Objective To explore the clinical effect of small cell lung cancer(SCLC) treatment with recombinant human endostatin injection and cis-platinum complexes.Methods 100 patients with SCLC were divided into 2groups.The experiment group used cis-platinum complexes while the control group used recombinant human endostatin injection.Results The effective rate of experiment group was obviously higher than the control group ( 74.0％ vs60.0％,x2=2.16,P ＜ 0.05 ).The median survival time of experiment group was better than control group( t=2.02,P ＜ 0.05 ).The diverse of untoward effect of two groups had no difference ( P ＞ 0.05).Conclusion Recombinant human endostatin injection and cis-platinum complexes were better therapy for SCLC,which had stable effect,no severe untoward effect and overcome the drug-fast of cis-platinum complexes.

Objective To investigate the susceptibilities of HCMV clinical strains isolated to ganciclovir from the patients after hematopoietic stem cell transplantation.Methods Eight HCMV clinical isolates were isolated from the blood or the urine of hematopoietic stem cell transplantation recipients who had been treated with GCV.Tissue cell infection median dose(TCID50) were calculated by Reed-Muench method.Drug susceptibility was determined by MTT assay.Results TCID50 values of eight HCMV clinical strains were 10-4.12/0.1ml,10-4.29/0.1ml,10-4.3/0.1ml,10-4.4/0.1ml 10-4.42/0.1ml,10-4.5/0.1ml,10-4.52/0.1ml and 10-4.62/0.1ml respectively.50％ inhibitory concentration(IC50) to GCV of eight HCMV clinical strains were 0.638,1.438,0.965,0.698,0.482,1.167,1.519,1.511 mg/L respectively.Conclusion Our results suggest that resistant HCMV strains are not prevalent in Guangzhou.Continuous monitoring of HCMV is needed to understand the antiviral resistance status of the virus in patients after hematopoietic stem cell transplantation and guide its clinical management.

Objective To analyze the clinical and imaging features of pulmonary metastasis of giant cell tumor of bone for clinical diagnosis and treatment.Methods Five patients with histologically proven pulmonary metastasis from giant cell tumor of bone were reviewed,the imaging features and the progression of the pulmonary metastasis were evaluated.Results The first operation of primary tumor was curettages and then local recurrence was seen in all 5 cases.The interval to metastasis ranged from 5 to 26 months.Pulmonary metastasis was diagnosed by chest radiographs in 4 cases and CT in all 5 cases.The imaging findings included solitary solid nodule (n =1),multiple solid nodules and mass (n =5),multiple groundglass nodules (n =1) and complex form (n =2).The dynamic follow-up CT findings showed spontaneous regress nodules (n =1),metastasis occurring again 19 months after surgery of solitary nodule (n =1),some solid nodules unchangable for a long time in 3 patients with multiple nodules.Conclusions The dynamic follow-up CT findings of pulmonary metastasis of giant cell tumor of bone are specific.The regular follow-up could play an essential role in early detection and prognosis of pulmonary metastasis within 2 years after primary tumor diagnosed.

Objective:To investigate the death of patients with granulocytopenia complicated with infection after chemotherapy and the changes of vital signs before emergency treatment, and to analyze the prognosis of different vital signs on patients' prognosis and emergency treatment.Methods:This study used a case-control study method to select 211 patients with hematologic malignancies who met the inclusion criteria in two tertiary hospitals in Weifang City. The vital signs of patients were collected and the vital signs were analyzed using SPSS 17.0 software. And the statistical significance and predictive value in the emergency response group.Results:The heart rate, respiratory rate, systolic blood pressure, blood oxygen saturation and urine volume were significantly different between the survival group (112 cases) and the death group (99 cases)( t values were 11.038-177.102, P<0.01). The area under the receiver operating characteristic curve of body temperature, heart rate, respiratory rate, systolic blood pressure, and blood oxygenation saturation and urine volume were 0.547, 0.495, 0.294, 0.899, 0.988, and 0.827, respectively. The highest predictive efficiency (higher level) was observed with the change of blood oxygen saturation, and the corresponding optimal cutoff point. 0.91; between the emergency treatment group (103 cases) and the non-emergency treatment group(108 cases), the difference in heart rate, respiratory rate and oxygen saturation between the two groups was statistically significant ( t values were 5.247, 8.001, 9.066, P<0.01). The area under the receiver operating characteristic curve of body temperature, heart rate, respiratory rate, systolic blood pressure, blood oxygen saturation and urine volume were 0.581, 0.732, 0.813, 0.346, 0.102, and 0.543, respectively. Among them, the predicted value of respiratory frequency change was the highest (medium level), which was the best corresponding. The cutoff point was 27.5. Conclusions:Patients with granulocytic infection after malignant hematologic disease will have abnormal changes in vital signs before death and emergency treatment. However, different vital signs have different effects on predicting disease changes, and should focus on respiratory rate and oxygen saturation. Changes, when the respiratory rate exceeds 27 beats/min, the probability that the patient needs to implement emergency treatment such as rescue will increase. If the condition is not effectively controlled, the blood oxygen saturation is lower than 0.91, the risk of death of the patient is greatly increased.

