MicroRNAs (miRNAs) are a class of small non-coding RNAs which involve in the regulation after gene transplantation.Researches show that miRNA is closely related to the development and progression of non-small-cell lung cancer (NSCLC).They caused a significantly change in NSCLC cells through downregulate tumor suppressor gene,or act as oncogene or work on some targets which is important in cell signal pathway,in the end it lead to oncogenesis,cell proliferation,cell apoptosis and resistance to chemotherapy or radiotherapy.Therefore,miRNA will be hopefully used in the diagnose and therapy of cancer.

Objective To investigate the risk factors of syncope symptom in patients with pulmonary embolism (PE).Methods 457 patients with confirmed pulmonary embolism were recruited in the study.They were divided into two groups:the syncope group (44 patients) and the group without syncope (413 patients).The clinical manifestation,laboratory examination,physical examination,imagingof all patients were analyzed by unconditional logistic regression.Results (1) Single factor analysis,prevalence of syncope was 9.6％ (44/457) in these patients with PE.Those with syncope had some higher risk factors,including age over 60,coronary heart disease,hypertension,stroke and lower limb vein thrombosis history.The proportion of falling pressure chest painand centricity thrombus in syncope group were increasing compared with the groupwithout syncope.Pulmonary embolism severity index (sPESI) score was higher than groupwithout syncope.(2) Multivariate analysis showed that hypertension coronary heart disease and Centricity thrombus were the independent correlates of the presence of syncope in the patients with PE.Conclusions Patients who had histories of hypertension and coronary heart disease may have the higher risk factors of syncope.Blood pressure falling and central localization may be more likely to happen in PE patients with syncope.

Objective To investigate the clinical characteristics and the course of diagnosis and therapy of asparaginase associated pancreatitis (AAP) in adults, in order to improve the ability of diagnosis and treatment.Methods Data of 384 cases of acute lymphoblastic leukemia (ALL) who received treatment in Department of Hematology, Zhejiang Hospital, and Department of Hematology, Second Hospital Affiliated to Wenzhou Medical University from January 2009 to June 2015 was retrospectively analyzed.All patients were given multi-drug chemotherapy including PEG-asparaginase or L-asparaginase, the incidence of AAP, clinical manifestations, diagnosis, treatment and prognosis were analyzed.Results Among the 384 cases, 18 patients developed AAP, and the incidence of AAP was 4.7％, including 13 cases of mild AAP (MAAP), 5 cases of severe AAP (SAAP).Sixteen cases of AAP occurred during the induction-remission treatment phase, 2 cases during the maintenance-intensification phase.The major manifestations of AAP were abdominal pain, and increased serum amylase and lipase.After treatment, abdominal pain of MAAP patients alleviated, serum amylase and lipase obviously decreased, and re-use of PEG-Asparaginase or L-Asparaginase was not associated with the recurrence of AP.Levels of serum amylase and lipase in 5 cases of SAAP repeatedly increased, 1 case died of severe infection, cyst rupture and hemorrhage.Conclusions Adults patients with ALL present with abdominal pain during chemotherapy of aspargase should consider the possibility of AAP, the measurement of serum amylase and serum lipase should be strengthened, in addition, ultrasound and CT scanning may be helpful for early diagnosis and treatment of AAP, and improve the prognosis.

Objactive:To study the color changes of SY-1 silicone elastomer before and after polymerization.Methods:L*a*b*color parameters of 10 samples of SY-1 silicone elastomer were measured with Minolta chroma-ticity instrument(CS-321) before and after polymerization.The color difference(△E) between precure and post-cure was calculated as△E =[(△L)2+(△a)2+(△b)2]1/2.Results:After polymerization L*and a*valueswere increased(P

objective: To study the properties of keepers treated with different methods. Methods: Eighteen Z 3 magnetic attachments were divided into three groups at random. Cobalt chromium alloy was used for root cap. The keepers in the first group were cast to the caps, those in the second group were welded to the caps by Nd:YAG laser welding apparatus. Keepers in the third group were untreated. Universal testing machine was adopted to measure the breakaway retention of the attachments. The roughness of keeper surfaces was measured by roughness tester. Results: No statistical difference was observed as to the breakaway retention between magnetic attachments and laser welded coping keeper or between those and cast coping keepers. But retention of the keepers in the two groups was slightly lower than that of untreated keepers. Defects of pits were found on the surfaces of the cast coping keepers. The surface smoothness of the cast coping keepers was inferior to that of the laser welded coping keepers. Conclusion: Laser welded keepers and cast coping keepers can meet clinical demands for the use of magnetic attachments.

