Objective: To explore the effects of acupuncture on nutritional status in patients in a persistent vegetative state. Methods: A prospective randomized controlled trial was designed. A total of 66 patients in a persistent vegetative state were randomized into a control group and an observation group, with 33 cases in each group. The control group was given conventional treatment plus enteral nutrition support. The observation group was treated with additional Tiao Shen Jian Pi acupuncture therapy (acupuncture for spirit-regulating and spleen-invigorating) based on the same interventions in the control group. Both groups were treated for 8 weeks. The levels of total protein (TP), prealbumin (PA), albumin (Alb), and hemoglobin (Hb) were measured before and after treatment. The upper arm circumference and skinfold thickness of triceps brachii were measured. And the intestinal flora and fecal short-chain fatty acids contents were determined.Results: After treatment, the levels of TP, PA, Alb, and Hb in the control group were decreased (P<0.05), while in the observation group, compared with those before treatment, the levels of TP, PA, Alb, and Hb had no statistical differences (P>0.05), and the levels were all higher than those in the control group (P<0.05). The upper arm circumference and skinfold thickness of triceps brachii in both groups decreased (P<0.05), and the values of these two items in the observation group were higher than those in the control group (P<0.05). In the control group, the contents of Bifidobacterium and Lactobacillus in feces decreased (P<0.05), and the content of Enterococcus increased (P<0.05). In the observation group, the contents of Bifidobacterium and Lactobacillus in feces increased (P<0.05), and the content of Enterococcus decreased (P<0.05). The differences between the two groups were statistically significant (P<0.05). In the control group, the total content of fecal short-chain fatty acids and the contents of acetic acid and butyric acid in feces decreased (P<0.05). In the observation group, the total content of fecal short-chain fatty acids and the contents of acetic acid and butyric acid in feces increased (P<0.05) and were all higher than those in the control group (P<0.05). Conclusion: Acupuncture can improve nutrition-related blood indicators in patients in a persistent vegetative state and delay the decrease of upper arm circumference and skinfold thickness of triceps brachii, which may be related to the regulation of intestinal flora and fecal short-chain fatty acids contents.

Objective To study the synergism effect of 131 I-Herceptin and high-energy X-ray on HER2 overexpressed breast cancer SK-BR-3 cells.Methods The protein expression and gene amplification of human epidermal growth factor receptor-2 ( HER2 ) in SK-BR-3 cells were identified by immunohistochemistry and fluorescence in situ hybridization ( FISH ) method, 131 I-Herceptin was prepared by iodogen method, and the IC15 concentration of 131 I-Herceptin on SK-BR-3 cell were selected by MTT method.The cells were divided into control group and drug group according to 131 I-Herceptin used or not, and were delivered five different doses of external irradiation (0,2,4 and 6Gy), and the synergism effect was detected by colonogenic assay.The cells were divided into blank group, drug group(131I-Herceptin), X-ray group(2 Gy external irradiation) and combination group (131I-Herceptin+2 Gy external irradiation), the apoptosis rate and death rate were detected by AO/EB method and cell cycle were detected by flow cytometry.Results The labling rate, radiochemical purity and specific radioactivity of 131 I-Herceptin were 86.8%, 93.9% and 868.3 μci/mg, respectively.The IC15 of 131 I-Herceptin was 15.625μci/mL.131 I-Herceptin and high-energy X-ray significantly reduced surviving fraction ( SF) ( F=628.888,F=964.97,P<0.05) and there were interactions between them (F=113.046,P<0.05).There were significant differences in apoptosis rate and death rate among blank group, drug group, X-ray group and combination group(F=103.324,F=13.33,all P<0.05),and there were significant differences of pairwise comparison (P<0.05).After irradiation and 131I-Herceptin administration, the cell cycle changed obviously from G1-phase to G2-and S-phase.Conclusion 131 I-Herceptin combined with high-energy X-ray has the synergism effect on HER2 overexpressed breast cancer SK-BR-3 cells.

