Research on lightweight model of intelligent-assisted diagnosis of common fundus diseases based on fundus color photography / 中华眼底病杂志

Objective:To observe the diagnostic value of six classification intelligent auxiliary diagnosis lightweight model for common fundus diseases based on fundus color photography.Methods:A applied research. A dataset of 2 400 color fundus images from Nanjing Medical University Eye Hospital and Zhejiang Mathematical Medical Society Smart Eye Database was collected, which was desensitized and labeled by a fundus specialist. Of these, 400 each were for diabetic retinopathy, glaucoma, retinal vein occlusion, high myopia, age-related macular degeneration, and normal fundus. The parameters obtained from the classical classification models VGGNet16, ResNet50, DenseNet121 and lightweight classification models MobileNet3, ShuffleNet2, GhostNet trained on the ImageNet dataset were migrated to the six-classified common fundus disease intelligent aid diagnostic model using a migration learning approach during training as initialization parameters for training to obtain the latest model. 1 315 color fundus images of clinical patients were used as the test set. Evaluation metrics included sensitivity, specificity, accuracy, F1-Score and agreement of diagnostic tests (Kappa value); comparison of subject working characteristic curves as well as area under the curve values for different models.Result:Compared with the classical classification model, the storage size and number of parameters of the three lightweight classification models were significantly reduced, with ShuffleNetV2 having an average recognition time per sheet 438.08 ms faster than the classical classification model VGGNet16. All 3 lightweight classification models had Accuracy > 80.0%; Kappa values > 70.0% with significant agreement; sensitivity, specificity, and F1-Score for the diagnosis of normal fundus images were ≥ 98.0%; Macro-F1 was 78.2%, 79.4%, and 81.5%, respectively.Conclusion:The intelligent assisted diagnosis of common fundus diseases based on fundus color photography is a lightweight model with high recognition accuracy and speed; the storage size and number of parameters are significantly reduced compared with the classical classification model.

Effect of timing of immune checkpoint inhibitor monotherapy and application of hormone on the efficacy and safety of brain metastasis in advanced non-small cell lung cancer: a Meta-analysis / 肿瘤研究与临床

Objective:To evaluate the efficacy and safety of programmed death 1 (PD-1), programmed death ligand 1 (PD-L1) immune checkpoint inhibitor (ICI) monotherapy for brain metastasis in advanced non-small cell lung cancer (NSCLC), and to explore the timing of immunomonotherapy and the application of hormone on the efficacy of ICI.Methods:By searching literature in CNKI, Wanfang, VIP, PubMed, CBM, Embase, Cochrane Library and Web of Science databases, the advanced NSCLC patients with brain metastasis who received ICI treatment were identified, including patients with symptomatic brain metastasis who had received hormone therapy or brain surgery or radiotherapy. Meta-analysis was performed on the collected data to evaluate the systemic objective response rate (sORR) and intracerebral tumor objective response rate (iORR), the iORR of whether ICI monotherapy was first-line therapy, and the iORR of whether hormone was used were evaluated, and the incidence of adverse reactions was evaluated.Results:Fifteen studies were finally included, with a total of 4 033 patients, including 917 patients with brain metastasis. The iORR of immunomonotherapy was 26% (95% CI 19%-34%) and the sORR was 28% (95% CI 18%-40%). The iORR of first-line immunomonotherapy was 49% (95% CI 39%-58%). The iORR of symptomatic patients with hormone therapy and asymptomatic patients without hormone therapy was 26% (95% CI 20%-33%) and 19% (95% CI 16%-22%), respectively. The overall incidence of grade 3-4 adverse reactions was 14% (95% CI 11%-17%). Conclusions:The efficacy of ICI monotherapy in the first-line treatment of PD-L1-positive NSCLC patients with brain metastasis is better than that in the subsequent line therapy, and the application of hormone does not affect the efficacy of ICI. ICI monotherapy in the treatment of advanced NSCLC patients with brain metastasis is safe.

