Objective:To study lncRNA MEG3 expression and its relationship with Th17/CD4+T cells in patients with non-small cell lung cancer(NSCLC)with different pleural effusion severity and prognosis.Methods:A total of 104 NSCLC malignant pleural effusion patients admitted to Quanzhou First Hospital Affiliated to Fujian Medical University from January 2020 to December 2022 were selected as research subjects,and divided into three groups based on amount of pleural effusion,including small amount of pleural effusion group(35 cases),moderate amount of pleural effusion group(42 cases)and large amount of pleural effusion group(27 cases).According to actual development and prognosis of patient's disease,they were divided into good prognosis group(29 cases without recurrence and metastasis)and poor prognosis group(75 cases with recurrence and metastasis).Another 60 patients with benign pleural effusion due to pneumonia who were treated in Quanzhou First Hospital Affiliated to Fujian Medical University at same time were selected as control group.MEG3 expression in pleural effusion of two groups was detected by real-time fluorescent quantita-tive PCR,and peripheral venous blood of subjects was collected.Th17 cell and CD4+T cell ratios of peripheral blood were detected by flow cytometry,and Th17/CD4+T was calculated.lncRNA MEG3 and peripheral blood Th17 and CD4+T levels in each group of patients compared.Logistic regression analysis was used to analyze pleural effusion and prognostic factors in NSCLC.Results:lncRNA MEG3 expression and CD4+T percentage in pleural effusion in NSCLC group were lower than control group,while Th17 percentage and Th17/CD4+T were higher than control group(P<0.05).lncRNA MEG3 expression and CD4+T percentage in large pleural effusion group were lower than small and moderate pleural effusion groups.lncRNA MEG3 expression and CD4+T percentage in modarate pleural effusion group were lower than small pleural effusion group,while Th17 percentage and Th17/CD4+T in large pleural effusion group were higher than small and moderate pleural effusion groups.Th17/CD4+T was higher in small amount pleural effusion group(P<0.05).lncRNA MEG3 expression and CD4+T percentage in poor prognosis group were lower than those in good prognosis group,while Th17 percentage and Th17/CD4+T were higher than good prognosis group(P<0.05).Logistic regression analysis showed that lncRNA MEG3 was a protective factor for NSCLC pleural effusion,and Th17/CD4+T was a risk factor(P<0.05),lncRNA MEG3 was a protective factor of NSCLC prognosis,and Th17/CD4+T was a risk factor(P<0.05).Conclusion:lncRNA MEG3 expression and Th17/CD4+T in NSCLC patients with different pleural effusion severity and prognosis is not same.lncRNA MEG3 is a risk factor for NSCLC pleural effusion and prognosis,while Th17/CD4+T is a risk factor,which can be used as an effective biomarker for pleural effusion severity and progno-sis diagnosis.

Objective:To explore the clinical characteristics, treatment and prognosis of patients with severe lacrimal duct obstruction caused by tegafur-gimeracil-oteracil potassium (S-1).Methods:The medical records and follow-up data of the surgical inpatients with severe lacrimal duct obstruction caused by S-1 in Lacrimal Center of Ophthalmology, the Third Medical Center of Chinese PLA General Hospital from January 2017 to January 2019 were analyzed retrospectively.Results:A total of 12 patients were enrolled in this study, including 7 males and 5 females, aged (53±8) years. The time of oral administration of S-1 was (4.1±1.1) months, and the time from the beginning of administration of S-1 to the onset of epiphora symptoms was (53.3±31.2) days. All the 12 patients had binocular diseases (involving 12 cases, 24 eyes) and obstruction of both upper and lower lacrimal canaliculi (involving 48 lacrimal canaliculi). Among the 48 obstructed lacrimal canaliculi, 45 (93.8%) were severe, and 3 (6.2%) were moderate. The 8 lacrimal points of the upper and lower lacrimal canaliculi in both eyes of the 2 patients were completely atresic. In 12 patients, 16 eyes in 8 patients were complicated with complete obstruction of nasolacrimal ducts and 8 eyes in the other 4 patients were complicated with incomplete obstruction of nasolacrimal ducts. Eight patients underwent laser dacryoplasty combined with bicanalicular intubation assisted by lacrimal canaliculus micro-endoscopy. After taking off the tubes, epiphora was relieved in 5 patients but not improved in the other 3 patients. Two patients underwent retrograde exploration to probe canaliculi transdacryocyst combined with bicanalicular intubation. After taking off the tubes, epiphora was relieved. Two patients underwent retrograde exploration to probe canaliculi transdacryocyst combined with dacryocystorhinostomy. After taking off the tubes, epiphora was improved obviously and only slight epiphora was found.Conclusions:Severe lacrimal duct obstruction caused by S-1 was characterized by extensive multiple obstruction. Appropriate surgical treatment can improve the symptoms of epiphora in some patients.

