Background and purpose:Brain is one of the most common sites for distant metastasis in patients with non-small cell lung cancer,and the prognosis of patients with brain metastasis is usually dismal.The purpose of this retrospective study is to document the relationship between the prognosis of lung cancer patients with brain metastasis and the expressions of p53,nm23 and VEGF in resected lung cancer tissues.Methods:Ninety-two patients who were definitively treated with surgery for non-small cell lung cancer but lately developed brain metastasis between 1997 and 2005 were identified in our institution.Their clinical data were retrieved and retrospectively reviewed.All pathological specimens of their resected lung cancer were examined for the expressions of p53,nm23 and VEGF by immunohistochemical staining.The association between the treatment outcome and the expression of the above mentioned biomarkers were analyzed.Results:The median survival time(MST) of patients with p53(+) versus p53(-) was 11.0 versus 11.9 month,respectively.The 1,2,and 3-year overall survival rates were 45.71%,22.86%,and 18.29% respectively for p53(+) patients,and 49.55%,16.12%,and 8.89% respectively for p53(-) patients(P=0.5179);The MST of patients with nm23(+) versus nm23(-) was 13.0 versus 10.1 month,respectively.The 1,2,and 3-year overall survival rates were 54.20%,21.51%,and 16.45% respectively for nm23(+) patients,and 32.0%,12.0%,and 4.0% respectively for nm23(-) patients(P=0.1075);The MST of patients with VEGF(+) versus VEGF(-) was 10.5 versus 12.2 months,respectively.The 1,2,and 3 year overall survival rates were 42.20%,0,and 0 respectively for VEGF(+) patients,and 50.0%,25.41%,and 16.57% respectively for VEGF(-) patients(P=0.0231).Conclusions:VEGF was a significant adverse prognostic factor for patients with non-small cell lung cancer who developed brain metastasis.Lung cancer patients whose tumor tissue demonstrated positive VEGF expression had reduced overall survival rates at 1,2,and 3 years after surgery.The expression of p53 and nm23 are not significantly associated to the prognosis of this group of patients.

Objective To introduce and analyze the current user security authentication system in the campus network and point out the secure problems and hidden dangers of the correspondence entities in the campus network. Methods The authentication technologies and protocols in the TCP/IP network model were compared. It was proposed that the campus network security authentication solution should include access control in data link layer, connection control in network layer and unified authentication in application layer. Results The solution could improve the campus network authentication security rank. Conclusion The security and reliability of the network system are enhanced.

Objective:To study the effect of mesalazine hydroxyl-propyl-β-cyclodextrin inclusion compound ( MSZ-HP-β-CD) liq-uid suppositories on ulcerative colitis ( UC) in rats. Methods:Dextran sulfate sodium was used to induce UC in rats. The marketed MSZ suppositories were applied as the positive control, and the changes in morphology and histopathology of the UC rats were observed after the treatment with MSZ-HP-β-CD liquid suppositories. Results:The results of morphology study showed that CMDI was decreased in the two MSZ preparation groups when compared with that in the model group (P<0. 01), and that in MSZ-HP-β-CD liquid supposi-tories group was the lowest (P<0. 05). The results of histopathology study showed that with the treatment of the marketed MSZ sup-positories and MSZ-HP-β-CD liquid suppositories, the ulcer and damage were improved, and the improvement in the MSZ-HP-β-CD liquid suppositories group was more significant. Conclusion: MSZ-HP-β-CD liquid suppositories exhibit better effect on UC in rats when compared with the marketed MSZ suppositories, which is worthy of further studies.

