Objective To investigate the etiology,characteristics of upper gastrointestinal bleeding (UGIB) in China,and to investigate the main causes of different population.Methods Literature on the causes of UGIB were retrieved and screened according to strict inclusion and exclusion standards.Results A total of 15733 UGIB patients were enrolled in the study.The most common causes of UGIB were duodenal ulcer (31.2％),gastric ulcer (15.2％),acute gastric mucosal lesions (AGML) (12.0％),cancer (11.7％),and esophageal varices (11.3％).The incidences of duodenal ulcer,gastric ulcer,AGML,esophageal varices,cancer were 32.3％,15.1％,12.1％,7.2％,and 12.5％ before 2006,and 29.7％,15.4％,11.1％,15.3％,and 10.9％ after 2006.The ratio of male to female was 3.25: 1.The most common causes of UGIB in older patients were gastric ulcer,cancer,AGML,duodenal ulcer,esophageal varices,while those in children were duodenal ulcer,gastric ulcer and AGML.Conclusion Peptic ulcers,AGML,cancer and esophageal varices were the most common causes of UGIB in China.The causes of UGIB have changed significantly in the past 5 years (P ＜0.01).

[ ABSTRACT] AIM:To evaluate the clinical application of single nucleotide polymorphism array ( SNP array) in prenatal diagnosis for screening the abnormality of women with Down’ s syndrome ( DS) .METHODS:The amniotic fluid samples ( n=312) collected by amniocentesis for the DS screening abnormality women were tested by karyotyping and SNP array analysis, respectively.The findings of karyotyping and SNP array analysis were compared.RESULTS:Two cases of trisomy 21 were identified by karyotyping and SNP array analysis, but SNP array analysis failed to identify 6 cases of chro-mosome balanced structural rearrangement.SNP detected 176 cases copy number variants ( CNVs) in 303 cases normal karyotype were detected by SNP, including 106 benign CNVs, 61 variants of unknown significance (VOUS), 9 de novo CNVs, and none of them was pathogenic.The distribution difference of CNVs in DS screening positive group and DS screening positive plus advanced maternal age group was not statistically significant ( P>0.05) .Furthermore, we reported 14 kinds of CNVs for the first time in population.CONCLUSION:SNP array can further assure chromosome microdupli-cation/microdeletion.In normal karyotype fetus of prenatal diagnosis, SNP can detect some clinical significant CNVs.

AIM: To study the effect of calcium sensing receptor (CaSR) on icariin (ICA) induced mouse embryonic stem cells ( mESCs) to differentiate into cardiomyocytes in vitro.METHODS:mESCs were cultured to embry-oid bodies ( EBs) by direct suspension method and the differentiation of EBs into cardiomyocytes was induced by ICA.The expression of cardiac specific proteinsα-actinin and cardiac troponin-I ( cTnI) was analyzed by Western blot and immuno-fluorescence.The differentiation rate was determined by flow cytometry.The ultrastructure of the derived cardiomyocytes was further characterized by transmission electron microscopy.The expression of cardiac-specific transcription factors Nkx2.5 and GATA-4,as well as CaSR was detected by Western blot.RESULTS: After induction with ICA, the positive characteristics of myocardial cells appeared in the EBs cultured for 2 d.The expression of cardiac-specific sarcomeric pro-tein actinin (α-actinin) and cTnI showed an overall upward trend by Western blot in different phases of ICA induced differ-entiation.The expression of CaSR, Nkx2.5 and GATA-4 was the highest at an early stage of ICA-induced differentiation. Neomycin (an activator of CaSR) up-regulated CaSR, NKx2.5 and GATA-4 expression in the EBs at early stage of ICA-in-duced differentiation, all of which were reversed by NPS2390 ( an inhibitor of CaSR) .CONCLUSION:CaSR is function-ally expressed in mESC-derived cardiomyocytes, and activation of CaSR is involved in the differentiation of mESCs into car-diomyocytes by facilitating the expression of NKx2.5 and GATA-4.

Purpose To compare the relationship between the maximum standardized uptake value (SUVmax) of PET/CT imaging and tumor markers in lung cancer, and to provide evidence for the comprehensive assessment of non small cell lung cancer. Materials and Methods The results of PET/CT imaging, serum carcinoembryonic antigen (CEA), cytokeratin-19 fragment antigen 21-1 (CYFRA21-1) and neuronspecific enolase (NSE) of 179 patients with non small cell lung cancer were analyzed, subjects were then divided into different groups according to their clinical features and pathological types, the differences of SUVmax and tumor markers'' level were compared between different groups, and their correlations with tumor histological type, differentiation and the clinical stages were also analyzed.Results SUVmax of the tumor was related with lesion size,≥3 cm tumors'' SUVmax were significantly higher than that of <3 cm tumors (P<0.01), SUVmax and serum NSE level were related with tumor differentiation, and these in low differentiation group were higher than those in high and medium differentiation group (P<0.05,P<0.01). In addition, SUVmax, CEA, CYFRA21-1 and NSE had no correlation with gender, age, pathological type and clinical stage (P>0.05).Conclusion SUVmax and NSE have a certain relationship with tumor differentiation in non small cell lung cancer patients, thus can be used as a reference index for prognosis of indirect prediction of lung cancer.

