Objective To elucidate the significance of CYFRA21-1 and β2-microglobulin expression in pleural fluid and develop diagnostic application for malignant pleural effusion differentiation. Methods Detected expression of CYFRA21-1 by RIA analysis and β2-MG by immunoturbidimetry assay (ITA), in 40 cases of benign pleural effusion and 40 cases of malignant pleural effusion. Results The mean level of CYFRA21-1 in malignant pleural effusions was (78.80±24.90)μg/L higher than that in benign pleural effusions (26.20±15.60)μg/L (P<0.05) and β2-MG in benign pleural effusions was (6.11±0.87)mg/L, significantly higher than that in malignant pleural effusions which was (3.12±0.91)mg/L respectively (P<0.05). Conclusion Evaluation of CYFRA21-1 and β2-MG in chest fluid can improve the differential diagnosis of malignant pleural effusion from benign pleural effusion and significantly increase the sensitivity of diagnosis.

Objective:To investigate the effect of levosimendan on myocardial injury in patients with sepsis.Methods:Eighty-two patients with sepsis complicated by myocardial injury who received treatment in Yinzhou Second Hospital from June 2015 to September 2017 were included in this study. They were randomly assigned to receive either dobutamine treatment (control group, n = 41) or levosimendan treatment (study group, n = 41) based on conventional basic treatment. Before and after treatment, serum levels of heart-type fatty acid-binding protein (H-FABP), cardiac troponin I (cTnI), N-terminal pro brain natriuretic peptide (NT-proBNP), left ventricular ejection fraction (LEVF), Acute Physiology, Age, and Chronic Health Evaluation II (APACHE II) score, intensive care unit (ICU) stay, and 28-day mortality were compared between the control and study groups. Results:Before treatment, there were no significant differences in serum levels of H-FABP, cTnI, and NT-proBNP as well as LVEF and APACHE II score between the control and study groups (all P > 0.05). At 6 hours after treatment, serum levels of H-FABP, cTnI, and NT-proBNP in the control and study groups [(26.22 ± 7.22) μg/L vs. (39.93 ± 9.85) μg/L, (25.97 ± 6.93) μg/L vs. (34.86 ± 8.55) μg/L, (0.004 ± 0.002) μg/L vs. (1.580 ± 0.360) μg/L, (0.003 ± 0.003) μg/L vs. (0.760 ± 0.210) μg/L, (1 561.73 ± 633.70) ng/L vs. (2 570.06 ± 747.95) ng/L, (1 602.28 ± 681.45) ng/L vs. (2 225.53 ± 585.14) ng/L] were significantly increased compared with before treatment ( t = 7.188, 5.172, 28.031, 23.079, 6.586, 4.443, all P < 0.05). After treatment, serum levels of H-FABP, cTnI, and NT-proBNP in the study group were significantly lower than those in the control group ( t = 2.489, 12.598, 2.323, all P < 0.05). In each group, serum level of H-FABP at 72 hours after treatment was significantly lower than that at 6 hours after treatment [(39.93 ± 9.85) μg/L vs. (6.28 ± 1.07) μg/L, (34.86 ± 8.55) μg/L vs. (5.82 ± 1.88) μg/L], serum levels of cTnI and NT-proBNP at 72 hours after treatment were significantly increased compared with those at 6 hours after treatment [(1.58 ± 0.36) μg/L vs. (2.72 ± 0.55) μg/L, (0.76 ± 0.21) μg/L vs. (1.78 ± 0.49) μg/L, (2 570.06 ± 747.95 ) ng/L vs. (3 623.27 ± 1 105.28) ng/L, (2 225.53 ± 585.14) ng/L vs. (3 128.08 ± 1 098.07) ng/L, t = 11.105, 12.251, 5.053, 4.645, all P < 0.05). At 72 hours after treatment, serum levels of cTnI and NT-proBNP levels in the control group were significantly higher than those in the study group ( t = 8.171, 2.035, both P < 0.05). At 72 hours after treatment, there was no significant difference in serum H-FABP level between the control and study groups ( P > 0.05). At 72 hours after treatment, APACHE II score in each group was significantly decreased and LVEF in each group was significantly increased compared with before treatment ( t = 7.718, 11.380, 9.049, 9.501, all P < 0.05). The change in APACHE II score at 72 hours after treatment relative to before treatment in the study group was more obvious than that in the control group ( t = 2.583, P < 0.05). At 72 hours after treatment, there were no significant differences in LVEF, ICU stay and 28-day mortality between the control and study groups (all P > 0.05). Conclusion:Levosimendan can reduce the serum levels of H-FABP, cTnI and NT-proBNP as well as APACHE II score in patients with sepsis, increase serum level of LVEF, and alleviate myocardial injury.

