Objective To investigate the significance of miR-193b to biological behaviors of hepatocellular carcinoma (HCC). Methods 48 cases of HCC specimens and corresponding adjacent tissues were collected, and the miR-193b expression levels in these specimens were measured by real-time quantitative PCR. The miR-193b expression was measured by the same way in HepG2 and SMMC-7721 cells. The HepG2 and SMMC-7721 were transfected with miR-193b mimics or negative control miRNA mimic with Lipofectamine 2000, and the non-transfected cells were taken as blank control. The proliferation ability of the HCC cells were detected by MTT method, and the apoptosis rate was tested by flow cytometry. Results The expression level of miR-193b in HCC tissues (2.441 ±0.569) was significantly lower than that in the corresponding adjacent tissues (15.488±4.326) (P < 0.05). Compared with normal liver cell line L-O2, the expression levels of miR-193b were significantly lower in HepG2 and SMMC-7721 cells. Transfected with miR-193b mimic, the proliferation ability of HepG2 and SMMC-7721 cells were reduced, while their apoptosis were increased. Conclusion miR-193b may be negative to regulate the proliferation of HCC and increase its apoptosis.

Objective To summarize our experience in endovascular repair of 83 cases with type B aortic dissection.Methods A retrospective analysis was performed in 83 cases of type B aortic dissections who were treated in our hospital.Results The surgical procedure was successful for all the patients.Two patients died peri-operatively.One case encountered a coma,but no post-operative paraplegia occurred.Conclusion Endovascular repair for type B aortic dissection is a micro-invasive,safe and effective technique.Long-term follow-up is required to give a comprehensive evaluation.

Objective To study the features of eye wounds in subtropical mountain and bush zone so as to improve success rate of medical therapy and decrease disability rate for eye wounds. Methods The clinical data of eye wounds caused by Selfdefense War against Vietnam from No. 59 Hos-pital of PLA were analyzed. Results Monocular injuries accounted for 81.7% of eye wounds, with no statistical difference in the injuries between left eye and right eye. Eye wounds caused by shrapnel ac-counted for 82.2%, and it was the main injury factor. The rate of eye injuries complicated with other in-juries of the body was up to 75.6%. Globe wounds were the most commonly seen, with open globe wound accounting for 45.1%. Conclusion Timely and correct ophthalmological treatment can effectively re-duce the blinding rate.

Objective To summarize the experience in the diagnosis and management of insulinoma. Methods From January 1966 to December 2007, the clinical data of 131 patients with insulinoma were retrospectively analyzed. Results All the 131 cases had Whipple triad syndrome and 64 eases suffered from psychoneurosis symptoms. The fasting blood glucose or insultus blood glucose concentration of all the cases was lower than 2.8 mmol/L. The ratios of serum insulin to glucose were all higher than 0.3. Before operation, tumor was detected in 8 of 75 patients by B-us scan, and in 17 of 68 by CT, and in 5 of 10 by MRI. The intraoperative ultrasonography(IOUS) was applied in 44 eases, and tumor was found in 43 cases. Surgery included enucleation of insulinoma (88 cases), resection of the corpus and eauda of the pancreas (40 cases), duodenopancreatectomy (2 cases), and biopsy (1 case). The low blood glucose symptoms disappeared postoperatively in 130 cases. Pancreatic fistulae occurred in 20 cases, acute pancreatitis occurred in 32 cases. Conclusions Insulinoma can be diagnosed based on symptoms of Whipple triad and the ratio of serum insulin to glucose. Exploration and IOUS are the simple and effective methods to localize insulinoma.

OBJECTIVETo study operative effects for the treatment of multiple ligament injuries of knee joints.

METHODSFrom 2008 to 2013, 26 patients (17 males and 9 females) with multiple ligament injuries of knee joints were treated surgically. The average age was 40.7 years old, ranging from 29 to 55 years old. All the patients were treated with arthroscopic reconstruction of cruiate ligament with autogenous or allogeneic hamstrings and tendon, and at the same time received repair of medial collateral ligament and lateral collateral ligament, as well as the treatment of exterior and interior complex injuries. Nine patients received second stage operation after the initial operation for mistake or missed diagnosis, and other patients were treated at the first stage. The Lysholm scoring system was used to evaluate function and stability of knee joints before and after operation.

RESULTSAll the patients were followed up for an average duration of 1.6 years (ranged, 0.8 to 3.2 years). The mean awaiting time for operation was 1.2 months. The Lysholm score was improved from preoperative 42.5 +/- 4.5 (ranged, 33 to 48) to the latest follow-up 78.1 +/- 3.9 (ranged, 57 to 95). The function of knee joint was improved obviously in the arthroscopic reconstruction patients, with joint range of motion exceeding 900 and with Varus & Valgus tests near to normal. All the patients had negative findings in the Lachman test at 70 degrees of flexion.

