Circulating microRNAs (miRNAs) is a class of non-coding small RNA molecules.As tumor biomarkers, circulating miRNAs deregulation is associated with the initiation and progression of human cancer.Studies indicate that circulating miRNAs have great potential in the early diagnosis and prognosis of primary or metastatic tumors (colorectal, breast, prostate, hepatocellular and ovarian cancer and other epithelial cancer).

Objective:To investigate the efficacy of re-treatment for cervical lymph node recurrence in nasopharyngeal carcinoma patients after radiotherapy and to explore the prognostic factors.Methods:Eighty-two patients who received therapy due to cervical lymph node recurrence after deftnitive radiotherapy were reviewed.The relevant factors including sex.the interval between radiotherapy and recurrence,rN stage,recurrence site,treatment modalities,and treatment efficacy were analyzed.Subgroup analysis was performed to review the relevant factors including the involvement in the adjacent tissues,the number of positive nodes and surgical range.Kaplan-Meier method,Log-rank test and Cox method were used for statistical analysis.Results:The 1-,3-and 5-year local control rates were 58%,39.0%,and 39.0%,respectively.The 1-,3-and 5-year overall survival rates were 82.9%,47.6%.and 25.0%,respectively.The 1-,3-and 5-year overall survival rates in the radiotherapy-based treatment group were 80.8%,37.1%and 19.1%,respectively.The 1-,3-and 5-year overall survival rates in the surgery-based treatment group were 86.7%,66% and 34.2%,respectively.The efficacy of surgery-based treatment was superior to that of radiotherapy-based treatment.In the multivariate analysis,tumor recurrence site was an independent prognostic factor.Conclusion:Radical neck dissection-based treatment can achieve satisfactory efficacy for cervical lymph node recurrence after radiotherapy in nasopharyngeal carcinoma patients.

OBJECTIVE:To investigate the thoughts and ways of clinical pharmacist in nephrology department to review medi-cal orders,and to provide reference for rational drug use in nephrology department. METHODS:Based on specific cases of nephrolo-gy department,the thoughts and ways of clinical pharmacist in nephrology department to review medical orders were investigated from several aspects,including whether the therapeutic drugs had covered all the problems,drug duplication,drug selection,usage and dosage and course of treatments,drug interaction and compatibility. RESULTS & CONCLUSIONS:By establishing rigorous and systematic review thinking mode,based on their professional specialty,clinical pharmacists of nephrology department can sort the reviewing thought,fill in the gaps of medical orders reviewing and enhance the ability of participating in the clinical practice.

OBJECTIVE To evaluate the relationship between the degree of nasal septum deviation and inferior turbinate hypertrophy with the CT. METHODS The paranasal sinus CTs of 98 cases with septum deviation were evaluated. Inferior turbinate on the deviated side of the nasal septum was considered as the control group and the inferior turbinate on the other side was taken as the study group in the same patient. The septal deviation angle, thickness of the bone, medial mucosa and lateral mucosa of the inferior turbinate were measured. RESULTS The thickness of the bone, medial mucosa and lateral mucosa of the inferior turbinate were statistically different between the study group and the control group(P<0.05). There were statistically differences between the medial and lateral mucosal thickness in study group(P<0.05). There was no positive correlation between the deviation angle and the thickness bone, medial and lateral mucosa of the inferior turbinate in the study group(P>0.05), but the value of correlation coefficents revealed the inferior turbinate bone correlated with the deviation angle most, followed by medial and lateral mucosal thickness. CONCLUSION The hypertrophy of inferior turbinate in patients with nasal septum deviation is not only caused by mucosal hypertrophy, but also by hypertrophy of the inferior turbinate bone. The preoperative CT before septoplasty can be helpful to choose the surgical methods during the operation.

