Band 12, Heft 1

Coexistence of aortic coarctation with aneurysm of subclavian artery is a uncommon situation and may require unusual treatment in patients. A 40-year-old patient diagnosed incidentally with left subclavian artery aneurysm coexisting with aortic coarctation. Patient was initially referred for hybrid treatment. Initially ostium of the left subclavian artery was covered with a stent-graft. Over a 30-month follow-up period aneurysm became thrombosed all the way up to the ostium of internal mammary artery. The patient did not present with neurological symptoms or signs of upper limb ischemia. Taking into consideration good blood supply to the axillary artery via reversed blood flow in the thyreocervical trunk, hence we decided not to proceed with cervicoaxillary bypass grafting. Implantation stent-graft into aorta coarctation with covering axillary artery is proper way of treatment and may need no other surgical procedures.

Interferential current electrical stimulation alters blood flow velocity and vessel size. We aimed to investigate the changes in the autonomic nervous system depending on electrical stimulation parameters. Forty-five healthy adult male and female subjects were studied. Bipolar adhesive pad electrodes were used to stimulate the autonomic nervous system at the thoracic vertebrae 1-4 levels for 20 min. Using Doppler ultrasonography, blood flow was measured to determine velocity and vessel size before, immediately after, and 30 min after electrical stimulation. Changes in blood flow velocity were significantly different immediately and 30 min after stimulation. The interaction between intervention periods and groups was significantly different between the exercise and pain stimulation groups immediately after stimulation (p<0.05). The vessel size was significantly different before and 30 min after stimulation (p<0.05). Imbalances in the sympathetic nervous system, which regulates balance throughout the body, may present with various symptoms. Therefore, in the clinical practice, the parameters of electrical stimulation should be selectively applied in accordance with various conditions and changes in form.

IgA anti-β2glycoprotein I antibodies (IgA-anti-β2GPI) seems to be the most prevalent isotype in patients with Systemic Lupus Erythematosus (SLE) with a significant association to thrombotic events. Both SLE and antiphospholipid syndrome (APS) can be associated with implantation failure, fetal loss and obstetric complications. Recent reports highlight the clinical value of IgA-anti-β2GPI determination in supporting in vitro fertilization (IVF) treatment and IVF pregnancy outcomes. We report a 36-year-old female diagnosed with SLE, endometriosis and unexplained infertility. Conventional APS markers were consistently negative: anti-cardiolipin (aCL) and anti-β2GPI: IgG/IgM. She was then tested with reports of repeatedly high IgA-anti-β2GPI and tested positive from 2014 after IgA (aCL; anti-β2GPI) were established in our APS diagnostic panel. She underwent successful first IVF procedure with a 30 week live birth pregnancy outcome. During the follow up no lupus flare, thrombosis or ovarian hyperstimulation syndrome were registered. Serum IgA anti-β2GPI and anti-dsDNA levels declined statistically significant during the second and third trimester. Titres of IgA-anti-β2GPI remained lower postpartum as well. This case highlights the clinical importance of IgA-anti-β2GPI testing for family planning, assisted reproduction and pregnancy in women with SLE and/or APS.

Periodontal ligament stem cells (PDLSCs) are promising cell resource for the cell-based therapy for periodontitis and regeneration of bio-root. In this study, we investigated the effect of PDLSCs on neutrophil, a critical constituent of innate immunity, and the underlying mechanisms. The effect of PDLSCs on the proliferation and apoptosis of resting neutrophils and IL-8 activated neutrophils was tested under cell-cell contact culture and Transwell culture, with or without anti-IL-6 neutralizing antibody. We found that PDLSCs could promote the proliferation and reduce the apoptosis of neutrophils whether under cell-cell contact or Transwell culture. Anti-IL-6 antibody reduced PDLSCs-mediated inhibition of neutrophil apoptosis. IL-6 at the concentration of 10ng/ml and 20ng/ml could inhibit neutrophil apoptosis statistically. Collectively, PDLSCs could reduce the apoptosis of neutrophils via IL-6.

Most common techniques for alveolar bone augmentation are guided bone regeneration (GBR) and autologous bone grafting. GBR studies demonstrated long-term reabsorption using heterologous bone graft. A general consensus has been achieved in implant surgery for a minimal amount of 2 mm of healthy bone around the implant. A current height loss of about 3-4 mm will result in proper deeper implant insertion when alveolar bone expansion is not planned because of the dome shape of the alveolar crest. To manage this situation a split crest technique has been proposed for alveolar bone expansion and the implants’ insertion in one stage surgery. Platelet-rich fibrin (PRF) is a healing biomaterial with a great potential for bone and soft tissue regeneration without inflammatory reactions, and may be used alone or in combination with bone grafts, promoting hemostasis, bone growth, and maturation. Aim The aim of this study was to demonstrate the clinical effectiveness of PRF combined with a new split crest flapless modified technique in 5 patients vs. 5 control patients. Materials and methods Ten patients with horizontal alveolar crests deficiency were treated in this study, divided into 2 groups: Group 1 (test) of 5 patients treated by the flapless split crest new procedure; Group 2 (control) of 5 patients treated by traditional technique with deeper insertion of smaller implants without split crest. The follow-up was performed with x-ray orthopantomography and intraoral radiographs at T0 (before surgery), T1 (operation time), T2 (3 months) and T3 (6 months) post-operation. Results All cases were successful; there were no problems at surgery and post-operative times. All implants succeeded osteointegration and all patients underwent uneventful prosthetic rehabilitation. Mean height bone loss was 1 mm, measured as bone-implant most coronal contact (Δ-BIC), and occurred at immediate T2 post-operative time (3 months). No alveolar bone height loss was detected at implant insertion time, which was instead identified in the control group because of deeper implant insertion. Conclusion This modified split crest technique combined with PRF appears to be reliable, safe, and to improve the clinical outcome of patients with horizontal alveolar crests deficiency compared to traditional implanting techniques by avoiding alveolar height-loss related to deeper insertion of smaller implants.

Useful parameters that can predict return of spontaneous circulation (ROSC) in patients with cardiopulmonary arrest (CPA) have not been established. We previously reported the usefulness of anion gap (AG) and albumin-corrected anion gap (ACAG) calculated from a blood sample obtained on arrival at the hospital for the prediction of ROSC. Otherwise, it has been reported that strong ion gap (SIG), which shows the difference between the levels of fully dissociated cations and anions in the serum, is useful to predict the prognosis of critically ill patients. This was a prospective and observational clinical study. Patients with CPA transferred to the emergency department of our hospital between January 2013 and December 2014 were evaluated. Patients were divided into two groups: patients who obtained ROSC [ROSC(+) group] and those who did not [ROSC(−) group]. We compared AG, ACAG and SIG between the two groups. A total of 170 patients were enrolled. Fifty patients were included in the ROSC(+) group, and the remaining 120 in the ROSC(−) group. Both AG and ACAG were significantly better in the ROSC(+) group; however, there was no significant difference in SIG between the two groups. The area under the receiver operating characteristic curves (AUC) for ROSC of both AG and ACAG were almost the same (0.72 and 0.708, respectively); the AUC of SIG (0.57) was inferior to those of AG and ACAG. Our results suggest that AG and ACAG can better predict ROSC following cardiopulmonary resuscitation (CPR) compared with SIG.

The objective of this study was to explore the expression of EpCAM and EGFR in human epithelial ovarian cancer (EOC) and their correlation with clinicopathological parameters. The protein expression levels of epithelial cell adhesion molecule (EpCAM) and epidermal growth factor receptor (EGFR) were evaluated by immunohistochemistry in formalin-fixed paraffin-embedded specimens from 30 patients with epithelial ovarian carcinoma and 15 normal ovary tissues. Clinicopathological characteristics were gathered by retrospective review of the patients’ files. The correlation between EpCAM and EGFR expression, as well as their association with clinical pathological parameters were investigated. The SPSS 17.0 package was used to perform statistical analyses. The positive expression rates of EpCAM and EGFR were significantly elevated in epithelial ovarian cancer tissues than in normal ovary tissues. The positive expressions of EpCAM and EGFR in EOC were associated with International Federation of Gynecology and Obstetrics (FIGO) stage and tumor differentiation, lymph node metastasis. Spearman correlation analysis demonstrated a significant positive association between EpCAM and EGFR expression in EOC. The co-expression of EpCAM and EGFR may play an important role in the carcinogenesis of EOC and might provide a promising molecular therapeutic target.

Lipoma is a benign tumour originating from mature adipose tissue. It can occur in any place in the body where adipose tissue is located. Intraosseous lipoma is a very rare bone tumour. The authors present an infrequent case involving intraosseous lipoma of the mandible in a 32-year old man and provide a review of case studies documented earlier in the literature.

We present an original case report of a bladder explosion during a TURP intervention for benign prostatic hypertrophy, that was brought on by the absorption of about 5 liters of glycine 1.5% and then onset of a severe hyponatremia. The quick and inappropriate correction of this electrolyte imbalance led the onset of encephalopathy and the death of the patient. The authors discuss the pathogenesis of these uncommon diseases and, considering the most recent Italian Legislation, they highlight the importance to respect good clinical practice standards and guidelines to ensure the most appropriate treatments for the patient and remove any assumptions of medical liability.

Brain stroke connected with aortic blood flow disturbances is a rare disease and its incidence is difficult to assume. Nevertheless, 10-50% of patients with aortic dissection may not experience any pain. In case of 18-30% patients with aortic dissection neurological signs are first disease presentation and among them ischemic stroke is the most common. The most popular aortic dissection classification is with use of Stanford system. Type A involves the ascending aorta and type B is occurring distal to the subclavian artery. Aortic dissection risk factors include hypertension, cystic medionecrosis, bicuspid aortic valve and Marfan’s or Ehlers-Danlos syndrome.

