Objective To study the growth effect of human cholangiocarcinoma cell line QBC939 treated by norcantharidin (NCTD) and preliminary illustrate the potential mechanism.Methods The human cholangiocarcinoma cell line QBC939 was detected by MTT assay,flow cytometry,immunocytochemistry after the treatment of NCTD in vitro.Results NCTD displayed inhibitory effect on growth of QBC939 from different doses of 0.125,0.75,2.5,10,120 μg/ml after 48 h (P ＜0.05).It was in a dose and time dependent manner.Dose-effect curve was drawn and IC50 value was (3.66±1.14) μg/ml.The flow cytometric profiles showed that the rate of cell apoptosis enhanced following increasing the concentration of NCTD[(8.6±0.4) ％,(17.6±0.3) ％,(22.9±0.4) ％,(25.5±0.9) ％ and (31.1±1.5) ％,respectively]and cells blocked in the G2/M phase after treatment with 2.5 μg/ml NCTD[(14.1±1.0) ％ and (5.7±0.3) ％].The expression of the protein caspase-3 elevated after different concentrations of NCTD co-cultured with QBC939 compare with contrast group.Conclusion NCTD has an inhibitory effect on proliferation of QBC939 cell line,and the mechanism might be related to the induction of cell apoptosis and blockade of cell cycle.

Objective To study the effective evaluation of short peptide enteral nutrition powder in advanced digestive tract cancer. Methods 50 cases of advanced digestive tract cancer were randomly divided into two groups: experimental group(short peptide enteral nutrition powder) and control group(routine treatment). Results Data regarding to nutritional status and immune function (WT/IBW, TSF, MANC, ALB, TRF, PA, lgG, lgM, IgA, C3, CD3, CD4, CD8, CD4/CD8) showed a significant difference between experimental group and control group after two weeks's treatment,as well as between before and after two weeks's treatment in experimental group(P <0.05). Conclusion Short peptide enteral nutrition powder maintenance is beneficial to improve the nutritional status and the immune function of patients with advanced cancer and to promote their life quality.

Objective To evaluate the apphcation value of peripheral blood neutrophil CD64 expression in early differential diagnosis of etiology in children with community-acquired pneumonia.Methods From June 2014 to June 2015 in our hospital,total of 99 cases of different pathogen infection were divided into three groups,bacterial pneumonia group (n =41),non-bacterial pneumonia group(n =38),healthy children group (n =20);and the non-bacterial pneumonia group was divided into two subgroups,viral pneumonia group (n =22) and mycoplasma pneumoniae pneumonia group(n =16).Flow cytometry was used to test the median fluorescence intensity (MFI) of peripheral blood neutrophil CD64.The levels of peripheral blood CRP,WBC and neutrophil percentage were detected.Results The levels of CD64 expression,CRP and WBC in bacterial pneumonia group were statistically higher than those of non-bacterial pneumonia group and healthy children group respectively (both P ＜ 0.01).The optimal cutoff value of CD64 was 6 519 MFI when using ROC curve,and the sensitivity and specificity of the diagnosis of bacterial pneumonia were 87.8％ and 89.7％ respectively.The levels of CD64 expression in bacterial pneumonia group were significantly higher than those in viral pneumonia group,mycoplasma pneumoniae pneumonia group and healthy children group (all P ＜ 0.01).Conclusion The expression of peripheral blood neutrophil CD64 increases in children with community-acquired pneumonia of bacteria infection.It can be used to guide early diagnosis of children with bacterial pneumonia and the using of antibiotics.

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Objective To investigate the diagnosis and treatment of anorectal malignant melanoma,in order to regulate surgical methods and explore multi-modality treatment.Methods Clinical pathological features,diagnosis and treatment procedures of 38 patients with anorectal melanoma were reviewed,and their correlation with prognosis were analyzed.Results In 38 patients,10 of them were male and 28 were female,with the mean age of 58.7 years old (ranged 28-75 years old).28 patients underwent abdominoperineal resection,10 patients underwent wide local excision.The 1-,3-,and 5-year disease-free survival rates were 64.9 ％,18.5 ％ and 5.7 ％,respectively.The 1-,3-,and 5-year overall survival rates were 85.8 ％,24.1％ and 6.4 ％,respectively.Tumor thickness (≥ 1.51 rm) and tumor diameter (≥3 cm) were associated with lymph metastases (x2 =13.093,4.449,P =0.011,0.020),tumor thickness was also associated with distant metastases (x2 =11.965,P =0.018).According to the Kaplan-Meier method,comprehensive treatment after surgery had significant effects on disease-free survival (x2 =7.441,P =0.006).Tumor thickness,lymph metastases,and clinical staging had significant effects on overall survival (x2 =16.741,16.474,16.775,P =0.002,0.000,0.000).Cox proportional hazards model indicated that comprehensive treatment after surgery was the independent prognostic risk factors of disease-free survival (95 ％ CI 1.420-17.621,P =0.012).Tumor thickness and lymph metastases were the independent prognostic risk factors of overall survival (95 ％ CI 0.250-0.949,1.033-2.573,P =0.035,0.036).Conclusion Early detection,reasonable surgical procedure,generalized systemic focus on immunotherapy treatment are the key to improve quality of life and prolong the survival time of anorectal malignant melanoma patients.