CONCLUSIONArthroscopic reconstruction should be the first choice in treating multiple ligament injuries of knee joints. If the anterior and posterior cruciate ligament injuries can't be treated simultaneously, the posterior cruciate ligament injuries should be treated preferentially at the first stage and the anterior cruciate ligament injuries should be treated at the second stage. The diagnosis of posterior cruciate ligament is easy to be missed.

Adult ; Arthroscopy ; Female ; Humans ; Knee Joint ; physiopathology ; surgery ; Ligaments ; physiopathology ; surgery ; Male ; Middle Aged ; Multiple Trauma ; physiopathology ; surgery ; Range of Motion, Articular ; Treatment Outcome

OBJECTIVETo explore surgical therapeutic strategies and clinical effects for floating shoulder injury.

METHODSFrom March 2010 to December 2013, 12 patients with floating shoulder injury were treated by open reduction and plate screw fixation,including 10 males and 2 females aged from 22 to 45 years old with an average of 31.7 years old. Preoperative X-ray and CT showed 11 cases were ipsilateral clavicle fracture with scapular neck fractures, 1 case was scapular neck fracture with ipsilateral acromioclavicular dislocation. Postoperative complications were observed and Herscvici functional scoring were used to evaluate clinical effects.

RESULTSTwelve patients were followed up from 8 to 26 months (averaged 15 months). All patients obtained bone union, and no inflammation, loosening and breakage of plate and screw were found. According to Herscvici scoring, 9 cases got excellent results, 2 good and 1 moderate.

CONCLUSIONReconstruction of anatomical structure and stability of floating shoulder joint injury could shorten time of shoulder joint brake and fixation, then got excellent clinical outcomes.

Adult ; Clavicle ; injuries ; Female ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Scapula ; injuries

Objective To investigate the correlation between serum alkaline phosphatase (ALP) level and early functional outcomes in young patients with acute ischemic stroke. Methods From January 2017 to December 2018, consecutive young patients (18-45 years old) with acute ischemic stroke admitted to the Department of Neurology, Fuyang People's Hospital were enrolled. According to the modified Rankin Scale score at discharge or on the 14th day of hospitalization (whichever occurs first), the patients were divided into poor outcome group ( > 2) and good outcome group (0-2). Multivariate logistic regression analysis was used to determine the independent correlation between the serum ALP level and outcomes. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of baseline serum ALP level for poor outcomes. Results A total of 200 young patients with acute ischemic stroke were enrolled, and 138 (69. 0％) in the good outcome group and 62 (31. 0％) in the poor outcome group. Univariate analysis showed that the serum ALP level (87. 72 ±25. 60 U/L vs. 81. 70 ±22. 95 U/L; t = -4. 464, P < 0. 001) and baseline National Institutes of Health Stroke Scale (NIHSS) score (median and interquartile range: 9 [8- 12] vs. 2 [1-4]; Z = -10. 540, P < 0. 001) in the poor outcome group were significantly higher than those in the good outcome group. Multivariate logistic regression analysis showed that high serum ALP levels (odds ratio 1. 030, 95％ confidence interval 1. 001-1. 060; P = 0. 040) and high baseline NIHSS score (odds ratio 2. 387, 95％ confidence interval 1. 799-3. 142; P < 0. 001) were the independent risk factors for early poor outcomes. ROC curve analysis showed that the optimal cut-off value of the baseline serum ALP level predicting poor outcome was 86. 25 U/L, and its sensitivity and specificity were 53. 2％ and 79. 7％, respectively. Conclusions High serum ALP level is independently associated with poor early outcomes in young patients with acute ischemic stroke. Baseline serum ALP level has certain predictive value for poor outcomes.

Objective: To analyze the efficacy and safety of cytoreduction surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) for pseudomyxoma peritonei (PMP) in the early stage. Methods: The clinical data, including pathological features, recurrence and survival of 65 PMP patients in the early stage underwent CRS combined with HIPEC in Aerospace Center Hospital from January, 2011 to December, 2018 were retrospectively analyzed. Results: 65 patients with early stage PMP underwent CRS+ HIPEC. Among these patients, 25 were males and 40 were females, and the mean age was 52.5 years. The median peritoneal cancer index was 3 (0-16). The score of completeness of cytoreduction (CC) of 63 patients (96.9%) was 0, and 2 patients (3.1%) was 1. No perioperative death occurred, the incidence of surgical complications above grade 3 was 3.1%. Three patients relapsed during the follow-up period, including 1 patient with low-grade PMP, 1 patient with high-grade PMP, and 1 patient with high-grade PMP accompanied by signet ring cell. The 5-year disease-free survival rate of the whole group was 92.4%. Conclusions PMP patients in the early stage treated by CRS combined with HIPEC can achieve benefit and safety. A close long-term follow-up is necessary.

