OBJECTIVE To discuss the effect of preventive medication for preventing incision infection before cesarean.METHODS Patients with cesarean section accepted parturients were divided in 2 groups randomly: group A(medicine before operation) and group B(no medicine before operation),and infection rate were observed after operation.RESULTS The incision infection rate of group A was 3.8%,and that of group B was 9.3%(?2=6.00,P

Immunity is the basic defense barrier for body, and also closely related to the development, progression, treatment and prognosis of breast cancer. Adjuvant radiotherapy plays an important role in the multidisciplinary treatment of breast cancer. It has long been believed that radiotherapy was immunosuppressive because it could destroy the body’s immune cells directly. While recent studies have shown that radiotherapy can stimulate the host immune system in the antitumor process, including antigen processing, presentation, recognition, and eventually tumor-cell killing. In the clinical aspect, a variety of immune targeted therapies, combined with radiotherapy, have entered clinical trials. The article reviewed research progress and status of the inlfuence of breast cancer adjuvant radiotherapy on antitumor immunity.

Objective To evaluate the safety and effectiveness of robotic surgery in surgical staging of endometrial cancer. Methods Searched English and Chinese databases, including Cochrane library, PubMed, Embase, Web of Science, China National Knowledge Internet, data base of Wanfang, China Science and Technology Journal(CSTJ), and relevant journals and magazines by hand from Jan. 2000 to Oct. 2016.(1)In accordance with the inclusion criteria,two independent investigators screened databases and extracted the relevant data respectively, then evaluated the quality of including studies in Newcastle-Ottawa Scale(NOS).(2)Meta-analysis was performed with RevMan 5.3 software. Heterogeneity inspection was done for each study and different effect model included the random effect model and fixed effect model was chose according to the results of the inspection. At last, the related parameters of the robotic surgery and laparoscopic surgery was analysed. Results (1) Thirteen articles were ultimately included. All of them were written in English and included a total of 1554 patients, included 739 cases of robotic surgery and 815 cases of laparoscopic surgery. Thirteen articles were all cohort study, four of them were prospective cohort study, while others were retrospective cohort study. After quality assessment, all studies had more than 5 stars and illustrated the higher quality.(2)Meta-analysis results showed:compared with laparoscopic surgery in surgical staging of endometrial cancer, robotic surgery had less estimated blood loss [standard deviation (SD)=-72.31 ml,95%CI:-107.29 to-37.33,P<0.01], less time for hospital stay (SD=-0.29 days,95%CI:-0.46 to-0.13,P=0.001), less need for blood transfusion [risk ratio (RR)=0.57,95%CI:0.33 to 0.97,P=0.040], and conversion to open surgery (RR=0.41,95%CI: 0.26 to 0.65,P=0.000),less intraoperative complications (RR=0.43,95%CI: 0.24 to 0.76,P=0.004) in surgical staging of endometrial cancer. There was no statistically significant difference in aspects of operative time (SD=10.26 minutes, 95%CI:-13.62 to 34.13,P=0.400), postoperative complications (RR=0.87, 95%CI: 0.67 to 1.12,P=0.280), the total number of lymph nodes removed (SD=-0.04,95%CI:-3.99 to 3.91,P=0.980), the number of pelvic lymph node dissection (SD=0.48,95%CI:-1.76 to 2.71,P=0.680) and the number of para-aortic lymph node dissection (SD=0.46,95%CI:-1.42 to 2.34,P=0.630). Conclusions Compared the robotic surgery with laparoscopic surgery in surgical staging of endometrial cancer, robotic surgery has less estimated blood loss, less need for blood transfusion and conversion to open surgery,less intraoperative complications and other advantages. While its cost is so expensive that restrict clinical application.