Objective To evaluate the feasibility of laparoscopic nephroureterectomy with bladder-cuff resection by TUR for upper urinary tract carcinoma. Methods Eighty-two patients with upper urinary tract transitional cell carcinoma(69 cases in renal pelvis and 13 in ureter)underwent retroperitoneal laparoscopic nephroureterectomy and bladder-cuff resection by TUR. This group of cases was retrospectively summarized including operative time, blood loss, drainage mounting days, catheterizing days, post-operative complications and hospital stays. Results All 82 operation procedures were successfully performed without severe complication. The mean operative time was 135 minutes.The mean length of hospital stay was 7 days postoperatively. The mean time with drainage and Foley catheter were 3 days and 6 days respectively. Follow-up time ranged from 6 to 76 months for 74 patients. The 3-year carcinoma recurrence was 10.6% (5/47). Only 1 patient was found incision tumor recurrence in 8 month after the procedure. Conclusion Retroperitoneoscopic nephroureterectomy with bladder cuff resection by TUR could be a feasible procedure to treat upper urinary tract transitional cell carcinoma.

OBJECTIVE:To observe the effects of dexmedetomidine combined with ulinastatin on stress reaction indexes,ex-travascular lung water value(EVLW)and pulmonary vascular permeability indexes(PVPI)and other parameters in one-lung venti-lation(OLV)lobectomy patients. METHODS:A total of 80 patients underwent OLV lobectomy selected from the Affiliated Hospi-tal of Southwest Medical University during Nov. 2015-Nov. 2016 were divided into control group (group N),ulinastatin pretreat-ment group(group U),dexmedetomidine continuous pump group(group D),ulinastatin pretreatment+dexmedetomidine continu-ous pump group(group U+D),with 20 cases in each group. Thirty min before anesthesia induction,all patients were given atro-pine sulfate 0.5 mg intramuscularly and received catheterization of right internal jugular vein and ipsilateral femoral artery under lo-cal anesthesia. Based on that,group N was given 0.9％ Sodium chloride injection 100 mL intravenously;group U was given sodi-um chloride mixed solution 100 mL containing Ulinastatin for injection 200000 U intravenously;group D was given continuous in-travenous pump of Dexmedetomidine hydrochloride injection 2 μg/mL mixed with sodium chloride mixed solution at 1 μg/(kg·h), and after induction intravenous pump at 0.5 μg/(kg·h)until the end of surgery;group U+D was given Sodium chloride mixed so-lution containing 200000 U ulinastatin 50 mL and 4 μg/mL dexmedetomidine sodium chloride mixed solution 50 mL intravenously (same dose as above during induction period and maintenance period). The levels of blood glucose,partial pressure of oxy-gen [p(O2)],adrenocorticotropic hormone (ACTH),norepi-nephrine (NE),heart rate (HR),cardiac output (CO),sys-temic vascular resistance(SVR),EVLW and PVPI were com-pared among 4 groups 30 min before anesthesia induction(T1),2 h after the beginning of surgery(T2),immediately after extuba-tion(T3)and 12 h after surgery(T4). Liquid intake and output volume were recorded during T2-T4. The occurrence of ADR among 4 groups was observed. RESULTS:There was no statistical significance in each index among 4 groups at T1 (P>0.05). During T2-T4,the levels of blood glucose,ACTH,NE,SVR,EVLW and PVPI in group N were significantly higher than other 3 groups, and group U and D were significantly higher than group U+D,with statistical significance(P<0.05);there was no statistical sig-nificance between U and D(P>0.05). The levels of p(O2)and CO in groups U+D were significantly higher than other 3 groups, with statistical significance (P<0.05);there was no statistical significance among other 3 groups (P>0.05). HR of group N and U were significantly higher than other 2 groups,with statistical significance (P<0.05). There was no statistical significance be-tween group N and U,between group D and U+D(P>0.05). There was no statistical significance in liquid intake or output vol-ume among 4 groups (P>0.05). No obvious ADR was found in 4 groups. CONCLUSIONS:Dexmedetomidine combined with ulinastatin can significantly relieve stress reaction,and reduce the levels of part blood flow and respiratory dynamics indexes as EV-LW,PVPI in patients with OLV lobectomy so as to play lung protective effect.

