Objective Through clinical observation and research with persistent atrial fibrillation in patients with blood-brain natriuretic peptide ( BNP) level change detection renin, angiotensin Ⅱ, aldosterone, analyze their data, investigate persistent atrial fibrillation ( PAF ) serum brain natriuretic hormone levels change and the relationship between the renin-angiotensin-aldosterone system (RAAS).Methods 80 patients with coronary artery disease in our hospital from December 2013 to October 2015 were selected, randomly divided into experimental principle PAF group (40 cases) and control group ( patients in sinus rhythm,with 40 cases) , BNP, renin, angiotensinⅡ, aldosterone levels were measured in two groups, and left atrial diameter (LAD) measurements.Results Under the same condition of cardiac function, the blood BNP concentration in PAF group was higher than that in control group (P <0.05).The results of the linear regression analysis showed that the correlation coefficient of blood BNP level and AngII concentration in PAF group was 0.301, the correlation coefficient of blood BNP level and LAD indicators in PAF group was 0.373, the concentrations of BNP and RAAS were positively correlated with LVMI, the differences were statistically significant (P<0.05), the blood BNP level was closely related to the level of RAAS in the PAF group (P<0.05).Conclusion Blood BNP concentration was significantly higher in patients with PAF and blood BNP concentration is closely related with the RAAS, LAD indicators, and a positive correlation.

Objective: To evaluate the application of frontal flap in reconstructing the defect of nose, the clinical data of 12 cases were reported. Methods: Twelve patients with nasal skin cancers undertaking radical dissection of tumor accompanied frontal flap reconstructing one stage were reviewed retrospectively.Results: The overall following\|up rate was 100%, 10 of these patients curled slightly after reconstructing the nose, but influence of the nasal outline was little. Two cases were recurrent locally, one occurred 24 months after operation, the other occurred 38 months. Both of them received radiotherapy. Malformation arised after radiotherapy. The total successful rate of reconstruct nasal outlook was 83.33%, the 3\|year locally recurrent rate was 8.33%,5\|year survival rate ws 100%, 5\|year survival rate without tumor was 83.33%.Conclusion:The blood supply of frontal flap is abundance;healing up soon after reconstruction; the manipulation of surgery is simple and safe. It is worth applying this operation generally in clinical practice.

Objective To investigate the relationship between Pin1 and CyclinD1 expression and the development of gastrointestinal stromal tu?mor(GIST). Methods The protein and mRNA expression of Pin1 and CyclinD1 in 85 samples of GIST and adjacent non?cancerous tissues were detected by immunohistochemistry and real?time quantitative polymerase chain reaction. Results The expression rate of Pin1 protein in GIST tis?sues(64.7%;55/85)was higher than that in adjacent non?cancerous tissues(26.7%;4/15). Similarly,the expression rate of CyclinD1 protein in GIST tissues(42.3%;36/85)was higher than that in adjacent non?cancerous tissues(6.7%;1/15). The expression of Pin1 and CyclinD1 mRNA in GIST tissues was 7.03 and 5.53 times that in adjacent non?cancerous tissues ,respectively. There was no obvious correlation between the expres?sion of Pin1 and clinicopathological parameters. The expression of CyclinD1 was positively correlated with the grade of NIH and tumor diameter (P<0.05). There was a significant correlation between the expression of Pin1 and CyclinD1 in GIST tissues. Conclusion The expression of both Pin1 and CyclinD1 was up?regulated in GIST tissues. The significant correlation between the expression of Pin1 and CyclinD1 in GIST tissues sug?gests that their synergistic effect promotes carcinogenesis and the development of GIST.

Objective To investigate the effects of in situ venous arterialization on extensive artery obliterans occlusion of the lower extremity. Methods Lumbar sympathetic ganglionectomy and one stage in situ arterialization of the great saphemous vein were performed in 104 ischemic limbs of 88 patients with extensive arterial occlusion. Results Eighty-two of 104 limbs were followed-up from 6 months to over 6 years. The intermittent claudication, night pain improved in all cases, with satisfactory wound healing and no swelling of the lower limbs. Conclusions Arterial blood flow through venous conduit improves and reconstructs the blood circulation of the ischemic limbs.

