Abstract:Application of artificial intelligence has made revolutionary advances in many medical scenarios such as diagnosis, drug screening, medical imaging and nursing. Images of pathological sections (2D) are a preliminary breakthrough of artificial intelligence. Abundant medical and pathological resources, and standardization, digitization of pathological section images provide big data for the in-depth study of artificial intelligence. Through a series of research on artificial intelligence in pathologies of breast cancer, gastric cancer, and cholangiocarcinoma, we established a labeling standard of tumor cells and an in-depth learning process, and we also developed an artificial intelligence algorithm for hilar cholangiocarcinoma. However, there are still many problems and we tried to search for the solutions. With the improvement in precision of artificial intelligence diagnosis, pathology of artificial intelligence may be soon applied in future clinical practice.

Abstract:Objective To compare the hearing and vestibular function in patients with vestibular migraine (VM) and Ménière's disease (MD), so as to identify and diagnose the two diseases. Methods The clinical data of patients with VM or MD, who were treated in the Department of Neurology, Jing'an District Zhabei Centre Hospital of Shanghai from Jan. 1, to Dec. 31, 2016, were retrospectively analyzed. All patients received pure-tone audiometry, video head pulse (VHIT) and videonystagmography (VNG) tests within 2 weeks of onset, and the results were compared between the two groups. Results A total of 31 patients with VM, including 7 males and 24 females, had an average age of (53.52±13.80) years old. Seventeen of 31 cases (54.8%) were abnormal in pure-tone audiometry, showing sensorineural hearing loss; and 13 cases had bilateral symmetry high frequency mild to moderate hearing loss. VHIT test was abnormal in 5 cases (16.1%). There was no spontaneous nystagmus in VM patients by VNG test, while position nystagmus existed in 4 cases (12.9%) by positioning test. Ten cases (32.3%) were abnormal in the saccade test, 8(25.8%) were abnormal in the smooth tracking test, 13(41.9%) were abnormal in the optokinetic nystagmus test, 12(38.7%) were abnormal in the caloric test, and no case was abnormal in the gaze test. A total of 31 patients with MD, including 17 males and 14 females, had an average age of (55.48±12.32) years old. All cases had unilateral low to medium frequency sensorineural hearing loss by pure-tone audiometry. VHIT test was abnormal in 9 cases (29.0%). There was one case (3.2%) showing spontaneous nystagmus by VNG test, and no position nystagmus was found. Six cases (19.4%) were abnormal in the saccade test, 8(25.8%) were abnormal in the smooth tracking test, 6(19.4%) were abnormal in the optokinetic nystagmus test, 13(41.9%) were abnormal in the caloric test, and no case was abnormal in the gaze test. There were significant differences in the results of pure-tone audiometry, positioning test and optokinetic nystagmus test between the patients with VM and MD (all P<0.05). Conclusion Compared with MD patients, patients with VM showed lower abnormal rate of pure-tone audiometry, with more having bilateral symmetry high frequency hearing loss, and higher rate of abnormal results in positioning test and optokinetic nystagmus test. Pure-tone audiometry, positioning test, and optokinetic nystagmus test can provide references for the differentiation of VM and MD.

Abstract:Objective To explore the role of serum 25-hydroxyvitamin D (25[OH]D) in the occurrence and recurrence of benign paroxysmal positional vertigo (BPPV) in patients with BPPV. Methods Patients with non-recurrent BPPV (n=207) and recurrent BPPV (n=42) were recruited from Department of Neurology of Shanghai Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine from Jan. 2013 to Dec. 2014, and patients with non-BPPV vertigo diseases in the same period were enrolled as controls (n=43). The recurrence of BPPV was determined within one year of follow-up. The differences of serum 25(OH)D levels between three groups were compared, and the factors influencing the levels of serum 25(OH)D of all subjects were analyzed. Results Compared with the control group, serum 25(OH)D levels in the non-recurrent BPPV and recurrent BPPV groups were significantly decreased (both P<0.01), while there was no significant difference between the non-recurrent BPPV and recurrent BPPV groups. The female proportion was increased in the recurrent BPPV group versus the other two groups, but the difference was not significant (P=0.073). The serum 25(OH)D level in female patients was significantly lower than that in male patients ([18.7±7.5] ng/mL vs[21.7±8.3] ng/mL, P=0.002). Multiple stepwise linear regression analysis showed that females(β=-2.6, P=0.005)and BPPV (β=-5.5, P<0.001) were the independent factors influencing the level of serum 25(OH)D. Conclusion There are gender differences in human serum 25(OH)D levels, and the level of 25(OH)D is decreased in patients with BPPV.