Objective: To analyze the epidemiological characteristics of coronavirus disease 2019 （COVID-19） cases reported in Ningbo from January 22 to February 22, 2020, so as to provide guidance for the prevention and control of the COVID-19 epidemic. Methods: The confirmed cases of COVID-19 reported by Ningbo were selected from National Diseases Prevention and Control Information System to analyze the epidemiological characteristics by descriptive epidemiological method, including time, spatial and population distribution, clinical symptoms and exposure history. Results: A total of 157 confirmed cases of COVID-19 were reported and there was no death. The first confirmed case was reported on January 22. On the incidence curve, the peak was from January 22 to February 4, with a maximum of 15 cases in a single day. The incidence curve presented sustained human-to-human transmission. The number of the cases showed a declining trend from February 5. The confirmed cases were reported in all 10 counties（cities or districts）,among which 69（43.95%）cases were reported in Haishu District. The confirmed cases were mainly 30-69 years old,accounting for 78.34%;were mainly farmers,household workers and retired people,accounting for 59.87%;and were mainly clinically mild,accounting for 87.90%.There were 51 imported cases, accounting for 32.48%. The initial confirmed case was a local case. In the early stage of the epidemic, local cases and imported cases prevalent together,which was due to the outbreak caused by the large-scale buddhist activity on January 19.This event resulted in 67 confirmed cases and 15 asymptomatic cases. There totally reported 22 clusters with 138 （87.90%）confirmed cases. Conclusions In the early stage of the COVID-19 epidemic in Ningbo, the imported cases and local cases prevalent at the same time. Most of the cases were female, aged from 30 to 69 years, and their occupation were farmers, household workers and retired people. With comprehensive measures taken, the epidemic of COVID-19 in Ningbo have been under control.

OBJECTIVETo monitor human cytomegalovirus (HCMV) drug resistance in recipients of hematopoietic stem cell transplantation by phenotypic and genotypic methods.

METHODSHCMV clinical isolates was isolated from the urine of hematopoietic stem cell transplantation recipients treated with GCV. Tissue cell infection median dose (TCID50) of the isolates was calculated using Reed-Muench method, and their drug susceptibility was determined by plaque reduction assay. We amplified the UL97 DNA fragment of the virus by nested PCR followed by automated DNA sequencing.

RESULTSHCMV clinical strain isolated from the urine samples of the recipients using a human fibroblast cell line showed a TCID50 value of 10(-4.618)/0.1 ml and a 50% inhibitory concentration (IC50) to GCV of 5.847 µmol/L, suggesting its sensitivity to GCV. Alignment with the AD169 DNA reference sequence identified 4 point mutations of the virus at 1509 (T-C), 1575 (C-T), 1794 (T-C), and 1815 (C-G), and only the last mutation resulted in one amino acid mutation to D605E. No gene mutation was found in relation to GCV resistance.

CONCLUSIONSPhenotypic and genotypic assays were established to examine antiviral drug resistance of HCMV in recipients of hematopoietic stem cell transplantation. We did not find any drug resistance of the clinical HCMV isolate.

