Adolescent ; Child ; Humans ; Reference Values ; Vitamin D ; analogs & derivatives ; blood ; Vitamin D Deficiency

Objective To evaluate the prognostic significance of metastastic lymph node ratio in patients with gastric cancer. Methods Clinical data of 319 patients with gastric cancer who underwent radical gastrectomy with at least 15 lymph nodes dissected per patient were analyzed retrospectively. Patients were divided into 4 groups according to the TNM staging system (1997,5th edition): pN0 (no positive lymph node), pN1(with 1～6 metastatic lymph nodes), pN2 group (with 7～15 metastatic lymph nodes), and pN3 group (with more than 15 metastatic lymph nodes), or into 4 groups according to the lymph node metastatic ratio: rN0 group (without metastasis of lymph node), rN1 group (with a lymph node metastatic ratio of <30%), rN2 group (with a lymph node metastatic ratio of 30%～60%), and rN3 group ( with a lymph node metastatic ratio of >60%). Survival was determined by the Kaplan-Meier method and differences were assessed by the Log-rank test. Multivariate analysis was performed using the COX proportional hazard regression model in forward stepwise regression with SPSS 13.0. Results Kaplan-Meier survival analysis demonstrated that the metastatic lymph node ratio significantly influenced the postoperative survival time. According to the lymph node metastasis system 77 patients were in group 1, 109in group 2, 60 in group 3, and 73 in group 4. The 2-year survival rate was 84.4%,66.1%, 35.0%,and 15.1% respectively, 3-year survival rate was 80.5%,45.0%,15.0% and 5.5% respectively, and 4-year survival rate was 71.4%,33.0%,5.0% and 1.4% respectively. If cases with the same positive number of lymph node (pN) group were stratified futher by lymph node metastatic ratio, there were no significant differences in the 3-year survival rate among the new rN groups (P>0.05), but there was a great difference in the distribution of prognosis among different groups. COX proportional hazard regression model analysis showed that the metastatic lymph node ratio was an independent factor for poor prognosis. Lymph node metastatic ratio was closely related with the location, modality of the operation and infiltration depth. Conclusions The staging system based on metastatic lymph node ratio is more reliable than the system based on the number of metastatic lymph nodes in the prediction of the prognosis of gastric cancer.

Objective To investigate the correlation between inducible nitric oxide synthase (iNOS) gene polymorphism and ischemic stroke in Chinese Han population.Methods Patients with first-ever stroke and the age-and sex-matched healthy controls were enrolled in the study.Taqman probe fluorescence quantitative polymerase chain reaction technique was used to detect the genotype distribution of rs2779248 C/T and rs1137933 C/T polymorphisms.Results A total of 246 patients with ischemic stroke and 246 controls were enrolled.The distribution frequencies of rs2779248 CC,CT and TT genotypes in the patient group were 57.7％,36.6％,and 5.7％,respectively,and in the control group were 68.7％,28.0％,and 3.3％,respectively.The T allele frequency of the patient group was significantly higher than that of the control group (24.0％ vs.17.3％;P =0.015).Multivariate logistic regression analysis showed that after adjusting for the risk factors including age,sex,hypertension,and diabetes,the risk of ischemic stroke in the CT + TT genotype carriers was 1.64 times of the CC genotype carriers (odds ratio 1.64,95％ confidence interval 1.07-2.51;P=0.022).The distribution frequencies of rs1137933 CC,CT and TT in the patient group were 58.1％,37.8％,and 4.1％,respectively and in the control group were 68.3％,29.3％,and 2.4％,respectively.The T allele frequency of the patient group was significantly higher than that of the control group (23.0％ vs.17.1％;P =0.013).Multivariate logistic regression analysis showed that after adjusting for traditional risk factors,the risk of ischemic stroke of patients with the TT + CT genotype carriers was 1.60 times of the CC genotype carriers (odds ratio 1.60,95％ confidence interval 1.05-2.46;P=0.030).Conclusions The rs2779248 C/T and rs1137933 C/T polymorphisms in iNOS gene may be associated with the risk of onset of ischemic stroke in Chinese Han population.

Objective:To investigate the clinical significance of dynamic analysis of plasma brain natriuretic peptide in patients with dilated cardiomyopathy with chronic heart failure.Methods:Ninety patients with dilated cardiomyopathy with chronic heart failure admitted into our hospital firom March 2012 to March 2016 were divided into group A (20 cases),group B (38 cases),and group C (32 cases) according to the NYHA grading.The plasma BNP levels and LVEF,LA,LVEDD,and LVESD in the three groups were detected and compared.The correlation of plasma BNP and cardiac function and ultrasonic cardiogram indexes were analyzed.And the capability of plasma BNP and LVEF in diagnosis of patients were analyzed and compared.Results:The plasma BNP level in group C was markedly higher than that of group A and group B (P＜0.05),and that in group B was much higher than that of group A (P＜0.05).And LA in group C was significantly higher than that of group A (P＜0.05),while differences in LVEF,LVEDD,and LVESD were not obvious (P＞0.05).The plasma BNP was positively correlated to NYHA grading,but had no significant correlation with the LVEF,LVEDD,LVESD,and LA (P＞0.05).Based on results of receiver operating characteristic curve analysis,plasma BNP =523.5 pg/mL was the threshold value for identification of patients with NYHA Ⅲ and Ⅳ (AUC=0.901,P＜0.001),while LVEF had not the capability (AUC=0.392,P=0.276).Conclusion:Detection of plasma BNP level had important clinical significance on diagnosis,screening and cardiac functional grading of patients with dilated cardiomyopathy with chronic heart failure.