Abstract:With the in-depth understanding of dizziness and vertigo mechanisms, it has been found that there are multiple mechanisms for dizziness/vertigo induced or aggravated by turning of neck, of which proprioception afferent abnormality in the upper cervical region and posterior circulation ischemia associated with vertebral basilar artery compression are the two most important ones. The clinical manifestations, examination and diagnosis methods, and treatments of dizziness/vertigo induced by these two mechanisms are quite different. Therefore, it is inappropriate to use the concept of "cervical vertigo" to cover these two different situations, and the concept should no longer to be used.

Abstract:Objective To investigate the efficiency of early vestibular rehabilitation in managing residual dizziness after successful canalith repositioning maneuver in patients with benign paroxysmal positional vertigo. Methods A total of 100 patients with primary benign paroxysmal positional vertigo were enrolled after successful canalith repositioning in Department of Neurology, Changzheng Hospital of Second Military Medical University from March to December of 2016. There were 38 cases had residual dizziness 24 hours after successful canalith repositioning maneuvers, and they were divided into vestibular rehabilitation group to receive Cawthorne-Cooksey vestibular rehabilitation training and control group without special treatment. All patients were followed up by neurologists once a week for 4 weeks. The Dizziness Handicap Inventory (DHI) scale was used to evaluate the efficiency of vestibular rehabilitation. Results The DHI scores of patients in the two groups were significantly improved at 1-4 weeks of follow-up (all P<0.05). There were no significant differences in DHI scores between the two groups immediately after canalith repositioning maneuvers (P=0.609) or at 1 week of follow-up (P=0.627). The DHI scores in the vestibular rehabilitation group were significantly lower than those in the control group at 2-4 weeks of follow-up (all P<0.05). Conclusion Early vestibular rehabilitation can relieve residual dizziness and reduce the incidence of functional disability after successful canalith repositioning maneuvers in patients with benign paroxysmal positional vertigo.

Abstract:Objective To investigate the incidence of right-to-left shunt (RLS) of heart in patients with vestibular migraine (VM) using transcranial Doppler (TCD) foaming test. Methods The clinical data of patients with VM who were diagnosed in Shaanxi Provincial People's Hospital from Jun. 2016 to Jan. 2017 were collected, and the volunteers without history of cardiac disease or headache during the same period were included as controls. The incidences of RLS of heart in each group were determined using TCD foaming test, and the relationship between the volume of RLS and the concomitnta symptoms of VM was analyzed. Results A total of 139 VM patients (23 males and 116 females) and 30 volunteers were included in this study. There was no significant difference in the incidence of RLS between the VM and control groups (25.9% vs 23.3%, P>0.05). RLS-positive VM patients had a significantly higher rate of palpitation than those with negative RLS (P<0.05). There was no significant difference in visual aura between RLS-positive and RLS-negative VM patients (P>0.05). The shunt volume of RLS was not related to the age of onset or the duration of VM (P>0.05). Among RLS-positive VM patients, the frequency of vertigo in the small shunt amount group (air slug signal of RLS ≤ 10) was significantly higher than that in the large shunt amount group (air slug signal of RLS>10) (7.35 times per year vs 7.27 times per year, P<0.05). Conclusion There is no significant difference in the incidence of RLS between VM patients and normal population. RLS-positive VM patients with small shunt amount are more likely to experience palpitation, and palpitation is more common in RLS-positive VM patients than in RLS-negative patients.

Abstract:Objective To analyze the clinical characteristics of patients with unilateral idiopathic posterior canal-benign paroxysmal positional vertigo (PC-BPPV). Methods We retrospectively analyzed and summarized the clinical characteristics of 214 patients with unilateral idiopathic PC-BPPV who were diagnosed in the First Hospital of Shanxi Medical University from Nov. 2013 to Feb. 2015. Results In the Dix-Hallpike displacement test (D-H test), the average latency of nystagmus in patients with unilateral idiopathic PC-BPPV was (2.02±1.19) s, and the average duration was (21.3±14.5) s. There were no gender or age differences in the latency or duration of nystagmus. Typical nystagmus was induced in 184 cases (86.0%) by one or two D-H tests. The first onset time of 162 cases (75.7%) was in wake up or sleep-tuning at night. Fifty-one cases (23.8%) displayed the reversal phase of nystagmus. The cure rate of patients was 88.3%, and the effective rate was 98.1%. Among 210 patients sensitive to treatment, the recurrence rates were 0 (0/210, 0 case lost to follow-up), 5.7% (12/210, 0), 8.7% (18/208, 2), 11.8% (23/195, 15) and 17.4% (31/178, 32) on 1^st, 3^rd, 6^th, 12^th and 18^th month, respectively. Forteen cases (6.5%) had canal switch phenomenon after reduction, and 67 cases (31.9%) had residual dizziness or unstable symptoms after reduction. Conclusion The most common first onset time of patients with unilateral idiopathic PC-BPPV is in wake up or sleep-tuning at night. Most patients can be cured by Epley method, but the long-term efficacy still need follow-up observation.

