Objective to investigate the outcome and EP treatment outcome of small‐cell lung cancer (SCLC) patients with different hyponatraemia .Methods This retrospective study analyzed the relationship between the serum sodium ,serum osmolality , urine sodium ,urine osmolality and survival time of 51 patients .Moreover ,we analyzed the survival time and chemotherapy outcome of SCLC patients in hypovolaemic and euvolaemic hyponatraemia .Results The data indicated that the serum sodium and osmolality correlated with the survival time positively ,and the pearson correlation coefficient are 0 .48 [95% CI:(0 .23 to 0 .67)]and 0 .61 [95% CI:(0 .40 to 0 .76)] ,respectively .urine sodium and osmolality correlated with survival time negatively ,and the pearson corre‐lation coefficient are -0 .6 [95% CI:(-0 .75 to -0 .38)] and‐0 .31 [95% CI:(-0 .54 to -0 .04)] ,respectively .Etoposide plus cisplatin treatment showed less effectiveness to the SCLC patients in euvolaemic hyponatraemia (29 .17% VS .66 .7% ,P<0 .05) , and the survival time of SCLC patients in euvolaemic hyponatraemia is shorter (33 .3% VS .92 .6% ,P<0 .05) .Conclusion Euvol‐aemic hyponatraemia could be a risk factor for poor outcome in SCLC .

Objective To compare the effects of transforaminal peripheral nerve stimulation(PNS) and spinal cord stimulation(SCS) in treatment of postherpetic neuralgia.Methods A total of 64 patients with postherpetic neuralgia in our hospital from January 2015 to January 2016 were divided into PNS group and SCS group according to random number table.Both two groups were treated with PNS or SCS for 14 days,respectively.Visual analogue scale(VAS) and piasburgh sleep quality index(PSQI) were adapted to assess the effects at the different time of preoperation, postoperation 1 day,1 week,1 month,2 months.Results At the preoperation and 2 months postoperation,in PNS group,the VAS were (8.4±1.6) and (1.4±1.0),the PSQI were (16.1±2.1) and (5.8±1.3),respectively;meanwhile in the SCS group,the VAS were (8.6±1.8) and (2.9±1.2),the PSQI were (15.6±2.3),(7.5±1.5),respectively.Obviously,the VAS and PQSI at different follow-up stages were improved after transforaminal PNS or SCS treatment, the differences were signicant(P<0.05).Moreover,the PNS group had lower VAS and higher PQSI compared with the SCS group at different follow-up stages,the differences were signicant(P<0.05).Conclusion The transforaminal PNS achieved satisfying outcomes on pain relief and quality of sleep improvements for the postherpetic neuralgia patients,which was superior to that of the SCS.

Erythropoietin (EPO),which is routinely used in clinic to treat anemia,has been implicated in a wide range of activities on diverse tissues.Recently,accumulating evidence shows that EPO has antidepressant-like effects and may be a po-tential drug candidate for treating mood symptoms and memory dysfunction in depression.This review summarizes the current progress on EPO’s antidepressant-like effects,and explores its potential mechanism and clinical application in the future,provi-ding a general view of the research and application status of EPO in depression.

Purpose To investigate the expression of miR-200a and PTEN in colorectal carcinoma (CRC) and their relationships with clinicopathologic features. Methods In situ hybridization and immunohistochemistry ( EnVision method) for miR-200a and PTEN were performed in 87 CRCs and normal colorectal tissues distant from tumors. Relationship between expression of miR-200a and PTEN and clinicopathologic parameters of CRC was also analyzed. Results The in situ hybridization showed that the positive expression rate of the miR-200a in CRC was higher than those in normal colorectal mucosa (P<0. 01). The expression of miR-200a was correlated with the degree of tumor differentiation (rs =0. 503, P<0. 01). The immunohistochemistry showed that the positive expression rate of the PTEN in CRC was lower than those in normal colorectal mucosa (P<0. 01). The expression of miR-200a was correlated with the degree of tumor differentiation (rs = -0. 493, P<0. 01). Expression of miR-200a and PTEN was not correlated with age, sex, tumor size, depth of tumor invasion, lymph node metastasis and TNM stage (P>0. 05). The expression of miR-200a had a close negative correlation to that of PTEN in CRC (P<0. 01). Conclusions Overexpression of miR-200a might be associated with the occurrence and development by targeting PTEN, and they could be the indicators in the early diagnosis,treatment and prognosis of CRC.

