Objective To investigate the association of circulating free blood DNA and prognosis of non-small cell lung cancer (NSCLC).Methods Forty-six untreated NSCLC patients and 21 controls were selected as our subjects,and all underwent a 6 years follow-up.The level of circulating free blood DNA was determined by real-time quantitative polymerase chain reaction (qPCR) targeting the human β-globin gene.Overall survival of the patients were analyzed by Kaplan-Meier method and Cox-regression.Results At the end of follow-up,the median free DNA concentration of experimental patients was higher than that of control patients(52 μg/L vs.29 μg/L,P =0.03).The median free DNA concentration of experimental death patients (87％) died was significantly higher than that of still survived patients (59 mg/L vs.25 mg/L,P =0.02).No association of DNA concentration with tumor pathology,clinical stage,age,gender,smoking or pulmonary inflammatory conditions were found in current study.Conclusion For NSCLC patients,the circulating free blood DNA level was negative correlation with the survival of the patients,suggesting that it may be utilized as a prognostic factor for survival analysis.But there is no relationship of free blood DNA concentration with tumor pathology,age,gender,smoking or pulmonary inflammatory conditions.

Objective To study the level of serum high-sensitive C-reactive protein and HbA1c in diabetes patients with blood stasis syndrome,and to investigate the relationship among them.Methods 58 cases of diabetes patients with blood stasis syndrome and 65 cases without blood stasis syndrome were observed.The level of FPG,hsCRP,HbA1c,24 h UAER,TC,TG,HDL-C and LDL-C were estimated.Results The level of FPG,LDL-C,TG,HbA1c,hsCRP of diabetes with blood stasis syndrome were higher than the control group(P 0.05).In patients with blood stasis syndrome,the hsCRP was positively correlated to HbA1c,24 h UAER,BMI,LDL-C,TC,TG,but the multifactor regression analysis indicated that hsCRP was only correlated to the HbA1c independently.Conclusions The long-term hyperglycemia and inflammatory may be one of the reasons for the formation of blood stasis syndrome of diabetes patients,hsCRP and HbA1c may be new evidences for diagnosis of diabetes patients with blood stasis syndrome.

Objective To optimize the parameters for the diffusion tensor imaging (DTI)of the ulnar nerve in elbow.Methods 5 groups of DTI sequences with different b values and numbers of diffusion gradient directions (NDGDs)were used to collect ulnar nerve images from 13 volunteers,and then the diffusion tensor tractography (DTT)was established.The fractional anisotropy (FA),apparent diffusion coefficient (ADC),length of ulnar nerve fiber and DTI image quality were compared under different imaging parameters. Results DTI results for 18 normal ulnar nerves were included in the study.Under different imaging conditions,FAs showed no significant differences.With constant NDGDs,increasing b value decreased both image quality and ADCs of the ulnar nerve.NDGDs had no significant effects on ADCs or image quality.When b=1 000 s/mm2 and NDGDs=20,the length of the ulnar nerve fiber was the longest and DTT had the best subjective scoring in image quality.Conclusion b=1 000 s/mm2 and NDGDs=20 is recommended for DTI of elbow ulnar nerve,so as to obtain high image quality and stable observing targets.

As an anti-inflammatory factor, Interleukin 35 (IL-35) is composed of p35 subunit and EBI3 subunit. IL-35 plays an important role in many diseases, but many mechanisms are not clear. In recent years, it has been found that IL-35 plays an important immunomodulatory role in autoimmune diseases, such as rheumatoid arthritis, inflammatory bowel disease, psoriasis, idiopathic inflammatory myopathy, systemic lupus erythematosus, multiple sclerosis, type I diabetes, pemphigus and primary biliary cirrhosis, etc. This review summarizes the research progress of the mechanism of IL-35 in the above autoimmune diseases.

Objective: To investigate the impact of thyroid hormone on atrial ifbrillation (AF) prevalence in patients with chronic heart failure (CHF).
Methods: A total of 322 non-valvular heart disease CHF patients treated in our hospital from 2011-0-01 to 2012-10-01 were retrospectively studied. Based on previous history and the ECG at admission, the patients were divided into 2 groups: AF group,n=187 and Sinus rhythm group,n=135. The proifle of serum levels of free thyroxine (FT4), free triiodothyronine (FT3), hyroid stimulating hormone (TSH) and LDL-C were examined within 24 hours of admission; 12 lead ECG and echocardiography were conducted to analyze the related factor for AF occurrence.
Results: Compared with Sinus rhythm group, AF group had increased FT4 level as 14.52 (12.74, 15.85) pmol/L vs 13.11 (11.68, 14.85) pmol/L,P<0.001, while FT3 level was similar between 2 groups as 4.06 (3.76, 4.44) pmol/L vs 4.1(3.80, 4.52) pmol/L,P=0.250. Spearman related analysis indicated that FT4 level was positively related to left atrial dimension (LAD) (r=0.134,P=0.016), FT3 level was positively related to LDL-C (r=0.235,P<0.001) and negatively related to age (r=-0.268, P<0.001). Taking FT4 as the continuous variable, Logistic regression analysis indicated that FT4 level [OR=1.227, 95% CI (1.112-1.354),P<0.001], LAD [OR=1.154, 95% CI (1.105-1.205),P<0.001], age [OR=1.038, 95% CI (1.012-1.064),P=0.003], CHF duration [OR=1.111, 95% CI (1.021-1.209),P=0.015], LDL-C level [OR=0.689, 95% CI (0.493-0.963),P=0.029] were related to AF prevalence in CHF patients.
Conclusion: High serum level of FT4 may increase the risk AF occurrence in CHF patients.

