Objective To explore the relationship of microRNA(miR)-155,miR-92a and miR-126 with in-stent restenosis(ISR)after percutaneous coronary intervention(PCI)in elderly patients with coronary heart disease(CHD).Methods A total of 118 elderly CHD patients receiving PCI in our hospital from January 2021 to June 2023 were enrolled,and according to whether ISR occurred by coronary angiography(CAG)at 1 year after surgery,they were divided into a stenosis group(45 cases)and a non-stenosis group(73 cases).Their baseline data,number of stent,stent diameter,medication,coronary artery lesion score,and serum expression levels of miR-155,miR-92a and miR-126 were compared between the two groups.The correlation of expression levels of the three miRNAs and clinical indicators was analyzed.Multivariate logistic regression analysis was performed to identify the risk factors of ISR in elderly CHD patients.ROC curve was adopted to analyze the diagnostic value of the three miRNAs for ISR in the elderly patients.Results Signifi-cantly higher BMI,SBP and DBP,and larger proportions of stent count ≥3 and stent diameter＜3 mm were observed in the stenosis group than the non-stenosis group(P＜0.05,P＜0.01).The expression levels of miR-155 and miR-126 were obviously lower,while that of miR-92a was nota-bly higher in the stenosis group than the non-stenosis group(P＜0.01).Pearson correlation analy-sis showed that miR-155 and miR-126 were negatively correlated with BMI,SBP,DBP,and stent count,and positively correlated with stent diameter(P＜0.01);miR-92a was positively correlated with BMI,SBP,DBP,and stent count,and negatively with stent diameter(P＜0.01).Multivariate logistic regression analysis suggested that stent count,stent diameter and miR-92a were risk fac-tors for ISR in elderly CHD patients after PCI,and miR-155 and miR-126 were protective factors(P＜0.05,P＜0.01).ROC curve analysis revealed that the AUC value of miR-155,miR-92a,and miR-126 alone and combined together was 0.742,0.778,0.751 and 0.853,respectively,with a sen-sitivity of 86.67％,71.11％,73.33％and 93.33％respectively,and the combined detection showed better diagnostic value for ISR than the single detection(P＜0.01).Conclusion Down-regulation of miR-155 and miR-126 and up-regulation of miR-92a may be involved in the occurrence of ISR in elderly CHD patients after PCI.Monitoring the three miRNAs is beneficial to auxiliary clinical prediction for ISR after PCI.

Objective To explore the relationship of microRNA(miR)-155,miR-92a and miR-126 with in-stent restenosis(ISR)after percutaneous coronary intervention(PCI)in elderly patients with coronary heart disease(CHD).Methods A total of 118 elderly CHD patients receiving PCI in our hospital from January 2021 to June 2023 were enrolled,and according to whether ISR occurred by coronary angiography(CAG)at 1 year after surgery,they were divided into a stenosis group(45 cases)and a non-stenosis group(73 cases).Their baseline data,number of stent,stent diameter,medication,coronary artery lesion score,and serum expression levels of miR-155,miR-92a and miR-126 were compared between the two groups.The correlation of expression levels of the three miRNAs and clinical indicators was analyzed.Multivariate logistic regression analysis was performed to identify the risk factors of ISR in elderly CHD patients.ROC curve was adopted to analyze the diagnostic value of the three miRNAs for ISR in the elderly patients.Results Signifi-cantly higher BMI,SBP and DBP,and larger proportions of stent count ≥3 and stent diameter＜3 mm were observed in the stenosis group than the non-stenosis group(P＜0.05,P＜0.01).The expression levels of miR-155 and miR-126 were obviously lower,while that of miR-92a was nota-bly higher in the stenosis group than the non-stenosis group(P＜0.01).Pearson correlation analy-sis showed that miR-155 and miR-126 were negatively correlated with BMI,SBP,DBP,and stent count,and positively correlated with stent diameter(P＜0.01);miR-92a was positively correlated with BMI,SBP,DBP,and stent count,and negatively with stent diameter(P＜0.01).Multivariate logistic regression analysis suggested that stent count,stent diameter and miR-92a were risk fac-tors for ISR in elderly CHD patients after PCI,and miR-155 and miR-126 were protective factors(P＜0.05,P＜0.01).ROC curve analysis revealed that the AUC value of miR-155,miR-92a,and miR-126 alone and combined together was 0.742,0.778,0.751 and 0.853,respectively,with a sen-sitivity of 86.67％,71.11％,73.33％and 93.33％respectively,and the combined detection showed better diagnostic value for ISR than the single detection(P＜0.01).Conclusion Down-regulation of miR-155 and miR-126 and up-regulation of miR-92a may be involved in the occurrence of ISR in elderly CHD patients after PCI.Monitoring the three miRNAs is beneficial to auxiliary clinical prediction for ISR after PCI.