Abstract:Objective To evaluate the role and value of Changhai fulcrum bending radiograph (CH-FBR) in curve flexibility assessment of patients with skeletal mature idiopathic scoliosis. Methods Twenty-five thoracic and lumbar vertebrae curves derived from 19 patients with skeletal mature idiopathic scoliosis treated in Changhai Hospital of Second Military Medical University between Jun. 2013 and Feb. 2015 using Changhai fulcrum bending radiographic technique were enrolled. The patients included 15 females and 4 males, with an average age of (23.1±3.5) years old (ranged from 20 to 30 years old). The assessment of radiographs included preoperative standing posterior-anterior radiograph, Changhai fulcrum bending radiograph (starting fulcrum bending, maximum fulcrum bending), supine side-bending radiograph, traditional fulcrum bending radiograph and postoperative standing posterior-anterior radiograph one week after surgery. Paired t-test was used to assess the differences between preoperative and postoperative parameters, and the correlation between parameters was analyzed by Pearson correlation analysis. Results There were a total of 25 curves in this study, including 17 thoracic curves and 8 thoracolumbar/lunbar curves. Cobb's angles in supine side-bending, traditional fulcrum bending and Changhai starting fulcrum bending were significantly different from the Cobb's angles in postoperative standing posterior-anterior (all P<0.05); Cobb's angles in traditional fulcrum bending and Changhai maximum fulcrum bending were significantly different from the Cobb's angle in Changhai starting fulcrum bending (P<0.05). The results of 17 thoracic and 8 thoracolumbar/lunbar curves were same as 25 curves. Correlation analysis of 25 curves showed that the flexibility rates in Changhai starting fulcrum bending and Changhai maximum fulcrum bending were both positively related to correction rate (r=0.84, 0.87; both P<0.01). The height of Changhai maximum fulcrum bending radiograph was positively correlated with the maximum weight (r=0.67, P=0.001), and the height changes of Changhai maximum fulcrum bending radiograph was positively correlated with the weight changes (r=0.60, P=0.001). Conclusion Changhai fulcrum bending radiograph is more reliable and effective than traditional fulcrum bending radiograph and supine side-bending for curve flexibility evaluation in patients with skeletal mature idiopathic scoliosis. Compared with the traditional fulcrum bending radiograph and side-bending radiograph, the flexibility suggested by the Changhai fulcrum bending radiograph is closer to the postoperative result made by pedicle screws fixation and fusion.

Abstract:Objective To evaluate the effect of postoperative transcatheter arterial chemoembolization (pTACE) on the long-term prognosis of patients with intrahepatic cholangiocarcinoma (ICC), and to identify the proper ICC patients for the adjuvant therapy. Methods A total of 114 ICC patients were included, who received radical resection at the Eastern Hepatobiliary Surgery Hospital of Second Military Medical University from Jan. 2010 to Dec. 2011. Univariate and multivariate analyses were performed to determine the independent risk factors of overall survival (OS) and recurrence-free survival (RFS). Patients with one or more risk factors for relapse were included in the high-risk group (n=73) and those without risk factors of relapse were included in the low-risk group (n=41). The effect of pTACE on the prognosis of patients in the two groups was compared. Results Multivariate analysis results showed that multiple tumor (HR=3.515, 95%CI 2.083-5.932, P<0.001), tumor maximum diameter >5 cm (HR=2.050, 95%CI 1.309-3.210, P=0.002), microvascular invasion (HR=2.287, 95%CI 1.104-4.736, P=0.026), positive surgical margin (HR=5.089, 95%CI 2.055-12.600, P<0.001) and lymph node metastasis (HR=2.880, 95%CI 1.579-5.251, P=0.001) were the independent risk factors of OS; and multiple tumor (HR=2.752, 95%CI 1.619-4.678, P<0.001), tumor maximum diameter >5 cm (HR=2.010, 95%CI:1.298-3.113, P=0.002) and microvascular invasion (HR=3.857, 95%CI:1.856-8.013, P<0.001) were the independent risk factors of RFS. pTACE was not an independent prognostic factor of OS or RFS, but pTACE significantly improved OS and RFS of patients in the high-risk group compared with the low-risk group (P< 0.05). Conclusion ICC patients with independent risk factors of relapse after surgery can benefit from pTACE, suggesting that they should receive pTACE therapy.