Progress of rare epidermal growth factor receptor mutations in non-small cell lung cancer / 肿瘤研究与临床

With the development of biomolecular diagnostic technology and genetic analysis, it has been gradually discovered that some gene abnormalities can drive the occurrence and development of lung cancer. Among them, epidermal growth factor receptor (EGFR) is the most common mutant gene in non-small cell lung cancer (NSCLC). However, most of the current researches focus on the common mutations of EGFR, such as exon 19 deletion (19del) and exon 21 point mutation (L858R). There are few studies on rare EGFR mutations. This article reviews the progress of rare EGFR mutations in NSCLC.

New mutation site c.361C > T of RS1 gene in X-linked retinoschisis / 中华眼底病杂志

Objective:To study the characteristics of the genotype and phenotypic in a family with X-linked retinoschisis (XLRS) due to RS1 mutation. Methods:A retrospective clinical study. An XLRS family of 4 generations of 26 people were included in the study. Among them, 8 participants were males and 7 participants were females. Routine ophthalmologic examination was performed on 3 patients in the family including the proband and 12 patients with normal phenotype. Optical coherence tomography was performed in 2 of the 3 patients. Peripheral venous blood was extracted from all participants, whole-genome DNA was extracted, and potential pathogenic genes were screened by Panel sequencing. Conservative analysis, pathogenicity analysis and protein structure prediction were carried out by software tools. The pathogenicity of gene mutations was analyzed according to the American Society of Medical Genetics and Genomics (ACMG) guidelines.Results:The proband was 3 years old. Optical coherence tomography (OCT) examination showed that the retinal core layer in the macular area of both eyes had a cystic change, which was segmented by vertical or oblique bridging tissue. The proband's uncle was 32 years old. OCT examination showed atrophy in the macular area of the left eye. The macular area of the right eye was cystoid, segmented by vertical or oblique bridging tissue. No abnormality was found in the fundus examination of the proband's parents and 10 members of his family. Panel sequencing showed that c.361C>T/ p.Q121X hemizygous mutation was found in the fifth exon of RS1 gene in the proband (Ⅳ3) and 2 patients (Ⅱ1, Ⅲ8). The mother was a heterozygous mutation carrier of the gene, while the father had no mutation. The mutant gene causes premature termination of RS1, a truncated protein encoding 224 amino acids to 120 amino acids. Of the 10 patients with normal fundus examination, 6 participants were normal. The mutation was carried by four people, which were women. Homology analysis of the protein sequence showed that the mutant site was highly conserved in 12 mammals. Three-dimensional structural analysis of RS1 protein showed that the c-terminal amino acid sequence of the mutant protein was more than 50% missing. Analysis of ACMG guidelines indicated that the mutation was pathogenic. Conclusion:The RS1 mutation site c.361C>T/p.Q121X is a new mutation site of XLRS.

Evaluation of low-quality fundus image enhancement based on cycle-constraint adversarial network / 中华实验眼科杂志

Objective:To propose and evaluate the cycle-constraint adversarial network (CycleGAN) for enhancing the low-quality fundus images such as the blurred, underexposed and overexposed etc.Methods:A dataset including 700 high-quality and 700 low-quality fundus images selected from the EyePACS dataset was used to train the image enhancement network in this study.The selected images were cropped and uniformly scaled to 512×512 pixels.Two generative models and two discriminative models were used to establish CycleGAN.The generative model generated matching high/low-quality images according to the input low/high-quality fundus images, and the discriminative model determined whether the image was original or generated.The algorithm proposed in this study was compared with three image enhancement algorithms of contrast limited adaptive histogram equalization (CLAHE), dynamic histogram equalization (DHE), and multi-scale retinex with color restoration (MSRCR) to perform qualitative visual assessment with clarity, BRISQUE, hue and saturation as quantitative indicators.The original and enhanced images were applied to the diabetic retinopathy (DR) diagnostic network to diagnose, and the accuracy and specificity were compared.Results:CycleGAN achieved the optimal results on enhancing the three types of low-quality fundus images including the blurred, underexposed and overexposed.The enhanced fundus images were of high contrast, rich colors, and with clear optic disc and blood vessel structures.The clarity of the images enhanced by CycleGAN was second only to the CLAHE algorithm.The BRISQUE quality score of the images enhanced by CycleGAN was 0.571, which was 10.2%, 7.3%, and 10.0% higher than that of CLAHE, DHE and MSRCR algorithms, respectively.CycleGAN achieved 103.03 in hue and 123.24 in saturation, both higher than those of the other three algorithms.CycleGAN took only 35 seconds to enhance 100 images, only slower than CLAHE.The images enhanced by CycleGAN achieved accuracy of 96.75% and specificity of 99.60% in DR diagnosis, which were higher than those of oringinal images.Conclusions:CycleGAN can effectively enhance low-quality blurry, underexposed and overexposed fundus images and improve the accuracy of computer-aided DR diagnostic network.The enhanced fundus image is helpful for doctors to carry out pathological analysis and may have great application value in clinical diagnosis of ophthalmology.