Objective To discuss the effect of preserving ovaries on the prognosis of young early endometrial cancer patients. Methods Searched English and Chinese databases by computors, including Cochrane library, Embase, PubMed, Web of Science, China National Knowledge Internet (CNKI), data base of Wanfang, China Science and Technology Journal(CSTJ), and also relevant journals and magazines by hand. Retrieval time from January 1996 to March 2016. In accordance with the inclusion criteria, two independent investigators screened the studies and extracted the relevant data respectively. Then evaluated the quality of included studies. Finally, conducted the meta-analysis with RevMan 5.3 software from cochrane collaboration network, in which heterogeneity test of enrolled studies firstly was completed and combined analysis with effect models according to the heterogeneity secondary. In the light of the result, effect of remaining ovaries on the prognosis (5-year recurrence rate and 5-year overall survival rate) of young early endometrial cancer patients was determined. Results Ten trials were included. All of them were cohort studies, a total of 5 299 patients, in which 916 patients′ ovaries were remained. Quality assessment of all 10 studies were based on Newcastle-Ottawa Scale (NOS) scale. All of the studies enrolled were of high quality with a score of ≥7. After quality assessment,all studies illustrated the higher the quality. Meta-analysis showed that there was no statistically significant difference between who had ovarian preservation and without preservation in terms of 5-year overall survival rate [96.00%(863/899) vs 96.51%(3 736/3 871);RR=1.00,95%CI:0.99-1.02,P=0.792] and the 5-year recurrence rate [2.58%(7/271) vs 4.43%(51/1 150);RR=1.01, 95%CI:0.46-2.22, P=0.986]. Conclusion Ovarian preservation in young early stage patients of endometrial cancer could not effect the 5-year overall survival rateand the 5-year recurrence rate.

OBJECTIVE To know the antibacterial activity of cefotaxime/sulbactam against 4 kinds of Gram- negative bacilli in vitro in general clinics. METHODS By double-disk test to detect the ESBLs of Escherichia coli and Klebsiella pneumoniae and the metallo-?-lactamase of Pseudomonas aeruginosa and Acinetobacter baumannii. And all the tested bacilli were tested by 14 kinds of general antibacterial drugs through K-B experiment. RESULTS Fifty one of 164 Enterobacteriaceae strains were ESBLs positive, including 23 E. coli strains with positive rate of 26.3% and 28 K. pneumoniae strains with positive rate of 35.9%. The metallo-?-lactamase was produced in 33 of 85 P. aeruginosa strains and the positive rate was 38.8%, and none in A. baumannii. The result showed cefotaxime /sulbactam was very sensitive to Enterobacteriaceae, no matter it had enzyme or not. These drugs had a special high sensitivity to ESBLs producing E. coli and K. pneumoniae, and their sensitivity rate was 87.0% and 89.3%. The sensitivity rate to P. aeruginosa, produced enzyme or not was 56.7% and 92.3%. CONCLUSIONS Cefotaxime/sulbactam has a powerful antibacterial activity against 4 kinds of Gram-negative bacilli in vitro in general clinics, especially to the infection caused by ESBLs-producing or metallo-?-lactamase-producing bacteria, and can be taken as the preferred drugs.

OBJECTIVE To survey the chromosome-encoded ?-lactamase gene families: SHV,LEN and OKP in(continuously) isolated Klebsiella pneumoniae in China.METHODS The existence and statistical distribution of all three gene families in antibiotic resistant K.pneumoniae strains were detected by applying nPCR.RESULTS In 44 strains,28 strains were SHV gene positive(63.6%),4 strains were LEN gene positive(9.1%) and none in OKP gene.CONCLUSIONS All the three gene families are chromosome-encoded and have 80-92% of genetic(homogeneity),so they all could identifiy the most important factors assisting the spread of bacterial drug (resistance).nPCR is an economic and convenient measurement to detect the chromosome-encoded ?-lactamase gene.

Objective To study the effects of ischemic postconditioning and ischemic preconditioning on cerebral ischemia-reperfusion injury following middle cerebral artery occlusion in rats.Methods A reversible focal cerebral ischemia-reperfusion injury was modeled using middle cerebral artery occlusion. Thirty male Sprague-Dawley rats were randomized into three groups (n = 10 in each group) : a cerebral ischemia-reperfusion group, an ischemic postconditioning group and an ischemic preconditioning group. The impairment of neurological function was scored and the infarct volume, the activity of superoxide dismutase and malondiadehyde (MDA) content were measured after the operation.Results In the ischemic postconditioning and preconditioning groups the neurological function was better and the infarction volume was significantly smaller compared with the model group. In the preconditioning group both infarction volume and neurological function were significantly better than in the postconditioning group. In the brain tissues of the preconditioning and postconditioning groups MDA content was lower, while the activity of superoxide dismutase was significantly higher than in the model group.Conclusions lschemic postconditioning can attenuate pathological injury induced by focal cerebral ischemia and repedusion. The neuroprotective effect induced by ischemic preconditioning is stronger than that induced by ischemic postconditioning.

