Objective To explore the association between the relative expression level of SNORD55 in peripheral blood and the outcomes of all-cause mortality and stroke in patients with atrial fibrillation(AF),and to evaluate the predictive value of SNORD55 for prognosis.Methods A total of 133 patients with non-valvular AF admitted in Department of Cardiology of the First Affiliated Hospital of Army Medical University from January 2014 to December 2017 were enrolled in this study.Their baseline information was collected,and the relative expression level of plasma SNORD55 was detected.Cox proportional hazards model was used to explore the association between the relative expression level of SNORD55 in peripheral blood and all-cause mortality as well as stroke in the patients.The predictive performance of CHA2DS2-VASc score for all-cause mortality and stroke was compared with the score combined with the relative expression level of SNORD55 in the AF patients.The area under the receiver operating characteristic curve(AUC)was utilized to evaluate the discrimination,and the net reclassification index(NRI)and comprehensive discriminant improvement index(IDI)were calculated to evaluate the improvement of reclassification ability.Decision curve analysis(DCA)was applied to analyze the change in clinical net benefit.Results The results of multivariate Cox regression showed that high expression of SNORD55 in peripheral blood was an independent risk factor for all-cause mortality and stroke in the AF patients.In predicting the outcomes of all-cause mortality and stroke,the addition of relative expression SNORD55 level with the CHA2DS2-VASc score obtained higher AUC value[0.80(95％CI:0.67～0.93)vs 0.67(95％CI:0.53～0.81),P＜0.05].In predicting the outcome of all-cause death and stroke,combination of the relative expression level of SNORD55 with CHA2DS2-VASc score increased both NRI[54.3(95％CI:10.6～61.9)vs 31.9(95％CI:2.8～47.5),P＜0.05]and IDI[16.1(95％CI:2.4～27.0)vs 7.9(95％CI:0.5～14.8),P＜0.05].The results of DCA showed that our combination of CHA2DS2-VASc score relative expression level of SNORD55 had higher clinical net benefits than the foreign ABC score in the prediction of the outcomes.Conclusion Peripheral blood SNORD55 level is an independent risk factor for all-cause mortality and stroke in AF patients,and has good predictive performance for all-cause mortality and stroke in the patients.

Objectives To explore the association of peripheral blood PIWI-interacting RNA,piR-hsa-2700592,with all-cause mortality and stroke outcomes in patients with atrial fibrillation(AF),and to determine whether piR-hsa-2700592 has the potential to be an AF biomarker.Methods A total of 127 patients with non-valvular AF were enrolled,and the relative expression level of plasma piR-hsa-2700592 was detected.Cox proportional hazard regression was used to analyze the correlation between the expression of piR-hsa-2700592 and all-cause death as well as stroke outcome in the patients.Then the molecule expression level was combined with CHA2DS2-VASc score and ABC stroke(or death)score to establish 2 new prediction models,the improvement of the predictive performance was compared and analyzed.Receiver operating characteristic(ROC)curve analysis(area under the curve,AUC),net reclassification index(NRI),and comprehensive discriminant improvement index(IDI)were used to evaluate the predictive performance,and decision curve analysis(DCA)was employed to assess the clinical benefit.Results Multivariate Cox regression analysis showed that the patients with higher expression level of piR-hsa-2700592 in peripheral blood had a higher risk of stroke(HR:2.203,95%CI:1.120～4.332;P=0.022).In the stroke outcome,combination of plasma piR-hsa-2700592 expression level with CHA2DS2-VASc score and ABC stroke score obtained an AUC of 0.70(95%CI:0.55～0.85,P＜0.001)and 0.84(95%CI:0.73～0.96,P=0.02),respectively.But,no significant association was observed between high plasma piR-hsa-2700592 level and all-cause mortality in the AF patients(HR:1.997;95%CI:0.884～4.509;P=0.096).Combination of plasma piR-hsa-2700592 level improved the discriminative capability than the single CHA2DS2-VASc score and ABC stroke score models,with an NRI and IDI value of 44.20%(95%CI:3.40～59.90,P＜0.001)and 8.20%(95%CI:0.60～15.40,P＜0.001),respectively for the new CHA2DS2-VASc score model,and an NRI and IDI value of 44.20%(95%CI:9.80～58.90,P＜0.001)and 10.40%(95%CI:0.70～21.40,P＜0.001),respectively for the new ABC stroke score model.The DCA curve showed that both new prediction models obtained better net clinical benefits.Conclusion High peripheral blood expression of piR-hsa-2700592 is an independent risk factor for stroke in the AF patients,and the indicator has a good predictive value for prognosis of the patients.piR-hsa-2700592 might be used as a potential biomarker in the diagnosis and prevention of cardiovascular diseases.