Objective To investigate a more pedect method for a nice outward appearance of a reconstructed thumb.Methods A free one-stage plasty second toe transfer for thumb reconstruction by interchanging the whole skin-nail flap from the great toe with another one from the second toe.Results There were 12 cases in this group,following-up 6-9 months in 8 cases,7 cases was excellent and 1 cases was good.The reconstructed thumb got a nice looking and more normal function while no blight to the great toe occurred.Conclusion It is an effective new procedure in ameliorating outward appearance of the reconstructed thumb by transferring the free moulded second toe.

Objective:To compare the application value of Caprini thrombosis risk assessment scale and Shanghai venous thrombosis risk factor scale in predicting venous thromboembolism in hospitalized maternal patients.Methods:This was a case-control study. A total of 67 pregnant women complicated with venous thromboembolism in the Obstetrics Department of Shandong Provincial Hospital Affiliated to Shandong First Medical University from January 2010 to September 2021 were retrospectively analyzed. And 144 pregnant women without venous thromboembolism in the same period were selected. Two venous thrombosis risk assessment tools were used to evaluate the pregnant women, and the predictive effectiveness and accuracy of the two assessment tools were compared.Results:The effects of the two risk assessment tools for venous thrombosis were different before and after delivery with statistical difference ( Z=8.15, 5.97, both P<0.01), but the Shanghai venous thrombosis risk factor scale (83.9%, 67.3%) was superior to Caprini thrombosis risk assessment scale (52.1%, 45.0%) in the accuracy of prenatal and postnatal prediction. The area under receiver operating characteristic curve showed that the Shanghai venous thrombosis risk factor rating scale (0.863) was significantly superior to the Caprini thrombosis risk assessment scale (0.748) after delivery. Conclusions:The Shanghai venous thrombosis risk factor scale is more valuable than the Caprini thrombosis risk assessment scale in the early risk identification of venous thromboembolism in pregnant women.

Objective:To evaluate the effect of interstitial lung disease(ILD) on postoperative morbidity and mortality in pulmonary resection for lung cancer patients.Methods:We retrospectively analyzed 971 patients undergoing pulmonary operation from January 2010 to January 2018 in our hospital. Clinical data including age, sex, history of chronic obstructive pulmonary disease(COPD), smoking history, smoking index, American Society of Anesthesiologists(ASA) classification, forced expiratory volume in 1 s(FEV1) % predict, surgical procedure, video assisted thoracoscopic surgery(VATS) or not, intraoperative blood transfusion, anesthesia time, operation time/one-lung ventilation time, blood loss, histology, postoperative morbidity, 60-days mortality, onset of acute exacerbation of interstitial lung disease(AE-ILD), drainage, extubation time, and postoperative stay were collected and analyzed.Results:There were 80(8.2%) and 891(91.8%) patients in ILD and non-ILD group, respectively. AE-ILD occurred in 5 patients, with a 60-day mortality of 80%. A multivariate regression analysis identified that the sex( P=0.023), ILD( P=0.001), COPD( P=0.027) were independent risk factors for postoperative morbidity. ILD( P=0.023) and postoperative morbidity( P=0.001) were independent risk factors for 60-day mortality in multivariate analysis. Conclusion:Patients with ILD had a higher incidence of postoperative morbidity and 60-day mortality. Based on the obvious postoperative morbidity and mortality, special attention and management should be taken in ILD patients.

Objective     To investigate the significance of neoadjuvant chemotherapy in the treatment of limited-disease small cell lung cancer (LD-SCLC). Methods     We retrospectively analyzed the clinical data of 55 LD-SCLC patients who underwent surgery in the Department of Thoracic Surgery, China-Japan Friendship Hospital from May 2007 to August 2016. There were 42 males and 13 females with a mean age of 57 years. All patients underwent clinical staging before treatment. According to the different treatments, the patients were divided into two groups, a preoperative neoadjuvant chemotherapy group and a direct surgery group. The comparison of long-term survival rates was made between the two groups. Results     Among the 55 patients, median survival time was 27 months. The 1-, 3-, 5-year survival rate was 89.1%, 45.0%, 33.8% respectively. Treatment methods and clinical N stage were significantly different in prognosis (P<0. 05). The results of Cox proportional hazards regression model showed that clinical N stage was prognostic factor of LD-SCLC patients (P<0. 05). Conclusion     Patients with clinical stage Ⅰ and Ⅱ SCLC are better to receive direct surgery. For patients with clinical stage Ⅲ, it is recommended to reach partial response or complete response with neoadjuvant chemotherapy before surgery. The status of lymph node metastasis is closely related to survival, thus identifying the accurate clinical stage is crucial before treatment.