Objective: To observe the safety and effects of application of analgesic and sedative drugs in severely burned patients during shock stage. Methods: One hundred and eighty patients with severe burns, conforming to the study criteria, were admitted to our unit from August 2014 to August 2016. Patients were divided into analgesia and sedation group and control group according to whether receiving analgesic and sedative treatment or not, with 90 cases in each group. Patients in control group received conventional treatment, while those in analgesia and sedation group received analgesic and sedative treatment for 24 hours besides conventional treatment. Before and at drug administration hour 2, 8, 16, and 24, pain degree of patients in two groups was scored by visual analogue scale (VAS). At drug administration hour 2, 8, 16, and 24, sedation degree of patients in two groups was scored by richmond agitation sedation scale, and the success rate of sedation was calculated. Mental state of patients within 24 hours of drug administration was observed, while pulse oxygen saturation (SpO₂), respiratory rate, heart rate, and blood pressure were observed and dynamically evaluated every 2 hours. The accidental extubation, tachycardia, hypertension, hypoxia, bradycardia, hypotension, urinary retention, and respiratory depression of patients within 24 hours of drug administration were monitored and recorded. Data were processed with analysis of variance for repeated measurement, one-way analysis of variance, t test, chi-square test, Wilcoxon rank sum test, and Fisher′s exact probability test. Results: (1) The VAS scores of patients in two groups were close before drug administration (t=0.675, P>0.05). The VAS scores of patients in analgesia and sedation group at drug administration hour 2, 8, 16, and 24 were (3.8±0.4), (3.9±0.6), (3.9±0.5), and (3.9±0.9) points, respectively, significantly lower than (6.0±0.9), (6.0±1.2), (6.2±0.6), and (6.3±0.4) points in control group (t=0.785, 0.730, 0.805, 0.895, P<0.05). The success rate of sedation of patients in analgesia and sedation group at drug administration hour 2, 8, 16, and 24 were 91.1% (82/90), 86.7% (78/90), 93.3% (84/90), and 90.0% (81/90), respectively, significantly higher than 7.8% (7/90), 6.7% (6/90), 14.4% (13/90), and 5.6% (5/90) in control group (Z=8.035, 7.946, 8.129, 8.014, P<0.05). (2) The respiratory rate of patients in analgesia and sedation group at drug administration hour 8, 16, and 24 were (15.78±0.69), (16.08±0.59), and (16.21±0.20) times per minute, and the heart rate were (87±9), (83±7), and (76±9) times per minute, respectively, significantly lower than (16.80±0.81), (17.09±0.50), and (17.02±0.61) times per minute and (89±8), (86±7), and (85±6) times per minute in control group (t=7.655, 7.022, 6.536, -6.931, -7.053, -10.196, P<0.01). There were no statistically significant difference in SpO₂, systolic blood pressure, and diastolic blood pressure before and at drug administration hour 2, 8, 16, and 24 between the two groups (t=3.417, -2.894, -6.501, -3.719, -4.573, 2.336, 3.315, 0.942, -1.583, 1.907, 1.147, -0.968, 0.931, -1.682, 1.076, P>0.05). (3) The rates of respiratory depression, hypoxia, bradycardia, urinary retention, and hypotension of patients in the two groups were close (χ²=0.310, P>0.05). The rates of hypertension, accidental extubation, and tachycardia of patients in analgesia and sedation group were significantly lower than those in control group (χ²=16.364, 5.143, 73.309, P<0.05 or P<0.01). Conclusions Proper application of analgesic and sedative drugs in severely burned patients during shock stage has good clinical effect with low incidence rates of complications.

