Objective To study the genotyping of clarithromycin-resistant Helicobacter pylori(Hp) isolates.Methods From March 2007 to October 2007,247 gastric mucosa specimens were collected by the endoscopy from the patients with peptic ulcer or gastritis at the affiliated hospital of Youjiang Medical College for Nationalities.A total of 126 Hp strains were isolated.Resistance to clarithromycin in Hp was determined by E-test.All of the resistant isolates were genotyped with REP-PCR and further clustered with NTsys_2 software.The clinical data was collected for these patients with clarithromycin-resistant Hp.Results The 26 clarithromycin-resistant isolates from the west of Guangxi were divided into six genotypea including Group Ⅰ,Group Ⅱ,Group Ⅲ,Group Ⅲ,Group Ⅳ,Group Ⅴ and Group Ⅵ according to the homology of 78%.Every group have 2,11,1,8,3,1 strains Hp,respectively.Strains of group Ⅱ were isolated from patients with peptic ulcer and most of them from Chuang patients.All strains of group Ⅳ were isolated from patients with gastritis.Conclusions The clarithromycin-resistant isolates were divided into six groups by REP-PCR Disease type.nationality of patients and family history of stomach diseases were associated with the genotypes.

Objective　To explore the characteristics of toxic heavy metal pollution in atmospheric PM2.5 (Particulate matter 2.5) during winter in Nanning City and to evaluate the health risks for the population. Methods　Atmospheric PM2.5 samples were continuously collected in the urban areas of Nanning from January to February 2019. The concentrations of seven toxic heavy metals, including cadmium (Cd), arsenic (As), chromium (Cr), lead (Pb), nickel (Ni), mercury (Hg), and manganese (Mn) in atmospheric PM2.5 were analyzed by X-ray fluorescence spectrometry. The pollution characteristics of toxic heavy metals were studied by geo-accumulation index and enrichment factor methods, and their health risks to children and adults were assessed using the health risk assessment model of the United States Environmental Protection Agency. Results　The mass concentration of atmospheric PM2.5 in Nanning in winter 2019 was (44±29) μg/m3, which was generally at a low level. Different degrees of pollution were found for Hg, Cd, As, Cr, and Pb in PM2.5, with Hg and Cd being more seriously polluted. Hg and Cd were highly enriched in PM2.5, followed by Pb with moderate enrichment. These three elements mainly originated from man-made pollution. As, Cr and Ni were mildly enriched and affected by both natural and anthropogenic sources. The non-carcinogenic risks were in the order of As>Pb>Hg>Cr>Cd>Mn>Ni. The total non-carcinogenic risks for the three populations were all less than 1, which is within acceptable limits. The carcinogenic risks were ranked as Cr>As>Cd>Ni, with Cr, As, and Cd posing carcinogenic risks to children and adults ranging from 1×10-6 to 1×10-4. Moreover, the total carcinogenic risks of heavy metals (Cr, As, Cd, and Ni) were higher than 1×10-4 for children, indicating a potential carcinogenic risk. Conclusions　The mass concentration of PM2.5 and heavy metal elements in Nanning City during the winter of 2019 was relatively low, but the pollution of heavy metals still exists. The non-carcinogenic risk of heavy metals is within an acceptable range, but the carcinogenic risk poses a potential danger to children.