Abstract:Objective To compare the mechanical stability and efficacy of anterior column plate combined with posterior column lag screw and double column plate in fixing the complicated acetabular fracture. Methods Six pelvic specimens retaining ligaments and hip joint capsules from adult males were selected to construct the acetabular T fracture models, with three fracture lines at the anterior column, posterior column and quadrilateral area. The acetabular fracture model was fixed with anterior column plate combined with posterior column lag screw on the right side (experimental group), and was fixed with double column plate on the left side (control group). A total of six pairs of marking points, with two pairs each in the anterior column, posterior column and quadrilateral aera, were recorded as 1 and 2, 3 and 4, 5 and 6 according to the order of anterior column, posterior column and quadrilateral area on both sides. The specimens were fixed on a biomechanical pressurizer for axial compression, with a vertical loading pressure from 0 N to 1 500 N, circulating 6 times; the vertical displacement (difference of the distance between the two points of the pair of marking points before and after the load) of each pair of marking points were recorded at 300 N, 600 N, 900 N, 1 200 N, and 1 500 N. The average vertical displacement and shear stiffness of the specimens were calculated and compared in the two groups. Results No fracture or internal fixation fracture was observed in the 6 cycles axial loading. The longitudinal displacement of each pair of marking points in the two groups were increased with the increase of load, but the maximum longitudinal displacement did not exceed 1 mm, and there was no significant difference between the two groups. The shear stiffness of the specimens in the experimental group was less than that in the control group ([1 428±57] N/mm vs[1 621±62] N/mm), but there was no significant difference between the two groups (P>0.05). Conclusion Anterior column plate combined with posterior column lag screw (with the load of 300 N, 600 N, 900 N, 1 200 N, 1 500 N) can effectively fix T fracture and meet the requirements of fracture fixation, which is stable and reliable, and is similar to conventional double column plate in fixing the complicated acetabular fracture.

Abstract:Objective To investigate the expression levels of long non-coding RNA XIST (lncRNA-XIST) in cancer tissues and plasma of gastric cancer patients and its clinical significance. Methods Resected tumor tissues and adjacent non-tumor tissues of 40 patients with gastric cancer in Changhai Hospital of Second Military Medical University were collected from Feb. to Jul. 2017; the plasma samples were collected from 90 patients with gastric cancer and 90 healthy volunteers. The expression level of lncRNA-XIST in the above samples was detected by real-time quantitative PCR (qPCR).The relationship between the expression level of lncRNA-XIST and the clinicopathological parameters related to gastric cancer (age, gender, TNM stage, tumor maximum diameter, lymph node metastasis, differentiation, and Ki-67 positive rate) were analyzed by nonparametric test. The efficacy of plasma lncRNA-XIST in the diagnosis of gastric cancer was evaluated by plotting the receiver operating characteristic (ROC) curve. Results The expression of lncRNA-XIST in tumor tissues was significantly increased compared with adjacent non-tumor tissues (0.150[0.094, 0.247] vs 0.085[0.041, 0.193], P<0.05), and the lncRNA-XIST expression in plasma in the gastric cancer group was significantly higher than that in the healthy group (0.189[0.119, 0.256] vs 0.144[0.095, 0.180], P<0.05). The expression levels of lncRNA-XIST in plasma and cancer tissues of gastric cancer patients were related to TNM staging, lymph node metastasis and differentiation (cancer tissues:Z=3.147, 2.729 and 2.393; plasma:Z=2.769, 2.431 and 2.144; all P<0.05). Area under ROC curve (AUC) performed by plasmatic lncRNA-XIST for gastric cancer was 0.753 (95%CI 0.681-0.825, P<0.001); when the cut-off value was 0.197, the sensitivity was 51.1% and the specificity was 95.6%. The AUC of diagnosing gastric cancer in TNM Ⅰ-Ⅱ was 0.694(95%CI 0.592-0.796, P<0.01), with a sensitivity of 38.5% a the specificity of 95.6%. All values in above two cases were higher than those of carcino-embryonic antigen (CEA), carbohydrate antigen (CA)19-9, CA72-4 alone or combined detection. Conclusion The expression levels of lncRNA-XIST are increased in cancer tissues and plasma of gastric cancer patients, which may be a potential tumor marker for diagnosing gastric cancer.

Abstract:Objective To investigate whether microRNA-30e-5p (miR-30e-5p) can inhibit tumor growth by down-regulating the expression of ubiquitin-specific protease 22 (USP22) in non-small cell lung cancer (NSCLC). Methods We detected the expressions of miR-30e-5p and USP22 in NSCLC tissues and adjacent non-tumor tissues by qPCR, Western blotting, and immunohistochemistry. After transfecting with miR-30e-5p mimic or miR-30e-5p inhibitor, the expressions of miR-30e-5p and USP22 in H460 cells was detected by qPCR and Western blotting. USP22 mutant vector was constructed and used to identify miR-30e-5p binding sites in the USP22 gene by luciferase reporter assay. The proliferation of H460 cells was measured in vitro by MTT assay and the tumor growth in nude mice was measured in vivo by xenograft assay. The cell cycle arrest and apoptosis of H460 cells were detected by flow cytometry. Results The expressions of MiR-30e-5p and USP22 in NSCLC tissues were significantly higher than those in adjacent non-tumor tissues (both P<0.01). Overexpression of miR-30e-5p significantly down-regulated the expressions of USP22 mRNA and protein in NSCLC tissues (both P<0.01), while inhibition of miR-30e-5p expression significantly up-regulated the expressions of USP22 mRNA and protein (both P<0.01). MiR-30e-5p was negatively related to USP22 in NSCLC tissues (P<0.01). MiR-30e-5p could negatively regulate the expression of USP22 by binding to the specific sequence of 3'UTR. Overexpression of miR-30e-5p significantly inhibited proliferation of H460 cells, induced cell cycle arrest and apoptosis, and inhibited tumor growth in nude mice (P<0.05, P<0.01); while inhibition of miR-30e-5p significantly promoted the cell proliferation and inhibited cell cycle arrest and apoptosis (P<0.05, P<0.01). Conclusion MiR-30e-5p can down-regulate the expression of USP22, thereby inhibiting the development and progression of NSCLC, suggesting that it can be used as a potential therapeutic target for NSCLC.