Synthesis of L-2-aminobutyric acid by leucine dehydrogenase coupling with an NADH regeneration system / 生物工程学报

In this study, Escherichia coli BL21 (DE3) was used as the host to construct 2 recombinant E. coli strains that co-expressed leucine dehydrogenase (LDH, Bacillus cereus)/formate dehydrogenase (FDH, Ancylobacter aquaticus), or leucine dehydrogenase (LDH, Bacillus cereus)/alcohol dehydrogenase (ADH, Rhodococcus), respectively. L-2-aminobutyric acid was then synthesized by L-threonine deaminase (L-TD) with LDH-FDH or LDH-ADH by coupling with two different NADH regeneration systems. LDH-FDH process and LDH-ADH process were optimized and compared with each other. The optimum reaction pH of LDH-FDH process was 7.5, and the optimum reaction temperature was 35 °C. After 28 h, the concentration of L-2-aminobutyric acid was 161.8 g/L with a yield of 97%, when adding L-threonine in batches for controlling 2-ketobutyric acid concentration less than 15 g/L and using 50 g/L ammonium formate, 0.3 g/L NAD+, 10% LDH-FDH crude enzyme solution (V/V) and 7 500 U/L L-TD. The optimum reaction pH of LDH-ADH process was 8.0, and the optimum reaction temperature was 35 °C. After 24 h, the concentration of L-2-aminobutyric acid was 119.6 g/L with a yield of 98%, when adding L-threonine and isopropanol (1.2 times of L-threonine) in batches for controlling 2-ketobutyric acid concentration less than 15 g/L, removing acetone in time and using 0.3 g/L NAD⁺, 10% LDH-ADH crude enzyme solution (V/V) and 7 500 U/L L-TD. The process and results used in this paper provide a reference for the industrialization of L-2-aminobutyric acid.

Establishment and application of diabetic retinopathy intelligent assisted diagnostic technology evaluation system based on fundus photography / 中华实验眼科杂志

Objective To propose a new evaluation system and evaluate the application value of diabetic retinopathy ( DR) intelligence assisted diagnostic technology based on fundus photography. Methods By using the diagnostic test method,an evaluation system of DR intelligent diagnostic technology based on fundus photography was established. The fundus photographs of 331 diabetic patients (662 eyes) with DR screening were collected in the First Affiliated Hospital of Huzhou University from January 2017 to October 2018. The results of experts ' diagnosis and intelligence assisted diagnosis were compared and evaluated. The evaluation system includes primary evaluation, intermediate evaluation and advanced evaluation. The primary evaluation is the consistency of non-DR ( NDR) in all diabetic patients receiving DR-assisted diagnostic techniques;the intermediate evaluation is the diagnosis consistency of DR lesion degree in patients diagnosed with DR (grade 1-4);the advanced evaluation is the diagnosis consistency of DR classification ( grade 0 -4 ) in all diabetic patients receiving DR-assisted diagnostic techniques. The intermediate evaluation includes two evaluation methods. The main evaluation indicators include sensitivity,specificity and Kappa value. Results Based on experts ' diagnosis, NDR accounted for 22. 7％;mild non-proliferative DR (NPDR),moderate NPDR,and severe NPDR accounted for 19. 9％,18. 7％ and 25. 7％,respectively;proliferative DR( PDR) accounted for 13. 0％. Based on intelligence diagnostic system,NDR accounted for 25. 8％;mild NPDR, moderate NPDR and severe NPDR accounted for 19. 7％,19. 3％ and 22. 8％,respectively;proliferative DR( PDR) accounted for 12. 4％. Based on evaluation system in the paper,the sensitivity,specificity and Kappa value in primary evaluation were 91. 4％, 84. 7％ and 0. 72;the sensitivity, specificity and Kappa value in intermediate evaluation method one were 88. 4％,91. 1％ and 0. 79;the sensitivity, specificity and Kappa value in intermediate evaluation method two were 80. 5％,93. 3％ and 0. 75;the Kappa value in advanced evaluation was 0. 62. Conclusions The evaluation system can be applied to the evaluation of DR intelligent diagnostic technology,and the evaluation result can be used as the basis for the selection of DR intelligent diagnosis application scene.

