MicroRNAs (miRNAs) are a class of small non-coding RNAs which involve in the regulation after gene transplantation.Researches show that miRNA is closely related to the development and progression of non-small-cell lung cancer (NSCLC).They caused a significantly change in NSCLC cells through downregulate tumor suppressor gene,or act as oncogene or work on some targets which is important in cell signal pathway,in the end it lead to oncogenesis,cell proliferation,cell apoptosis and resistance to chemotherapy or radiotherapy.Therefore,miRNA will be hopefully used in the diagnose and therapy of cancer.

Objective To investigate the risk factors of syncope symptom in patients with pulmonary embolism (PE).Methods 457 patients with confirmed pulmonary embolism were recruited in the study.They were divided into two groups:the syncope group (44 patients) and the group without syncope (413 patients).The clinical manifestation,laboratory examination,physical examination,imagingof all patients were analyzed by unconditional logistic regression.Results (1) Single factor analysis,prevalence of syncope was 9.6％ (44/457) in these patients with PE.Those with syncope had some higher risk factors,including age over 60,coronary heart disease,hypertension,stroke and lower limb vein thrombosis history.The proportion of falling pressure chest painand centricity thrombus in syncope group were increasing compared with the groupwithout syncope.Pulmonary embolism severity index (sPESI) score was higher than groupwithout syncope.(2) Multivariate analysis showed that hypertension coronary heart disease and Centricity thrombus were the independent correlates of the presence of syncope in the patients with PE.Conclusions Patients who had histories of hypertension and coronary heart disease may have the higher risk factors of syncope.Blood pressure falling and central localization may be more likely to happen in PE patients with syncope.

Objactive:To study the color changes of SY-1 silicone elastomer before and after polymerization.Methods:L*a*b*color parameters of 10 samples of SY-1 silicone elastomer were measured with Minolta chroma-ticity instrument(CS-321) before and after polymerization.The color difference(△E) between precure and post-cure was calculated as△E =[(△L)2+(△a)2+(△b)2]1/2.Results:After polymerization L*and a*valueswere increased(P

objective: To study the properties of keepers treated with different methods. Methods: Eighteen Z 3 magnetic attachments were divided into three groups at random. Cobalt chromium alloy was used for root cap. The keepers in the first group were cast to the caps, those in the second group were welded to the caps by Nd:YAG laser welding apparatus. Keepers in the third group were untreated. Universal testing machine was adopted to measure the breakaway retention of the attachments. The roughness of keeper surfaces was measured by roughness tester. Results: No statistical difference was observed as to the breakaway retention between magnetic attachments and laser welded coping keeper or between those and cast coping keepers. But retention of the keepers in the two groups was slightly lower than that of untreated keepers. Defects of pits were found on the surfaces of the cast coping keepers. The surface smoothness of the cast coping keepers was inferior to that of the laser welded coping keepers. Conclusion: Laser welded keepers and cast coping keepers can meet clinical demands for the use of magnetic attachments.

Objective To investigate the clinical characteristics and the course of diagnosis and therapy of asparaginase associated pancreatitis (AAP) in adults, in order to improve the ability of diagnosis and treatment.Methods Data of 384 cases of acute lymphoblastic leukemia (ALL) who received treatment in Department of Hematology, Zhejiang Hospital, and Department of Hematology, Second Hospital Affiliated to Wenzhou Medical University from January 2009 to June 2015 was retrospectively analyzed.All patients were given multi-drug chemotherapy including PEG-asparaginase or L-asparaginase, the incidence of AAP, clinical manifestations, diagnosis, treatment and prognosis were analyzed.Results Among the 384 cases, 18 patients developed AAP, and the incidence of AAP was 4.7％, including 13 cases of mild AAP (MAAP), 5 cases of severe AAP (SAAP).Sixteen cases of AAP occurred during the induction-remission treatment phase, 2 cases during the maintenance-intensification phase.The major manifestations of AAP were abdominal pain, and increased serum amylase and lipase.After treatment, abdominal pain of MAAP patients alleviated, serum amylase and lipase obviously decreased, and re-use of PEG-Asparaginase or L-Asparaginase was not associated with the recurrence of AP.Levels of serum amylase and lipase in 5 cases of SAAP repeatedly increased, 1 case died of severe infection, cyst rupture and hemorrhage.Conclusions Adults patients with ALL present with abdominal pain during chemotherapy of aspargase should consider the possibility of AAP, the measurement of serum amylase and serum lipase should be strengthened, in addition, ultrasound and CT scanning may be helpful for early diagnosis and treatment of AAP, and improve the prognosis.