Objective:To explore the clinical characteristics, treatment and prognosis of patients with severe lacrimal duct obstruction caused by tegafur-gimeracil-oteracil potassium (S-1).Methods:The medical records and follow-up data of the surgical inpatients with severe lacrimal duct obstruction caused by S-1 in Lacrimal Center of Ophthalmology, the Third Medical Center of Chinese PLA General Hospital from January 2017 to January 2019 were analyzed retrospectively.Results:A total of 12 patients were enrolled in this study, including 7 males and 5 females, aged (53±8) years. The time of oral administration of S-1 was (4.1±1.1) months, and the time from the beginning of administration of S-1 to the onset of epiphora symptoms was (53.3±31.2) days. All the 12 patients had binocular diseases (involving 12 cases, 24 eyes) and obstruction of both upper and lower lacrimal canaliculi (involving 48 lacrimal canaliculi). Among the 48 obstructed lacrimal canaliculi, 45 (93.8%) were severe, and 3 (6.2%) were moderate. The 8 lacrimal points of the upper and lower lacrimal canaliculi in both eyes of the 2 patients were completely atresic. In 12 patients, 16 eyes in 8 patients were complicated with complete obstruction of nasolacrimal ducts and 8 eyes in the other 4 patients were complicated with incomplete obstruction of nasolacrimal ducts. Eight patients underwent laser dacryoplasty combined with bicanalicular intubation assisted by lacrimal canaliculus micro-endoscopy. After taking off the tubes, epiphora was relieved in 5 patients but not improved in the other 3 patients. Two patients underwent retrograde exploration to probe canaliculi transdacryocyst combined with bicanalicular intubation. After taking off the tubes, epiphora was relieved. Two patients underwent retrograde exploration to probe canaliculi transdacryocyst combined with dacryocystorhinostomy. After taking off the tubes, epiphora was improved obviously and only slight epiphora was found.Conclusions:Severe lacrimal duct obstruction caused by S-1 was characterized by extensive multiple obstruction. Appropriate surgical treatment can improve the symptoms of epiphora in some patients.

Objective To investigate the distribution and antimicrobial resistance of pathogens causing pneumonia in acute stroke patients,and guide clinical antimicrobial use.Methods Patients with stroke-associated pneumonia (SAP)admitted to a tertiary first-class hospital from 2008 to 2013 were investigated retrospectively,distribution and antimicrobial susceptibility testing results of pathogens from sputum were analyzed.Results A total of 98 pa-tients with SAP were investigated,124 stains were isolated from sputum specimens,75 strains (60.48% )were gram-negative bacteria,44 (35.49% )were gram-positive bacteria,and 5 (4.03% )were fungi. There were 21 cases of mixed infection (21.43% ),bacterial alterations during treatment process existed among 23 cases(23.47% ).The top 4 isolated pathogens were Staphylococcus aureus (S. aureus,n= 43,34.68% ),Klebsiella pneumoniae (K. pneumoniae,n= 19,15.32% ),Pseudomonasaeruginosa(P. aeruginosa,n= 18,14.52% ),and Acinetobacterbau-mannii(A. baumannii,n= 18,14.52% ). Antimicrobial resistance rates of K. pneumoniae were all <32% ,and susceptibility rates to ceftazidime,piperacillin/tazobactam,imipenem,ciprofloxacin,levofloxacin,amikacin,and tobramycin were all 100% . Both A.baumannii and P.aeruginosa showed severe multidrug resistance. Resistance rates of A.baumannii to ceftazidime was >80% ,resistance rates of P.aeruginosa to imipenem was 33 .33% . No resistant strains were detected among fungi.Conclusion The main pathogens causing SAP in this hospital are S.au-reus,K.pneumoniae,A.baumannii,and P.aeruginosa,except K.pneumoniae,the other strains are severely re-sistant to antimicrobial agents,clinicians should choose antimicrobial agents according to the distribution character-istics and antimicrobial susceptibility testing results.

Objective To compare the di-syllabic tone between hearing-impaired children and normal-hearing children. Methods 120 hearing-impaired children and 36 normal-hearing children aged 3~5 years were asked to read aloud 32 word with 16 kinds of di-syllabic tone. Results All the normal-hearing children read all the words correctly, and the hearing-impaired children faulted in pronouncing as their peers. The correct incidence improved in 4-year old hearing-impaired children compared with that of the 3-year old, but it was not significant different between the 4- and the 5- year old. There was not significant difference of the high and level tone between the hearing-impaired children and normal-hearing children. However, the rising, falling- rising and falling tones were significantly different between the two groups. Conclusion The hearing-impaired children aged 3~5 years delay to speech words with di-syllabic tone, especially for those with rising, falling-rising and falling tones.

