The mammalian target of rapamycin (mTOR) pathway is abnormally activated in lung cancer. However, the anti-lung cancer effect of mTOR inhibitors as monotherapy is modest. Here, we identified that ginsenoside Rh2, an active component of Panax ginseng C. A. Mey., enhanced the anti-cancer effect of the mTOR inhibitor everolimus both in vitro and in vivo. Moreover, ginsenoside Rh2 alleviated the hepatic fat accumulation caused by everolimus in xenograft nude mice models. The combination of everolimus and ginsenoside Rh2 (labeled Eve-Rh2) induced caspase-independent cell death and cytoplasmic vacuolation in lung cancer cells, indicating that Eve-Rh2 prevented tumor progression by triggering paraptosis. Eve-Rh2 up-regulated the expression of c-MYC in cancer cells as well as tumor tissues. The increased c-MYC mediated the accumulation of tribbles homolog 3 (TRIB3)/P62⁺ aggresomes and consequently triggered paraptosis, bypassing the classical c-MYC/MAX pathway. Our study offers a potential effective and safe strategy for the treatment of lung cancer. Moreover, we have identified a new mechanism of TRIB3/P62⁺ aggresomes-triggered paraptosis and revealed a unique function of c-MYC.

Objective To learn the present efficiency of medical equipments at public hospitals in Liaoning province, and provide scientific basis for rational distribution of such resources, and for control of medical expenses.Methods Data envelop analysis (DEA) was used to appraise the deployment efficiency of 2 784 such equipments worth over 100 000 yuan per unit, with equipments randomly sampled from 31 public hospitals in the province.Results The equipment deployment at public hospitals in Liaoning was found at a low level.9.7% of the hospitals were found as relatively efficient, 3.2% of them as in relatively weak efficiency, while 87.1% of them relatively inefficient.Gaps were found between urban hospitals and tertiary hospitals, and rural hospitals and secondary hospitals in their deployment efficiency, as evidenced in overinvestment of equipments and insufficiency of competent operators.Conclusions Hospitals should strengthen their scientific management of the equipments, and emphasize human resource investment, thus elevating the efficiency of equipment deployment.

BACKGROUND: Hip arthroplasty and internal fixation with intramedullary cannulated screws are mainly used for senile femoral neck fractures. However, osteoporosis can usually lead to failure in internal fixation.OBJECTIVE: To analyze the joint function after fixed with intramedullary cannulated screws in elderly patients with femoral neck fractures, and to explore the factors related to functional recovery.METHODS: Clinical data of 89 patients with femoral neck fractures undergoing internal fixation with intramedullary cannulated screws after 2-year follow-up were analyzed retrospectively. The sex, age, Garden type, bone mineral density, body mass index, screw distribution, reduction index, operation time, bearing time and Harris hip scores were analyzed. Rank related analysis and accumulative Logistic regression analysis were performed on SPSS18.0 software. RESULTS AND CONCLUSION: (1) Normal Q-Q plot and normality test results indicated that the Horris scores in all patients after 2-year follow-up presented with skewed distribution (P=0.000). (2) Rank related analysis showed that age,Garden type, bone mineral density, and reduction index were related with Harris score (P < 0.05 or P < 0.01). (3) Accumulative Logistic regression analysis showed that the independent variables including age, Garden type, bone mineral density, and reduction index made significant effect on Harris hip scores. (4) To conclude, age, Garden type,bone mineral density, and reduction index are important factors for functional recovery of the hip after fixed with intramedullary cannulated screws.

Objective To evaluate the palatal rugae individual-specific properties and stability before and after orthodontic treatments for investigating the reliability of palatal rugae for individual identification of forensic dentistry based on the palatal rugae model ananlysis. Methods Maxillary models of 70 patients were obtained before and after orthodontic treatments respectively. Palatal rugae morphologic changes and individual identification were examined by model analysis including changes in number, orientation, shape, and length of palatal rugae, as well as mesial and distal endpoint displacement in the anterioposterior(AP) and mesiodistal (MD) direction. Furthermore, The examination of palatal rugae average match accuracy(%) was performed between the pre-treatment and post-treatment orthodontics models and post-treatment and duplicated post-treatment orthodontics models. Results ① The palatal rugae morphological changes were found and the incidence of palatal rugae changes were showed in length(28.6%), segmenta-tion(4.3%); unification(2.9%); orientation(1.4%) and shape(1.4%) after orthodontic treatment. Also the displacement of the distal endpoint of palatal rugae was 45.7% for anterioposterior indirection, 40% for mesiodistal indirection after orthodontic treatment, while the anterioposterior displacement of the mesial endpoint of palatal rugae was 32.9% and mesiodistal displacement was 17.1%. ② The identical palatal rugae patterns were not found both the pre-treatment and post-treatment groups. ③ The palatal rugae average match accuracy was 92.19% between pre-treatment and post-treatment groups, however, the rate had increased by 99.05% when matching the palatal rugae patterns of post-treatment groups to their duplicates. Conclusion Palatal rugae patterns have the high specific properties to each indivi-dual. Although there are some changes in morphology of palatal rugae after orthodontic treatment, it still can be used as a novel method for individual identification in forensic dentistry.

