Objective To investigate the identification role of plasma high sensitive Creactive protein (hs-CRP) and lipoprotein (a) (Lp [a]) levels in the diagnosis of patients with acute ischemic stroke according to the TOAST classification. Methods The levels of plasma hsCRP and Lp (a) in 82 acute stroke patients ( ＜24 hours) and 60 healthy controls were detected using immune scatter turbidimetry and immune transmission turbidity, and try to make use of Holter, ultrasonography, magnetic resonance imaging, magnetic resonance angiography/CT angiography/dagital subtraction angiography and other tests. Finally, they were classified according to the diagnostic criteria of the TOAST classification of ischemic stroke. Results There were significant differences in plasma hs-CRP and Lp (a) levels between all the subtypes of the acute ischemic sroke group and the control group (all P ＜0. 001). The the level of plasma hsCRP in patients with cardioembolism (CE) was highest. Hs-CRP could be used as a biological marker of CE subtype (odds ratio[OR] = 1. 84,95% confidence interval [CI] 1. 18-2. 85, P ＜ 0. 05). When its concentration was ＞ 3. 48 mg/L, the sensitivity and specificity of predicting CE were 89% and 83% respectively. The plasma level of the AT patients was highest, it could be used as a biological marker of AT subtype (OR = 1. 02, 95% CI 1. 01-1. 03, P＜0. 05); when its concentration was ＞ 183. 5 mg/L, the sensitivity and specificity of predicting AT were 87% and 85% respectively. Conclusions The plasma hs-CRP and Lp (a) levels of patients with acute ischemic stroke may provide some help for timely and accurate etiological typing.

Blood Coagulation Factors ; antagonists & inhibitors ; Hemophilia A ; blood ; Humans

Blood Platelets ; Hematologic Diseases ; therapy ; Humans ; Platelet Aggregation Inhibitors ; therapeutic use

and drug development; therefore, it has received wide attention in the field of life sciences.

Objective To discuss the effect of targeted information support on the sense of uncertainty and anxiety among patients treated with percutaneous coronary intervention and its instructive significance to nursing work.Methods We randomized 118 patients treated with percutaneous coronary intervention whose sense of uncertainty and anxiety were relative intensive into the test group and the control group with 59 cases in each group.We gave routine health instructions to the control group while targeted information support besides routine health instructions to the test group.We investigated the patients in two groups by Chinese version of uncertainty scale and State Anxiety Inventory at 4 time points,that is ,the first day in hospital,night before the operation,24 hours after the operation and 1 day before leaving hospital.Results The anxiety level and sense of uncertainty about illness decreased at the night before operation,24 hours after operation and 1 day after operation compared with the control group.The sense of uncertainty and anxiety level has statistical difference between whatever two adjacent time points except for anxiety level between the time points between the first day in hospital and before operation.Drop of sense of uncertainty at 24 hours after operation was significantly different between the two groups(P<0.01).Conclusion Supplying targeted information support could decrease the sense of uncertainty and anxiety among patients treated with percutaneous coronary intervention.

A summary and analysis of acupuncture, electro-acupuncture, moxibustion, injection of acupoint, and research progress from ancient and modern related literatures on the treatment of hyper-lipemia by acupuncturingFenglong acupointwas made. It was cognized and affirmed thatFenglong acupoint has the unique superiority of definite curative effect and little poisonous side effect in treating hyperlipemia.

Based on both domestic and abroad research results concerning the local therapeutic efficacy, influence factors, survival time and prognosis of radiofrequency ablation (RFA) in treating recurrent hepatocellular carcinoma (HCC), this paper aims to make a review of medical literatures about RFA treatment of recurrent HCC that were published in Chinese and in English during the period from 2005 to 2014, and to analyze the related factors that may influence the local therapeutic efficacy and survival rate. The results indicate that the recurrent tumor size, tumor number, recurrence interval, serum alpha fetoprotein (AFP) level, serum prothrombin, etc. are important factors that will affect the therapeutic efficacy of recurrent HCC. At the same time, the results point out that the study of imaging predictors can help suggest the different recurrent types, which is very useful in making individualized follow-up strategy and in monitoring tumor recurrence. Local treatment, with RFA being the main method, together with comprehensive therapies, including other new technologies and new drugs, will improve the current clinical situation in treating recurrent HCC.

Heme oxygenase-1(HO-1)is a type of stress related gene,which harbors the ability of anti-inflammatory,anti-apoptosis,anti-oxidation and drug resistance.In physiological status,the expression of HO-1 gene in human normal tissues is extremely low.When subjected to a constant stimulation of alcohol,spicy and hot,over expression of HO-1 gene in the related tissues is often observed.In tumor tissues,the abnormal expres-sion of HO-1 is closely related to their biological behaviors.In recent years,there is a trend to believe that the gene polymorphism and its metabolic products( bilirubin,Fe2+,CO) involve in the decomposition of heme partici-pate in the activation of many signaling pathways,and affect the initiation and development of tumor diseases.In addition,the expression level of HO-1 gene is up-regulated in many tumor diseases,which can not only affect the growth and proliferation of tumor cells by regulation of the oxidative stress levels of tumor microenvironments, but also induce the tumor cells to produce drug resistance.Therefore,the abnormal expression of HO-1 may be involved in the initiation and development processes of tumors.