Liver injury is one of the most common complications in patients after kidney transplantation. Bicyclol tablets possess obvious anti-inflammatory and liver-protective functions. This study aimed to explore the clinical effect of preventive application of Bicyclol on drug induced liver injuries at an early stage after kidney transplantation. A total of 1600 patients who accepted kidney transplantations at our hospital from January 2009 to May 2015 were enrolled in this study, and divided into the prevention group (Bicyclol) and the control group (no hepatic protectors) based on whether or not hepatic protectors were regularly administered after the operation. The occurrence of liver injuries at an early stage after the operation and their influencing factors were analyzed. Total of 745 cases were included in the final analysis of which 82 developed liver injuries post-operation, with 22 in the prevention group (4.82%) as compared to 60 in the control group (20.76%) (P= 0.001). As compared to the control group, OR (95% CI) of the prevention group was 0.197 (0.116, 0.334) after revising HBsAg status, age and maintenance immunosuppression. Prophylactic application of Bicyclol as liver-protective treatment was a protective factor against drug induced liver injuries at an early stage after kidney transplantation.

We evaluated the free fatty acids differences in plasma between hyperemesis gravidarum(HG) and healthy pregnant in first trimester pregnancy. Objective We aimed to compare the plasma levels of DHA, AA and EPA, between HG patients and healthy pregnant women Design Fifty-two pregnants were involved in the study. Twenty-six pregnants of them were HG as study group, and twenty-six pregnants were enrolled as healthy pregnant women at the similar gestational age. The saturated fatty acids C14, C15, C16, C18, C20, C22, and C24; the omega-3 fatty acids eicosapentaenoic acid, (EPA) and docosahexaenoic acid, (DHA); the omega-6 fatty acids linoleic acid, arachidonic acid (AA), and homo-gamma-linolenic acid; and the omega-9 fatty acids oleic acid, erucic acid, and nervonic acid were analysed by gas chromatography. Results Statistically differences was not seen between the groups with maternal age, gestational age, or plasma levels of EPA, DHA, and AA. Statistically significant difference was seen between the groups with plasma levels of C20 and C22(p < 0.05). C20 was declined but C22 was rised in the HG patients. Conclusion EPA, DHA, or AA, which related to placental and fetal neural development are not changing from Hyperemesis gravidarum.

Genomic instability, including genetic mutations and chromosomal rearrangements, can lead to cancer development. Aberrant DNA methylation occurs commonly in cancer cells. The aim of this study is to determine the effects of a specific chromosomal lesion the BCR-ABL translocation t(9:22), in establishing DNA methylation profiles in cancer. Materials and methods We compared DNA methylation of 1,505 selected promoter CpGs in chronic myelogenous leukemia (CML), acute lymphoblastic leukemia (ALL) with and without the Philadelphia chromosome t(9:22), CD34+ hematopoietic stem cells transfected with BCR-ABL , and other tumors without BCR-ABL (acute promyelocytic leukemia (APL) and gastrointestinal stromal tumors (GIST). In this study, the DNA methylation profile of CML was more closely related to APL, another myeloid leukemia, than Ph+ ALL. Although DNA methylation profiles were consistent within a specific tumor type, overall DNA methylation profiles were no influenced by BCR-ABL gene translocation in the cancers and tissues studied. We conclude that DNA methylation profiles may reflect the cell of origin in cancers rather than the chromosomal lesions involved in leukemogenesis.

The objective of this study was to perform a meta-analysis to evaluate the efficacy and toxicity of gefitinib and docetaxel in treated patients with non-small-cell lung cancer (NSCLC). Methods. A literature search was performed using PubMed and CNKI databases for relevant keywords and the Medical Subject Headings. After further full-text screening, 10 clinical trials were included in the final meta-analysis. Specific odds ratios (OR) and confidence intervals were calculated. Results. The outcomes of treatment efficacy included disease control rates, quality-of-life improvement rates, 3~4 grade adverse events. Comparing gefitinib to docetaxel for NSCLC patients, the pooled odds ratios (OR) of disease control rates was 1.09, (95% confidential index [CI] = 0.84–1.43), the pooled OR of quality-of-life improvement rates was 2.49, (95% CI = 1.77–3.49), the pooled OR of 3~4 grade adverse events was 0.49, (95% CI = 0.32–0.75). Conclusion. Gefitinib was found to significantly improve patients’ quality-of-life and obviously decrease patients’ adverse events of 3~4 grade.There is no difference of disease control rates between gefitinib and docetaxel.

The aim of this study was to investigate the clinical characteristics, treatment outcomes and psychological distress in patients with chronic idiopathic anal pain. The study was conducted on patients referred to Hangzhou Third Hospital for chronic anal pain from January, 2010 to December, 2014. Patient demographics, clinical history, anorectal physiology, and radiological imaging data were recorded for all patients. The treatment outcome was noted for patients treated and followed up for more than 6 month at the present unit. Ninety-six patients with mean age of 45.1 years (range, 17-82) were studied. Seventy-one patients (74.0%) had functional anorectal pain(FARP). The main complaints were dull, sharp, stabbing, or spasm pain. Among all patients, 34.3% reported that their pain radiated into other locations. Fifty-one patients (53.1%) had bowel dysfunction, while 28.1% patients had urinary dysfunction. The common factors associated with pain relief were day time, lying down and warm water baths; the factors that contributed to aggravated pain were night time, defecation or sitting. 92.7% (89/96) of patients reported symptoms of psychological disturbance. FARP patients exhibited increased depression than non-FARP patients(P<0.05). In addition, female patients were more likely to have depression than male patients (P<0.05). The overall pain treatment success rate was 55.2% (53/96). The pain treatment outcome was better in non-FARP patients than in FARP patients(χ2=3.85, P<0.05). Conclusively, chronic idiopathic anal pain is a complex clinical symptom, involving pelvic floor muscles, the nervous system, endocrine system, and the patients’ psychological conditions. Further research is needed to improve diagnosis and treatment for patients with chronic idiopathic anal pain.

The purpose of this study was to investigate whether the bone tunnel impaction technique performed by dilators could dwindle the tibial tunnel enlargement after anterior cruciate ligament (ACL) reconstruction with hamstring tendon using both extracortical suspensory fixation devices at femoral and tibial site. Thirty-one consecutive patients undergoing primary ACL reconstruction with the hamstring autograft were enrolled in this research. Patients were randomly allotted to group A (bone tunnel impaction technique using dilators) or group B (regular extraction bone tunnel drilling). Results The average follow-up was 16.2 months. The mean femoral tunnel widening was 1.05 mm and 1.02 mm respectively in group A and B. The mean tibial tunnel widening was 0.61 mm and 1.08 mm respectively in group A and B. There was no statistical difference for tunnel enlargement between the two groups at the femoral site (P = 0.62) but significant difference at the tibial site (P < 0.0001). Conclusion Bone tunnel impaction technique leaded to a reduction of tibial bone tunnel enlargement after ACL reconstruction with hamstring tendon using both extracortical suspensory fixation devices at femoral and tibial site.

The aim of this meta-analysis was to evaluate the effects and toxicity of S-1 combined with radiotherapy in the treatment of nasopharyngeal cancer (NPC). Through a search of the databases of PubMed, Embase, the Chinese Biomedicine Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang system and Chongqing VIP Information (CQVIP), the efficacy and side effects data of S-1 combined with radiotherapy in the treatment of NPC patients from open published randomized controlled trials (RCTs) were collected. The pooled complete response (CR), partial response (PR), objective response rate (ORR), 2-year survival rate and treatment related toxicity were analyzed by Stata12.0 software. Eight RCTs with 599 cases were included and analyzed in this meta-analysis. The general quality of the 8 studies were deemed as having moderate risk of bias. Adequate sequence generation was reported in 4 studies. Incomplete outcome data address was reported in 7 publications. Five studies indicated to be free of selective reporting. Seven studies reported the treatment complete response (CR) between S-1 combined with radiotherapy and radiotherapy alone. With significant heterogeneity, the data was pooled by random effect model. The pooled results indicated that S-1 combined with radiotherapy can significant increase the CR rate compared to radiotherapy alone (RR=1.52, 95%CI:1.33-1.74, P<0.05). Eight studies reported the partial response (PR) rate between the combined treatment and radiotherapy alone. The pooled results showed that there was no statistical difference for PR between combined treatment and radiotherapy alone (RR=0.85, 95%CI:0.62-1.16, P>0.05). For the effect size of objective response rate (ORR), pooled results indicated that S-1 combined with radiotherapy can significantly increased the ORR by random effect model (RR=1.39, 95%CI:1.23-1.57, P<0.05). The pooled results showed that S-1 combined with radiotherapy significant increase the risk of developing bone marrow suppression (RR=1.94, 95%CI:1.40-2.69, P<0.05) and gastrointestinal reaction (RR=1.81, 95%CI:1.38-2.38, P<0.05) with fixed effect model. However, the pooled oral mucositis (RR=1.22, 95%CI:0.99-1.50, P>0.05) and radiodermatitis (RR=0.93, 95%CI:0.77-1.12, P<0.05) were not statistically different. Two studies reported the 2-year survival rate between the two groups. The pooled results showed the combined treatment significantly increased the 2-year survival rate for patients with nasopharyngeal carcinoma (RR=1.14, 95%CI:1.01-1.28, P<0.05). The funnel plot demonstrated significant publication bias for complete response, partial response, objective response rate and oral mucositis. The egger’s line regression test indicated significant publication bias for complete response (t=5.98, P=0.002) and objective response rate(t=6.23, P=0.003). Conclusion S-1 combined with radiotherapy can significant improve the clinical efficacy with more treatment related toxicity compared to radiotherapy alone in the treatment of nasopharyngeal carcinoma.

