Acute respiratory distress syndrome (ARDS) is a common clinical critical condition of the respiratory system, with a high fatality rate and lack of effective drug treatment, hence it is a global medical problem to be solved urgently. Recently, with the in-depth research on extracellular vesicles (EVs) at home and abroad, more and more evidences suggest that EVs play a critical role in the initiation, development and progression of ARDS and have potential clinical application value. The role of different cells derived EVs in ARDS will be reviewed in this paper.

Objective To observe the clinical effect of preoperative acupuncture on hypercoagulability of elderly patients with intertrochanteric fracture. Methods Sixty elderly patients with intertrochanteric fracture were evenly randomized into control group and acupuncture group. Both groups were treated with external application of Shangke Huangshui gauze on the affected region, and additionally the acupuncture group was treated with acupuncture on bilateral acupoints of Huantiao, Xuehai, Liangqiu, Zusanli, Sanyinjiao, and Taichong. The treatment for the two groups was performed from the hospitalized day to the day before operation. The parameters of thrombelastograph (TEG) before and after treatment and the occurrence of deep venous thrombosis (DVT) were observed . Results After treatment, the difference of TEG parameters of the control group was insignificant as compared with those before treatment (P>0.05). In the acupuncture group, the coagulation reaction time(R) and clot formation time(K) were significantly prolonged(P < 0.05) , and coagulation angle alpha (α), maximal amplitude (MA)of thrombus and clot strength (G) were significantly decreased (P <0.05), the effect being superior to that in the control group(P<0.05). Till the day before operation , 3 cases from the control group suffered from DVT, but none of acupuncture group suffered from DVT, the difference between the two groups being insignificant(P > 0.05). Conclusion Preoperative application of acupuncture can improve the hypercoagulability of elderly patients after hip fracture.

As a high sensitive biomarker of lung cancer ,IGFBP2 plays an important role in the occur-rence,development and treatment of lung cancer .Studies have showed that it promotes tumor progression by acti-vating the IGF1R and integrin mediated signal transduction pathway .Recent researches have demonstrated that it participates in targeted therapy of lung cancer ,which may become a new target for the treatment of lung cancer . This paper makes a review on the relationship between IGFBP 2 and lung cancer .

Objective: To detect the correlation of the expression of c-erbB-2, p53, PCNA and bcl-2 with the biological behavior of breast cancer. Methods: We used immunohistochemistry to detect the expression of c-erbB-2, p53, PCNA and bcl-2 in 56 breast cancer patients. Results: The expression of c-erbB-2 was 41.1% and was negatively correlated with histological classification but was not correlated with age, clinical stage, ER, or PR. The expression of p53 was 48.2% and was positively related with ER and PR but was negatively correlated with clinical stage and pathological type. The expression of bcl-2 was 50.0% and was negatively correlated with histological classification, ER and PR and was positively correlated with clinical stage and pathological type. PCNA was highly expressed in the 56 cases. Conclusion: We should combine the detection of c-erbB-2, p53, PCNA and bcl-2 with the evaluation of clinical stage, histological degree and pathological type in order to improve the prognostic estimation of breast cancer.

Objective To investigate the effects of spinal nerve ligation (SNL) on the changes of intestinal pathology and the levels of serum immunoglobulin in rats with ulcerative colitis.Methods Thirty-six healthy male rats, weighing 200-220 g, were randomly divided into three groups using the random number table method: spinal nerve ligation model group (group SNL), sham-operationgroup (group Sham) and non-operatedcontrol group (group Con), 12 in each group.After the establishment of SNL models, the three groups were given trinitro-benzene-sulfonic acid (TNBS) to induce ulcerative colitis.The serum level of immunoglobulin (IgG, IgM) were measured on the day before SNL, before TNBS modeling and 7, 14 d after TNBS modeling, respectively.Besides, the intestinal pathology were observed on 7 d after TNBS modeling.Results The basic values of IgM and IgG before operation were not statistically different among three groups.The level of IgG in group SNL was lower than that in group Sham after SNL operation with no significant difference, but the level of IgM was significantly lower than that of group Sham (P<0.05).On 7 d after TNBS modeling, both levels of IgG and IgM in group SNL were significantly lower than those in group Sham and group Con (P<0.01).On 14 d after TNBS modeling, the level of IgG in group SNL was significantly lower than that in group Sham and group Con (P<0.05).Furthermore, the colon lesions were more extensive and the inflammation was more serious in group SNL than those in group Sham and group Con on 7 d after TNBS modeling.Conclusion Neuropathic pain suppress immune activities, reduces the serum level of IgM and IgG and aggravates intestinal inflammation caused by TNBS.

OBJECTIVE:To systematically review the efficacy and safety of Shenxian shengmai oral liquid in the treatment of slow arrhythmia,and provide evidence-based reference for clinical treatment. METHODS:Cochrane library,EMbase,PubMed, CJFD,CBM and VIP database were retrieved to collect the randomized controlled trails(RCT)of Shenxian shengmai oral liquid(tri-al group)vs.other Chinese medicines(control group)in the treatment of slow arrhythmia. After quality evaluation,the Meta-analysis was performed using Rev Man 5.14 software. RESULTS:A total of 13 RCTs were included,involving 1 023 patients. The results of Meta-analysis showed that the effective rate [RR=1.26,95%CI(1.18,1.35),P<0.001] and average heart rate [MD=5.80,95%CI (4.01,7.58),P<0.001] in test group were significantly higher than control group;there were no significant difference in the inci-dence of adverse reactions between test group and control group[OR=0.46,95%CI(0.17,1.22),P=0.12]. CONCLUSIONS:Shenx-ian shengmai oral liquid is effective with good safety in the treatment of slow arrhythmia. However,due to low quality of included studies,it remains to be further verified by high-quality and large-sample long-term RCT.