Objective To study the susceptibility of Neisseria gonorrhoeae to antibiotic agents from 1988 to 2002 in Shanghai. Methods The clinical isolates from patients with gonorrhea were collected and tested for their susceptibility to five antibiotics. Agarose-dilution-method was used to detect minimal inhibitory concentration (MIC) of anti-microbial agents including penicillin, tetracycline, spectinomycin, ciprofloxacin and ceftriaxone, and penicillinase producing Neisseria gonorrhoeae (PPNG) were tested with acidometric method. Results Susceptible strains to penicillin decreased from 11.28% in 1988 to 0 in 2002, MIC50 and MIC90 increased 8 and 4 times, respectively, the resistant rate and proportion of PPNG were 94.29% and 50.95%, respectively in 2002. The strains of high resistance to tetracycline increased from 0 in 1995 to 20.95% in 2002. The susceptible strains to ceftriaxone decreased from 100% in 1995 to 23.80% in 2002. The susceptibility to ciprofloxacin decreased significantly and resistant rate reached 99.05% in 2002. However, these strains were kept highly susceptible to spectionmycin. Concerning the multi-drug resistance, we found that the strains resistant to penicillin, ciprofloxacin and tetracycline simultaneously increased from 20.87% in 2001 to 23.30% in 2002, those resistant to both penicillin and ciprofloxacin reached to 70% in the past 2 years. Conclusions In Shanghai the resistant rates of Neisseria gonorrhoeae to antibiotics increased year by year in the past 15 years. The study indicates that spectinomycin and ceftriaxone should be the first choice for the treatment of gonorrhea at present and new sensitive antibiotic should be developed for the treatment of gonorrhea.

Objective:To summarize our experience in 13 cases of intestinal autotransplantation (IATx) after resection of lesions involving the roots of mesenteric vessels.Methods:The clinical data of 13 patients undergoing IATx in Xijing hospital were retrospectively analyzed. The etiology, surgical procedure and complications were analyzed. The patients were followed up by telephone and regular evaluations.Results:All 13 cases of IATx were successfully completed. For 12 patients who were diagnosed with tumors involving the mesenteric roots, the tumors were removed for cure intent avoiding massive intestinal resection. Pancreaticoduodenectomy was carried out simultaneously in 11 cases. The postoperative complication rate was 85% (11/13). The autograft was resected in 1 patient on the 1st postoperative day due to necrosis from mesenteric thrombosis, leading to short bowel syndrome. One-year survival was 69% (9/13). Among 4 deaths, 1 patient died of liver metastasis, and another died of liver and lung metastases. Five patients were alive 2 years postoperatively.Conclusion:IATx while-technically challenging, avoiding short small bowel syndrome in properly selected patients after resection of lesions especially benign ones involving the roots of mesenteric vessels that were traditionally considered to be "unresectable".

Background: Zhongyi paste is a traditional Chinese medicine herbal paste that is externally applied to reduce inflammation and relieve pain. Methods: An acute foot swelling inflammation model in C57BL/6J mice was established by carrageenan-induced pathogenesis. Zhongyi paste raised the pain threshold and also reduced the degree of swelling in mice with carrageenan-induced foot swelling. Results: Analysis indicated that serum tumor necrosis factor-alpha, interleukin-1 beta, and prostaglandin E2 (PGE2) cytokine levels and PGE2levels in the paw tissue of the mice were decreased by Zhongyi paste treatment. The quantitative polymerase chain reaction and western blot results showed that Zhongyi paste downregulated the mRNA and protein expression of extracellular signal-regulated kinase 1/2 (ERK1/2), and cyclooxygenase-2 (COX-2), and also downregulated the mRNA expression of PGE2 . At the same time, the Zhongyi paste exerted a stronger effect as an external drug than that of indomethacin, which is an oral drug, and voltaren, which is an externally applied drug. Conclusions Our results indicated that Zhongyi paste is a very effective drug to reduce inflammatory swelling of the foot, and its mechanism of action is related to regulation of the ERK1/2–COX-2–PGE2 pathway.

