0.05).Conclusion Among the DM patients,the incidence rate of PC is obviously increasing,and with the course of DM elongating,the risk of PC is increasing.There is no obvious difference between sexes.Compared with common people,the incidence rate of PC in DM patients is higher.Type 2 diabetes mellitus might be initial symptom of PC.

OBJECTIVE:To systematically review the relationship of clinical efficacy between XPD Lys751Gln (A/C),XPD Asp312Asn(G/A)and platinum-based chemotherapy in patients with advanced non-small cell lung cancer(NSCLC),and provide evidence-based reference for clinical treatment. METHODS:Retrieved from PubMed, Cochrane Library, EMBase, Medline, CJFD,VIP database and WanFang database,studies about the effects of XPD Lys751Gln and XPD Asp312Asn polymorphism on ef-fectiveness,clinical outcomes and adverse drug reaction of platinum-based chemotherapy in advanced NSCLC patients were collect-ed,and Meta-analysis was performed by using Rev Man 5.3 software. RESULTS:Totally 30 studies were included,involving 5 028 patients. Genetic testing showed that XPD Lys751Gln divided into mutant gene (Lys/Gln + Gln/ Gln) and wild-type gene (Lys/Lys),while XPD Asp312Asn divided into mutant gene (Asp/Asn + Asn/Asn) and wild-type gene (Asp/Asp). Results of Me-ta-analysis showed,the progression-free survival (PFS) of Lys/Gln+Gln/Gln patients with platinum in XPD Lys751Gln polymor-phism was obviously lower than Lys/Lys patients [OR=-1.12,95%CI(-1.73,-0.50),P<0.001],while there was no significant difference in the chemotherapy effectiveness and total survival period. The effective rate of Asp/Asn+Asn/Asn patients for platinum in XPD Asp312Asn polymorphism was lower than Asp/Asp patients [OR=0.80,95%CI(0.68,0.96),P=0.02],while there was no significant difference in the total survival period and PFS. Meanwhile,the incidence of Ⅲ-Ⅳ level gastrointestinal adverse reac-tions of Lys/Gln+Gln/Gln with platinum in XPD Lys751Gln polymorphism was higher than Lys/Lys patients [OR=0.43,95%CI (0.20,0.94),P=0.03],and there was no significant difference in Ⅲ-Ⅳ level blood system adverse reactions. CONCLUSIONS:XPD Lys751Gln polymorphism may be associated with PFS and Ⅲ-Ⅳ level gastrointestinal adverse reactions for advanced NSCLC patients with platinum-based chemotherapy,while XPD Asp312Asn polymorphism may have effect on platinum-based chemotherapy,both of them may be as estimate the chemotherapy effect and prognosis detection index of platinum-based chemo-therapy.

Objective To investigate and evaluate the diagnostic value of transcranial doppler ultrasound (TCD) on brain death in patients with severe craniocerebral injury.Methods Forty-two cases of severe craniocerebral injury from Affiliated Hospital of Jining Medical University were divided into brain death group and survival group,according to the clinical prognosis.TCD was conducted to examine brain blood flow numerical and changed characteristics of the spectrum.Average blood flow velocity (Vm),pulse index (PI),diastolic blood flow in reverse (reverberating flow) and small systolic peaks in early systole (wave of spikes)were documented.TCD parameters were compared between the two groups with t test.Results In the brain death group,frequency of reverberating flow was 86.67％ and frequency of wave of spikes was 13.33％.In survival group,frequency of reverberating flow was 14.81％ and no wave of spikes was recorded.The difference in frequencies of reverberating flow and wave of spikes between the two groups was significant(x2 =28.25,P ＜0.01).The average speed of bilateral middle cerebral artery blood flow in brain death group((20.02±13.96) cm/s) was significantly reduced compared with survival group((56.81± 16.84) cm/s,t=2.30,P＜0.05).Pulse index (PI) values in brain death group (4.02±3.49)were significantly increased compared with survival group (1.24±1.03) (t=2.10,P＜0.05).Conclusion Reverberating flow or wave of spikes is an important marker for brain death in patients with severe craniocerebral injury.TCD may be applied to clinically confirm the diagnosis of brain death.

