ABSTRACT
Objective To investigate the clinical value of vitamin D receptor ( VDR) gene polymorphism in lung cancer screening .Methods From January 2017 to September 2017 ,2000 lung cancer screening patients in the Fifth People's Hospital of Foshan were selected in the research .The VDR gene polymorphism was determined by phenol-chloroform method .DNA was extracted from the peripheral blood of patients ,different VDR genotypes [ Bsm1 bb and Bb),Apal(aa,Aa and AA)] were analyzed by univariate analysis to determine the correlation between lung cancer and VDR gene polymorphism and lung cancer incidence by multivariate non -conditional logistic regression analysis, thus to explore the relationship between different VDR genotypes and risk factors of lung cancer . Results The level of serum vitamin D in the non -lung cancer patients was (46.5 ±2.3) ng/L,which was signifi-cantly higher than (26.5 ±1.1)ng/L in the lung cancer patients (t=49.614,P=0.000).The Bsm1bp genotype, Apal aa genotype and Apal Aa genotype were the risk factors of lung cancer .The Bsm1bp and Apal Aa genotypes were independent risk factors of lung cancer .Conclusion The Bsm1 locus and Apal locus Aa genotype in VDR receptor are high risk population of lung cancer .Therefore,we should pay more attention to the clinical screening and avoid misdiagnosis and missed diagnosis .
ABSTRACT
<p><b>OBJECTIVE</b>Transesophageal echocardiography was performed during closed-chest cardiopulmonary resuscitation (CPR) in in-hospital cardiac arrest to further explore the hemodynamic mechanism of CPR.</p><p><b>METHODS</b>CPR attempts were performed according to advanced cardiovascular life support guidelines in 6 cases of in-hospital cardiac arrest. Multi-plane transesophageal echocardiography was carried out within 15 min of initiation of CPR. Throughout CPR, the motion of the mitral, tricuspid and aortic valves, the changes in the left ventricular cavity size and the thoracic aortic diameter were observed. Trans-mitral and trans-aortic Doppler files of blood flow were also documented.</p><p><b>RESULTS</b>A closure of the mitral and tricuspid valves with simultaneous opening of the aortic valve occurred exclusively during chest compression, resulting in forward blood flow in the pulmonary and systemic circulation. Peak forward aortic flow at a velocity of 58.8 +/- 11.6 cm/s was recorded during the compression phase. Whereas, a closure of the aortic valve and rapid opening of the atrioventricular valves associated with ventricular filling during relaxation of chest compression was noted in all 6 patients. Peak forward mitral flow at a velocity of 60.6 +/- 20.0 cm/s was recorded during the release phase. Mitral regurgitation during the chest compression period was detected in 5 patients, reflecting a positive ventricular-to-atrial pressure gradient. A reduction in the left ventricular chamber and an increase in the thoracic aortic diameter during the compression phase was found in all patients, indicating that direct cardiac compression contributed to forward blood flow.</p><p><b>CONCLUSION</b>These observations favor the cardiac pump theory as the predominant hemodynamic mechanism of forward blood flow during CPR in human beings.</p>