Objective To investigate the clinical efficacy and safety of ziprasidone and risperidone in the treatment of schizophrenia.Methods According to the digital table,64 patients with schizophrenia were randomly divided into the two groups,32 cases in each group.The control group was given risperidone for treatment,while the observation group was given ziprasidone for treatment.The clinical efficacy was assessed by using the positive and negative symptom scale(PANSS),and adverse events were observed.Results The total effective rates of the control group and the observation group were 84.38％ and 87.50％,there was no significant difference between the two groups(x2 =2.66,P ＞ 0.05);The PANSS score and each factor score of the two groups after treatment decreased significantly than before treatment (t =8.11,7.86,7.72,7.90,6.77,6.58,7.52,7.40,all P ＜ 0.05),but there was no significant difference between the two groups (t =2.18,P ＞ 0.05) ;The incidence rate of adverse reaction of the observation group was 18.75％,which was significantly lower than 40.63％ of the control group (x2 =8.66,P ＜0.05).Conclusion Ziprasidone has therapeutic equivalence with risperidone in the treatment of schizophrenia,with less adverse reaction,high security,it has good clinical application value.

Objective To construct and screen the human immunodeficiency virus-1 (HIV-1) negative regulation factor (Nef) peptide-specific CD4+ T lymphocyte clone.Methods Peripheral blood mononuclear cells (PBMC) from five asymptomatic HIV-1 infected patients were collected and Bulkcultured with Nef end peptides.The CD4 molecule and intracellular interferon (IFN)-gamma of cultured cells were detected by two-color flow cytometry.The Nef end peptide-specific T cell clone was then constructed by limited dilution and confirmed through enzyme linked immunospot assay (ELISPOT).The best grown cells were selected and cultured as the final clone.Results The Nef end peptide-specific-T lymphocyte clone was successfully constructed from PBMC of one HIV-infected patient and confirmed by ELISPOT.The detection of human leukocyte antigen (HLA)-DRB1 type showed that the epitope of this peptide was probably HLA-DRB1 * 0406.Conclusion The Nef end specific-T cell clone is successfully constructed,and a new epitope in the C-terminus of Nef protein and its HLA restriction are identified.

About 5％- 15％ patients suffered from gallbladder stones may have secondary bile duct stones.How to diagnose secondary bile duct stones in time preoperatively or intraoperatively has been a focus of research.In this paper,the advantages and disadvantages of a variety of diagnostic methods of secondary bile duct stones including B ultrasonography,computed tomography,percutaneous transhepatic cholangiography,endoscopic retrograde cholangiopancreatography,endoscopic ultrasonography,magnetic resonanced cholangiopancreatography,intraoperative cholangiography,intraoperative ultrasonography,choledochoscope,are reviewed.

ObjectiveTo evaluate the therapeutic value of neoadjuvant chemotherapy for patients with stages Ⅱ and ⅢA(Only T3N1M0) breast cancer,and assess the relationship of the tumor size and pathologically complete response.MethodA total of 408 breast cancers patients at stages Ⅱ and ⅢA,were studied,which were divided into neoadjuvant chemotherapy group (group A) and control group (group B).All patients of group A received 2-4 cycles NAC with TE scheme in breast cancer.The impact of neoadjuvant chemotherapy on surgical methods choice,local control rate,5-year overall survival rate and 5-year disease free survival rate were analyzed.ResultsFor patients of stage Ⅱ,the rate of breast conservation significantly increased from 23.6％ to 49.1％ (P =0.000) and there was no significant difference between groups A and B ( P =0.939,0.858 ) in 5-year overall survival rate and disease free survival rate.For patients of stage ⅢA,the 5-year overall survival rate (59.8％ ) and disease free survival rate (51.8％) in group A were greatly higher than that in group B (35.7％ and 27.6％ ) (P =0.000,0.000).The 3-year local relapse and metastasis rate(7.9％ ) was lower than group B (18.4％)(P ＜ 0.05 ).The tumor less than 3.0 cm is easy to achieve pathological complete remission (P =0.001 ).ConclusionsThe neoadjuvant chemotherapy can improve potential rate of breast conservation,reduce the rate of local-regional recurrence rate for the patients with stage Ⅱ and ⅢA breast cancer,and also improve the 5-year survival rate for the patients of stage ⅢA.Patients with clinically complete response or PCR may have higher 5- year overall survival rate and disease free survival rate.Primary tumor size was found to be the significant predictive factor for pathologically complete response to neoadjuvant chemotherapy in patients with breast cancer,particularly,the small tumor is easy to reach pathologically complete response.

