Objective:To explore the expressions of long non-coding RNA LINC00673 and ISG15 protein in pancreatic cancer and their clinical significances.Methods:The clinical data of 57 patients diagnosed as pancreatic ductal carcinoma (PDAC) at the Affiliated Cancer Hospital of Xiangya Medical College of Central South University from January 2014 to December 2018 were retrospectively analyzed. The relative expressions of LINC00673 in pancreatic cancer tissues and paracancerous normal tissues (within 3 cm from the edge of cancer tissues) were examined by using quantificational reverse transcription-polymerase chain reaction (qRT-PCR). The ISG15 protein expressions in pancreatic cancer tissues and paracancerous normal tissues were examined by using immunohistochemistry. The difference in LINC00673 expression between ISG15 protein positive and negative patients was compared. The correlation between LINC00673 and ISG15 protein expressions in pancreatic cancer was analyzed by Spearman rank correlation analysis. Moreover, the correlations of LINC00673 and ISG15 protein expressions with clinical stage and pathological classification of pancreatic cancer patients were analyzed.Results:The positive expression of ISG15 protein in pancreatic cancer tissues was 40.4% (23/57), which was higher than that in paracancerous normal tissues [15.8% (9/57)] ( χ2 = 7.90, P = 0.004), and the relative expression of LINC00673 in pancreatic cancer tissues was 0.99±0.36, which was lower than that in paracancerous normal tissues (1.26±0.41) ( t = 4.80, P < 0.001). For 23 (40.4%) ISG15-positive patients and 34 (59.7%) ISG15-negative patients, the relative expression of LINC00673 was 0.77±0.46 and 0.45±0.27 ( P < 0.001). Spearman analysis showed that there was a correlation between LINC00673 and ISG15 protein expressions ( ρ = -0.429, P = 0.001). The relative expression of LINC00673 decreased in patients with low differentiated or undifferentiated tumor, vascular invasion and lymph node metastasis (all P < 0.05), but there was no correlation between LINC00673 expression and patients' age, tumor site, preoperative CA199 level, and TNM stage (all P > 0.05); ISG15 protein expression increased in patients with low differentiated or undifferentiated tumor, TNM stage Ⅲ-Ⅳ, vascular invasion and lymph node metastasis (all P < 0.05), but there was no correlation between ISG15 protein expression and patients' gender, age, tumor site, and preoperative CA199 level (all P > 0.05). Conclusions:The expression of LINC00673 in pancreatic cancer is related to vascular invasion, tumor differentiation degree and lymph node metastasis, and the expression of ISG15 in pancreatic cancer is related to vascular invasion, tumor differentiation degree, lymph node metastasis and TNM stage. The combined detection of LINC00673 and ISG15 protein could be a valuable prognostic indicator for pancreatic cancer. The therapies targeting LINC00673 and ISG15 protein signaling pathways are expected to be a potential option for immunotherapy of pancreatic cancer.

Objective To evaluate the efficacy of high performance liquid chromatography (HPLC) for simultaneous determination of propofol and remifentanil concentrations in human plasma.Methods Methods Eighteen healthy volunteers of both sexes,aged 18-45 yr,weighing 52-81 kg,were enrolled in the study.Venous blood samples were collected,and the concentrations of propofol and remifentanil in human plasma were detected simultaneously by HPLC.The internal standard was thymol.Potassium dihydrogen phosphate 0.1 mol/L was added to the plasma and then the plasma samples were extracted with extract liquor (ethyl acetate ∶ hexane =4 ∶ 1,V/V).The analytical column was ZORBAX Eclipse XDB-C18 (4.6 mm×250 mm,5 μm).The mobile phase was methano ∶ 0.02 mol/L NaH2PO4 ∶ acetonitrile,the flow rate was 1.0 ml/min,the detection wavelength was 210 nm within 1-7 min,and 266 nm within 7-16 min,and the sample size was 20 μl.Linear regression analysis was performed by using the least-squares method.The specimens of the blood with the final concentration of remifentanil 1.00,5.00 and 20.00 ng/ml and propofol 0.50,2.00 and 10.00 μg/ml were obtained to determine the recovery,precision and stability.Results Linear regression equation of remifentanil was C=12.853 5Ai/As+0.084 8 (R2 =0.999 4),and this system showed a good linear relationship with the concentration of remifentanil ranged 0.5-40.0 ng/ml.Linear regression equation of propofol was C=8.554 3 Ai/As+0.029 1 (R2=0.998 6),and this system showed a good linear relationship with the concentration of propofol ranged 0.2-20.0 μg/ml.For both propofol and remifentanil concentrations,the relative recovery was within the range of 85％-115％,the absolute recovery was larger than 75％,and the relative standard deviation of intra-and inter-day precision and stability was less than 5％.The method was proved to meet the requirements of biological sample analysis.Conclusion For HPLC method established in this trial,the determination is sensitive,reproducible,rapid and simple,and it can be used for simultaneous determination of propofol and remifentanil concentrations in human plasma and for clinical pharmacokinetic research.

