Objective To investigate the clinical value of extracellular volume(ECV)based on CT delayed phase in combination with pathologic indicators in predicting early recurrence of gastric mesenchymal tumors after surgery.Methods A retrospective case-control trial was conducted on the imaging,clinical and pathological data of 110 patients with gastric mesenchymal tumors who were surgically resected at the First Affiliated Hospital of Army Medical University from January 2011 to August 2022.They were 60 males and 50 females,at a mean age of 58±10 years.All of them received preoperative multiphase dynamic CT enhancement examination of the abdomen,and ECV value was calculated with the formula:ECV=(1-hematocrit)×(△HU tumor/△HU aorta).According to the postoperative recurrence within 24 months after surgery,they were divided into early recurrence group and non early recurrence group.Statistical indexes:① Consistency analysis.② The factors affecting early recurrence after resection of gastric mesenchymal stromal tumors were analyzed and a prediction model was conducted.Delong test was used to assess the predictive value of the model.Then a nomogram was plotted based on the combines model,and calibration curves were drawn to assess the efficacy of the column charts,and decision curve analysis(DCA)was adopted to assess the value of the model for clinical application.Results ① Consistency analysis.After 2 radiologists outlined the region of interest and obtained ECV value according to the above formula,The intraclass correlation coefficient(ICC)was 0.806.② For the 110 subjected patients,21 cases of them had early recurrence,and 89 one did not.Multivariate analysis showed that ECV value,risk degree,and tumor length were independent influencing factors for predicting early recurrence.Receiver operating characteristic(ROC)curve analysis indicated that the area under the curve(AUC)value of ECV,hazard degree,and tumor length diameter in predicting early recurrence was 0.838(95％CI 0.758～0.918),0.774(95％CI 0.656～0.892),and 0.700(95％CI 0.589～0.810),respectively,and the value of their combined model was 0.899(95％CI 0.811～0.987),which was higher than that of each independent model.The sensitivity and specificity of the combined model was 85.71％and 86.52％,respectively,and the optimal cutoff value was 0.19.Delong test revealed that there was statistical difference between the combined model and the clinical model established by the hazard level(Z=6.548,P＜0.001,95％CI 0.140～0.259).Calibration curve analysis suggested that the combined model had a better fit,and DCA displayed that the combined model had a better net benefit.Conclusion The model established by ECV combined with pathological indicators has good predictive performance and can be used as a more effective predictor of early recurrence of gastric mesenchymal tumors after surgery.

Objective:To compare the effect of various antigen retrieval methods in paraffin sections of renal biopsy tissue, and explore the best antigen retrieval method.Methods:Forty-five renal biopsy specimens were collected from the First Affiliated Hospital of Zhengzhou University, including lupus nephritis ( n=10), membranous nephropathy ( n=10), IgA nephropathy ( n=10) and amyloidosis glomerulopathy ( n=15). Five retrieval methods (including high pressure thermal retrieval combined with trypsin retrieval, microwave thermal retrieval combined with trypsin retrieval, high pressure thermal retrieval, microwave thermal retrieval and gastroprotease retrieval) were used for immunofluorescence staining of paraffin sections. Renal tissue specimens were divided into six groups according to different antigen retrieval methods, frozen section specimens used as a control group. The immunofluorescence semi-quantitative scores of paraffin sections of the five heat-repairing antigen methods and frozen sections were compared. Results:Immunofluorescence staining of hyperbaric thermal retrieval combined with trypsin retrieval group and microwave thermal retrieval combined with trypsin retrieval group were similar with those of frozen sections. Compared with the control group, there were no significant difference in the semi-quantitative immunofluorescence scores between the two groups (all P>0.05). However, Immunofluorescence staining of hyperbaric thermal retrieval, microwave thermal retrieval, pepsin digestion had significantly higher false negative rate than those of frozen sections. Compared with the control group, the difference in semi-quantitative immunofluorescence score was statistically significant (all P<0.05). Conclusion:High pressure heat retrieval combined with trypsin retrieval or microwave heat retrieval combined with trypsin retrieval is the first choice of antigen retrieval methods.