Objective To assess the diagnostic value of mediastinal lymph node in non-small cell lung cancer using PET-CT by Meta-analysis. Methods Publications on mediastinal lymph node staging of non-small cell lung cancer by PET-CT published from January 2002 to January 2016 were filtered and assessed according to criteria from the PubMed, EMBASE, Cochrane library database. The number of true positive, false positive, false negative and true negative were extracted, meta-analysis was performed using STATA software, and receiver operating characteristic curve was applied, then area under the curve(AUC) was calculated. At last, heterogeneous sources were discussed and subgroup analyses were performed. Results Twenty-three relevant literatures(2 959 patients) were enrolled, the diagnostic sensitivity and specificity based on the patients were 0.66(0.55—0.75) and 0.84(0.79—0.89), AUC was 0.84 (0.80—0.87). The results of subgroup analysis suggested that pulmonary tuberculosis was one important factor that influenced the PET-CT diagnosis of mediastinal lymph node metastasis in NSCLC patients(P=0.01). Conclusions PET-CT has a high accuracy for the mediastinal lymph node staging in non-small cell lung cancer, and it is the recommendedexamination method in these patients. Patients who had suffered from pulmonary tuberculosis should be treated with caution.

Objective To explore the characteristics and significance signification of changes of cerebral glucose metabolism in patients with Alzheimer's disease (AD).Methods Seventeen patients diagnosed with AD based on standard clinical diagnostic criteria (AD group),and 15 healthy volunteers as normal control group (HC group)were enrolled in this study.Positron emission tomography (PET)were performed in both groups and three-dimensional reconstruction images were obtained.The visual evaluation,regions of interesting (ROI)technology and brain function analysis software were used to analyze PET results data in of each group.Results ①In AD group,glucose metabolisam was decreased and mainly distributed in the parietal lobe,temporal lobe,frontal cortex,posterior cingultate and hippocampus,but not in occipital lobe,basal ganglia,thalamus and cerebellum nuclei basales,thalamus and opisthencephalon.Ssomatic sensation and motor functionand were not affected.②Compared with mild AD patients,glucose metabolism inof moderate and severe AD patients was decreased more significantly in parietal lobe,temporal lobe,frontal cortex,posterior cingultate and hippocampus,with a wider range of lesionsthe range also expanded,and visual area and speech centerpartly followed by the disorder of visual center and speech center may bewere involved in some patients.③The built-in brain function analysis software of PET system software carried by PET system was more objectiveprecise and accurate than visual evaluation or and ROI technology,can accurately reflected the changes in brain glucose metabolism which and iwas suitable for popularization and application.Conclusion Because the distribution of impaired glucose metabolism in cerebral cortex hads certain characteristics and regularity laws in AD patients.18 F-FDG PET imaging can maybe meaningful valuable in diagnosis,differential diagnosis and therapeutic evaluation in AD.

Objective:To explore the effects of micro-class combined with closed-loop modularized teaching in practical course of emergency nursing.Methods:From March to July 2018, this study selected nursing students of four classes in Grade 2016 of Xianyang Vocational Technical College as subjects by convenience sampling. All of nursing students were randomly divided into observation group ( n=160) and control group ( n=162) with the method of tossing a coin by classes. Control group carried out the routine teaching, while observation group applied the micro-class combined with closed-loop modularized teaching in practical course of emergency nursing. This study compared the nursing students' examination scores and recognition on teaching model between two groups. Results:At the end of practical course of emergency nursing, the theoretical and operation achievements of observation group were (85.59±7.24) and (88.34±5.62) respectively higher than those of control group with statistical differences ( t=-6.308, -7.008; P<0.05) . Recognition of observation group on teaching model was higher than that of control group also with a statistical difference ( P<0.05) . Conclusions:Micro-class combined with closed-loop modularized teaching can improve the learning effects of nursing students in practical course of emergency nursing and is recognized highly by nursing students which is worthy of generalization and application.

PURPOSE: Fanconi anemia complementation group F (FANCF) is a key factor to maintaining the function of Fanconi anaemia/BRCA (FA/BRCA) pathway, a DNA-damage response pathway. However, the functional role of FANCF in breast cancer has not been elucidated. In the present study, we evaluated the chemosensitization effect of FANCF in breast cancer cells. METHODS: We performed specific knockdown of the endogenous FANCF in breast cancer cells by transfecting the cells with an FANCF short hairpin RNA (shRNA) vector. Cell viability was measured with a Cell Counting Kit-8, and DNA damage was assessed with the alkaline comet assay. The apoptosis, cell cycle, and drug accumulation were measured by flow cytometric analysis. Protein expression levels were determined by Western blot analysis, using specific antibodies. RESULTS: The analyses of two breast cancer cell lines (MCF-7 and MDA-MB-435S) demonstrated that the FANCF shRNA could effectively block the FA/BRCA pathway through the inhibition of Fanconi anemia complementation group D2 ubiquitination. Moreover, FANCF silencing potentiated the sensitivity of cells to mitomycin C (MMC), where combined FANCF shRNA/MMC treatment inhibited cell proliferation, induced S-phase arrest, apoptosis, and DNA fragmentation, and reduced the mitochondrial membrane potential, compared with MMC treatment alone. CONCLUSION: Taken together, this study demonstrates that the inhibition of FANCF by its shRNA leads to a synergistic enhancement of MMC cytotoxicity in breast cancer cells. These results suggest that the inhibition of the FA/BRCA pathway is a useful adjunct to cytotoxic chemotherapy for the treatment of breast cancer.
Apoptosis ; Blotting, Western ; Breast ; Breast Neoplasms ; Cell Count ; Cell Cycle ; Cell Line ; Cell Line, Tumor ; Cell Proliferation ; Cell Survival ; Comet Assay ; Complement System Proteins ; DNA Damage ; DNA Fragmentation ; Fanconi Anemia ; Fanconi Anemia Complementation Group F Protein ; Membrane Potential, Mitochondrial ; Mitomycin ; RNA, Small Interfering ; Ubiquitin ; Ubiquitination