OBJECTIVE: To establish a proper animal model of pyogenic spondylitis, to evaluate the efficacy of silver nanoparticles for treatment of spinal pyogenic infections, and to explore the distribution of the particles in the body of the animals. METHODS: Staphylococcus aureus was inoculated into intervertebral discs of rabbits to establish a spinal pyogenic infection model. These rabbits were divided into Group A [0.1 mg/(kg.d)], Group B [1 mg/(kg.d)], and a Control group. Groups A and B were injected with different doses of silver nanoparticles solution daily at locally infected side. Two weeks later, bacterial cultures, radiographic outcomes, histopathology were analyzed. Atomic absorption spectrometry was utilized to measure silver contents in some vital organs of the rabbits to detect the distribution and accumulation of silver particles. RESULTS: Staphylococcus aureus (100 CFU/mL), induced 100% pyogenic spondylitis. 1 mg/kg dose of silver nanoparticles solution could effectively inhibit the occurrence of spinal pyogenic infection with the effective rate of 75%. While the effect of 0.1 mg/kg dose of silver nanoparticles solution was less obvious, the efficiency was only 25%. Significant numbers of silver nanoparticles were observed to accumulate in the animal. In the 1 mg/kg group silver was deposited mainly in the spinal cord, liver, kidneys, spleen, and testicles, while in the 0.1 mg/kg group it accumulated only in the spinal cord. CONCLUSION Local administration of silver nanoparticles can effectively prevent and treat pyogenic spondylitis; the particles accumulate in the body commensurate with the administered drug concentration.
Animals ; Infusions, Intralesional ; Lumbar Vertebrae ; Male ; Metal Nanoparticles ; administration & dosage ; Rabbits ; Silver ; administration & dosage ; pharmacology ; Spondylitis ; drug therapy ; microbiology ; Staphylococcal Infections ; drug therapy

Seventy patients with advanced non-small-cell lung cancer (NSCLC) aged 65 or above were treated with epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) erlotinib or gefitinib from February 2006 to September 2010. The efficacy and toxicities of treatment were retrospectively analyzed.The overall response rate and disease control rate were 31.4％ and 84.3％,respectively. Themedian progression-free survival time and median survival time were 8.0 months and 13.5 months,respectively(P ＜ 0.05 ). One-year survival rate was 54.3％. Response rate ( CR + PR) ( 42.9％ ) anddisease control rate (94.3％ )in female patients were superior to males (20.0％ and 74.3％ ) (P ＜ 0.05 ).Non-smoking and PS score ＜ 2 were good predictors for survival.The side effects were generally mild and mainly were skin rash and diarrhea.

OBJECTIVE： To study the effects of superfine grinding on the powder properties and dissolution of oyster shell， and to provide experimental basis for its comprehensive exploitation. METHODS： Oyster shells were firstly prepared into ordinary powder by grinder. Then the ordinary powder was prepared into micro-powder Ⅰ （crushing 5 min） and Ⅱ （crushing 10 min） by ultrafine pulverizer. The differences of micromeritic properties were investigated before and after superfine grinding from the aspects of particle size distribution， specific surface area and porosity， angle of repose， bulk density， hygroscopicity， etc. Scanning electron microscope （SEM）， Fourier transform infrared spectroscopy （FTIR） and X-ray powder diffraction （XRD） techniques were used to analyze the morphological characteristics and chemical structure of oyster shell before and after superfine grinding. The dissolution were investigated. RESULTS： Compared with ordinary powder， micropowder Ⅰ and micropowder Ⅱ’s were small in particle size and uniformly distributed， but the particles were easy to adhere and aggregate； the specific surface area， porosity and the angle of repose increased， while bulk density decreased； the hygroscopicity increased. FTIR and XRD showed no significant change in chemical structure of oyster shell after superfine grinding. The dissolution rate of micropowder Ⅱ and micropowder Ⅰ was 18.5％ and 10.3％ at 10 min， and the dissolution of ordinary powder was only 6.4％ at 60 min. CONCLUSIONS： Compared with ordinary powder， oyster shell show obvious differences in powder properties after superfine grinding； the dissolution rate of the powders increases， and there is no significant change in chemical structure.

Background and objectiveIcotinib is the ifrst self-developed small molecular drug in China for targeted therapy of lung cancer. Compared to the other two commercially available epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors, geiftinib and erlotinib, icotinib is similar to them in chemical structure, mechanism of activity and therapeutic effects. To explore the effcacy and side effects of icotinib hydrochloride in the treatment of the advanced non-small cell lung cancer (NSCLC) patients withEGFR mutation and wild-type.MethodsPatients with advanced NSCLC who were treated with icotinib hydrochloride in Beijing Chest Hospital were retrospective analyzed from March 2009 to December 2014.Re-sults hTe clinical data of 124 patients (99 withEGFR mutation and 25 with wild type) with advanced NSCLC were enrolled in this study. hTe patients’ overall objective response rate (ORR) was 51.6 % and the disease control rate (DCR) was 79.8%; hTe patients withEGFR mutation, ORR was 63.6%, DCR was 93.9%. hTe ORR was 4.0% and the DCR was 24.0% in the wild-type patients. Median progression-free survival (PFS) with icotinib treatment inEGFR mutation patients was 10.5 months and 1.0 month in wild-type patients. hTe major adverse events were mild skin rash (30.6%) and diarrhea (16.1%).Conclusion Monotherapy with icotinib hydrochloride is effective and tolerable for the advanced NSCLCEGFR mutation patients.

