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ObjectiveTo screen out the microRNAs (miRNAs) associated with the prognosis of hepatocellular carcinoma (HCC) through data mining of miRNA transcriptome data of HCC downloaded from The Cancer Genome Atlas (TCGA) database, to establish a miRNA risk score model, and to investigate its value in predicting the prognosis of HCC. MethodsThe miRNA expression data and clinical data of HCC samples were downloaded from TCGA database and R language was used to screen out differentially expressed miRNAs between HCC tissue and adjacent tissue, which were randomly divided into training set and testing set after being integrated into clinical data. Univariate Cox regression analysis and least absolute shrinkage and selection operator (LASSO) Cox regression analysis were performed for the training set to screen out the miRNAs associated with the prognosis of HCC, and then a miRNA risk score model was established. The Kaplan-Meier method was used to evaluate the robustness of the model and whether it could predict the prognosis of patients in the same clinical stage. Finally, the receiver operating characteristic (ROC) curve was plotted and the area under the ROC curve (AUC) was calculated to compare the predictive accuracy of the model versus TNM staging in the training set, the testing set, and the entire set. ResultsA total of 300 differentially expressed miRNAs were screened out and the LASSO Cox regression analysis revealed that hsa-miR-139-5p, hsa-miR-1180-3p, hsa-miR-1269b, hsa-miR-3680-3p, hsa-miR-509-3-5p, and hsa-miR-31-5p were associated with the prognosis of HCC. The risk score was calculated for each sample according to the established miRNA risk score model, and the samples were divided into high-risk group and low-risk group according to the median risk score. The Kaplan-Meier curve showed that in both training and testing sets, the high-risk group had a significantly lower survival rate than the low-risk group (P＜0.05). The ROC curve was used to evaluate the prediction efficiency of this model, and the results showed that in the training set, the testing set, and the entire set, the miRNA model had an AUC of 0.817, 0.808, and 0.814, respectively, while TNM staging had an AUC of 0.667, 0.665, and 0.663, respectively. The results of independent prognostic analysis also showed that this miRNA score model could be used as an independent prognostic factor for HCC (P＜0.05). ConclusionHsa-miR-139-5p, hsa-miR-1180-3p, hsa-miR-1269b, hsa-miR-3680-3p, hsa-miR-509-3-5p, and hsa-miR-31-5p are associated with the prognosis of HCC, and the miRNA risk score model has a better prediction accuracy than TNM staging in the training set, the testing set, and the entire set. The stratified analysis also shows that the model can predict the prognosis of patients within the same TNM stage, and therefore, it has a certain reference value in clinical practice and can be used as an independent model for predicting the prognosis of HCC patients.
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Objective To explore security and preventive measures of the single medical oxygen cabin.Methods The safety risks of the cabin were analyzed in design,installation,management,usage,maintenance and test with considerations on its characteristics and clinical application,and then some preventive measures were proposed accordingly for safety management.Results Safety management of the cabin had to be improved from the aspects of design,manufacture,installation,patient management and etc.Conclusion Safety of the cabin can be enhanced by management system,operating instruction,personnel awareness and etc.
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Objective To observe and compare the effect of different concentration of ropivacaine on elderly patient with bra-chial plexus block under ultrasound-guided ,to assess its effectiveness and security ,so as to determine the optimum dosage of anes-thetic for elderly patients with brachial plexus block .Methods 120 patients undergoing elective surgery of forearm or hand in this hospital from February 2013 to December 2014 were selected as the observation group in this study .These patients were randomly divided into four groups on average ,narcosis was conducted in each group with ultrasound-guided :group A with 30 mL of 0 .250%ropivacaine ,group B with 30 mL of 0 .375% ropivacaine ,group C with 30 mL of 0 .500% ropivacaine ,group D with 30 mL of 0 .750% ropivacaine .The onset time of sensory block ,motor block level ,duration of analgesia and adverse reactions were observed and recorded .Results With the increase of concentration of ropivacaine ,the onset time of narcotize became shorter(P0 .05) .There was no complications occurred in four groups after narcosis .Conclusion Concentration of ropivacaine more than 0 .375% can achieve perfect clinical effect on elderly patients with brachial plexus block under guidance of ultrasound .
