Objective To assess the efficacy of pulmonary surfactant on acute lung injury.Methods The randomized controlled study involving pulmonary surfactant on acute lung injury were identified from Cochrane Library,PubMed,China Academic Journals Full-text database,Chinese Biomedical Literature Database and Chinese Journal Full-text database.According to inclusion and exclusion criteria,the quality of papers were evaluated and then extract the valid data for meta-analysis.Results The current study included 5 English papers,including 1219 cases of patients.Meta analysis showed that:(1) There was no significant difference between experimental group and control group in term of mechanical ventilation(WMD =-1.08,95％ CI(-3.00,0.85),P =0.27).(2) Two studies conducted the ICU time comparison and there was no difference in experimental group and control group(WMD =-0.61,95％CI(-4.63-3.41),P =0.77).(3) Three studies were conducted the survival rates and no difference had found regarding of survival rates between experimental and control group (RR =1.41,95 ％ CI(0.94-2.11),P =0.10).Conclusion The existing clinical evidences showed the addition of pulmonary surfactant have no significant effect regarding of mechanical ventilation time,ICU length of stay and survival rate in patients with acute lung injury compared with conventional therapy However,due to the quality and the limitations of the studies and selection bias and measurement bias,it was needed more high-quality,large-scale randomized controlled clinical studies to validate.

Objective To understand the trend of occurrence,diagnosis,and prognosis of breast cancer in the cases treated in Peking Union Medical College Hospital(PUMCH) between 1975 and 2006.Methods A total of 1092 cases of breast cancer treated in the PUMCH from 1975 to 2006 were classified into six groups by time span and reviewed for a comparative study on the parameters of gender,age,menstruation status,tumor size,mumber of positive axillary nodes,pathologic stage,recurrence and metastasis and disease-free survival rate.Results The average age of breast cancer patient has risen from 50.90 to 53.92,while 40-49 year-old group was the largest age group of breast cancer patients,and the percentage of menopause female was the highest.Tumor size has gradually been smaller especially since 2000.The number of positive axillary nodes showed no significant change during the time periods.In all 6 groups,stage-II cases were more frequent,although the percentage of stage-0 and stage-I cases was on the rise,while the percentage of stage-III declined,and that of stage-IV remained stable.In all 6 groups,the 5-year and 10-year disease free survival rate had steadily increased.Conclusions The early diagnostic rate of breast cancer has been improving and subsequently the prognosis has improved as well.

· AlM:To investigate the effect of compound anisodine on fundus blood circulation after vitrectomy with face-down position.
· METHODS: Sixty patients ( 60 eyes ) with rhegmatogenous retinal detachment received vitrectomy with silicone oil tamponade operation, who were randomized divided into treatment group ( 30 eyes ) and control group ( 30 eyes ) .The patients in the treatment group received the subcutaneously injection of compound anisodine hydrobromide by the superficial temporal artery once daily for 14d since postoperative first day.Retinal microcirculation blood flow parameters were recorded with Heidelberg retinal flowmeter postoperative 1d, 1 and 2wk, and were compared between two groups.
·RESULTS: The blood flow parameters ( Vol, Flw, Vel) of control group postoperative 1 and 2wk were significantly less than those postoperative 1d.Otherwise the parameters of treatment postoperative 1 and 2wk were significantly more than those postoperative 1d. The parameters between two groups were significant different ( P<0.01) .
· CONCLUSlON: Facing down after vitrectomy with
silicone oil tamponade may reduce retinal blood supply, consequently lead to retinal ischemia; compound anisodine can effectively improve the retinal and choroidal microcirculation after vitrectomy with face-down posture, reduce retinal ischemia, and enhance the visual function.

