The objective of this retrospective study was to evaluate the myocardial protection of different periop erative procedures in 100 cases with heart-valve replacement (HVR) between 1980 and 1992. Before Feburary. 1989. HVRs of 48 cases (group Ⅰ) were undertaken with hypothermia (28C=30C) and cold cardioplegic solution (4C. 500ml). under morphine-diazepam-pancuronium anesthesia: following cardiac resuscitation, the procedures were performed including blood transfusion, diuresis, supplemental KCI. inotropic support with dopomine, norepincphrine and aramine. and continuous mechnical ventilation. Since 1989, the procedures were increased to be conducted in 52 cases (group Ⅱ) as followed: A. preoperative managements for achiving the optimum status of cardiac function: 1. oxygen therapy by mask. 2. antirhenmatic treatment for patients aged less than 35 years. 3. oral isosorbide and captopril for pulmonary hypertension, 4, infusion with fructose 1.6-diphusphatc and glucose-insulin-KC1 mixture. 5. clinical dose of digitora and diuretics for cardiac failure; B. methods during surgery: 1. anesthesia was induced with fentanyl, midazolam and pancuronium. and maintained with inhalation of nitrous oxide and infusion of fentanyl at 30-35?g/kg/min, 2, hy pothermia (24C-27C) and cold cardioplegic solution(600-1000ml) 3. immediately before the blockage of aorta was overcome. the artificial perfusion blood pressure was reduced; afterwards, it was gradually recovered, in order to prevent myocardium from injury of reperfusion. 4. intra-and extracoporal circulations worked together over half of blokage time of arota, to improve myoardial oxygen delivery; C. treatments in early postoperative stage: 1. continuous positive end-expiratory pressure ventilation, 2. infusion with magnesium-potassium aspartyl: and the others were similar to those before 1989. As compared with those in group 1. the rate of spontanous restoration of beats increased significantly (P

Objective:To analyze the clinical effect of different surgical methods on giant-cell tumor of bone (GCTB). Methods:Between January 2007 and June 2012, 37 patients receiving treatment for GCTB were enrolled in this study. These patients included 20 males and 17 females whose ages ranged from 20 to 56 (average=31.6). The prosthesis replacement and nonprosthetic replacement op-eration on the postoperative recurrence, limb function, comprehensive evaluation of the curative effect, as well as morbidity and recur-rence rate among different nations and in the upper and lower limbs of GCTB patients were analyzed. Results:The predilection age of the cases ranged from 20 to 50 years old. The incidence was higher in the Uighur population of Xinjiang, China. However, the recur-rence rate in ethnic difference was not statistically significant (P>0.05). Conclusion:The predilection age of GCTB cases was 20~50 years old, with higher morbidity in Uighur than in Han and other ethnic groups. The morbidity and recurrence rate were higher in the lower limbs than in the upper limbs of patients. The scraping bone graft and bone cement filling, the internal fixation of the scraping bone graft, and the artificial joint replacement of tumor resection were all reliable modes of treatment.

Objective To examine the expression of hypoxia inducible factor-1 α (hypoxia-inducible factor 1α,HIF-1α),tumor cell proliferation antigen Ki67 and vascular endothelial growth factor (VEGF) in breast cancer tissues,adjacent tissues and normal breast tissues.Methods Immunohistochemistry HRP method was used to detect the expression of HIF-1α,Ki67 and VEGF in 70 cases of breast cancer tissues and their adjacent tissues and 10 cases of normal breast tissues.Difference of the positive rate was assessed viax2 test,and the correlation between the 3 were analyzed in a disorderly classified manner.Results The positive expression rate of HIF-1α,Ki67 and VEGF in 70 cases of breast cancer tissues was 78.6％ (55/70),88.6％ (62/70) and 65.7％ (46/70) respectively,significantly higher than that in adjacent tissues and normal breast tissues (P ＜ 0.01).The positive expression rate of HIF-1 α,Ki67 and VEGF was closely related with clinical stage,lymph node metastasis and histological grade (P ＜0.05).The expression intensity of HIF-1α was positively correlated with Ki67 and VEGF in breast cancer (P ＜ 0.05).Conclusions Detection of HIF-1 α,Ki67,VEGF may be an important indicator to predict the development,invasion,metastasis and prognosis of breast cancer.Tissue hypoxia may promote the proliferation of breast cancer cell and angiogenesis.A presumption is that HIF-1αmay be a new t()get of breast cancer,thus it deserves further study.

