0.05). Conclusions Silencing STAT3 gene can decrease STAT3 gene expressions , increase Bax gene expressions , induce cell apoptosis and suppress the tumor growth in the human breast carcinoma model by the RNAi technology .

OBJECTIVETo evaluate the use of free/total prostate-specific antigen ratio (fPSA/tPSA ratio) in improving the early diagnosis of prostate cancer.

METHODSfPSA/tPSA ratio in the serum was analyzed prospectively in 187 men with tPSA ranging between 4.0 and 20.0 microg/L. All of them underwent ultrasound-guided sextant prostatic biopsies. Sensitivity, specificity, positive and negative predictive values were calculated by SPSS 10.0 software.

RESULTSProstate cancer detection rates were 18.1% and 22.5% when tPSA was within the ranges of 4.0-10.0 g/L and 10.0-20.0 g/L respectively. fPSA/tPSA ratio was more significant than tPSA in all the men. When the cut-off value of fPSA/tPSA ratio was set at 0.25, 90.5% and 87.5% of cancers could be detected; and 26.7% and 11.3% of biopsies could be avoided within the tPSA ranges of 4.0-10.0 g/L and 10.0-20.0 g/L, respectively.

CONCLUSIONThe use of fPSA/tPSA ratio can improve prostate cancer detection and reduce unnecessary biopsies when tPSA is within the range of 4.0-10.0 microg/L and 10.0-20.0 microg/L.

Aged ; Aged, 80 and over ; Area Under Curve ; Early Diagnosis ; Humans ; Male ; Mass Screening ; Middle Aged ; Prospective Studies ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; diagnosis ; Sensitivity and Specificity

Objective To study the distribution of diseases in Medical Information Mart for Intensive Care Ⅲ(MIMIC-Ⅲ) database in order to provide reference for clinicians and engineers who use MIMIC-Ⅲ database to solve clinical research problems. Methods The exploratory data analysis technologies were used to explore the distribution characteristics of diseases and emergencies of patients (excluding newborns) in MIMIC-Ⅲ database were explored; then, neonatal gestational age, weight, length of hospital stay in intensive care unit (ICU) were analyzed with the same method. Results In the MIMIC-Ⅲ database, 46 428 patients were admitted for the first time, and 49 214 ICU records were recorded. There were 26 076 males and 20 352 females; the median age was 60.5 (38.6, 75.6) years, and most patients were between 60 and 80 years old. The first diagnosis in the disease spectrum analysis was firstly ranked by circulatory diseases (32%), followed by injury and poisoning (14%), digestive system disease (8%), tumor (7%), respiratory disease (6%) and so on. Patients with ischemic heart disease accounted for the largest proportion of circulatory disease (42%), the proportion of these patients gradually increased with age of 60-70 years old, then decreased. However, the proportion of patients with cerebrovascular disease declined first and then increased with age, which was the main cause of death of circulatory system disease (ICU mortality was 22.5%). Injury and poisoning patients showed a significant decrease with age. Digestive system diseases were younger than the general population (most people aged between 50 to 60 years), and non-infectious enteritis and colitis were the main causes of death (ICU mortality was 18.3%). Respiratory infections were predominant in infected patients (34%), but circulatory system infections were the main cause of death (ICU mortality was 25.6%). Secondly, in the neonatal care unit, premature infants accounted for the vast majority (82%). As the gestational age increased, the duration of ICU was decreased, and the mortality was decreased. Conclusions The diseases distribution of patients can be provided by MIMIC-Ⅲ database, which helps to grasp the overview of the volume and age distribution of the target patients in advance, and carry out the next step of research. Meanwhile, it points out the important role of exploratory data analysis in electronic health records analysis.

Objective To construct a database containing multiple kinds of diseases that can provide "real world"data for first-aid clinical research. Methods Structured or non-structured information from hospital information system, laboratory information system, emergency medical system, emergency nursing system and bedside monitoring instruments of patients who visited department of emergency in PLA General Hospital from January 2014 to January 2018 were extracted. Database was created by forms, code writing, and data process. Results Emergency Rescue Database is a single center database established by PLA General Hospital. The information was collected from the patients who had visited the emergency department in PLA General Hospital since January 2014 to January 2018. The database included 530 585 patients' information of triage and 22 941 patients' information of treatment in critical rescue room, including information related to human demography, triage, medical records, vital signs, lab tests, image and biological examinations and so on. There were 12 tables (PATIENTS, TRIAGE_PATIENTS, EMG_PATIENTS_VISIT, VITAL_SIGNS, CHARTEVENTS, MEDICAL_ORDER, MEDICAL_RECORD, NURSING_RECORD, LAB_TEST_MASTER, LAB_RESULT, MEDICAL_EXAMINATION, EMG_INOUT_RECORD) that containing different kinds of patients' information. Conclusions The setup of high quality emergency databases lay solid ground for scientific researches based on data. The model of constructing Emergency Rescue Database could be the reference for other medical institutions to build multiple-diseases databases.