Objective:To analyze the application effect of online and offline linkage teaching model based on dynamic cases on the residency teaching of department of otolaryngology head and neck surgery.Methods:The teaching data of 62 residents who received standardized residency training in this specialty between December 2018 and July 2020 were collected in the study. According to the sequence of admission to the department, the residents were divided into observation group ( n=32, online and offline linkage teaching) and control group ( n=30, traditional offline teaching). The professional knowledge assessment scores and teaching satisfaction of the two groups of standardized residents, the independent learning ability scores and 360-degree evaluation scale scores under different teaching methods after 6 months were compared between the two groups. SPSS 19.0 was used for chi-square test and t test. Results:The professional knowledge assessment scores of standardized residents in observation group were significantly higher than those in control group [(86.79±7.03) vs. (82.14±6.52)]. After 5 months of teaching, the independent learning ability in both groups was improved, and the scores of learning motivation and learning strategy in observation group were higher than those in control group ( P<0.05). The teaching satisfaction was 93.75% in observation group and 66.67% in control group, and that was better in observation group compared with control group ( P<0.05). The ability scores of seven roles of medical experts, communicators, collaborators, leaders, health advocates, scholars and professionals were significantly better in observation group compared to control group ( P<0.05). Conclusion:Online and offline linkage teaching model based on dynamic cases has a good effect and high teaching satisfaction for the residency teaching of department of otolaryngology head and neck surgery, and it stimulates the learning enthusiasm of the trainees and is conducive to the formation of clinical thinking.

Background and objective Status of epidermal growth factor receptor (EGFR) gene is a predictor of response to EGFR tyrosine kinase inhibitor (TKI). However, lile is know about the relationship between EGFR status and response to chemotherapy. We evaluated the prediction value of EGFR mutation status on response to first-line chemotherapy in patients with advanced non-small-cell lung cancer (NSCLC). Methods e data of 181 patients with stage IIIb/IV NSCLC who diagnosed by histopathology from January 10, 2006 to December 20, 2013 in Beijing Chest Hospital, Capital Medical University were collected. e relationships between EGFR gene status, clinical characteristics and response and progression-free survival (PFS) were analyzed. Results All of the 181 patients’ EGFR statuses were determined. 75 (41.4%) patients har-bored EGFR-activating mutations and 106 (58.6%) patients were EGFR wild-type. All patients received first-line chemother-apy. e objective response rate (ORR) was 26.0% and disease control rate (DCR) was 70.2%. Patients with EGFR-activating mutations had a higher DCR than patients with EGFR wild-type (84.0% vs 60.4%, P=0.001) did. Subgroup analysis showed that the ORR and DCR in patients with EGFR exon 19 deletions were remarkably higher than those with EGFR wild-type (P= 0.049, 0.002, respectively). e DCR in patients with EGFR exon 21 L858R mutation was significantly higher than that in patients with EGFR wild-type (P=0.010). 168 patients were available for response evaluation in all of 181 patients and median PFS was 4.3 mo. e PFS of patients with adenocarcinoma was significantly higher than that patients with squamous cell carci-noma (4.7 mo vs 3.0 mo, P=0.036). e PFS in patients harbored EGFR-activating mutations was significantly higher than that in the patients with EGFR wild-type (6.3 mo vs 3.0 mo, P=0.002). e PFS of patients with a performance status (PS) of 0-1 was significantly higher than that in patients with a PS of 2 (4.4 months vs. 0.7 months, P= 0.016). Cox multivariate analysis indicates the EGFR-activating mutation is an independent factor aecting PFS (HR=0.654, 95%CI: 0.470-0.909, P=0.012). Conclusion EGFR-activating mutation is a predictor for PFS of first-line chemotherapy in advanced NSCLC patients.