Objective To observe the efficacy of psychological intervention on treatment compliance rate, clinical effect and quality of life in patients with advanced cancer pain.Methods Using a sealed envelope method, 80 patients with advanced cancer pain were randomly divided into two groups: the experimental group (EG) (40 cases) and the control group (CG) (40 cases).All patients were treated with standardized cancer pain treatment, and the patients of EG were treated with positive psychological intervention.The treatment compliance rate, clinical effect and quality of life after intervention by 14 days between two groups were compared.Results In EG and CG, the clinical efficiencies of cancer pain were 95.0 ％ (38/40) and 80.0 ％ (32/40), respectively (P ＜ 0.05).The treatment compliance rates were 87.5 ％ (35/40) and 62.5 ％ (25/40), respectively (P ＜ 0.01), and the improvement rates of quality of life were 80.0 ％ (32/40) and 57.5 ％ (23/40), respectively (P ＜ 0.05).Conclusion Psychological intervention is effective to improve the treatment compliance, clinical effect and quality of life for the patients with advanced cancer pain.

Objective To investigate the effect of reformative ventilation method (head-high leg-low 30°-declivate prone position ) in the ventilation of acute respiratory distress syndrome ( ARDS ) patients, and compared with normal prone position ventilation. Methods Forty-four patients of ARDS underwent ventilation were divided into prone position group (22 cases) and reformative prone position group (22cases) by random digits talle. Continuous 30° semireclining position was kept in normal time. The patients of the two groups underwent different prone position ventilation 4 hours every day,and indexes of hemodynamics and respiration before,during and after prone position ventilation were recorded and analyzed. Results After prone position ventilation, oxygenation index of two groups improved similarly (P ＞ 0.05 ). In prone position group, lung compliance decreased [2 h, ( 25.6 ± 5.8 ) ml/cm H2O ( 1 cm H2O = 0.098 kPa) vs. ( 37.2 ± 20.5 )ml/cm H2O] ,average airway pressure increased [2 h, ( 18.5 ± 3.9) cm H2O vs. ( 15.6 ± 5.3 )cm H2O] ,heart rate increased [2 h, ( 112.0 ± 16.2 ) beats/min vs. ( 102.0 ± 11.3 ) beats/min], mean arterial blood pressure decreased [2 h, (86.0 ± 6.7) mm Hg ( 1 mm Hg = 0.133 kPa) vs. (93.5 ± 7.5 ) mm Hg] ,central venous pressure increased[2 h, ( 15.5 ± 3.3 ) cm H2O vs. ( 12.6 ± 4.3 ) cm H2O]. These changes persistently existed during prone position ventilation (P ＜ 0.05 ),and they disappeared in 1 hour when recovered to 30 °semireclining position. Conclusion Reformative prone position ventilation not only has same effect on improving oxygenation index, but also obviates adverse effect on lung compliance and hemodynamics.

Objective To evaluate the effect of late course accelerated hyperfractionated irradiation combined with intraluminal hyperthermia for esophageal carcinoma. Methods From March 2000 to October 2002, totally 91 such eligible patients were entered into the prospective randomized control trial of late course accelerated hyperfractionated irradiation (LCAH-, 44 patients) versus LCAH combined with intraluminal hyperthermia ( LCAH-HT-, 47 patients). Radiotherapy regimen consisted of conventional fractionation radiotherapy (1.8 ?Gy/f, 5f/w, totally 41.4 ?Gy/23fx) during the first two-thirds of the radiotherapy course, followed by accelerated hyperfractionation radiotherapy (1.5?Gy/f, 2f/d, with 6 h interval), using the cone-down fields, to a total dose of 68.4?Gy/41fx . Hyperthermia was given weekly during conventional fractionation irradiation, totally 4 times. Results The CR and PR rates were 47.7% and 72.3%, 52.3%and 27.8% in the LCAH arm and LCAH-HT group,respectively(P=0.016). The median survivals were 30.3 and 30.6 months,the 1-,2-,3-year survival rates were 77.3%,57.4% ,37.3% and 80.5%,68.6%, 46.3%(P= 0.526 ), the 1-,2-,3-year local control rates were 86.3%,70.5%,56.5% and 92.4%,72.5%,65.5% (P= 0.686 )in the LCAH group and LCAH-HT group,respectively. Grade III and severer of esophagitis were 18.2% and 27.6% in LCAH and LCAH-HT (P= 0.498 ), Grade III and severer tracheitis were 11.4% and 19.2% respectively (P=0.191). Conclusions The immediate effect of LCAH combined with hyperthermia is better than that of LCAH alone. Additional hyperthermia to LCAH does not increase the likelihood of radiation injury.