Objective To explore the value of preoperative detection of soluble fragments of cytokeratin-19 (CYFRA21-1), carcinoembryonic antigen (CEA), and postoperative detection of nuclear proliferation associated antigen Ki67 in prognostic evaluation of non-small cell lung cancer patients. Methods The clinicopathological data and follow-up results of patients with non-small cell lung cancer treated in the Department of Thoracic Surgery of the First Affiliated Hospital of Xiamen University in 2017 were collected. CYFRA21-1>3.39 ng/mL was defined as positive, and CEA>5 ng/mL was defined as positive. The receiver operating characteristic curve (ROC curve) of Ki67 expression level was drawn. The maximum area under the curve (AUC) was the cutoff value of Ki67 expression level, and the Ki67 expression level greater than its cutoff value was defined as positive. Cox regression analysis was used to determine the independent risk factors for poor prognosis in patients with non-small cell lung cancer. Results Finally 248 patients were collected, including 125 males and 123 females, with a median age of 61 years (ranging from 30 to 81 years) at the time of surgery. Univariate analysis showed that positive CYFRA21-1, high expression of Ki67, positive CEA, age≥60 years at operation, distant metastasis, lymph node metastasis, maximum tumor diameter>3 cm, and TNM stage Ⅲ were associated with poor prognosis in patients with non-small cell lung cancer. When combined detection of preoperative tumor markers and postoperative Ki67, the prognosis of all negative patients was the best, and that of all positive patients was the worst. Cox regression analysis showed that positive CEA+positive CYFRA21-1+high expression of Ki67 was an independent risk factor for poor prognosis in patients with non-small cell lung cancer (P<0.05). Conclusion The combined detection of preoperative serum CYFRA21-1, CEA, and postoperative Ki67 has important value in evaluating the prognosis of non-small cell lung cancer patients.

Objective:To investigate the association between pulse pressure(PP) and new-onset diabetes in overweight and obese people.Methods:A prospective cohort study was conducted in overweight or obese participants selected from Kailuan Study who underwent 2006-2007 annual checkup and met the inclusion and exclusion criteria. PP was calculated by blood pressure and participants were divided into 4 groups according to PP quartile. The cumulative incidence of new-onset diabetes of different PP groups was calculated by Kaplan- Meier method and compare by Log- Rank test. The multivariate Cox proportional hazards model was used to analyze the association between different PP groups and new-onset diabetes. Results:During an average follow-up of 8.45 years, 8 922 diabetes was identified. The cumulative incidence rate of the Q1, Q2, Q3, and Q4 groups were 22.12%, 24.48%, 27.97%, and 33.44% respectively, which were statistically different( χ2=368.16, P<0.01). Cox proportional hazards regression analysis showed that after adjusting for multiple confounding factors, compared with Q1 group, the hazard ratio for diabetes in Q2, Q3, and Q4 groups were 1.07(1.00-1.14), 1.13(1.05-1.21), and 1.17(1.09-1.27) respectively. And the HR of diabetes event in pulse pressure(per 1 SD increase) was 1.04(1.02-1.07). Similar results were found in participants who were over-weight, obese, with normal blood pressure or hypertensive without drugs use. Conclusion:PP is positively correlated with the new-onset diabetes. High PP is one of the risk factors for developing diabetes in overweight and obese people.

Scar, especially pathological scar, not only cause cosmetic concerns, but also affect the physiological function of related tissues or organs, leading to malformation and dysfunction, that will seriously affect the quality of patients’ life. Nowadays, there are many ways to prevent and improve scar. Local topical medicine such as silicone-based products and plant extracts, become more and more popular with patients because of convenience and reasonable price. In this review, the topical agents for the prevention and improvement of scar, and their therapeutic mechanisms were summarized, providing ideas for the treatment of scar with topical agents.

