Objective To evaluate the value of acute physiology and chronic health condition evaluation Ⅱ(APACHEⅡ) and National Institute of Health Stroke Scale(NIHSS) score in evaluating outcome of patients with acute cerebral infarction(ACI).Methods 399 patients with ACI were scored by APACHEⅡ and NIHSS in 3 d after onset.Prognosis judgement accorded to the patients survival or death during 28 d after onset.Area under of the receiver operator characteristic(ROC) curves was used to scale the ability of APACHEⅡ and NIHSS scoring systems evaluating severity and predicting outcomes of patients with ACI to find best cut-off points of the two scoring systems.Using discriminant analysis method to analysis the two scoring systems and estabished mathematical functional equation to calculate accuracy.Results For prognosis of patients with ACI,the areas under ROC curves were 0.835 and 0.822,and the best cut-off points were 12 and 10 respectively for APACHEⅡand NIHSS.The accuracy rates of APACHEⅡand NIHSS were 74.5% and 76.9%,respectively.The accuracy rate of APACHEⅡcombined NIHSS was 85.5%.Conclusions The APACHEⅡand NIHSS score systems have satisfactory discrimination for patients witn ACI,The predictive accuracy may improve if APACHEⅡ is combined with NIHSS.

Objective To observe the clinical effect of recombinant bovine basic fibroblast growth factor gel combined with esberitox for recurrent oral ulcer.Methods Forty-six patients with recurrent oral ulcer were divided into treatment group of 22 patients and control group of 24 patients by random digits table method.The patients in treatment group were given recombinant bovine basic fibroblast growth factor gel and esberitox.The patients in control group were given the watermelon frost spray only.After treatment for 1 week,the curative effect was compared.Results The cure rate in treatment group was 90.9％ (20/22),which was significantly higher than that in control group (66.7％,16/24),and there was significant difference (P ＜0.05).The time of pain vanish,oral ulcer decrease,oral ulcer healing in treatment group were significantly shorter than those in control group,and there were significant differences (P ＜0.05).Conclusions Recombinant bovine basic fibroblast growth factor gel combined with esberitox for recurrent oral ulcer can promote ulcer healing,shorten the course of disease,and has no adverse reaction.It is worthy of applying in clinic.

Objective To investigate the signal transduction pathway of arachidonic acid(AA) and prostaglandin E-2(PGE-2) synthesis in macrophage invaded by Toxoplasma gondii. Methods Synthesis of AA and PGE-2, expression of COX_2 mRNA and protein following stimulation infection by Toxoplasma gondii were evaluated in RAW264^7 cells by ELISA, RT_PCR and Western blotting after treatment with calcium channel blocker verapamil, chelator of extracellular calcium EGTA and inhibitor of CaM trifluoperazine (TFP), selective PKC inhibitor H7. Results Production of AA and PGE-2 induced by tachyzoite was significantly inhibited by EGTA, TFP and BAPTA/AM, and the PGE-2 production was inhibited by H7, with a reduced expression of COX_2 mRNA and protein in a dose_dependent manner. Conclusion The parasite down_regulates macrophage functions by affecting PKC signaling pathways, and triggers a biochemical cascade whose signals ultimately conduct to the secretion of immunosuppressive molecules PGE-2.

Objective To detect expression of PRKACB protein in non-small cell lung cancer ,thus to study its clinical significance and to analyze the relationship between PRKACB expression and prognosis .Methods We detected the PRKACB protein using immunohistochemistry in 109 lung cancer tissues and corresponding adjacent 20 normal tissues of non-small cell lung cancer patients .Results Compared with normal tissues , the level of PRKACB significantly decreased in lung cancers (χ2 =25.217,P<0.05),and was associated with differentiation (χ2 =9.664,P<0.05),lymph node metastasis(χ2 =4.430,P<0.05),and TNM staging(χ2 =4.430,P<0.05). Furthermore,the low expression of PRKACB protein was correlated with poor prognosis ( overall survival and disease-free survival ) of the patients .Conclusion PRKACB was lowly expressed in non-small cell lung cancer ,and associat-ed with clinical features ,which indicated its important role in clinical diagnosis of non-small cell lung cancer .