Objective To evaluate the efficacy, safety and risk factors of endoscopic treatment for patients with early gastric cancer. Methods A retrospective study was conducted in a single center and data was collected from 186 early gastric cancers in 168 pathologically confirmed patients who received endoscopic treatment in Peking Union Medical College Hospital from January 2006 to December 2015. The cases were divided into different groups according to indications of endoscopic treatment. The curative resection rate and complication rate were analyzed. Post-resection outcomes were evaluated by long-term surveillance. Results The curative resection rate was 86. 9%( 73/84) in the group with absolute indications, 61. 7%(50/81)in the group with expanded indications, and 33. 3%(7/21) in the group beyond indications (P＜0. 01). Multivariate analysis revealed that the significant independent predictors for curative resection included lower third location of stomach, no ulceration,≤2 cm at diameter, no adhesion, and well-differentiation in histopathology. In the expanded indications group, discordance of differentiation type and deeper invasion mainly resulted in non-curative resection in en bloc lesions. The rate of bleeding and perforation was 4. 8%( 9/186) and 3. 8%( 7/186), respectively. The perforation rate was significantly lower in the lesions located in the lower third of stomach, without adhesion or performed by en bloc resection. During a median follow-up period of 22. 3 months, 154 patients were followed successfully. The incidence of synchronous and metachronous gastric cancers in curative resected lesions was 7. 5%( 8/106) and 0. 9%(1/106), respectively. Conclusion Endoscopic resection is an optimal treatment with high curative resection rate for early gastric cancer patients with absolute indications. Patients with expanded indications should take precise preoperative evaluation to avoid higher risk of non-curative resection endoscopically. Close follow-up is necessary for synchronous and metachronous gastric cancers after endoscopic resection.

Objective To investigate the association and difference between patent foramen ovale(PFO), atrial septal aneurysm(ASA), atrial septal defect(ASD) in normal controls and cryptogenic ischemic stroke(CS) in youth diagnosed by double source CT.Methods A total of 168 CS patients and 180 controls matched age and gender were included in the present study.The two groups were diagnosed by double source CT and clinical materials.The incident rate of PFO, ASA, ASD, the degrees of PFO, ASD,the lengths of PFO and difference between CS in two groups were analysed.Results The incident rates of PFO, ASA, ASD were 40.6%,10.7%,6.5% and 15.6%,3.3%,2.2% in CS groups and controls respectively(P<0.001).The incident rates of PFO merged ASA and ASA merged ASD were 6.0%,3.0% and 0%,0% respectively between two groups(P<0.001).The diameters of PFO, ASD were (1.71±0.62) mm,(3.42±0.72) mm and (0.85±0.51) mm,(2.45±0.42) mm in two groups respectively(P<0.001).The lengths of PFO were (14.6±3.8) mm and (8.2±2.3) mm in two groups(P<0.001).The correlations between stroke in two groups were no difference(P>0.001).Conclusion PFO,ASA and ASD are important to CS.While PFO,ASA and ASD can accurately be diagnosed by double source CT.

Objective To evaluate the association between the expression of breast cancer metastasis suppressor gene 1 (BRMS1) and the progression of cancer,and provide the basis for predicting the occurrence and metastasis of cancer.Methods Articles about BRMS1 with the clinical research literatures of cancer from PubMed,EMBase,China National Knowledge Infrastructure,Wanfang and VIP database were retrieved.The association between the expression of BRMS1 and tumorigenesis was evaluated by odds ratio (OR).The RevMan 5.3 software was used to complete the meta-analysis.Results A total of 27 articles were included,involving 2 282 cases in cancer group and 1 236 cases in the control group.The meta-analysis results showed that BRMS1 expression was significantly upregulated in cancer lesions compared with paired non-cancer (OR =0.10,95％ CI:O.08-0.14,Z =15.37,P ＜0.000 O1).In the subgroup about the type of cancers,there was statistically significant difference in the pooled OR between breast cancer and the control group (OR =0.10,95％ CI:0.05-0.20,Z =6.18,P ＜ 0.000 01).Conclusion The level of BRMS1 is negatively correlated with tumorigenesis including breast cancer.Low or absent BRMS1 expression in the tumor tissue may be an adverse predictive factor of tumorigenesis and metastasis.

