Immoderate medication is a common phenomenon in medical institutions with very complicated causes.Intervention measures should be employed in order to relieve the burden on patients and realize the rational use of drug.Therefore,it remains a highly complex and difficult task before the healthcare administrators.The improvement must be accomplished through moral education for medical staff and concentrating on institutional improvement,thus the patient-oriented creed of medical institutions could be truly incarnated.

Objective Cyclic RNA ( circRNAs) was discovered in 1970s,which is different from other RNA,its structure is special,which is a closed covalent ring structure,and shows high and stable expression in eukaryotic cells?In recent years, the study found that a large number of endogenous circRNAs exists in mammalian cells,and most circRNAs with stable expression,RNA enzyme degradation resistance,usually in the tissue cells with the characteristic of diversity and specificity?CircRNAs most formed by exons,part formed by introns?For the functional study of circRNAs,circRNAs has a similar competitive endogenous RNA ( ceRNA) of the sponge function,but also can regulate transcription and translation?More and more evidence indicates that circRNAs circRNAs may be abnormal expression in many diseases,especially in tumor cells?This could be some new diagnostic and predictive biomarkers of disease?CircRNAs in the field of RNA is becoming a new research hotspot,and can be widely involved in many areas of life.

Objective To investigate Survivin protein and esophageal cancer with a systematic review.Methods The published studies were searched in the Cochrane Library (Issuel,2011),Pubmed and CNKI databases, and other relevant journals were also hand searched to identify all the relevant case-control trials.Then the quality of the included trials was assessed and meta-regression analysis was performed,by STATA 11.0 software.Results A total of 15 studies were recruited.As for the positive rate of Survivin expression, significant differences were tested between esophageal cancer vs.normal esophageal tissues (OR =39.98, 95 ％ CI =15.08-106.02, P ＜ 0.05).No significant difference was tested between cell differentiation G3 vs.cell differentiation G1-G2(OR =1.47,95 ％ CI =0.59-3.68,P ＞ 0.05).There were significant differences between T stagesⅢ-Ⅳ vs.T stages Ⅰ-Ⅱ (OR =2.82,95 ％ CI =1.35-5.90,P ＜ 0.05),clinic stages Ⅲ-Ⅳ vs.clinic stages Ⅰ-Ⅱ (OR =2.99, 95 ％ CI =2.03-4.41, P ＜ 0.05), lymph node metastasis vs.non-lymph node metastasis (OR =4.11,95 ％ CI =2.79-6.05,P ＜ 0.05).Moreover,Survivin expression was positively correlated with the expression of hypoxia inducible factor-1α (HIF-1α) (r =0.542,P ＜ 0.005).Conclusion Survivin expression increased malignant behaviors of esophageal cancer.There might be substantial correlations between Survivin and HIF-1α expression and esophageal cancer.

0.05). The stepwise regression analysis showed that the logarithm of the duration of residual gas had a parallel relationship with the gas volume under the hemi-diaphragm 24 hours after operation(r=0.616,P=0.006),a negative correlation with the duration of pneumoperitoneum (r=-0.228,P=0.014), and no correlation with patients’ age,body weight,height,operation time and gas volume consumed. Postoperatively, 26 patients reported postoperative shoulder pain. The shoulder pain VAS scores were significantly increased with the increasing of CO_2 pressure in the three groups (F=9.635, P=0.000). The shoulder pain VAS scores had a parallel relationship with the gas volume under the right hemi-diaphragm 24 hours after operation (r=0.333, P=0.005) and the duration of residual gas (r=0.296, P=0.014). Conclusions The CO_2 should be removed as thoroughly as possible at the end of operation to reduce the absorption of residual gas. The different CO_2 pressures of pneumoperitoneum have little effects on the volume of residual CO_2 24 hours after operation and the duration of residual gas. The shoulder pain following LC, will be aggravated with the increasing of pneumoperitoneum pressure. The over-stretching of the diaphragmatic fibers due to insufflation is the main cause of shoulder pain.

Objective:To evaluate the clinical effects of oncoplastic breast-conserving surgery on patients with early breast can-cer near the mammary areola. Methods:A total of 60 patients with early breast cancer underwent breast-conserving surgery in the Sec-ond Department of Breast Surgery, Tangshan People's Hospital from February 2011 to November 2013. These patients were random-ized into two groups, namely, the experimental Group A (n=30) and the control Group B (n=30). Oncoplastic breast-conserving surgery was performed on the patients in Group A, whereas Group B underwent standard breast-conserving surgery. The specimen weight of the locally excised breast, the nearest distance of the tumor to the surgical margins, and the postoperative cosmetic result of the affected breast were compared between the two groups. Results: The specimen weights of the locally excised breast were 71.03 ± 12.92 and 41.53±7.13 g, and the nearest distances of the tumor to the surgical margins were 13.30±2.97 and 10.63±1.65 mm in Groups A and B, respectively, with significant differences between the two groups (P<0.05). The postoperative satisfaction rates of the affected breast were 93.33%and 83.33%in Groups A and B, respectively, without any significant differences between the two groups (P>0.05). Con-clusion:A larger amount of excised breast tissue and a wider scope of surgical margins were observed in Group A patients. However, the postoperative cosmetic result of the affected breast was almost similar for both groups. Therefore, oncoplastic breast-conserving sur-gery is a feasible and effective approach for early breast cancer patients.