Hydrogen evolution from water electrolysis is one of the effective ways to obtain clean hydrogen energy in the future. Pt-based materials are the efficient catalysts in hydrogen evolution reaction, but it is expensive, difficult to recycle, which impedes its application in the development of hydrogen energy and economy. Therefore, it is the key trend to develop efficient non-noble metal electrocatalysts with the aim of providing cost-competitive hydrogen energy. In this review, we highlighted the recent research efforts toward the synthesis of noble metal-free electrocatalysts for the hydrogen evolution reaction ( HER) , mainly focusing on nanomaterial catalysts supported on carbon fiber materials. We reviewed several important kinds of heterogeneous non-noble metal electrocatalysts, including sulfides, selenides, carbides, phosphides, and oxides. In the discussion, emphasis was given to the synthetic methods of these HER electrocatalysts, and the strategies for performance improvement. In addition, this paper also briefly summarized the application of carbon fiber material as substrate in the field of electroanalytical chemistry.

Objective To investigate effect of artesunate on expressions of Toll-like receotor-4 (TLR4) and interleu?kin-8 (IL-8) in renal tissue of diabetic nephropathy rats. Methods Male SD rats of over 200 g in body weight (n=45) were injected with low dosage streptozotocin and fed with high fat and sucrose diets to establish diabetes nephropathy (DN) model. Among all rats of successful model, thirty-two were randomly selected and divided into four groups (n=8 in each group), Mod?el group (Group B), Artesunate at high dose treatment group [30 mg/(kg · d)] (Group C), Artesunate at low dose treatment group [10 mg/(kg·d)] (Group D), Enalapril treatment group [10 mg/(kg·d)] (Group E). Another eight rats without STZ injec?tion whose body weight is under 200 g were assigned as Normal group (Group A). Then, rats in Group A and B were given the same volume of normal saline [10 mg/(kg·d)] while rats in Group C, D and E were given 30 mg/(kg·d) Artesunate, 10 mg/(kg·d) Artesunate and 10 mg/(kg · d) Enalapril respectively intragastrically for consecutive 12 weeks. Fasting blood glucose, body weight, kidney index, 24-hours proteinuria, serum creatinine (Cr) and blood urea nitrogen (BUN) were measured. Expression level of TLR4 in renal tissue of rats were examined by Western blot;ELISA was used to quantify the concentration of IL-8 in serum and renal tissue of rats. Results Compared with rats in Group A, the levels of Fasting blood glucose, kidney index , 24-hours proteinuria, Cr and BUN as well as the level of TLR4 in kidney, levels of IL-8 in serum and kidney all significant?ly increased in rats in Group B, C, D and E(P<0.05). On the other hand, body weight were decreased in rats of Group B, C, D and E compared to rats in Group A(P<0.05). The level of TLR4 in kidney, levels of IL-8 in serum and kidney, 24-hours proteinuria, Cr and BUN in rats of Group C, D and E were significantly lower than those in rats of Group B(P<0.05). Furthermore, compared with rats in Group D, the levels of TLR4 in kidney, IL-8 in serum and kidney, 24-hours proteinuria, Cr and BUN were decreased in rats in Group C and E(P<0.05). Pearson correlation analysis showed that the expression lev?el of TLR4 positively correlated with IL-8 level in serum (r=0.969, P<0.05), IL-8 level in kidney (r=0.972, P<0.05), 24-hours proteinuria(r=0.965, P<0.05), Cr(r=0.944, P<0.05)and BUN(r=0.903, P<0.05). IL-8 level in kidney positively correlated with 24-hours proteinuria(r=0.962, P<0.05), Cr(r=0.929, P<0.05)and BUN(r=0.940, P<0.05). Conclu?sion Artesunate decreases expression of TLR4 and IL-8, reduce 24-hours proteinuria, inhibits the inflammation of the DN,relives the pathological lesions of nephron rats with diabetic nephropathy.