Objective To revise the assessment of consonant vowel and tone recognition for cochlear implanted children. Methods 300 normal hearing children aged 2~6 years old were assessed with word lists for consonant and vowel recognition, and analysed with equivalency analysis. Results The incidence of consonant vowel and tone recognition was less than 90% in children aged 2~3 years old, but more than 90% in those aged 3 or more. Conclusion The assessment of consonant vowel and tone recognition for cochlear implanted children aged of 3 and above has been modified, and the assessment for those aged 2~3 years old has been developed.

Objective To outline the research fronts of ten major sub-specialties in internal medicine.Methods Based on their impact factor scores and the proportion of the journals of 10 subspecialties (endocrinology & metabolism,cardiac & cardiovascular systems,hematology,infectious diseases,nephrology,gastroenterology & hepatology,respiratory system,rheumatology,critical care medicine,clinical neurology) in Journal Citation Report (JCR),and careful consulation of expert clinicians,we identified 50 journals.Their bibliographic records (including references) published in 2011 were downloaded,and the frequency of the references (citations) in each sub-specialty was counted and the highly cited records were extracted.We performed a clustering analysis according to the co-cited times among any pairs of the highly cited records.To tag each cluster of highly cited records,we browsed the titles and abstracts of all highly cited records in the same cluster,and concluded the main topics of each cluster.Finally,we extracted the current published papers devoted to particular cluster by some clustering analysis indicators.The clusters of highly cited records were considered as the intelligence base,and the main topics in current papers which citing these highly cited papers were considered as research fronts.Results Totally 50 journals on 10 sub-specialties in internal medicine were identified.A total of 202 highly cited papers,38 clusters (knowledge bases),and 152 corresponding current citing papers presenting the research fronts were selected.Conclusions We confirm and present research fronts in 10 major sub-specialties of internal medicine.This study provides a synchronic structure of contemporary research activities in internal medicine sub-specialties.

Objective To compare the effect of high volume continuous blood purification (CBP) with routine CBP on multiple organ dysfunction syndrome(MODS).Methods 38 patients with MODS were randomly divided into high volume CBP group( treatment group,18 cases) and routine CBP group (control group,20 cases).And they were respectively detected on mean arterial pressure(MAP),dosage of Dopamine,PaO2/FiO2,APACHE [ score,lactic acid,length of stay and mortality in ICU post-treatment 24h and 48h.Results Compared with control group,MAP and PaO2/FiO2 on treatment group were more higher( P ＜ 0.05 ),while dosage of Dopamine,APACHE Ⅱ score,lactic acid were significantly shorter than these of treatment group( P ＜ 0.05 ),and length of stay and mortality in ICU were significantly lower than those of treatmen group [ ( 8.54 ± 4.15 ) d vs ( 11.82 ± 5.76) d,P ＜ 0.05:22.2％ vs 35.0％,P ＜0.05 ].Conclusion High volume CBP could reduce the mortality in ICU compared with control group routine CBP.

Objective To study the characteristics of language function development and establish the reference standards in children of4~6 years old. Methods 616 hearing normal children at the age of 3~7 from 13 provinces in China were assessed with Language FunctionEvaluation for Hearing-impaired Children. 583 usable data were analyzed via SPSS 17.0. Results The older the children were, the highertheir scores of language function evaluation were (P<0.001). The differences between boys and girls on coordination function and relaxationfunction were significant (P<0.01). The girls were better than the boys. The reference standards of children of 4~6 years old were set downbased on the regression analysis. Conclusion There are some laws on children's language function development. The reference standards ofchildren by 4~6 years old has been developed.

The cluster sampling method was used and a retrospective survey on mortality trends of cerebrovascular diseases from 1989 to 2008 was conducted among residents from Erqi District in Zhengzhou city and Xigong District in Luoyang city. The average mortality rate of cerebrovascular diseases in these two districts was 69. 5/100 000 in 1989 to 2008. The standardized mortality rate for men was 118. 67/100 000 in 1989 to 1993, and dropped to 44. 23/100 000 in 2004 to 2008. The standardized mortality rate for women was 68.21/100 000 in 1989 to 1993, and dropped to 30. 2/100 000 in 2004 to 2008. The declining trends of cerebrovascular disease mortality rates might be related to early diagnosis and early treatment of the disease, and the extensive health education and prevention programs.