Background It is imperative for the microbial monitor after opening the bottle of eyedrops in order to ensure the safety during use of ophthalmic solutions with multi-dose packaging.Objective This study was to research the microbiological properties and sterile duration of methylcellulose (MC) eye drops in three common environmental conditions,including room temperature condition of community,refrigeration condition of community and room temperature condition of hospital.Methods MC eye drops were assigned to the community room temperature group,community refrigeration group and hospital room temperature group,and 200 bottles of MC eye drops with or without ethylparaben were collected in each group,including sealed or unsealed drugs at average.The containers of all the eye drops were opened and the opening times were record.The drugs was admistered 1 drop for 3 times per day,with the opening period for 5-10 seconds.Then the drugs were preserved in different environments based on grouping.Microbial isolation and purification were performed by the same lab technician at 8:00 from 1 through 10 days after opening of drugs with automatic microbial analyzer.Results In the unsealed MC eye drops without ethylparaben,the bacterial positive rates were about 30％ in the community room temperature group,community refrigeration group and hospital room temperature group,but no microbial colony was seen in the sealed eye drops.Ten days after opening of containers,the bacterial cultured rates were 30％,32％ and 36％ in the eye drops without ethylparaben in the community room temperature group,community refrigeration group and hospital room temperature group,and those in the eye drops with ethylparaben were 15％,19％ and 23％,respectively,showing significant differences between the eye drops with and without ethylparaben (x2 =6.452,4.448,4.063,all at P＜0.05).The 95％ confidence interval (CI) of difference values of intergroup bacterial rates were-0.166-0.126,-0.110-0.190 and-0.088-0.208 between the community room temperature group and the community refrigeration group,between the hospital room temperature group and the community refrigeration group,between the hospital room temperature group and the community room temperature group respectively in the unsealed eye drops without ethylparaben,and those in the unsealed eye drops with ethylparaben were-0.159-0.079,-0.089-0.169 and-0.043-0.203 respectively,indicating insignificant differences among the groups.Cultured bacteria were identified as Micrococcus luteus,Acinetobacter lwoffii,Bacillus subtilis,Acinetobacter radioresistens,Myroides and Staptococcus xylosus.Conclusions Ethylparaben can reduce the contamination rate of microorganisms after opening of MC eye drops.Three environmental conditions do not play an influence on microbial contamination of MC eye drops after opening.The bacteria of contaminated eye drops appear to be common microorganisms in atmosphere and soil,rather than eye common pathogens.

Objective To explore Wang Xingkuan’s rules of syndrome and treatment of chest blocking and heartache (Xiongbixintong).Methods Collection of professor Wang Xingkuan’s 267 consilia of patients with Xiongbixintong for outpatients. Chinese medicine terminology was regulated and Excelldatabase was established. Symptom, syndrome element, pathogenesis and treatment were statistically described by using Weka3.6 software, and Apriori algorithm was adopted for the main pathogenesis→treatment analysis of association rules.Results Symptoms include:chest pain, heart palpitations, shortness of breath, pale tongue (dark) red, etc. Syndrome elements include:in liver, and heart, and blood stasis, phlegm, qi stagnation, etc. The key pathogenesis is liver-heart imbalance, including stagnation of liver qi, heart and blood stasis, deficiency of heart qi-ying, disturbing heart-mind, etc. The principle of treatment is liver-heart Tongzhi, so the treatment is of“liver” with Shu gan-mu;treatment of“heart” contains freeing channels, eliminating phlegm and blood stasis, quiet the heart, replenishing qi-ying, etc. The main pathogenesis related credibility→treatment was higher than 0.50;with high reliability, the liver-heart imbalance→liver-heart Tongzhi was 0.71. Medication includes catharsis and tonic,“catharsis” to salvia, allium macrostemon, pseudo-ginseng, bupleurum, etc;“tonic” to white ginseng, ophiopogon japonicus, radix paeoniae alba, poria with hostwood, polygala tenuifolia, etc. Conclusion “Xintongzhigan, liver-heart Tongzhi, catharsis and tonic” is Wang Xingkuan’s thoughts and experience in treating Xiongbixintong.