Objective To evaluate the therapeutic effect of bone marrow mesenchymal stem cells (BMSC) transplantation via renal artery in treating experimental rats with adriamycin-induced chronic nephro -pathy.Methods A total of 50 male Sprague-Dawley (SD) rats were used as experimental animals.Two rats were used for the isolation and culture of BMSC.Twelve rats were designed as blank control group (group N);in other 36 rats adriamycin was injected through caudal vein to establish rat models of chronic nephropathy,these 36 rats were randomly and equally divided into three groups with 12 rats in each group:control group (group C,n=12),BMSC transplantation via renal artery group (group A,n=12),and BMSC transplantation via caudal vein group (group V,n=12).For the rats of group N,the same amount of normal saline was injected through caudal vein.Results At each observation point,the levels of blood urea nitrogen,serum creatinine,24 h urinary protein and 24 h urinary microprotein in group A,V and C were remarkably higher than those in group N (P＜0.01).One and two weeks after BMSC transplantation,the 24 h urinary microprotein level in group A was significantly lower than that in group C (P＜0.01);the serum creatinine level in group A was significantly lower than that in group C and group V (P＜0.01).One week after BMSC transplantation,both the 24 h urinary protein level and 24 h urinary microprotein level in group A were strikingly lower than those in group V (P＜0.01),but two weeks after BMSC transplantation these differences between group A and group V became not statistically significant.Conclusion BMSC transplantation via renal artery can improve cell-homing efficiency and improve the repair of damaged tissue as well.

Objective To investigate the effect of different doses of protamine neutralizing heparin on perioperation of on-pump coronary artery bypass graftting (CABG).Methods A total of 180 on-pump CABG patients hospitalized from January 2015 to November 2016 were randomly divided into three groups,the protamine group l,protamine group 2 and protamine group 3,60 patients in each group.Heparin (3 mg/kg) was used before extracorporeal circulation.After intracardiac operation was over,protamine was used to neutralize the heparin to adjust the activated clotting time (ACT) in protamine group 1,which was 10％ higher than that of intubation.Meanwhile,protamine group 2 was neutralized to equal to the ACT before intubation,and protamine group 3 was 10％ lower than that before the intubation.The differences of intraoperative and postoperative parameters were compared between the three groups.Results No death was found in the three groups during hospitalization.Comparing with protamine group 1 and protamine group 2,the time of operation,the ACT before the leaving operation room,the ACT of the first hour after returning to ICU,the amount of bleeding during operation,the time of closing and the amount of red blood for transfusion were decreased in protamine group 3 (P ＞ 0.05).The total amount of protamine for neutralizing and the ratio of protamine and heparin were significantly increased in protamine group 3 (P ＜ 0.05).The heart dysfunction after operation,perioperative myocardial infarction,pulmonary edema,pulmonary infection,renal dysfunction,poor wound healing,neurological complications,and time of in hospital stay showed no significant differences between three groups (P＞0.05).Conclusion ACT below 10％ of preoperation is safe,after neutralization of heparin by protamine,which can obviously reduce the bleeding,the time of sternal closure and the amount of red blood cell transfusion,showing a positive clinical significance.

Objective:To investigate the clinical effect of ginger-partitioned moxibustion combined with manual repositioning for benign paroxysmal positional vertigo (BPPV). Methods:A total of 76 BPPV cases were randomly allocated into an observation group (n=38) and a control group (n=38). Patients in the observation group received ginger-partitioned moxibustion at Tinggong (SI 19) plus manual repositioning, whereas patients in the control group received the same manual repositioning alone. Results: After 48 h of treatment, the total effective rate was 94.7% in the observation group, versus 86.8% in the control group; after 7 d of treatment, the total effective rate was 78.9% in the observation group, versus 73.7% in the control group, both showing between-group statistical differences (P<0.05). The follow-up after 3 months showed that 2 cases (6.7%) got relapse in the observation group, versus 8 cases (28.6%) in the control group, showing a statistical difference (P<0.05). The adverse reaction rate was 2.6% in the observation group, versus 21.1% in the control group, showing a statistical difference (P<0.05).Conclusion: Ginger-partitioned moxibustion at Tinggong (SI 19) plus manual repositioning can obtain better effect for BPPV than manual repositioning alone. In addition, this therapy has stable efficacy and causes less adverse reactions.

Objective To investigate the clinical efficacy of acupuncture at point Shanzhong(CV17) plus cupping on Back-Shu points in treating migraine. Methods Seventy migraine patients were randomly allocated to treatment and control groups, 35 cases each. The control group received conventional acupuncture and the treatment group, acupuncture at point Shanzhong(CV17) plus cupping on Back-Shu points in addition. The VAS score was counted in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups. Results The cure and marked efficacy rate and the total efficacy rate were 88.6%and 100.0%, respectively, in the treatment group and 62.9%and 94.3%, respectively, in the control group. There was a statistically significant difference in the cure and marked efficacy rate between the two groups (P＜0.05). There was a statistically significant pre-/post-treatment difference in the VAS score in the two groups (P＜0.05). There was a statistically significant post-treatment difference in the VAS score between the treatment and control groups (P>0.01). The clinical symptom improvement rate was (78.3±10.6)%in the treatment group and (49.8±11.2)%in the control group;there was a statistically significant difference between the two groups (P＜0.01). Conclusion Acupuncture at point Shanzhong plus cupping on Back-Shu(CV17) points is an effective way to treat migraine.