Objective: To study the role of alternative complement pathway overactivation in malignant nephrosclerosis. Methods: (1) Fifty patients with confirmed malignant nephrosclerosis by renal needle biopsy were enrolled. Meanwhile, twenty-five cases of time-zero renal needle biopsy were enrolled as control subjects. Enzyme linked immunosorbent assay (ELISA) was used to detect alternative complement pathway of the complement initiation factor B, positive regulation factor P, negative regulation factor H, and the complement end products C3a and C5a in the plasma and urine. (2) Immunohistochemistry was used to detect the deposition of the complement end product C5b-9, C4d and mannan binding lectin (MBL) of lectin pathway in the renal biopsies. Double immunofluorescence labeling method was used to assay the deposition of C5b-9 and CD34 (endothelial cell marker) in the arteriolar endothelium and glomerular capillary endothelium. Results: (1) The plasma and urine levels of complement factor B, factor P, C3a and C5a in malignant nephrosclerosis patients were significantly higher than those in control subjects (all P<0.05), while the plasma and urine levels of complement factor H in malignant nephrosclerosis patients were lower than those in control subjects (all P<0.05). (2) The plasma level of factor P was positively correlated with 24 h urine protein (r_s=0.465, P=0.001). Urinary factor B/urinary creatinine, urinary factor P/urinary creatinine and urinary C3a/urinary creatinine were positively correlated with serum creatinine in malignant nephrosclerosis patients (r_s=0.483, P<0.001; r_s=0.352, P=0.012; r_s=0.319, P=0.024), while urinary factor H/urinary creatinine was negatively correlated with serum creatinine and 24 h urine protein (r_s=-0.299, P=0.035; r_s=-0.342, P=0.015). Urinary C5a/urinary creatinine was positively correlated with serum creatinine and 24 h urine protein (r_s=0.525, P<0.001; r_s=0.496, P<0.001). (3) Immunohistochemical results showed that there were C5b-9 deposited in the arterioles and glomerular capillary wall in malignant nephrosclerosis patients, and no deposition in control renal tissues. Meanwhile, the semi-quantitative scores showed that C5b-9 deposition intensity was positively correlated with serum creatinine and 24 h urine protein (r_s=0.791, P<0.001; r_s=0.345, P=0.014). The double immunofluorescence labeling analysis showed that the C5b-9 and CD34 deposited in the arteriolar endothelium and glomerular capillary endothelium. (4) Plasma level of factor B in malignant nephrosclerosis patients was positively correlated with plasma C3a level (r=0.331, P=0.022). Plasma level of factor P was positively correlated with C5b-9 score (r_s=0.300, P=0.034). Urinary B was positively correlated with urinary C3a, C5a and C5b-9 score (r_s=0.311, P=0.028; r_s=0.465, P=0.001; r_s=0.428, P=0.002). Urinary factor P was also positively correlated with urinary C3a and C5a (r_s=0.307, P=0.030; r_s=0.442, P=0.001). Immunohistochemical result showed that there were C4d deposited in the arterioles and glomerular, and no deposition of MBL. Conclusion Complement activation via the alternative pathway may be involved in malignant nephrosclerosis and related to the severity of the disease.