Objective:To evaluate the clinical value of activated carbon nanoparticles for guiding lymphadenectomy in advanc-ing rectal cancer. Methods:Eighty rectal cancer patients who underwent laparoscopic curative resection for rectal cancer were divided into two groups:control group (40 cases) and experiment group (40 cases). The experiment group received carbon nanoparticle-labeled lymph nodes in surgery. The number of lymph nodes, lymph nodes≤5 mm in size, and positive lymph nodes, as well as the side effect of the procedure, were analyzed. Results:No complications were observed in the experiment group. The experiment group showed sig-nificantly higher values (P<0.05) than the control group for average number of lymph nodes (25.5 ± 8.78 vs. 16.05 ± 4.84), lymph nodes≤5mm in size (22.6 ± 8.25 vs. 13.65 ± 4.62), and positive lymph nodes (3.13 ± 4.14 vs. 1.35 ± 2.06). During operation, two dyed lymph nodes in two cases were found at the roof of the inferior mesenteric artery and along the side of the internal iliac artery. Dissec-tion was extended for these patients and the dyed lymph nodes were confirmed to be positive. Conclusion:Local injection of activated carbon nanoparticles around the tumor during surgical exploration was an effective, secure, and easy approach for guiding lymphade-nectomy in rectal cancer patients.

0.1), but which were inhibited significantly in the left ventricular cardiac myocytes of the subjects with heart failure(P≤0.05). Both carvedilol and metoprolol exhibited no effect on eNOS activity in all the investigated cardiac myocytes. CONCLUSIONS: Nebivolol does no effect on eNOS activity of left ventricular cadiocytes in subjects or rats without hear failure but it can inhibit eNOS activity of cadiocytes in subjects or rats with heart failure so as to exert its beneficial clinical effect.

OBJECTIVE To investigate the diagnostic value of 131I-SPECT/CT fusion images in detecting the metastases of differentiated thyroid carcinoma(DTC)in the regions of the head,neck and superior mediastinum.METHODS 131I-SPECT/CT fusion images was preformed for 30 patients with DTC,and the results of image were compared with the pathology after surgery.RESULTS There were 110 cases positive findings in 115 metastatic lesions with 131I-SPECT/CT fusion images examination(95.65%).5 cases of the metastatic lesions showed negative in 131I-SPECT/CT(4.35%).There was no false positive case.CONCLUSION 131I-SPECT/CT fusion images can detect and locate the metastasis and exclude the false positive results accurately.It is a good method to detect the cervical and superior mediastinal metastatic lesion in differentiated thyroid carcinoma.

Objective To evaluate the efficacy and survival rate of neoadjuvant chemotherapy with docetaxe and pirarubicin in triple negative breast cancer (TNBC).Methods Total 51 breast cancer patients were divided into TNBC group (n =26,including 16 of stage Ⅱ and 10 of stage Ⅲ patients) and non-TNBC group (n =25,including 14 of stage Ⅱ and 11 of stage Ⅲ patients).All patients received a median of 4 treatment cycles with TAC regimen [docetaxe 75 mg/m2 on day 1,pirarubicin 40 mg/m2 on day 1 and cyclophosphamide (CTX) 500 mg/m2 on day 1 of each 21 day cycle].The efficacy of treatment and survival rate of two groups were evaluated.Results In TNBC group,9 out of 26 (34.62 ％) patients achieved clinical complete response (cCR),and 14 (53.85 ％) had partial response (cPR).Overall,88.46 ％ of TNBC patients had clinical response and 26.92 ％ (7/26) showed pathology complete response (pCR).In non-TNBC group,6 (24.00 ％) patients reached cCR and 8 (32.00 ％) showed cPR.The overall response rate was of 56.00 ％,and 4 (16.00 ％) patients achieved pCR.The overall 3-year survival rates in TNBC and non-TNBC groups were 73.08 ％ and 88.00 ％,respectively,indicating a poorer prognosis of TNBC.The 5-year survival rates of TNBC patients with and without pCR were 88.89 ％ and 47.06 ％,respectively.Conclusion TAC regimen improves the prognosis for locally advanced TNBC,indicating that the neoadjuvant chemotherapy is effective and safe for TNBC patients.

OBJECTIVE: To investigate the expression of B-cell translocation gene 1 (BTG1) and to determine the relationship between BTG1 expression and clinicopathological features, biological behaviors in laryngeal squamous cell carcinoma. METHOD: Immunohistochemistry and Western blot were used to analyze BTG1 protein expression in 70 cases of laryngeal cancer and 35 cases of adjacent corresponding laryngeal mucosal tissues to illuminate the relationship between BTG1 expression and clinical factors. RESULT: The positive rate of BTG1 protein expression was 31.43% in laryngeal carcinoma tissues, significantly lower than 91.43% in the adjacent laryngeal tissues (P < 0.05). Western blot showed the relative expression of BTG1 protein between cancer lesion and adjacent tissue were 0.217 ± 0.032 and 0.918 ± 0.081, showing the difference with statistical significance (P < 0.05). The expression of protein was significantly correlated with the tumor invasion, lymph node metastasis, clinic stage and histological grade (P < 0.05 or P < 0.01), but not with sex, age and tumor location (P > 0.05) of patients with laryngeal cancer. CONCLUSION The expression of BTG1 protein was decreased in laryngeal squamous cell carcinoma, suggesting that BTG1 gene may be closely associated with the carcinogenesis and the degree of malignancy. Detection of BTG1 expression may be useful in diagnosis, treatment and prognosis of laryngeal carcinoma.
Carcinoma, Squamous Cell ; metabolism ; pathology ; Head and Neck Neoplasms ; metabolism ; pathology ; Humans ; Immunohistochemistry ; Laryngeal Mucosa ; metabolism ; Laryngeal Neoplasms ; metabolism ; pathology ; Lymphatic Metastasis ; Neoplasm Grading ; Neoplasm Proteins ; metabolism ; Neoplasm Staging ; Prognosis ; Squamous Cell Carcinoma of Head and Neck