The large epidemiological studies demonstrated that atrial fibrillation is correlated with high mortality and adverse events in patients with acute myocardial infarction. The aim of this study was to determinate predictors of atrial fibrillation develop during the hospital period in patients with acute myocardial infarction as well as short- and long-term mortality depending on the atrial fibrillation presentation. The 600 patients with an acute myocardial infarction were included in the study and follow-up 84 months. Atrial fibrillation develops during the hospital period was registered in 48 patients (8%). After adjustment by logistic regression model the strongest predictor of atrial fibrillation develop during the hospital period was older age, particularly more than 70 years (odds ratio 2.37, CI 1.23-4.58, p=0.010), followed by increased of Body Mass Index (odds ratio 1.17, CI 1.04-1.33, p=0.012), enlarged diameter of left atrium (LA) (odds ratio 1,18, CI 1,03-1,33, p=0,015) presentation of mitral regurgitation (odds ratio 3.56, CI 1.25-10.32, p=0.018) and B-type natriuretic peptide (odds ratio 2.12, CI 1.24-3.33, p=0.048).Patients with atrial fibrillation develop during the hospital period had a higher mortality during the hospital course (10.4% vs. 5.6%) p=0.179. as well as follow-up period of 84 months than patients without it (64.6% vs. 39.1%) p=0.569, than patients without it, but without statistically significance. Patients with AF develop during the hospital period had higher mortality during the hospital course as well as follow up period of 84 months than patients without it, but without statistically significance.

Objective To explore the clinical application of the intracavitary electrocardiogram (IC-ECG) guided Peripherally Inserted Central Catheter (PICC) tip placement among neonates. Background the ECGs of neonates are difficult to perform and their wave shapes are of doubtful accuracy due to various interfering factors Method 115 neonates were admitted to perform PICC guided by IC-ECG. Logistic regression was performed to analyze all possible influencing factors of the accuracy from the tip placement. The puncture site of the PICC, gestational age, height, weight, basal P/R amplitude and positioning P/R amplitude might be related to the accuracy of IC-ECG location. Result The accuracy in the lower extremity was higher than that in the upper extremity. Multivariate logistic regression analysis showed that the weight (Odds Ratio (OR)=1.93, 95%Confidence Interval(CI):1.06-3.50) and positioning P/R amplitude (OR=32.33, 95%CI: 2.02-517.41) are statistically significant risks to the accuracy PICC tip placement. Conclusions Possible methods to improve the accuracy might be Catheterizing through lower extremity, keeping the neonates calm, enhancing the electrocardiogram signal and strengthening technical training. Therefore it is practical to perfrom a tip placement by the dynamic change in the P waves from an electrocardiogram (ECG) guided PICC among neonates and as reliable as using X-rays.

Objective To evaluate the diagnostic value of combination detection of serum cancer antigen 125 (CA125), carbohydrate antigen 19-9 (CA199) and carci noembryonic antigen(CEA) in patients with epithelial ovarian cancer by pooling the open published studies according to meta-analysis method. Methods Diagnostic studies related to combination detection of serum CA125, CA199 and CEA in patients with epithelial ovarian cancer were electronic searched in the databases of PubMed, Cochrane, Google scholar, EMBASE, ISI Web of Knowledge and CNKI by two independent reviewers. The combined diagnostic sensitivity, specificity, positive likely hood ratio (+LR), negative likely hood ratio (-LR), diagnostic odds ratio (DOR), and area under the receiver operating characteristic curve (AUC) were pooled by Med DiSc1.4 software. Results Twelve prospective diagnostic publications were finally fulfilled the inclusion criteria and were included in this meta-analysis. The pooled diagnostic sensitivity specificity, positive likely hood ratio, negative likely hood ratio, diagnostic odds ratio, and AUC were 0.90 (95%CI: 0.80 to 0.92), 0.83 (95%CI: 0.80 to 0.86), 5.35(95%CI:3.90 to 7.33), 0.13 (95%CI: 0.10 to 0.16), 48.53 (95%CI: 29.91 to 78.72) and 0.92 (95%C: 0.89 to 0.94) respectively by fixed or random effect model. No publication bias was found according to the funnel plot and line regression test (t=-1.34, P=0.21). Conclusion Combination detection serum CA125, CA199 and CEA was a promising biomarker forepithelial ovarian cancer diagnosis with relative high sensitivity and specificity.

Objective To evaluate the clinical application of phased-array surface coil intensity correction in magnetic resonance imaging (MRI) in spinal metastases. Methods 3 phantoms and 50 patients with a corresponding total number of 80 spinal metastases were included in this study. Fast spin echo T1- and T2- weighted MRI with and without surface coil intensity correction was routinely performed for all phantoms and patients. Phantoms were evaluated by means of variance to mean ratio of signal intensity on both T1- and T2- weighted MRI obtained with and without surface coil intensity correction. Spinal metastases were evaluated by image quality scores; reading time per case on both T1- and T2- weighted MRI obtained with and without surface coil intensity correction. Results Spinal metastases were diagnosed more successfully on MRI with surface coil intensity correction than on MRI with conventional surface coil technique. The variance to mean ratio of signal intensity was 53.36% for original T1-weighted MRI and 53.58% for original T2-weighted MRI. The variance to mean ratio of signal intensity was reduced to 18.99% for T1-weighted MRI with surface coil intensity correction and 22.77% for T2-weighted MRI with surface coil intensity correction. The overall image quality scores (interface conspicuity of lesion and details of lesion) were significantly higher than those of the original MRI. The reading time per case was shorter for MRI with surface coil intensity correction than for MRI without surface coil intensity correction. Conclusions Phased-array surface coil intensity correction in MRIs of spinal metastases provides improvements in image quality that leads to more successfully detection and assessment of spinal metastases than original MRI.

In the last 15 years, it emerged that the practice of regular physical activity reduces the risks of many diseases (cardiovascular diseases, diabetes, etc.) and it is fundamental in weight control and energy consuming to contrast obesity. Different groups proposed many molecular mechanisms as responsible for the positive effects of physical activity in healthy life. However, many points remain to be clarified. In this mini-review we reported the latest observations on the effects of physical exercise on healthy skeletal and cardiac muscle focusing on muscle stem cells. The last ones represent the fundamental elements for muscle regeneration post injury, but also for healthy muscle homeostasis. Interestingly, in both muscle tissues the morphological consequence of physical activity is a physiological hypertrophy that depends on different phenomena both in differentiated cells and stem cells. The signaling pathways for physical exercise effects present common elements in skeletal and cardiac muscle, like activation of specific transcription factors, proliferative pathways, and cytokines. More recently, post translational (miRNAs) or epigenetic (DNA methylation) modifications have been demonstrated. However, several points remain unresolved thus requiring new research on the effect of exercise on muscle stem cells.

Aberrantly expressed microRNAs have been implicated in lots of cancers. Reduced amounts of let-7g have been found in breast cancer tissues. The function of let-7g in bone metastasis of breast cancer remains poorly understood. This study is to explore the significance of let-7g and its novel target gene in bone metastasis of breast cancer. The expression of let-7g or forkhead box C2 (FOXC2) was measured in human clinical breast cancer tissues with bone metastasis by using quantitative real-time Polymerase Chain Reaction (qRT-PCR). After transfection with let-7g or anti-let-7g in breast cancer cell linesMDA-MB-231or SK-BR3, qRT-PCR and Western blot were done to test the levels of let-7g and FOXC2. The effect of anti-let-7g and/ or FOXC2 RNA interference (RNAi) on cell migration in breast cancer cells was evaluated by using wound healing assay. Clinically, qRT-PCR showed that FOXC2 levels were higher in breast cancer tissues with bone metastasis than those in their noncancerous counterparts. Let-7g was showed to be negatively correlated with FOXC2 in human breast cancer samples with bone metastasis. We found that enforced expression of let-7g reduced levels of FOXC2 protein by using Western blot in MDA-MB-231 cells. Conversely, anti-let-7g enhanced levels of FOXC2 in SK-BR3 cells. In terms of function, anti-let-7g accelerated migration of SK-BR3 cells. Interestingly, FOXC2 RNAi abrogated anti-let-7g-mediated migration in breast cancer cells. Thus, we conclude that let-7g suppresses cell migration through targeting FOXC2 in breast cancer. Our finding provides a new perspective for understanding the mechanism of bone metastasis in breast cancer.

This study aimed to assess the attitudes of Lithuanian public health professionals towards health inequality monitoring in municipalities. The survey was conducted in public health bureaus (PHBs) and administrations of municipalities in March 2015. All employees of PHBs, all municipal doctors and all employees of health departments were invited to participate in the study (N=318; response rate, 47.2%). The study participants had positive attitudes towards the importance of health inequality monitoring at the municipal level, meanwhile systematic health inequality monitoring was assessed moderately. The majority of the interviewed professionals working at PHBs and municipalities (91.4% and 88.2%, respectively) declared that health indicators were monitored and analysed in their institutions. The respondents acknowledged the importance of routine monitoring of health indicators for assessment of inequalities, but these indicators were not monitored systematically in every municipality and PHB. Public health professionals identified the following measures for better health inequality monitoring: to strengthen intersectoral collaboration, formulate specific objectives of health programmes, promote actions in reducing health inequalities. Conclusions Public health professionals working at the municipal level outlined the importance of monitoring and reducing health inequalities. However, health inequality monitoring at the municipal level was considered as insufficient.

Southern China experiences larger extent of total cancer pathologies, of which nasopharyngeal carcinoma has the highest incidence under otorhinolaryngeal malignant carcinomas. Risk factor of nasopharyngeal carcinoma varies from hereditary causes to virus infection, among which Epstein-Barr virus (EBV) infection is the mostly investigated. The study into mechanism of EBV in occurrence, development and prognosis of nasopharyngeal carcinoma has been studied for several decades. The pathophysiology in making of EBV into a cancerogen includes proteins as latent membrane protein 1 (LMPs) and nucleic acids as micro-RNAs. In this paper, we reviewed till date studies focusing on relationship between EBV and nasopharyngeal carcinoma.