OBJECTIVE: To investigate the expression of CDC25A in non- small cell lung cancer (NSCLC) tissues and explore its correlation with the clinicpathological features of the patients and the expressions of let-7a1 and let-7c. METHODS: We collected surgical specimens of pathologically confirmed NSCLC tissues and paired adjacent lung tissues from 44 patients and tissues of benign lung lesions from 9 patients. The expressions of CDC25A protein and mRNA in the tissues were detected by immunohistochemistry and fluorescence quantitative RT-PCR, respectively; the expressions of let-7a1 and let-7c mRNA were detected using tail-adding fluorescence quantitative RT-PCR. RESULTS: The positivity rate of CDC25A protein expression was significantly higher in NSCLC tissues than in the adjacent tissues and benign pulmonary lesions ( CONCLUSIONS The expression level of CDC25A is significantly increased in NSCLC with a negative correlation with Let-7c expression, which identifies CDC25A as a possible downstream target gene of Let-7c.
Carcinoma, Non-Small-Cell Lung/genetics* ; Gene Expression Regulation, Neoplastic ; Humans ; Lung ; Lung Neoplasms/genetics* ; Lymphatic Metastasis ; MicroRNAs ; RNA, Messenger/genetics* ; cdc25 Phosphatases

Objective To investigate the effect of active abdominal compression-decompression cardiopulmonary resuscitation (AACD-CPR) in patients with pre-hospital respiratory and cardiac arrest.Methods Forty-five patients with respiratory and cardiac arrest,and with contraindication of chest compression admitted to Baiyin Central Hospital of Gansu Province from March 2012 to September 2018 were enrolled,and they were divided into two groups according to random number table.AACD-CPR (abdominal compression-decompression group,n =24) and cardiopulmonary resuscitation (CPR) with unarmed abdominal compression (unarmed abdominal pressure group,n =21) were performed respectively.The success rate of rescue was observed in the two groups,and the changes in heart rate (HR),pulse oxygen saturation (SpO2) and blood pressure 30 minutes after CPR in patients with restoration of spontaneous circulation (ROSC) were observed.Results Among the 24 patients in the abdominal compression-decompression group,5 patients (20.83％) had ROSC,and 2 patients (9.52％) had ROSC in 21 patients of the unarmed abdominal pressure group.The success rate of resuscitation in the abdominal compression-decompression group was significantly higher than that in the unarmed abdominal pressure group (P ＜ 0.05).HR of ROSC patients at 30 minutes of CPR in abdominal compression-decompression group was significantly lower than that in unarmed abdominal compression group (bpm:139.45±5.08 vs.147.62±5.24,P ＜ 0.05),and SpO2 and blood pressure were significantly higher than those in unarmed abdominal compression group with significant differences [SpO2:0.92 ± 0.03 vs.0.85 ± 0.03,systolic blood pressure (SBP,mmHg,1 mmHg =0.133 kPa):118.23 ± 3.26 vs.98.51 ± 3.10,diastolic blood pressure (DBP,mmHg):60.10 ± 2.50 vs.56.36 ± 2.45,all P ＜ 0.05].Conclusion The effect of AACD-CPR was superior to that of unarmed abdominal pressure CPR,which had higher application value to rescue patients with respiratory and cardiac arrest with chest pressure contraindication.

Objective To investigate the survival status of people with disabilities in urban areas of Lanzhou, China and discuss the correlation of their quality of life to disability attitude and quality of care and support of disabled people. Methods From August to November, 2016, 606 persons with disability registered in Chengguan District of Lanzhou were selected by multistage stratified cluster sampling. They were investigated in home-based visit with World Health Organization Quality of Life-Disability Scale for physical disability, World Health Organization-Disability Attitude Scale and World Health Organization Quality of Care and Support Scale-Disability Scale. Results The quality of life scored in average of (40.76±14.79), and different with the demographic characteristics (P<0.05). Pearson's correlation analysis showed that the score in all fields of quality of life and the total score positively correlated with most dimensions of disability attitude score (r>0.080, P<0.05) and most dimensions score of quality of care and support (r>0.083, P<0.05).Conclusion It is important to strengthen the precise security system for people with disabilities, and strive to establish a full-cycle, all-round social support system for them.