Objective To assess the results of emergency endovascular stent-grafting for patients with acute Stanford type B aortic dissection(type B AAD)within 24 hours of onset.Methods Between June 2007 and October 2008,30 patients with acute type B aortic dissection underwent emergency endOVascular stent-grafting within 24 hours of presentation.Under general anesthesia,stent-graft was deploved at the proper position of first tear entry through femoral artery under X-ray monitering.Follow-up by CT was performed 1 w,1 m ,3 m,6 m,1 y postoperatively to observe the efficacy and complications such as endoleak,migration and fracture of stent-graft. Result The technical success rate was 100%;13.4%(4 cases) endoleak rate was identified immediately after deployment.Follow up was made between 1 month to 19 months,averaging at(12±8)months,3.3%type-1 endoleak Was observed after 6 months;One patient died within 30 days possibly of dissection rupture;One patient died of acute liver failure during the follow-up. Conclusion Endovascular repair with stent-graft within 24 hours of presentation was effectivefor the treatment of acute type B aortic dissection.

Objective To analyze the clinical characteristics and risk factors of patients with confirmed venous thromboembolism (VTE) in order to improve recognition of VTE, and reduce the rate of missed diagnosis and wrong diagnosis. Methods A retrospectively review was performed for 205 patients diagnosed with VTE confirmed by CT pulmonary angiography (CTPA), radionuclide pulmonary ventilation/perfusion (V/Q) imaging, lower extremity deep vein ultrasound or venography in the First Affiliated Hospital of Bengbu Medical College from January 2009 to December 2018. The clinical manifestations, laboratory examination results, imaging results, treatment and prognosis of patients diagnosed with VTE were analyzed. The clinical possibility was assessed by pulmonary thromboembolism (PTE) simplified Wells score and deep venous thrombosis (DVT) Wells score. 130 non-VTE patients admitted in the same period were enrolled as controls, and the risk factors of VTE were screened by multivariate Logistic regression analysis. Results Among 205 VTE patients, 14 cases had incomplete data, 2 cases were complicated with other diseases deteriorated, 2 cases were excluded because of economic reasons, 10 cases abandoned treatment because of serious illness, and finally 177 cases were included in the analysis. The main clinical symptoms of VTE patients were chest tightness (36.16%), followed by chest pain (29.94%), dyspnea (29.38%) and hemoptysis (24.29%). Swelling or tenderness of unilateral/bilateral lower extremities (38.98%) and lung moist rale (20.90%) were the most common signs. ST-T changes were the main changes in electrocardiogram (ECG, 49.15%), followed by SⅠQⅢTⅢ or QⅢTⅢ changes (35.03%). Only 5.65% of the patients had plasma D-dimer less than 0.5 mg/L. 31.07% (55/177) patients had normal arterial blood gas results. Of the 177 VTE patients, 175 were diagnosed as PTE by CTPA, with bilateral/multi-lobar pulmonary artery embolism and its branches being the main type [44.57% (78/175)]. Two cases were diagnosed as PTE by V/Q imaging. Among them, 112 cases were received lower extremity deep venous ultrasound or lower extremity deep venography, 51 cases were diagnosed as lower extremity DVT, with thrombosis of popliteal and above vein as common [68.63% (35/51)]. The clinical possibility assessment showed that 67.23% (119/177) patients might have PTE (PTE simplified Wells score greater than or equal to 2), 38.98% (69/177) patients might have lower extremity DVT (DVT Wells score greater than or equal to 2). Multivariate Logistic regression analysis showed that operation less than 4 weeks [odds ratio (OR) = 5.503, 95% confidence interval (95%CI) = 1.577-19.206, P = 0.007], trauma or fracture less than 3 months (OR = 6.771, 95%CI = 1.510-30.370, P = 0.012), VTE history (OR = 0.072, 95%CI =0.009-0.549, P = 0.011) were independent risk factors for VTE occurrence. Thrombolytic therapy was administered in 13 cases while anticoagulant therapy alone was prescribed in 164 cases. 176 patients recovered, while 1 case died. Conclusions VTE clinical manifestations are not specific. Patients with risk factors should be vigilant, be strengthen with diagnostic awareness, paid attention to the evaluation of clinical possibilities. Timely thrombolytic or anticoagulant treatment after diagnosis, can improve the survival rate.

Coronavirus disease 2019(COVID-19)can induce coagulation dysfunction in patients and is associated with an increased risk of thrombotic complications,including microvascular thrombo-sis,venous thromboembolism,and stroke.In patients undergoing maintenance hemodialysis,the risk of COVID-19-related coagulation dysfunction and thrombotic complications is further elevated.This ar-ticle reviewed the pathogenesis of COVID-19-related hypercoagulability and thrombotic complications in patients undergoing maintenance hemodialysis,aiming to provide a reference for the diagnosis and treatment of this disease.