Objective To investigate the feasibilty of the disposable tracheotomy tube as trocar in the electronic bronchoscope instead of thoracoscope. Methods 86 patients with effusion of unknown origin undergoing medical tho-racoscopy from January 2015 to October 2015, 59 male (68.6%) and 27 female (31.4 %), mean age (49.00 ± 20.00) years (15 ~ 83) years, were randomly divided into two groups, Tracheostomy tube group (group T) and Conventional chest tube group (group C). Group T uses disposable cannula tracheostomy tube as trocar, and group C received conventional medical thoracoscopy chest tube. Then compare the positive rate of pathological diagnosis, operation time, inspection fees, and other adverse reactions between the two groups. Results 40 cases (93.0%) in group T were confirmed diagnosis, including 8 cases of lung pleural metastasis, 31 cases of erculous pleurisy, 1 case of empyema, while 4 cases of unknown diagnosis (7.0%). 33 cases (76.7%) in group C were confirmed diagnosis, in-cluding 4 cases of lung pleural metastasis, 29 cases of tuberculous pleurisy, while 10 cases of unknown diagnosis (23.3 %). The difference was statistically significant between the two groups ( < 0.05). Operative time in group T was (23.86 ± 2.45) minutes, while in group C was (29.88 ± 3.67) minutes, the difference was statistically significant ( <0.05). While the complication rate was no significant difference. Conclusions It is demonstrated that the dispos-able tracheotomy tube as trocar in the electronic bronchoscope instead of thoracoscope which can shorten the opera-tion time, improve the diagnosis rate, reduce costs, worthy of promoting.

Objective To explore the prognostic value of ventricular wall motion score (WMS) and left ventricular ejection fraction (LVEF) in patients with acute myocardial infarction (AMI) combined with heart failure (HF) in the recent 12 months Methods We selected hospitalized AMI patients in our department from Jan. 2014 to Nov. 2014. Cardiac ultrasound was performed to detect WMS and LVEF within 48 hours and during the 6?month follow?up period and the occurrence of HF was recorded. Results Totally 127 AMI patients were recruited, including 20 cases combined with HF. The WMS was higher in HF group than those in non?HF group (23.55 ± 3.73 vs 20.11 ± 3.13, P<0.01), while the LVEF in HF group was lower than those in non?HF group (48.77 ± 8.08 vs 56.99 ± 5.17, P<0.01). Multiple logistic regression analysis revealed that WMS and LVEF were both independent predictors of HF in the recent 12 months (P < 0.05). The prediction effect of WMS ROC curve area was 0.81 (P < 0.01) , and LVEF 0.76 (P < 0.05). WMS and LVEF combined assessment area under ROC curve was 0.82 (P < 0.01). Conclusion WMS and LVEF are independent predictors of HF in patients with AMI in the recent 12 months and the combined application of WMS and LVEF can significantly improve the prediction effect.

0.05). Conclusions HF could not only relax cerebral vessels, reduce the CVR and enhance the CBF, but also dilate the femoral vessels of CVS dogs. Nevertheless, the latter action was much weaker. Furthermore, there was no relationship between effects of HF on vascular relaxation and contraction activity and the blood vessel endothelium.

Objective To observe the clinical efficacy and toxicity of intraperitoneal chemotherapy combined with intravenous chemotherapy in treatment of cervical cancer.Methods The experimental group of 40 patients received systemic chemotherapy of docetaxel and cisplatin combined abdominal intraperitoneal high-frequency hyperthermia in the control group,40 patients received docetaxel plus cisplatin chemotherapy,The efficacy and toxicity were observed.Results The complete remission rate of observotion group was 82.5％,significantly higher than 62.5％ in control group.Effective rate in observation group was 92.5％ and also significantly higher than 75.0％ in control gronp.After 6 cycles of chemotherapy,the improvement of the experimental group was 85.0％ higher than 57.5 ％ in control gronp.The differemles between the two groups was statistically significant(P ＜ 0.05); the main side effects during chemotherapy are gastrointestinal reactions,since the cells decreased,hair loss,the difference was not statistically significant(P ＞0.05).Conclusion The chemotherapy of docetaxel and cisplatin intraperitoneal chemotherapy can significantly improve the treatment of cervical cancer,without increasing side effects.