Background and objective Activating mutations in epidermal growth factor receptor (EGFR) and KARS are important markers in non-small cell lung cancer. However, EGFR and KARS gene mutations in lung squamous cell carcinoma are rarely reported. hTe aim of this study was to analyze EGFR and KARS gene mutation rate and their relationship with clinical features in patients with lung squamous cell carcinomas. Methods A total of 139 patients undergoing treatment for na?ve lung squamous cell carcinomas with tumor tissue samples available for testing were recruited. EGFR and KARS mutation statuses of the tumor samples were detected using a mutant enriched liquid chip. Results Of the 139 cases of lung squamous cell carcinoma, EGFR mutations were detected in 25 cases (18%), KARS mutations were detected in 7 cases (5%), and the pres-ence of both EGFR and KARS mutations was detected in 1 case (0.7%). EGFR mutations occurred more otfen in females than in males (33.3%vs 16.5%) and in patients that never smoked than in those who smoke (29.6%vs 16.1%). However, the differ-ence did not reach statistical signiifcance (P>0.05). No signiifcant differences were observed in age, stage, and different biopsy type. KARS mutations occurred more otfen in males than in females (5.5%vs 0%), but the difference did not reach statistical signiifcance (P>0.05). No signiifcant differences were observed in age, stage, different biopsy type, and smoking status (P>0.05). Conclusion EGFR and KARS mutations were low in lung squamous cell carcinomas, and had no signiifcant correlation with clinical features. Before using tyrosine kinase inhibitor targeted therapy, EGFR and KARS mutations should be detected in pa-tients with lung squamous cell carcinomas.

Objective:To provide evidence for optimizing the screening strategy for gastric cancer (GC), we evaluated the risk of incident GC for individuals with different precancerous gastric lesions in a prospective cohort study.Methods:Based on the National Upper Gastrointestinal Cancer Early Detection Program launched in Linqu, Shandong, a high-risk area of gastric cancer in China, we included a total of 14 087 subjects diagnosed with different gastric lesions stages by endoscopic screening from 2012 to 2018. Study subjects were prospectively followed up until December 31, 2019. The incidence of GC during the follow-up was ascertained by repeated endoscopic examinations, cancer, death registry reports, and active follow-up of study subjects and was confirmed by reviewing medical records extracted from the hospital information management system. The Poisson regression model was applied to calculate the relative risk ( RR) and 95% CI for GC occurrence among subjects with different gastric lesions. Results:Among 14 087 subjects with different gastric lesions as determined by their first endoscopic examination in 2012-2018, 7 608 (54.00%) had a global diagnosis of superficial gastritis (SG), 2 848 (20.22%) had chronic atrophic gastritis (CAG), 3 103 (22.03%) had intestinal metaplasia (IM), and 520 (3.69%) had low-grade intestinal neoplasia (LGIN). During the follow-up, 109 subjects were diagnosed with GC, including 63 with high-grade intestinal neoplasia (HGIN) and 46 with invasive GC. Compared to subjects having normal gastric mucosa or SG, those with CAG ( RR=3.85, 95% CI: 2.04-7.28), IM ( RR=5.18, 95% CI: 2.79-9.60), and LGIN ( RR=19.08, 95% CI: 9.97-36.53) had significantly increased risk of progression to GC. Individuals with these gastric lesions had an elevated risk of developing HGIN and invasive GC. For subjects with LGIN, the RR was 22.96 (95% CI: 9.71-54.27) for developing HGIN and 14.64 (95% CI: 5.37-39.93) for developing invasive GC. Subgroup analyses found that all age group subjects with LGIN diagnosed during the initial endoscopic examination had a significantly increased risk of developing the GC. Conclusions:Our large-scale prospective study on a high-risk area of GC showed that most residents aged 40-69 years had gastric lesions of different stages. Subjects with more advanced gastric lesions had a significantly increased risk of progression to GC.