Abstract:Objective To compare the efficacy of short-term in vitro fertilization (IVF) combined with early rescue intracytoplasmic sperm injection (ICSI) and half-ICSI in preventing low IVF fertilization in initial IVF cycles. Methods Data of patients with high-risk factors of sperm-egg binding disorders during initial IVF cycles, who received short-term IVF combined with early rescue ICSI (Group A, n=192) or half-ICSI (Group B, n=85) to prevent low IVF fertilization from May. 1, 2015, to Dec. 31, 2016, were retrospectivey analyzed. The general characteristics, fertilization, embryo formation, and pregnancy outcome after receiving fresh embryo transfer of patients were compared between the two groups. Patients with low IVF fertilization (fertilization rate ≤ 30%) in the two groups were selected as Group A1 (n=20) and Group B1(n=9), respectively, and then the fertilization outcomes in the two groups were compared. Results There were no significant differences in general characteristics between the two groups. Compared with Group B, there was no excessive ICSI in Group A (0.0% vs 89.8%, χ²=479.888, P<0.01). The normal fertilization rate in the Group A was significantly lower than that in the Group B (73.3% vs 79.6%, χ²=14.780, P<0.01), while there were no significant differences in available embryo rate, good-quality embryo rate, blastocyst formation rate, clinical pregnancy rate, embryo implantation rate or abortion rate between the two groups(all P>0.05). In the cycles with low IVF fertilization, the normal fertilization rate in the Group A1 was significantly increased versus the Group B1 (77.9% vs 49.4%, χ²=28.823, P<0.01). Conclusion Compared with half-ICSI, short-term IVF combined with early rescue ICSI can avoid excessive ICSI and increase the normal fertilization rate in low IVF fertilization cycles, indicating that it is more accurate and effective in prevention of low IVF fertilization.

Abstract:Statins are mainly used to reduce the content of low-density lipoprotein-cholesterol (LDL-C) and to prevent cardiovascular disease, but its clinical efficacy and the tolerance of body are still uncertain. Human proprotein convertase subtilisin/kexin type 9 (PCSK9), a member of pre-protein convertase family, is mainly produced in the liver and then released into blood, and plays an important role in regulating plasma LDL-C levels by promoting the degradation of low-density lipoprotein receptor (LDLR) in the liver. Both gain-of-function-and loss-of-function-mutation of PCSK9 have great impact on circulating LDL-C levels and the risk of cardiovascular diseases. Statins can up-regulate the expression of PCSK9 through negative feedback regulation by decreasing hepatic cholesterol. As a result, PCSK9 can reduce the efficiency of statins by promoting the degradation of LDLR; therefore inhibiting PCSK9 is expected to be an effective treatment for hypercholesterolemia. In this paper we reviewed the function of PCSK9 in cholesterol metabolism and its clinical application.

Abstract:Cauda equina syndrome involves a series of pathological processes, including nerve cell necrosis and apoptosis, tissue edema and Wallerian degeneration of nerve fibers, and leads to in dysfunction of the corresponding motors, sensations and sphincters. Surgical treatment can relieve the cauda equina compression and reduce secondary injuries, only providing limited space for recovery of the cauda equina function, but not achieving a satisfactory result. However, the advances in basic research may lead to breakthrough. Neural science development has broken the traditional theory that axons are not reproducible after nerve injury, which has created a new situation for the repairment of injuried nerve. The development of cell transplantation technique and molecular technique has brought a new hope for efficiently repairing injuried cauda equina. This review focuses on the basic research progresses of pathological mechanism, animal model, nerve injury and repairment of cauda equina syndrome, and discusses the potential for therapies for cauda equine syndrome.