Objective To evaluate the roles of high-resolution computer tomography (HRCT) and bron- choalveolar lavage (BALF) in the diagnosis of connective tissue diseases associated with interstitial lung disease (CTD-ILD). Methods Clinical data of chest HRCT and BALF of patients with CTD-ILD from January 1997 to December 2007 in in-patient department of Peking University First Hospital, were retrospectively analyzed. Results ①Among 46 cases with the picture of chest HRCT, 19 (41.3%)showed usual interstitial pneumonia(UIP) -like pattern and 18 (39.1%) showed lobular and interlobular septa thickening. 8 (8/17) of ANCA vasculitis (AASV) and 5 (5/9) of rheumatoid arthritis (RA) manifested as UIP-like patterns respectively. In polymyositis/dermatomyositis(PM/DM) and Sjogren's syndrome (KS) patients, the organizing pneumonia(OP)-like pattern and lymphocytic interstitial pneumonia(LIP)-like pattern were 2/4 and 2/4 respectively. ②Among 32 cases undergoing BAL, 10/10 patients with AASV-ILD all showed that neutrophils were dominant in BALF, while, the other 22 patients showed that the ratio of neutrophils elevation (14/22, 63.6%) and the ratio of lymphocytes elevation (18/22, 81.8%) were comparable, and there were 12/22(54.5%)patients with both types of cell elevation. Among 13 cases with iymphocytes elevation in BALF who performed analysis of sub-type lymphocytes, 10/13 cases showed decreased CD4/CD8 ratio, 3/13 cases showed increased CD4/CD8 ratio which were all related with SS. ③Among 15 patients undertaken HRCT and BALF detection together, 7/7 UIP-like cases showed the ratio of neutrephils elevation in BALK While in non-UIP-like cases, 5/8 showed the ratio of lymphocytes elevation. Conclusion ①UIP-like patterns and patterns of lobular and interlobular septa thickening are the most common imaging features of HRCT in CTD-ILD, the former are mostly seen in AASV and RA. OP-like patterns and LIP-like patterns are commonly seen in PM/DM and SS respectively. ②Tbe increased neutrophil percentage is dominant in BAL fluid of patients with AASV-ILD, while the others show that the ratio of neutrophil and lymphocyte elevation are comparable, lymphocytes subtype analysis shows decreased CD4/CD8 ratio is dominant in CTD-ILD patients with lymphocytes increased. There is a significant relationship between increased CD4/CD8 ratio and SS-LIP. ③All of the cases with UIP-like patterns show the ratio of neutrophils elevation in BALF. While the ratio of lymphocytes elevation is dominant in non-UIP-like cases.

Objective:To amendment a tool of theory of mind (TOM) tests that can be applied to children with autism spectrum disorder (ASD) in mainland China,and assess the ability of ToM of children with ASD.Methods:The items of the ToM tests were revised by observing and recording events of children's life.Totally 200 normal children were selected in line with the standard from kindergarten to Grade 6 for formal tes-ting.With 156 valid data,Pearson correlation coefficient and Cronbach α coefficient were established for the test.Three experts were invited to make sure the content validity.Researchers randomly selected 30 normal children for retest purpose after 2 months.Twenty five children with ASD were tested and compared with normal children's test scores.Results:The revised test included 39 entries,which was divided into three sub-tests,42 points in total.The correlation coefficient of three subtests of the tests was 0.54-0.77,the correlation coefficient between the test and the subtest was 0.62-0.93 (Ps ＜ 0.01).The scores of three experts for the test were 114,108,and 105.The total scores and subtest scores were lower in children with ASD than in normal children (Ps ＜0.01).The Cronbach a coefficient of the test was 0.84,Cronbach a coefficients for three subtest were 0.83,0.80,and 0.78,respectively.The retest reliability was 0.84,and reliabilities for three subtest were 0.75,0.74,and 1.00.Conclusion:The revised Theory of Mind Tests for Children with Autism Spectrum Disorder are fulfilled mostly in line with psychometric testing requirement.It might be a selection to measure the ability of theory of mind of children with ASD in mainland China.