Progress of brain metastases of lung cancer / 肿瘤研究与临床

Lung cancer ranks first in the incidence of malignancies in China.It not only has a high mortality rate,but also has a high rate of brain metastases because of its special texture characteristics.With the development of imaging techniques and the improvement of diagnosis and treatment,the overall survival rate of lung cancer patients with brain metastases has been increased,however,the 5-year survival rate at each stage is still about 18％.This article reviews the current effective treatment strategies,including surgery,radiotherapy,chemotherapy,and targeted therapies for brain metastases of lung cancer.

VisConnectome: an independent and graph-theory based software for visualizing the human brain connectome / 生物医学工程学杂志

As a complex system, the topology of human's brain network has an important effect on further study of brain's structural and functional mechanism. Graph theory, a kind of sophisticated analytic strategies, is widely used for analyzing complex brain networks effectively and comparing difference of topological structure alteration in normal development and pathological condition. For the purpose of using this analysis methodology efficiently, it is necessary to develop graph-based visualization software. Thus, we developed VisConnectome, which displays analysis results of the brain network friendly and intuitively. It provides an original graphical user interface (GUI) including the tool window, tool bar and innovative double slider filter, brain region bar, runs in any Windows operating system and doesn't rely on any platform such as Matlab. When importing the user-defined script file that initializes the brain network, VisConnectome abstracts the brain network to the ball-and-stick model and render it. VisConnectome allows a series of visual operations, such as identifying nodes and connection, modifying properties of nodes and connection such as color and size with the color palette and size double slider, imaging the brain regions, filtering the brain network according to its size property in a specific domain as simplification and blending with the brain surface as a context of the brain network. Through experiment and analysis, we conclude that VisConnectome is an effective visualization software with high speed and quality, which helps researchers to visualize and compare the structural and functional brain networks flexibly.

Correlation of serum neuron-specific enolase and progastrin-releasing peptide with initial chemotherapeutic effect and survival of patients with small cell lung cancer / 肿瘤研究与临床

Objective To investigate the relationships of neuron-specific enolase (NSE) and progastrin-releasing peptide (ProGRP) with the initial chemotherapeutic effect and survival of patients with small-cell lung cancer (SCLC).Methods A total of 197 patients with SCLC diagnosed pathologically from January 2011 to September 2013 in Shanxi Provincial Cancer Hospital were selected.x 2 test and logistic regression analysis were used to analyze the factors affecting the initial chemotherapeutic response;KaplanMeier method,log-rank test and Cox regression analysis were used to analyze the factors affecting survival of patients.Results Among the 197 patients,NSE was negative in 64 cases and positive in 133 cases;ProGRP was negative in 51 cases and positive in 146 cases;41 cases with hyponatremia and 156 cases without hyponatremia.152 cases (77.2 ％) had well response to initial treatment and 45 cases (22.8 ％) had no reaction.Univariate analysis showed that stage of disease (x2 =4.456,P =0.033) and ProGRP (x2 =13.424,P ＜ 0.001) were associated with initial therapeutic response.Logistic regression analysis showed that stage of disease (OR =0.404,95 ％ CI 0.197-0.828％,P =0.013) and ProGRP (OR =4.058,95 ％ CI 1.939-8.491,P =0.000) were the independent predictors of initial therapeutic response.Kaplan-Meier survival analysis showed that sex,age,smoking,with or without hyponatremia,stage of disease,NSE,ProGRP and number of chemotherapy cycles were all associated with 2-year survival rate (x2 values were 4.319,6.811,4.264,4.687,32.631,41.045,11.379,33.466,respectively,all P ＜ 0.05).Multivariate analysis showed that stage of disease (RR =2.110,95 ％ CI 1.491-2.985,P ＜ 0.001),number of chemotherapy cycles (RR =0.398,95 ％ CI 0.283-0.588,P ＜ 0.001) and NSE (RR =1.422,95 ％ CI 1.113-1.784,P =0.002) were independent predictors of survival.However,ProGRP was not associated with survival of patients (RR =1.065,95 ％ CI 0.854-1.328,P =0.587).Conclusions ProGRP is associated with the initial chemotherapeutic response in patients with SCLC,and it has certain clinical significance in predicting the initial chemotherapeutic effect.NSE is associated with the survival prognosis of SCLC,and it is a prognostic factor of poor survival.

