MicroRNA (miRNA) is a family of endogenous,non-coding small RNAs molecules that function as gene regulators.It has been revealed that miRNAs may play a critical role in many biological processes including cell proliferation,differentiation and apoptosis.Recent studies demonstrate that aberrant expression of miRNAs can lead to several human diseases even cancer.These tiny but potent molecules have the function as anti-oncogene or oncogene.Accordingly,further study of miRNAs has opened a novel avenue in the diagnosis and treatment of human cancer.

Objective:To investigate the efficacy and safety of different doses of tirofiban combined with coronary artery intervention in treatment of Non ST-segment elevation acute coronary syndromes (NST-ASC).Methods:110 cases with NST-ACS from October 2014 to January 2016 in our hospital were chosen and divided into the all dose group and half dose group.The TIMI blood grade before and after treatment,cardiac function before and after treatment for 30 d,major adverse cardiac events and bleeding events,hospitalization expenses and hospitalization days were recorded and compared between two groups.Results:Compared with before treatment,the TIMI 2 grade and 3 grade were obvious decreased,and the left ventricular end diastolic volume (LVEDV),left ventricular end systolic volume (LVESV) after treatment for 30 d were all obvious decreased,while the left ventricular ejection fraction (LVEF) were significant increased,P＜0.05.And the TIMI blood flow grading,LVEDV,LVESV and LVEF before and after treatment in two groups had no significant difference (P＞0.05),and the major adverse cardiac events and hospitalization days of two groups had no significant difference,P＞0.05.While the bleeding events and hospitalization expense of all dose group was obvious higher than those of half dose group,P＜0.05.Conclusions:The half dose group of tirofiban combined with coronary artery intervention in treatment NST-ACS has obvious efficacy,it can decrease the bleeding events and hospitalization expense.

Objective To investigate the effect of trimetazidine combined with atorvastatin on cardiac function and the level of hs-CRP,IL-6,and Fib in patients with coronary heart disease.Methods Patients (120 cases) with coronary heart disease in the first people's Hospital of Xianyang City from January 2014 to January 2016 were selected and randomly divided into two groups.The observation group was treated with trimetazidine combined with atorvastatin,the control group was treated with trimetazidine,the curative effect,left ventricular ejection fraction,left ventricular diastolic end systolic diameter,left ventricular posterior wall thickness and serum hs-CRP,IL-6,and Fib levels were compared.Results The effective rate of observation group was 91.67％ (55/60),significantly higher than the control group 76.67％ (46/60) (P ＜ 0.05);The left ventricular ejection fraction,left ventricular end-diastolic diameter,and left ventricular posterior wall thickness of two groups were significantly improved (P ＜ 0.05),and the improvement of the observation group was significantly better than that of control group (P ＜ 0.05);The serum levels of hs-CRP,IL-6,and Fib were significantly lower (P ＜ 0.05),and the observation group was more obvious (P ＜ 0.05);The incidence of adverse reactions of two groups had no significant difference.Conclusion Trimetazidine combined with atorvastatin have high curative effect on coronary heart disease,and can improve cardiac function,significantly reduce the levels of hs-CRP,IL-6,and Fib,worth clinical promotion.

In recent years, the virtual surgery training system with force feedback has provided a new way for young doctors to improve their surgical skills in a safe, efficient and flexible training method. Precise drilling force and realistic hand feeling of manipulation are the cruxes in the virtual surgery training, and the accurate simulation of bone drilling depends on the accurate establishment of drilling force prediction model. The establishment of force prediction model with finite element analysis is the key part in the development of virtual training system. In this paper, the current research status of finite element analysis of bone drilling presented in four aspects: bone model reconstruction, material model, mesh model and prediction of drilling force, especially the construction of bone tissue material model is discussed in detail and several important models are analyzed. This paper presented a relatively complete overview of the approaches commonly used in this research field to promote the establishment of more accurate force prediction models of bone drilling.

Objective:To explore the characteristic of parenting style and its relationship with self congruence in Tibet middle school students.Methods:Totally 1149 Tibet students in 2 middle schools were investigated by the Scale of EMBU (Egma Minnen av Bardndosnauppforstran)and SCCS (Self Consistency and Congruence Scale) from counties resided mainly by Tibet people.Results:The total average scores of Tibet students'self-congruence were lower than the median[(2.8 ± 0.3) < median 3].There was no significant difference between genders [(2.6 ±0.3)vs.(2.7 ±0.4),P >0.05],and the scores of self flexibility had statistical significant difference in gender [(2.9 ±0.5)vs.(2.8 ±0.5),P <0.05].The scores of parenting style in positive elements were negatively correlated with self congruence in Tibet middle school students (r =-0.20,P <0.01 ).Multi-linear regression showed that the element of maternal emotion and understanding had negative relevance with SCCS(β=-0.16,P <0.01),while the element of maternal rejection and denial had positive relevance with SCCS(β=0.16,P <0.01) .Conclusion:It indicates that the level of self-congruence is higher than median,and that parenting style might have a certain relationship with self congruence in Tibet middle school students.