Objective:To investigate the influence of Jinshuibao tablet on immune function, therapeutic efficacy and safety in treatment of advanced lung squamous cell carcinoma patients treated by chemotherapy.Methods:The clinical data of 124 patients with stage Ⅳ lung squamous cell carcinoma who were admitted to Shanxi Provincial Cancer Hospital from January 2015 to December 2017 were retrospectively analyzed, including 60 patients treated by Jinshuibao tablet combined with chemotherapy (the observation group) and 64 patients treated by chemotherapy alone (the control group). The changes of immune function, therapeutic effect, and side effects were compared between the two groups.Results:The percentage of CD4 + cells after treatment [(33.4±8.9)% vs. (45.5±11.8)%, t = 2.71, P < 0.05] and CD4 +/CD8 + (0.9±0.3 vs. 1.5±0.4, t = 3.31, P < 0.05) in the observation group was increased compared with that before treatment, CD8 + cells was decreased compared with that before treatment [(30.9±8.6)% vs. (21.1±8.1)%, t = 2.42, P < 0.05], interferon-γ (IFN-γ) [(7.7±2.8)% vs. (14.1±2.4)%, t = 2.74, P < 0.05] and interleukin-2 (IL-2) [(8.8±3.2)% vs. (12.7±1.6)%, t = 2.96, P < 0.05] was increased compared with that before treatment. The percentage of CD3 + cells [(57.9±8.2)% vs. (45.2±10.8)%, t = 2.70, P < 0.05], CD4 + cells [(32.9±9.0)% vs. (22.8±9.6)%, t = 3.19, P < 0.05], NK cells [(14.9±3.1)% vs. (9.3±1.4)%, t = 2.97, P < 0.05] in the control group was decreased compared with that before treatment. Tumor necrosis factor α (TNF-α) was decreased compared with that before treatment [(6.8±1.4)% vs. (4.3±0.5)%, t = 3.23, P < 0.05]. There was a statistically significant difference in the level of T-cell subsets of both groups after treatment (all P <0.05); and the level of CD3 +, CD4 +, CD4 +/CD8 +, NK cells in the observation group was higher than that in the control group; CD8 + cell in the observation group was lower than that in the control group. There was no statistical difference in the level of IFN-γ, IL-2, TNF-α of both groups before treatment (all P > 0.05); the level of IFN-γ, IL-2, TNF-α in the observation group was higher than that in the control group after treatment, and the difference was statistically significant of both groups (all P < 0.05). The total effective rate of the observation group was higher than that in the control group, and the difference was statistically significant [31.3% (20/64) vs. 48.3% (29/60), χ 2 = 4.538, P = 0.033]; and the disease control rate in the observation group was higher than that in the control [56.3% (36/64) vs. 71.7% (43/60), χ 2 = 5.276, P = 0.022]. There was no significant difference between the two groups in adverse reactions of chemotherapy (all P > 0.05). Conclusion:Jinshuibao tablet combined with chemotherapy can improve the immune function and the efficacy of chemotherapy for patients with advanced lung squamous cell carcinoma.

Objective To study the incidence rate of prostate cancer detected in the specimen of radial cystoprostatectomy for bladder cancer and to evaluate its effect on the prognosis.Methods From June 2012 to June 2017,the clinical data of 132 patients with bladder cancer undergoing radical cystectomy (RCP) were analyzed retrospectively.The average age of 132 patients with bladder cancer was 61.2 years (37-89 years old).The serum of PSA of 89 cases out of 132 patients was examined before operation,21 cases 4 ng/ml ＜ tPSA ＜ 10 ng/ml,1 case tPSA 17 ng/ml and 67 cases tPSA ＜ 4 ng/ml.The pathology of bladder and prostate,the location and range of prostate cancer and Gleason score and the prognostic effect of prostate cancer was evaluated.Results The 132 patients with bladder cancer,116 cases (87.9％) were high grade urothelial carcinoma,8 cases (6.0％) were bladder carcinoma in situ,6 cases (4.5％) were low grade urothelial carcinoma,1 case was neuroendocrine bladder carcinoma and 1 case was signet ring cell carcinoma.The 21 cases of prostate cancer were combined with Gleason score,among which 3 + 2 score in 1 cases,3 +3 score in 17 cases,4 +3 and 3 +4 in 1 cases,and 4 +5 score in 1 cases.The lesions were unilateral in 14 cases and bilateral in 7 cases.The lesions were ＜0.5 ml in 3 cases,0.5-0.7 ml in 14 cases and 0.7-1.0 ml in 4 cases.The average age of 21 cases with prostate cancer was 67.5 years old (41-89 years).Of the 21 cases of prostate cancer,the serum tPSA was abnormal in 4 cases with an average of 8.8 ng/ml (4.2-17.0 ng/ml),the serum tPSA was normal in 12 cases with an average of 2.5 ng/ml (1.3-3.7 ng/ml),and the serum PSA in 5 cases was not detected before operation.Three cases of prostate cancer aged less than 60 years old with the detection rate of 9.6％ (3/31);18 cases were equal or older than 60 years old with the detection rate of 17.8％ (18/101).Multi parameter analysis showed that the incidence of prostate cancer increased with the age of the patients (OR =1.36,P =0.048).Followed up for 5 to 51 months,no PSA relapse was found and no patient receiving related treatment.Conclusions The detection rate of prostate cancer is very high in the specimen of radial cystoprostatectomy for bladder cancer.The clinical manifestation of the prostatic involvement is concealed.Radical resection of the prostate is necessary in radical resection of bladder cancer.