Detection of CALR mutations in peripheral blood of myeloproliferative neoplasm patients with high resolution melting curve analysis / 中华检验医学杂志

Objective To establish a rapid, accurate and low-cost screening method for the detection of calreticulin (CALR) mutations in myeloproliferative neoplasms (MPN).Methods Seventy cases diagnosed with MPN were collected from 2012 to 2016. PCR combined with high resolution melting (HRM) analysis were used to screen the CALR mutations, and Sanger sequencing and T-A sequencing were applied to verify the HRM positive samples. CALR wild type DNA, type 1 and type 2 mutant DNA samples were selected and analyzed 4 times/day for 5 days to detected the CVs of Tm (melting temperature) respectively. JAK2 mutations were also analyzed in MPN patients to compare the association between JAK2 and CALR mutations.Results PCR-HRM analysis showed 7 cases (26.9%) and 5 cases (20.8%) patients with CALR mutations were screened out from 26 essential thrombocythaemia (ET) cases and 24 primary myelofibrosis (PMF) cases, but no CALR mutations were found in cases with polycythaemia vera (PV). All mutations were confirmed by direct sequencing or cloning sequencing. The CVs for HRM analysis of CALR wild type DNA, type 1 and type 2 mutant DNA samples were 1.91%,1.59% and 1.43%, respectively.There were 47 cases with JAK2 V617F and 1 case with exon12 mutation. No coexistence of JAK2 mutation and CALR mutations were found in a single sample.Conclusion PCR-HRM can be used for rapid screening of CALR mutation. Subsequent sequencing can be applied for rapid diagnosis of MPN patients in clinical practice.

Therapeutic Observation of Acupoint Application plus ModifiedZhi Sou Powder for Post-cold Cough / 上海针灸杂志

Objective To observe the clinical efficacy of acupoint application plus modifiedZhi Sou powder in treating post-cold cough.Method A total of 120 patients with post-cold cough were randomized into group A, group B, and group C, 40 cases in each group. Group A was intervened by acupoint application plus modifiedZhi Sou powder, group B by oral administration ofZhi Sou powder, and group C by oral administration of compound Dextromethorphan syrup. The three groups were intervened once a day, 7 days as a treatment course. The clinical efficacies were compared after 2 treatment courses, and the adverse reactions during the study were observed.Result The total effective rate was 87.5% in group A, 67.5% in group B and 60.0% in group C. The total effective rate in group A was significantly different from that in group B and group C (P<0.05). The adverse reaction rate was 7.5% in group A, 5.0% in group B and 72.5% in group C. The adverse reaction rates in group A and B were significantly different from the rate in group C (P<0.01).Conclusion Acupoint application plusZhi Sou powder is an effective approach in treating post-cold cough, and it’s more effective than ordinary drug and produces less adverse reactions.

