Objective To investigate the therapeutic effect and safety of high intensity focused ultrasound(HIFU) combined with Gemcitabine in treating unresectable pancreatic carcinoma Methods Forty one patients suffering from unresectable pancreatic carcinoma were randomly divided into two groups.The patients in experimental group(n =21) were provided with HIFU in combination with gemcitabine therapy and those in control group(n =20)received HIFU treatment alone.The effect,clinical benefit rates,changes of tumor marker carbohydrate antigen 19-9(CA19-9)and adverse reactions were compared between these two groups.The median survival time,6-month and 12-month survival rates were calculated by Kaplan-Meier method and Logrank test.Results The median survival time,6-month and 12-month survival rates were 10.22 months,76.2％(16/21) and 42.9％(9/21) in experimental group,and they were 7.43 months,50.0％(10/20) and 15.0％(3/20) respectively in control group.Among them,12-month survival rates was significantly higher in experimental group than that in control group(x2 =4.00,P ＜ 0.05).The clinical benefit rates in experimental group were significantly higher than that in control group[76.2％(16/21) vs 45.0％(9/20),x2 =4.20,P ＜0.05].But there was no significant difference on pain remission rate between the two groups(66.6％ vs45.0％,P ＞ 0.05).There was significant difference on CA19-9 after treated for 2,3,4,5 and 6 months in experimental group than that in control group(t =2.225,2.133,1.743,2.599,2.278,respectively,P ＜ 0.05)Conclusion HIFU in combination with Gemcitabine therapy is better than application of HIFU treatment alone.The former may become of the most effective treatmenffor unresectable pancreatic carcinoma.

OBJECTIVETo apply multiplex polymerase chain reaction (MPCR) assay and sequencing in study of the carrying status of four pathogenicity-related genes of Vibrio cholerae (V.cholerae) and the variation of ctxA.

METHODSPrimers targeting cholera toxin sub-unit A gene (ctxA), toxin-coregulated pilus gene (tcpA), accessory cholera enterotoxin gene (ace), zonula occludens toxin gene (zot) were designed and the MPCR method was applied to detect the pathogenicity-related genes of 276 strains of V.cholerae isolates. The amplified fragments of ctxA gene were sequenced and the genetic homology of the amplified fragments of ctxA was analyzed.

RESULTSOf the 276 strains of V.cholerae, 93.9% strains from human sources belong to the pathogenicity-related genes type A (ctxA(+)tcpA(+)ace(+)zot(+) type) and 6.1% belong to pathogenicity-related genes type C (ctxA(-)tcpA(-)ace(-)zot(-) type). Type A strains from clinical sources were isolated from patients with mild to severe symptom and carriers, among which 68.5% were isolated from patients with mild symptom and 21.9% from carriers. All 63.6% of type C strains from clinical sources were isolated from patients with mild symptom and 36.4% from carriers. The proportion of type C strains that caused mild symptom was higher than that of type A strains. Of the 78 strains isolated from the environment, 9.0% strains belong to pathogenicity-related type A and 35.9% belong to the pathogenicity-related genes type B (ctxA(-)tcpA(-)ace(+)zot(+) type), while 55.1% belong to pathogenicity-related genes type C. The sequencing results showed little genetic variation among the amplified fragments for ctxA.

CONCLUSIONMPCR disclosed the polymorphic status of pathogenicity-related gene patterns in V.cholerae isolates of Guangzhou, providing effective means for further study on evolution of pathogenicity-related genes among V.cholerae isolates from human and environmental sources. This study also offers significant guidance for effective prevention, control and warning against cholera epidemic in local area.

China ; Cholera Toxin ; genetics ; DNA, Bacterial ; Genes, Bacterial ; genetics ; Genotype ; Humans ; Polymerase Chain Reaction ; Sequence Analysis ; Vibrio cholerae ; classification ; genetics ; isolation & purification

OBJECTIVETo apply pulse-field gel electrophoresis analysis(PFGE) in the analysis of cholera outbreak events and to determine the molecular epidemiological characteristics of Vibrio cholerae ( V. cholerae) isolates.

METHODSPFGE using restriction enzyme Not I was employed in the molecular subtyping of forty-one strains of V. cholerae isolated in cholera outbreak events from 2003 to 2005 in Guangzhou area and PFGE patterns were analyzed by BioNumerics Version 4.0 software to perform cluster analysis. Pattern profiles were compared by utilizing of Dice coefficient and UPGMA(unweighted pair group method with arithmetic averages). Comparison of PFGE typing results was performed with phage-biological typing and pathogenicity-associated genes typing.

RESULTSIn cholera outbreak events, PFGE could discriminate epidemiologically related and unrelated strains, having more discriminatory power than phage-biological typing and pathogenicity-associated genes-typing.

CONCLUSIONSMolecular sub-typing by PFGE could disclose the epidemiological relationships of strains from humans and the environment, providing molecular epidemiological evidence and support for the source-tracking of cholera outbreak events.

Bacterial Typing Techniques ; methods ; Cholera ; epidemiology ; microbiology ; Disease Outbreaks ; Electrophoresis, Gel, Pulsed-Field ; Humans ; Molecular Epidemiology ; Vibrio cholerae ; classification ; genetics ; isolation & purification