Objective To explore the differences of patient comfort and nursing workload between ultrasound guidance on upper arm placement of PICC and traditional placement of PICC, and to provide a reference for correct selection of catheter way. Methods Using a nonrandomized controlled study, a total of 1 116 patients were divided into the control group and the observation group, patients with traditional placement of PICC were set as the control group, and the patients with upper arm placement of PICC were named as the observation group. The patient comfort and workload of use and maintenance of PICC by nurses were compared between two groups. Results The incidence of catheter sliding out of PICC in the observation group was 1.9%(7/365), obviously higher than that of the control group, which was 0.3%(2/751), the difference was significant (χ2=8.37,P=0.007). The patient comfort had no statistical significance between two groups (t=2.13,P=0.082). The workload of use and maintenance of PICC in the observation group were (1.87±0.31) min and (9.16±1.07) min ,which were obviously higher than that of the control group [(0.85±0.16) min and(7.22±2.13) min] in winter (t=4.39, P=0.022;t=3.44, P=0.041), but there was no statistical significance between two groups in summer (P>0.05). Conclusions The workload of use and maintenance of PICC on upper arm placement was higher than traditional placement of PICC in winter, but the obvious differences of patient comfort and nursing workload in summer between the two PICC groups were not been found.

Objective To observe the effect of Bupiyichang pills combined with levocetirizine in the treatment of 56 patients with chronic urticaria,so as to provide clinical guidance and basis.Methods 118 patients with chronic urticaria were selected for our study,and after informed consent they were randomly divided into observation group and control group.The observation group were was treated by Bupiyichang pills combined with levocetirizine,and the control group were was treated by levocetirizine.When they were curingAfter treatment for 10,20,and 30 days,the effective rates in the two groups were calculated and compared with each other.And at the day before treating and the day after treating for 20 days,the serum IgE levels in each group was detected and compared.The falling ranges between the two groups were calculated and compared.Results When they were curing treated for 10,20,and 30 days,the effective rates in the observation group were 76.79％,94.64 ％,85.71％,respectively,which in those of the control group were 59.68％,74.19％,64.52％,respectively,the differences between the two groups were statistically significance significant (x2 =3.94,9.11,6.97,all P ＜ 0.05).At the day before treating and the day after treating for 20 days,the serum IgE levels in the observation group were (384.71 ± 65.62) U/mL and (214.59 ±40.71) U/mL respectively,the difference was statistically significance significant (t =10.93,P ＜ 0.05);and the serum IgE levels in the control group were (380.25 ± 67.81)U/mL and (256.99 ± 53.21)U/mL respectively,the difference was statistically significancesignificant (t =9.37,P ＜ 0.05).The falling ranges in the observation group and the control group were (170.12 ± 35.59) U/mL and (123.26 ± 53.31) U/mL respectively,the difference was statistically significance significant between the two groups (t =7.82,P ＜ 0.05).Conclusion Bupiyichang pills combined with levocetirizine is more effective than single medication of levocetirizine.

Objective To explore the clinical effects of the packet therapy combined with Chinese prescrip-tion soaking in the treatment of patients with verruca plantaris,so as to provide clinical guidance and basis.Methods 101 patients with verruca plantaris were chosen as study objects,and they were divided into two groups,namely obser-vation group and control group.Observation group was treated by the packet therapy combined with Chinese prescrip-tion soaking,and control group was treated by Chinese prescription soaking.When they were cured for 4 weeks,the main symptoms and effective rate in the two groups were calculated and compared.For the recovery patients,when their drugs were withdrew for 8 weeks,the recurrence rate between the observation group and control group was compared.Results After being treated for 4 weeks,both of the skin lesion and pain degree between the observation group and control group had significant differences (Z=4.48,P<0.05;Z=4.18,P<0.05).The effective rates in the observation group and control group were 85.71% and 48.08%,respectively,and the difference between the two groups was statistically significant (χ2 =16.00,P<0.001).The recurrence rates in the observation group and control group were 13.33% and 27.27%,respectively,and the difference between the two groups was no statistically signifi-cant (P>0.05).Conclusion The packet therapy combined with Chinese prescription soaking is more effective than Chinese prescription soaking.