Objective To investigate the prevalence of Helicobacter pylori (H .pylori)infection in type 2 diabetic patients and its effects on diabetic gastroparesis.Methods Prospective clinical case-control study was applied.From January 2011 to December 2013,125 hospitalized patients with type 2 diabetes and 142 healthy controls without dyspeptic symptoms were enrolled.The prevalence of H .pylori infection and the incidence of gastroparesis in 125 patients with diabetes were investigated in both two groups.The patients with type 2 diabetes were divided into groups according to the course of the disease,and the prevalence of gastroparesis and H .pylori infection of each group were analyzed.The patients with type 2 diabetes and healthy controls confirmed with H .pylori infection were treated with eradication therapy,the rate of eradication of two groups was compared.The improved symptoms of gastroparesis before and after eradication therapy of patients with type 2 diabetes were compared.The chi-square test was performed for statistical analysis.Results The prevalence of H .pylori infection in type 2 diabetic patients was 66.4%(83/125),which was significantly higher than that of healthy control group (51 .4%,73/142 )(χ2 =5 .549,P <0.05).The prevalence of gastroparesis in diabetic patients with the disease course less than 10 years,10 to 20 years and more than 20 years was 33.8% (27/80 ),47.1 % (16/34 )and 8/11 , respectively.The difference was statistically significant (χ2 = 6.554,P < 0.05).The prevalence of H .pylori infection in patients with gastroparesis was 78.4% (40/51 ),which was significantly higher than that of patients without gastroparesis (58.1 %,43/74)(χ2 =4.716,P <0.05).The eradication rate of H .pylori infection in patients with type 2 diabetes was 68.7% (57/83),which was lower than that of healthy control group (87.8%,36/41),and the difference was statistically significant (χ2 =4.385 ,P <0.05).The incidence of epigastric pain and distension,early satiety and apocleisis before H .pylori eradication in type 2 diabetes patients was 75 .9% (63/83 ),66.3% (55/83 )and 67.5 % (56/83 ), respectively,while after eradication which was 44.6%(37/83),37.3%(31/83)and 39.8%(33/83)after eradication,respectively.The differences were statistically significant (χ2 =15 .720,12.764 and 11 .724;all P <0.01).Conclusions The prevalence of H .pylori infection is significantly higher in type 2 diabetic patients,and gastroparesis in type 2 diabetic patients may be correlated with H .pylori infection.The eradication rate in type 2 diabetic patients was lower,and H .pylori eradication therapy can efficiently improve the symptoms of dyspepsia in diabetic patients with gastroparesis.

OBJECTIVE To investigate the prevalence,antibiotic resistance and genotype of the extended-spectrum ?-lactamases(ESBLs)-producing clinical isolates of Klebsiella pneumoniae.METHODS A total of 104 isolates of K.pneumoniae were examined for the ESBLs production and the susceptibilities of the bacteria to 15 antimicrobial agents.PCR was performed to detect the genes encoding the ESBLs belonging to SHV and TEM families as well as CTX-M-1 and CTX-M-9 groups.RESULTS The ESBLs-producers of K.pneumoniae were 54.0% in the total of 104 isolates.Almost all of the ESBLs-producing isolates were resistant to the antibiotics commonly used,and only remained susceptible to carbapenems and the combination of cefoperazone with sulbactam.The genes of SHV,CTX-M-1 and TEM groups were detected in the ESBLs-producing isolates by 64.3%,46.4%,and 32.1%,respectively,and 35.7% and 8.9% of ESBLs-producing K.pneumoniae strains carried two and three genes.CONCLUSIONS The clinical isolates of K.pneumoniae in Tianjin Nankai Hospital are shown a high rate of ESBLs-producing and antibiotic resistance.SHV and CTX-M-1 groups of ESBLs are the dominant genotypes in the isolates of ESBLs-producing K.pneumoniae.

Objective To investigate antibiotic resistance and staphylococcal cassette chromosome mec(SCCmec)genotype of Staphylococcus aureus isolated from patients with nosocomial infections.Methods Antibiotic susceptibility pattern anti the gene mecA were examined in 89 Staphylococcus aureus isolates from patients with nosocomial infection in Tianjin Medical University Cancer Institute and Hospital.The SCCmec genotype in the mecA-positive strains were fuaher investigated with multiplex PCR.Results In 89 Staphylococcus aureus strains,21(23.6%)were phenotypic methicillin-resistant Staphylococcus aureus (MRSA)and 39(43.8%)were rnecA positive,the difierence was of statistical significance(χ2=8.146,P=0.004).MRSA strains showed multiple-antibiotic resistance but sensitive to vancomycin.Tvpe Ⅲ SCCmec carriers were the major epidemiological strains(26/39,66.7%).ConclusionMRSA strains isolated from Tianjin Medieal University Cancer Institute and Hospital are characterized by multi-drug resistance,and type Ⅲ is the dominant SCCmec earried by the MRSA strains.