Clinical research of drug-resistant gene detection combined with adenosine triphosphate-tumor chemosensitivity assay for guiding the second-line chemotherapy of lung squamous cell cancer / 肿瘤研究与临床

Objective To investigate the significance of resistant gene detection combined with adenosine triphosphate-tumor chemosensitivity assay (ATP-TCA) in the second-line chemotherapy of lung squamous cell cancer, and to provide a reference for clinical treatment. Methods 150 patients with lung squamous cell cancer diagnosed by histopathology or cytology and with the disease progressed after NP regime chemotherapy were enrolled. The mRNA expressions of excision repair cross complementation 1 (ERCC1) and ribonucleotide reductase M1 (RRM1) were detected by RT-PCR, and ATP-TCA was carried out. After detected by RT-PCR and ATP-TCA, the patients who were sensitive to gemcitabine plus cisplatin (GP) accepted the second-line systemic chemotherapy with GP regimen, and the others who were not sensitive to GP regimen or whose results of gene detection and ATP-TCA were on the contrary took the second-line chemotherapy regimens with docetaxel plus cisplatin (DP). Both groups accepted 2-4 cycles of systemic chemotherapy. The chest CT was followed up, and the response rate (RR), progression-free survival (PFS) and median survival time (MST) were investigated. Results The RR of GP group was 36.2 % (17/47), while the DP group was 28.1 % (26/92), and the difference was statistically significant (χ2= 4.274, P 0.05). Conclusion The resistance gene detection combined with ATP-TCA have certain guiding significance on the second-line chemotherapy for advanced lung squamous cell cancer.

Application of Laparoscopic Complete Mesocolic Excision in Radical Resection for Right Colon Cancer / 中国微创外科杂志

Objective To evaluate the safety of laparoscopic complete mesocolic excision (CME) in radical resection for right colon cancer. Methods From January 2012 to June 2013, laparoscopic CME was performed in 40 patients with right colon cancer. Another group of 38 patients underwent traditional radical resection from January 2011 to December 2011.Surgical outcomes were compared between the two groups . Results The number of lymph nodes retrieved in the laparoscopic group ( 22.1 ±7.8 ) was significantly more than that in the traditional group (18.6 ±4.3, t =2.436, P =0.017).In patients with stage Ⅲ cancer, the laparoscopic group was associated with higher lymph node counts (23.0 ±6.0 vs.18.2 ±5.1, t=2.699, P=0.000), however, there were no significant differences in those with stage Ⅱ cancer between the two groups (t=0.758, P=0.454).There were no differences in operation time and intraoperative blood loss between the two groups (t=0.716, P=0.476;t=-1.547, P=0.126), but in the laparoscopic group the time to pelvic drainage tube removal , time to first flatus, time to liquid diet intake , duration of hospital stay, and postoperative complications were significantly better than those in the traditional group (t=-2.950, P=0.004;t=-5.767, P=0.000; t =-7.817, P =0.000; t =-6.065, P =0.000; χ2 =4.504, P =0.034). Conclusions CME technique in laparoscopic radical right hemicolectomy is feasible , safe, and effective.CME improves the surgical quality with keeping the integrity of mesocolon , more harvested lymph nodes , and not increasing surgical risks and postoperative complications .

To explore the clinical of ovarian malignant tumor with increased count of platelet / 国际检验医学杂志

Objective To explore the clinical significance of platelet count increasing in patients with ovarian malignant tumor . Methods 80 cases of ovarian malignant tumor patients ,80 patients with ovarian benign tumor and 80 cases of healthy women were enrolled in the study as group A ,B ,C respectively .The group A was divided into FIGOⅠ group(n=30) ,and FIGOⅡ and above group(n=50) .Platelet count was detected by using fully automatic blood cell analyzer and the serum CA125 concentrations were also measured for all the groups .Results The platelet count and CA125 concentrations in group A were higher than group B and group C(P< 0 .05) .The positive rate of platelet increasing and serum CA125 were also higher than group B and group C(P<0 .05) .There were significant differences between FIGOⅠ group and FIGOⅡ and above group in platelet count and CA125 concen‐trations .Conclusion Ovarian malignant tumor complicated with increased platelet count is common in patients of advanced stage . The increased platelet count could indicate the malignant degree of ovarian malignant tumor .