Objective To evaluate the value of CT guided percutaneous transthoracic needle biopsy (PTNB) for the diagnosis of lung ground‐glass opacity (GGO) with a Meta‐analysis .Methods Relevant English and Chinese language studies were searched on the PubMed ,EMBASE ,EBSCO ,OVID ,CNKI ,CBM ,VIP and WANFANG databases ,respectively .Data were calculated with software of Stata 12 .0 and Meta‐Disc 1 .4 .Results 6 of 82 retrieved studies were included (n=341) .The pooled sensitivity ,specifici‐ty ,LR+ ,LR- ,DOR ,AUC and 95% CI were 0 .92(0 .86-0 .95) ,0 .98(0 .85-1 .00) ,49 .03(5 .72-420 .18) ,0 .08(0 .05-0 .15) , 586 .24(65 .18-5 272 .83) and 0 .99(0 .98-1 .00) ,respectively .Conclusion CT guided PTNB can be used as one of the primary examination modalities for lung GGO with moderate sensitivity and specificity .

OBJECTIVETo evaluate the efficacy of pedicled supraclavicular artery island flaps for head and neck reconstruction.

METHODSReconstructive surgeries for head and neck oncologic defects were performed with the pedicled supraclavicular artery island flaps in 10 patients from May 2013 to December 2014 and the cases were review. Among them, 6 were performed for hypopharyngeal cancer, 2 for oral tongue cancer, 1 for oral base cancer and 1 for cervical esophageal cancer. The size of the flaps was measured in (5-8) cm × (6-12) cm.

RESULTSSeven flaps survived, one flap failured and two flaps had partial necrosis. Donor sites were closed primarily without morbidity.

CONCLUSIONThe pedicled supraclavicular artery island flap is an easy harvesting and reliable for head and neck reconstruction, especially suitable for otolaryngo-head and neck surgeon and maxillofacial surgeon in the local hospital.

Arteries ; Esophageal Neoplasms ; surgery ; Head ; surgery ; Head and Neck Neoplasms ; surgery ; Humans ; Mouth Neoplasms ; surgery ; Neck ; surgery ; Reconstructive Surgical Procedures ; Surgical Flaps ; Tongue Neoplasms ; surgery ; Treatment Outcome

Objective To evaluate the value of dynamic contrast-enhanced MRI (DCE-MRI)in diagnosing benign and malignant solitary pulmonary nodule (SPN)with Meta-analysis.Methods The databases including PubMed,EBSCO,Cochrane Library,Ovid, CBM,VIP,Wan Fang Database and CNKI were searched to select the literatures about the diagnosis of SPN with DCE-MRI.Inclusion criteria were established,according to the validity criteria for diagnostic research published by the Cochrane Methods Group on Screening and Diagnostic Tests .Methodological quality was assessed by using the quality assessment of diagnostic studies (QUADAS-2)instrument.Meta-analysis was performed by Stata 12.0 and Meta-Disc 1.4.According to the results of heterogeneity of the included articles,proper effect model was selected to calculate the pooled sensitivity,specificity,positive likelihood ration,negative likelihood ration,and diagnostic odds ratio.Summary receiver operating characteristic (SROC)curve was drawed and the area under the curve (AUC)was calculated.Results A total of 17 studies involving 1255 lesions were included.The results of Meta-analysis showed the pooled sensitivity,specificity,positive likelihood ration,negative likelihood ration,and diagnostic odds ratio were 0.95,0.81,4.9,0.06 and 85,respectively.The AUC of SROC was 0.97.Conclusion DCE-MRI has relatively high sensitivity and specificity in the differential diagnosis of benign and malignant SPN.