Objective To establish an assessment scale for hospital stroke patients with Delphi method,by using it to help the nurses evaluate patients' existing and potential problems,and to provide foundations for specific assessment on different patient groups.Methods The first-level indicators and second-level indicators were developed on the basis of the Omaha system.210 nursing records of hospital stroke patients were then combined with to form concrete items.Totally 22 nursing specialists were interviewed with two rounds in order to further collect the opinions and suggestions about the assessment scale.Results 4 first-level indicators,35 second-level indicators and a number of items were included in the assessment scale.Conclusions The assessment scale for hospital stroke patients established by Delphi method comprehensively shows the environmental,physical,mental and behavioral condition in hospital,and it could be used as a tool to assess the hospital stroke patients.

Objective To investigate the high risk factors for pneumonia-related bloodstream infection (BSI) caused by Acinetobacter baumannii (AB) in ventilated patients. Methods A retrospective observation was conducted. The data of invasive-ventilated patients underwent AB pneumonia admitted to Department of Critical Care Medicine of the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Disease from January 2011 to December 2015 were enrolled. The patients were divided into non-AB-BSI group and AB-BSI group. The following factors were evaluated including gender, age, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score at admission of intensive care unit (ICU), clinic pulmonary infection score (CPIS), underlying disease, neutropenia or agranulocytosis, hemoptysis, treatment of steroid or immunosuppressant in recent 3 months, central venous catheter (CVC), parenteral nutrition (PN), combined antibiotic therapy after the diagnose of AB pneumonia, duration of mechanical ventilation and the resistance of AB. The risk factors were analyzed by logistic regression analysis to confirm the independent high risk factors for the pneumonia-related BSI caused by AB in ventilated patients. Results 612 patients were enrolled, 561 patients in non-BSI group, and 51 in BSI group with 5-year BSI incidence of 8.3%. There was no significant difference in gender or age between the two groups. Compared with non-BSI group, the APACHE Ⅱ score (20.8±9.2 vs. 17.3±5.5) and CPIS (7.1±3.9 vs. 5.6±1.6) in BSI group were significantly increased (both P < 0.05). The patients with CPIS > 6 [80.4% (41/51) vs. 28.0% (157/561)], chronic obstructive pulmonary diseases [COPD, 86.3% (44/51) vs. 46.7% (262/561)], diabetes mellitus [DM, 25.5% (13/51) vs. 14.8% (83/561)] in BSI group were more than patients in non-BSI group, the incidence of heart failure [HF, 5.9% (3/51) vs. 23.5% (132/561)] was significantly decreased, and the incidence of hemoptysis [27.4% (14/51) vs. 3.4% (19/561)], therapy of steroid or immunosuppressant [19.6% (10/51) vs. 7.8% (44/561)] and duration of mechanical ventilation > 14 days [80.4% (41/51) vs. 48.5% (272/561)] were significant increased (all P < 0.05); no significant difference was found in other parameters between the two groups, including gender, age, other underlying diseases, neutropenia or agranulocytosis, CVC, PN, combined antibiotic therapy, and resistance of AB. It was showed by logistic regression analysis that CPIS > 6 [odds ratio (OR) = 2.513, 95% confidence interval (95%CI) = 1.400-20.439, P = 0.011], history of COPD (OR = 1.921, 95%CI = 0.068-5.603, P = 0.030), the treatment of steroid or immunosuppressant (OR = 2.012, 95%CI = 0.556-16.313, P = 0.021) and hemoptysis (OR = 1.866, 95%CI = 1.114-6.213, P = 0.037) were the independent risk factors for the pneumonia-related BSI caused by AB in ventilated patients. Conclusion CPIS > 6, history of COPD, the therapy of steroid or immunosuppressant and hemoptysis were the independent risk factors for the pneumonia-related BSI caused by AB in ventilated patients.

