ObjectiveTo study the effect of a fast-track surgery (FTS) program on the clinical outcomes in cirrhotic patients with portal hypertension.Methods42 cirrhotic patients with portal hypertension were randomly allocated into the FTS group (n=21) and the conventional therapy control group (n=21).The postoperative time to first defecation,hospital stay,hospitalization cost,and postoperative complications were compared between the two groups.ResultsCompared with the control group,the postoperative time to first defecation was significantly shorter in the FTS group (P=0.0287).Furthermore,the postoperative hospital stay was significantly shorter in the FTS group than the control group (P=0.002).Additionally,hospitalization cost was significantly lower in the FTS group than the control group (P＜0.001).The postoperative complication was also significantly different between the two groups (7.15 ％ vs 21.5 ％,P=0.001).ConclusionA FTS program contributed to better postoperative rehabilitation in cirrhotic patients with portal hypertension.

Objective To analyze the total cost and clinical effectiveness of internal fixation and hemiar-throplasty in the treatment of femoral neck fracture for the elderly. Methods From October 2013 to May 2015,85 patients above 60-year old who were diagnosed as displaced femoral neck fracture and received operation in our hospital. All the patients were divided into internal fixation(IF)group and hemiarthroplasty(HA)group respec-tively. There were 40 cases in the IF group and 45 cases in the HA group. The total cost associated with fracture in a year was collected by medical record ,telephone interview and standard methods. At the last follow-up ,we ap-plied Harris scores to evaluate the clinical outcome for each group. Results All the patients completed the operation successfully. During 1 year follow-up the total cost in the IF group was less than that in the HA group including higher primary hospitalization cost and less post-discharge cost. The total cost was 44,556.1 Yuan in the IF group and 72,198.0 Yuan in the HA group respectively. The data showed that the total cost of HA was 1.6 times higher than that of IF. At the last follow-up the mean Harris scores was 71.1 ± 12.1 in the IF group and 74.3 ± 10.3 in the HA group while the EQ-5D index was 0.74 ± 0.15 and 0.76 ± 0.13 respectively which showed no significant differ-ence(P > 0.05). Conclusions Both internal fixation and hemiarthroplasty have effective treatment for elderly pa-tients with femoral neck fracture. Compared to hemiarthroplasty IF can provide similar clinical effectiveness with less total cost. Therefore IF may contribute to decrease the economic burden for elderly patients in China.

Objective To understand teicoplanin concentration in cerebrospinal fluid (CSF)during intravenous in-fusion in patients following neurosurgery operation,and evaluate whether drug concentration can be increased if blood-brain barrier was damaged, and effect of continuous pump of drug on drug concentration in CSF. Methods The post-neurosurgical surgery patients with surgical site/ventricular drainage were enrolled in the study, patients were divided into routine administration group(a dose of teicoplanin of 400 mg/12 h was administered for 30 min)and continuous administration group (a dose of 400 mg teicoplanin was administered for 30 min followed by a continuous infusion of 200 mg/6 h).CSF specimens were collected at respective time points of administration, teicoplanin concentration in specimens was measured.Results For routine administration group,drug concentration in CSF was (0.004 ± 0.0123 )mg/L immediately after teicoplanin was bumped,the peak concentration was (0.712 ± 1.028)mg/L after 1-hour bumping,then concentration decreased gradually,which were (0.254 ±0.222),(0.173 ± 0.152),and (0.355±0.207)mg/L at 12,18,and 24 hours of bumping respectively.For continuous administration group, drug concentration in CSF was(0.017±0.020))mg/L immediately after teicoplanin was bumped,the peak concentration reached (0.587±0.255)mg/L after 4-hour bumping,then concentration were (0.429±0.416),(0.325±0.254),(0.476 ±0.686),and (0.318 ±0.464)mg/L at 6,12,18,and 24 hours of bumping respectively,teicoplanin concentration was relatively stable 6 hours later,which were (0.318±0.464)mg/L-(0.476±0.686)mg/L.The area under the curve during 24 hours (AUC0-24 )in routine administration group and continuous administration group were 5.590 mg/L·h and 9.082 mg/L·h respectively.For two groups of patients,teicoplanin concentration only at the area near peak value a-chieved 50% minimum inhibitory concentration(MIC50 )for coagulase negative staphylococcus (CNS),but the time for a-chieving concentration higher than CNS MIC50 was far less than 50% of total administration time;teicoplanin concentration in CSF of both groups of patients didn’t achieve MIC50 for Staphylococcus aureus .Conclusion After continuous infusion of teicoplanin,drug concentration in CSF can be increased compared with routine administration group,but still can’t achieve the effective MIC;the increase of blood drug concentration is benefit to drug concentration in CSF,it is necessary to in-crease the dose appropriately to achieve clinical effectiveness.

