Objective To explore the application effect of strengthened pulmonary rehabilitation exercise in lung cancer patients with severe pulmonary ventilation dysfunction during perioperative period. Methods A total of 96 patients receiving lung cancer radical treatment under thoracoscope in our hospital during March 2013 to April 2015 were collected, and for all these patients, pulmonary function test before treatment showed that there was severe pulmonary ventilation dysfunction. The patients were divided into the routine group and the intervention group by random digital table method, with 48 patients in each group;patients in the routine group received routine perioperative nursing, and those in the intervention group received the strengthened pulmonary rehabilitation intervention plan; change in pulmonary function before treatment, duration of mechanical ventilation, time of oxygen therapy, retaining time of chest tube, length of hospital stay and occurrence of complications after treatment were compared between the two groups. Results After strengthened pulmonary rehabilitation intervention in the intervention group, the FVC was (2.63±0.47) L, the MVV was(53.14±9.40) L, the DLCO was(19.26±2.63) ml·min-1·mmHg-1, the VO2 was (23.15±4.36) ml/kg and the O2Pulse was(10.98±2.52) ml·min-1·times-1, Which were significantly improved compared with those before treatment, (2.41±0.40) L,(46.98±8.91) L,(17.56±2.83) ml·min -1·mmHg -1, (20.17±4.35)ml/kg and(9.82±2.07) ml·min-1·times-1, t=2.521, 3.512, 3.112, 3.421, 2.515, P<0.01 or 0.05. While there was no obvious change in the above- mentioned indexes of those in the routine group. After treatment of patients in the intervention group the duration of mechanical ventilation was (9.42±3.17) hours, time of oxygen therapy was (76.23±21.18) hours, retaining time of chest tube was (3.58±1.44) days and length of hospital stay was (6.62±2.14) days, which were significantly shorter than those in the routine group, (17.29±4.79) hours,(92.14±24.29) hours, (4.73±2.15) days and(8.68±2.96) days. The occurrence rates of complications such as pulmonary infection, pulmonary atelectasis and respiratory failure were 12.50%(6/48),10.42%(5/48) and 4.17%(2/48)in the intervention group, significantly lower than those in the routine group, 41.67%(20/48),29.17%(14/48) and 18.75%(9/48), χ2=10.338, 5.315, 5.031, P <0.01 or 0.05. Conclusions Strengthened pulmonary rehabilitation intervention can improve pulmonary function of lung cancer patients with severe pulmonary ventilation dysfunction before treatment, reduce the occurrence rate of post- operative complications and enhance safety during the perioperative period; it is worth of being further promoted clinically.

Objective Streptococcus sanguis is a possible candidate bacterium for the caries replacement therapy, which has no advantages in the acidic environment.The aim of the study was to construct acid-resistant strains of Streptococcus sanguis, determine its acid tolerance, and explore the mechanism of its antagonism against Sterptococcus mutans.Methods By gradually reducing the pH value of the medium, we constructed acid-resistant strains of Streptococcus sanguis, observed their growth and measured their acid tolerance according to their survival rate against lethal pH.We evaluated the competitive relationship between Streptococcus sanguis and Streptococcus mutans by plate experiment and detected the changes of related acid resistance genes by real-time quantitative PCR.Results The growth of Streptococcus sanguis and its acid-resistant strains were limited by the pH value, and that of Streptococcus sanguis was better in either acidic or normal environment.The lethal pH value of Streptococcus sanguis was 3.6, that of its acid-resistant strains was 2.3, and the survival rate of the acid-resistant strains was 66.59% in the pH 3.6 environment.In comparison, the lethal pH value of Streptococcus mutans was 2.5, that of its acid-resistant strains was 2.1, and the survival rate of the acid-resistant strains was 2.55% in the pH 2.5 environment.In the presence of chloramphenicol, the acid-resistant strains could not survive in the original lethal pH.In the sub-lethal pH environment, the expressions of the acid resistance-related genes Groel and Dnak in the acid-resistant strains were significantly up-regulated as compared with those in the original Streptococcus sanguis (P<0.05).Conclusion Streptococcus sanguis has an acid adaptability and can enhance acid resistance in the sub-lethal pH environment.Acid-resistant Streptococcus sanguis in the replacement therapy may provide some new ideas for the treatment of dental caries.

