Objective To explore the expression of miRLet-7 family members in breast cancer and its correlation with overall survivals (OS), and to find more effective molecular targets for breast cancer prevention and treatment.Methods Kaplan-Meier (KM) plotter online database was used to analyze the correlation among the expression of Let-7 family members (Let-7a, 7b, 7c, 7d, 7e, 7f, 7g, 7i, miR-98, miR-202) correlated with overall survival (OS) and the prognosis and clinical pathological parameters of breast cancer patients, and Hazard ratio (HR), 95％confidence interval (CI), and P value were determined.ResultsThe study showed that the high expression level of Let-7a, Let-7b, Let-7c, Let-7e, Let-7f, Let-7g, miR-98 and the low expression level of miR-202 was associated with better OS for breast cancer patients (P＜0.05).We further assessed the prognostic value of Let-7 in different subtypes and clinical stage.The expression of Let-7a, Let-7b, Let-7f, Let-7g, miR-98, miR-202 was related to clinical stage (P＜0.05).Let-7a, Let-7b, Let-7c, Let-7e, Let-7f, Let-7g, miR-98 and miR-202 was related to lymph node status (P＜0.05).In triple-negative breast cancers (TNBC), with breast cancer subtype, the expression of Let-7b, Let-7c, Let-7g and miR-202 was significantly correlated to overall survival (P＜0.05).Conclusion The Let-7 is significantly correlated with OS in breast cancer patients.The results suggested that members of the Let-7 have different values in predicting the prognosis of breast cancer.Among them, Let-7b, Let-7g and miR-202 are closely related with clinical stage and TNBC, and might promote development of Let-7 as targeted inhibitors for the treatment of breast cancer.

Objective To analyze the structure and component of gouty tophus around joint, and provide basis to select solvent of gouty tophus and surgical cleaning method.Methods The sample of gouty tophus were obtained from 6 patients in 187 hospital of PLA from January2016 to December 2017, which were rinsed by distilled water, and then dried and accepted other dispose.The sample were analyzed by Fourier Transform Infrared Spectroscopy (FTIR), scanning electron microscope and thermal gravimetric analyzer.Results Sodium urate was the main component of the uratoma, the proportion was 56％;the organic component was about 14％of the uratoma.The microstructure of the uratoma under scanning electron microscope have two forms, the one looks like column crystal and the other like granules head up to lump.Conclusion The main component of the gouty tophus are sodium urate and organic tissues, the possible solvent should react on the both of them.

Objective To investigate the role of microRNA-10b (miR-10b) in the proliferation and invasion potential of osteosarcoma cell lines MG-63 and the exact underlying mechanism.Methods The expression level of miR-10b in human osteosarcoma tissue samples and adjacent normal bone tissues were detected by relative quantitative real-time PCR (qRT-PCR).miR-10b mimic and siRNA against Twist (Twist siRNA) were transfected into human osteosarcoma cell lines MG-63 respectively using lipofactamine 2000, and RT-PCR was used to detect the mRNA expression levels of miR-10b and Twist, and Twist protein expression level was detected by Western blot.The effect of miR-10b mimic and Twist siRNA on proliferation of MG-63 were detected by MTT[3- (4, 5-dimethylthiazol-2-yl) -5- (3-carboxymethoxyphenyl) -2- (4-sulfophenyl) -2 H-tetrazolium].The in-vitro cell invasion ability was determined by Transwell invasion assays after up-regulating miR-10b or knocking down of Twist.Results The expression levels of miR-10b was higher in human osteosarcoma tissue samples compared with adjacent normal bone tissues, the differences were extremely statistical significance (P＜0.01).miR-10b directly up regulated the mRNA and protein expression levels of Twist, the differences were significant (P＜0.05).In addition, miR-10b had enhanced the cell invasion and the proliferation (P＜0.05), whereas the proliferation and invasion ability of MG-63 which transfected by both miR-10b mimic and Twist siRNA were significantly reduced than that transfected by miR-10b mimic (P＜0.05).Conclusion miR-10b in MG-63 promotes the proliferation and invasion potential of human osteosarcoma cell lines MG-63, at least partly through the upregulation of Twist gene.