Objective:To observe the changes of TLR4 and IL-6 expression in rats hippocampus CA1 region in remote ischemic postconditioning(RIP) and explore its significance.Methods: All the 72 male SD rats were divided into Sham group,Contrast group and RIP group randomly.Each group was divided into 4 time points:12h,24 h,48 h and 72 h group.There were 6 rats in each group.Use the cerebral ischemia-reperfusion model which was established with modified Longa method as the contrast group.The method of RIP was to Fasten rats Posterior limbs by a tourniquet for 30 min immediately,then relax them for 30 min, repeat 3 times.To observe the pathological variation of hippocampus CA1 region by HE dyeing;to test the expression of TLR4 and IL-6 by immunohistochemical staining.Results: Compared to contrast group, neuronal loss and swelling reduced significantly in RIP group.Compared to sham group, the TLR4 and IL-6 expression in contrast group and RIP group increased significantly ( P<0.05 ) .Compared to contrast group,the TLR4 and IL-6 expression in RIP group reduced significantly(P<0.05).Conclusion:RIP dose have protective effect on cerebral ischemia.The effect may be associated with the inhibition of TLR4 and IL-6 expression.

OBJECTIVE：To preliminarily study the antitumor mechanism of Periplaneta americana extract C Ⅱ-3 on MFC tumor-bearing mice. METHODS ：Balb/c mice were randomly divided into model group （normal saline 20 mL/kg）and C Ⅱ-3 group （200 mg/kg），with 6 mice in each group. MFC cell suspension （0.2 mL）was injected under the right armpit of mice. On the next day，mice were given relevant medicine intragastrically ，once a day ，for consecutive 10 d. 24 h after the last administration ，Based on the measurement of tumor size ， 1H-NMR technology combined with unsupervised PCA ，supervised PLS-DA and OPLS-DA were used to compare metabolic spectrum of liver tissue from tumor-bearing mice of 2 groups，to analyze differential metabolites and to explore the potential antitumor mechanis m of C Ⅱ -3. RESULTS ：Compared with model group ，the tumor body was significantly reduced in tumor-bearing mice of C Ⅱ-3 group. There were differences in 1H-NMR spectra between the 2 No.81960712）； groups. According to unsupervised PCA ，supervised PLS-DA and OPLS-DA ，totally six potential differential metabolites ，as glycogen （increased），pyruvate （decreased），arginine （de- creased），hydroxyproline （increased），inosine （increased） and niacinamide （increased），were identified in the liver tissue，which were mainly attributed to the metabolism of arginine ，energy and nucleic acid. CONCLUSIONS：The anti tumor effect of C Ⅱ-3 may be related to the regulation of arginine metabolism ，energy metabolism and nucleic acid metabolism.

On October 23, 2017, a 52-year-old male patient with 3 recurrences of dermatofibrosarcoma protuberans in the left shoulder and chest was admitted to the Department of Burns and Plastic Surgery of Dali Bai Autonomous Prefecture People′s Hospital. Dermatofibrosarcoma protuberans on the skin were completely resected, leaving wound defect of 10 cm×10 cm. The wound was planned to be repaired by the transplantation of right anterolateral thigh perforator free flap. However, the anterolateral thigh perforator branch was absent during flap removal, and only one small perforating branch was found. Moreover, it was difficult to separate. Therefore, this flap cutting was given up. The anteromedial thigh perforator was explored through the same incision, and a thicker perforator was found, which was supplied by an independent iatrogenic artery. The length and diameter of the vascular pedicle matched with the blood vessels in the receiving site. An anteromedial thigh perforator flap (10 cm×10 cm) was cut to repair the defect. The postoperative 9-month follow-up revealed that the color, texture, and thickness of the flap were good, the two-point discrimination distance was 30 mm, and the linear scar remained at the donor site of right thigh.