Objective To evaluate the association between the expression of PTEN protein and the clinicopathological char‐acteristics of breast cancer patients .Methods All eligible studies regarding the association of PTEN protein expression with clini‐copathological features in patients with breast cancer were retrieved from PubMed ,Embase ,Cochrane Library ,CNKI and Wanfang databases .Odds ratio(OR) with corresponding 95% confidence interval(95% CI) form eligible studies were pooled .Heterogeneity and publication bias were also evaluated .All analyses were operated using RevMan 5 .2 software .Results A total of 28 articles con‐taining 3 172 patients were ultimately included for this Meta‐analysis .Our findings revealed that the expression level of PTEN was significantly correlated with estrogen receptor status(OR= 3 .16 ,95% CI:2 .01 -4 .97 ,P< 0 .01) ,progesterone receptor status (OR=2 .27 ,95% CI:1 .70 -3 .04 ,P<0 .01) ,lymph node metastasis(OR=0 .36 ,95% CI :0 .27 -0 .49 ,P<0 .01) ,clinical stage (OR=2 .59 ,95% CI:2 .04-3 .30 ,P<0 .01) and histological grade(OR=2 .19 ,95% CI:1 .74-2 .75 ,P<0 .01) .Conclusion Aber‐rant PTEN expression might have strong impacts on carcinogenesis ,tumor progression ,invasion and prognosis ,which makes it a potential biomarker for early cancer screening and endocrine therapy in breast cancer .

Objective To evaluate the clinical efficacy and safety of compound polymyxin B ointment combined with desonide cream for the treatment of subacute or chronic eczema. Methods A multicenter, randomized, double?blind, parallel?group, controlled clinical study was conducted. Totally, 144 patients with subacute eczema and 144 patients with chronic eczema were enrolled into this study, and both randomly and equally divided into the test group and control group. The test group and control group firstly topically applied compound polymyxin B ointment and its vehicle respectively, then both topically applied desonide cream 3 hours later. The drugs or vehicle were applied twice a day in all the patients. Patients′ symptoms and signs (including degree of itching, inflammation, erosion/exudation and infiltration/thickening, as well as area of target lesions) were evaluated, and the time to onset and duration of itching?alleviating effect were recorded. The clinical efficacy and safety of treatments were analyzed and compared between the test group and control group. Results The total symptom and sign scores significantly decreased to different extents on days 7 and 14 in the test group(subacute eczema patients:6.09 ± 2.78 and 3.68 ± 3.18 vs. 13.44 ± 1.66; chronic eczema patients: 6.56 ± 2.68 and 4.38 ± 3.27 vs. 12.96 ± 1.16)and control group(subacute eczema patients:8.26 ± 3.17 and 5.28 ± 4.05 vs. 13.60 ± 1.75;chronic eczema patients: 8.84 ± 2.90 and 6.25 ± 3.78 and vs. 12.64 ± 1.18)compared with those at baseline. Moreover, the total symptom and sign score of patients with subacute or chronic eczema was significantly lower in the test group than in the control group on days 7 and 14(all P<0.05). A significant increment was observed in the degree of decrease in scores for itch, infiltration/thickening in patients with subacute eczema in the test group compared with that in the control group(all P<0.01), as well as in scores for itch, infiltration/thickening and area of target lesions in patients with chronic eczema in the test group compared with those in the control group (all P < 0.05). In addition, patients with subacute eczema in the test group showed significantly shorter onset and longer duration of itching?alleviating effect than those in the control group(both P<0.05). The time to onset of itching?alleviating effect was also significantly shorter in patients with chronic eczema in the test group than in those in the control group(P<0.000 1), but there was no significant difference in the duration of it between the two groups of patients with chronic eczema. Clinicians and patients were both more satisfied with therapeutic effects in the test group than in the control group(all P<0.05). Conclusions Topical compound polymyxin B ointment can increase the efficacy of topical desonide cream for the treatment of subacute or chronic eczema, especially subacute eczema. Compound polymyxin B ointment also shows a favorable therapeutic effect on itching and infiltration/thickening in patients with eczema.

