Objective To investigate the relationship between cyclin A2 (CCNA2) and the prognosis of colon cancer, and its possible mechanism from the perspective of immune infiltration. Methods We downloaded the transcriptome data of colon cancer patients from The Cancer Genome Atlas database. Clinicopathological feature analysis and survival analysis were performed based on the expression levels of CCNA2. A total of 75 specimens of colon cancer and normal tissues were collected, and the expression level of CCNA2 was analyzed using immunohistochemical methods. Multivariate analysis was conducted to explore its relationship with clinicopathological features. Gene Set Enrichment Analysis (GSEA) was used to assess the potential molecular functions of CCNA2 in colon cancer. CIBERSORT algorithm was applied to calculate the correlation between CCNA2 and immune-cell infiltration in colon cancer. Results Database and immunohistochemical analyses indicated that CCNA2 was expressed at a significantly higher level in colon cancer tissues than normal tissues (P<0.001). The overall survival, disease-specific survival, and progression-free interval were all longer in the group with high CCNA2 expression than the group with low expression (all P<0.05). In tumor tissues, the expression level of CCNA2 decreased with increased pathological and TNM stages (P<0.05). The expression level of CCNA2 in normal tissues was consistently lower than that in colon cancer tissues across all clinical stages (all P<0.001). GSEA suggested that Wnt/β-catenin, KRAS, and other signaling pathways were enriched when CCNA2 was lowly expressed. CIBERSORT analysis revealed an increase in the infiltration of immune cells such as regulatory T cells and macrophages M0 when CCNA2 expression was low. Conclusion CCNA2 is highly expressed in colon cancer and closely associated with grade of pathology and TNM stage. It may recruit regulatory T cells through the KRAS and Wnt/β-catenin pathways, thereby reducing immune-cell infiltration and promoting colon cancer progression, leading to poor prognosis.

Objective To evaluate the efficacy of pulmonary surfactant(PS)in the treatment of acute respira﹣tory distress syndrome(ARDS)in the infants after congenital heart disease(CHD)operation. Methods The trial Was conducted from January 2012 to June 2017 in FuWai Hospital,and 90 infants Who had ARDS after cardiac surgery Were enrolled. They Were divided into 2 separate groups,PS group(conventional therapy +PS treatment,43 cases)and con﹣trol group(conventional therapy,47 cases). The clinical data,including age,body Weight,risk adjustment for congenital heart surgery 1(RACHS－1)degree,cardiopulmonary bypass( CPB)time,aortic occlusion time,mechanical ventila﹣tion time,intensive care unit(ICU)care time,mortality,complications,partial pressure of oxygen[pa(O2 )],fraction of inspiration O2(FiO2 )and pa(O2 )／FiO2(P／F),Were collected and analyzed. Results The average age,body Weight, RACHS－1 degree,CPB time and aortic occlusion time had no difference betWeen the 2 groups(P＞0. 05). After 24 h of treatment,pa(O2 )in PS group Was(94. 76 ± 13. 25)mmHg(1 mmHg﹦0. 133 kPa),Which Was significantly higher than that in control group[(67. 59 ± 7. 47)mmHg](P﹤0. 01). P／F in PS group Was 170. 37 ± 20. 62,Which Was sig﹣nificantly higher than that in control group(102. 65 ± 15. 29)( P﹤0. 01),While FiO2 in PS group Was(55. 18 ± 6. 89)%,Which Was significantly loWer than that in control group[(68. 59 ± 9. 59)%](P﹤0. 01). The mean me﹣chanical ventilation time[(194. 39 ± 26. 30)h]and ICU care time[(11. 64 ± 3. 26)d]of the experimental group Were shorter than control group[(288. 63 ± 26. 42)h and(16. 65 ± 4. 18)d],and the differences Were statistically significant(P﹤0. 01). Eight deaths occurred,PS group had 1 infant dead,and the control group had 7 deaths,so the mortality in PS group Was 2. 32%,loWer than that in control group(14. 89%),and the difference Was statistically sig﹣nificant(P﹤0. 01). Postoperative complications occurred in 23 patients,of Which PS group had 9 cases postoperative complications and control group had 15 cases,so the incidence of complications in PS group Was 20. 93%,loWer than that in control group(31. 91%),and the difference Was statistically significant(P ﹤0. 01). Conclusions PS has good efficacy in treating ARDS in infants With ARDS after congenital heart disease operation.