Objective To study the value of Procalcitonin (PCT) in predicting the severity of the critically ill children by analyzing the clinical data of increased PCT level.Methods A total of 392 patients with increased PCT admitted to the PICU of Hunan Children's Hospital from August 2011 to April 2012 were enrolled.The data of clinical manifestations,medical condition,sputum culture,organ function and prognosis were summarized and analyzed statistically.The continuous variables were analyzed with t-test,the categorical variables were analyzed with Chi-squared test,and the correlation analysis was calculated using Pearson coefficients.Results Serum PCT had a positive correlation with inflammatory markers such as C-reactive protein (CRP),white blood cell (WBC) count and the percentage of neutrophils (NEU％) (P ＜ 0.01).PCT was significantly higher when sputum culture was positive (P ＜0.05) but there were no obvious changes in CRP,WBC and NEUT％ (P ＞ 0.05).Serum PCT increased obviously in the presence of organ dysfunction.The higher serum PCT,the more likely multiple organ failure would happen.The PCT level upon admission in death group (63 cases) was (62.43 ± 70.19) ng/ml,which was higher than that in survival group (P ＜ 0.01).Conclusions PCT level is helpful in assessment of severity and prognosis of bacterial infection in critically ill children,and can reflect the organ dysfunction objectively.It can improve the survival rate and the life quality in critically ill children.

Objective To establish an assessment scale for hospital stroke patients with Delphi method,by using it to help the nurses evaluate patients' existing and potential problems,and to provide foundations for specific assessment on different patient groups.Methods The first-level indicators and second-level indicators were developed on the basis of the Omaha system.210 nursing records of hospital stroke patients were then combined with to form concrete items.Totally 22 nursing specialists were interviewed with two rounds in order to further collect the opinions and suggestions about the assessment scale.Results 4 first-level indicators,35 second-level indicators and a number of items were included in the assessment scale.Conclusions The assessment scale for hospital stroke patients established by Delphi method comprehensively shows the environmental,physical,mental and behavioral condition in hospital,and it could be used as a tool to assess the hospital stroke patients.

Objective To evaluate the diagnosis value of plasma Dickkopf-1(DKK1)in hepatocellular carcinoma (HCC)pa-tients.Methods Selected 48 patients with HCC,20 patients with liver cirrhosis (LC),20 patients with chronic hepatitis B (CHB),and all of them were clinically diagnosed in the Third People’s Hospital of Nantong City,chose 20 cases of health examination as healthy controls (HC),that were ruled out other chronic disease.Enzyme-linked immunosorbent assay (ELISA)and Abbott i2000 microparticle chemiluminescence immunoassay analyzer were used to determine the plasma DKK1 and alpha-fetoprotein (AFP)levels.At the same time,analysesed and compared the receiver operating characteristic (ROC)curve and correlation of the DKK1 and AFP results.Results The plasma level of DKK1 in patients with HCC was significantly higher than that in patients with chronic hepatitis B,cirrhosis and healthy controls (Z=-4.132~-5.828,P<0.001).The area under ROC curve (AUC)of plasma DKK1 in the diagnosis of HCC was 0.889 and 95% confidence in-terval was 0.831~0.947,when the Cut-off value of DKK1 was 565 ng/L,the sensitivity was 93.8% and specificity was 70% in diagnosing HCC.The areaunder ROC curve of AFP in the diagnosis of HCC was 0.759 and 95% confidence interval was 0.667~0.850.The AUC of DKK1 was significantly higher than that of AFP (Z=2.28,P=0.022).DKK1 and AFP in diagnosing HCC were no significantly correlated (r=0.148,P=0.316).21 patients with AFP under 20μg/L showed higer DKK1 above 565 ng/L in 48 patients with HCC.Conclusion Detection of DKK1 in plasma can be used as a complement of AFP in the diagnosis of HCC,Especially DKK1 early diagnostic value of AFP negative HCC patients is remarkable.

Objective In a large-scale clinical medical examination, A2 type best multiple-choice test questions to the same knowledge were used respectively in simple and complex form, to compare the difficulty and discrimination indices of the two forms of test questions and provide evidence to the improve-ment of clinical medical examination. Method In a large-scale clinical medical examination more than 4000 candidates participated, and 20 questions to different knowledge points were randomly selected and used in the examination respectively in simple and complex A2 type best multiple-choice test questions. The difficulty and discrimination indices of the two forms of test questions were compared. Results The average difficulty coefficient of the 20 simple test questions (65.5 words per question in average) is 0.6829, and the average discriminative powers are 0.2675 and 0.2579 respectively using identification index method and point biserial correlation method. The average difficulty coefficient of the 20 complex test ques-tions (135.5 words per question in average) is 0.7095, and the average discriminative powers are 0.3065 and 0.2967 respectively using identification index method and point biserial correlation method. Conclusion To the same knowledge points, the average difficulty of complex A2 type best multiple-choice test questions is slightly lower than the simple ones, while the average discriminative power is increased in the complex questions. The complex A2 type test questions are of higher quality and more in line with the requirements of the medical entrance examination, medical education and examination reform.

Applying combined PBL and traditional teaching method to medical chemistry experimental teaching.Questionnaire and course examination were used to evaluate teaching ef-fect.The conclusion was that PBL teaching method was more helpful and effective than that of single traditional teaching method.