This study was a retrospective analysis of the efficacy of thrombectomy plus local catheter-directed thrombolysis (CDT) for the treatment of lower extremity deep venous thrombosis (LDVT). The experimental group underwent thrombectomy plus LCDT, whereas the control group underwent thrombectomy plus systemic thrombolysis via the dorsalis pedis vein. Venography and vascular color Doppler ultrasound were performed 7 days after surgery and at follow-up. The differences in the thigh and calf circumferences of normal and affected limbs were compared between groups. The venous patency score and venous patency rate were used for outcome evaluation. Compared with the control group, the experimental group showed a lower venous patency score and higher venous patency rate after treatment (P<0.05). Thirty patients were followed for 3 to 6 months, and according to the last evaluation, the differences in thigh and calf circumference between the normal and affected limbs remained lower in the experimental group than in the control group (P<0.05). Moreover, the venous patency score was lower, and the venous patency rate was higher in the experimental group than in the control group (P<0.05). Conclusion Thrombectomy plus CDT yields a higher venous patency rate and lower recurrence rate than pure thrombectomy for the treatment of LDVT.

Objective To investigate the expression of Hepcidin and Neogenin in tissue from patients with colorectal cancer, to evaluate the relationship between Hepcidin and Neogenin with clinical features, and to study their relationship with anemia. Methods Immuno- histochemical method was used to detect the expression of Hepcidin and Neogenin in 62 cases of colorectal cancer. At the same time, the relationship between them and their relationship with clinical characteristics and anemia were analyzed. Results The expression of Hepcidin was related to T stage (P<0.05), but not with age, gender, lymph node metastasis and distant metastasis. The expression of Neogenin was not correlated with T stage and lymph node metastasis, age, gender, and distant metastasis (P>0.05). There was no significant difference in the expression of Hepcidin and Neogenin between anemia group and non-anemia group. There was no correlation between Hepcidin and Neogenin (r =-0.04, P>0.05). Conclusion The expression of Hepcidin in colorectal cancer was related to the T stage, and had no correlation with Neogenin. The expression of Neogenin could not be used as an objective index to reflect the biological behavior of colorectal cancer.

In this study, serum carnitine (CRNT) and adiponectin (APN) levels and the correlation of these parameters in patients with breast cancer before and after treatment with radiotherapy (RT) were determined. Materials and methods Serum adiponectin and carnitine levels were assessed in 58 patients with breast carcinoma and 30 control subjects. Serum carnitine and APN levels were determined using a specific enzyme-linked immunosorbent assay. Results While serum carnitine level was significantly lower in the patients with breast cancer after RT compared with the control group and before treatment (p=0.002 and p=0.019, respectively), serum APN level was significantly higher than in the control group and before treatment ( p=0.003 and p=0.027, respectively). Carnitine level showed a negative correlation with APN level in the patients after RT (r= -0.626, p= 0.001). There was no correlation between carnitine and APN levels in subjects of control group and before treatment. Also, neither carnitine nor APN levels demonstrated correlation other parameters. Conclusions Results suggest that increased serum adiponectin and decreased carnitine levels in breast cancer after RT than control group. Carnitine level showed a negative correlation with APN level in the patient with breast cancer after RT. While carnitine, HDL-C and total cholesterol levels are decreased, trygliceride and LDL-C levels are increased in patients than control group. In addition, serum APN concentration was inversely correlated with serum carnitine levels. Furthermore, increased serum APN level in breast cancer after RT might be associated with hypocarnitinemia.

Meningioma is among the most frequent brain tumours predominantly affecting elderly women. Epidemiological studies have shown that at the age of fertility the incidence is relatively low. The biological behaviour of meningioma in pregnancy is different from other meningiomas. The possible explanation is rooted in the complex physiological changes and hormonal differences during pregnancy. The increased meningioma growth observed in pregnancy is presumably the result of endocrine mechanisms. These include increase in progesterone, human placental lactogen (hPL) and prolactin (PRL) serum levels. In contrast, levels of pituitary hormones such as follicle stimulating hormone (FSH), luteinizing hormone (LH) and human chorionic gonadotropin (hCG) produced by the placenta are decreasing in the mother prior to childbirth. Besides, vascular factors also play a crucial role. Peritumoral brain edema (PTBE), with well-known causative association with vascular endothelial growth factor (VEGF), can often be seen both with imaging and in the surgical specimens. Our aim is to assess published research on this topic including diagnostic and therapeutic guidelines, and to provide a clinically useful overview on the pathophysiology and biological behaviour of this rare complication of pregnancy.

We aim to analyze in bounds KJ Tracey’s immunological homunculus conception the relationships between parameters of electroencephalogram (EEG) and heart rate variability (HRV), on the one hand, and the parameters of bhite blood cell count, on the other hand. Methods In basal conditions in 23 men, patients with chronic pyelonephritis and cholecystitis in remission, recorded EEG (“NeuroCom Standard”, KhAI Medica, Ukraine) and HRV (“Cardiolab+VSR”, KhAI Medica, Ukraine). In portion of blood counted up white blood cell count. Results Revealed that canonical correlation between constellation EEG and HRV parameters form with blood level of leukocytes 0.92 (p<10-5), with relative content in white blood cell count stubnuclear neutrophiles 0.93 (p<10-5), segmentonucleary neutrophiles 0.89 (p<10-3), eosinophiles 0.87 (p=0.003), lymphocytes 0.77 (p<10-3) and with monocytes 0.75 (p=0.003). Conclusion Parameters of white blood cell count significantly modulated by electrical activity some structures of central and autonomic nervous systems.

The chief aim of this study was to analyze secondary healthcare providers' efficiency, focusing on the efficiency analysis of Slovene general hospitals. We intended to present a complete picture of technical, allocative, and cost or economic efficiency of general hospitals. Methods We researched the aspects of efficiency with two econometric methods. First, we calculated the necessary quotients of efficiency with the stochastic frontier analyze (SFA), which are realized by econometric evaluation of stochastic frontier functions; then, with the data envelopment analyze (DEA), we calculated the necessary quotients that are based on the linear programming method. Results Results on measures of efficiency showed that the two chosen methods produced two different conclusions. The SFA method concluded Celje General Hospital is the most efficient general hospital, whereas the DEA method concluded Brežice General Hospital was the hospital to be declared as the most efficient hospital. Conclusion Our results are a useful tool that can aid managers, payers, and designers of healthcare policy to better understand how general hospitals operate. The participants can accordingly decide with less difficulty on any further business operations of general hospitals, having the best practices of general hospitals at their disposal.

Objective To explore the expression levels of galectin-3 in colorectal cancer and the association between galectin-3 and its clinical pathological parameters, as well as the prognosis of colorectal cancer patients. Methods An immunohistochemistry assay was used to test the expression levels of galectin-3 in cancer tissues of 61 colorectal cancer cases and in normal intestinal tissues adjacent to the cancer tissues of 23 cases. The associations between protein expression levels of galectin-3 and the clinicopathological features, such as age, sex, pathology type, lymphatic metastasis, and prognosis were also analyzed. Results The positive rate of galectin-3 in cancer tissues was significantly higher than that of cancer-adjacent tissues: 62.5% (38/61) versus 13.0% (3/23) (P<0.05), respectively. Correlation was found between the protein expression of galectin-3 and the tumor size (P<0.05), as well as between the tumor differentiation (P<0.05) and Duke staging (P<0.05). The median progression-free survival times of patients with galectin-3 positive and negative expression were 19.2 and 35.1 months, respectively, with significant statistical difference (P<0.05). Conclusion Galectin-3 expression was correlated with the genesis and development of colorectal cancer and which could be used a biological marker for the prognosis of colorectal cancer patients.

Allergic conjunctivitis (AC), which is characterized by ocular itching, hyperemia, and edema, deteriorates quality of life. In this study, effects of anti-allergic drugs were evaluated by assessing eye-scratching behavior, the number of eosinophils in conjunctiva epithelial tissues, and concentrations of chemical mediators in the tears of the guinea pig model of ovalbumin (OA)-induced AC. Methodology On day 0, 3-week-old guinea pigs were sensitized by OA subconjunctival injections. On days 15, 17, and 19, OA solution was administered. Anti-allergic eye drops were administered 5 and 15 min before the final OA challenge on day 19. Scratching behavior within 1 h after OA exposure was studied. Eosinophils in the conjunctiva were stained with Giemsa reagent. Histamine and substance P (SP) concentrations in tears were measured using ELISA. Results Subconjunctivally injected guinea pigs were observed for clinical symptoms. Scratching responses significantly reduced with ketotifen or olopatadine treatment. Eosinophil numbers reduced in animals treated with ketotifen, levocabastine, or tranilast. Histamine and/or SP concentrations in tears were inhibited by some of these anti-allergic drugs. Conclusions It is important to assess the anti-allergic AC drugs objectively because there are several of these drugs currently available. This model allows for an objective evaluation of anti-allergic drugs for AC.

It is currently estimated that the lack of adequate pain management affects 80% of the global population and the phenomenon poses a serious problem in more than 150 countries. On a national level, the greatest burden of inadequate treatment is borne, among others, by elderly patients. The purpose of the paper was to compare the prevalence of barriers to optimum post-operative pain management in elderly patients, observed by nurses in a clinical, provincial and municipal hospital in Poland. The research project was a multi-center one and took over a year. The study was questionnaire-based. It used the Polish version of the Nurses’ Perceived Obstacles to Pain Assessment and Management Practices questionnaire. The study included a total of 1602 nurses working at a clinical, provincial and municipal hospital. In the university hospital, difficulties in pain assessment related to the healthcare system occurred statistically significantly more often.

Glioma is one of the most malignant and fatal tumors in adults. Researchers and physicians endeavor to improve clinical efficacy towards it but made little achievement. In recent years, people have made advances in understanding characteristics and functions of tumor microenvironment and its role in different processes of tumor. In this paper, we describe the effects of tumor microenvironment on glioma proliferation, invasion and treatments. By explaining underlying mechanisms and enumerating new therapy strategies employing tumor microenvironment, we aim to provide novel ideas to improve clinical outcomes of glioma.