Objective To evaluate the efficacy of pulmonary surfactant (PS) on severe acute respiratory distress syndrome (ARDS) in different age baby with congenital heart disease. Methods We divided 43 baby patients into two separate groups including a little baby group (12 patients with age less than 3 months) and an infants group (31 patients with age of 3 months to one year). Both groups of patients were treated with intratracheal PS at the same time. The clinical data were collected and analyzed. Results The little baby group had lower body weight. There was no statistical difference in the cardiopulmonary bypass (CPB) time, operation blocking time, mechanical ventilation time, ICU stay time between the two groups (P>0.05). Before treatment, arterial partial presurre of oxygen (PaO2), fractional oxygen concentration in inspire gas (FiO2), the ratio of arterial PO2 to the inspired oxygen fraction (P/F) and arterial-alveolar N2 difference or gradient (a/A) had no difference between the two groups (P>0.05). After treatment, PaO2 and P/F of both groups were significantly lower than before (P<0.05), and FiO2 and P/F were significantly higher than before (P<0.05). After 24 h of treatment, PaO2 and P/F of the little baby group was significantly higher than that of the infants group (P<0.05), and FiO2 and P/F were significantly lower than those of the infants group (P<0.05). Conclusion PS treating severe ARDS in little baby with congenital heart disease has better effect than infants.

Objective To investigate the clinical effect of combined treatment of upper gastrointestinal bleeding in emergency internal medicine. Methods A total of 102 patients with upper gastrointestinal bleeding were enrolled in the Department of Emergency Gastroenterology, Peking Binhai University Hospital from June 2014 to October 2016. The patients were randomly divided into observation group and control group, 51 cases in each group.The control group were only given omeprazole sodium, tranexamic acid injection,the observation group were given Agkistrodon hemocoagulase for injection on patients on the basis of the control group.After treatment, the clinical curative effect of two groups of patients were evaluated, the hospitalization days, the average hemostasis time, blood transfusion, bowel recovery time, abdominal pain relief time, the adverse reactions occurred of the two groups were observed.Results The total effective rate of the observation group was significantly higher than that of the control group (P< 0.05). The hemostasis time,the time of hospitalization and the average blood transfusion in the observation group were significantly lower than those in the control group (P<0.05). The recovery time of bowel and the time of pain relief in the observation group were significantly lower than in the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the observation group and the control group.Conclusion Comprehensive treatment of upper gastrointestinal bleeding with emergency internal medicine can significantly improve the clinical efficacy, shorten the time of hemostasis and recovery, and is worthy of clinical application.

Objective To summarize 500 cases of surgical experience in restoration of adult congenital heart disease ( ACHD) treatment and early postoperative.Methods During January 2012 to December 2014 in Fuwai Hospital, 500 cases of ACHD treated by operation were chosen to collect the clinical data .We divided the groups according to whether the case was a complex malformation and whether the case had an ICU retention time is more than the 5 days.Results The average age was 35, the average weight was 59 kg.The operation average cardiopulmonary bypass(CPB) time was 102min.The average ICU treatment time was 2 days, the average duration of mechanical ventilation was 23 hours, 3 early deaths occurred.The complex malformation group had younger age and less weight than the simple malformation group , the complex malformation group had longer time of cardiopulmonary bypass time, aortic cross clamping time, mechanical ventilation time and ICU treatment time, had higher rate of complication and blood transfusion peri-operative period than the simple malformation group.(P<0.05) The group of ICU retention time less than 5 days had higher rate of the male proportion, had younger age and less weigh, had longer time of cardiopulmonary bypass time , mechanical ventilation time and ICU treatment time , had higher rate of complication and blood transfusion peri-operative period than the control group(P <0.01).Conclusion Although ACHD patients have long medical history and complicated pathological and physiological changes , when they get proper surgical operation and periopera-tive treatment, they should obtain satisfied effect.Professional medical team or organization service for the ACHD patient is very important and urgent to build.