OBJECTIVE:To observe the efficacy and safety of oxaliplatin combined with thymosin in the treatment of lung can-cer with malignant pleural effusion. METHODS:120 lung cancer patients with malignant pleural effusion were randomly divided in-to control group(60 cases)and observation group(60 cases). All patients received chest microtubules drainage,then thoracic cavi-ty drug infusion after clean effusion drainage verified by B ultrasound,10 mg Loratadine tablet was orally given before going to bed 1 d before drug infusion,for 1 week;25 mg Promethazine hydrochloride injection was intramuscularly injected 30 min before drug infusion for allergy prevention,20 mg metoclopramide for gastrointestinal reaction prevention,10 mg dexamethasone and 10 ml 2% lidocaine,adding into 10 ml 0.9%Sodium chloride solution,injected to thoracic cavity by drainage tube to prevent and re-lief chest pain,fever,and other pleural reaction symptoms. Based on it,control group was injected 100 mg/m2 Oxaliplatin for injec-tion to thoracic cavity by drainage tube. Observation group was additionally given 300 mg Thymosin injection,to thoracic cavity by drainage tube. Pleural effusion was drained after 2 d. Once every week in 2 groups,4-week was regarded as 1 coure,and it lasted 2 courses. Clinical efficacy,clinical benefit rate,and serum T lymphocyte subsets(CD3+,CD4+,CD8+),inflammatory cytokines lev-els [interleukin(IL)-6,tumor necrosis factor(TNF)-α)] before and after treatment in 2 groups were observed,survival status and the incidence of toxicity reactions were followed-up. RESULTS:The objective response rate,disease control rate,clinical benefit rate,survival rate in observation group were significantly higher than control group,the incidence of toxicity reactions was signifi-cantly lower than control group,the differences were statistically significant(P<0.05). After treatment,CD3+,CD4+,CD8+ levels in observation group were significantly lower than before,and observation group was lower than control group,the differences were statistically significant(P<0.05),there were no significant differences in CD3+,CD4+,CD8+ levels before and after treatment in 2 groups(P>0.05). CONCLUSIONS:Oxaliplatin combined with thymosin can improve efficacy in the treatment of lung cancer with malignant pleural effusion,prolong survival period,improve survival quality and reduce the incidence of toxicity reactions.

Objective To investigate the safety and clinical effect of Ⅰ-stage resection of colon cancer and synchronous liver metastasis after conversion therapy.Methods The retrospective descriptive study was adopted.The clinical data of 1 patient with sigmoid cancer with synchronous multiple liver metastases who was admitted to the Zhongshan Hospital of Fudan University in April 2013 were collected.The patient was diagnosed as sigmoid cancer with multiple lymph nodes surrounding colon and 5 metastatic lesions found in liver by preoperative imaging examination,and the maximum diameters of 2 metastatic lesions were 4.5 cm and 3.6 cm.The pathological results of colonoscopy indicated adenocarcinoma.After discussion of the multidisciplinary team,liver metastatic lesions were significantly reduced through mFOLFOX6 chemotherapy combined with bevacizumab treatment,and then patient underwent Ⅰ-stage resection of colon cancer with synchronous liver metastasis by the surgical procedures of partial hepatectomy + 3D laparoscopy-assisted radical resection of sigmoid cancer.The patient received convention treatment of antibiotic,nutrition support therapy and mFOLFOX6 adjuvant chemotherapy.The changes of lesions in liver and tumor markers were observed by tumor marker test,abdominal/pelvic CT and MRI in the upper abdomen after conversion therapy.The operation time,volume of intraoptrative blood loss,number of lymph nodes dissected and vital sign were observed in the operation.The liver function,time for out-off-bed activity,time to anal exsufflation,time of drainage tube removal,duration of hospital stay,complications,results of pathological examination and recurrence and mnetastasis of tumor were observed after operation.After discharge from hospital,the patient underwent monthly tumor marker test,B ultrasound and chest X-ray examination till January 2014 and abdominaL/pelvic CT,magnetic resonance imaging (MRI) in the upper abdomen and colonoscopy every 6 months.The follow-up of outpatient examination and telephone interview was performed to detect the recurrence and metastasis of tumor up to September 2015.Results After preoperative 4-cycle chemotherapy,the diameters of 2 metastatic lesions in liver reduced to 3.2 cm and 2.0 cm,the levels of carcinoembryonic antigen(CEA) and CA19-9 (tumor marker) were reduced to 95.9 μg/L and 252.4 kU/L.The patient underwent successful Ⅰ-stage resection of colon cancer and synohronous liver metastasis.The operation time,volume of intraoperative blood loss,numbers of lymph nodes dissected and cancerous nodes were 208 minutes,250mL,14 and 1,respectively.The patient had no blood transfusion and metastasis,with the stable vital signs and good postoperative recovery.The levels of alanine transaminase (ALT) and aspartate transaminase (AST) were 1 147 U/L and 2 631 U/L at postoperative day 1,101 U/L and 37 U/L at postoperative day 7,respectively.The out-off-bed activity,anal exsufflation,drainage tube removal and discharge from hospital were occurred at postoperative day 2,3,7 and 9,respectively.No anastomotic fistula,bleeding and infection were occurred aftcr operation.The patient was diagnosed as with ulcerated sigmoid adenocarcinoma in T3N1cM1 stage (combining with liver metastasis).The patient received adjuvant therapy of mFOLFOX6 and oral capecitabine at postoperative day 40,and was followed up for 30 months with a good quality of life and without metastasis and recurrence.Conclusion Ⅰ-stage resection of colon cancer with synohronous liver metastasis can be used for initial unresectable colon cancer with liver metastasis after conversion therapy,and it is safe and feasible,with a good therapeutic effect.