Objective: To explore the clinical value of N-terminal Pro-brain natriuretic peptide (NT-ProBNP) and cardial troponin I (cTnI) for evaluating the patients with acute pulmonary embolism (APE) combining right ventricular dysfunction (RVD). Methods: A total 92 APE patients treated in our hospital were studied. The blood levels of NT-ProBNP and cTnI were measured on next morning of administration and echocardiography was performed within 24 hours of APE diagnosis. According to echocardiographic results, the patients were divided into 2 groups: APE with RVD group,n=47 and APE without RVD group,n=45. Blood levels of NT-ProBNP and cTnI were compared between 2 groups. Results: Compared with APE without RVD group, APE with RVD group presented increased levels of NT-ProBNP, cTnI and right ventricular end-diastolic diameter (RVEDD), allP<0.01. ROC curve analysis found that both AUC of NT-ProBNP and cTnI > 90%, the optimum operating point for NT-ProBNP and cTnI were 554 pg/ml and 0.09 ng/ml respectively. Logistic regression analysis showed that NT-ProBNP (r=1.227,P=0.005), cTnI (r=0.862,P=0.016), right ventricular dysfunction (r=0.936,P=0.008) and heart rate (r=0.809,P=0.023) were related to poor prognosis for in-hospital patients. Conclusion: Blood levels of NT-ProBNP and cTnI may help diagnosing the patients with acute pulmonary embolism with right ventricular dysfunction, it may also predict the short term prognosis in clinical practice.

Lynch syndrome.(LS) is an autosomal dominant condition caused by a mutation in the mismatch repair genes (MMR).Endometrial cancer (EC) is the most common extra-colonic cancers of LS Ⅱ type.Among the female members of LS family with the MMR gene mutation,EC has an overall lifetime risk more than 35％.LS-associated EC is more likely present as the clinical pathological characteristics of early age of onset,endometrioid adenocarcinoma,lower grade,lower uterine segment involvement,and better prognosis.LS patients with family history and early age of onset should be performed with a combined screening and genetic testing,while high-risk patients should be taken clinical monitoring methods as endometrial biopsy.Oral contraceptives mav be reasonable chemopreventive agents in the patients with LS.Although prophylactic hysterectomy with bilateral salpingo-oophorectomy is an effective strategy to prevent EC in women with LS,preoperative counseling should address the trade-offs between the reduction in the risk of cancer,and the risks and side effects of surgery.The patients need hormone replacement therapy after surgery.

The vaccine based on dendritic ceil has becomes a new research focus in the biotherapy of breast cancer. And the ways of making the vaccine are vary and no one approach has been shown to be superior to another.

BACKGROUND:Spine, due to its complicated structure and special functions, is always the difficulty and emphasis in clinical practice and medical education. It is an interesting top how to apply modern software in clinical teaching. OBJECTIVE:To investigate the application of Spine Decide software in clinical teaching of spine surgery. METHODS:Teachers can actively guide students to learn the diagnosis of spine diseases and to design surgery program using Spine Decide software. Then the students wil participate in the surgical operation of the patients, which helps them better understand the diagnosis and treatment of spine surgery disease and the occurrence and development of spine diseases. RESULTS AND CONCLUSION:The students actively participated in the process of learning through Spine Decide software, which helps them learn systematical y, structural y the pathogenesis, diagnosis, treatment and prognosis of spine diseases in a short period. Application of Spine Decide into teaching activities has greatly improved the students’ abilities in self-learning and clinical analysis. Their enthusiasm to the learning and creativity has been greatly improved compared to traditional teaching methods;innovation and exploration have breakthrough improvement, final y achieving a good teaching effect.

Objective To investigate potential association of XRCC1-Arg399Gln polymorphism with hyroid-tassociated ophthalmopathy(TAO).Methods XRCC1-Arg399Gln polymorphism was identified by PCR-RFLP in 182 patients with TAO and 182 healthy subjects.Results The significant difference of the allelic frequency distribution was found between TAO and control group(P

Intracranial atherosclerotic stenosis (ICAS) is an important cause for the occurrence,development,and recurrence of ischemic stroke.Age,hypertension,diabetes,and smoking etc.are its traditional risk factors.Among them,symptomatic ICAS is the key of clinical intervention.Its treatments include intensive medical therapy,endovascular treatment,extracranial intracranial arterial bypass grafting,encephaloduroarteriosynangiosis,and external counterpulsation,etc.

Objective To detect the expressions of circulating microRNAs (miRNAs) of peripheral whole blood in Alzheimer's disease (AD) and investigate the potential roles of the miRNAs as diagnostic bi omarkers for Alzheimer's disease.Methods Peripheral blood samples were obtained from 110 AD patients and 150 age-and gender-matched normal controls.The concentrations of seven candidate miRNAs,including miR-9,miR-29a,miR-29b,miR-101,miR-181c,miR-137and miR-126,were measured with a real-time quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) method.The data of two groups were collected and analyzed by SPSS 19.0 software.Results It was found that miR-29a (P=1.12×10-5) and miR-101 (P=6.24× 10-7) were markedly down-regulated in peripheral blood of AD patients compared with normal controls.In addition,logistic regression analysis revealed peripheral whole blood miR-29a/101 combination could be a potential biomarker of AD with better specificity (82％) and sensitivity (75％).Conclusions miR-29a/101 combination in peripheral whole blood may serve as a useful noninvasive diagnostic biomarker for AD.