Objective To investigate the safety and efficiency of laparoscopic gallbladder - preserving chole-lithotomy in the treatment of cholecystolithiasis in children. Methods The clinical data obtained from 18 children with gallstones undergoing laparoscopic gallbladder - preserving cholelithotomy at Dalian Children′s Hospital of Dalian Medi-cal University during July 2010 and December 2016 were retrospectively analyzed. Eight boys and 10 girls of 5 - 14 years old [mean (9. 2 ± 3. 1)years old]were included in the study,of whom 11 cases had a single stone,7 cases with multiple stones. All patients were followed up for 3 - 72 months. Results All of 18 patients without pancreaticobiliary maljunction were diagnosed by Color Doppler ultrasound and magnetic resonance cholangiopancreatography(MRCP). Gallbladder functions were assessed preoperatively and they were all in good condition. Laparoscopic gallbladder - pre-serving cholelithotomy was successfully performed in all patients without conversion to cholecystectomy. Operation time was 28 - 66 min,with mean value of (40. 2 ± 14. 3)min;intraoperative blood loss was 4 - 12 mL,with mean value of (8. 3 ± 2. 8)mL;postoperative hospital stay lasted 3 - 5 d,with mean value of (3. 8 ± 1. 2)d. There were no complica-tions such as bile leakage,postoperative bleeding,biliary duct damage,biliary pancreatitis during therapy. The patients were followed up for 3 - 72 months,and the Color Doppler ultrasound showed no gallstone recurrence after surgery. Conclusions For children with good gallbladder function,laparoscopic gallbladder - preserving cholelithotomy can preserve gallbladder function and the integrity of biliary tract. The operation is easy and reliable,with minimal invasion, quick recovery,and low recurrence rate. It is a feasible method for the treatment of gallstones in children.

Objective:To evaluate the effect of novel erythrocyte preservation solution on the quality of erythrocytes in stored blood of type 2 diabetes mellitus (T2DM) rats.Methods:Forty SPF male Sprague-Dawley rats, aged 8 weeks, weighing 180-220 g, were used in this study. Ten rats randomly selected served as conventional erythrocyte preservation solution group (group A). T2DM model was prepared in the remaining 30 rats. Twenty T2DM rats were divided into 2 groups ( n=10 each) using a random number table method: T2DM conventional erythrocyte preservation solution control group (group C) and T2DM novel erythrocyte preservation solution observation group (group Y). Erythrocyte preservation solution was prepared to simulate the preoperative autologous blood donation process, and blood was collected from the tail vein to isolate the red blood cells, and then the corresponding preservation solution was added. Immediately after blood collection (T 0) and at 7, 14 and 21 days of preservation (T 1-3), the morphological structure of erythrocytes was observed with a light microscope, and the concentrations of 2, 3-diphosphoglycerate (2, 3-DPG) and reactive oxygen species (ROS) were also determined by enzyme-linked immunosorbent assay at T 0-T 3 and 28 days of preservation (T 4). PKH26 was used to label the erythrocytes stored in vitro for 28 days, and then the erythrocytes were transfused back into rats. The survival rate of erythrocytes was detected by flow cytometry at 1, 7, 13 and 18 h after retransfusion. Results:The erythrocyte damage was aggravated at different time points of preservation in group C when compared with group A. Compared with group C, the damage to erythrocytes was significantly alleviated at different time points of preservation in group Y. Compared with group A, the concentration of 2, 3-DPG in erythrocytes was significantly decreased at T 0 and T 2-T 4, the concentration of ROS was increased at T 0-T 4, and the survival rate of erythrocytes was decreased at 1, 7 and 18 h after retransfusion in group C ( P<0.05). Compared with group C, the concentration of 2, 3-DPG in erythrocytes was significantly increased at T 0-T 4, the content of ROS was decreased at T 1, T 3 and T 4, and the survival rate of erythrocytes was increased at 1, 7 and 18 h after retransfusion in group Y ( P<0.05). Conclusions:The novel erythrocyte preservation solution can improve the quality of stored erythrocytes and increase the survival rate of erythrocytes in vivo after retransfusion in T2DM rats.