Objective To investigate the drug resistance and genotype of methicillin-resistant Staphylococcus (MRS), and to study the epidemiology of drug resistance in Staphylococcus. Methods Drug susceptibility tests were performed for 138 Staphylococcus strains clinically isolated, and mecA gene was detected with PCR. For mecA positive strains, Staphylococcal cassette chromosome mec (SCCmec) gene was detected by two multiplex PCR assays. Results Seven (10.8%) out of 65 Staphylococcus aureus strains were methicillin-resistant Staphylococcus aureus (MRSA) strains, and 44 (60.3%) out of 73 coagulase negative Staphylococcus strains were methicillin-resistant coagulase negative Staphylococcus (MRCNS)strains. There was statistical significance on the difference of isolation rates (x2 = 37. 05, P ＜0.01). No vancomycin or nitrofurantoin resistant strain was found. There were 52 (52/138, 37.7%) mecA positive strains, including 16 SCCmec type Ⅰ strains, 1 type Ⅱ strain, 13 type Ⅲ strains, 9 type Ⅳ strains and 4 type Ⅴ strains. Conclusions Drug resistance in MRS is increasingly serious. MRCNS strains are more popular than MRSA in clinic, and SCCmec Ⅰ and Ⅲ may account for most infections.

Objective To evaluate the collateral circulation after canine acute coronary artery occlusion with contrast real-time three-dimensional echocardiography (RT-3DE). Methods Left anterior descending coronary artery was ligated in 12 healthy mongrel dogs. All dogs underwent myocardial contrast echocardiography (MCE) before ligation, immediately after ligation, at 30 min and 180 min after ligation respectively, and myocardial mass with collateral supply was calculated. Results Different degrees of collateral circulation were established in all dogs after left anterior descending coronary artery ligation. At 30 min after ligation, the myocardial mass with collateral supply was (9.65±2.90) g, while at 180 min after ligation were (12.58±3.98) g (P<0.01). Conclusion The coronary collateral circulation can be observed clearly and myocardial mass with collateral supply can be quantified accurately with contrast RT-3DE.

Objective:To examine the potential influence factors of abdominal aortic aneurysm (AAA).Methods:A 1∶2 pair-matched, case-control study was conducted from July 2011 to December 2012 .A pair was composed of one AAA patient recruited from the Vascular Surgery Department , Chinese PLA General Hospital and two gender-and age-matched non-AAA subjects , one from the same hospital and the other from the community in Fangshan District in Beijing .Demographic data , medical history and the lifestyle of each subject were collected .Moreover , all the participants underwent abdominal ultra-sound or computed tomography ( CT ) and peripheral venous blood samples were obtained .Results:There were 155 case/control pairs .The multivariate conditional logistic regression model confirmed that suffering from hypertension conferred a 1.98-fold (95%CI 1.12-3.18) increased likelihood of AAA. Smoking was a strong independent risk factor of AAA , with odds ratios ( 95% confidence intervals ) of 5.23 (2.44-11.23).Dyslipidemia(OR=2.61,95%CI 1.45-4.70), a higher level of serum hs-CRP (OR=2.43,95%CI 1.37-4.31) and homocysteine (OR=2.73,95%CI 1.61-4.65) were all asso-ciated with AAA.Conclusion: Hypertension and smoking are the risk factors of AAA .Dyslipidemia, hsCRP and Hcy are associated with AAA .

Objective To share the content and the entry point of the clinical pharmacist participating in the oncology emergency drug treatment. Methods Five typical cases of oncologic emergency occurred in patients with advanced cancer. Clinical pharmacists participated in the drug treatment of circulatory system of emergency,nervous system emergency,metabolic system emergency,blood system emergency and multi-drug resistant bacteria infection.Clinical pharmacists provided suggestions for clinical medication and a whole-course pharmaceutical care by using pharmaceutical knowledge and reviewing relevant information material. Results The work of pharmacists get clinical recognition by assisting clinicians to solve the critical emergencies of cancer patients and improving the effect of drug treatment. Conclusion Clinical pharmacists can be gradually integrated into the medical team and play a critical role as clinical pharmacists in terms of drug treatment.