Objective To study the variation of serum Hcy and UA of Parkinson's disease.Methods 46 pa-tients with Parkinson's disease in our hospital from April 2015 to March 2016 were selected as observation group,and 57 patients with other disease at the same time were selected as control group.The contents of serum Hcy and UA of the two groups were analyzed and compared.Results The contents of serum Hcy and UA of the observation group were (17.82 ±3.12)μmol/L,(321.42 ±79.42)μmol/L.Those of the control group were (10.12 ±3.05)μmol/L, (420.15 ±70.18)μmol/L.The content of serum Hcy of observation group was higher than the control group,the con-tent of serum UA of the observation group was lower than the control group(t =12.608,P <0.01).Hcy content of middle and late patients[(18.86 ±3.12)μmol/L]was higher than early patients[(16.16 ±3.04)μmol/L](t =2.378,P <0.05),serum Hcy level was positively correlated with UPDRS(r =0.462,P =0.037),the differences were significant.Conclusion Changes of serum Hcy and UA levels were related to the occurrence of Parkinson's disease.

Objective: To explore the clinical efficacy of a new drug for acute coronary syndrome (ACS), ticagrelor in treating the patients with acute ST-segment elevation myocardial infarction (STEMI), and to compare the effect between ticagrelor and clopidogrel in order to obtain the prospective information of ticagrelor in clinical practice.
Methods: A total of 307 STEMI patients were divided into 2 groups, Treatment group, the patients received ticagrelor with aspirin, n=157 and Control group, the patients received clopidogrel with aspirin, n=150. With a period of treatment, the major adverse cardiac events (MACE), rate of thrombosis re-formation and routine blood test result were compared between 2 groups.
Results: Treatment group presented the better LVDD, LVEF, platelet level and ST-segment recovery than those in Control group, P<0.05 or P<0.01. Treatment group showed slightly higher rate of side effect such as dififcult breathing and bleeding, while those reaction did not affect the treatment or special management for the patients.
Conclusion: The clinical effect of ticagrelor is similar to clopidogre for improving the platelet level and cardiac function in STEMI patients, while the clinical advantage reported in abroad should be further studied.

Objective To analyze the clincopathological features and prognosis of 77 colorectal cancer patients with synchronous liver metastases after resection of the primary tumors.Methods Seventy seven colorec-tal cancer patients with synchronous liver metastases who underwent resection of the primary tumors and patholog-ical confirmed were enrolled in this retrospective study.The clincopathological features and prognosis were ana-lyzed.Kaplan-Meier method was used to analyze survival rate.The differences between survival curves were cal-culated by Log-rank test.Results The analysis showed that sex,tumor differentiation and TNM stage were as-sociated with prognosis(P<0.05).The analyses demonstrated no differences in age,primary tumor site,treat-ment,number of liver metastases and extrahepatic metastasis(P>0.05).There was a significant correlation be-tween CEA,CA19-9 level and gender,tumor differentiation and TNM stage(P<0.001)and the corresponding surgical procedure and TNM stage(P<0.05).Conclusion The analysis show that male,the low differentiation and stageⅢare poor prognosis factors.

Objective To observe the effects of electroacupuncture at Ganshu (BL18) and Zusanli (ST36) on depression state and gastrointestinal motility and relevant protein expressions in brain of rats with stress-induced depressive functional dyspepsia. Methods Totally 48 Wistar rats were randomly divided into normal, model, electroacupuncture (EA) and sham-operation group, with 12 rats in each group. Depressive functional dyspepsia model was established by chronic unpredictable mild stress protocols. From day 15 to day 28, the EA group was given electroacupuncture at BL18 and ST36, and the sham-operation group was stimulated by electroacupuncture at 1/3 and 2/3 of the tail. Body weight test, open field test and sucrose preference test were measured on day 0, day 14 and day 28. After 14-day administration, gastric residual volume and intestinal propulsion rate of semisolid paste were detected. The expression of βCaMK inⅡ lateral habenulas and BDNF in hippocampus were measured by Western blot. Results Compared with the normal group, the weight, the sucrose preference rate, the behavior score, the small intestinal propulsion rate of semisolid paste and the expression of BDNF in hippocampus decreased significantly both in the model group and sham-operation group (P<0.01), and the gastric residual volume of semisolid paste and the expression of βCaMK inⅡ lateral habenulas increased significantly (P<0.01). Compared with the model group, the weight, the sucrose preference rate, the behavior score, the small intestinal propulsion rate of semisolid paste and the expression of BDNF in hippocampus increased significantly in EA group (P<0.01), and the gastric residual volume of semisolid paste and the expression of βCaMK inⅡ lateral habenulas decreased significantly (P<0.01). Compared with the sham-operation group, the expression of βCaMKⅡ in lateral habenulas decreased significantly, the expression of BDNF in hippocampus increased significantly in EA group (P<0.01). Conclusion Electroacupuncture at Ganshu (BL18) and Zusanli (ST36) can improve depression and gastrointestinal motility of rats with depressive functional dyspepsia, which may be related to the inhibition of βCaMK inⅡ lateral habenulas and the activation of BDNF in hippocampus dyspepsia.