Objective:To investigate microRNA-29b ( miR-29b) expression in cerebral cortex , spinal cord, fore limb muscle, and serum of SOD1-G93A amyotrophic lateral sclerosis ( ALS) mice, and to identify the biomarker and to assess diagnostic values for ALS .Methods:Cerebral cortex , spinal cord , fore limb muscle and serum from 16 SOD1-G93 A ALS mice and 16 wild-type mice were taken and then microRNA extracted , detecting the expression of miR-29 b by real-time quantitative polymerase chain re-action ( RT-qPCR ) .The diagnostic performance of miR-29b for ALS was estimated by the receiver operating characteristic ( ROC ) curve . Results: The results from the validation indicated that the differences in miR-29b between the cerebral cortex of SOD1-G93A ALS and the healthy control subjects were statistically significant (P=0.001).Meanwhile, the expressions 8, 12, and 16 weeks later were higher than those of the controls ( ALS vs.Control: 8 weeks, P=0.044; 12 weeks, P=0.018; 16 weeks, P=0.045).When the relative expression level of miR-29b was used to diagnose ALS in SOD1-G93A ALS mice, the area under the ROC (area under the curve, AUC) was 0.885, if the diagnostic threshold was set at 0.185 6, the sensitivity and specificity were 92.9%and 71.4%.Conclusion:MiR-29 b may act as medical monitoring indices of ALS in early time .

Objective To study the diagnostic and monitoring values of the loss of heteroxygosity(LOH) of 3p loci in free plasma DNA of small cell lung cancer. Methods PCR silver staining was used for the detection of LOH of three microsatellite sites in the 3p loci of plasma free DNA and tissue of SCLC. Results In 33 cases of tissue, the incidence rate of LOH was 54.5%(18/33), but the positive rate of LOH in plasma free DNA was 42.4%(14/33). The correlation between them was 78.8%(14/18). Conclusion The plasma free DNA in patients with lung cancer is primarily originated from the tumor tissue. LOH of plasma free DNA may be valuable molecular markers in the diagnosis of SCLC.

Objective To study the diagnostic value of LOH and MSI of free DNA 3p microsatellite point in plasma of lung cancer patients. Methods Using PCR and sliver dye techniques, LOH and MSI of three microsatellite sites of plasma DNA on chromosome 3p in resected fresh tissue from 37 patients and whole blood sample from 94 patients were detected. Results The plasma free DNA concentration of most lung cancer patients was above microgramme level. Above 70% of tissues and plasma were positive. No significant difference was found at different stages and in different pathologic types. The result of patients with lymph node metastasis was significantly different from that of the patients without lymph node metastasis. Conclusion Plasma DNA of lung cancer patients is a good medium for gene diagnosis and may be used widely in the future.

Objective To summarize the experience of surgical management of carotid tumors ( CBT ) and application of shunt between common and internal carotid artery intraoperatively. Methods Thirty patients of CBT (mean age:39. 2 ±2. 3 years old,10 male and 20 female, 15 in left, 14 in right and 1 in both sides) who underwent surgical resection, were retrospectively reviewed. The average size of CBT was 4.9 ±0.3 cm. The diagnosis was established by ultrasound, CT, MRI or carotid arteriography. 16 patients underwent surgical resection of CBT, 10 patients underwent additional ligation of external carotid artery, and 4 patients underwent additional intraoperative shunt between common and internal carotid artery. Results Surgical procedures were successfully performeded in all 30 patients with CBT. Intraoperative shunts were successfully used between common and internal carotid artery in 4 patients. The postoperative complications included hoarseness (15) , bucking (11), crooked tongue ( 17) , dyspnea (1), dysphagia(3). There was no hemiplegia and death. Conclusion Surgical resection is the choice of treatment of carotid body tumor. The application of intraoperative shunt between common and internal carotid artery in complicated Shamblin Ⅲ stage is safe and effective.