Objective To investigate the effect of exosomes secreted from human lung adenocarcinoma A549 cells under hypoxic or normoxic conditions on the radiosensitivity and invasiveness of normoxia cells.Methods A549 cells were cultured in hypoxic (1％ O2) and normoxic (21％ O2) conditions,respectively.The exosomes (N-EXO and H-EXO) secreted from normoxic or hypoxic A549 cells were collected by ultracentrifugation and its number was measured using a NanoSight detector.The appearance and size distribution of exosomes were observed by a scanning electron microscopy.The exosomal marker protein CD63 was measured by Western blot.The proliferation of cells exposed to X-rays under hypoxic or normoxic conditions were detected by CCK8 assay.The cell uptake situation of exosomes labeled with PKH67 was observed by a fluorescence microscopy.Cell migration and invasiveness were detected by a cell scratch test and transwell assay.The expression of matrix metalloproteinase 2 (MMP2) and MMP9 was detected by ELISA.Cellular radioresistance effect of exosomes was evaluated by a colony formation assay.Results The NanoSight measurement showed the number of exosomes in cell culture medium was increased after hypoxia treatment.The H-EXO and N-EXO showed typical ring cake shape.The size distribution of H-EXO was mainly between 30 nm and 200 nm,smaller than that of N-EXO (50-220 nm).Western blot assay showed that CD63 was expressed in both H-EXO and N-EXO.At 4 and 6 days after 2 Gy X-rays irradiation,cell proliferation rate of hypoxia A549 cells was significantly higher than that of normoxia cells.The green fluorescent marker of exosomes,PKH67,was distributed inside of the cell.Cell scratch test showed that the width of H-EXO group was much smaller than that of N-EXO group at 12,24 and 48 hours after exosomes treatment (t =2.96,6.76,3.35,P ＜ 0.05).Transwell assay showed that the number of transmembrane cells in the H-EXO group was more than that in the N-EXO group and the control group (t =4.84,7.88,P ＜ 0.O1).The expression levels of MMP2 (t =4.70,3.21,P＜0.05) and MMP9 (t =5.61,3.76,P＜0.05) in the supernatant of H-EXO group were significantly higher than those in the control and N-EXO groups.Cell survival assay showed that the D0 values of control,N-EXO and H-EXO group were 2.614,2.552 and 4.50 respectively,indicating that H-EXO could enhance radioresistance of A549 cells significantly.Conclusions This study finds that the number of exosomes released from A549 cells was increased under hypoxic condition but its size becomes smaller than that under normoxia.Hypoxic exosomes can promote the migration of normoxia cells andenhance cell radioresistance as well.

Objective:To investigate the expression of circular RNA 102958 (circRNA_102958) in human gastric cancer tissues and its clinical significance.Methods:Thirty cancer tissues from gastric cancer patients in Jiangsu Cancer Hospital from September 2017 to March 2018 and their matched normal gastric mucosa tissue samples were collected. The relative expression of circRNA_102958 in the tissues was detected by fluorescence quantitative real-time polymerase chain reaction (qRT-PCR). The relationship between the expression of circRNA_102958 in gastric cancer tissues and clinicopathological features was analyzed. The receiver operating characteristic curve (ROC) was used to evaluate the efficacy of circRNA_102958 in the diagnosis of gastric cancer.Results:The relative expression of circRNA_102958 in gastric cancer tissues was higher than that in normal gastric mucosa tissues, and the difference was statistically significant (5.1±1.0 vs. 1.0±0.0, t = 4.045, P = 0.000 2). The relative expression of circRNA_102958 in gastric cancer tissues of patients with stage Ⅲ-Ⅳ was higher than that of patients with stage Ⅰ-Ⅱ, and the difference was statistically significant (9.3±2.6 vs. 2.0±0.5, t = 2.302, P = 0.029). There was no statistical difference in the relative expression of circRNA_102958 among patients with different gender, age, the longest tumor diameter, tissue differentiation degree, and lymph node metastasis (all P > 0.05). ROC analysis showed that the sensitivity and specificity of circRNA_102958 in the diagnosis of gastric cancer were 74% and 61%, and the area under the curve was 0.74. Conclusions:circRNA_102958 is highly expressed in gastric cancer tissues, and its expression is related to the stage of gastric cancer, which may be related to the occurrence and development of gastric cancer. circRNA_102958 is expected to become a molecular marker for gastric cancer diagnosis.