Abstract:Retinal neovascular disease is a serious blinding disease. The construction of the related animal models is an important basis for conducting mechanism research and can contribute to better prevention, diagnosis and treatment of the disease. The mouse model of oxygen-induced retinopathy is the most commonly used animal model for studying retinal neovascular diseases, and its construction is similar to the development of retinopathy of prematurity, with the advantages of simple preparation method and good reproducibility. In this paper, we focused on the construction methods and principles of mouse models with oxygen-induced retinopathy, the role of model-related angiogenic cytokines, and factors influencing the construction of models (animal species, percentage of oxygen, effects of hyperoxia on maternal mice, postnatal weight gain, exposure of light and so on). Meanwhile, we briefly introduced the quantitative evaluation methods commonly used in the model, hoping to help researchers to accurately and effectively construct and evaluate the mouse model with oxygen-induced retinopathy.

Abstract:Objective To investigate the significance of D₂₆₀/D₂₃₀ ratio of NanoDrop detection in quality assay of DNA in genome wide association study (GWAS). Methods Blood samples from 1 494 patients with ankylosing spondylitis (AS) were collected and the DNA was extracted. The concentrations of DNA samples were detected by NanoDrop and PicoGreen methods. In first stage, 24 DNA samples with concentrations>50 ng/μL were detected by Omni ZhongHua-8 microarray. Among the samples, 16 cases of chip reaction were successful and 8 were failure, and then the ratios of D₂₆₀/D₂₈₀ and D₂₆₀/D₂₃₀ were compared between the two groups. In second stage, 1 122 DNA samples with a concentration greater than 50 ng/μL according to NanoDrop and PicoGreen tests were selected for PCR detection of house-keeping genes. Samples with successful PCR reaction were detected by Human Omni ZhongHua-8 microarray. The 1 122 samples are divided into two groups according to the results of PCR (successful and failure groups). Mann-Whitney U test was used to compare the ratio of D₂₆₀/D₂₃₀ between the two groups, and receiver operating characteristic (ROC) curve was used to evaluate the predictive efficiency of D₂₆₀/D₂₃₀ value in PCR results. Results In the first stage, there were no significant differences in D₂₆₀/D₂₃₀ values between DNA samples with successful chip reaction and failure chip reaction (P=0.444), while the D₂₆₀/D₂₃₀ value of the fomer samples was significantly lower than that of the latter (Z=-3.920, P<0.001). In the second stage, the success rate of genotyping of DNA samples with positive PCR results was 100%. There were significant differences in D₂₆₀/D₂₃₀ values between the DNA samples with positive and negative PCR results (Z=-5.983, P<0.01. The area under curve of D₂₆₀/D₂₃₀value predicting the PCR results was 0.727; the D₂₆₀/D₂₃₀ values of the best diagnostic point and the point of specificity 95% were 0.89 and 2.305, respectively. Conclusion In GWAS, when DNA sample has better concentration and D₂₆₀/D₂₈₀ value and has lower D₂₆₀/D₂₃₀ value, PCR test should be performed to ensure the quality of the samples; when D₂₆₀/D₂₃₀ value is higher than 2.305, the samples are pure enough for microarray detection and the PCR detection can be omitted.

Abstract:Objective To establish a population pharmacokinetic model of sodium valproate in patients with epilepsy in China, so as to promote individualized drug administration. Methods The plasma concentrations and clinical data were collected from 69 patients with epilepsy after receiving sodium valproate. Population pharmacokinetic model (n=101, showed by proportional residual model) was established using Phoenixs NLME software, and the effects of covariate (gender, age, body weight, drug combination and so on) on absorption rate constant (Ka), distribution volume (Vd) and clearance (CL) were estimated. The final model was validated and evaluated by Bootstraps (n=500). Results The final population pharmacokinetic model was:TvKa=2.38, V=TvV, CL=TvCL·exp(η_CL), and the robust rate was 100% as displayed by the Bootstrap. The average value and median of parameters obtained by Bootstrap were consistent with the model parameters, indicating that the model was relatively stable. Age, gender, body weight, drug combination and other variables were not introduced into the final model. Conclusion The population pharmacokinetic model established in this study is consistent with the basic model, providing reference for rational individualized drug administration in clinical practice.

Abstract:Objective To investigate and analyze the health status of special service personnel in the naval strategic transformation period, and to analyze their two-week prevalence and the changing trends, so as to provide pertinent medical and health care. Methods A total of 761 navy special service personnel were selected for this study. The two-week prevalence rate and the severity of diseases were investigated by on-site questionnaire survey, with the data of naval special service personnel investigation as in 2004 used control. Results There were significant differences in the two-week prevalence rate and disease composition of naval special service personnel in different periods and different categories. The two-week prevalence rate of naval special service personnel in our study was significantly higher than that in 2004 naval special service personnel investigation (41.13%[313/761] vs 32.26%[349/1 082], P<0.01). The two-week prevalence rates of skeletal muscle system diseases and neurological diseases were significantly higher those that in 2004 (P<0.01), and the two-week prevalence rate of connective tissue disease in skin was lower than that in 2004 (P<0.01). Divers had the highest two-week prevalence (64.21%, 61/95), followed by submarine crew (41.12%, 213/518), and the lowest was the pilot (26.35%, 39/148). The two-week prevalence rates of skeletal muscle system diseases, nervous system diseases and ears, nose, ihroat and oral diseases of divers were higher. Conclusion The two-week prevalence rate of naval special service personnel is increased during the naval strategic transformation period. The morbidity of common and frequent diseases is decreased, while the morbidity of occupational-related diseases is increased. Divers have a high two-week prevalence rate, with a significant occupational relevance.

