Objective To investigate the efficacy and side effects of new combination of high-dose methotrexate (MTX),cisplatin (DDP),pirarubicin (THP),and ifosfamide (IFO) in the treatment of extremity osteosarcoma patients.Methods A retrospective analysis was conducted for 125 osteosarcoma patients treated with the optimized neo-adjuvant chemotherapy combined with the four drugs mentioned above (MTX 200 mg/kg iv 6 h d1,CF 9 mg at one time,12 times; DDP 100 mg/m2,THP 30 mg iv,d8-10;IFO 3.0 g/m2 iv d16-18,mesna after IFO for 0,3,6,9 h).The efficacy and side effects of the therapeutic scheme were evaluated.Results The effective salvage rates of Ⅱ a and Ⅱb schemes were 36.4％ (8/22) and 79.6％ (82/103) with a statistical significance (P ＜ 0.05).The 2-year survival rate of schemes was 62.4％,and the survival time was(17.7 ± 8.3)months.The main side effects were myelo-suppression,nausea,and vomiting,etc.The incidence rate of myelo-suppression,nausea,and vomiting with grade Ⅲ-Ⅳ accounted for 71.2％,37.6％,and 13.6％,respectively.Conclusions The optimized neo-adjuvant therapy strategy based on high-dose MTX,DDP,THP,and IFO is effective in the treatment of osteosarcoma.

Objective To evaluate the sensitivity and specificity of Rome Ⅲ criteria in diagnosis of functional dyspepsia (FD) and assess its value in differentiate FD from other organic diseases in upper gastrointestinal tract. Methods Four thousand nine hundred and sixty-two patients, who underwent gastroscopy from July to August 2006 and March to April 2007, were consecutively enrolled and interviewed face to face with a standard questionnaire. The patients who were diagnosed as FD were according to Rome Ⅲ criteria, and those who were diagnosed as upper gastrointestinal diseases, such as chronic erosive gastritis (CEG), gastric ulcer (GU), duodenal ulcer (DU) and gastric carcinoma (GC), were done by gastroscopy and pathology. The differences of clinical characteristics among these diseases were analyzed. Results The FD patients accounted for 7.58% (376/4962) with female in predominant (P = 0.000). The patient with CEG, GU, DU or GC accounted for 29.99% (1488/4962), 1.89% (94/4962),4.25% (211/4962) or 4.57% (227/4962), respectively, all with male in predominant (P<0.05). Further analysis indicated that the age of onset between patients with FD and DU was no difference, but was younger than those with other three diseases (P<0.05). The incidence of early satiation and postprandial in FD patients were higher than those in other patients (P<0.05). The incidence of belching, nausea and vomiting showed no difference among these patients(P>0.05). According to Rome Ⅲ criteria, the symptoms of epigastric pain, early satiation, postprandial fullness and epigastric burning had higher sensitivity and specificity (except epigastric burning)in diagnosing FD (P<0.05), with highest Youden index in epigastric pain (0.42) and postprandial fullness (0.46). Conclusion Rome Ⅲ criteria has high specificity and sensitivity in diagnosing FD, and also has an important value in differentiate FD from other organic diseases.

MicroRNA (miRNA) is a family of endogenous single-stranded RNA about 22 nucleotides in length. Through targeting 3' UTR of message RNA (mRNA), they play important roles in post-transcriptional regulatory functions. For further research of miRNA function, the identification of more miRNA positive targets is needed urgently. Aiming at the high-dimensional small sample data sets in miRNA target prediction, an algorithm of eliminating redundant features is proposed based on v-SVM in this paper, and classification and features selection are also fused. The algorithm of eliminating redundant features optimizes the combination of features, and then constructs the best features combination which can represent miRNA and targets interaction model. The prior parameter v (0 < u < or = 1) controls the compression proportion of data set and selects more distinguishing support vectors. Finally, the classifier model of miRNA target prediction is built. The unbiased assessment of the classifier is achieved with a completely independent test dataset. Experiment results indicated that in both classification recognition and generalization performance of miRNA targets predicition, this model was superior to the present machine learning algorithms such as miTarget, NBmiRTar and TargetMiner, etc.
MicroRNAs ; Models, Theoretical ; Support Vector Machine

Objective To investigate the value of echocardiography for assessing the right ventricular function before and af ter treatment in the patients with pulmonary embolism.Methods Ninety-six patients with pulmonary embolism in our hospital from June 2014 to December 2015 were selected as the research subjects and divided into low-risk group,intermediate-risk group and high-risk group according to the disease severity.The echocardiographic examination was performed before and after treatment in all cases.Results The pulmonary artery systolic pressure after treatment in the low-risk group was lower than that before treatment (P＜0.05).The transverse diameter of right ventricle,transverse diameter of right ventricle and pulmonary artery systolic pressure after treatment in the intermediate-risk group and high-risk group were lower than those before treatment (P＜0.05).The Tei index after treatment in the low-risk group,intermediate-risk group and high-risk group was lower than that before treatment (P＜ 0.05).The right ventricle ejection fraction (RVEF),right ventricular end-systolic volume (RVESV) and right ventricular end-dias tolic volume (RVEDV) in the low-risk group had no statistically significant difference between before and after treatment.RVEF after treatment in the intermediate-risk group and high-risk group was higher than that before treatment(P＜0.05),while RVESV and RVEDV after treatment were lower than those before treatment (P＜0.05).Conclusion Echocardiography can objectively re flect the change situation of right heart function before and after treatment in the patients with pulmonary embolism,and can be used as an evaluation method for the effect of pulmonary embolism treatment.