Objective To explore the ideal treatment mode of brain metastases by Meta-analysis.Methods Articles were searched for from the databases at home and abroad using English and Chinese keywords.Searching time limited from the databases setting up to December 30,2012.Jadad score was applied to evaluate the qualities of literatures.RevMan5.0 software was applied to perform the Meta-analysis.A totle of 25 articles including 2 750 patients were eligible for the Meta-analysis,which divided into groups with different treatment.Results Compared with monotherapy,combined therapy improved 1-year survival (OR =0.58,95％ CI:0.46 ～0.71,P ＜0.000 01).In combined therapy groups,compared with two methods,three kinds of therapies improved 1-year survival (OR =0.63,95 ％ CI:0.50 ～ 0.80,P =0.000 1).Compared with local therapy only or systemic therapy only,systemic combined local therapy improved 1-year survival (OR =0.68,95％ CI:0.53 ～ 0.86,P =0.001 ; OR =0.59,95％ CI:0.41 ～ 0.86,P =0.006).In systemic combined local therapy groups,three kinds of treatments improved 1-year survival compared with two methods (OR =0.52,95％ CI:0.35 ～ 0.78,P =0.002).Compared with non-molecular targeted therapy,molecular targeted therapy improved 1-year survival (OR =0.76,95％ CI:0.67 ～ 0.87,P ＜ 0.000 1).Conclusion The reasonable treatment for patients with brain metastases is combined treatment with operation,radiotherapy and chemotherapy.There is better curative effect added molecular targeted therapy based on original scheme,if patients have targeted therapy indications.

Objective ToexploretheclinicalvalueofMSCTcombinedwithultrasonographyinthediagnosisofacuteappendicitis. Methods 238patientswithsuspiciousappendicitisunderwentMSCTandultrasonographybeforesurgery.Allpatientsweredivided intoappendicitisgroupandnormalappendixgroupaccordingtoCTappearances.TheefficacyofMSCTcombinedwithultrasoundin diagnosingappendicitiswasanalyzedbycomparisonofsurgicalpathologicalfindings.Results Therewere220casesinappendicitis group,whichhad165casesofappendicitisconfirmedbypathology,and55casesofnormalappendix.Therewere18casesinnormal group,2caseswereconfirmedappendicitisbypathology,and16caseswerenormalappendix.Theoveralldiagnosticperformancesof theCTscanwere98.8%ofsensitivity,22.5%ofspecificity,82.5%ofpositivepredictivevalue,88.9%ofnegativepredictivevalue, and76.1%ofaccuracy.TheperformancesofMSCTcombinedwithultrasonographywere90.4%ofsensitivity,93.0%ofspecificity, 96.8%ofpositivepredictivevalue,80.5%ofnegativepredictivevalue,and91.2%ofaccuracy.Thedifferencewasstatisticallysignificant indiagnosisperformancesbeforeandafterMSCTcombinedwithultrasonography (P＜0.001).Conclusion MSCTcombinedwith ultrasonographyexaminationcouldimprovethediagnosticaccuracyofappendicitis,andmayreducethenegativerateofappendectomy.

Objective: To understand mental health status of middle school students in Weifang, and to analyze its association with health risk behaviors, and to provide a reference basis for the effective prevention of mental health problems. Methods: Using the self-designed questionnaire and Kessler l0 (K10), a total of 3 185 middle school students in Weifang selected by using stratified clustered sampling were investigated. Chi-square test and binary Logistic regression was used for statistical analysis. Results: Among the middle school students in Weifang, 1 634(51.3%) reported good mental health, 854(26.8%) in moderate level, 394(12.4%) reported poor mental health, and 303(9.5%) reported very poor mental health. Sleep duration and smoking were associated with mental health of middle school students (P<0.05). Logistic regression analyses showed that, compared with adolescents with sleep duration less than 8 h, mental health among students whose sleep duration ≥8 h was better(OR=0.36); compared with non-smokers, students who smoked showed worse mental health status (OR=3.53). Conclusion Health-risk behaviors are closely related to mental health of middle school students. Relevant departments should strengthen education and publicity of healthy lifestyles, and pay close attention to the impact of health risk behaviors on mental health.

Background: Gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN) is a rare heterogeneous tumor. Liver metastasis seriously affects the prognosis of GEP-NEN. However, few tools are existed to predict GEP-NEN complicated with synchronous liver metastasis. Aims: To analyze the risk factors of synchronous liver metastasis in patients with GEP-NEN and establish a nomogram to predict synchronous liver metastasis in patients with GEP-NEN. Methods: A total of 10 973 pathologically confirmed patients with GEP-NEN from Jan. 2010 to Dec. 2017 were collected from SEER database and divided randomly into training set (n=7 511) and test set (n=3 462). Both groups were divided into liver metastasis group and non-liver metastasis group according to the occurrence of liver metastasis. Multifactorical logistic regression analysis was used to identify the risk factors of liver metastasis in patients with GEP-NEN. R software was used to establish and verify the nomogram of liver metastasis in GEP-NEN patients. Results: Liver metastasis was associated with gender, age, race, primary tumor site, degree of differentiation, tumor diameter, T3/4 stage, and lymph node metastasis in patients with GEP-NEN. The results of multivariate logistic regression analysis showed that primary tumor site (small intestine and pancreas), differentiation degree (poorly differentiated and undifferentiated), diameter of tumor ≥ 5 cm, T3/4 stage and lymph node metastasis were independent risk factors affecting liver metastasis in patients with GEP-NEN (P< 0.001). The concordance index of internal validation for nomogram was 0.838 (95% CI: 0.826-0.849), and the concordance index of external validation was 0.847 (95% CI: 0.829-0.864). Conclusions: GEP-NEN patients with primary tumor site in small intestine or pancreas, poor differentiation and undifferentiation, diameter of tumor ≥5 cm, T3/4 stage and lymph node metastasis are more likely to develop liver metastasis which suggested that such patients need to be alert for the occurrence of liver metastasis and need more aggressive treatment. The calibration curves fits are good for both the training and test sets, and can help clinicians to make individualized prediction for whether the GEP-NEN patient has synchronous liver metastasis at the initial diagnosis.