Objective To explore the internal jugular vein liver inside door body bypass surgery (Transjugularintrahepatie portosystemic shunt,TIPS) and part of the spleen embolization (PaniM splenicembolization,PSE) after laparoscopic resection combined with spleen schistosomiasis compounds with cirrhosis of the liver function of spleen hyperthyroidism curative effect.Methods Fifty-two cases had schistosomiasis hepatocirrhosis with spleen function in patients with hyperthyroidism,doing any operation after a week PSE TIPS.Postoperative liver function and adopted to monitor changes,two weeks left hand done help type laparoscopic splenectomy.Results Fifty-two patients underwent TIPS and PSE after surgical treatment,blood picture and liver function back to normal,in two weeks or so do help laparoscopic resection of the hand of the spleen,five cases were transfered to open surgery,patients were cured and discharged.And the previous similar average hospitalization days compared with patients who shorten,average hospital expenses dropped,and less complications,little pain.Conclusion TIPS and PSE joint laparoscopic splenectomy are schistosomiasis compounds with cirrhosis of the liver function of spleen hyperthyroidism,definite effect not only,and safety,minimally invasive,has a good value of clinical application.

Objective To study the effect the edaravone on the expressions of ICAM-1,TNF-α after focal cerebral ischemia reperfusion in male rats.Methods 45 male SD rats were selected and randomly assigned into 3 groups:sham operation group(SO),ischemia reperfusion group(I/R),and edaravone treatment group(ED),each group had 15 rats.The expression of ICAM-1,TNF-α were checked by immunohistochemistry.All data in the groups were analyzed with t test.Results The expression of ICAM-1 and TNF-α in the I/R group and ED group were higher than the SO group(t=21.919,27.758,26.576,17.395,32.821,43.021,14.195,31.828,21.201,10.195,25.768,17.900,all P＜0.05)at reperfusion 3 hours,6 hours,and 12 hours.The expression of ICAM-1 and TNF-α in the I/R group were higher than the ED group(t=9.623,13.845,7.201,11.313,all P＜0.05)at reperfusion 3 hours and 6 hours.Conclusion Edaravone may exert the neuroprotective effect against the cerebral ischemia in rats by decreasing the expression of ICAM-1 and inhibiting the activation of TNF-α.This process could inhibit free radical generation.

Objective To investigate the prognostic value of red cell distribution width (RDW) and relationship between RDW and severity of critical illness patients and prognostic role of RDW.Methods This was a prospective observational and diagnostic test study.From February 2011 to May 2013,196 medical patients in ICU were enrolled to study.Blood samples were taken within 24 hrs after admission to ICU for blood routine test and other chemical routine test,including RDW.Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score were also calculated.The patients were divided into survival group (n =126) and death group (n =70) based on their hospital outcomes.Differences in RDW levels and APACHE Ⅱ score between survival and death groups were compared with One-way ANOVA.The correlation between RDW and APACHE Ⅱ score were analyzed by Spearman correlation test.Receiver operator curve (ROC) test was used to determine the predictive value of RDW and APACHE Ⅱ for hospital death.Results Both RDW level and APACHE Ⅱ score were significantly higher in death group than those in survival group,whichwere (13.35 ±2.21) vs.(11.34 ±1.32) and (20.43 ±6.41) vs.(13.94 ±6.77) respectively (both P ＜ 0.01).RDW significantly correlated with APACHE Ⅱ score (r =0.309,P ＜0.01).To predict hospital death area under curve (AUC) of ROC curve by RDW and APACHE Ⅱ score were 0.792 (0.725,0.860) and 0.754 (0.686,0.822) respectively.The best cut-off value was determined by Yoden Index were 12.35 for RDW and 17.5 for APACHE Ⅱ score.The Accuracy of prediction was 76.5％ and 70.4％ respectively.In addition,all the 12 paticnts whose RDW level ＞ 15.4 were dead.Conclusion RDW level at admission to ICU correlate well with the severity of critical illness.RDW level has an additional predictive value for the prognosis of critical ill patients.