Objective To compare the early clinical efficacy of unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) for elderly patients with medial compartmental knee osteoarthritis.Methods A total of 35 elderly patients with medial compartmental knee osteoarthritis were selected from September 2014 to March 2018 in our hospital, of whom 16 cases treated by UKA were observation group and 19 cases treated by TKA were control group.ResultsThe operation time, intraoperative blood loss, the rate of perioperative blood transfusion, postoperative drainage volume and hospitalization stays of observation group were less than those of control group, the difference were significant (P＜0.05).Before the treatment, there was no significant differences in the KSS score between two groups (P＞0.05).After the treatment, KSS scores of two groups had been improved to some extent, and the observation group was better than the control group, the difference was significant (P＜0.05).No revision or infection happened in 1 year post-operative follow-up of either group.The observation group (0) were less than the control group (26.32％) in thrombosis rate, the difference was significantly (P＜0.05).ConclusionBoth UKA and TKA have certain early clinical efficacy, but UKA had advantages such as shorter operation time, shorter hospitalization, less pain, lower incidence of adverse reaction, which can promote the postoperative function recovery, the early clinical efficacy is more significant.

Objective To investigate the efficacy of ureteroscopic pneumatic lithotripsy and percutaneous renal holmium laser lithotripsy in the treatment of upper ureteral calculi. Methods A total of 132 patients with upper ureteral calculi admitted to our hospital from December 2016 to December 2017 were randomly divided into observation group and control group, 66 cases in each group. The control group underwent ureteroscopic pneumatic lithotripsy, and the observation group used percutaneous nephrolithotomy holmium laser lithotripsy. The clinical efficacy, surgical index and complication rate between two groups were compared. Results The clinical efficacy of the observation group (90. 91％) was higher than that of the control group(75. 76％),and the difference was statistically significant(P ＜ 0. 05). The operation time of the observation group was (27. 53 ± 3. 97) minutes,which was shorter than (42. 59 ± 4. 34) minutes of the control group,and the postoperative blood loss was (18. 59 ± 5. 21) mL,which was less than (31. 68 ± 4. 72) mL of the control group, the difference was statistically significant(P ＜ 0. 05). There was no significant difference in postoperative hospital stay between observation group[(5. 31 ± 1. 62) days]and control group[(5. 28 ± 1. 48) days](P ＞ 0. 05). There was no significant difference in the incidence of complications between two groups (P ＞ 0. 05). Conclusion Percutaneous nephrolithotomy with holmium laser lithotripsy is more effective than pneumatic lithotripsy in the treatment of upper ureteral calculi. It can shorten the operation time, reduce the amount of bleeding, and has higher safety.

Objective To investigate the effect of the laparotomy and laparoscopic surgery on the stress parameters and complication of patients with gastric cancer. Methods A total of 96 patients diagnosed as gastric cancer and treated by surgery in our hospital from January 2015 to January 2017 were divided into open operation group and laparoscopy group according to the operation method,48 cases in each group. Compared the operation time,bleeding volume,dissected lymph node number,postoperative hospitalization duration and anus exhausting time and complications in 6 months after surgery. The levels of WBC,CRP,TNF-α, IL-6 in serum before and after operation were detected by enzyme - linked immuno sorbent assay and compared. Results Compared with the open operation group, the bleeding volume,postoperative hospitalization duration and anus exhausting time of laparoscopy group were better with less dissected lymph node number and longer operation time, the differences were extremely significant(P ＜ 0. 01); the WBC,CRP,TNF-α, IL-6 levels of laparoscopy group at 1 day after the operation were lower than those of open operation group(P ＜ 0. 05). The incidence of complication of laparoscopy group was 22. 8％, which was less than 54. 7％ of control group, the difference was significant(P ＜ 0. 05). Conclusion Compared with the traditional open operation, laparoscopic radical gastrectomy can shorten the hospital stays and reduce the intraoperative blood loss, the stress response and complication rate after operation.