Objective To investigate the expression of CD40,CD40L and MMP9 in carotid atherosclerotic plaques and evaluate their roles in carotid atherosclerotic plaque stability.Methods Carotid atherosclerotic plaques were isolated in carotid eversion endarterectomy (GEE) in 37 patients with high-grade stenosis (>70%) including 20 stroke (A group) and 17 non-stroke patients (B group).The control group included samples of normal carotid artery from 11 normal individuals,The RNA expression levels of CD40,CD40 L and MMP9 in all A,B and control groups were quantitatively detected by real-time quantification polymerase chain reaction (PCR) and the protein expression levels were detected by Western blotting analysis.The expression and distribution of CD40,CD40L and MMP9 in carotid atherosclerotic plaques were detected by immunohistochemistry staining.Then correlations between CD40-CD40L and MMP9 were statistically analyzed.Results The relative CD40 mRNA level in high-grade stenosis of A group,B group and normal control were 2.41±0.43,1.03±0.38 and 0.31±0.12,respectively,and MMP9 mRNA 6.88±1.57,1.90±0.44 and 0.39±0.12,respectively.The levels of CD40 and MMP9 mRNA in A group were significantly higher than those in B group (P=0.000),the levels of CD40 and MMP9 in B group were significantly higher than those in controls (P=0.000).There was a linear correlation between CD40 and MMP9 mRNA (r=0.929,P=0.000).However,there were no significantly difference in mRNA levels of CD40L between carotid atherosclerosis and controls.The protein expression levels of CD40,CD40L and MMP9 in A group were significantly higher than those in B group (FCD40=104.100,P=0.000;FCD40L=129.932,P=0.000;FMMP9=13.565,P=0.021) and B group higher than normal controls (FCD40=115.848,P = 0.000;FCD40L= 30.482,P=0.005;FMMP9=35.557,P=0.004).The areas of positive staining of CD40,CD40L and MMP9 in immunochemistry study in A group were significantly higher than those in B group and B group was significantly higher than controls.There were linear correlations between positive staining areas Of CD40 and CD40L,CD40 and MMP9,CD40L and MMP9 (r=0.963,0.959,0.929,P=0.000).Expressions of CD40,CD40L and MMP9 were significantly higher in the shoulder areas of the atherosclerotic plaques than in other areas.Conclusions The CD40-CD40L has an important role in the formation of carotid atherosclerosis and plaque instability,probably by up-regulating MMP9.The expression of CD40L may be regulated by post-transcriptional modification to exert biological effects.

Based on the conception analysis of the organizational change leadership of the upper-and mid-level nursing manager,this review described connovations of the organizational change leadership and its applications in nursing field at home and abroad,and pointed out the current research status,limitations and the inspirations we got,so as to provide references for promotion and evaluation of the upper-and midlevel nursing manager's organizational change leadership.

Objective • To investigate the effect of microenvironment on the expression of β-site amyloid precursor protein cleaving enzyme 1 (BACE1) in PC12 cells. Methods • The PC12 cells were respectively treated with thapsigargin (Tg), lipopolysaccharide (LPS), H2O2, hypoxia incubator and hypoglycemic medium to produce mild endoplasmic reticulum stress (ERS), inflammatory environment, mild oxidative stress, hypoxia and low glucose conditions. Western blotting and fluorescence quantitative PCR were used to detect the expression of BACE1 protein and BACE1 mRNA. Results • After PC12 cells were treated with Tg (0.13 μmol/L) for 12 h or LPS (0.01 mg/mL) for 36 h, BACE1 protein and mRNA levels were significantly up-regulated (P<0.05). No significant changes were observed in the expression of BACE1 protein and mRNA of the PC12 cells treated with H2O2 (0.13 mmol/L or 0.25 mmol/L) for 12 h, under hypoxic or hypoglycemic environment (P>0.05). Conclusion • Mild ERS and inflammatory condition can up-regulate BACE1 mRNA and protein expression in PC12 cells.

The choroid is one of the most common ocular sites for metastatic disease. Lung cancer is the first cause of choroidal metastasis among primary cancers in China. The current management of choroidal metastasis of lung cancer is based on the combination of systemic treatments and local treatments. The latter mainly include radiotherapy, transpupillary thermotherapy, photodynamic therapy, intravitreous injection and enucleation. This review covers the research progress in local treatments on choroidal metastasis of lung cancer.

Abstract: Objective To analyze the epidemiological characteristics of pulmonary tuberculosis (PTB) in Ankang City from 2011 to 2021, so as to provide a scientific basis for the formulation of PTB prevention and control strategy. Methods Descriptive statistics were used to analyze the epidemiological characteristics of PTB in Ankang City from 2011 to 2021, and a time series model was established to quantitatively predict the incidence of pulmonary tuberculosis in 2023. Results The incidence rate in Ankang City showed a significant upward trend from 2011 to 2017, and a more obvious downward trend in 2017-2021 (P<0.05), and the decrease rate in 2021 was 40.36% compared with that in 2017. The proportion of etiological positivity increased from 12.5% in 2014 to over 50.00% after 2019. The incidence season was mainly concentrated in the first quarter, accounting for 28.39% of the annual incidence. High incidence areas were concentrated in the south of Ankang: Langao County, Ziyang County and Zhenping County, with 128.32/100 000, 117.07/100 000 and 110.44/100 000, respectively. Low incidence areas were located in the north of Ankang: Ningshan County, with 60.62/100 000. Farmers and students were the high incidence groups, accounting for 81.80% and 4.97% of the total cases respectively. The incidence of young children was relatively low, but cases were reported every year. The incidence rate of male was 2.39 times that of female. The age of onset increased significantly from 15 years old, and the peak incidence was in the age group of 60-<80 years old, followed by the age group of 45-<60 years old, the average annual incidence was 136.44/100 000 and 104.47/100 000, respectively. The model ARIMA(0,1,1)(0,1,1)12 predicted that the incidence of the disease generally increased from October 2022 to March 2023, then steadily decreased, and increased again in December. Conclusions The incidence of tuberculosis varies in different areas of Ankang City, and males, farmers, students and the elderly are all factors of high incidence of tuberculosis. Therefore, different prevention and control strategies should be adopted according to the characteristics of population in different areas. The number of cases in Ankang City in 2023 showed an overall downward trend, which can provide a reference for the prevention and control of PTB.