Objective To establish a HPLC method for the simultaneous determination of artemisinin,arteannuin B,chrysosplenetin and chrysosplenol-D in the water extract of Artemisia annua L.Methods The analysis was performed on Agilent ZORBAX SB-C18(250 mm×4.6 mm,5 μm)column with a mobile phase of acetonitrile(A)-water(B)and the flow rate of 0.8 mL·min-1 in a gradient elution manner.The column temperature was 30℃.The injection volume was 10 μL,and the detection wavelength was 210 nm.Results Artemisinin,arteannuin B,chrysosplenetin and chrysosplenol-D were correlated well linearly with peak area in their respective ranges 1.608 8-16.088 μg(r=0.999 9),0.014 1-0.141 4 μg(r=1),0.185 1-1.850 9 μg(r=0.999 9),0.144 1-1.441 4 μg(r=0.999 9),the average recovery rate(n=6)were 102.44%,97.82%,95.07%,95.55%,and the RSD values were 1.12%,1.44%,1.29%,1.53%.Conclusion This method is convenient and accurate.It has good stability and repeatability,and can be used to simultaneously determine the content of artemisinin,arteannuin B,chrysosplenetin and chrysosplenol-D in the water extract of Artemisia annua L.

Objective To analyze the 18 F?FDG uptake features and the correlation between 18 F?FDG uptake and the prognosis in patients with pathologic stageⅠlung adenocarcinoma. Methods One hundred and seventeen patients with stageⅠlung adenocarcinoma proved by surgery, who underwent a preoperative 18 F?FDG PET?CT, were studied retrospectively. The tumors′ SUVmax in different groups of clinicopathologic factors were compared. The correlations between the SUVmax and clinicopathologic factors were analyzed using Spearman rank correlation. The ROC was plotted to estimate the most discriminative cut?off point for SUVmax in predicting the recurrence or progression of tumor. The progression?free survival ( PFS) in different clinicopathologic groups were estimated using the Kaplan?Meier method and Log?rank test. Results The SUVmax of pathologic stageⅠlung adenocarcinomas were significantly different in different groups of gender,tumor size, density, tumor differentiation grade and T staging, respectively ( P<0.05 for all) . Patients with a larger tumor size, a higher proportion of solid component, poorer grade of tumor differentiation had a higher SUVmax. The T1b group had a higher SUVmax than T1a and T2a groups. The male group had a higher SUVmax than the female group. The SUVmax was positively correlated with the size of the adenocarcinomas ( P<0. 01 ) , and was negatively correlated with both the density and tumor differentiation grade (P<0.01). But there was no correlation between SUVmax and the T stage (P>0.05). The patients with an SUVmax of<3.0 had a much better PFS (75.1±3.0 month)than those with an SUVmax of ≥3.0 (52.7±5.9 month)(P<0.01). The tumor with a poorer differentiation grade was associated with reduced PFS (45.7±5.4 months) compared with those with well differentiated tumor (76.7±4.2 month)(P<0.05) . The PFS showed no statistically significant differences in different gender, age, smoking history, tumor size, density and T staging groups (P>0.05). Conclusions 18F?FDG uptake is correlated with the tumor size, density, and differentiation grade, and has a prognostic value for predicting the PFS in the patients with pathologic stageⅠ lung?adenocarcinoma. Patients with an SUVmax of <3.0 have a much better PFS than those with an SUVmax of ≥3.0.

Objective To explore the effect of FBXW7 on ferroptosis in head and neck squamous cell carcinoma.Methods Head and neck squamous cell lines HN4 and HN6 were cultured in vitro.FBXW7 and SOX2 overexpression plasmids were constructed,and the plasmids were stably transfected into cell lines.The overexpression transfection efficiency was verified at the transcription level and protein level by qRT-PCR and Western blot experiments,respectively.The lipid peroxidation levels of head and neck squamous cell carcinoma cells with overexpressing FBXW7 were verified by measuring malondialdehyde(MDA),glutathione(GSH),and reactive ox-ygen species(ROS)levels.After treating cells with ferroptosis inhibitor Fer-1,the changes in cell viability were further detected to ver-ify the effect of FBXW7 on ferroptosis.The effect of transfection of the overexpressed plasmid on cellular pathways was detected by Western blot.Results HN4 and HN6 cell lines showed increased levels of lipid peroxidation after overexpression of FBXW7,and the ferroptosis inhibitor Fer-1 was able to effectively reverse the ferroptosis induced by overexpression of FBXW7.Western blot assay results showed that overexpression of FBXW7 reduced the expression of c-Myc,SOX2 and SLC7A11.Conclusion FBXW7 regulates the ex-pression of SOX2-SLC7A11 by degrading c-Myc,thereby effectively regulating ferroptosis in HNSCC.