Abstract:Objective To investigate the protein expressions of vascular endothelial growth factor (VEGF)-C, VEGF-D and vascular endothelial growth factor receptor 3 (VEGFR-3) in primary gastric tumor, adjacent non-tumor and perigastric lymph node tissues and their relationships with clinic-pathological features. Methods The protein levels of VEGF-C, VEGF-D and VEGFR-3 in tumor, adjacent non-tumor and perigastric lymph node tissues of 60 patients with gastric cancer were detected by immunohistochemical method. The effects of clinic-pathological features included tumor differentiation, Lauren classification, depth of tumor invasion, lymph node metastasis, and Helicobacter pylori (H.pylori) infection on VEGF-C, VEGF-D and VEGFR-3 protein levels in gastric cancer tissues were also analyzed. Results The expressions of VEGF-C and VEGF-D in gastric cancer tissues were significantly higher than those in adjacent non-tumor tissues (2.82±1.66 vs 2.13±1.75, 4.81±2.30 vs 3.78±1.94; n=60; both P<0.05). There was no significant difference in VEGFR-3 protein expression between gastric cancer and adjacent non-tumor tissues (P>0.05). The expression levels of VEGF-C, VEGF-D and VEGFR-3 proteins in lymph nodes with gastric cancer metastasis (3.77±2.43, 2.86±1.95, 2.55±2.11; n=44) were significantly higher than those without gastric cancer metastasis (2.25±2.01, 1.98±1.73, 0.76±1.13; n=59; all P<0.05). Statistical analysis results showed that the expression levels of VEGF-C and VEGF-D proteins in gastric cancer tissues with lymph node metastasis were significantly higher than those without lymphatic metastasis (both P<0.05), and the VEGFR-3 expression in H.pylori-positive gastric cancer tissues was significantly higher than that in H.pylori-negative tissues (P<0.05). Conclusion VEGF-C and VEGF-D protein expressions are upregulated in primary gastric cancer tissues and related metastatic lymph node, which are correlated with lymph node metastasis of gastric cancer.

Abstract:Objective To analyze the contents of amino acids in Paecilomyces hepiali (P. hepiali) and Tolypocladium sinenis (T. sinensis) and their nutritive values, so as to provide a basis for related researches and applications of the two kinds of fungi. Methods The mycelia of P. hepiali and T. sinensis were hydrolyzed with 6 mol·L^-1 HCl, and the amino acids from the mycelia were separated by C₁₈ reversed-phase column with gradient elution and o-phthalaldehyde-fluorenylmethyl chloroformate (OPA-FMOC) pre-column derivation using Agilent 1200 high-performance liquid chromatograph. The content of sample amino acids was determined by the peak areas ratio between the samples and standard amino acids. Results A total of 17 proteolytic amino acids from P. hepiali and T. sinensis were determined in this study. The contents of 4 kinds of amino acids (aspartic acid, valine, isoleucine and leucine) in P. hepiali were higher than those in T. inensis, while the contents of 11 kinds of amino acids (glutamic acid, serine, glycine, threonine, arginine, alanine, tyrosine, cystine, methionine, lysine and proline) in T. inensis were higher than those in P. hepiali. The total contents of amino acids, essential amino acids and non-essential amino acids in T. Sinensis were higher than those in P. hepiali, and the content of branched chain amino acids in P. hepiali was higher that in T. sinensis. World Health Organization/Food and Agriculture Organization (FAO/WHO) reference model of essential amino acids was used to evaluate the nutritional values of amino acids in P. hepiali and T. sinensis, and the results showed that the scores of ratio coefficient of amino acids in P. hepiali and T. sinensis were 92.06 and 88.17, respectively. Conclusion The contents of protein amino acids in P. hepiali and T. sinensis are different, but they both have relatively high nutritional values.