Objective To analyze the clinical and radiographic characterstics of ureteral polyps with hydronephrosis in children.Methods Thirteen patients with ureteral polyps and hydronephrosis were studied retrospectively.All patients underwent abdominal plain film,intravenous pyelogram(IVP)and ultrasound(US)examinations,contrast-enhanced CT scan was performed in 10 cases.Results Intermittent or recurrent abdominal pain with painless hematuria was presented in most cases.Hydronephrosis was demonstrated in radiographic images.IVP delineated the dilatation of the ureter and filling defects within the ureteral lumen in 5 cases.Computed tomography(CT)showed all abnormal changes of ureter and irregular intraluminal soft tissue masses in 6 cases.Moderate and low echoic structures were showed in ureters by US in 2 cases.Conclusion US and CT,as an important imaging modalities,can improve the diagnostic accuracy for ureteral polyps.

BACKGROUND:Studies have different views on the effect of repetitive transcranial magnetic stimulation applied in stroke patients for improving motor function.
OBJECTIVE:To evaluate the effect of repetitive transcranial magnetic stimulation on rehabilitation of motor function in patients with stroke.
METHODS:We searched Cochrane Central Register of Control ed Trials, PubMed, ISI Web of science, Medline, EMBASE, China Biology Medicine disc, China National Knowledge Infrastructure, VIP Database for Chinese Technical Periodical, Wanfang Data (from database building to July 2013) for randomized control ed trials concerning repetitive transcranial magnetic stimulation on improving motor function in patients with stroke. The included studies were evaluated according to the method recommended by the Cochrane Col aboration. Meta analysis was performed in qualified literatures. The extracted data were analyzed by RevMan 5.1 software and GRADEprofiler 3.6 software.
RESULTS AND CONCLUSION:A total of 23 trials were included (intervention group n=400, control group n=301). Quantitative analysis was conducted in seven studies, and descriptive study was performed in the remaining studies. Meta-analyses analyzed Fugl Meyer Motor Scale and Barthel index. Results showed that Fugl Meyer Motor Scale [SMD=0.48, 95%CI(0.10, 0.86)] and Barthel index [SMD=1.38, 95%CI (0.68, 2.09)] were significantly higher in the intervention group than that in the control group. In accordance with The Grading of Recommendations Assessment, Development and Evaluation, outcome indexes were evaluated, and the two indexes were graded low quality. The current evidence shows that repetitive transcranial magnetic stimulation appears to enhance motor function and activities of daily living of the patients with stroke. Considering the limitations of the included studies, more multi-central randomized control ed trials with large sample sizes and high qualities are required in future to verify the therapeutic efficacy of repetitive transcranial magnetic stimulation on motor function of stroke patients.

Objective To evaluate the diagnostic value of ultrasonography in neonatal necrotizing enterocolitis (NEC)by Meta analysis.Methods PubMed,EMbase,CBM,CNKI,VIP and WanFang databases were retrieved to incorporate studies on the diagnostic value of ultrasound in NEC that met the inclusion criteria.The retrieval time limit was from establishment of the databases to July 24th,2015. QUADAS was used to assess the quality of the literatures and Meta -Disc software (Version 1 .4)was used for Meta analysis.The SROC was drawn and the area under curve (AUC)of SROC was calculated.Results A total of 7 studies were included and 485 patients were involved.The sensitivity of the ultrasonography was 0.65 (95%CI 0.58 ~0.71 )and the specificity was 0.61 (95%CI 0.55 ~0.67).The AUC of the SROC was 0.726.Conclusion The ultrasonography showed no clear advantage for diagnosis of NEC.Combining with clinical manifestations would enhance the diagnostic ability of the ultrasound.

Humans ; Aortic Dissection/surgery* ; Aortic Rupture/surgery* ; Death ; Treatment Outcome