Objective To investigate the clinical therapeutic effect of Xuebijing injection for treatment of patients with diabetic nephropathy(DN)and its mechanism. Methods 60 DN patients were randomly divided into Xuebijing group and control group(each,30 cases). The patients in both groups received western conventional treatment,and the patients in Xuebijing group received additionally Xuebijing injection intra-venous injection once a day for 14 days. The fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),urinary albumin excretion rate(AER),blood urea nitrogen(BUN),serum creatinine(SCr),hematocrit(HCT),fibrinogen(Fg),whole blood viscosity,total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)and interleukin -6(IL-6),tumor necrosis factor-α(TNF-α)and urine β2-microglobulin(β2-MG)levels before and after treatment were detected,and the curative effect was also observed in both groups. Results In the control group blood FBG,BUN,SCr,TC,IL-6 and TNF-αafter treatment were significantly decreased and HDL-C significantly increased compared with those before treatment(all P<0.05). Compared with those before treatment,in Xuebijing group after Xuebijing therapy,blood FBG,β2-MG,AER,BUN, SCr,TC,TG,HCT,blood viscosity,IL-6 and TNF-αwere significantly decreased,and HDL-C was obviously increased,but there were no significant differences in HbA1c,LDL-C and Fg before and after treatment. The above indexes were changed significantly in Xuebijing group compared with those in control group〔FBG(μg/L):6.98±1.14 vs. 9.73±1.62,β2-MG(μg/L):32.1±10.9 vs. 57.2±15.1,AER(μg/min):86.0±28.1 vs. 152.0±51.6,BUN (mmol/L):12.4±8.1 vs. 19.5±8.9,SCr(μmol/L):301.2±151.9 vs. 371.3±168.6,HCT:0.283±0.075 vs. 0.351±0.059,TC(mmol/L):3.4±1.8 vs. 4.1±1.5,TG(mmol/L):3.4±1.5 vs. 3.6±1.7,HDL-C(mmol/L):1.90±0.75 vs. 1.50±0.25, IL-6 (ng/L):8.96±2.07 vs. 12.75±2.47, TNF-α(pmol/L):17.85±4.75 vs. 20.87±4.90,P<0.05 or P<0.01〕. The total efficiency in Xuebijing group was significantly higher than that in control group(83.3%vs. 36.7%,P<0.01). Conclusion Xuebijing injection has significant protective effects on patients with DN,and the mechanism might be associated with increasing tissue perfusion and inhibiting excessive inflammatory cytokines release.

Algorithms ; Noise, Occupational ; Numerical Analysis, Computer-Assisted

Adult ; Balloon Occlusion ; instrumentation ; Cardiac Catheterization ; instrumentation ; Ductus Arteriosus, Patent ; surgery ; Female ; Humans ; Ligation ; instrumentation ; Recurrence

Objective To investigate the effects of the silence of teratocarcinoma-derived growth factor-1 ( TDGF-1 ) gene on invasion of human pancreatic cancer cell. Methods Three small interfering RNA (siRNA) targeting for TDGF-1 genes (S1, S2, S3 ) were designed and established, then the gene with the best silencing effects was screened. Human pancreatic cancer cell line PANC1 were transfected by siRNA with different concentrations (3. 125, 6.25, 12.5 nmoL/L), the cells without transfection, and simply treated with liposomes were controls. The expressions of mRNA and protein of TDGF-1 were determined by real time PCR and Western blot assay, respectively. The anchorage-independent growth was examined by clon formation in soft agar, and invasion ability was evaluated by boyden chamber model. PANC1 cells with transfection for 48h were injected into the nude mice to evaluate the invasion ability in vivo. Results The expressions of TDGF-1 mRNA and protein of cells transfected by siRNA were decreased in a dose-and time-dependent manner, which were significantly lower than those in liposomes group. Number of colony formation and transmembrane cell were 19.8 ± 2.2 and 49.8 + 2.6 in the control group, and 5.6 + 1.2 and 8. 1 + 1.1 in the 12.5 nmol/L transfection group. The volumes of tumor 4 weeks after transplation in the control group, liposomes group and the 12.5 nmol/L transfection group were (2.228 ± 0.016 ) cm3, ( 2.186 ± 0.028 )cm3 and ( 0.728 ± 0.023 )cm3. Conclusions TDGF-1 gene silence could inhibit invasion ability of human pancreatic cancer cell PANC1.