Objective To analyze the distribution and drug resistance of Streptococcus pneumoniae in 0-14 year old children of 0 to 4 year-old in theour hospital.Methods S.pneumoniae were identified by using ma-trix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS).Drug suscepti-bility test was performed by using ATB STREP 5 for each isolate.Penicillin G minimum inhibitory concentra-tion (MIC) was performed by using E-test.Results A total of 327 strains of S.pneumoniae were isolated,a-mong which 287(87.8%)were from sputum,25(7.6%) from the ear secretions,10(2.9%) from the nasal sinuses puncture fluid,and 3(0.9%)from the blood.The most strains were isolated in spring(28.4%),and the least in winter (22%),and there was no significant difference in the separation rate among the four sea-sons (P<0.05).The sensitivity rate,intermediate rate and drug resistant rate of non meningitis S.pneumoni-ae strains to penicillin G were 97.9%,0.6%,1.5%,respectively.The resistance rates of the bacteria to eryth-romycin,clindamycin,compoundtrimethoprim sulfamethoxazole and tetracycline were relatively high,a small number of levofloxacin resistant strains were found,and vancomycin and quinopin /Dafoe-P resistant strains were not detected.The resistance rates of penicillin G,penicillin resistant Streptococcus pneumoniae (PRSP) and penicillin inter mediated Streptococcus pneumoniae (PISP)to amoxicillin and cefotaximeto were markedly higher than that of penicillin G sensitive Streptococcus pneumoniae (PSSP),and the difference was statistically significant (P<0.01).A total of 227 strains of multidrug resistance Streptococcus pneumoniae (69.4%)were isolated,which were resistant to erythromycin,tetracycline,trimethopri compoundm-sulfamethoxazol and clin-damycin(46.2%).Conclusion The drug resistance monitoring of Streptococcus pneumoniae in children can not be ignored.The drug resistance of the bacteria to penicillin G is low.Penicillin G is still a cheap and effec-tive drug for the treatment of Streptococcus pneumoniae infection.

OBJECTIVE: To identify and analyze drug sensitivity of Corynebacterium glucuronolyticum iscolated from clinic, and to provide reference for clinical drug use. METHODS: Two strains isolated from the urine specimens of urolithiasis-induced urinary tract infection patients in our hospital were inoculated into Columbia blood plate and the MacConkey plate. The growth of strains was observed and counted. Protein mass spectrometry of strains was detected by MALDI-TOF-MS. DNA of strains was extracted, and PCR was used to amplify the 16S ribosome RNA (rRNA) sequence. Bi-directional sequencing of 1 500 bp target bands was conducted. Blast comparison between it and GenBank database was conducted to identify bacterial strain. Drug resistance of 2 strains was monitored by Etest assay. RESULTS: Two strains grew on the Columbia blood plate (with colony forming unit ＞105 CFU/mL) and did not grow on the MacConkey plate. Two strains were Gram-positive Corynebacterium and showed palisading or eight type arrangement. Two strains were C. glucuronolyticum by MALDI-TOF-MS identification, with reliability of 99. 9％. The characteristic peaks of m/z 2 431, 3 089, 3 364, 3 378, 4 200, 5 508, 6 302, 6 637, 6 730, 6 946, 12 603 appeared. Blast comparison showed that the sequence homology of 2 strains compared with C. glucuronolyticum strain known in GenBank were higher than 98 ％. Results of drug sensitivity test showed that strain 1 was resistant to ceftriaxone and ciprofloxacin, and sensitive to 14 other antibiotics as penicillin G; strain 2 was resistant to ceftriaxone, erythromycin, ciprofloxacin, tetracycline and clindamycin, moderately sensitive to cefotaxime, and sensitive to 10 other antibiotics. CONCLUSIONS: Two strains are C. glucuronolyticum, and drug resistance of them to commonly used antibiotics is different. The strains are rare pathogen of urinary tract and show multidrug resistance. Antibiotics should be selected according to the results of strain identification and drug sensitivity test.