This study was aimed to observe the effect of Tao-He Cheng-Qi Decoction (THCQD) on tissue injury of different organs among rats with sepsis. A total of 100 Kunming male SD rats of clean grade were randomly divided into five groups, which were the normal control group, model 6 h control group, model 12 h control group, THCQD 6 h group and THCQD 12 h group. The normal control group received no treatment. The classic CLP method was ap-plied in the establishment of sepsis rat model in other groups. Intragastric administration of saline 1 ml/100 g (weight) was given to each rat in the model group every day. Intragastric administration of THCQD 1 ml/100 g (weight) was given to each rat in the THCQD group every day. The model was established after 7 days. Tissue speci-mens of lung, heart, kidney, liver, and small intestine were collected at 6 h and 12 h after modeling, respectively. Pathomorphological changes of each group were observed by light microscopy and electron microscope. The results showed that compared with the model group at the same time point, pathomorphological changes of tissues of the lung, heart, kidney in THCQD group were not significant. However, pathomorphology of tissues of the liver and small intestine changed significantly in the THCQD 12h group. And there were statistical differences (P < 0.05) between two groups in the score of pathomorphology. It was concluded that THCQD had protective effect on tissues of the liv-er and small intestine among rats with sepsis. However, the mechanism is not clear and requires further research.

Data mining technology is called into play to comb and excavate data in the hospital information system(HIS)for the purposes of hospital management and patient safety.Data tables in the electronic medical record system were effectively remodeled as necessary.These measures help build a medical quality surveillance system which is based on the electronic medical record system,with such functions as real-time monitoring and pre-warning.The control framework consists the critical cases control system,surgery and invasive operation control system,overall control system,and TCM strengths application control system.

This study examined the effect of subcellular localization of P21 on the proliferation and apoptosis of HepG2 cells. The coding genes of the wild and the mutant P21 were amplified by mega primer PCR from the plasmid pCEP-WAF1 which contains human P21 cDNA in the nuclear localizational signal (NLS) sequence, and then inserted into the eukaryotic expression vector pDsRed1-C1. The recombinants were transfected into HepG2 cells. The transcription and expression of P21 were determined by RT-PCR and fluorescence microscopy. The cell proliferation was measured by MTT, and the cell cycle and apoptosis of HepG2 cells by flow cytometry. The results of restriction analysis, DNA sequencing and fluorescence microscopy confirmed the construction of the wild and the mutant P21 in the eukaryotic expression plasmid. The plasmid containing the mutant P21 was found to accelerate cell proliferation and the wild P21 plasmid to inhibit cell proliferation. Cell cycle analysis showed that the cell ratio of G(0)/G(1) in the wild type group was significantly increased as compared with that in the mutant type group, and cell apoptosis analysis revealed that the apoptosis rate in the wild type group was much higher than that in the mutant type group. It was concluded that the subcellular localization of P21 may contribute to the development of hepatic cancer.

This study examined the effect of subcellular localization of P21 on the proliferation and apoptosis of HepG2 cells.The coding genes of the wild and the mutant P21 were amplified by mega primer PCR from the plasmid pCEP-WAF1 which contains human P21 cDNA in the nuclear localizational signal (NLS) sequence,and then inserted into the eukaryotic expression vector pDsRed1-C1.The recombinants were transfected into HepG2 cells.The transcription and expression of P21 were determined by RT-PCR and fluorescence microscopy.The cell proliferation was measured by MTT,and the cell cycle and apoptosis of HepG2 cells by flow cytometry.The results of restriction analysis,DNA sequencing and fluorescence microscopy confirmed the construction of the wild and the mutant P21 in the eukaryotic expression plasmid.The plasmid containing the mutant P21 was found to accelerate cell proliferation and the wild P21 plasmid to inhibit cell proliferation.Cell cycle analysis showed that the cell ratio of G0/G1 in the wild type group was significantly increased as compared with that in the mutant type group,and cell apoptosis analysis revealed that the apoptosis rate in the wild type group was much higher than that in the mutant type group.It was concluded that the subcellular localization of P21 may contribute to the development of hepatic cancer.