Objective To prepare the monodisperse,colloidal gold nanoparticles (AuNPs) with controllable sizes (50 nm,65 nm,79 nm and 102 nm) for the qualitative detection of cardiac troponin Ⅰ (cTnⅠ) by immunochromatography assay,and to evaluate the effectiveness of the detection.Methods Four kinds of monodisperse citrate-stabilized AuNPs were prepared using small AuNPs as growth centers (seeds) by a seeded growth thermal aging protocol.As controls,two conventional AuNPs (20 nm,40 nm) were prepared by the traditional citrate-reduction method.The mouse monoclonal antibody against cTnⅠ labeled AuNPs were dropped on polyester mat to make AuNPs conjugate pad.The detection line and quality control line of immunochromatography assay kits for detection of cTnⅠ were coated by mouse anti human cTnⅠ monoclonal antibody paired with antibody in AuNPs and goat anti mouse polyclonal antiboy respectively.The six kinds of AuNPs were employed as color-labels in immunochromatography assay kits for detecting cTnⅠ,and the corresponding detection effects were evaluated in signal intensity,sensitivity,specificity and stability.The assay kit with the best performance was chosen and compared with the commercialized kits for the detection of cTnⅠ in clinical samples.Results Four kinds of monodisperse AuNPs with large sizes of 50 nm,65 nm,79 nm,102 nm respectively were successfully synthesized by the seeded growth thermal aging method.The signal strength of four kinds of kits produced by the four large-sized AuNPs was superior to the kits produced by 20 nm AuNPs in detecting cTnⅠ(all P＜0.01).The signal strength of the kits produced by 65nm AuNPs showed the best performance among the six kinds of AuNPs(all P＜0.01).The lowest detectable limit was 0.50 ng/ml.To compare the agreement of results from chemiluminescent immunoassay versus the results from kits produced by 65nm AuNPs,100 serum samples have been used for detecting cTnⅠ.Their positive coincidence rate was 97.30％ and negative coincidence rate was 100％,the sensitivity and signal strength of the kits produced by 65nm AuNPs was superior to similar products which produced by ABON and Bottests company(all P＜0.01).Conclusions Monodisperse,largesized,citrate-stabilized AuNPs are controllably prepared by a seeded growth-thermal aging method.The development of large-size AuNPs-based immunochromatography assay kits is feasible.65 nm AuNPs can be a suitable candidate for cTnⅠ immunochromatography assay kit.Our findings provides a new idea for the current immunochromatography assay kits which still adopt small-sized AuNPs as color labels.

Objective:To investigate the difference of accuracy between magnetic induction Freehand-3D ultrasound and two-dimensional ultrasound in measuring the volume of thyroid model.Methods:Forty thyroid models were established using porcine liver, and the Archimedes procedure was set as gold standard in the measurement of the volume of each model. The accuracy of measurement of the porcine thyroid model volume between two-dimensional ultrasound and magnetic induction Freehand-3D ultrasound were compared.Results:There were no significant differences in the accuracy of measurements of thyroid model volume among two-dimensional ultrasound, magnetic induction Freehand-3D ultrasound and Archimedes procedure (all P>0.05). Compared with the Archimedes procedure, magnetic induction Freehand-3D ultrasonic method showed higher correlation coefficient of the measurement of thyroid model volume ( r=0.998). Bland-Altman analysis showed the lower measure error with a relative error of 3.42% and range of -9.57% to 12.07%. And the limits of agreement were (-1.253, 0.999) in the magnetic induction Freehand-3D ultrasonic measurement. Conclusions:Compared with two-dimensional ultrasound, the magnetic induction Freehand-3D ultrasound show higher accuracy in the measurement of the volume of the thyroid model.

