Growth arrest special 5 (GAS5) is a common long non-coding RNA (lncRNA).Recent studies find that lncRNA GAS5 is down-regulated in various tumors,such as breast cancer,cervical cancer,lung cancer,gastrointestinal cancers and urologic cancers.GAS5 is closely related to the development,metastasis and prognosis of cancers,which becomes a new hotspot in cancer research.

Objective:To scientifically measure and morphologically evaluate the anatomical shape of the skin in the first web space based on cadavers, and to guide the design of flap in this area.Methods:Sixteen human cadavers fixed with 10% formaldehyde without injury or deformity on the hand were selected in the Department of Hand Surgery, the Third Hospital of Suqian. According to the characteristics of the first web area, marker points were selected for measurement and morphological observation. Morphological characteristics of the first web with thumb radial abduction(r) or palmar abduction(p) were measured and compared. The t-test was used for statistical analysis. P<0.05 was considered statistically significant. According to the results of measurement, standardised shapes and parameters of the skin were obtained for flap repair of defect of the first web. Results:When the thumb was in palmar abduction, the maximum distance [a(p)] of the first web of female(F) and male(M) was 5.78/8.42 cm(F/M), and the skin [S(p)] was 17.09/23.63 cm 2(F/M), both were significantly greater than the distance [a(r)] at 4.86/6.28 cm and the area of skin area [S(r)] at 14.39/20.15 cm 2 when thumb was in the radial abduction position( P<0.05). There was no significant difference in the length of [b(r)] and [b(p)] alone the long axis of flap between palmar and radial abductions(7.54/9.38 cm and 7.34/9.74 cm, respectively) of the thumb( P>0.05). It was found that the area of first web was not shaped as a symmetrical spindle, but an irregular quadrilateral inclined to the index finger. Conclusion:Design and measurement of a flap for the first web space should take the maximum palmar abduction of a thumb as a reference. The asymmetric quadrilateral flap design is more in line with the anatomical and characteristics in the region.

Biological Evolution ; Morphinans ; Papaver ; Plant Proteins ; genetics

OBJECTIVE：To evaluate the benefit and risk of tirofiban in the treatment of acute coronary syndrome （ACS），and to provide evidence-based reference for clinical drug selection and decision. METHODS ：Retrieved from domestic and foreign database as PubMed ，the Cochrane Library ，CNKI and Wanfang database ，during the establishment of database to Apr. 2020，two researcher independently screened the literature based on inclusion and exclusion criteria and extracted the data. After the quality evaluation of the included literatures ，based on rapid health technology assessment ，the extracted results were classifiedly evaluated and comprehensively analyzed. RESULTS ：A total of 13 researches of systematic review/Meta-analysis and 1 research of pharmacoeconomics were included. Compared with placebo ，tirofiban could significantly reduce all-cause mortality [OR ＝0.68， 95％CI（0.54，0.86），P＝0.000 1] and the incidence of major adverse cardiac events （MACE）in patients with ACS [RR ＝0.24， 95％CI（0.14，0.40），P＜0.01]，and increased the incidence of TIMI 3 [OR＝5.73，95％CI（2.99.10.97），P＜0.01]. Tirofiban and eptifibatide had similar therapeutic efficacy in the treatment of ACS ，but tirofiban significantly increased the risk of TIMI small bleeding in patients with ACS [RR ＝0.61，95％CI（0.38，0.98），P＝0.04]. For ACS patients with non-ST elevation （NSTE-ACS）， compared with placbo ，tirofiban significantly reduced the incidence of MACE [RR ＝0.76，95％ CI（0.61，0.96），P＝0.018]，but significantly increased the risk of bleeding [OR ＝1.49，95％CI（1.12，1.98），P＝0.006]，while there was no significant difference in its effects on the all-cause mortality of NSTE-ACS patients （P＞0.05）. For STEMI patients ，compared with placebo ，tirofiban significantly reduced the all-cause mortality [RR＝0.61，95％CI（0.35，1.05），P＝0.007] and the incidence of MACE [RR ＝0.63，95％ CI（0.44，0.90），P＝0.007]. When combined with liposuction ，tirofiban also significantly reduced the incidence of MACE [RR ＝ 2.05，95％CI（1.71，2.46），P＜0.01]，and significantly increased the incidence of TIMI 3 [OR＝3.18，95％ CI（2.4，4.22），P＜ 0.01]，but there was no significant difference in its effects on bleeding risk （P＞0.05）. The included pharmacoeconomic study showed that patients treated with bivalutine could get 10.07 QALYs，patients treated with heparin combined with tirofiban could get 9.98 QALYs，and the incremental cost-effectiveness ratio bivalutine compared to the latter one was 28 575.77 yuan/QALYs，which was lower than 3 times of the per capita GDP of some cities. CONCLUSIONS ：Tirofiban has good efficacy in the treatment of ACS，but it can increase the risk of bleeding than eptifibatide and placebo. Domestic bivalirudin treating for ACS has a cost-effectiveness advantage over tirofiban combined with heparin.