Objective:To explore the risk factors of intensive care unit-acquired weakness (ICU-AW) and the characteristics of Medical Research Council (MRC) score and electromyogram.Methods:A case control study was conducted. Patients with mechanical ventilation ≥ 7 days and MRC score admitted to department of respiratory and critical care medicine of China-Japan Friendship Hospital from September 2018 to January 2020 were enrolled, and they were divided into ICU-AW group (MRC score < 48) and non-ICU-AW group (MRC score ≥ 48) according to MRC score. The general situation, past medical history, related risk factors, MRC score, respiratory support mode, laboratory examination results, electromyogram examination results, ICU-AW related treatment, outcome and length of ICU stay were collected, and the differences between the two groups were compared. The risk factors of ICU-AW were analyzed by binary multivariate Logistic regression, and the characteristics of MRC score and electromyogram were analyzed.Results:A total of 60 patients were enrolled in the analysis, including 17 patients in ICU-AW group and 43 patients in non-ICU-AW group. Univariate analysis showed that there were significant differences in acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, sequential organ failure assessment (SOFA) score, brain natriuretic peptide (BNP), blood urea nitrogen (BUN) on the first day of ICU admission and the ratio of invasive mechanical ventilation between ICU-AW group and non-ICU-AW group [APACHEⅡ score: 21 (18, 25) vs. 18 (15, 22), SOFA score: 7 (5, 12) vs. 5 (3, 8), BNP (ng/L): 364.3 (210.1, 551.2) vs. 160.1 (66.8, 357.8), BUN (mmol/L): 9.9 (6.2, 17.0) vs. 6.0 (4.8, 9.8), invasive mechanical ventilation ratio: 88.2% vs. 46.5%, all P < 0.05]. Binary multivariate Logistic regression analysis showed no independent risk factor for ICU-AW. The average MRC score of 17 ICU-AW patients was 33±11. The limb weakness was symmetrical, and the proximal limb weakness was the main manifestation. Electromyography examination showed that the results of nerve conduction examination in ICU-AW patients mainly revealed that the amplitude of compound muscle action potential (CMAP) and sensory nerve action potentials (SNAP) were decreased, and the conduction velocity was slowed down; needle electromyography showed increased area of motor unit potential (MUP), prolonged time limit and a large number of spontaneous potentials. Prognosis evaluation showed that compared with non-ICU-AW group, patients in ICU-AW group underwent more tracheotomy (70.6% vs. 11.6%), longer length of ICU stay (days: 57±52 vs. 16±8), and more rehabilitation treatment (58.8% vs. 14.0%), and the differences were statistically significant (all P < 0.01). Conclusions:The occurrence of ICU-AW may be related to high APACHEⅡ score and SOFA score, high levels of BNP and BUN on the first day of ICU admission and the proportion of invasive mechanical ventilation, but the above factors are not independent risk factors for ICU-AW. The MRC score of ICU-AW patients was characterized by symmetrical limb weakness, mainly proximal limb weakness; in electromyography examination, the nerve conduction examination results mainly showed that CMAP and SNAP amplitude were decreased, and conduction velocity was slowed down; needle electromyography examination showed increased MUP area, prolonged duration and a large number of spontaneous potentials.

Objective:To observe the effect of ankle stretching on ankle biomechanics, balance, walking ability and ability in the activities of daily living among stroke survivors.Methods:Eighteen hemiplegic stroke survivors were randomly divided into an experimental group ( n=9) and a control group ( n=9). In addition to routine medication and rehabilitation training, the experimental group received 20 minutes of ankle joint stretching daily while the control group underwent an additional twenty minutes of routine rehabilitation training. Before and after the treatment, both groups′ ankle joint stiffness (K), muscle strength, active range of motion (AROM) and passive range of motion (PROM) were evaluated. They were also assessed using the modified Ashworth scale (MAS), the Fugl-Meyer lower extremity assessment (FMA-LE), the Berg balance scale (BBS), the 6-minute walking test (6MWT) and the modified Barthel Index (MBI). Results:After two weeks of treatment significant improvement was observed in the AROM and muscle strength of both groups in dorsiflexion and plantarflexion. The average BBS and FMA-LE scores of both groups had also improved significantly. Significant improvement in the average PROM of plantarflexion and the K of dorsiflexion, as well as in average MBI score was observed only in the treatment group. After two weeks the treatment group′s average muscle strength in plantarflexion and dorsiflexion was significantly better than the control group′s.Conclusions:Stretching can reduce ankle stiffness, improve the range of motion, muscle strength, and ability of in the activities of daily living after a stroke.