MicroRNAs (miRNAs) are a group of multifunctional regulators which plays crucial role in physiological and pathological processed ranging from development,differentiation and apoptosis to stress responscs.Over 50 ％ miRNAs are located in the tumor-associated region or the fragile chrosomal regions which are susceptible to amplification,deletion or translocation during the process of tumor onset and development.More recently,the new publications indicated that the miRNAs broaden the insight for the mechanism research of tumor metastasis and the applications of miRNAs in carcinoma diagnosis.The article focuses on the mechanism by which some miRNAs are deregulated in lung cancer,the clinical potential of these molecules as the diagnosis and prognosis biomarkers and the future of miRNAs to be potential therapeutic drugs.

Objective To investigate clinical effect of surgery combined with the rehabilitation treatment for the patients with burn scar contracture on hand,to provide a reference for clinical treatment.Methods 60 cases of hand burn scar contracture patients were selected,according to the digital table they were divided into control group and observation group(n =30 cases),which was underwent surgery in both groups.The control group was treated based on out -patient routine hand exercise methods,while a heated therapy,compression therapy and other profes-sional rehabilitation exercises were performed in the observation group.TAM in patients and ADL were compared. Results The observation group after treatment TAM score was (198.67 ±21.08)point,which was significantly higher than (144.43 ±16.65)point,the difference was statistically significant (t =8.476,P =0.000).Manicure, taking food,combing,brushing teeth,washing face,clothing,shoeing ADL scores in the observation group after treatment were (3.26 ±0.51)point,(3.56 ±0.55)point,(3.68 ±0.72)point,(3.38 ±0.68)point,(3.61 ±0.52)point, (3.55 ±0.61 )point and (2.57 ±0.47)point,which were improved significantly better than those of the control group,the differences were statistically significant (t =4.524,P =0.024;t =5.041,P =0.011;t =4.924,P =0.019;t =4.442,P =0.027;t =5.136,P =0.010;t =5.347,P =0.008).Conclusion Clinical effect of surgery combined with professional rehabilitation on hand burn scar contracture is good,and it is worthy of clinical application.

Objective To compare the influence of radiotherapy,chemotherapy and radiation combined with chemotherapy in the treatment of patients with non-small cell lung cancer on the state of EGFR gene mutation.Methods 328 patients with non-small cell lung cancer were selected.On the basis of the condition of the patients,they were treated with radiation therapy,combination treatment with chemotherapy and radiation.And according to the different treatment methods,they were divided into chemotherapy group (112 cases),radiotherapy group (108 cases) and radiation combined with chemotherapy group(108 cases).Before and after treatment,the plasma EGFR mutations situation was detected and analyzed.Results Before treatment,the plasma EGFR mutation rates in the chemotherapy,radiotherapy,radiation combined with chemotherapy group were 34.82％ (39/112),31.48％ (34/108),32.41％ (35/108),which were significantly higher than 20.54％ (23/112),18.52％ (20/108),19.44％ (21/108) after treatment(x2 =5.709,4.840,4.725,all P ＜ 0.05).The frequency of the mutant EGFR gene in the patients after chemotherapy was 20.5％ (23/112),which was significantly lower than 34.8％ (39/112) before chemotherapy,the difference was statistically significant(x2 =5.709,P ＜ 0.05).After radiotherapy,the frequency of the mutant EGFR gene in the patients was 18.5 ％ (20/108),which was significantly lower than 31.5 ％ (34/108) before radiotherapy,the difference was statistically significant(x2 =4.840,P ＜ 0.05).After chemoradiation therapy,the frequency of the mutant EGFR gene in the patients was 19.4％ (21/108),which was significantly lower than 32.4％ (35/108) before chemoradiation therapy,the difference was statistically significant (x2 =4.725,P ＜ 0.05).Conclusion Radiotherapy,chemotherapy and radiation combined with chemotherapy in the treatment of non-small cell lung cancer can affect the state of EGFR gene mutation,which has significant decline.