Objective To investigate the influence of collateral circulation recruitment on cognitive functions in patients with severe unilateral stenosis or unilateral occlusion of the internal carotid artery by using TCD.Methods A total of 176 patients with severe unilateral stenosis or unilateral occlusion of the internal carotid artery were enrolled and were divided into a single vessel collateral group(n=80,45.5 ％),a multiple vessel collateral group(n=74,42.1％) and a no collateral group(n=22,12.5 ％).In order to study the influence of single vessel collateral circulation on cognitive functions,the single vessel collateral group was further divided into an anterior communicating subgroup(AcoA),a posterior communicating subgroup(PcoA),an ocular artery subgroup(OA),and a normal control subgroup.All patients and 34 normal controls(NC) received MoCA,and scores for the overall assessment and individual domains were analyzed.Results Compared with the control group (26.3± 1.1,4.7 ± 0.5,2.0 ± 0.0,3.6 ± 1.0),the multiple vessel collateral group,the single vessel collateral group and the no collateral group had lower overall scores (24.2 ± 1.7,21.9 ± 2.3,19.0 ± 2.4),lower executive/visuospatial function(3.9 ± 0.7,3.2 ± 0.8,2.4 ± 0.6),lower abstraction (1.7 ± 0.5,1.6±0.5,1.3±0.5),and lower delayed recall(2.9±0.8,1.9±0.8,1.6±0.5)(F=80.52,63.21,12,48.99,all P＜0.05);both collateral groups had lower scores in subtraction and attention (4.6±0.6 vs.5.2±0.7,4.3±0.7 vs.5.2±0.7);the no collateral group had lower scores in orientation(4.7±0.7 vs.5.7±0.5)(P＜0.05).Compared with the multiple vessel collateral group,both the single vessel collateral group and the no collateral group had lower overall scores(21.9±2.3 vs.24.2 ± 1.7,19.0± 2.4 vs.24.2 ± 1.7),executive/visuospatial function (3.2 ± 0.8 vs.3.9 ± 0.7,2.4±0.6 vs.3.9±0.7),subtraction and attention(4.6±0.6 vs.5.1±0.5,4.3±0.7 vs.5.1±0.5) (all P＜ 0.05);the no collateral group had lower scores in abstraction (1.3 ± 0.5 vs.1.7 ± 0.5),delayed recall(1.6 ± 0.5 vs.2.9 ± 0.8) and orientation (4.7 ± 0.7 vs.5.7 ± 0.5) (all P ＜ 0.05).Compared with the single vessel collateral group,the no collateral group had lower overall scores(19.0 ±2.4 vs.21.9±2.3),executive/visuospatial function(2.4±0.6 vs.3.2±0.8)and orientation(4.7± 0.7 vs.5.7 ± 0.6) (all P ＜0.05).In single vessel collateral patients,the AcoA subgroup had higher MoCAscores than the PcoA subgroup(22.9± 1.7 vs.21.2±2.7) (P＜0.05),and the AcoA subgroup had higher scores in delayed recall than the OA subgroup(2.2±0.8 vs.1.7±0.6) (P＜ 0.05).Conclusions Severe unilateral stenosis or unilateral occlusion in the internal carotid artery can result in cognitive impairment,especially in executive/visuospatial function,abstraction,delayed recall,subtraction and attention.However,collateral circulation can protect cognitive function in patients with unilateral internal carotid artery stenosis or occlusion and multiple vessel collateral circulation is more effective than single vessel collateral circulation,and AcoA is more effective than either PcoA or OA,but the difference between PcoA and OA is not significant.

Medical big data is a hot research topic in China,and it is also the main research direction in the field of emergency medicine.The current situation of the construction of the first-aid big data platform and the construction of the first-aid clinical decision support system were analyzed,the problems existing in the development of the first-aid big data research field were enumerated,to explore the theoretical methods for promoting the development of domestic first-aid big data,so as to provide references for the research in related fields.