Objective To analyze the causes of infection after cesarean section.Methods 80 patients having infection after cesarean section from Jan.2008 to Jan.2013 in our hospital were studied.The clinical data were retrospectively analyzed.The nosocomial infection-related factors were observed and related factors were ana-lyzed by Logistic regression analysis.Results 80 cases of maternal infection occurs after cesarean section.The highest rate of infection was urinary tract infection and respiratory infection, accounting for 43.75%and 31.25%respectively.We found the possible factors related to infection after cesarean section induding operative time, the number of invasive procedures, premature rupture of membranes, and the use of antibiotics.Conclusions Knowing the factors related to infection and improving the operative skills of gynecologists can help to reduce the rate of infection after cesarean section.

Objective To observe the clinical effect of therapy of budesonide/formoterol powder for inhalation in treatment of adult with bronchial asthma.Methods 90 cases with bronchial asthma and were divided into observation group and control group randomly from February 2014 to February 2015.45 cases in each group.Control group was treated with budesonide inhalants +formoterol inhalants, observation group was given budesonide/formoterol powder inhalation.Changes of related indicators were followed up and recorded.Results After treatment, IL-5, IL-12 and IFN-γwere (60.2 ±9.7)pg/mL,(31.4 ±3.1)pg/mL,(1.6 ±0.2) ng/mL of observation group were better than control group (72.8 ±10.7)pg/mL,(38.5 ± 5.6)pg/mL,(2.3 ±0.3) ng/mL (P<0.05).After treatment,total effective rate in observation group was 68.9%, which was better than control group (48.9%)(P<0.05).Conclusion Clinical effect of budesonide/formoterol powder for inhalation in treatment of patients with bronchial asthma is accurate, and there is no obvious adverse reaction.

Objective To understand the cognitive level of urban and rural general practitioners in the concept, diagnosis and treatment of chronic obstructive pulmonary disease and to provide the basis for continuing medical education in basic level hospital for all general practitioners. Methods General practitioners from 21 urban community health service centers (group A) and 27 of the rural community health service centers (group B) were surveyed on chronic obstructive pulmonary disease knowledge through a anonymous questionnaire, the survey contents included five aspects of chronic obstructive pulmonary disease such as basic concept, diagnosis, grouping diagnosis, treatment on stable phase and acute exacerbation. Results The correct rates of five questions in group A were 25.89%, 17.26%, 5.58%, 4.06%, 18.78 and in group B were 8.97%, 8.55%, 5.13%, 4.27%, 17.52%. In chronic obstructive pulmonary disease concept and diagnosis, there was significant difference between two groups(χ2=21.99, P<0.05 and χ2=7.41, P<0.05) . Conclusion The level of the cognitive of COPD (chronic obstructive pulmonary disease) among the general practitioners is very poor, and is strong against to the management work of chronic obstructive pulmonary disease. We need more continuing medical ed-ucation on "the guidelines on diagnosis and treatment of chronic obstructive pulmonary disease " among the urban and rural general practitioners.

Objective To evaluate the clinical efficacy of Clostridium butyricum tablets in treatment of diarrhea in patients with hepatitis B-related liver cirrhosis.Methods Eighty-seven patients with hepatitis B-related liver cirrhosis and diarrhea were collected from Pujiang People' s Hospital in Zhejiang province during January 2011 and May 2013.According to random number table,patients were divided into Clostridium butyricum treated group (n =44) and control group (n =43).Both groups were given antiviral,liver support,jaundice-relieving and fluid infusion treatments,while patients in Clostridium butyricum group were given Clostridium butyricum tablets (2 tables per time,3 tables per day for 4 weeks) additionally.Diarrhea remission time,improvements in liver function and the complications were observed.Differences in measurement data were compared with t test,and enumeration data were compared with x2 test or rank-sum test.Results The total effective rate in Clostridium butyricum group was 95.45％ (42/44),while that in control group was 74.4％ (32/43) (Z =2.82,P ＜ 0.05).After 4 weeks of treatment,the improvements of alanine aminotransferase (ALT),aspartate transaminase (AST),total bilirubin (TBil),albumin (Alb) and Child-Pugh (CTP) score in Clostridium butyricum group were more marked than those in control group (t =2.13,2.57,4.83,5.93 and 3.30,P ＜ 0.01).Hepatic encephalopathy occurred in 2 patients in control group and none in Clostridium buayricum group.Conclusion Clostridium butyricum has significant curative effect on diarrhea in patients with hepatitis B-related liver cirrhosis,and it can also improve liver function and reduce the incidence of hepatic encephalopathy.