Objective To analyze the drug resistance phenotype and genetic background of New Delhi metallo-β-lactamase (NDM)-producing bacterial strains in Lishui area of Zhejiang province.Methods The imipenem-resistant Enterobacteriaceae strains were isolated from January 2012 to December 2016 in Lishui Municipal Central Hospital of Zhejiang Province.Mrieux Vitek 2 Compact system was used to identified strains and PCR was used to screen for blaNDMgene.Susceptibility was detected by K-B method and MICs were obtained by Vitek 2 with GN13 cards.Plasmids typing was carried out by DNA sequencing of the replication initiator with the transconjugates as templates.The blaNDMgenetic contexts were detected by PCR and complete genome sequencing.Results A total of 102 strains of carbapenem-resistant enterobacteria (CRE), mainly Escherichia coli and Enterobacter cloacae, were isolated, of which 15 were positive for blaNDMwith a positive detection rate of 14.7%.The resistance rate to β-lactam antibiotics was 100%, and the resistance rates to aztreonam, compound sulfamethoxazole , tobramycin and gentamicin were all ＞80%;and the resistance rate to quinolones was ＞50%.Among the 15 NDM-producing strains , 12 strains were positive for Hodge test, and 2 strains of Enterobacter cloacae and 1 strain of Escherichia coli were negative. There were 11 strains of blaNDM-1and 4 strains of blaNDM-1.A variety of plasmid types such as IncX 3, IncFIIγ and IncA/C were detected, and 4 blaNDM-5genes were located in the IncX3 plasmid.Four blaNDMsurrounding gene structures were found, of which 8 blaNDM-1genes were located in ISAb125-hyp-blaNDM-1-bleMBL-TrpF-DsbC-IS26, while blaNDM-5was located in IS3000-IS5-blaNDM-5-bleMBL-TrpF-DsbC-IS26 structure, and the former was reported for the first time in China.Conclusion NDM-producing bacterial strains in Lishui area are prevalent at a low level and have high sensitivity to fosfomycin and polymyxin .The blaNDMgene may have multiple sources, but IncX3 plasmid is still the main source for gene transfer.Some new types of blaNDM-1 gene structure have been also found in this study.

BACKGROUND:Combined radiation and wound injury appeared mainly in patients with tumor radiotherapy and nuclear radiation accidents.The radiation destroys the repair mechanism,resulting in delayed or prolonged wound healing.It still lacks an effective therapeutic strategy currently. OBJECTIVE:To prepare multifunctional wound dressings based on the multiple clinical symptoms of combined radiation and wound injury,which are designed to be antibacteria,promoted healing and analgesics. METHODS:Using levofloxacin,fibroin and lidocaine hydrochloride as raw materials,3D bioprinting technology was applied to prepare the multifunctional wound dressing.(1)The multifunctional dressing was placed on a fixed culture plate coated with Staphylococcus aureus,Escherichia coli and Pseudomonas aeruginosa,and incubated at 37 ℃ overnight to detect the diameter of the antibacterial zone.(2)40 Kunming mice were randomly divided into trauma group,radiation and trauma model group,treatment group and positive drug group,with 10 mice in each group.Mice in the radiation and trauma model group,treatment group and positive drug group were irradiated by 60Co gamma rays.After 1 hour of radiation,a full-layer skin defect wound with a diameter of 1 cm was made on the back of each mouse in the four groups.Normal saline was applied to the wounds of the trauma group and the radiation and trauma model group.Trethanolamine cream was applied to the wounds of the positive drug group.Multifunctional dressing was applied to the wounds of the treatment group.The dressing was changed every 2 days,and the treatment was continued for 14 days.Wound healing rate and serum interleukin-6 level were measured at 3,7 and 14 days after wound modeling.14 days after the wound modeling,the skin tissue of the wound was obtained and received hematoxylin-eosin staining,Masson staining and cytokeratin-14 immunohistochemical staining. RESULTS AND CONCLUSION:(1)3D-printed multifunctional wound dressing had good antibacterial activity.The antibacterial zone diameters against Staphylococcus aureus,Escherichia coli and Pseudomonas aeruginosa were(4.15±0.09),(4.18±0.23)and(4.35±0.13)cm,respectively.(2)With the extension of modeling time,the wound healed gradually.The wound healing rate of the treatment group and the positive drug group was higher than that of the radiation and trauma model group at 3,7 and 14 days after modeling(P<0.01,P<0.001).The wound healing rate of the treatment group was higher than that of the positive drug group.With the extension of modeling time,the serum interleukin level of mice increased first and then decreased.The serum interleukin level in the treatment group at 3,7 and 14 days after modeling was lower than that in the radiation and trauma model group.Hematoxylin-eosin staining and Masson staining exhibited that inflammatory cells infiltrated the granuloma tissue in the trauma group,and the dermal collagen fibers were densely arranged.The normal structure of epidermis and dermis was destroyed and inflammatory cells were infiltrated in the radiation and trauma model group.In the treatment group,normal skin mucosal tissue was observed,the epidermis was arranged closely,and the sweat glands,hair follicles and dermal collagen fibers were arranged regularly.In the positive drug group,the arrangement of epidermal layer was tight,and the arrangement of sweat glands,hair follicles and dermal collagen fibers was regular.Cytokeratin-14 immunohistochemical staining displayed that the epidermal tissue thickness in the treatment group was lower than that in the other three groups(P<0.01,P<0.001).(3)The results confirm that the 3D-printed multifunctional dressing has multiple functions of local anesthesia,anti-infection and promoting healing.