Objective To study the effect of letrozole (LE) on ovulation in patients with polycystic ovary syndrome (PCOS).Methods One hundred and sixty-four patients with PCOS were divided into LE treatment group (n=68) and chloramiphene (CC) treatment group (n=96).Growth rate of follicles,serum hormone level,endometrial thickness,and cervix mucus were observed before and after treatment.Results The growth rate of follicles was 1.67 and 1.78 mm/d,respectively,in LE and CC treatment groups (P=0.14).The serum T level on the day of LH peak was 2.1?1.9 and 2.0?1.7ng/dL,respectively,in LE and CC treatment groups (P=0.93).The serum testosterone (T) level on day of LH peak and on day 3 of menses was 2.1?1.9 and 1.4?1.5 ng/d,respectively,in LE and CC treatment groups (P=0.09).The serum E2 level on day of LH peak was 89.0?59.5 and 108.1?46.0 pg/ml,respectively,in LE and CC treatment groups (P=0.13).The endometrial thickness was 11.3?1.6 and 9.7?1.4 mm,respectively,in LE and CC treatment groups (P=0.07).The score of cervix mucus was 11.0?1.1 and 8.3?3.1,respectively,in LE and CC treatment groups (P=0.003).Conclusion Letrozole can effectively induce ovulation in patients with polycystic ovary syndrome,and does not increase serum T level.

Objective:To explore the hemodynamic effect of the modified Z Trendelenburg position in patients undergoing laparoscopic radical surgery of endometrial carcinoma, to provide a reference for the selection of the operative position of patients.Methods:A total of 80 patients who undergoing laparoscopic radical surgery of endometrial carcinoma from April 2017 to April 2019 in the Central Hospital of Xiangyang were recruited and assigned to experiment group and control group by random digits table method with 40 cases in each group. Patients in the experiment group were positioned in modified Z Trendelenburg position, while the patients in the control group were placed in conventional Trendelenburg position. The data of heart rate, mean arterial pressure, central venous pressure, systemic circulation resistance, cardiac output were recorded at 10 minutes before pneumoperitoneum (T 0), pneumoperitoneum immediately (T 1) and 5 minutes (T 2), 10 minutes (T 3), 30 minutes (T 4), 60 minutes (T 5) after pneumoperitoneum and 1 minute after recover horizontal position (T 6). Followed up investigation at 24 h after surgery, the degree of pain in the shoulder and the lower limbs were also recorded by Visual Analogue Scale(VAS). Results:The differences of heart rate, mean arterial pressure, systemic circulation resistance and cardiac output between the two groups had no statistical significance at T 0 to T 6 (all P>0.05). The central venous pressure were (9.86±1.95), (10.94±1.53), (11.33±2.24), (11.14±1.54),(7.75±1.59) cmH 2O(1 cmH 2O=0.098 kPa) respectively from T 2 to T 6 in the experiment group, lower than that of control group (18.83±2.82), (16.81±2.93), (16.27±3.56), (15.76±2.33), (8.92±1.68) cmH 2O at the same time, the differences were statically significant ( t values were 3.057-15.736, all P<0.05). The VAS scores of shoulder pain and low leg pain in experiment group were (3.48±1.10), (2.35±0.66) points, lower than that of control group (4.16±1.32), (2.99±1.02) points, the differences were statically significant ( t values were 2.404, 3.228, P<0.05). Conclusions:Modified Z Trendelenburg position can maintain the circulatory system hemodynamic stability, reduce the degree of shoulder pain and low leg pain after surgery in the laparoscopic radical resection for endometrial carcinoma patients.

Objective · To determine the expression of miRNA-7 in TWEAK-stimulated macrophages and their secreted exosomes;to investigate the role of exosomal miRNA-7 from TWEAK-stimulated macrophages in modulating the metastasis of epithelial ovarian cancer (EOC) cells.Methods · Real-time PCR analysis was used to determine the miRNA-7 expression in TWEAK-stimulated macrophages,their exosomes and recipient HO8910-PM cells.The activity of EGFR signaling pathway in HO8910-PM cells was detected by Western blotting analysis.AntagomiR-7 was used to downregulate the miRNA-7expressions in macrophage exosomes and then their effect on metastasis of HO8910-PM cells was examined by transwell assay.Results ·TWEAK increased the levels of miRNA-7 in macrophages and their secreted exosomes and also resulted in an elevated level of miRNA-7 in recipient HO8910-PM cells,which eventually reduced the activity of EGFR/AKT/ERK1/2 pathway.Pre-transfection of antagomiR-7 remarkably decreased the levels of miRNA-7 in macrophages,their secreted exosomes and the recipient EOC cells,with the enhancement of HO8910-PM metastasis.Conclusion · Exosomal miRNA-7 from TWEAK-stimulated macrophages plays a critical role in suppressing the metastasis of EOC cells by attenuation of EGFR signaling pathway.

