste homolog 2 (EZH2). Methods: A total of 40 pairs of colon cancer tissues and corresponding para-cancerous tissues resected in the First Affiliated Hospital of Kunming Medical University from March 2015 to July 2017 were collected for this study. In addition, colon cancer cell lines (COLO320, RKO and CL-11) and normal intestinal mucosa NCM460 cells were also collected. qPCR was applied to detect the expression level of miR-143-3p in colon cancer tissues and cell lines. miR-143-3p mimics, miR-143-3p inhibitor, EZH2 siRNA and negative control plasmids were transfected into RKO cells, respectively. The effect of miR-143-3p/EZH2 axis on the proliferation, migration and invasion of RKO cells were detected by CCK-8 and Transwell assay, respectively. Western blotting was used to detect the expression level of EZH2 protein in RKO cells. The targeting relationship between miR-143-3p and EZH2 was verified by Dual luciferase reporter gene assay. Results: The expression level of miR-143-3p was downregulated in colon cancer tissues and cell lines (all P<0.01). Overexpression of miR-143-3p significantly inhibited the proliferation, migration and invasion of RKO cells (all P<0.01). Dual luciferase reporter gene assay confirmed that EZH2 was a target gene of miR-143-3p. Simultaneous knockdown of miR-143-3p and EZH2 attenuated the inhibition of EZH2 knockdown on the proliferation, migration and invasion of RKO cells. Conclusion: miR-143-3p suppresses the proliferation, migration and invasion of colon cancer cells via targetedly down-regulating EZH2.

By analyzing the physiological structure and motion characteristics of human ankle joint, a four degree of freedom generalized spherical parallel mechanism is proposed to meet the needs of ankle rehabilitation. Using the spiral theory to analyze the motion characteristics of the mechanism and based on the method of describing the position with spherical coordinates and the posture with Euler Angle, the inverse solution of the closed vector equation of mechanism position is established. The workspace of mechanism is analyzed according to the constraint conditions of inverse solution. The workspace of the moving spherical center of the mechanism is used to match the movement space of the tibiotalar joint, and the workspace of the dynamic platform is used to match the movement space of subtalar joint. Genetic algorithm is used to optimize the key scale parameters of the mechanism. The results show that the workspace of the generalized spherical parallel mechanism can satisfy the actual movement space of human ankle joint rehabilitation. The results of this paper can provide theoretical basis and experimental reference for the design of ankle joint rehabilitation robot with high matching degree.
Ankle Joint ; Biomechanical Phenomena ; Humans ; Movement ; Range of Motion, Articular