Diagnosis, Differential ; Humans ; Neoplasms

INTRODUCTION: To date, there have only been 2 systematic reviews, and 1 systematic review and meta-analysis on high-intensity focused ultrasound (HIFU) for benign thyroid nodules. The present systematic review and meta-analysis seeks to evaluate the efficacy and safety of HIFU in the treatment of benign thyroid nodules. METHODS: Pubmed, Embase and Cochrane databases were searched for relevant studies from 1990 to 2021. Nine studies were included in the systematic review and 6 in the meta-analysis. Pooled volume reduction rates (VRRs) at 3, 6 and 24 months after HIFU were assessed. RESULTS: This systematic review and meta-analysis showed that pooled VRRs at 3, 6, and 24 months after HIFU were 42.14 (95% confidence interval [CI] 28.66-55.62, I2=91%), 53.51 (95% CI 36.78-70.25, I2=97%) and 46.89 (95% CI 18.87-74.92, I2=99%), respectively. There was significant heterogeneity in the pooled VRRs at 3, 6 and 24 months after HIFU. No studies recorded complete disappearance of the nodules. Common side effects included pain, skin changes and oedema. There were no major complications except for transient vocal cord paralysis and voice hoarseness (0.014%) and transient Horner syndrome (0.5%). CONCLUSION HIFU may be an effective and safe alternative treatment modality for benign thyroid nodules. Larger clinical trials with longer follow-up are needed to evaluate the effectiveness of HIFU in treating benign thyroid nodules.
High-Intensity Focused Ultrasound Ablation/adverse effects* ; Humans ; Pain ; Reconstructive Surgical Procedures ; Thyroid Nodule/surgery* ; Treatment Outcome

Objective:To investigate the correlation between RNF213 gene p. R4810K polymorphism and posterior cerebral artery involvement in Chinese children with familial moyamoya disease.Methods:Children with familial moyamoya disease admitted to the Department of Neurosurgery, the Fifth Medical Center of PLA General Hospital from August 2004 to June 2018 were enrolled, and they were divided into posterior cerebral artery involved group and posterior cerebral artery uninvolved group. RNF213 gene p. R4810K single nucleotide polymorphism was detected. Multivariate logistic regression analysis was used to determine the independent risk factors for posterior cerebral artery involvement. Results:A total of 65 children with familial moyamoya disease were enrolled. Their age was 6.98±4.46 years and 37 (56.9%) were male. The first symptom of 55 children (84.6%) was cerebral ischemia, and 37 (56.9%) involved posterior cerebral artery. There were 3 (4.6%) children with p. R4810K AA genotype, 26 (40.0%) with GA genotype, and 36 (55.4%) with GG genotype. The p. R4810K genotype distribution in the posterior cerebral artery involved group was statistically different from that in the uninvolved group (GA+ AA genotype: 56.8% vs. 28.6%; χ2=5.124, P=0.024), and there were no statistical difference in gender, age, first symptom, and genetic pattern. Multivariate logistic regression analysis showed that after adjusting the first onset age and gender, p. R4810K G>A mutation was the only independent risk factor for posterior cerebral artery involvement (odds ratio 3.240, 95% confidence interval 1.082-9.705; P=0.020). Conclusion:The p. R4810K polymorphism of RNF213 gene is associated with posterior cerebral artery involvement in Chinese children with familial moyamoya disease.

Objectives To evaluate the effectiveness and safety of peramivir trihydrate in patients with influenza.Methods This was a randomized,double-blind,double-dummy,placebo and positive control,multicenter clinical trial,comparing peramivir trihydrate with oseltamivir and placebo.The inclusive criteria were 15-70 years old,onset within 48 h,positive rapid influenza antigen test,and febrile(＞38℃) accompanied with at least two associated symptoms.The severe cases complicated with chronic pulmonary and cardiac diseases,malignancies,organ transplantation,hemodialysis,uncontrolled diabetes,immunocompromised status,pregnancy and coexistence of bacterium infections were excluded.All patients were randomized 2:2:1 to receive peramivir,oseltamivir and placebo respectively.The primary endpoint was the disease duration,the secondary endpoints included time to normal axillary temperature and normal living activities,viral response,and adverse effects.Results Following informed consent,133 patients were included in this study.Four patients were exclude due to missing medical records,not fitting inclusion or exclusion criteria and poor compliance.A total of 129 patients were finally analyzed,including 49 cases,54 cases and 26 cases in peramivir group,oseltamivir group and placebo group.The median disease duration were 96 (76,120)hours,105(90,124) hours,and 124 (104,172)hours in three groups respectively(P＞0.05).The time to normal axillary temperature,normal living activities and viral response were not significantly different in three groups(P＞0.05).Conclusion The value of antiviral therapy in patients with mild influenza needs to be further determined.