There is a considerable increase in incidence of proximal humerus fractures.Locking plates are widely applied in the treatment of proximal humerus fractures due to their superior advantages.However,they may still lead to a high incidence of complications,especially in complex proximal humerus fractures.Reconstruction of medial support for a proximal humerus fracture can reduce complications effectively.At present,there is no consensus on the optimal method for medial support.The methods commonly used for medial support as an auxiliary fixation of proximal humerus fracture include screw support,bone transplantation,bone substitute and dual plates,all of which are discussed in this review.

Objective To compare the clinical characteristics and influence factors of hyperuricemia between genders,in order to provide references for better controlling and preventing the occurrence and development of hyperuricemiaprovide.Methods A total of 5 783 people who underwent physical examination in two Baoding Health Screening Centers from January 1st to June 1st,2016 were enrolled in this study,and all volunteers completed physical examination,laboratory examination and questionnaire survey.Patients with hyperuricemia were selected to analyse the clinical characteristics and influence factors.Results There were statistically significant differences in clinical characteristics,including obesity,blood pressure,blood glucose,blood lipids,liver function,renal function,anemia,blood rheology examination,thyroid ultrasound and lateral radiographs,between male and female patients with hyperuricemia (P＜0.05).The survey showed that there were statistically significant differences in age,education level,marital status,work status,sleeping status,smoking and drinking between male and female patients with hyperuricemia (P＜0.05).The red blood cells counts,marital status and education level were influence factors for female patients with hyperuricemia,while have little effect on male patients.The smoking,creatinine and diastolic blood pressure were influence factors for male patients with hyperuricemia,while have no effect on female patients.Conclusion The clinical characteristics and the influencing factors of male and female patients with hyperuricemia are different,so corresponding preventive and therapeutic measures should be taken for male and female patients.

Objective To evaluate the clinical outcomes of induced membrane technique in the treatment of traumatic segmental bone defects.Methods From May 2011 to January 2016,we treated 10 patients with traumatic segmental bone defect of the lower limb.They were 7 men and 3 women,with an average age of 41.6 years (from 18 to 61 years.The bone defects involved 8 tibias and 2 femurs;the mean length of the bone defects was 5.1 cm (from 2 to 15 cm).All the segmental bone defects were teated by induced membrane technique.At the first stage,the bone defects were filled with antibiotic-impregnated cement spacer after thorough debridement,the limb was fixated with external fixtor,and soft tissue repair was performed in 5 patients.On average all the patients received emergency treatment at the first stage 8.1 hours (from 4 to 13 hours) after trauma.At the second stage,after the cement was removed,the bone defects were filled with cancellous autografts.An allograft was used when the autograft was not adequate enough.The external fixtor was exchanged by internal fixation in one patient according to his soft tissue condition and will;the exteranl fixation was retained in the other 9 patients.Results The average follow-up was 2.8 years (from 1.0 to 5.5 years).Bone healing was achieved in 9 patients after an average of 7.1 months (from 5 to 9 months),and nonunion happened in one patient whose bone graft had been not sufficient enough.Stress fracture occurred in one patient 7 months after bone healing,but it responded to conservative management.One patient reported numbness on the anterolateral thigh of the donor site.Pin tract infection occurred in 3 patients.Follow-ups revealed no limb length discrepancy or deep infection.Conclusion Induced membrane technique is a simple and reliable technique for the treatment of traumatic segmental bone defects.