Abstract:Objective To observe the changes of uncorrected visual acuity, corneal curvature, corneal thickness and axial length in adolescent patients with myopia after wearing night-wear orthokeratology lens (Ortho-KCL). Methods Fifty adolescent patients (100 eyes) with degree of myopia <-6.00 D in Changzheng Hospital of Second Military Medical University were treated by wearing night-wear orthokeratology lens (Autek China Inc.) from Jun. 2010 to Jun. 2012. The uncorrected visual acuities of patients were measured by phoropter before treatment and on 3^rd, 6^th, 12^th and 24^th months after treatment, the corneal curvature and corneal thickness was measured by corneal topography, and the axial length was measured by A/B ultrasonic diagnostic system. Results The ucorrected visual acuities of patients at 3, 6, 12 and 24 months after treatment were increased compared with that before treatment, and the average K values of corneal curvature were significantly decreased (all P<0.01); the axial lengths were slightly increased, but the differences were not statistically significant (all P>0.05). There was no significant difference in corneal thickness of patients before and after treatment. Conclusion Night-wear orthokeratology can improve the uncorrected vision of adolescent patients with myopia, and can effectively and safely slow down the progression of myopia.

Abstract:Objective To evaluate the feasibility of bilateral anterior cervical pedicle screw plate system (ACPS) fixation using liner and angular measurements of subaxial cervical transverse CT and MR images. Methods The images of normal lower cervical vertebrae from 50 males undergoing CT scan of cervical spine from Feb. 2016 to Jan. 2017 in the Naval General Hospital were included, and 38 cervical transverse T₂WI images from the above-mentioned males were collected. The distance between optimal entry point and midline of vertebral body (DOM), length of cervical pedicle axis (CPA), outer pedicle width (OPW), actual screw trajectory (AST) at ipsilateral side (adjusted entry point was -2.5 mm away from midline of vertebral body at ipsilateral side, based on the assumption that radius of nut of 3.5 mm diameter pedicle screw was 2.25-2.50 mm), available trajectory width (ATW), pedicle transverse angle (PTA) and trajectory transverse angle (TTA) were measured based on transverse CT images (bone window). The distance between vertebral artery and cervical pedicle (DAP), distance between spinal cord and cervical pedicle (DCP), and diameter of vertebral artery (DVA) were measured based on transverse MR images. Results There were no significant differences in same measurement parameter between left and right sides at same cervical level, and then the left and right measurement data of the same parameter and same sequence were combined for subsequent analysis. The OPW was significantly higher than APW, and PTA was significantly higher than TTA from C₃ to C₆ (all P<0.05). We defined 4.5 mm width as safety limit for pedicle non-perforation, 20%, 18%, 17%, and 8% of OPW and 70%, 64%, 38% and 29% of APW from C₃ to C₆ failed to satisfy the criteria. Due to the presence of DAP and DCP, non-critical ACPS displacement (2.9 and 4.4 mm, respectively) might be asymptomatic. The minimum value of ATW at C₇ level was 5.6 mm. Conclusion The penetrating rate is high when bilateral ACPS is used in subaxial cervical pedicle, and the non-critical perforation may have no clinical symptoms due to the presence of DAP and DCP.

Abstract:Objective To investigate the clinical efficacy of nickel titanium alloy embracing fixator in the treatment of flail chest and its effect on hemodynamics. Methods A total of 68 patients with flail chest who were admitted to the First Affiliated Hospital of Harbin Medical University from Sep. 2010 to Oct. 2015 were enrolled in this study. The patients were divided into control group and observation group according to different treatment methods, with 34 cases in each group. Patients in the control group received conservative treatment of thoracic band external fixation, and those in the observation group received operative treatment with nickel titanium alloy embracing fixator; both groups were followed up until Oct. 2016. The hospital stay, duration of mechanical ventilation, drainage tube indwelling time, intensive care unit (ICU) observation time, post-treatment pain, dosage of analgesics, hemodynamics, pulmonary function 1 month after surgery, complications and mortality of patients were compared between the two groups. Results Compared with the control group, the average hospital stay, duration of mechanical ventilation, drainage tube indwelling time and ICU observation time of patients were significantly shorter in the observation group (all P<0.05), and the Visual Analogue Scale score and dosage of analgesics were significantly lower (both P<0.05). The hemodynamic indexes such as cardiac index (CI), central venous pressure (CVP) and extravascular lung water index (ELWI) at 24 h and 48 h after treatment were significantly higher than those before treatment in both groups (all P<0.05). The CI and ELWI in the observation group were significantly lower than those in the control group at 24 h and 48 h after treatment (both P<0.05), while the CVP in the observation group was significantly higher (P<0.05). The vital capacity (VC) and the ratio of forced vital capacity (FVC) in one second to FVC (FEV₁/FVC) in the observation group were significantly higher than those in the control group (both P<0.05), while there were no significant differences in maximal mid-expiratory flow and peak expiratory flow rate between the two groups (both P>0.05). The overall incidence of complications in the observation group was significantly lower than that in the control group (47.1%[16/34] vs 17.6%[6/34], P<0.05), and the mortality was significantly lower than that in the control group (2.9%[1/34] vs 17.6%[6/34], P<0.05). Conclusion Nickel titanium alloy embracing fixator is a safe and effective method in the treatment of flail chest with less trauma, quick recovery, low incidence of complications, and can improve hemodynamics and reduce pain of patients.