A case control study about quality of life of patients with mild to moderate primary hypertension with chronos medication / 重庆医学

Objective To study the quality of life(QOL) of patients with mild to moderate primary hypertension after treatment adjusted medication time by ambulatory blood pressure .Methods All 128 cases were divided into two groups randomly including chronos medication group and normal medication group .We tested ambulatory blood pressure ,QOL and influencing factors before medication and 6 months later .Results It′s observed the parameters of the ambulatory blood pressure improved significantly in all of the groups .There existed significant difference in nSBP ,nDBP ,nMAP ,SBP in dangerous night time ,and nocturnal blood pres‐sure decline rate between two groups (P<0 .05) .There existed very significant difference in DBP and MAP in dangerous night time (P<0 .01) .There were significant difference in the fields of MH (mental health) and RE (role limitation because of emotional health problem) (P<0 .05) ,and very significant difference in the fields of PF (physical functioning) ,RP (role limitation because of physical health) ,VT(vitality) (P<0 .01) .Multiple regression analysis indicate the influencing factors of the quality of life about patients with hypertension are age ,BMI index number ,medication time ,average family income ,medical insurance type ,culture de‐gree and job title .Age ,BMI index number and medication time depress QOL of patient with hypertension while average family in‐come ,better medical insurance type ,culture degree and job title improve it .Conclusion It′s possible to improved the parameters of the ambulatory blood pressure for patients with mild to moderate primary hypertension by chronos medication compared with nor‐mal medication more significantly .It′s useful to improve the QOL of patient with hypertension by improving average family income , medical insurance type and culture degree .

Quality of life changes after ischemia postconditioning in patients with acute ST segment elevation myocardial infarction / 中国医师进修杂志

Objective To compare the quality of life before ischemia postconditioning and 6 months after ischemia postconditioning in patients with acute ST segment elevation myocardial infarction,and investigate the related risk factors.Methods One hundred and twenty-nine patients with acute ST segment elevation myocardial infarction were given the ischemie postconditioning.The quality of life was evaluated before ischemia postconditioning and 6 months after ischemia postconditioning by 36-item short-form health survey (SF-36) and seattle angina questionnaire (SAQ).Results In acute ST segment elevation myocardial infarction patients treated with ischemia postconditioning,the scores of SF-36 and SAQ were significantly lower at 6 months after ischemia postconditioning than those before ischemia postconditioning [SF-36:total score of body health (76.4 ± 17.3) scores vs.(56.3 ± 16.8) scores,physiologic function (75.3 ± 18.1) scores vs.(52.4 ± 19.2) scores,physiologic functional authority (75.6 ± 16.5) scores vs.(48.5 ± 20.3) scores,body pain (77.2 ± 15.4) scores vs.(58.7 ± 16.6) scores,total health state (73.6 ± 17.8) scores vs.(50.6 ± 14.7)scores,total score of mental status (77.5 ± 15.3) scores vs.(55.3 ± 17.3) scores,vitality (69.3 ± 18.1)scores vs.(43.2 ± 17.4) scores,society function (70.3 ± 17.5) scores vs.(41.3 ± 14.2)scores,affection functional authority (80.2 ± 17.4)scores vs.(63.5 ± 14.3)scores,mental health (77.6 ± 18.4) scores vs.(55.6 ± 20.1) scores,health change (76.3 ± 17.4) scores vs.(53.4 ± 16.6) scores;SAQ:body limitation of activity (78.46 ± 12.21) scores vs.(35.34 ± 15.33)scores,angina stable state (74.23 ± 8.53) scores vs.(30.12 ± 5.38) scores,angina episode state (72.34 ± 10.33) scores vs.(27.33 ± 9.12) scores,satisfaction degree of treatment (76.42 ± 12.13)scores vs.(30.56 ± 15.57) scores,knowledge of diseases (74.22 ± 9.35)scores vs.(37.25 ± 20.32) scores] (P ＜ 0.05).The results of multiple linear regression equation showed that the older,more severe vascular lesions,and lower total score of body health score before ischemia postconditioning indicated lower total score of body health,and worse quality of life after ischemia postconditioning.Conclusions The quality of life of patients with acute ST segment elevation myocardial infarction after ischemia postconditioning is significantly improved,compared with that before ischemia postconditioning.Advanced age,vascular disease and lower total scores of body health before ischemia postconditioning are independent risk factors of total scores of body health after ischemia postconditioning.