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Objective To explore the clinical value of Glucosamine hydrochloride tablets(GH)alone and combination with Xianlinggubao capsules(XLGB)for treatment patients with knee osteoarthritis(KOA).Methods 96 patients with KOA were selected,and were divided into two groups according to the random number method, 48 cases in each group.The control group was treated with GH alone,while the observation group was treated with XL-GB on the basis of the control group.US Western Ontario and McMaster University Osteoarthritis Index (WOMAC) were used to evaluate the symptoms change,including pain,stiffness,physical function scores and total scores before and after treatment.The onset time,knee function (HSS)score at 3 months and 6 months after treatment were recor-ded.CRP and ESR were measured,and the total efficacy was evaluated at the end of treatment.Results The differ-ence of WOMAC score between the two groups was not statistically significant before treatment (P >0.05 ).After treatment,pain,stiffness,physical function scores and total scores were (10.2 ±1.4)points,(3.5 ±1.6)points, (40.5 ±5.0)points and (56.4 ±6.7)points in the observation group,those were (14.8 ±2.6)points,(6.2 ±2.3)points, (52.2 ±6.8)points and (73.3 ±4.5)points in the control group,the differences were statistically significant (t =7.631,4.721,6.791,10.26,all P <0.01).The onset time,HSS score at 3 months and 6 months after treatment in the observation group were (6.0 ±2.2)d,(68.2 ±6.4)points and (84.3 ±6.2)points,while those were (9.8 ± 2.8)d,(58.5 ±3.9)points and (72.8 ±5.4)points in the control group,the differences were statistically significant (t =5.228,6.341,6.852,all P <0.01 ).The improvements of CRP level and ESR in the observation group were more pronounced than those in the control group (t =3.880,2.668,all P <0.05).After treatment,the total effective rate of the observation group was 93.8%(45 /48),while that was 77.1%(37 /48)in the control group,the difference was statistically significant (χ2 =5.352,P <0.05).Conclusion GH combines with XLGB can significantly improve symptoms in patients with KOA,with more rapid recovery of knee function,thus it is a safe and effective therapy.
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Objective To study the relation between the levels of protein C(PC),protein S(PS),antithrombin Ⅲ(AT-Ⅲ)with cerebral infarction.Methods 126 patients with cerebral infarction were divided into the groups according to the age,onset time and infarction area and contemporaneous 30 individuals with healthy physical examination were selected as the control group.The levels of PC,PS and AT-Ⅲ were detected.The relation between the change of these indicator levels with the age,onset time and infarction area was analyzed Results The levels of AT-Ⅲ,PC and PS in the acute stage youth group were lower than those in the acute stage middle age and elderly group with statistical differences between them (P <0.05).The level of the AT-Ⅲ,PC and PS in the acute stage group were lower than those in the recovery stage group and the control group,difference had statistical significance(P <0.05).The levels of AT-Ⅲ and PS in the recovery stage group were lower than those in the control group with statistical difference (P <0.05),but the level of PC had no statistical difference between the recovery stage group and the control group.The further study found that the level of AT-Ⅲ,PC and PS in the small infarction group,middle infarction group and large infarction group showed the gradually decreasing trend,the differences had statistical significance (P <0.05).Conclusion The decrease of AT-Ⅲ, PC and PS levels is the importan factor of cerebral infarction occurrence and is closely correlated with cerebral infarction ocurrence especially in the patients less than 45 years old.Observing the change of PC,PS and AT-Ⅲ levels has the important significance for judging the cerebral infarction progression.
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Objective To evaluate the surgical technique in ventricular septal defect(VSD)associated with aortic valve insufficiency(AI)patients.Methods 115 VSD patients associated with AI were retrospectively analyzed.96 patients belong subarterial to VSD,membranous defect in 19 cases.Moderate hypothermia circulatory arrest in all cases.Direct closure of the VSD was undertaken in 16 cases and other cases repaired with patches.Aortic valvuloplasty in 92 cases.and 5 patients underwent aortic valve replacement.The other 18 cases were directly repaired the VSD with patches.Results The results of surgical treatment is satisfactory.In the 4 months to 2 years follow up,10 patients died,NYHA cardic function 72 cases is Ⅰ,31 is Ⅱ and 2 is Ⅲ.Conclusion Early and concomitant surgical treatment ventricular septal defect associated with aortic valve insufficiency can obtain an ideal results.