Objective To investigate the iodine intake level and the prevalence of thyroid nodules in Harbin City,and to study the correlation between the concentration of urinary iodine and the prevalence of thyroid nodules.Methods In Harbin,18 communities were randomly selected and specimens were collected from fasting morning urine from 2015 to 2017.The urine iodine concentration (UIC) was detected by arsenic cerium catalytic spectrophotometry,and the thyroid nodule was examined by B ultrasound.Results A total of 2 552 residents aged (45.79 ± 12.06) years old agreed to participate in the study,including 371 males and 2 181 females.The median UIC in all participants was 159.8 μg/L,there was a significant difference in urine iodine frequency distribution among age groups (x2 =40.097,P ＜ 0.01).Furthermore,the median UIC in male was 166.6 μg/L,and in female was 156.2 μg/L.There was a significant difference in UICs between male and female (U =2.122,P ＜ 0.05).The prevalence of total thyroid nodules in all participants was 48.75％ (1 244/2 552),and the standardized rate was 40.55％.Significant difference in the detection rate of thyroid nodules was observed among age groups (x2 =114.922,P ＜ 0.01),and there was a positive and significant correlation between the detection rate of thyroid nodules and increasing age (xtrand =111.746,P ＜ 0.01).Furthermore,in male,41.24％ (153/371) had thyroid nodules,with standardized prevalence rate of 41.13％,and in female,50.02％ (1 091/2 181) had thyroid nodules,with standardized prevalence rate of 49.20％.Likewise,there was a significant difference in the detection rate of thyroid nodules between male and female(x2 =9.790,P ＜ 0.01).The detection rate of thyroid nodules in the iodine deficient population (urinary iodine was 0-＜ 100 μg/L) was 55.58％ (244/439),and the incidence of thyroid nodules in the iodine adequate or optimal population (urinary iodine was 100-＜ 200 μg/L) was 46.68％ (591/1 266).Conclusions The total iodine level of the population in Harbin City of Heilongjiang Province is at adequate level.The detection rate of thyroid nodules is high and it is increased with age.The detection rate of thyroid nodules is higher in female than male.Regular detection of urine iodine and adjusting iodine nutrition will help prevent thyroid nodules.

Objective To analyze the factors that influence the articular function after open reduction and internal fixation for ankle fractures.Methods From July 2014 to January 2016,111 ankle fractures received surgery in our hospital.There were 54 males and 57 fenales,with a mean age of 43.5 years (frown 18 to 75 years).By the Broos & Bisschop classification,there were 43 unimalleolar,38 bimalleolar and 30 trimalleolar fractures.The postoperative articular function was evaluated according to the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scoring at the final follow-up.Comparisons were made between the patients with excellent functional scores and those with lower than excellent functional scores.The potential influencing factors were analyzed,including age,gender,body mass index,smoking history,primary hypertension history,diabetes history,injured side,fracture cause,Broos & Bisschop classification,combined presence of obvious inferior tibiofibular separation,combined presence of ankle dislocation,combined presence of other injury,time from injury to surgery,physical status classification by the American Society of Anesthesiologists system,operation time,early functional exercise,removal of internal fixation and postoperative complications.The influencing factors were identified using univariate analysis and logistic regression analysis.Results The average follow-up period was 15.5 months (from 8 to 25 months).The clinical union time of the fractures averaged 3.2 months (from 3 to 5 months).The ankle function at the final follow-up was excellent in 58 cases,good in 48,fair in 5 and poor in 0,with an excellent and good rate of 95.5％.Removal of internal fixation (P =0.001),early functional exercise (P =0.002),and postoperative complications (P =0.049) were identified as the independent risk factors influencing the articular function after surgery for ankle fractures.Conclusion For patients with ankle fracture,enhancing intraoperative procedures,reducing postoperative complications,encouraging the patients to do early functional exercise,and removing internal fixation after firacture union can effectively improve their ankle function.

Objective To investigate the clinical values of continuous hemoperfusion on the level of inter-leukin-18(IL-18)and prognosis in patients with acute paraquat poisoning(APP). Methods A total of 112 pa-tients with APP treated in our hospital from Jun 2013 to Jul 2017 were divided into two groups:control group(56 cases,routine drug and single hemoperfusion)and therapy group(56 cases,treated by continuous hemoperfusion based on control group).All APP patients were treated with continuous veno venous hemofiltration(CVVH)at 24 hours after treatment.Within admission 24 hours,3 days and 7 days after treatment,IL-18,lactic acid(Lac),ar-terial oxygen partial pressure(PaO2),alanine aminotransferase(ALT),creatinine(Cr)and creatine kinase(CK-MB)of patients were detected,28-day survival was recorded.Pearson correlation test was used to analyze the corre-lation between IL-18 in patients with APP and the survival rate. Results In admission,there were no differences in the levels of IL-18,Lac,PaO2,ALT,Cr and CK-MB between the two groups(P>0.05).At 3 days after treat-ment,the levels of IL-18,Lac,ALT,Cr and CK-MB were higher than those before treatment,and the therapy group was lower than the control group,while PaO2was lower than those before treatment,and the therapy group was higher than the control group(P<0.05);At 7 days after treatment,the two groups both had lower levels of IL-18,Lac,ALT,Cr and CK-MB than those after 3 days treatment,and the therapy group was lower than the con-trol group,while PaO2was lower than those after 3 days treatment,and the therapy group was higher than the con-trol group(P<0.05);There were 39 deaths in the therapy group and 49 deaths in the control group,the therapy group had a lower 28-day mortality rate than control group,the difference was statistically significant(69.64% vs 87.50%,χ2=5.303,P=0.021). The level of serum IL-18 in patients with APP was negatively correlated with the survival rate(r =-0.209,P = 0.027).Conclusions Therapeutic effect of continuous hemoperfusion in APP pa-tients is superior to single hemoperfusion. It could decrease the levels of IL-18,Lac,ALT,Cr and CK-MB,im-prove PaO2 and reduce the mortality rate of patients.The clinical curative effect is distinct.