A new modified inside-out repair technique of arthroscopic meniscal repair for peripherally torn menisci is described. Under arthroscopic control, after conventional inside-out technique using meniscal repair set using outside-in technique with 18-gauge needle, horizontal mattress sutures of absorbable monofilament(PDS 2-0) were placed across the tom site and tied over the capsule or fascia. Nearly all portions of meniscus were possible with this technique except most posterior and anterior portions. As this is the modification of inside-out technique, neurovascular complications could be avioded. The problem of outside-in technique, knot irritation inside joint could be avoided also because the knot is outside of the joint.
Fascia ; Joints ; Needles ; Sutures

Objective To analyze the clinical and pathological features of breast cancer in patients over 80 years old, to discuss the individualized treatment plan and further to provide foundation for clinical treatment . Methods Data of 58 breast cancer patients over 80 years old were retrospectively analyzed .They were treated from Jun.2008 to May.2014 and the diagnosis was confirmed by pathology after surgery .They were followed up by telephone.Results Among the 58 cases, invasive cancer accounted for 94.8%(55/58), in which triple-negative breast cancer accounted for 29.1%(16/55), and human epidermal growth factor receptor 2(HER2)pos-itive breast cancer accounted for 7.2%( 4/55 ) .Stage III breast cancer accounted for 24%( 14/58 ) .67.2%(39/58)patients underwent breast resection , 55.2%(32/58)patients underwent axillary treatment , 17.2%(10/58)patients received chemotherapy , and 51.7%(30/58) patients received endocrine therapy .Seven cases had recurrence and 3 cases died of the disease .Conclusions Breast cancer in elderly patients has its special clinical and pathological features .It has longer course , relatively late stage , and more complications .It has higher pro-portion of triple-negative breast cancer and lower proportion of positive HER 2.Elderly breast cancer patients are less tolerant to chemotherapy , thus surgery and endocrine therapy are the main treatment .

Objective To evaluate the quality control standard and check system of clinical using of antibiotics based on the change of the constituent ratio of antibiotics. Methods In this retrospective study, we compared consumption of the ten mostly prescribed antibiotics, constituent ratio of national essential drugs, antibiotics utilization ratio and antibiotics use density between the third quarter of 2012 and that of 2013. Results Compared with 2012, the usage of antibiotics was reduced by 39.91%, and the usage of national essential drugs rose by 71.46%, whereas the consumptions of cefoxitin, aztreonam, cefminox were reduced by 84.56%, 89.99%, and 56.52%, respectively, in 2013.The consumptions of cefazolin, cefuroxime, ceftriaxone rose by 36. 39%, 363. 50% and 24. 06%, respectively. The amount of used antibiotics was reduced by 35. 41%, and the application frequency of antibiotics was reduced by 36.62%. Conclusion The establishment, running and implement of the quality control standard and check system of clinical using of antibiotics make constituent ratio of antibiotics used in the first people's hospital of Jining City more reasonable, which will help to promote the rational use of antibiotics in clinic.

Objective To evaluate the effect of Angio-Seal vascular closure device by the femoral artery hemostasis.Methods Relative literature was searched by computer,according to the inclusion and the exclusion criteria,which were analyzed by RevMan5.2 software.Results A total of four studies of randomized controlled trial were brought into this research,the total sample size was involved in 3 191 cases,the sample size of the intervention group and the control group respectively was 1 583 and 1 608.The analysis results showed,Angio-seal vascular closure device can significantly shorten the time of hemostasis after femoral artery interventional therapy in patients and the limb braking time.The sensitive analysis results showed that the results stability were high and the conclusions were reliable.Conclusions Application of Angio-seal vascular closure device can significantly shorten the interventional therapy in patients with bleeding time and braking time.