Objective To evaluate by meta-analysis the effects of dexmedetomidine versus midazolam on postoperative delirium in patients that received postoperative mechanical ventilation. Methods The electronic databases of PubMed, Web of Science, EMbase, CNKI, CBM, Cochrane library and WanFang were searched by two reviewers. All the clinical studies related to dexmedetomidine versus midazolam on postoperative delirium were screened and collected in this meta-analysis. The combined postoperative delirium risk between dexmedetomidine and midazolam groups was pooled by random effect model. The publication bias was assessed by Begg’s funnel plot and Egger’s line regression test. Results A total of six studies including 386 subjects (202 in the dexmedetomidine group and 184 in the midazolam group) were finally included in this meta-analysis. All six studies reported adequate sequence generation. Three studies used blindness methods and 2 publications were free of selective reporting. However, only 1 publication reported allocation concealment. Because of significant heterogeneity across the studies (I 2 =61.7%, p<0.05), the data were pooled by random effect model. Pooled data showed the postoperative delirium risk in the dexmedetomidine group was significantly lower than that of the midazolam group (RR=0.20 (095%CI:0.09~0.47, p<0.05)).The Begg’s funnel plot showed obvious asymmetry at the bottom and Egger’s line regression test also indicated significant publication bias (t=-6.51, p<0.05). Conclusion Compared with midazolam, patients that received dexmedetomidine for postoperative mechanical ventilation sedation had less risk of developing delirium.

Hemangiomas of the rib are extremely rare benign neoplasm. Here we present a case in a 47-year-old female, detected by chest X-ray and underwent a surgical resection. Histologically, the tumor was composed of a homogeneous conglomerate, irregular, thin walled and dilated blood vessels containing red blood cells, supported by fibrous stroma and intermingled to regular bone trabeculae. The postoperative courses were uneventful, and there was no recurrence during 64 months follow-up.

Objective conventional forceps biopsy (CFB) is the most popular way to screen for gastric epithelial neoplasia (GEN). Our study aimed to compare the diagnostic accuracy between conventional forceps biopsy and endoscopic submucosal dissection (ESD). Methods 105 patients diagnosed GEN finally undertook ESD in our hospital were enrolled. We retrospectively assessed the characteristics of pathological results of CFB and ESD. Results The overall pathologic concordance rate between the CFB and ESD specimens was 68.57%. 55 cases of CFB maintained low-grade intraepithelial neoplasia (LGIN) under ESD,18 cases (23.1%) diagnosis for high-grade intraepithelial neoplasia (HGIN), 5 cases (6.4%) diagnosis for cancer. Moreover, 10 cases of CFB maintained HGIN under ESD. Lesions with surface hyperemia (44.4% vs. 27.54%) or surface ulcer (57.14% vs.26.76%) were more likely to cancerate (P<0.05). Conclusion endoscopic biopsy in the diagnosis of low-grade intraepithelial neoplasia, may exist or progression to high-grade intraepithelial neoplasia, some may have cancer, should take active treatment measures.

Objective To evaluate miR-25 expression in serum of gastric cancer (GC) patients and whether it can be a potential biomarker for GC diagnosis. Methods Forty one pathology confirmed GC patients and 41 healthy controls were included in this study. 10 mL peripheral venous blood were collected from GC patients and healthy controls. miR-25 relative expression and CA19-9 level in serum of GC patients and healthy controls were measured by real-time reverse transcription quantitative polymerase chain reaction (RT-qPCR) and enzyme linked immunosorbent assay (ELISA), respectively. The diagnostic sensitivity, specificity and receiver operating characteristic (ROC) curve of serum miR-25 and CA19-9 were calculated by STATA11.0 software. Results The relative expression of miR-25 was 0.47±0.53 and 0.05±0.36 in serum of GC patients and healthy controls respectively with significant statistical difference (P<0.05). The serum level of CA19-9 for GC patients and healthy controls were 11.91±6.17 U/mL and 7.40±3.97 U/mL, indicating GC patients were much higher than those of healthy controls (P<0.05). The diagnostic sensitivity and specificity were 78.05% and 60.98% with the cut-off value of 0.32 for serum miR-25. Under this cut-off value, the area under the ROC curve was 0.75. For serum CA19-9, the diagnostic sensitivity and specificity were 70.73% and 56.10% with the cut-off value of 9.22 U/mL. Under this cut-off value, the area under the ROC curve was 0.73 with the 95% confidence interval of 0.62-0.84. Positive correlation was found between serum miR-25 relative expression and CA19-9 concentration of GC patients (r=0.75, P<0.05). Conclusion According to our present study, serum miR-25 was elevated in GC patients which may serve as a diagnostic biomarker for GC.

Science always strives to find an improved way of doing things and nanoscience is one such approach. Nanomaterials are suitable for pharmaceutical applications mostly because of their size which facilitates absorption, distribution, metabolism and excretion of the nanoparticles. Whether labile or insoluble nanoparticles, their cytotoxic effect on malignant cells has moved the use of nanomedicine into focus. Since nanomedicine can be described as the science and technology of diagnosing, treating and preventing diseases towards ultimately improving human health, a lot of nanotechnology options have received approval by various regulatory agencies. Nanodrugs also have been discovered to be more precise in targeting the desired site, hence maximizing the therapeutic effects, while minimizing side-effects on the rest of the body. This unique property and more has made nanomedicine popular in therapeutic medicine employing nanotechnology in genetic therapy, drug encapsulation, enzyme manipulation and control, tissue engineering, target drug delivery, pharmacogenomics, stem cell and cloning, and even virus-based hybrids. This review highlights nanoproducts that are in development and have gained approval through one clinical trial stage or the other.

Objective To evaluate the expression of PD-L1 (programmed death 1 ligand 1, PD-L1) and its clinical significance in breast invasive ductal carcinoma. Methods Tumor samples were collected from 64 cases of breast invasive ductal carcinoma patients, and tumor adjacent normal breast tissue were obtained as normal control. The expression of PD-L1 were examined by immunohistochemical staining and real time PCR assay, its correlations with patients’ clinical pathological characteristics were analyzed. Results PD-L1 was found to be over-expressed in 24 of 64 (37.5%) breast invasive ductal carcinoma samples, while in 1 of 22 (4.5%) tumor adjacent normal breast tissue which indicated PD-L1 was higher expressed in breast invasive ductal carcinoma samples than the tumor adjacent normal breast tissue (P < 0.05). PD-L1 positive expression was associated with clinical pathological characteristics of TNM stage and pathology grading (P < 0.05). However, PD-L1 positive expression was not correlated with age (P > 0.05), menstruation status (P >0.05), family history of breast cancer (P > 0.05), tumor diameter (P > 0.05), lymph node metastasis (P > 0.05) and tumor location (P > 0.05). Conclusion PD-L1 may play an important role in invasive ductal carcinoma, which could be a potential indicator for advanced clinical stage and poor prognosis.

Background The development of acute pancreatitis (AP) is associated with intracellular events in pancreatic cells, as well as with early and late inflammatory responses; however, their underlying mechanisms remain unclear. This study investigated trypsinogen activation peptide (TAP)-induced release of high mobility group box-l (HMGB1) from pancreatic acinar cells and how ethyl pyruvate (EP) affects this release. Methodology Pancreatic acinar cells from Sprague Dawley rats were divided into control, TAP (administered TAP), and EP (administered TAP and EP) groups. Cells were collected at 3, 6, 12, and 24 hours after TAP administration to detect HMGB1 mRNA and protein levels using quantitative PCR (qPCR) and Western blotting, respectively. Results The TAP and EP groups exhibited higher levels of HMGB1 mRNA and protein expression (P<0.05) than the control group. The HMGB1 mRNA and protein expression levels also increased with prolonged TAP activity (P<0.05)–especially at 12 and 24 hours (P<0.01)–and showed positive correlations with TAP activity duration (3, 6, 12, and 24 hours) (r=0.971, P<0.01; r=0.966, P<0.01, respectively). Conclusion TAP induces HMGB1 release from pancreatic acinar cells. A positive temporal link exists between early TAP activity and late HMGB1 expression in AP, and EP inhibits HMGB1 release.

PA-MSHA and BPIFB1 play especially important roles in triggering innate immune responses by inducing production of pro- or anti-inflammatory cytokines in the oral cavity and upper airway. We found that PA-MSHA had a strong ability to activate pro-inflammatory cytokines such as IL-1β, IL-6 and TNF-α. However, BPIFB1 alone did not express a directly inductive effect. With incubation of PA-MSHA and BPIFB1, the combination can activate the CD14/TLR4/MyD88 complex and induce secretion of subsequent downstream cytokines. We used a proteome profiler antibody array to evaluate the phosphokinases status with PA-MSHA and BPIFB1 treatment. The results showed that the activation of MAPK, STAT, and PI-3K pathways is involved in PA-MSHA-BPIFB1 treatment, and that the related pathways control the secretion of targeting cytokines in the downstream. When we assessed the content changes of cytokines, we found that PA-MSHA-BPIFB1 treatment increased the production of pro-inflammatory cytokines in the early phase of treatment and induced the increase of IL-4 in the late phase. Our observations suggest that PA-MSHA-BPIFB1 stimulates the release of pro-inflammatory cytokines, and thereby initiates the innate immune system against inflammation. Meanwhile, the gradual release of anti-inflammatory cytokine IL-4 by PA-MSHA-BPIFB1 can also regulate the degree of inflammatory response; thus the host can effectively resist the environmental risks, but also manipulate inflammatory response in an appropriate and adjustable manner.

Multipotent stem cells - such as mesenchymal stem/stromal cells and stem cells derived from different sources like vascular wall are intensely studied to try to rapidly translate their discovered features from bench to bedside. Vascular wall resident stem cells recruitment, differentiation, survival, proliferation, growth factor production, and signaling pathways transduced were analyzed. We studied biological properties of vascular resident stem cells and explored the relationship from several factors as Matrix Metalloproteinases (MMPs) and regulations of biological, translational and clinical features of these cells. In this review we described a translational and clinical approach to Adult Vascular Wall Resident Multipotent Vascular Stem Cells (VW-SCs) and reported their involvement in alternative clinical approach as cells based therapy in vascular disease like arterial aneurysms or peripheral arterial obstructive disease.