Objective To explore the role of γ-synuclein(SNCG) siRNA in the radiosensitivity of breast cancer T47D cells.Methods SNCG siRNA was synthesized according to the coding sequence of SNCG mRNA and then transiently transferred into T 47D cell with lipofectamine .The expression of SNCG gene and protein was detected by RT-PCR and Western-blot, respectively.Cells were divided into three groups, SNCG siRNA interference group , negative control group and blank control group , which were irradiated with different doses of 60 Coγ-rays.Cell radiosensitivity was evaluated by colony formation assay , cell proliferation was assayed by CCK-8 kit, and the protein expressions of phosphorylated-AKT and mTOR were detected by Western blot assay .Results Compared with blank control cells , the expressions of SNCG gene and protein in the SNCG siRNA transferred T 47D cells were efficiently diminished .Cell colony formation results showed that , under 4, 6, 8 Gy irradiation, the cell survival of siRNA transfection group was lower than that of control group (t=5.449, 8.882, 21.503, P<0.05).CCK-8 experiments showed that the cell proliferation abilities of siRNA group at 24, 48, 72 h after 6 Gy irradiation were lower than those of control group (t=5.603, 4.839, 6.115, P<0.05).In addition, after 6 Gy irraddaition, the AKT and mTOR phosphorylation levels in the siRNA group were more obviously reduced compared with blank groups , but the total AKT and mTOR had no changes .Conclusions Transfection of SNCG siRNA can enhance the radiosensitivity of breast cancer cells probably by inhibiting p -AKT signal pathway .

Objective To understand the changing characteristics of drug concentration in the serum and cerebrospinal fluid(CSF) after intravenous (IV) drip of norvancomycin in patients after neurosurgery procedure.Methods Patients with surgical cavity/ventricular drainages after neurosurgery procedure in a hospital in 2014 were selected, and they were divided into 2 groups according to the administration modes (12 in each group), conventional administration group: 0.8 g norvancomycin IV drip for 60 minutes, repeated every 12 hours;continuous administration group, 0.8 g norvancomycin, IV drip for 60 minutes, followed by 0.4 g of IV drip for 11 hours, then 0.4 g for 12 hours, serum and CSF specimens were collected at different time points after administration, concentration of norvancomycin was determined.Results Serum norvancomycin concentration reached a peak of (55.52±26.04) and (59.22±41.88) mg/L in conventional administration group and continuous administration group respectively, 24-hour serum concentration were (8.21±6.04) and (9.11±5.09)mg/L respectively;CSF norvancomycin concentration reached a peak of (16.31±11.15) and (8.82±8.91)mg/L in conventional administration group and continuous administration group respectively, 24-hour CSF concentration were (6.12±2.34)and (5.71±4.72)mg/L respectively;CSF penetration rate of conventional administration group was calculated by ratio of area under curve (AUCCSF/AUCserum), at 0-12 and 12-24 h hour were 63.3% and 59.0% respectively;in continuous administration group were 25.4% and 47.4% respectively.According to 95% of the minimum inhibitory concentration (MIC90) 2 mg/L of target bacteria methicillin-resistant Staphylococcus aureus (MRSA), AUC0-24/MIC90 in conventional administration group and continuous administration group were 192 and 184 respectively.Conclusion For patients who receives early use of standard dose of norvancomycin after neurosurgery procedure, CSF drug concentration after convention and continuous administration of norvancomycin can both reach MIC90 against target bacteria.

Objective To investigate the clinical efficacy and safety of oxycodone hydrochloride controlled-release tablets in treatment of advanced cancer pain.Methods 130 patients with advanced cancer pain were selected and randomly divided into two groups,65 patients received oxycodone hydrochloride controlled-release tablets as observation group,65 patients received morphine sulfate controlled-release tablets as control group.Quality of life score was evaluated, clinical efficacy and safety were compared between two groups.Results After treatment, cancer pain of patients in two groups were relieved than pre-treatment (P<0.05), and patients in observation group were better than control group (P<0.05).After treatment, the quality of life in two groups were all improved ( P <0.05 ) , and patients in observation group was more obvious than control group ( P <0.05 ) .During the treatment, adverse reactions occurred in different degrees, and the incidence of adverse reactions in the observation group was lower than control group (P<0.05).Conclusion Oxycodone hydrochloride controlled-release tablets are effective drug in treatment of advanced cancer pain,which can significantly relieve pain and improve quality of life.

Objective To explore the effects of high background radiation on the expressions of miR-16, miR-106b, miR-449a, miR-34a and let-7g in peripheral blood plasma of the residents .Methods Totally 110 healthy female long-term local residents aged over 50 years were randomly selected from the high background radiation area and the control area , while their age, body mass index(BMI) and other indicators were surveyed .The relative expression levels of miRNAs in peripheral blood plasma of these women were quantitatively detected by real-time fluorescence quantitative PCR ( RT-PCR) .Then t-test was used to analyze the cumulative dose , age and BMI between the high background and control group .Mann-Whitney U-test was used for statistical analysis of miRNA expression levels between two groups , and the multiple regression analysis was used finally .Results Compared with the control group , the cumulative dose of individuals in the high background group was about four times higher (t=42.803, P<0.05), and the levels of miR-16 and miR-106b in plasma of high background group were down-regulated, while the level of miR-449a was up-regulated ( Z =4.180, 2.422, 2.794, P <0.05 ).After controlling of confounding factors such as age and BMI , the expression levels of miR-16 and miR-106b were negatively correlated with the cumulative dose of individuals (P<0.05).On the contrary, no significant correlation was observed between the levels of miR-449a, miR-34a, let-7g and the individual cumulative dose (P>0.05).Conclusions miR-16 and miR-106b may serve as biomarkers for the early stage of low dose radiation health effects .