Objective To learn the present pre-hospital emergency resources allocation in Liaoning province.Methods Site survey and questionnaire survey were used to survey the basic information,number of pre-hospital emergency ambulances,human resources,and communication/control systems of 19 pre-hospital emergency centers in Liaoning province in 2014.Results The number of pre-hospital emergency sub-stations,ambulances and human resource fall short of demand.Furthermore,these resources are found with such problems as greater service radius of average pre-hospital emergency service and longer average pre-hospital response time in countryside than cities,insufficient and obsolete ambulances short of onboard equipment and communication systems,not to mention shortage of medical workers of higher degrees and academic titles.Conclusions A great gap is found between urban and rural pre-hospital emergency resource allocation in Liaoning province,with poor resources in the countryside.The government is recommended to step up financial support in increasing pre-hospital emergency substations and resources allocation,regularly update pre-hospital emergency vehicles,set up independent title promotion mechanism,perfect communication scheduling system,in order to satisfy the demands of pre-hospital first aid.

Objective To observe the clinical curative effect of Tangbining granule in the treatment of diabetic periph-eral neuropathy syndrome of Yang deficiency and blood stasis type and the effect on oxidative stress. Methods selec-tion of diabetic peripheral neuropathy in patients with syndrome of Yang deficiency and blood stasis type, on the basis of the control group adds the clothing Tangbining granule, with symptom scores as the criterion of curative effect ob-servation of sugar,Tangbining granule in the treatment of diabetic peripheral neuropathy (DPN)effectiveness,safety,and observed before and after treatment with indicators of oxidative stress in the body superoxide dismutase enzyme(SOD)and malondialdehyde(MDA)changes. Results The total efficiency of the control group 70.37%,the total effec-tive rate of treatment group was 92.59%,there was significant difference between two groups (P<0.05); the SOD and MDA changes of the control group had no significant difference before and after the treatment, the SOD and MDA changes of the treatment group before and after treatment were statistically differences,and there was significant differ-ence in the change of MDA and SOD after treatment between two groups. There was no adverse reaction in two groups. Conclusion Tangbining granule in the treatment of diabetic peripheralneuropathy with Yang deficiency and blood stasis syndrome has exact curative effect,at the same time can improve oxidative stress in the body,without adverse reaction.

Objective To explore the effect of suction toothbrushing in oral care of patients with dysphagia.Methods sixty patients with dysphagia from the neurology department and rehabilitation department in our hospital were equally divided into the experiment group and the control group randomly: the former used suction toothbrushing for oral care and the latter physiological saline for oral care.The two groups were compared in respect of bad breath,oral cleanliness,time for conducting oral care,stomatitis, oral ulcer and pathogenic bacteria in oral cavity.Results The time for conducting oral care in the experiment group was significantly shorter than that in the control group(P<0.001).The score on oral cleanliness of the experiment group was significantly higher than that in control group(P<0.001).The bad breath,stomatitis or oral ulcer,and mucosa damage in the experiments group were all lower than those in the control group.The number of oral bacteria on the 5th day in the experiment group was smaller than that in the control group(P<0.005).Conclusion For the patients with dysphagia,the suction toothbrushing may be effective for cleaning the mouth,reducing oral complications and improving the satisfaction degree.

Objective: To study clinical application value of dobutamine stress echocardiography (DSE) and nitroglycerin stress single photon emission computed tomography (SPECT) for evaluation of restenosis after percutaneous coronary intervention (PCI). Methods: A total of 39 patients after PCI were examined by DSE and SPECT one week before coronary angiography (CAG). Dose incremental program of dobutamine included five levels：5μg•kg-1•min-1, 10μg• kg-1• min-1, 20μg•kg-1•min-1, 30μg•kg-1•min-1, 40μg•kg-1•min-1, and each level maintained for three minutes. Sensitivity, specificity and accuracy of DSE and SPECT were determined according to CAG examined result and examined results were compared between DSE and SPECT. Results: Compared with CAG, SPECT and DSE were no significant differences （P>0.05）in sensitivity (83.3% vs. 75.0%) and accuracy (71.8% vs. 87.2%) for evaluating restenosis after PCI, but compared with SPECT, DSE possessed higher specificity (66.7% vs. 92.6%). Conclusions: Dobutamine stress echocardiography is accurate, and its specificity is better than that of SPECT for evaluating restenosis after percutaneous coronary intervention.

Objective To study the changes of endothelin,nitric oxide and vascular endothelial growth factor level in patients with type 2 diabetic retinopathy (DR). Methods Eighty diabetes patients (53 with diabetic retinopathy and 27 without). Another 30 healthy volunteers were recruited as control. Plasma ET and VEGF levels were measured by enzyme-linked immunosorbent assay. NO levels were measured by nitrate reductase method. Results Plasma levels of ET were higher in patients with type 2 diabetes with DR (DR)(80. 68 ± 13.57) mg/L than (65. 33 ± 11.24) mg/L, (45.25 ±9. 06) mg/L, in control and in type 2 diabetes patients without DR (NDR) (Ps ＜ 0, 01 ). Plasna levels of NO in DR group (69. 82 ± 14. 89) μmol/L were higher than (37. 85 ±-9. 11 ) μmol'L, in control group,but lower than (77.52 ±± 18.56) μmol/L in NDR group (Ps ＜ 0. 05 ). Plasma levels of VEGF ( 110. 52 ± 25.65 ) μg/L in DR were significantly increased compared with control (82.42 ± 18. 47 ) μg/L, and NDR(97.55 ±25.61)μg/L, (Ps ＜0.05).Conclusion ET, NO and VEGF may be involved in the pathogenesis of type 2 diabetic retinopathy.