Objective:Based on experience of robotic gastrointestinal surgery at the Department of General Surgery, Clinical Medicine Center of Gansu Provincial Hospital, this study explored the principles and methods of trocar layout for robotic "3+2" mode gastrointestinal surgery, suitable for beginners.Methods:From Apr 2017 to Oct 2022, the robotic gastrointestinal surgery team of Gansu Provincial Hospital completed 998 cases of robotic "3+2" mode gastrointestinal surgery, including 600 cases of gastric cancer, 100 cases of rectal cancer, 98 cases of descending colon and sigmoid colon cancer, 20 cases of transverse colon cancer, and 180 cases of right colon cancer. Through the continuous optimization and improvement of the problems encountered during the operation, combined with the operator's experience, and taking into account various aspects, we developed the robotic "3+2" mode trocar layout for gastrointestinal surgery.Results:Four principles of trocar layout were developed, namely, the principle of lens placement around the navel, the principle of symmetry in the main operation, the principle of 8-10cm distance between trocar holes, and the principle of symmetry in the auxiliary hole lens. Three trocar layout methods and principles applicable to robotic gastric surgery, and four applicable to robotic colorectal surgery were developed.Conclusion:The trocar layout method of robotic "3+2" mode gastrointestinal surgery is established based on a large number of robotic gastrointestinal surgery experiences. This method is simple and easy to learn, with strong repeatability and operability.

ObjectiveTo develop basic training courses for family doctor teams for people with disabilities. MethodsUtilizing the methods and theories of the World Health Organization (WHO) rehabilitation competency framework (RCF), and referring to the WHO universal health coverage global competency framework, the rehabilitation competency characteristics of family doctor teams for people with disabilities in community settings were analyzed, and a basic training course system for these teams based on the RCF was developed. Results and ConclusionBased on RCF, a competency framework for family doctor teams serving people with disabilities has been constructed. The objectives, content and training course system for basic rehabilitation training has been established.

Objective To examine survival differences in prognosis and survival between patients with HPV-positive and those with HPV-negative oropharyngeal squamous cell carcinoma (OPSCC).Methods Pubmed,Embase,Web of science and Medline databases were searched from their inception till June 2014.A random-effect meta-analysis was used to pool study estimates evaluating overall (all-cause mortality),disease-specific (death from OPSCC),disease-free (recurrence free),progression-free survival outcomes and local regional control rate in HPV-positive vs HPV-negative OPSCC.After study selection,two reviewers assessed and extracted data independently.Meta-analysis was performed using the STATA 11.0software.Results Thirty-seven studies were included.HPV-positive OPSCC patients had a better overall survival compared to HPV-negative patients (HR 0.39,95％ CI 0.32-0.46).HPV-positive OPSCC patients had a significantly lower disease specific mortality (HR 0.31,95％ CI 0.22-0.39) and were less likely to experience progression or recurrence of their cancers than HPV-negative patients (HR 0.34,95％CI 0.25-0.42).Both disease-free survival and progression-free survival were significantly improved in patients with HPV-positive OPSCC (HR 0.38,95％ CI 0.29-0.47 and HR 0.46,95％ CI 0.29-0.63,respectively).Conclusions HPV infection is an important prognostic factor of OPSCC.Stratified therapies can be applied in OPSCC based on HPV status of tumours.

Objective To study effects of oligo-peptide I-C-F-6 in carapax trionycis on rats with liver fibrosis induced by CCl4;To discuss its anti-liver fibrosis effects and possible mechanisms. Methods Forty-eight SD male rats were randomly divided into normal control group, model group, bifendate group, and oligo-peptide I-C-F-6 group, 12 in each group.CCl4 was injected intraperitoneally to build rat liver fibrosis model.Oligo-peptide I-C-F-6 group and bifendate group were given subcutaneous injection of oligo-peptide I-C-F-6 (0.12μg/g) or bifendate (0.12μg/g). At the same time, normal control group and model group were giventhe same volume of saline for seven weeks. The levels ofALT, AST,MDA, SOD, IL-4, IL-10 and TNF-α were tested.The histomorphology changes were observed under optical microscopeby HE, and the expressions of transforming growth TGF-β1 were determined by immunohistochemistry.Results Compared with model group, serum levels of ALT and AST were reduced evidently in oligo-peptide I-C-F-6 group. Hepatic content of MDA, IL-4 and TNF-α decreased, while SOD activity and IL-10 were found significantly increased. Liver fibrosis was ameliorated significantly. Hepatic expressions of TGF-β1 were weakly positive.Conclusion Oligo-peptide I-C-F-6 can ameliorate hepatocyte damage of model rats, thus it has anti-oxidative and anti-liver fibrosis effects on liver fibrosis in rats.