Objective To investigate the diagnosis and treatment of pancreatic cystic tumors. Methods The clinical data of 35 patients with pancreatic cystic tumors were retrospectively analyzed. Results The preoperative diagnosis rate was as follows: ultrasound was 28.6% ( 10/35 ), CT 44.4% ( 12/27 ), MRI 70% (7/10). Twenty-eight cases underwent operation and were diagnosed finally by postoperative pathology. Serous cystic neoplasm (SCN) was found in 2 cases, mucinous cystic neoplasm (MCN) in 9 cases,cystic adenocarcinoma in 7 cases, intraductal papillary mucinous neoplasm ( IPMN ) in 3 cases, solid pseudopapillary tumor (SPT) in 7 cases. Twenty-three cases were followed up successfully. The post-operative 5 years survival rate was 62.5% (5/8) in pancreatic cystic adenoma without recurrence. The longest survival time in cystic adenocarcinoma after complete resection was 5 years and 8 months, while in which after incomplete resection was 6 months. The 4 cases of SPT are all alive, and one of them has survived for 4 years as the longest one. Conclusions It is difficult to diagnose the pancreatic cystic neoplasm accurately before operation. CT and MRI may be helpful to make the diagnosis. Surgical resection is the most effective treatment. The enhancement of the communication and cooperation between the related departments, the early diagnosis, and the appropriate operation are needed to improve the diagnostic and therapeutic efficacy.

ObjectiveTo analyze the characteristic of the T peak-end interval (Tpe) in dilated cardiomyopathy(DCM) patients with heart failure and its significance in evaluation of global dispersion of ventricular repolarization.MethodsFifty-three inpatients were enrolled in this study,which included 28patients with DCM and heart failure (DCM group),and 25 patients with supraventricular tachycardia and without structural heart disease (control group).The Tpe and the dispersion of QT interval (QTd) from the 12-lead surface electrocardiogram(ECG) were acquired and measured,and consequently the corrected numerals of the average of Tpe (Tpe-AVEC),the maximal Tpe (Tpe-MAXC) were acquired.ResultsThe levels of Tpe-AVEC,Tpe-MAXC and QTd in DCM group were significantly higher than those in control group [ ( 106.31 ±26.34) ms vs.(82.72 ± 10.01 ) ms,(234.05 ± 69.75) ms vs.( 119.15 ± 11.55 ) ms,( 119.17 ± 67.62) ms vs.( 39.74 ± 17.04 ) ms ] ( P ＜ 0.05 or ＜ 0.01 ).ConclusionsThe global dispersion of ventricular repolarization is significantly increased in patients with DCM and heart failure.The Tpe-AVEC and Tpe-MAxc are recommended to be used for evaluating the dispersion of ventricular repolarization as the prognostic index in patients with DCM and heart failure.

Objective To analyze expression of interleukin (IL)-23p19 and IL-23 receptor (IL-23R) in inflammatory bowel disease (IBD),and the role in the induction of peripheral blood T cell activation and proinflammatory cytokine secretion.Methods Peripheral blood (PB) and intestinal mueosal biopsies were collected from 12 patients with Crohn's disease (CD),25 patients with ulcerative colitis (UC) and 20 healthy controls.Expression of IL-23p19 was determined by immunohistochemistry and RT-PCR.IL-23R expression in CD4+,CD8+ T and NK cells from peripheral blood and lamina propria was analyzed by flow eytometry.Peripheral blood mononuclear ceils (PBMC) were isolated and cultured under stimulation with IL-23 and anti-CD3,and the levels of tumor necrosis factor α (TNFα) interferon (IFN)γ and IL-2 were determined by enzyme-linked immunosorbent assay (ELISA).Results The expression of II.-23p19 was significantly increased in inflamed mucosa of CD at both the transcriptional and translational levels compared with that in UC and healthy controls.IL-23R was mainly expressed in PB- and lamina propria-CD4+,CD8+T cells and NK cells from IBD patients,and markedly increased compared with controls (P＜0.05).IL-23 strongly triggered PBMC from IBD patients to produce significantly higher levels of IFN-γ,TNF-α and IL-2(P＜0.05).Conclusions IL-23p19 and IL-23R are highly expressed in IBD,particularly in CD,and may play an important role in the induction of T cell activation and proinflammatory cytokine secretion,suggesting that targeted therapy directed against IL-23 may have a therapeutic role in IBD.