Objective To investigate the clinical value of cardiopulmonary resuscitation (CPR) with abdominal lifting and compression on patients with breathing and cardiac arrest induced by severe chest trauma.Methods Sixty-six breathing and cardiac arrest patients induced by severe chest trauma admitted to the General Hospital of Jingyuan Coal Industry Group Company from October 2011 to October 2016 were enrolled,and they were divided into abdominal lifting and compression group (n =32) and unarmed abdominal compression group (n =34) by random number table.The patients in both two groups were given the airway open,respiration support,defibrillation treatment,venous access establishment,vasoactive drugs application and other conventional treatments.On the basis of the routine treatment,the patients in abdominal lifting and compression group were given application of abdominal lifting and compression device with 100 times/min frequency and continuously alternating press down to lift the abdomen,the amplitude of pressing and pulling were 3-5 cm below or above the original level of the abdomen.Those in unarmed abdominal compression group were given abdominal CPR pressing method by hand,the frequency of pressing and depth of subsidence was the same as abdominal lifting and compression group.Heart rate (HR) and arterial blood gas at 30 minutes after CPR as well as the success rate of resuscitation were compared between the two groups.The changes in HR,mean arterial pressure (MAP) and pulse oxygen saturation (SpO2) before and 30 minutes and 60 minutes after CPR were dynamically observed in patients with restoration of spontaneous circulation (ROSC) after abdominal lifting and compression CPR treatment.Results Compared with the unarmed abdominal compression group,HR (bmp:136.13±6.14 vs.148.45±5.16) and arterial partial pressure of carbon dioxide [PaCO2 (mmHg,1 mmHg =0.133 kPa):48.51 ±2.60 vs.62.51 ±2.50] at 30 minutes after CPR in abdominal lifting and compression group were significantly lowered,and arterial partial pressure of oxygen (PaO2) was significantly increased (mmHg:88.07±3.92 vs.74.12±2.12,all P ＜ 0.05).Four patients with ROSC were found in abdominal lifting and compression group,and 2 in unarmed abdominal compression group.The success rate of resuscitation in abdominal lifting and compression group was significantly higher than that of unarmed abdominal compression group (12.50％ vs.5.82％,P ＜ 0.05).In 4 patients with ROSC after abdominal lifting and compression CPR showed a downward trend in HR and an upward trend in MAP and SpO2 with CPR time prolongation.Conclusions The effect of abdominal lifting and compression CPR is better than that of unarmed abdominal compression CPR,which is of great value for the life saving of patients with breathing and cardiac arrest induced bv severe chest trauma.

Obejective To explore the diagnostic and curative evaluation value of gastrin-releasing pep-tide precursor (ProGRP) and neuron specific enolization enzyme (NSE) in small cell lung cancer (SCLC). Methods Sixty SCLC patients, sixty non-small cell lung cancer (NSCLC) patients and forty patients with be-nign pulmonary disease were collected fromJanuary 2014 to October 2015. The levels of serum ProGRP and NSE in all patients were determined by ELISA method and radioimmunoassay respectively then the clinical value of ProGRP and NSE on SCLC was evaluated. Results The levels of ProGRP and NSE in SCLC group were signif-icantly higher than those in NSCLC group and those in lung benign disease group (P < 0.05). The levels of Pro-GRP and NSE in extensive stage were higher than those in limited stage in SCLC group (P < 0.05). The bound-ary value of SCLC through ProGRP identified through ROC curve was 64.68 pg/mL. The diagnostic sensitivity , specific degree and Youdenindex of ProGRP in SCLC were 86.7%, 97.5% and 0.842 respectively, which were significantly higher than NSE (P < 0.05). After 2 cycles of chemotherapy, serum ProGRP in SCLC disease con-trol groupwere significantly decreased(P < 0.05) but on difference of serum ProGRP was found in SCLC progres-siongroup (P > 0.05). Conclusion ProGRP and NSE can be used as markers for the diagnostic and curative evaluation of SCLC. And ProGRP has higher sensitivity and specificity than NSE and can be promoted in clinic.