Lynch syndrome is the most common type of genetically determined colon-cancer predisposition syndrome, accounting for 5%of all colorectal cancer (CRC) cases. This hereditary syndrome is characterized by the germline mutation of human mismatch repair genes and microsatellite instability. Recent studies have shown that Lynch syndrome and sporadic CRC differ in diagnosis and treat-ment;these results are especially relevant for the clinical management of Lynch syndrome. In this review, we reverted to the original characterization of Lynch syndrome, and the developments in its screening and diagnosis were summarized. Furthermore, the manage-ment of families with this disorder was discussed.

Objective To investigate the efficacy of esomeprazole (Esomeprazole) and flupentixol and melitracen (Deanxit) in treatment of non-erosive gastroesophageal reflux disease (NERD) with depression and anxiety.Methods The diagnosis of NERD was based on the results of esorneprazole scale (reflux diagnostic ques- tionnaires,RDQ) and endoscopy,the degree and frequency of symptoms were graded and scored.Hamilton de- pression scale was used to evaluate depression and anxiety status.Sixty-three patients were randomly divided into group A (esomeprazole 20 mg qd),B (Deanxit 1 tab qd),C (esomeprazole 20 mg qd and Deanxit 1 tab qd) with each group 21 patients,and treated for four weeks.The efficacy was evaluated by the symptom scores.Results There were some effects of esomeprazole or Deanxit alone on the improvement of symptoms of NERD.Although the effect of Deanxit was not as good as esomeprazole,there was not difference for relieving heartburn and sub- sternal pain between two groups in time point of each week after treatment (P＞0.05).esomeprazole was better for relieving acid regurgitation than Deanxit (P＜0.01).Combined treatment of esomeprazole with Deanxit was better and faster for relieving the symptoms of NERD than esomeprazole or Deanxit alone (relieving rate 81% in group C,23.8% in group A and 14.3% in group B,P＜0.01).The total efficacy rate of group C (100%) was higher than that of group A (80.9%) or group B (61.9%,P＜0.01),but there were not difference of relieving rate and total efficacy rate between group A and B (P＞0.05).Conclusions There was better efficacy of com- bined treatment of esomeprazole and low-dose Deanxit in treating NERD with depression and anxiety.These re- sults suggest that depression and anxiety have some effects on the pathogenesis and progress of NERD.

Objective:To explore the clinical characteristics of patients with pituitary thyrotropin-secreting adenoma and evaluate the effect of preoperative short-acting octreotide treatment on hyperthyroidism.Methods:A retrospective analysis was performed in 40 patients with pituitary thyrotropin adenoma diagnosed in Beijing Tiantan Hospital from January 2008 to January 2018. The general data, laboratory examinations and imaging findings were reviewed and analyzed. The clinical effect of preoperative octreotide on hyperthyroidism was evaluated.Results:The age of onset year of the 40 patients (male: female = 24∶16) was (30.5±5.1) years. Among them, 35 patients (87.5%) were with macroadenoma. The most common symptoms were thyroid hypermetabolism syndrome, followed by headache, dizziness, visual field damage and hypogonadism. The thyroid function of 30 patients (75%) recovered to normal within 3-5 days after the octreotide treatment. The total effective rate of the octreotide was 90.0%. The level of free thyroxine (FT 4) before treatment in patients with more than 10 times of effective cumulative dose was significantly higher than that in patients with less than 10 doses. Conclusions:Thyroid hypermetabolism syndrome and pituitary occupying effect are the most common clinical manifestations of thyrotropin-secreting adenoma. Preoperative octreotide treatment can effectively control hyperthyroidism. The level of FT 4 is a crucial factor affecting the efficacy of octreotide.