Objective:To study serum procalcitonin (PCT), C-reactive protein (CRP) and platelet count (PLT) in evaluation of severity of acute cholangitis (AC).Methods:Ninety patients with AC who were treated at the General Surgery Department, Guangming Hospital, Liaocheng, Shandong Province from January 2016 to December 2018 entered into the observation group, while 60 patients with bile duct stones but without infection treated at the hospital during the study period entered into the control group. Using the " Guidelines for the Diagnosis and Treatment of Acute Biliary Tract Infections" , the study group of patient was further divided into the mild infection, moderate infection, and severe infection groups. The PCT, CRP and PLT levels of all the subjects were checked. Spearman correlation was used to analyze the relationship between PCT, CRP, PLT indexes with severity of infection. The receiver operating characteristic curve was used to analyze the sensitivity and specificity of PCT, CRP and PLT in the diagnosis of patients with different degrees of infection.Results:In the observation group, there were 46 males and 44 females with a Mean±SD age of (45.6±21.1) years. In the control group, there were 30 males and 30 females, with a Mean±SD age of (45.0±19.3) years. The levels of PLT in the observation group and the control group were (8.2±1.1) ng/ml and (0.4±0.1) ng/ml, respectively. The corresponding CRP were (92.7±21.1) mg/L and (6.1±1.0) mg/L, respectively. The observation group had higher levels than the control group. The PLT counts were (62.6±17.6)×10 9/L and (156.3±35.3)×10 9/L for the two groups, with the observation group having lower platelet count than the control group (both P<0.05). The severity of infection was positively correlated with blood PCT levels and CRP indicators ( r=0.427, r=0.584, all P<0.05), and negatively correlated with the PLT ( r=-0.429, P<0.05). The sensitivity and specificity of PCT using a cut-off value of 9.4 μg/L were 84.0% and 65.0%, respectively, which were higher than the CRP using a cut-off value of 145.7 mg/L. The sensitivity and specificity were 67.0% and 48.0%, respectively. When PLT using a cut-off value of 52.8×10 9/L, the sensitivity and specificity were 71.0% and 52.0%, respectively. Conclusions:Changes in serum PCT, CRP and PLT reflected the severity of infection in patients with AC; PCT had a higher sensitivity and specificity, and it can be used to guide treatment.

Objective To observe potential effect of radon hot springs on the changes of cell cycle and its regulatory proteins of CDK1,CDK2,CDK4,CDK6,CyclinD1,CyclinE1,WEE1,CDC25A in the peripheral blood lymphocytes of residents.Methods A random sampling method was used to persons 46 persons from the residents around radon hot spring in Wentang town,and 39 persons were selected from the control area without radon exposure.Flow cytometry was used to detect the changes of cell cycle and the expressions of cell cycle-related regulatory proteins.Multiple linear regression method was used to analyze the relationship between the expressions of cell cycle regulatory proteins and radon exposure.Results The percentages of cells at G0/G1 phase and S phase in lymphocytes were different in the two groups (t =2.250,-2.382,P ＜ 0.05).The expression levels of CDK1,CDK6 and CyclinE1 in the peripheral blood lymphocytes of radon hot spring group were significantly decreased (t =4.770,11.419,5.238,P ＜ 0.05) and negatively correlated with radon exposure (t =-5.097,-11.128,-5.117,P ＜0.05).The expression levels of CDK2,CDK4,CyclinD1,WEE1 and CDC25A in the peripheral blood lymphocytes of radon hot spring group were increased but not significantly(P ＞ 0.05).Conclusions The incidences of a higher ratio of S-phase cells and lower expression levels of CDK1,CDK6 and CyclinE1 in the peripheral blood lymphocytes of residents in Wentang town may be related to long-term radon exposure.

Objective To analyze the biological dose estimation ability of the radiation health technology institutions nationwide from 2015 to 2017,and their development in recent years.Methods SPSS 19.0 software was used to analyze and pack the data involved in the 2015-2017 year assessments by using x2 test.Statistical analysis was conducted of qualification rate,excellent rate,participating units and dose estimation deviation distribution.Results The qualification rate gradually increased from 2015 to 2017.Compared with 2015,the passing rate significantly increased in 2017 with statistically significant difference(x2 =3.978,P ＜0.05).A total of 53 units participated in the biological dose assessment,of which 30 units were involved over the three consecutive years,accounting for 57％.In the distribution of the relative deviation of dose estimates made by the units participating in the three-year assessment,the proportion of estimated deviations in the range of 5％-10％ increased whereas those in the range of 15％-20％ and ＞ 20％ decreased.Conclusions During 2015-2017 year period the biological dose estimation ability of all units involved in the assessment nationwide was basically stable,with gradually improved test level,qualification rate and steady excellence rate.