Antiviral Agents ; pharmacology ; Cell Line ; Cytomegalovirus ; drug effects ; genetics ; isolation & purification ; Drug Resistance, Viral ; genetics ; Ganciclovir ; pharmacology ; Genes, Viral ; Genotype ; Hematopoietic Stem Cell Transplantation ; Humans ; Mutation ; Phosphotransferases (Alcohol Group Acceptor) ; genetics

Objective To investigate the feasibility and safety of delta-shaped anastomosis in totally laparoscopic distal gastrectomy digestive tract reconstruction of gastric cancer. Methods Clinical data of 26 patients with distal gastric cancer who received total laparoscopic distal gastrectomy with delta-shaped anastomosis from August 2013 to December 2014 were retrospectively analyzed. Results A total of 26 patients were successfully performed by laparoscopic distal gastrectomy with delta-shaped anastomosis. The operative time and delta-shaped anastomosis time was (186 ±28) min and (30 ±24) min respectively. The lengths of upper and lower segment of resection from gastric cancer were (4.9±1.2) cm and (3.5±1.5) cm respectively. Blood loss was (67±39) ml and the number of dissected lymph nodes was (27±11) for every patient. First time to ground activities, first flatus, time to fluid diet and hospital stay were respectively (1.7±0.8) d, (3.5±1.3) d, (4.2±1.6) d and (12±4 ) d. Pathological results showed upper and lower segment of resection cancers were not found. Only 1 patient had gastric small curved stump fistula and recovered after conservative treatment. There were no complications related to the anastomosis in all patients. Conclusion The delta-shaped anastomosis is safe and feasible for totally laparoscopic distal gastrectomy digestive tract reconstruction of gastric cancer with satisfactory short-term efficacy.

Objective To investigate the application value of vessel-guided lymph node dissection (LND) in the laparoscopic distal gastrectomy (D2) of distal gastric cancer.Methods The retrospective crosssectional study was conducted.The clinicopathological data of 157 patients who underwent laparoscopic distal gastrectomy (D2) of distal gastric cancer in the Affiliated Tumor Hospital of Shanxi Medical University from October 2012 to July 2015 were collected.Patients used vessel-guided LND that was divided into 4 steps:middle colic vessel-guided LND in the upper pyloric region,gastroduodenal artery-guided LND in the lower pyloric region,common hepatic artery-guided LND in the right upper margin of pancreas and splenic artery-guided LND in the left upper margin of pancreas.Observation indicators:(1) surgical and intraoperative situations,(2) postoperative pathological results,(3) follow-up situations.Follow-up using outpatient examination and telephone interview was performed to detect the postoperative 3-year survival rate up to June 2017.Measurement data with normal distribution were represented as xes.The survival rate was calculated using the Kaplan-Meier method.Results (1) Surgical and intraoperative situations:157 patients underwent successful laparoscopic distal gastrectomy (D2) of distal gastric cancer.Operation time,LND time,volume of intraoperative blood loss,time for initial out-of-bed activity,time to initial anal exsufflation and time of postoperative abdominal drainage-tube removal were (178± 38) minutes,(61 ± 27) minutes,(87 ± 40) mL,(1.2± 0.4) days,(2.8 ± 1.3) days and (7.5 ± 2.6) days,respectively.Of 157 patients,10 with postoperative complications were improved by conservative treatment,including 5 with intestinal obstruction,3 with anastomotic fistula and 2 dying of pulmonary infection;other patients didn't have complications.Duration of hospital stay of 157 patients was (9±3)days.(2) Postoperative pathological results:total number of LND,numbers of LND in the lower pyloric region and in the upper margin of pancreas were 34.6±11.0,4.8±2.1 and 12.3±4.7,respectively.TNM staging:26,33,18,24,37 and 19 patients were respectively detected in stage Ⅰ a,Ⅰ b,Ⅱa,Ⅱ b,Ⅲa and Ⅲb.(3) Follow-up situations:142 of 157 patients were followed up for 6-56 months,with a median time of 27 months,and postoperative 3-year survival rate was 67.6％.Conclusion The vessel-guided LND is safe and effective in the laparoscopic distal gastrectomy (D2) of distal gastric cancer,and the operation steps can be simplified.