Objective To analysis the re-hearing expectations and the need for auditory training and the time of adaptation exchanges after cochlear implantation .Methods Sixteen cases of adult postlingual deafness, which were selected, from 2002 to 2011, were treated by cochlear implantation .9 cases participated in speech training right after cochlear implantation , and 7 cases didn ’ t participate in speech training .In the initial stage, the patients were given the tone and input hearing test with voice frequency in the natural environment.The auditory training was for 2 hours a day, which included single and combined training .The training method was comprehensive , including auditory speech perception , writing and verbal expression .The training focused on the coherence and clarity of oral Reading .One training course was 3 -10 weeks .The efficacy of the training with the combination of sound and the ability to adapt to society was analyzed . Results In 10 cases joining the training , 4 cases instantly began to auditory training after cochlear implantation and lasted for more than 5 weeks.1 case discontinuously trained for 4 weeks, and other 5 cases trained transiently ( less than 3 ~4 days ) .6 cases refused to participate in the training process after cochlear implantation .Assessed by the “the lowest auditory function test vocabulary”, the distinguish rate of 5 patients was 90.3%after training for more than 4 weeks, who gradually adapted to working and learning environment after 5-7 months, and gained normal communication after 1.5-2.0 years.The distinguish rate of 5 patients was 36.0%after training for several days , and 2 patients cannot accomplish the test .Besides, the 6 patients without participation the training program cannot finish the assessment for over 2 years after cochlear implantation.Conclusions Cochlear implantation provides patients with the possibility of re-hearing, and the postoperative training can help patients in communicating in social life .A variety of factors can affect the efficacy of re-hearing adult patients with post-lingual hearing after cochlear implantation .

Objective To explore the methods of auditory enlightenment and whole ability training in severe hearing impaired children with inner ear malformations and growth retardation .Methods Eleven severe hearing impaired children with inner ear malformations were chosen , and received the methods of multiple stimuli including auditory, vision, tactile sensation, large and fine motor and so on in order to train their skills including the response and discrimination of sounds , language , and cognition and so on .Results The abilities of hearing and sense were gradually establishment in children 3 months after the training .Seven children could perceive clearly sound , and finish the hearing examination after training 6-13 months so as to lay the foundation for behavioral responses after the cochlear implantation surgery .Two children finished the hearing assessment after the hearing compensation through the audiphone .Conclusions The methods of multiple stimuli in the different sense at the same time can promote the formation of auditory consciousness and auditory nerve loop in infants with inner ear malformations .

Objective To explore children with audition symptom as normal but heterophthongia impacting on the process of their growth , and try to find out the symptom of abnormal speech and hearing to prevent and cure early .Methods Fifty six children were selected at the age of 6 months to 8 years old whose development of audition and speech had not reached the normal norm and known their information relative growth factors such as medical history , present illness , family medical history and environment of growth inside out .We assessed the speech and audition of all cases by clinical objective and subjective audition test and they shown different level of audition damage .We provided different methods to prevent and cure disorders according to inducing factors .Results The characteristic of children , whose right and/or left ear had different damage ( earshot:35 -120 dB ) , usually could not arouse attention especially at early linguistic stage because of inapparent hearing and speech disorders .The delayed diagnosed audition problem already leaded that sixteen children from 4 -8 years old acquired the problems of inappropriate response to voice , simple and vague language and restricted study and twenty cases obtained no response to voice , delayed development of audition comparing with peers , and expressed their demand by body language until 2 to 4 years old until they sought medical advice .Neonatal audition had not passed first and second screen and the level of audition damage were at range of 20-90 dB; however , parents believed neonate could develop naturally when neonate grown up so that they attended training without consistency and worn hearing aid incontinuity .These kind of behavior leaded that neonate acquired medical treatment until 1.5 to 2 years and some reflections had been built up or delayed . Conclusions Children with a similar audition as normal children but heterophthongia are unapparent at early stage, but it will slight show out when they grow up .Parent should comprehend the children ’ s process of hearing and language development and try to find out language and hearing problem as earlier as possible .Early detection could decrease growth gab between children with audition problems and normal children .

Objective To investigate the pharmacokinetics of propofol when combined with remifentanil in patients with liver cirrhosis.Methods Ten patients (5 males, 5 females) with liver cirrhosis scheduled for endoscopic esophageal varix ligation (test group) and 10 cases (5 males, 5 females) with normal liver function scheduled for gastroscopy (control group), aged 18-55 yr, weighing 40-75 kg, were studied. The patients were unpremedicated. All the patients received iv injection of propofol 1.5 mg/kg and remifentanil 0.5 μg/kg, and 5 min later propofol 0.5 mg/kg and remifentanil 0.2 μg/kg was given again. Blood samples were taken from radial artery before administration and at 2, 5, 10, 15, 20, 30, 45, 60, 80 and 120 min after administration for determination of the plasma propofol concentration using gas chromatography-mass spectrography. The pharmacokinetic parameters were calculated using DAS 2.0 software.Results The pharmacokinetics of propofol was best described by a three-compartment open model. There was no significant difference in the distribution half-life, elimination halflife , terminal half-life, area under the curve and transfer rate constant between the two groups ( P ＞ 0.05) . The apparent volume of distribution of propofol and clearance were significantly increased in test group compared with control group (P ＜0.01) .Conclusion When propofol combined with remifentanil is used in patients with liver cirrhosis, the apparent volume of distribution of propofol and clearance are significantly increased, while no changes in the other pharmacokinetic parameters are found.