Scar, especially pathological scar, not only cause cosmetic concerns, but also affect the physiological function of related tissues or organs, leading to malformation and dysfunction, that will seriously affect the quality of patients’ life. Nowadays, there are many ways to prevent and improve scar. Local topical medicine such as silicone-based products and plant extracts, become more and more popular with patients because of convenience and reasonable price. In this review, the topical agents for the prevention and improvement of scar, and their therapeutic mechanisms were summarized, providing ideas for the treatment of scar with topical agents.

Madelung′s disease is a rare lipid metabolic disorder with unclear mechanism, characterized by the formation of diffuse uncapsulated lipomas in face, neck, shoulder and other body areas. This disease mainly affect middle-aged male, and is related to alcohol abuse. The treatment nowadays is only palliative surgery with a high recurrence rate, including lipectomy and liposuction. Both of them have advantages and disadvantages.

Objective To investigate the toxicity of urban PM2.5 in Guangzhou on PC-12 cells.Methods PM2.5 was collected in Guangzhou city.PC-12 cells were cultured in vitro and divided into several groups,including the control group,PM2.5 groups with different concentrations and NAC pretreated group (pretreaed with 10 μmol/mL NAC followed with 100 μg/mL PM2.5 exposure).Cells were incubated with indicated stimulator for 24 h,then cell viability was checked with cell counting Kit-8 assay,the level of intracellular ROS was labeled using H2DCFDA fluorescence probe,cell apoptosis was measured by the flow cytometry and the expression of apoptosis-related proteins,including Cytochrome C,Caspase 9,Caspase 3 and PARP,were detected by Western Blot assay.Results PM2.5 has a strong toxicity on PC-12 cells when its concentration is over 25 μg/mL.After exposure for 24 h,the cell viability was markedly decreased.The results of flow cytometry and Western blot assay showed that PM2.5 enhanced the apoptosis of PC-12 cells with the upregulatios of Cytochrome C,Caspase 9,Caspase 3 and PARP.Pretreatment with NAC could significantly diminish PM2.5-induced PC-12 cell toxicity,decreased ROS generation and apoptosis of PC-12 cells,with the down regulations of apoptosis-related proteins.Conclusion PM2.5 can cause apoptosis of PC-12 cells by inducing oxidative stress,upregulating the Cytochrome C expression and activating Caspase9/3,which may be one of the mechanisms underlying PM2.5-induced neurotoxicity.

Objective To explore the bone mineral density (BMD) status and its influencing factors in schizophrenia patients in order to provide basis for risk assessment in psychiatric nursing.Methods A total of 1,139 hospitalized schizophrenia patients were recruited and assigned into the medication group (n=652) and the non-medication group (n=487) according to previous antipsychotic drug history.T-score and Z-score of BMD were determined using Sunlight Omnisense 7000S Bone Densitometry.Blood calcium,blood phosphorus and serum prolactin levels were measured using fasting blood of ulnar vein.Results Differences in age,BMD,milk intake,level of activity,level of smoking,history of fall,history of fracture,serum Ca2+ and PRL were statistically significant between two groups(P＜0.05);there were significant differences in BMD rank distributions among schizophrenia patients with different courses of disease and lengths of taking antipsychotics (P＜0.001);multiple linear regression showed that influencing factors of BMD with statistical significance were courses of disease,lengths of taking antipsychotics,serum Ca2+,serum PRL,milk intake,level of activity,and level of smoking.Conclusion The BMD was lower in the medication group than that in the non-medication group,and the development of osteoporosis was correlated to various factors.Clinical nurses should master high-risk factors thoroughly and adopt intervention measures in a timely manner.