Anticancer effect of polysaccharide isolated from Polyporus sp. M05 / 国际肿瘤学杂志

Objective To study effect and mechanism of fungus polysaccharide PSM-a of Polyporus sp.M05 on S180 bearing mice. Methods MTT method was used to detect the inhibiting role of PSM-a on S180 cells proliferation in vitro. S180 mice model was established,and was administered by gavage. Tumor volume was detected, and the ratio of tumor to mile weight and inhibiting tumor rate. The activity of NK and LAK cells on the target cells was analyzed by MTT colorimetric assay ;HE stain was used to detect the necrosis of tumor cells. Results PSM-a could inhibit S180 cells grouth in vitro. PSM-a could decrease the tumor weight and increase the ratio of tumor volume and mice weight; Tumor inhibiting rate reached 80% and above when treated with 250 μg/nml PSM-a. PSM-a could increase the activity of NK and LAK cells, and necrosis happened. Conclusion PSM-a could significantly inhibit the growth of S180 cells, and the mechanism bnay be related with the increased killing activity of immunne cells to tumor cells.

Evaluation of the value and safety of transbronchial needle aspiration in the diagnosis of lung cancer / 肿瘤研究与临床

Objective To evaluate the value and safety of transbronchial needle aspiration (TBNA) in the diagnosis of lung cancer. Methods The cytologic diagnosis of TBNA in 82 patients with enlarged hilar and/or mediastinal lymphnodes or lesions adjacent to the bronchial wall were analyzed retrospectively. All specimens were detected by the ThinPrep cytologic test. Results There were 43 positive cases in the 82 patients, and the positive rate was 52.4 %. There were 18 SCLCs,11squamous cancers, 9 adenocarcinomas and 5 undefinable cancers, respectively. There were 39 patients with local bronchial wall swelling accompanied with abnormal mucosae. TBNA, douche, brushing and forcep biopsy were applied, and the diagnostic rate was 64.1%, 7.7 %, 25.6 % and 48.7 %, respectively. The total positive rate was 76.9 %. 43 patients with normal mucous membrane only underwent TBNA. 18 cases were positive, and the positive rate was 41.9 %. There was no obvious complication in the 82 patients. Conclusion The technique of TBNA enlarged the inspection scope of bronchoscopy. It has significant meaning to the diagnosis of lung cancer. TBNA was an useful and safe method in clinical application and could be used widely.

Clinical study on diagnostic value of the six tumor markers in pleural effusion of lung cancer / 肿瘤研究与临床

Objective To investigate the diagnostic value and the clinical significance of six tumour markers of pleural effusion and serum in patients with lung cancer by detecting tumour marker and pleural effusion cytological examination. Methods Carcinoembryanic antigen (CEA), cancer antigen 19-9 (CA19-9),squamous cell carcinoma antigen (SCC), neuron specific enolase(NSE), cytokeratin 19 fragments(CYFRA21-l)and progastrin releasing peptide (ProCRP) levels in pleural effusion and serum sample from 50 cases of lung cancer and 30 cases of benign lung disease were detected by chemical and enzyme-linked immunosorbent assay.At the same time, the specimen of patients from pleural effusion was examinated by cytological method.According to the data above, the rational clinical diagnosis value were established by ROC curves. Results Six tumour markers in pleural effusion of lung cancer were higher than those of benign lung diseases, CEA,CA19-9, CYFRA21-1 and ProGRP were the highest group (P<0.05). The ratio of CEA, serum CYFRA21-1and CEA levels in pleural fluid and serum (P/S) in the group was the largest area under the ROC curve.Conclusion Pleural fluid CEA, the ratio of CYFRA21-1 and CEA levels in pleural fluid and serum (P/S) is helpful to differentiating benign and malignant pleural effusion diseases.The diagnostic value of pleural fluid CEA is important.