Objective To explore the clinical efficacy of vaginal hysterectomy and uterine scar repair in the treatment of type Ⅱ cesare-an scar pregnancy. Methods A total of 157 patients with type Ⅱ cesarean scar pregnancy (CSP) admitted to our obstetrics and gynecology department of our hospital from July 2016 to July 2017 were selected as research subjects. They were divided into ultrasound curettage group (n =87) and vaginal repair group(n =70) according to different surgical methods. The surgical bleeding volume, operative time, hospital stay and human chorionic gonadotropin (β-HCG) level before and after operation,the time of blood β-HCG returning to normal level,hemoglobin (HB) level before and after operation,menstrual recovery time,stress response, inflammatory response and surgical complications were compared between the two groups. Results The intraoperative blood loss volume, operative time and hospital slay in ultrasound curettage group were lower than those in vaginal repair group,the difference was significant(P ＜0.05). The time of blood β-HCG returning to normal level in vaginal repair group after operation was shorter than that in ultrasound curettage group, the difference was significant (P ＜ 0. 05). There was no significant difference in the HB level between the two groups(P＞0.05). The menstrual recovery time in vaginal repair group was shorter than that in ultrasound curettage group,the difference was significant(P ＜0. 05). The levels of postoperative epinephrine (E) and Cortisol (Cor) in vaginal repair group after operation were lower than those in ultrasound curettage group, while the level of thyroid stimulating hormone (TSH) was higher than that in ultrasound curettage group,the difference was significant(P ＜0.05). The levels of IL-2, IL-6 and IL-8 in vaginal repair group after operation were lower than those in ultrasound curettage group while the level of C-reactive protein (CRP) was higher than that in ultrasound curettage group,the difference was significant(P ＜0.05). The incidence rate of postoperative complications in ultrasound curettage group was higher than that in vaginal repair group(P ＜0. 05). Conclusion Vaginal repair is more beneficial to shortern the time of blood β-HCG returning to normal level and menstrual recovery time, promote the inflammatory factor and hormone recovery to a normal level, and reduce the incidence of complication.

Objective To evaluate the clinical effect of electromagnetic navigation system to locate the distal locking screw of tibia intramedullary nail. Methods From February 2010 to December 2016, 79 cases of tibia shaft fractures requiring treatment with intramedullary nailing were selected and divided into the navigation group and free hand locking group according to intramedullary nail locking methods. Forty-four cases in navigation group used an electromagnetic navigation system to lock the distal end of the intramedullary nail,while 35 cases in free hand locking group used a free-hand technique. The intraoperative X-ray exposure time,distal locking time,healing time, and the success rate of one-time distal locking were recorded compared between two groups. Results The average time of diatal locking using electromagnetic navigation technology was less than that of the free hand locking group,and the exposure time of fluoroscopy was also reduced, the differences were significant(P ＜ 0. 05). There was no difference in fracture healing time between the two groups(P ＞ 0. 05), one-time success rate of navigation group was 100％,which was higher than 37. 34％ of the free hand locking group, the difference was significant(P ＜ 0. 05). Conclusion Compared with free hand technology, the advantage of using electromagnetic navigation system to lock the distal nail of tibia intramedullary nail is high efficiency, short locking time and no radiation.

Objective To explore the effect of minimally invasive techniques for removing impacted wisdom teeth on local inflammation and pain. Methods A total of 110 patients with impacted wisdom teeth removed in our department from June 2016 to February 2018 were divided into observation group(55 cases,minimally invasive removal) and control group (55 cases, traditional chisel) according to the surgical method. The operative status, the inflammatory mediators and pain mediators in the gingival sulcus before and after the treatment, and the therapeutic effects of the two groups were compared. Results The operative time of the observation group was shorter than that of the control group,the intraoperative blood loss was less than that in the control group, the differences were significant(P ＜ 0. 05). The levels of PTX3, cells in the gingival sulcus adhesion of cytokine 1 (ICAM1),peroxidase (MPO),prostaglandin E2 (PGE2) levels,pain mediator 5-hydroxytryptamine(5-HT), calcitonin gene-related peptide(CGRP), substance P(SP), galanin(Gla) and adenosine triphosphate(ATP) in the observation group after treatment was lower than those in the control group, the differences were significant(P ＜ 0. 05); The degree of mouth opening restriction, facial swelling and visual analog scale score(VAS) in the observation group were lower than those in the control group, the differences were significant(P ＜ 0. 05). Conclusion Compared with traditional chisel in extraction of impacted wisdom teeth, the minimally invasive wisdom tooth extraction can relieve the inflammatory response and pain sensation of patients,and the clinical treatment effect is significant.

Objective To investigate the efficacy of Ilizarov technique in treatment of Gustilo type Ⅲ B and C of large tibia bone defect combined with soft tissue defect. Methods Thirty cases with large tibia bone defect combined with soft tissue defect in our hospital from January 2016 to December 2018 were selected including 25 cases with type Ⅲ B and 5 cases with type Ⅲ C,who were all open tibia fractures and treated with Ilizarov technique. Results All patients were followed up for 10 to 18 months with an average of 15 months. The bone defects were reconstructed, the difference between the length of the affected limb and the healthy side was less than 2 cm. The fracture was healed and the wound was closed. One case was with paralysis of common peroneal nerve and recoveried after 3 months. Twenty-two cases recovered without extra surgery, five cases restored with skin graft and three cases covered the wound by rotating skin flap. Conclusion Ilizarov technique is one of effective ways to treat Gustilo Ⅲ type B and type C of large defect combined with soft tissue defect.