Objective To evaluate the effect and toxicity of alprostadil combined with thioctic acid injection in the treatment of patients with diabetic nephropathy (DN). Methods Sixty two patients with DN were included in this study and randomly divided into control group (n=32) and experiment group (n=30). Patients in the control group were given alprostadil 20ug+NS 100ml ivgtt, qd and patients in the experiment group were given alprostadil 20ug+NS 100ml ivgtt combined with thioctic acid injection of 0.45g+100ml ivgtt, qd for 14 days. After treatment, the renal function and serum level of CRP, IL-6 and TNF-α were compared between the two groups. Results After two weeks of treatment, the serum level of CysC and UAER significant decreased for both control and experiment group with statistical difference of p<0.05. After treatment, the serum level of CysC were 1.40 ±0.46 mg/L and 1.02±0.33 for control and experiment group respectively (p<0.05). The post-treatment UAER in experiment group was significantly lower than those of control group with statistical difference (81.02±0.33 vs112.45±20.32, p<0.05) ug/min. The serum level of CRP, IL-6 and TNF-α were significantly decreased after treatment for both control and experiment group (p<0.05). And the post-treatment serum CRP, IL-6 and TNF-α in experiment group were significantly lower than those of control group with statistical difference (p<0.05). No significant side effects were found for the two groupsin the course of treatment. Conclusion Alprostadil combined with α-lipoic acid may improve renal function in patients with diabetic nephropathy by decreasing the levels of serum inflammatory factors.

The aim of this study was to analyze nurses’ professional burnout and health complaints and the relationship between the two components. Methods The anonymous survey included 94 neonatal intensive care nurses from two centers of perinatology. The Maslach Burnout Inventory-Human Services Survey (MBI-HSS) was used to evaluate professional burnout; it consisted of 3 components, Emotional Exhaustion, Depersonalization, and Personal Accomplishments, with 22 items in total. Health complaints were evaluated by 21 items, where nurses were asked to report the occurrence of symptoms within the last year. Scale means were presented with standard deviations (SD). Inferential analysis was conducted with multivariate logistic regression, adjusting for age, residence, and work experience. Results The mean score of professional burnout on the Emotional Exhaustion subscale was 14.4 (SD=7.91), Depersonalization 3.8 (SD=4.75), and Personal Accomplishment 29.1 (SD=10.12). The health assessment revealed that sleeplessness, lack of rest, nervousness, and tiredness were the most common complaints. The regression analysis revealed that tiredness was independently associated with significantly increased odds of professional burnout (OR=4.1). Conclusions In our study, more than half of the nurses in neonatal intensive care had moderate or high levels of emotional exhaustion, while levels of depersonalization were significantly lower. In contrast, the level of personal accomplishment was low in more than half of the nurses. The most common health complaints were sleep disturbances, nervousness, and tiredness. Tiredness was most strongly associated with professional burnout.

Esophageal xanthoma is a rare lesion which is an asymptomatic small yellowish polyp, and most of the reported cases were solitary lesion. Histologically, aggregations of foam cells are found under the papillary hypertrophic squamous epithelium and the foam cells express CD68. The etiology of esophageal xanthoma is unknown. The focal irritation of the esophageal mucosa and infiltrated inflammatory cells are presumed to contribute to its pathogenesis. Although the pathogenesis may be associated with inflammation, the type and nature of the macrophages remain unclear. Here we report a 46-year-old male with esophageal xanthoma, which was incidentally found by endoscopy. Histologically, acute inflammation was not noted, and immunohistochemistry revealed that the foam cells seen in this case of esophageal xanthoma expressed increased levels of M2 macrophage markers. These findings suggest that esophageal xanthoma is associated with late inflammatory and reparative processes long after the initial inflammation of esophageal squamous epithelium.

The dynamic correlation between teeth and denture morphology as well as the morphological positions needs to be explored. Methodology 63 adult patients with skeletal class III malocclusions that met the inclusion criteria were enrolled and imaged with Cone Beam Computed Tomography (CBCT), and Digital Imaging and Communications in Medicine (DICOM) data were collected. The torque angle and axial inclination were measured and analyzed for the corona, root, and entire body of every tooth on the maxilla. Results There is a statistically significant difference between the coronal axial inclination/coronal torque angle for the skeletal class III malocclusion cases and Andrew’s six keys of occlusion. On the sagittal plane of the maxillary denture (except that the secondary molar is inclined medial-distally), the remaining teeth are inclined towards the labia with slightly larger angles compared to the normal occlusion. In the coronal direction, the maxillary anterior teeth tend to have a corona that inclines medial-distally, whereas the posterior teeth have a buccal inclination compared to the normal occlusion. Conclusion Sagittal and transversal compensations prevail in maxillary dentures; for the camouflaged treatment design for skeletal class III, there is limited scope of sagittal and transversal movements on the maxillary denture.

The aim of this study was to evaluate the diagnostic value of serumCK20 mRNA as a biomarker for colorectal cancer diagnosis by meta-analysis. Clinical studies related to serum CK20 mRNA expression for colorectal cancer diagnosis were searched in the databases of Pubmed, Cochrane Library, Embase, ISI Web of Knowledge, CNKI and Wanfang. The number of true positive (tp), false positive (fp), false negative (fn) and true negative (tn) of the original included publications were extracted by two reviewers independently. The diagnostic sensitivity, specificity, positive likely hood ratio (+LR), negative likelyhood ratio (-LR), diagnostic odds ratio (DOR) and area under the symmetric ROC curve (AUC) were pooled by random or fixed effect method according to the statistical heterogeneity among the studies. After screening the databases, nineteen publications met the inclusion criteria and were finally included in this meta-analysis. The diagnostic sensitivity and specificity were pooled by random effect model(I2>50%). The pooled diagnostic sensitivity and specificity of CK20 mRNA in serum as biomarker for colorectal cancer were 0.49 (95% CI:0.46 to 0.51) and 0.94 (95%CI:0.92-0.96) respectively. The pooled +LR and −LR were 10.90 (95%CI:5.78 to 20.55) and 0.51 (95%CI:0.45 to 0.57) respectively by random-effect method. The pooled DOR was 22.31 with the 95% CI of 11.65 to 42.71. The pooled area under the ROC curve (AUC) was 0.72for CK20 mRNA in serum as a biomarker for colorectal cancer diagnosis. Conclusion Serum CK20 mRNA expression was significantly elevated in colorectal cancer patients which could be a promising serum biomarker for colorectal cancer diagnosis with high specificity.

To evaluate the clinical value of serum α-L-fucosidase (AFU), 5’-nucleotidase (5’-NT) and alpha fetoprotein (AFP) as biomarkers for primary hepatocellular carcinoma (PHC) diagnosis. Methods: Thirty six primary hepatocellular carcinoma (PHC) patients and 36 healthy controls were recruited in this study from February 2014 to January 2016 in the Second People’s Hospital of Tianjin. The serum level of AFU, 5’-NT and AFP were examined and compared between the two groups. The diagnostic sensitivity, specificity area under the receiver operating characteristic (ROC) curve were calculated by STATA11.0 software. Results: The serum level of AFU, 5’-NT, AFP were 30.87±10.43(U/L), 5.58±3.89(U/L), 233.60±226.60 (μg/L) respectively for primary hepatocellular carcinoma group and 19.96±6.73 (U/L), 1.87±0.84 (U/L), 16.64±14.17 (μg/L) for healthy control groups. The serum level of AFU, 5’-NT and AFP in primary hepatocellular carcinoma group were significant higher than those of healthy control group (P<0.001). The diagnostic sensitivity and specificity were 0.78 (95%CI:l0.61-0.90), 0.64 (95%CI:0.46-0.79) for serum AFU, 0.75(95%CI:0.58-0.88), 0.72(95%CI:0.55- 0.86) for serum 5’-NT and 0.72 (95%CI:0.55-0.86), 0.92 (95%CI:0.78-0.98) for serum AFP respectively. The AUC under the ROC curve were 0.80 (0.69-0.90), 0.80 (0.69-0.91) and 0.87 (0.780-0.96) for serum AFU, 5’-NT and AFP respectively. Positive correlation between AFU and 5’-NT (rpearson=0.63, P<0.05), AFU and AFP (rpearson=0.49, P<0.05), 5’-NT and AFP(rpearson=0.44, P<0.05) were found in the primary hepatocellular carcinoma patients. Conclusion: Serum AFU, 5’-NT and AFP were higher in PHC patients than those of healthy controls. The difference between PHC patients and healthy controls made serum AFU, 5’-NT and AFP potential biomarker for PHC diagnosis.

The purpose of the study is to establish absolute reliability and concurrent validity between hand-held dynamometers (HHDs) and isokinetic dynamometers (IDs) in lower extremity peak torque assessment. Medline, Embase, CINAHL databases were searched for studies related to psychometric properties in muscle dynamometry. Studies considering standard error of measurement SEM (%) or limit of agreement LOA (%) expressed as percentage of the mean, were considered to establish absolute reliability while studies using intra-class correlation coefficient (ICC) were considered to establish concurrent validity between dynamometers. In total, 17 studies were included in the meta-analysis. The COSMIN checklist classified them between fair and poor. Using HHDs, knee extension LOA (%) was 33.59%, 95% confidence interval (CI) 23.91 to 43.26 and ankle plantar flexion LOA (%) was 48.87%, CI 35.19 to 62.56. Using IDs, hip adduction and extension; knee flexion and extension; and ankle dorsiflexion showed LOA (%) under 15%. Lower hip, knee, and ankle LOA (%) were obtained using an ID compared to HHD. ICC between devices ranged between 0.62, CI (0.37 to 0.87) for ankle dorsiflexion to 0.94, IC (0.91to 0.98) for hip adduction. Very high correlation were found for hip adductors and hip flexors and moderate correlations for knee flexors/extensors and ankle plantar/dorsiflexors.