Objective To study the mechanism of miR?200c in regulating RMP7?induced increases of blood?tumor barrier(BTB)permeability by targeting Ras homolog gene family member A(RhoA). Methods Endogenous expression of miR?200c was detected by real?time PCR in hu?man cerebral microvascular endothelial cell line hCMEC/D3(ECs)after RMP7 treatment. miR?200c mimic and miR?200c inhibitor were transfect?ed into GECs(ECs with U87 glioma cells co?culturing),respectively. Transfection efficiency of miR?200c mimic and miR?200c inhibitor were de?termined by real?time PCR. HRP flux and TEER assays revealed BTB permeability. The protein expression level of RhoA was assessed by West?ern blotting. The distribution of RhoA was assessed by immunofluorescence microscopy. RhoA luciferase assays were performed using the Dual?Lucif?erase reporter assay system. Results RMP7 significantly induced a decrease in miR?200c expression in GECs of BTB. miR?200c mimic and miR?200c inhibitor were successfully transfected into GECs. Overexpression of miR?200c inhibited endothelial leakage and restored normal transendo?thelial electric resistance values. Simultaneously ,overexpression of miR?200c significantly reduced the protein expression level of RhoA. In addi?tion,immunofluorescence analysis revealed that the distribution of RhoA in the cytoplasm and nuclei of GECs were decreased in miR?200c mimic group. RhoA was one of the direct targets of miR?200c with the specific binding site being located at the seed sequence. The results of miR?200c si?lencing were opposite to that of the miR?200c overexpression group. Conclusion miRNA?200c regulated RMP7?induced increases in BTB perme?ability by targeting RhoA.

Objective: To investigate the health-seeking delay in tuberculosis among school students in Yining City, Xinjiang Uygur Autonomous Region from 2009 to 2020, and analyze the influencing factors, so as to provide the evidence for reducing the health-seeking delay in tuberculosis among students in Yining City. Methods: The demographic features and diagnosis of students with tuberculosis in Yining City from 2009 to 2020 were retrieved from the Tuberculosis Management Information System of the Chinese Disease Control and Prevention Information System, and the factors affecting the health-seeking delay in tuberculosis were identified using the multivariable logistic regression analysis. Results: A total of 443 students with tuberculosis were reported in Yining City from 2009 to 2020, including 209 boys and 234 girls, with a male/female ratio of 1∶1.12. There were 29 primary school students ( 6.55% ), 81 junior high school students ( 18.28% ), 187 high school students ( 42.21% ) and 146 college students ( 32.96% ) reporting tuberculosis, and 394 cases ( 88.94% ) had locally registered residence. There were 287 students with health-seeking delay in tuberculosis ( 64.79% ), and the median duration of health-seeking delay was 35 ( interquartile range, 33 ) days. Multivariable logistic regression analysis showed that registered residence ( local, OR=1.899, 95%CI: 1.004-3.591 ) and origin of tuberculosis patients ( clinical consultation, OR=3.448, 95%CI: 1.755-6.775; recommendation for symptoms, OR=3.215, 95%CI: 1.161-8.900; tracking, OR=2.415, 95%CI: 1.269-4.596 ) and diagnostic results ( positive sputum smears, OR=3.081, 95%CI: 1.710-5.551 ) statistically correlated with health-seeking delay among students with tuberculosis. Conclusions The proportion of health-seeking delay in tuberculosis was high among students in Yining City from 2009 to 2020; registered residence, origin of tuberculosis patients and diagnostic results were associated.

[ABSTRACT]OBJECTIVETo evaluate the clinical value of ultrasound guided fine-needle aspiration (US-FNA) in the diagnosis of thyroid nodules with different size.METHODSThe clinical data of 122 thyroid nodules of 109 cases referred to FNAC for diagnosis were retrospectively reviewed. The final operating histological results of 122 nodules were considered gold standard. RESULTSNon-diagnostic FNAC results occurred in 17 nodules (13.9%). FNAC achieved a sensitivity of 78.6%, a specificity of 93.9%, a positive predictive value of 93.6%, a negative predictive value of 78.3%, and a total accuracy of 85.7%. There was no significant difference between the diameter of the nodule≤1 cm group and>1 cm group, except negative predictive value. The non-diagnostic results rate was no significant difference between groups of different nodule size, benign or malignant nodules, and different operators. CONCLUSIONFNAC is a sensitive, specific and accurate method for differential diagnosis of thyroid nodules.