Objective To investigate the effect of remifentanil on protein kinase C (PKC) activity during renal ischemia-reperfusion (I/R) in rats.Methods Seventy-five male Sprague-Dawley rats,weighing 250-300 g,were randomly divided into 5 groups (n=15 each) using a random number table:sham operation group (group S),I/R group,remifentanil group (group R),naloxone group (group N),and naloxone + remifentanil group (group NR).Renal ischemia was induced by clamping the bilateral renal arteries for 45 min using an atraumatic clamp followed by reperfusion.In R and NR groups,remifentanil 1.0 μg · kg-1 · min-1was infused via the caudal vein starting from 15 min before ischemia until 30 min of reperfusion.In N and NR groups,naloxone 0.3 mg/kg was injected via the caudal vein at 20 min before ischemia and 35 min of ischemia,respectively.The rats were sacrificed at 24 h of reperfusion and the kidneys were removed for determination of the ultrastructure of the renal tubular epithelial cells (using transmission electron microscope),activity of PKC in renal tissues (by ELISA),and expression of the PKC in renal tissues (by immuno-histochemistry).Results Compared with group S,the activity of PKC in renal tissues was significantly increased in the other four groups,and the expression of the PKC in renal tissues was up-regulated in group R.Compared with group I/R,the activity of PKC in renal tissues was significantlyincreased,the expression of PKC in renal tissues was up-regulated,and the pathological changes were attenuated in group R.Compared with group R,the activity of PKC in renal tissues was significantly decreased,the expression of PKC in renal tissues was down-regulated,and the pathological changes were aggravated in N and NR groups.Conclusion The mechanism by which remifentanil attenuates renal I/R injury may be related to up-regulation of PKC expression and increase in PKC activity through activating opioid receptors in rats.

Objective:To investigate the value of quantitative electroencephalography (qEEG) in the evaluation of thrombolytic efficacy in acute cerebral infarction.Methods:A prospective cohort study was conducted. Ninety-four patients with acute cerebral infarction who received intravenous thrombolysis admitted to the department of emergency of Qinhuangdao First Hospital from October 2019 to September 2020 were enrolled. The relative energy values of δ, θ, α and β waves in qEEG before and 2 hours, 24 hours and 7 days after intravenous recombinant tissue plasminogen activator (rt-PA) thrombolysis were dynamically monitored, and the power ratio index [DTABR, DTABR = (δ+θ)/(α+β)] was calculated. The National Institutes of Health stroke scale (NIHSS) score was also recorded. The reduction of NIHSS score ≥ 3 or the disappearance of neurological symptoms were regarded as effective thrombolytic therapy. The changes of DTABR before and after thrombolysis in patients with effective and ineffective thrombolysis were analyzed, and the correlation between DTABR and NIHSS score was analyzed by Pearson method.Results:A total of 94 patients were enrolled, including 64 males and 30 females. The average age was (61.71±10.11) years from 36 to 89 years old. Thrombolysis was effective in 57 cases and ineffective in 37 cases. Compared with before thrombolysis, DTABR of the effective group was significantly decreased at 2 hours, 24 hours and 7 days after thrombolysis (left cerebral infarction: 1.87±1.45, 1.59±0.88, 1.58±0.90 vs. 3.82±2.60; right cerebral infarction: 1.55±0.57, 1.41±0.50, 1.35±0.44 vs. 3.20±1.63, all P < 0.05). DTABR did not change or increase significantly at 2 hours, 24 hours and 7 days after thrombolysis compared with before thrombolysis (left cerebral infarction: 3.56±2.57, 3.48±2.19, 3.54±2.50 vs. 3.11±1.62; right cerebral infarction: 5.29±3.93, 5.33±3.94, 5.19±4.52 vs. 4.73±2.43, all P > 0.05). Pearson correlation analysis showed a significant positive correlation between DTABR and NIHSS score in patients with acute cerebral infarction (r = 0.691, P < 0.01).Conclusion:The quantitative index of qEEG, DTABR, can accurately and quickly monitor the process of thrombolysis in acute cerebral infarction, and can effectively evaluate the effect of thrombolysis in patients.

With the concepts of minimal invasive surgery and precision medicine embedding deeply in modern medicine, traditional clinical treatment strategies are constantly updated due to the rapid progression of medical research. Systematic dissection of the regional lymph nodes is a key component in the surgical therapy of gynecologic malignancies, however it may result in a series of complications, such as lower extremity lymphedema, deep venous thrombosis, immune disorders and so on, which seriously impact the patients' quality of life. The necessity of systematic lymphadenectomy and the extent of lymph nodes resection have always been one of the most controversial issues in gynecologic oncology. In recent years, the extensive application of sentinel lymph node (SLN) technology has been increasingly used in the treatment of gynecologic malignancies, which may provide important guidance on this issue. This article reviews the clinical application status, detection methods, detection efficiency, and current controversies regarding SLN mapping and biopsy in cervical cancer, endometrial cancer, ovarian cancer and vulvar cancer, discussing the application value of SLN technology in gynecologic oncology.