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 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.

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 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 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 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.

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 investigate the correlation between the unilateral middle cerebral artery (MCA)stenosis ratio and cerebrovascular reserve(CVR) using computed tomography perfusion (CTP) and CO2 inhalation test in patients with unilateral middle cerebral artery stenosis.Methods CTP were performed in 31 patients who were diagnosed as unilateral middle cerebral stenosis before and after CO2 inhalation.The basal ganglia and radial dimension were selected as interested regions (thickness 8 mm).The value of cerebral blood flow (CBF) was measured and the mean CBF values of all interested regions in each MCA territory were harvested separately.Then the CVR of each MCA territory was calculated according to the following formula:CVR =(CBF after CO2 inhalation test-CBF before CO2 inhalation test)/ CBF before CO2 inhalation test × 100％.Patients were divided into two groups:the severe stenosis group and the moderate stenosis group.The association between the MCA stenosis ratio and the CVR values was investigated.Results In 31 patients,different changes of CBF were found in affected MCA territory after CO2 inhalation.CBF increased in 17 cases,unchanged in 2 cases and decreased in 12 cases.A decreased CVR was detected in 51.6％ of the patients(16/31) and more likely found in the severe stenosis group (13/19) than that in the moderate stenosis group(3/12,P =0.029).The degree of stenosis in MCA was also significantly correlated with the changes of CVR(r =0.423,P =0.018).Conclusions CVR is decreased in some patients with unilateral MCA stenosis and significantly correlates with the severity of stenosis in MCA.

Objective To evaluate the effect of early nursing interventions on the dysphagia of strok e patients.Methods The randomized controlled trials (RCT) on early nursing interventions were collected using the database such as Chinese Science and Technology Periodical Database (VIP),China national knowledge internet (CNKI) and Wanfang Database.The results were analyzed with RevMan5.2 Software.Resuits Six studies were included in the study.The dysphagia recovery rate was significandy increased in the intervention group.Conclusions Early nursing interventions can effectively promote the dysphagia function recovery of stroke patients.

OBJECTIVE:To investigate the effects of preemptive analgesia of parecoxib-sodium for radical mastectomy of breast cancer. METHODS:A total of 60 female patients underwent selective radical mastectomy of breast cancer under general anes-thesia were randomly divided into observation group(40 cases)and control group(20 cases). 15 min before anesthesia induction, observation group was given intravenous injection of Parecoxib-sodium for injection 40 mg. Control group was given intravenous in-jection of 0.9% Sodium chloride injection 5 mL. The pain visual analogue scale(VAS),the frequency of patient controlled intrave-nous analgesia(PCA)and ADR were observed between 2 groups at different time points after surgery. RESULTS:VAS scores of observation group were significantly lower than those of control group 2,4,6,8 h after operation,and the frequency of PCA 0-4, 4-12,12-24,24-36 h after operation was significantly lower than control group,with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS:The preemptive analgesia of parecoxib-sodium can effectively reduce pain degree of patients with breast cancer after radical mastectomy,the frequency of PCA, and do not increase the occurrence of ADR.