Objective To evaluate comprehensive therapy in the treatment of keloid effect and the patients' satisfaction.Methods A total of 523 patients with comprehensive treatment,according to the treatment,were divided into group A (surgery combined radiotherapy) and group B (surgery plus corticosteroids),group C (hyperbaric oxygen in combination with radiotherapy),and the therapeutic effect of patients with satisfaction was analyzed.Results Total effective rate of three groups of patients were 69.47％,89.13％,90.32％,respectively.Effective rate in group A was higher than that of group B and group C,there was statistically significant difference between groups A and C (P ＜ 0.05),but no significant difference between the group A and group B (P＞0.05).Difference was statistically significant between three groups of patients' satisfaction,group B better than group A and group C,the difference between group B and C group was statistically significant (P ＜ 0.05).Conclusions Effectiveness of the three combined therapies is obvious,in which radiotherapy plus hyperbaric oxygen is most effective.

Objective To explore the relationship between cognitive function and sleep disturb-ance,depression and anxiety. Methods Totally 333 medical staff were investigated using the repetitive neu-ropsychological status questionnaire (RBANS),the Pittsburgh sleep quality index ( PSQI),the depression self-rating scale (SDS) and the anxiety self-rating scale ( SAS). Results ①The difference of visual span in gender(male:(81. 87±13. 48) vs female:(77. 12± 13. 09)) was statistically significant ( t=2. 928,P<0. 05).②Differences in immediate memory,language function,attention function and total score of RBANS among patients of different ages were statistically significant ( F=9. 654,8. 370,11. 465,11. 112, all P<0. 01).③There were significant differences in the RBANS,immediate memory,visual span,attention function and delayed memory between doctor and nurse(t=5. 374,4. 730,3. 389,4. 359,5. 675,all P<0. 01).④There were significant differences in the RBANS,immediate memory,and delayed memory between different PSQI levels ( F=3. 475,4. 892,4. 087, all P<0. 05). ⑤There were significant differences in RBANS ((88. 87±12. 47) vs (83. 69±13. 03)),immediate memory ((86. 18±16. 09) vs (80. 56±15. 38)),visual span ((79. 39±13. 32) vs (73. 47±12. 46)),and delayed memory ((89. 03±10. 26) vs (85. 49±11. 41)) between the depressive symptoms and not depressive symptoms groups( t=2. 794,2. 380,3. 042,2. 295,all P<0. 05) .⑥The total score of medical staff's RBANS was significantly negatively correlated with their PSQI,SDS and SAS scores (r=-0. 158,-0. 233,-0. 117,all P<0. 05).⑦SDS,age,occupation,education, time of sleep and PSQI entered multiple stepwise regression equations,which explain 39. 9% variation in cog-nitive function of medical staff. Conclusion The cognitive function of medical staff is affected by gender, age,occupation,education,depression,and sleep disturbance. The worse the sleep quality,the higher the de-gree of depression and anxiety,and the poorer the cognitive function.