Objective To review recent neuroimaging studies of aggressive/violent behaviors in schizophrenia and related the neural circuits of aggressive behaviors,tocusing on structure magnetic resonance imaging (MRI) method,published from 2000 to 2014.Methods A systematic literature search was conducted using articles from PsycINFO,Embase,Pubmed and Cnki pnblished between 2000 and 2014,we usedaggressive, violent, schizophrenia, structure M RI as the key words,to explore the relationship between schizophrenia of aggressive/violent behaviors and the related neural circuits.Results Of the 18 studies included in the analysis,mostly were case-control studies,two were written in Chinese.The neuroimaging literature on aggression in schizophrenia revealed the related grey matter volume of brain areas which contained the frontal lobe,temporal lobe,amygdala,hippocampus,cerebelum and caudate nucleus.Conclusion Findings from the current reviews suggest that the occurrence of violent/aggressive behaviors of schizophrenia were related with serval neural circuits as the frontal-temporal cognitive circuit,Papez circuit,cerebellum advaneed cognitive circuit and caudate nucleus-reward seeking cireuits.However,the precise violent/aggressive neural mechanism has vet to be studied further.

Objective To evaluate the performance of the Beckman Coulter ACT-5DIFF AL automated hematology analyzer and to verify whether it meets the clinical requirement.Methods The residual contamination rate,accuracy,precision,uncertainty,measurement range,reference interval,and sample injection pattern of detecting system were evaluated.Results The residual contamination of each parameter was less than or equal to 0.18％.According to room between qualitative evaluation results,compared to the target value,bias ranged from 0.32％ to 2.29％.Different concentrations of laboratory variation coefficient (namely precision) of each parameter ranged from 0.35％ to 4.46％,and both of which were less than a third of the CLIA'88 ability verification analysis quality requirements.The expanded uncertainty of each parameter was Uwhite blood cell (WBC) low =7.4％,UWBC high =3.8％,Ured blood cell (RBC) low =3.4 ％,U RBC high =2.8 ％,Uhemoglobin (HGB) low =3.9 ％,UHGB high =2.2 ％,Uplatelet (PLT) low =9.8 ％,UPLT high =7.6％,UMCV low =2.6％,and UMCV high =2.5％.Analysis had a wide measuring range:WBC (0.2 ～ 137.3) × 109/L,RBC(0.72 ～ 7.66) × 1012/L,HGB (20 ～ 231)g/L,PLT(25 ～983) × 109/L,and hematocrit (HCT) (6.1 ～68.0)％.All of them had a linear relationship,and the correlation coefficient of linear regression was close to 1.0.The reference interval quoted was suitable.Both of the automatic and the hand sample injection pattern had no significantly difference in result detection.Five categories of WBC were verified up to standard.Conclusions Under the circumstance of indoor quality control approved,each performance indicator approximately reached the laboratory quality requirements,and it also met the clinical requirements.

Objective To observe the efficacy and safety of levofloxacin for the theatment of com-munity acquired pneumonia(CAP) in the elderly patients. Methods Thirty-six elderly inpatients with CAP between May 2005 and May 2007 were treated with levofloxacin at a dosage intravenously of 500 mg once a day for 5 to 14 days treatment. Results Streptococcus pneumoniae of multiple drugs-resistant were found in sputum of 22 patients,pseudomonas aeruginosa in 8 patients and haemophilus influenzae in 6 patients de-pending on the results of the sputum culture. The total clinical efficacy rate of levofloxacin was 75.0% and bacteria elimination rate was 82.1%,and 16.7% patients showed related side effect of diarrhea,skin-rash and kidney injury. Conclusions Levofloxacin is an effective with little side effect in treatment of CAP in the elderly.