Objective To investigate the effects of sivelestat sodium on early inflammatory reaction in rats with smoke inhalation injury. Methods Forty SPF male SD rats were randomly divided into 5 groups:normal control group (A), injury group (B), smoke inhalation treated with 10 mg/kg sivelestat sodium group (C), smoke inhalation treated with 20 mg/kg sivelestat sodium group (D) and smoke inhalation treated with 30 mg/kg sivelestat sodium group (E), 8 rats for each group. After smoke inhalation injury model was established, the treatment groups were intraperitoneally injected sivelestat sodium 10 mg/kg, 20 mg/kg and 30 mg/kg separately. B group was treated with the same volume of physiological saline. After 24 hours,ELISA was used for detecting serum contents of neutrophil elastase (NE), myeloperoxidase (MPO), tumor necrosis factor-α(TNF-α) and interleukin-6 (IL-6) in five groups. Meanwhile the water content of lung tissue was measured, and the pathological changes were observed by HE staining. The thickness of alveolar septum was measured and compared between groups. Results Compared with control group, the serum levels of NE, MPO, IL-6, TNF-α, water content of the lung tissue and thickness of alveolar septum were significantly higher in other four groups (P<0.05). Compared with injury group, the serum levels of NE, MPO, IL-6, TNF-α, water content of the lung tissue and thickness of alveolar septum were significantly lower in treatment groups (P<0.05). Compared with 20 mg/kg treatment group and 30 mg/kg treatment group, the serum levels of NE, MPO, IL-6, TNF-α, water content of the lung tissue and thickness of alveolar septum were significantly lower in 10 mg/kg treatment group (P<0.05). Conclusion The result shows that sivelestat sodium can reduce the early inflammatory reaction of rats with smoke inhalation injury and attenuates the lung edema. In this experiment, the treatment effect of 10 mg/kg sivelestat sodium is better than other treatment doses.

Objective To evaluate the efficacy and safety of super-mini-percutaneous nephrolithotomy (SMP),retrograde intrarenal surge~(RIRS) for children with upper urinary tract calculus.Methods Clinical data of 85 children with upper urinary tract calculi treated by SMP or RIRS from April 2016 to June 2018 were retrospectively analyzed.Patients were divided into two groups according to operative method:group SMP and group RIRS.In group SMP:there were 38 male and 14 female patients;the mean age was (4.6 ± 2.7) years;the mean stone size was (15.2 ± 4.8) mm;17cases in left side,and 35 cases in right side;multiple stones were found in 18 cases and single stone was found in 34 cases.In group RIRS:there were 18 male and 15 female patients;the mean age was (4.6 ± 3.1) years;the mean stone size was (14.2 ±5.1)mm;9 cases in left side,and 24 cases in right side;multiple stones were found in 11 cases and single stone was found in 22 cases.No statistical significance was found between the two groups in sex,age,stone size,stone side (left/right),percentage of multiple calculi (P ＞ 0.05).Patients were evaluated with KUB radiography or CT after 1 month.The overall stone-free rate and complications of the two groups were compared.Results Group RIRS compared to group SMP showed longer operative time [(74.2 ± 31.8) min vs.(57.9±27.8)min,P =0.015],and hospital stay after operation [(4.8 ±2.8)days vs.(3.1 ±1.3) days,P =0.003].The overall stone-free rate was 90.4％ (47/52) for group SMP,and 48.5％ (16/33) for group RIRS(P ＜ 0.01).The re-treatment rate was significantly higher in group RIRS compared to group SMP[36.4％ (12/33) vs.1.9％ (1/52),P ＜ 0.01].The complication rate was 9.6 (3/52) and 27.3％ (9/33) for groups SMP and RIRS,respectively (P ＜0.05).Conclusions SMP was more effective than RIRS to obtain a better stone free rate,less complications and re-treatment rate in children with upper urinary tract renal calculus.

Objective: To evaluate the role of tuberculin skin test prified protein derivative (PPD) in defining the screening scope of close contacts of tuberculosis cases in disposal of tuberculosis outbreak in schools. Methods: In a senior middle school in August 2019, 1 553 students of the grade two were tested by PPD because of a school tuberculosis outbreak. PPD results were compared to grade one students without any association with this tuberculosis epidemic, who were also tested by PPD when beginning school. Potential association between PPD distribution characteristics and tuberculosis case distribution were analyzed. Results: Twenty nine grade two students were diagnozed as tuberculosis infection, seven of which were PPD positive, and with the same MIRU-VNTR genotype. In grade one, 0.1 % (1/796) student showed strong PPD positive, 34.3% (273/796) student showed positive. For grade two students, significant higher rate of strong PPD positive [5.9% (45/757)], and PPD positive [52.0% (394/757)] were observed ( χ 2=45.71, 49.90, P <0.01). Proportion of strong PPD positive in the first floor of the teaching building ( 19.4 %), where tuberculosis cases clustered, was significantly higher than that in other floors ( χ 2=89.81, P <0.01); Number of strong PPD positive students increased with TB cases in each floor of the teaching building ( r =0.99, P <0.01). Proportion of strong PPD positive and PPD positive in floors of the dormitory, where TB cases lived, was significantly higher than in other floors ( χ 2=49.4, 64.9 , P <0.01). Number of strong PPD positive and PPD positive students increased with TB cases in each floor of the teaching building ( r =0.84, 0.56, P <0.01). Conclusion Strong PPD positive rate well reflects tuberculosis infection of close contacts, and is recommended for defining the scope of screening.