Objective To determine the effect of losartan on vascular remodeling and the underlying mechanism in spontaneously hypertensive rats(SHR). Methods SHR of 12 weeks old were given losartan orally [0,15,30 mg/(kg·d),n=12]. The tail arterial pressure was measured every week.Eight weeks later, the pathological changes and p22phox expression in the thoracic aorta, the activity of catalase (CAT), the contents of H2O2 and AngⅡ in the plasma were evaluated. Results Blood pressure was increased in the SHR accompanied by the thickened wall and increased p22phox expression in the thoracic aorta. The plasma levels of H2O2 and AngⅡwere elevated while the CAT level was decreased in the SHR. Administration of losartan reversed the thickened wall and increased the CAT activity concomitantly with the decreased plasma levels of H2O2 and p22phox expression in the SHR. The plasma level of AngⅡincreased after the losartan treatment. Conclusion Oxidative stress induces the vascular remodeling of the aorta in the SHR. Losartan can reverse the vascular remodeling through down-regulating p22phox expression and inhibiting the oxidative stress.

Objective To analyze the imaging characteristics and the diagnostic value of conventional MRI and indirect MR arthrography in shoulder joint injury.Methods MR imaging in90 patients with shoulder joint disease were retrospectively analyzed by two musculoskeletal radiologist based on the results of arthroseopic examination,including 57 cases of rotator cuff disease and 33 cases of recurrent shoulder instability.The result of the indirect MR arthrography and conventional MR was statistically compared by Fisher exact probability test.Results (1)In the group of rotator cuff disease,37 patients underwent indirect MRA,demonstrating 10 cases of partial-thickness rotator cuff tear and 1 case of missed diagnosis;demonstrating 17 cases of full-thickness rotator cuff tear and 2 cases of misdiagnosis.For partialthickness rotator cuff tear,the sensitivity,specificity and accuracy of indirect MR arthrography were 90.9%(10/11),92.3%(24/26),and 91.9%(34/37),respectively;for full-thickness rotator cuff tear,the sensitivity,specificity and accuracy of indirect MR arthrography were 89.5%(17/19),94.4%(17/18),and 91.9%(34/37),respectively.Indirect MR arthrography in the diagnosis of partial and full thickness rotator cuff was significantly better than conventional MR(P＜0.05).(2)In the group of recurrent shoulder instability,labium tear was found in 26 cases,Hill-sachs lesion in 27,reverse Hill-sachs in 2,bony Bankart lesion in 7,and capsular tear in 18 cases,respectively.Twenty patients underwent indirect MRA,demonstrating 14 cases of labrum tear,1 case of missed diagnosis,and 5 cases of normal labrum.For labrum tear,the sensitivity,specificity and accuracy of indirect MR arthrography were 93.3%(14/15),100.0%(5/5),and 95.0%(19/20),respectively.Indirect MR arthrography in the diagnosis of labrum tear was significantly better than conventional MR(P＜0.05).Conclusion MRI,especially indirect MR arthrography,is the most helpful method for the diagnoses of shoulder joint injury.

OBJECTIVE To observe Staphylococcus aureus(SAU) infection at high altitude and plain after gunshot injury. METHODS Used 7.62mm bullets to injure posterior limbs of piglets with the same age.We got contusing tissues in different time after injury,to make bacteriologic examination,identify and make a statistic analysis of SAU. RESULTS The main infection was caused by SAU after gunshot injury in two regions.From contusing tissues in two regions,the rate of contamination caused by SAU in Chongqing and Lasa was 48% and 18%,respectively.The time of SAU colonization was 3 hours at high altitude,and less 3 hours at plain.The velocity of reproduction of SAU at high altitude for 12 hours was 5-6 passages,and at plain was 4-6 passages for 3-6h.The time of remaining relative steady state between tissues and germs was 48 hours at high aititude and 24 hours at plain.The difference of the number of SAU between two regions after injury 3-36 hours was significant,But after 36 hours the difference was unsignificant. CONCLUSIONS At high altitude region,SAU is the main germ that causes contamination after gunshot injury,the velocity of reproduction of SAU is slower than that at plain,the time of infection is delayed obviously.

Objective To evaluate the diagnostic value of indirect MR arthrography(MRA) and conventional MR for shoulder instability.Methods 24 cases of shoulder instability were retrospectively analyzed.13 patients underwent conventional MR,11 patients underwent indirect MRA.Based on the results of arthroscopic examination,the efficacy of indirect MRA images and conventional MR images in diagnosis of the labrum,the capsule, and the bone structure injury.Results Indirect MRA in diagnosis of labrum tear was signifiantly better than conventional MR(P0.05).Conclusion Indirect MRA is more helpful to diagnose the labrum tear than conventional MR.Further study should be taken for capsule and ligament injury.