Objective To investigate the feasibility and reliability of three-dimensional ultrasound in evaluating carotid artery vulnerable plaques with the method of prospective plaque scoring.Methods From February 2016 to March 2017,41 patients who performed carotid endarterectomy (CEA) in the department of neurosurgery at the First Affiliated Hospital of Soochow University were scheduled for conventional cervical vascular ultrasonography,three-dimensional ultrasonography (3D-US),CT angiography (CTA),CT perfusion imaging (CTP) and / or digital subtraction angiography (DSA) examinations before surgery.On pathology,the atherosclerotic plaque morphology and HE staining findings were evaluated after surgery.The results of preoperative 3D-US were compared with the corresponding postoperative pathologic findings.Each plaque was scored based on the plaque morphology,homogeneity,echo characteristics and degree of vascular stenosis in 3D-US.According to the pathological results,the plaques were divided into vulnerable plaque group (n=35) and stable plaque group (n=10).The plaque score difference between groups was compared using independent sample t test.Patients were classified into ischemic stroke group (n=27) and non-ischemic stroke group (n=14) according to whether ischemic stroke symptoms occurred during the last 6 months.Pearson x2 test was used to analyze the correlation between ischemic events and the vulnerable plaques.Results Plaque scores were significantly different between vulnerable plaque group and stable plaque group (5.3 ±0.2 vs 3.4±0.3,t=5.339,P ＜ 0.05).The accuracy of identifying vulnerable plaque by plaque score is high,while the area under the ROC curve is 0.907 with a cutoff 4.5 (the maximum Youden index is 0.671,the sensitivity is 77％,the specificity is 90％).There is a significant positive correlation between the occurrence of ischemic events and plaque vulnerability (r=0.858,P ＜ 0.05).Conclusion 3D-US can accurately and quantitatively assess vulnerability of carotid plaques,carotid artery vulnerable plaque was significantly associated with ischemic stroke,which can provide the basis for clinical individualized treatment.

Objective To investigate the adjuvant effect of intravenous immunoglobulin on patients with sepsis-associated thrombocytopenia. Methods A total of 229 patients with sepsis with platelet count less than 3 × 109/L, were included in this prospective, randomized, controlled study. The patients were divided into the intervening group and the control group. Conventional treatments were applied in the two both groups , while in the intervening group, intravenous immunoglobulin with a dose of 0.4 g/(kg·d) for 5 consecutive days was administered. The end-points were the platelet counts on day 1,day 3,day 5,and day 7 post-intravenous immunoglobulin, patients’ in-ICU time and the 28-day in-hospital mortality. Results Compared with the control group, the platelet count recovered dramatically after 5-day intravenous immunoglobulin in the intervening group. Moreover , the 28-day in-hospital mortality and in-ICU time were also dramatically improved in the intervening group. Conclusion Intravenous immunoglobulin can enhance the recovery of platelet counts , shorten the in-ICU time and reduce the hospital mortality in patients with sepsis- associated thrombocytopenia (PLT count < 30 × 109/L).

BACKGROUND:The relationship between the occurrence time and clinical symptoms of bone marrow edema in nontraumatic femoral head necrosis is stil controversial. OBJECTIVE:To evaluate the relationship of bone marrow edema in nontraumatic femoral head necrosis with Association Research Circulation Osseous (ARCO) staging and pain grading. METHODS: Forty-eight patients with nontraumatic femoral head necrosis (58 hips) were confirmed to have bone marrow edema on MRI T1 weighted images and T2 fat suppression images. Then, the patients were graded according to the MRI Classification Method reported by Zhao Pei-rong, the ARCO Staging System and Harris hip score for pain grading. We analyzed the correlation of bone marrow edema with ARCO staging and pain grading. RESULTS AND CONCLUSION:The incidence rate of bone marrow edema in ARCO I-III was increased in sequence, and the difference was statisticaly significant (χ2=27.69,P=0.001); the average rank of bone marrow edema in ARCO I-III was increased significantly (χ2=19.947,P=0.000). The incidence rate of bone marrow edema also increased among different pain grading, and the difference was statisticaly significant (χ2=57.0, P=0.000); the average rank of bone marrow edema among different pain grading was increased significantly (χ2=174.0,P=0.000). The presence and aggravation of bone marrow edema indicate the enlargement of necrosis area and the aggravation of symptoms in patients with nontraumatic femoral head necrosis, which can be used as an auxiliary index for the appraisal of disease progression.