Objective To systematically evaluate the association between vascular endothelial grow th factor‐C (VEGF‐C) ex‐pression in breast cancer tissue and clinical significance in the domestic patients with breast cancer by a Meta‐analysis .Methods The published case controlled trials on the VEGF‐C expression and the clinical manifestations of breast cancer were retrieved from the CNKI ,CBM ,VIP and Wanfang databases ,and other relevant journals were also manually retrieved to identify all the relevant case controlled trials .The retrieval year limit was from the database establishment to June 2014 .The included literatures were screened according to the inclusion and exclusion standards and the quality of included case controlled trials was assessed .The Rev‐Man 5 .2 software was used to conduct the Meta analysis .Results A total of 15 case controlled trials involving 975 patients with breast cancer were included .The Meta analysis results revealed that there were statistical differences in the VEGF‐C expression be‐tween the breast cancer group and the control group[OR = 8 .16 ,95% CI(5 .77 ,11 .54)] ,between the lymph node metastasis posi‐tive group and the non‐lymph node metastasis negative group[OR = 5 .19 ,95% CI(3 .63 ,7 .44)] and between the clinical stage Ⅰ -Ⅱ group and the stage Ⅲ - Ⅳ group[OR = 0 .35 ,95% CI(0 .21 ,0 .59)] ;the difference in the VEGF‐C expression between the 0 - <50 years group and the ≥ 50 years group had no statistical significance ,indicating that the VEGF‐C expression had no obvious as‐sociation with the patient′s age .Conclusion The present evidences reveal that VEGF‐C maybe participate in the development and progression process of lymph node metastasis of breast cancer and may be become an important factor influencing the prognosis of breast cancer .

Objective To investigate the association between the genetic variant in the promoter region of miR-34b/c and cancer risk.Methods Databases such as PubMed、EMBase、Wanfang、VIP、CNKI and so on were searched comprehensively.Based on the including and excluding criteria,literatures that were eligible were screened and data were retrieved.Meta analysis was performed by RevMan 5.1 software.Results Through searching and manually searching relevant references,a total of 9 articles with 10 independent studies were included.No significant associations were detected in C vs T,CC vs TT,CC + CT vs TT and CC vs CT + TT comparison models.However,in the CT vs TT comparison model,the result showed a significant association (Z =2.33,P =0.02).Meanwhile,subgroup analysis of hepatocellular carcinoma and colorectal cancer both showed significant associations with the polymorphism,with C vs T (OR =1.11,Z =2.10,P =0.04),CT vs TT (Z=2.40,P =0.02),CC +CT vs TT (Z=2.45,P=0.01) and CC vs TT (OR =0.66,Z=2.43,P=0.02),CC vs CT + TT (OR =0.67,Z =2.40,P =0.02) respectively.The C allele increased significantly the susceptibility of hepatocellular carcinoma,and the CC genotype reduced significantly the susceptibility of colorectal cancer.Conclusion The genetic variant in the promoter region of miR-34b/c rs4938723 T ＞ C is significantly associated with the susceptibility of hepatocellular carcinoma and colorectal cancer.

Objective To systematically evaluate the risk of BRCA1 mutation in patients with triplenegative breast cancer (TNBC).Methods Articles about the association between the TNBC and BRCA1 mutation were retrieved from database,such as PubMed,CNKI,Wanfang,VIP and CBM databases.The odds ratio (OR) was used to evaluate the risk of BRCA1 mutation in TNBC compared with non-TNBC.Rev Man 5.2 software was applied to perform the Meta-analysis.Results A total of 23 articles were eligible for the Meta-analysis,including 1 104 patients with TNBC and 4 245 patients with non-TNBC.The pooled OR was 7.67 and 95％ CI(6.24,9.42),and the difference was statistically significant (Z =19.38,P ＜ 0.000 01).In the subgroup analysis about the race,the pooled OR for Asian was 6.67 and 95％ CI (4.98,8.95).The pooled OR for Caucasian was 8.83 and 95％ CI (6.61,11.80).There was statistically significant difference in the pooled OR between the Asian and the Caucasian (Z =14.74,P ＜ 0.000 01).Conclusion The patients with TNBC are 7.67 times more likely to have BRCA1 mutation compared with non-TNBC phenotype.Largesample randomized controlled trials are warranted to demonstrate the detection of BRCA1 mutation can be a conven-tional application in clinical for the patients with TNBC.