Objective:To investigate the differences in the expression profiles of cyclic RNA (circRNA) in peripheral blood mononuclear cells (PBMCs) of rheumatoid arthritis (RA) and its clinical significance.Methods:Venous blood were collected from 4 patients with RA (group T) and 4 healthy subjects (group C). The expression profiles of circRNA in PBMCs of the two groups were detected by Arraystar circRNA microarray, and the differentially expressed circRNA was analyzed by clustering analysis. The binding sites for interaction between differentially expressed circRNA and miRNA were predicted, and functional analysis such as geneontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis was performed. quantitative real-time polymerase chain reaction (RT-qPCR) was used to verify the expression of partially differentially expressed circRNA in the two groups of PBMCs, and a circRNA-miRNA-mRNA regulatory network (ceRNA network) was constructed for the target circRNA with significantly differential expression. A receiver operating characteristic curve [receiver operating characteristic curve (ROC)] was established to analyze the potential diagnostic value of target circRNA. SPSS Statistics 23.0 and Graphpad Prism 8.0 were used to analyze the data, and the independent t test was used to analyze the difference between the two groups. Results:① Microarray results showed that, compared with group C, a total of 399 [fold of difference (FC)>1.5, and P<0.05] circRNA were abnormally expressed in PBMCs of group T; including 149 up-regulated and 250 down-regulated. ② Bioinformatics analysis: The prediction of the binding site of circRNA and miRNA suggested that the differentially expressed circRNA in RA might affect the inflammatory response by targeting miR-140-5p, miR-338-5p, and miR-9-5p. GO analysis showed that the differentially expressed circRNA was mainly involved in the intimal-binding organelles, protein metabolism and binding, etc. KEGG pathway analysis showed that most of the involved pathways were related to infection and human immune dysregulation. ③ The results of multi-sample RT-qPCR validation showed that the expression level of hsa_circRNA_009012 in group T was significantly higher than that in group C ( t=-4.417, P<0.01), the expression level of hsa_circRNA_101328 was significantly lower than that in group C ( t=-1.042, P<0.01), and the expression of hsa_circRNA_058230 had no significant change ( t=4.691, P>0.05). ④ ROC curve analysis indicated that hsa_circRNA_009012 had potential value in the diagnosis of RA [area under curve=0.96]. Conclusion:The expression of circRNA in PBMCs of patients with RA is imbalanced, and it may participate in the regulation of the development of RA. Among them, hsa_circRNA_009012 is expected to become a new biological marker for the diagnosis and treatment of RA.

Objective To investigate the predictive value of serum adiponectin level on morbidity of acute myocardial infarction, and to evaluate its impact on prognosis in patients with acute myocardial infarction after percutaneous coronary intervention (PCI). Methods We prospectively recruited patients with acute ST segment elevation myocardial infarction (STEMI) who had underwent primary PCI. Their serum adiponectin levels were measured. The TIMI blood flow classification of culprit vessel was recorded after PCI. Echocardiography was performed in 24 h after PCI to evaluate left ventricular ejection fraction (LVEF). Major adverse cardiac events (MACE) were recorded including cardiac death, recurrent nonfatal myocardial infarction, target vessel reascularization, and readmission for heart failure after 18 months′ followed-up. Results 108 consecutive patients with STEMI and 38 control patients without coronary artery stenosis were recruited. The serum adiponectin level in STEMI group was significantly lower than that in control: (1 413.9 ± 218.8) ng/L vs.(1 756.3 ± 205.5) ng/L (P<0.01). STEMI patients with LVEF < 50% had lower serum adiponectin level compared with LVEF ≥50%: (1 334.1 ± 226.3) ng/L vs. (1 453.0 ± 213.8) ng/L , P<0.01. The serum adiponectin level in the TIMI 0-2 group after PCI was significantly lower than that in the TIMI 3 group:(1 350.7 ± 214.9) ng/L vs. (1 430.6 ± 218.5) ng/L, P < 0.01. Multiple logistic regression analysis revealed that lower serum adiponectin level was an independent predictor of STEMI ( OR=0.992, 95% CI 0.987-0.996, P<0.01). MACE occurred in 22 patients (20.4% ). Cox regression analysis revealed that lower serum adiponectin level remained an independent predictor of MACE ( OR=0.996, 95% CI 0.993-0.999, P < 0.01). Conclusions Lower serum adiponectin level is significantly associated with morbidity of STEMI and adverse prognosis in patients with acute myocardial infarction.