Objective To explore the clinical value of fecal calprotectin (FCP) in peptic ulcer (PU) as an non-invasive indicator of disease activity compared with gastroscope. Methods The study was conducted in 62 patients with PU confirmed by endoscopy ( PU group) and 30 subjects with normal findings under endoscopy ( control group). Fecal sample ( weight 5-10 g) was collected within 3 days after endoscopy and FCP was measured by emzyme-linked immunosorbent assay (ELISA). The case history and clinical data were collected as well. Results The level of FCP in PU group was significantly higher than that in control group ( 154. 72 μg/g vs. 25. 18 μg/g, P < 0.001 ). In patients with PU at active stage ( n = 32), the level of FCP was significantly higher than that at scar stage (n =30,318.34 μg/g vs. 54. 10 μg/g, P <0. 01 ), and that in control group (25.18 μg/g, P <0.01), while there was no significant difference in FCP between the latter two groups ( P >0. 05 ). The level of FCP had no significant correlation with the location, size or number of the ulcer. Among patients in PU group, the level of FCP in patients presented with haematemesis or melena ( n = 20) was significantly higher than that in patients presented with other symptoms ( n = 42, 1257. 41 μg/g vs. 92. 77 μg/g, P < 0. 01 ). Conclusion The level of FCP is closely correlated with the activity of PU, which is significantly higher at active stage than that at scar stage, as well as in PU patients with bleeding than those without. Measurement of FCP is a convenient and noninvasive method with well compliance of patients, which might be used as an indicator of disease activity in PU.

Objective To evaluate the impact of sarpogrelate on the in-stent restenosis (ISR) after percutaneous transluminal angioplasty (PTA) in peripheral arterial diseases (PAD).Methods PAD patients who had PTA for the first time were divided into two groups receiving respectively clopidogrel and aspirin (clopidogrel group) or sarpogrelate and aspirin (sarpogrelate group).Vascular ultrasonography was performed at 6 months after PTA in all patients to evaluate the degree of ISR.Results 62 patients finished the follow-up visits as required.The in-stent restenosis in the sarpogrelate group and clopidogrel group was 7.0％ vs.18.1％ (P =0.036),the peak systolic velocity ratio was 1.34 vs.2.08 (P =0.010) and the cases of ISR was 1 vs.10 (P =0.005) respectively.No patients reported serious adverse events.Conclusions Sarpogrelate combined with aspirin is safe and effective.Compare with clopidogrel and aspirin,sarpogrelate and aspirin can significantly reduce the rate of ISR after PTA and the intimal proliferation in the stent.

Objective To estimate prenatal diagnoses strategy with abnormal results of non-invasive prenatal testing (NIPT) based on a case of mosaic for trisomy 22.Methods The pregnanct woman was recruited from Department of Prenatal Diagnosis Center of Xinhua Hospital.Ultrasound scans suggested fetal nuchal translucency was 3.5 mm.Peripheral venous blood was drawn from the pregnant woman for NIPT at 12+2 weeks gestation.For further prenatal diagnosis, amniocentesis was conducted at 16+2 weeks gestation, and karyotype analysis combination with chromosome microarray analysis (CMA) was executed to analysis amniocytes.Results NIPT results suggested that chromosome 21, 18 and 13 were normal and supplementary reports suggested that chromosome 22 were slightly above the normal range.Karyotype analyzed 35 cultured cells.Each of them revealed a normal female karyotype.However, CMA results suggested that chromosome 22 gain mosaic and its copy number was 2.26.The fetus was diagnosed as high possibility of mosaic for trisomy 22.Conclusions Combined with the NIPT results, which was slightly gain mosaic of chromosome 22, a prenatal diagnosis strategy were proposed.When NIPT results suggest chromosomal abnormities, karyotype analysis combination with CMA to diagnose were recommended.

Objective To investigate the expression of DNA methyltransferase 3b (DNMT3B) in hepatocellular carcinoma (HCC) and its effect and mechanism on the proliferation,invasion and migration of HCC cells.Methods The expression of DNMT3B gene was detected by qRT-PCR in 46 cases of HCC tissues and corresponding adjacent tissues;the results and clinical pathological parameters were analyzed.SiRNA targeting DNMT3B was transfected into MHCC97-H cells by RNA interference (RNAi) technique.The mRNA and protein expression levels of related genes were detected by qRT-PCR and Western blot.The cell proliferation was measured by MTT assay,and the invasion and migration abilities were measured by Transwell assay.Results In 46 HCC patients,the expression of DNMT3B (73.91％) was significantly higher in HCC than in adjacent normal tissue.The high expression of DNMT3B gene was associated with histological type and tumor size of HCC (all P＜0.05).Inhibition of DNMT3B gene expression decreased proliferation,invasion and migration of MHCC97-H cells.Interference with DNMT3B gene increased the expressions of tumor suppressor genes RASSFA1,APC and MTSS1 at mRNA and protein levels.Conclusion DNMT3B is associated with the progression of HCC.It may inhibit the proliferation,invasion and migration of HCC cells by regulating the methylation of downstream tumor suppressor gene.