Transfusion (or drinking) of blood or of its components has been thought as a rejuvenation method since ancient times. Parabiosis, the procedure of joining two animals so that they share each others blood circulation, has revitalized the concept of blood as a putative drug. Since 2005, a number of papers have reported the anti-ageing effect of heterochronic parabiosis, which is joining an aged mouse to a young partner. The hallmark of aging is the decline of regenerative properties in most tissues, partially attributed to impaired function of stem and progenitor cells. In the parabiosis experiments, it was elegantly shown that factors derived from the young systemic environment are able to activate molecular signaling pathways in hepatic, muscle or neural stem cells of the old parabiont leading to increased tissue regeneration. Eventually, further studies have brought to identify some soluble factors in part responsible for these rejuvenating effects, including the chemokine CCL11, the growth differentiation factor 11, a member of the TGF-β superfamily, and oxytocin. The question about giving whole blood or specific factors in helping rejuvenation is open, as well as the mechanisms of action of these factors, deserving further studies to be translated into the life of (old) human beings.

Objective This preliminary study investigated the clinical safety and efficacy of foam sclerotherapy during shunt surgery to treat portal hypertension and gastroesophageal varices. Methods Seven patients with confirmed portal hypertension and a variceal bleeding history underwent mesocaval shunt with simultaneous polidocanol foam injection into the varices. Computed tomography and endoscopic reviews were conducted within two weeks following the procedures and around six months later. Results Six patients underwent side-to-side mesocaval shunt. One received a prosthetic mesocaval shunt. Polidocanol foam was injected into the gastric varices or the inferior mesenteric vein during the surgery. Surgical success and survival was achieved in all patients. Gastric ulcer formation and thrombocytopenia occurred in one patient respectively, which were ameliorated by conservative treatment. During 12 to 24 months’ follow-up, three patients had obvious decrease or eradication of gastroesophageal varices; four patients had obvious decrease of gastric varices but residual esophageal varices; and all patents had unobstructed shunts. Encephalopathy occurred in one patient two months postoperatively. No sclerosant-related complications were observed and no postoperative recurrent variceal bleeding occurred. Conclusions Foam sclerotherapy during shunt surgery is safe and effective for portal hypertension and varices treatment.

Objectives This study aimed to identify a correlation between insomnia and the occurrence of depression among Japanese hospital employees using the data obtained from a self-reported questionnaire. Methods A self-administered questionnaire on sleeping patterns, depression, fatigue, lifestyle-related diseases, and chronic pain was given to 7690 employees aged 20-60 years, and 5,083 employees responded. Results An insomnia score of >2 was observed in 840 (13%) respondents. Chronic insomnia correlated significantly with gender, occupation, overtime work, metabolic syndrome, chronic pain, fatigue, and depression. Moreover, significant negative effects on depression scores were observed in males aged 30-39 (partial regression coefficient: b=0.357, p=0.016), females aged 20-29 (b=0.494, p<0.001), male administrative staff (b=0.475, p=0.003), males with metabolic syndrome (b=0.258, p=0.023), and both genders with chronic insomnia (male; b=0.480, p<0.001: female; b=0.485, p<0.001), and fatigue (male; b=1.180, p<0.001: female; b=1.151, p<0.001). Discussion Insomnia is a risk factor for depression and for other lifestyle-related diseases. The insomnia score may be useful in preventative care settings because it is associated with a wide spectrum of diseases and serves as a valuable marker for early detection of depression. Thus, our future studies will focus on establishing a method for early detection of depression symptoms among workers across various job profiles.

The aim of this study was to evaluate the serum NF-κBp65, TLR4 (Toll-like receptor 4) expression in patients of preeclampsia and its diagnostic value as biomarkers. Methods Thirty patients with preeclampsia (case group) and 30 normal pregnant women (control group) were included in this study. The serum level of NF-κBp65 and TLR4 were examined by enzyme linked immunosorbent assay (ELISA), and compared between the two groups. The diagnostic sensitivity, specificity and area under the receiver operating characteristic (ROC) curve were calculated by STATA11.0 statistical software. Results The expression level of TLR4 and NF-κBp65 in serum of preeclampsia patient group was 3.76±1.07ng/ ml and 183.20±49.19ng/ml, whereas that in the serum of the normal pregnant group was 2.43±0.69ng/ml and 98.68±29.80ng/ml. The expression of TLR4 and NF-κBp65 in serum of preeclampsia patient group was significantly higher than that of the normal pregnant group (P<0.05); The Pearson correlation test showed that the TLR4 expression in the serum of preeclampsia patients and normal pregnant women was positively correlated with their NF-κBp65 expression [r preeclampsia =0.46, (P<0.05), r normal =0.48, (P<0.05)]. When TLR4 and NF-κBp65 were selected as the reference indexes, the diagnostic sensitivity of preeclampsia was 86.67% (95%CI:69.28%-96.24%) and 90.33% (95%CI:73.47%-97.89%), and the specific ity was 70.00% (95%CI:50.60%-85.27%) and 83.33% (95%CI:65.28%-94.36%). The area under the ROC curve was 0.84 and 0.89. Conclusion Serum levels of TLR4 and NF-κBp65 was significantly higher in patients with preeclampsia which may involve in the pathogenesis of preeclampsia, and can be used as biomarker for predicting preeclampsia.

Background Therapeutic options for thymoma-associated myasthenia gravis (MG) patients complicated with hypertension and/or diabetes post thymectomy are often conventional steroids. As the prevalence of diabetes and hypertension globally increases, other therapeutic options for these patients are of great importance. Material/methods 9 patients with thymoma-associated MG complicated with hypertension and/or diabetes after thymectomy were administered 75 mg/m2 of docetaxel and 70 mg/m2 of cisplatin on day 1. The treatment could be repeated at 3-week intervals, ranging from 1 to 4 cycles according to the status of the patients. Therapeutic efficacy and side effects were evaluated. Results 2 patients were complicated with type 2 diabetes, 6 with hypertension, and 1 with both diabetes and hypertension. After docetaxel/cisplain therapy, the MG symptoms were markedly improved in all patients (2, complete remission; 3, basic remission; 3, marked improvement; 1, improvement). Acetylcholine receptor (AchR) antibody levels were decreased in 8 patients. Minor adverse effects were observed in 2 patients, 1 with Grade II gastrointestinal reaction, and the other with pulmonary infection. Conclusion Docetaxel plus cisplatin might be an effective therapeutic option for thymoma-associated MG patients complicated with hypertension /diabetes post thymectomy without worsening thymoma and hypertension / diabetes.

Background The aim of this study was to determine the relationship between fluid resuscitation and glycocalyx degradation in severe sepsis. Methodology 15 post-thoracotomy patients with severe sepsis and 11 patients in recovery after open chest surgery (controls) were enrolled. Results Plasma syndecan-1 concentrations were significantly higher in the sepsis group than that in control group, and were correlated with fluid balance in the sepsis group (P=0.026). Survival was not related to trends in plasma syndecan-1 concentrations (ascending/descending) in the sepsis group (P = 0.409). Fluid balance at 24 h was significantly higher in sepsis patients who died than in those who survived (P = 0.010). Acute Physiology and Chronic Health Evaluation II scores, Sequential Organ Failure Assessment scores, duration of mechanical ventilation, and length of intensive care unit stay did not differ with the trend of plasma syndecan-1 concentrations. Compared with plasma syndecan-1 concentrations, lactate clearance at a cutoff of 0.40% had a higher diagnostic value. Conclusions In patients with severe sepsis, the glycocalyx plays an important role in liquid distribution in different phases. With time, it changes as well. At present, lactate clearance has greater diagnostic value than plasma syndecan-1 concentrations in severe sepsis. A better indicator of endothelial glycocalyx is therefore required.

Objective To evaluate the clinical and radiographic outcomes of a modified Sauve-Kapandji procedure for patients with old fractures in the distal radius. Methods Fifteen patients (10 male and 5 female patients with an average age of 40 years old) were treated by the modified Sauve-Kapandji procedure from January 2014 to April 2016. All patients had undergone at least one previous operation on the involved wrist, and they were still suffering from pain and functional limitations at the time of admission. The postoperative follow-up period was 12-26 months and the average was 20 months. Functional assessment was made at the last follow-up. All patients were evaluated according a Modified Mayo Wrist Score system. Results Of the fifteen patients with posttraumatic arthritis, thirteen had excellent results, two had good results, and one had fair results. There were no major complications. Conclusions The modified Sauve-Kapandji procedure is a safe and effective surgical alternative for intractable disorders of the distal radioulnar joint and can be recommended as a salvage procedure when previous treatments fail.

Objective To evaluate the risk factors and outcome of bile leak after liver transplantation. Methods We undertook a retrospective study of patients who underwent liver transplantation in our institution between January 2010 and January 2014. The characteristics and survival rate of patients with or without bile leak were compared. Results Bile leak was observed in sixteen patients after liver transplantation (2.7% of the total number of patients transplanted). Total operating time and bile duct reconstruction technique (duct-to-duct anastomosis or Rouxen-Y cholangiojejunostomy) were found to differ significantly between patients with and without bile leak in univariate (p = 0.001 and 0.024, respectively) and multivariate analyses (p = 0.012 and 0.026, respectively). There was no difference in the one-year patient survival rate between the two groups. However, two-year patient survival rate was significantly lower in the bile leak group (p = 0.003). Both one-year and two-year graft survival rates were significantly lower in the bile leak group (p = 0.049 and <0.001, respectively). Conclusions Cholangiojejunostomy and prolonged total operating time are risk factors for bile leak after deceased donor liver transplantation. Bile leak reduces graft and patient survival rates after deceased donor liver transplantation.

Objective The aim of this study was to investigate the clinicopathological and immunohistochemical (including VEGF, Akt, HSP70, and HSP20 expression) factors that affect the overall and disease-free survival of HCC patients following surgical resection. Methods 234 patients with HCC following surgical resection were enrolled. Clinicopathological and survival data were analyzed, and immunohistochemical staining was performed on tissue microarray sections using the anti-VEGF, anti-Akt, anti-HSP70, and anti-HSP27 antibodies. Results The 3- and 5-year overall survival rates were 86.5 and 81.54%, respectively. Multivariate analysis revealed that VEGF expression (P = 0.017, HR = 2.573) and T stage (P < 0.001, HR = 4.953) were independent prognostic factors for overall survival. Immunohistochemical staining showed that the expression of Akt, HSP70, and HSP27 did not affect the overall survival rate. The 3- and 5-year disease-free survival rates were 58.2 and 49.4%, respectively. Compared to the VEGF(−)/(+) group, the VEGF(++)/(+++) group demonstrated significantly higher proportion of patients with AFP levels > 400 ng/mL, capsule invasion, and microvascular invasion. Conclusion VEGF overexpression was associated with capsule invasion, microvascular invasion, and a poor overall survival rate.