Objective To evaluate the diagnosis value of plasma Dickkopf-1(DKK1)in hepatocellular carcinoma (HCC)pa-tients.Methods Selected 48 patients with HCC,20 patients with liver cirrhosis (LC),20 patients with chronic hepatitis B (CHB),and all of them were clinically diagnosed in the Third People’s Hospital of Nantong City,chose 20 cases of health examination as healthy controls (HC),that were ruled out other chronic disease.Enzyme-linked immunosorbent assay (ELISA)and Abbott i2000 microparticle chemiluminescence immunoassay analyzer were used to determine the plasma DKK1 and alpha-fetoprotein (AFP)levels.At the same time,analysesed and compared the receiver operating characteristic (ROC)curve and correlation of the DKK1 and AFP results.Results The plasma level of DKK1 in patients with HCC was significantly higher than that in patients with chronic hepatitis B,cirrhosis and healthy controls (Z=-4.132~-5.828,P<0.001).The area under ROC curve (AUC)of plasma DKK1 in the diagnosis of HCC was 0.889 and 95% confidence in-terval was 0.831~0.947,when the Cut-off value of DKK1 was 565 ng/L,the sensitivity was 93.8% and specificity was 70% in diagnosing HCC.The areaunder ROC curve of AFP in the diagnosis of HCC was 0.759 and 95% confidence interval was 0.667~0.850.The AUC of DKK1 was significantly higher than that of AFP (Z=2.28,P=0.022).DKK1 and AFP in diagnosing HCC were no significantly correlated (r=0.148,P=0.316).21 patients with AFP under 20μg/L showed higer DKK1 above 565 ng/L in 48 patients with HCC.Conclusion Detection of DKK1 in plasma can be used as a complement of AFP in the diagnosis of HCC,Especially DKK1 early diagnostic value of AFP negative HCC patients is remarkable.

Objective To investigate the value of the application of fibrobronchoscopy in extubation for patients suffering from acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with low cough peak expiratory flow(CPEF). Methods A single-center prospective controlled study was conducted. The ventilated AECOPD patients who were cooperative at the time of extubation in Department of Critical Care Medicine of Guangzhou Institute of Respiratory Disease of Guangzhou Medical University from June 2009 to May 2014 were enrolled. All patients successfully passed the spontaneous breathing trial(SBT). Extubation was performed after determination of CPEF following energetic coughing. According to the CPEF,the patients were divided into CPEF≥60 L/min group (high CPEF group)and CPEF<60 L/min group(low CPEF group). After extubation,fibrobronchoscopic drainage was given to the patients in high CPEF group when necessary. Fibrobronchoscopic drainage was given to the patients in low CPEF group at least once a day,and the frequency of such treatment could be increased according to the patient's condition. If the patients did not require re-intubation within 48 hours,extubation was recorded as successful. The gender,age,acute physiology and chronic health evaluationⅡ(APACHEⅡ)score before extubation,ventilation time,the time of intensive care unit(ICU)stay,the mortality in ICU,the rate of re-intubation,the ability to cough and the frequency of application of fibrobronchoscopy after extubation were recorded. Results A total of 102 patients with AECOPD were enrolled,58 patients in high CPEF group and 44 in low CPEF group. Compared with high CPEF group,the mean age in low CPEF group was older(years:74.3±15.2 vs. 69.5±11.4,t=2.164,P=0.041),the time of ICU stay was significantly longer(days:20.1±11.2 vs. 17.4±7.3,t=2.274,P=0.030), but there was no significant difference in gender〔male/female(cases):35/9 vs. 45/13,χ2=0.057,P=0.812〕, APACHEⅡscore(11.9±1.9 vs. 10.3±4.2,t=1.290,P=0.200),mechanical ventilation time(days:14.8±10.8 vs. 13.3±9.6,t=0.677,P=0.501)and the rate of re-intubation〔18.18%(8/44)vs. 12.07%(7/58),χ2=1.412, P=0.235〕between low CPEF group and high CPEF group. The cough strength of patients in high CPEF group was almost alwaysstrong(52 cases),and in the low CPEF group,most of them wasmoderate(14 cases)orweak(26 cases). The frequency of application of fibrobronchoscopy in low CPEF group was higher than that in high CPEF group(times:4.1±1.8 vs. 1.3±0.9,t=2.626,P=0.011). All patients underwent weaning successfully,and no death occurred. Conclusion The application of fibrobronchoscopy in the extubated AECOPD patients with low CPEF can reduce the rate of re-intubation,avoid the prolonged ventilation,but cannot reduce the time of ICU stay.

Objective: Our purpose was to study whether exogenous adenosine triphosphate (ATP) could enter liver cell or not. Methods: Using continuous hypothermic machine perfusion model of rat liver, we used autoradiography in this experiment. Results: The light microscope pictures of group A(no ［α-32P］ ATP in the perfusate) showed that there was no specially labeled silver pellet in or out of rat liver cell. But the light microscope pictures of group B (37 MBq ［α- 32P］ATP in the perfusate) showed that distribution of numerous ［α-32P］ATP autoradiographic silver pellets in rat liver cell, and no autoradiographic silver pellet was found in the hepatic sinus and vessel. Conclusion: Exogenous ATP could enter cold storaged rat liver cell.