Objective : To learn the regulatory effect of Lactobacillus plantarum JX025073.1 on intestinal flora and blood lipid in mice, so as to provide the basis for the nutritional intervention of probiotics in hyperlipidemia population. Methods : Thirty male ICR mice were randomly divided into a control group, a model group and a intervention group. The mice in the control group were fed with basic diet, and in the other two groups were fed with high fat diet. The mice in the intervention group was given 0.4 mL of Lactobacillus plantarum JX025073.1 fermentation liquid by gavage every day, and in the other two groups were given 0.4 mL of normal saline. The body weight of mice, the mass of heart, liver, spleen and kidney organs were weighed, and the organ index was calculated. The contents of total cholesterol (TC), triacylglycerol/triglyceride ( TG ), low density lipoprotein cholesterol ( LDL-C ) in serum, TC, TG in liver and in feces were determined by biochemical analyzer. Bifidobacterium, Lactobacillus and Escherichia coli in feces were cultured and counted. Results : After 42 days, compared with the control group, The mice in the model group had higher body weights, higher levels of TC, TG and LDL-C in serum, higher levels of TC, TG in liver and in feces, more Escherichia coli, less Bifidobacterium and less Lactobacillus ( P<0.05 ). Compared with the model group, the mice in the intervention group had lower body weight, lower levels of TC, TG and LDL-C in serum, lower levels of TC in liver, less Escherichia coli, higher levels of TC in feces, more Bifidobacterium and more Lactobacillus ( P<0.05 ). Conclusion Lactobacillus plantarum JX025073.1 can effectively regulate the blood lipid and intestinal flora of mice fed with high fat diet.

Objective:To identify multimorbidity patterns in a nationally representative sample of elderly patients with chronic diseases and to explore the relationship between these multimorbidity patterns and health care utilization.Methods:Based on data from the China Health and Retirement Longitudinal Study(CHARLS)in 2018, 10 764 elderly people aged 60 years and older were included, and latent class analysis(LCA)was used to identify multimorbidity patterns in the elderly, and the Logistic model was used to analyze the relationship between multimorbidity patterns and healthcare utilization in 8 041 elderly people with complete information on the variables.Results:The primary LCA identified five categories, with 4 164(52.1%)participants belonging to the relatively healthy category.The other four categories represented different patterns of multimorbidity, with 473(5.7%)belonging to the respiratory disease category, 1994(25.3%)to the vascular disease category, 948(11.7%)to the stomach-arthritis/rheumatism disease category and 426(5.2%)to the multisystemic disease category.In terms of outpatient service utilization, compared with the relatively healthy category, the multisystemic disease category was the most likely one to seek outpatient services( aOR=2.920, 95% CI: 2.305-3.699), followed by the respiratory disease category( aOR=1.827, 95% CI: 1.429-2.336), the stomach-arthritis/rheumatism disease category( aOR=1.680, 95% CI: 1.392-2.027), and the vascular disease category( aOR=1.482, 95% CI: 1.267-1.734).In terms of inpatient service utilization, compared to the relatively healthy category, the multisystemic disease category was the most likely one to seek inpatient services( aOR=2.718, 95% CI: 2.158-3.425), followed by the respiratory disease category( aOR=2.627, 95% CI: 2.105-3.280), the stomach-arthritic/rheumatism disease category( aOR=1.940, 95% CI: 1.624-2.318), and the vascular disease group( aOR=1.887, 95% CI: 1.632-2.183). Conclusions:There is a significant correlation between multimorbidity patterns and outpatient and inpatient service utilization in the elderly.Compared to relatively healthy people, those with one of the other four multimorbidity patterns have a significantly increased risk needing outpatient and inpatient services.