The term vein of Galen aneurysm is related to a group of different vascular anomalies, with one common distinction being the dilatation of the vein of Galen. It represents a rear vascular anomaly, whose incidence is yet unknown, although some authors suggest numbers around 1:25000 deliveries. It accounts for only 1% of all intracranial malformations, but the percentage of this anomaly in pediatric populations is up to 30%. In most cases the diagnosis is made postnatal, while antenatal diagnosis, because of the pathophysiology of aneurysm itself, as well as pathophysiology of its possible complications, is made usually during the third trimester, frequently after the 34th week of gestation. The earliest reported diagnosis was made at 25 weeks’ gestation. In this case we present 25-year old gravida, pregnancy at 28th week of gestation with aneurysm, and sonographically detected aneurysm of the vein of Galen, that ended with termination of pregnancy.

Penetrating sacral injuries are very rare, but foreign bodies that penetrate the sacrum often cause pain, cerebrospinal fluid leakage, and neurological symptoms. Careful preoperative medical and imaging examinations, determining the position of the foreign body, and surgical exploration are essential in the management of such cases. We present the case of a woman who visited our emergency department with a broken sewing needle in her sacrum. The incident occurred when the patient accidentally sat on the needle while sewing by hand. Pain while sitting was the main clinical finding after the accident. The patient was treated successfully by surgical exploration aided by a permanent magnet. At follow-up a few months later, she was symptom-free. In clinical practice physicians often encounter patients with metallic foreign bodies. Permanent magnets play an important role in the removal of metallic foreign bodies, and emergency department physicians should master the methods and techniques.

Behavioral interventions can prevent the transmission of HIV and sexually transmitted infections. This systematic review and meta-analysis assesses the effectiveness and quality of available evidence of HIV prevention interventions for people living with HIV in high-income settings. Searches were conducted in MEDLINE, EMBASE, PsycINFO, and CDC Compendium of Effective Interventions. Interventions published between January, 1998 and September, 2015 were included. Quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Forty-six articles and 63 datasets involving 14,096 individuals met inclusion criteria. Included articles were grouped by intervention type, comparison group and outcome. Few of these had high or moderate quality of evidence and statistically significant effects. One intervention type, group-level health education interventions, were effective in reducing HIV/STI incidence when compared to attention controls. A second intervention type, comprehensive risk counseling and services, was effective in reducing sexual risk behaviors when compared to both active and attention controls. All other intervention types showed no statistically significant effect or had low or very low quality of evidence. Given that the majority of interventions produced low or very low quality of evidence, researchers should commit to rigorous evaluation and high quality reporting of HIV intervention studies.

Myeloperoxidase-antineutrophil cytoplasmic antibody-associated vasculitis (MPO-AAV) does not usually involve large vessels, such as the aorta. However, we experienced three cases having an aortic aneurysm as a complication of MPO-AAV with renal insufficiency. In one patient it involved the onset of descending aortic dissection during treatment for MPO-AAV; another two patients had an abdominal aortic aneurysm at the time of our diagnosis of MPO-AAV. Although we found no pathological evidence in our patients, MPO-AAV might result in large vessel inflammation. Therefore, we suggest that patients with MPO-AAV should be examined by computed tomography scan to check for the presence of an aortic aneurysm.

Background This study compared the realtime monitoring effects of conventional ultrasound and contrast-enhanced ultrasound (CEUS) on evaluating radio frequency ablation (RFA) in a living swine liver model. Methodology Liver RFA was performed on 10 young swine. Conventional ultrasound and CEUS were performed immediately. After the animals were sacrificed, ablation lesions were removed to histopathologically examine the range of the lesions. Ablation completeness based on three methods were compared using histopathology as the gold standard. Results Forty-three ablation lesions were produced in the animals. The horizontal diameter, vertical diameter and ablation lesion area based on conventional ultrasound were all significantly smaller than those based on the gross sample, but no significant differences existed between the results of the CEUS and the gross sample. Histopathology showed that 30 lesions were incompletely ablated and 13 were completely ablated, while CEUS showed that 28 lesions were incompletely ablated and 15 were completely ablated. Compared with histopathology, CEUS had an accuracy of 81.4%, a sensitivity of 83.3%, and a specificity of 76.9%. No significant difference in ablation completeness judgment between CEUS and histopathology was observed. Conclusion CEUS provides a real-time radiological foundation for evaluating RFA lesion ranges and completeness in a living swine liver model.

Situs inversus with dextrocardia is a rare condition, with complete transposition of all the body organs, including the heart. Percutaneous coronary intervention (PCI) in these patients is technically difficult because of the mirror image of organs. Here, we describe a 56-year-old man with coronary heart disease with known situs inversus with dextrocardia and coronary percutaneous intervention was performed for stenosis in the right coronary artery. A drug eluting stent was implanted at this site successfully. This case suggested that the interventional management of such patients follows the same general rules as for non-dextrocardia patients, but the manipulation of the catheter and projection position choices need to be taken into consideration to obtain optimal benefits for the patient.

Background Liposarcoma, which develops in adipose tissue, is one of the most common soft tissue sarcomas. It appears mostly in the lower limbs, particularly in the thigh and limb girdles, followed by the upper extremities, thoracoabdominal wall, and the internal trunk and retroperitoneum. Pleomorphic liposarcoma (PLS), a rare subtype of liposarcoma is considered a highgrade malignancy. Case presentation We present a case of primary PLS in the left fallopian tube of a 47-year-old female. Ten months previously, she was diagnosed with PLS of the left fallopian tube in another hospital and had a wide excision of left fallopian tube mass, including total abdominal hysterectomy and bilateral salpingo-oophorectomy for left fallopian tube PLS. Presently, she has developed a recurrence and metastasis of PLS in the pelvic and abdominal cavities. Conclusion This may be the first case of primary fallopian tube PLS, wherein the prognosis of this patient was poor due to the high-grade malignancy of PLS.

Objective To observe and analyze the effect of color doppler ultrasonography (CDU) in uterine arterial embolization (UAE). Methods 160 cases of patients with uterine fibroid were selected in this study. CDU were performed on all patients before UAE as well as 5-9 days and 3- 6 months after UAE, so as to observe the shape, size and ultrasonogram of the uterus and uterine fibroid, and the blood flow changes of the uterine fibroid. In addition, analysis was carried out on the improvement of the clinical symptoms 3 months to 6 months after UAE. Results 5-9 days and 3-6 months after UAE, the blood flow of uterine fibroid was significantly reduced or even disappeared, with P <0.05; according to the observation carried out 3-6 months after UAE, irregular menstruation and uterine fibroid compression were significantly relieved; the uterine size and the uterine fibroid volume were significantly decreased;high-level echo was generated inside of the uterine fibroid, which was then gradually reduced into slightly higher echo, equal echo and low echo. High-level echo was found around the uterine fibroid. Conclusion It is safe and reliable for the patients with symptomatic uterine fibroid to take UAE. The application of CDU can also provide a good basis and has great significance.

Alcohol is the most used psychoactive substance among adolescents, is an important public health problem and a major risk factor for the health of this group. This study is regarding to the pattern of alcohol consumption by adolescents. Descriptive, correlational and cross-sectional study, with a sample of 378 adolescents, which are attending three high schools, in north-eastern Portugal. In the data collection we used a questionnaire. Data was analysed using SPSS. The prevalence of alcohol is 86.8%. The mean score of Alcohol Use Disorders Identification Test (AUDIT) was 3.53±4.525 points. The vast majority of participants were located in the non-excessive alcohol consumption area (91.3%). The pattern of alcohol consumption differs significantly between gender (Wald: p ≤ 0,004) and the religious practice (Wald: p ≤ 0,027), with greater percentage of boys and students who did not practice any religion in excessive consumers. The prevalence of alcohol consumers is high. The proportion of young people with excessive consumption in our sample is lower than in other studies, but shows that there is a group of adolescents in excessive consumption. It found a relationship between consumption pattern, gender and religious practice. These results justify the development of public health interventions.

Objective This paper aims to explore specific effects of out-of-hospital continuing nursing on schizophrenia patients’ health rehabilitation and quality of life, and further improve application and popularization of out-of-hospital continuing nursing. Methods The 180 schizophrenia patients discharged from our hospital from March 2014 to March 2016 were selected as the subjects. The patients were divided into two groups according to the randomized double-blind method. Both groups received routine discharge guidance, and the observation group received out-of-hospital continuing nursing on this basis. Questionnaires and scales were used to compare differences of the two groups after discharge from hospital, such as medication compliance, recurrence rate of schizophrenia, awareness of health knowledge and quality of life. Results After 6 months of nursing for the observation group, complete medication compliance rate was 71.11% (64/90), awareness rate of schizophrenia-related health knowledge was 96.67% (87/90), and recurrence rate was 8.89% (8/90). For the control group, complete medication compliance rate was 45.56% (41/90), awareness rate of schizophrenia-related knowledge was 46.67% (42/90) and the recurrence rate of disease was 26.67% (24/90). Hence, the observation group enjoys significant advantages compared with the control group. Statistical analysis (P <0.05) showed statistical significance; In addition, life quality scores showed that the quality of life of the observation group was obviously better than the control group; the difference was statistically significant (P <0.05). Conclusion Out-of-hospital continuing nursing for schizophrenia patients after discharge can effectively improve medication compliance, awareness rate of health knowledge, effectively reduce incidence of schizophrenia and improve the quality of life of patients. Thus, the nursing concept and related methods are worthy of publicity and application in a wider range.