Objective To evaluate if mucinous subtype has a relevant impact on disease-free survival (DFS) of patients with rectal carcinoma.Methods The clinicopathological data of patients with rectal adenocarcinomas (ring cell carcinoma were excluded)undergoing radical surgery at Beijing Cancer Hospital from Jan 2010 to Jan 2012 were retrospectively studied,survival analysis was done to detect potential prognostic predictors.Results 353 patients with stage Ⅰ-Ⅲ rectal cancer were included in this study,of whom 28 (7.9％) had mucinous histology.The 3-year DFS for patients with a mucinous adenocarcinoma was 50.0％ and 83.4％ for patients with nonmucinous adenocarcinoma (P ＜ 0.001).Mucinous adenocarcinoma was associated with advanced pathologic T (T3/4,100％ vs 52.3％,P ＜0.001) and N stage (N1/2,64.3％ vs.32.6％,P =0.001).More patients were diagnosed under 40 years in mucinous adenocarcinoma group (21.4％ vs.5.5％,P =0.005).Conclusions Patients with mucinous adenocarcinoma more often present at a younger age,mucinous adenocarcinomas are associated with more advanced tumor stages,and should be regarded as a dismal prognostic factor for the survival of patients with rectal cancer.

Objective To compare the effects of BOSU ball exercise and treadmill walking on lower limbs function in patients after stroke. Methods 40 patients more than 6 months after stroke were randomly divided into BOSU ball group (n=20) and treadmill group (n=20), who accepted BOSU ball or treadmill exercise on the basis of routine rehabilitation. They were assessed with Berg Balance Scale (BBS), 30-s chair stand (CS-30), sit and reach (SR), 6 minutes walk test (6MWT) and modified Barthel Index (MBI) before and 12 weeks after treatment. Results The scores of all the assessment improved in both groups after treatment (P<0.05), and the socres of BBS and MBI improved more in the BOSU ball group than in the treadmill group (P<0.05). Conclusion BOSU ball exercise can improve more of the balance and activities of daily living in post-stroke patient than treadmill walking.

Objective To evaluate the efficacy of mid-axillary approach to transversus abdominis plane (TAP) block in each abdoninal and back region.Methods Twenty patients of both sexes,aged 18-64 yr,with body mass index of 20-27 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective laparoscopic cholecystectomy,who had expected operation time ＜1 h,were enrolled in the study.Ultrasound-guided TAP block was performed on the left side via the mid-axillary line with 0.25％ levobupivacaine 0.5 ml/kg.TAP block was assessed by cold stimulation (75％ alcohol) and acupuncture in each abdominal and back region (the left side of the body was divided into 19 regions using the anatomical landmarks on the body surface).The positive condition in each region at 20 min after administration was recorded.Results The regions in which the positive rate ≤5％ were 11,14,17 and 18 regions.The regions in which the positive rate ＞5％-20％ were 8,15 and 19 regions.The regions in which the positive rate ＞20％-50％ were 12,13 and 16 regions.The regions in which the positive rate ＞50％-70％ were 1 and 4 regions.The regions in which 70％ ＜ the positive rate ＜ 95％ were 7,9 and 10 regions.The regions in which the positive rate ≥ 95％ were 2,3,5 and 6 regions.Conclusion Mid-axillary approach to TAP block is effective in the left middle-lower regions of the anterior abdominal wall,however,it is ineffective in the left upper region between mid-axillary and posterior axillary lines and in the low back region.

Objective To prospectively compare the clinical effect of 131I therapy for Graves disease (GD) using the 131I-iodide dose determined by radioactive iodine uptake formula and by individualized experience method respectively.Methods (1) A total of 527 GD patients referred for 131I therapy were enrolled and divided into two groups using interval sampling method.Group 1 consisted of 241 patients with their 131I activity calculated by iodine uptake formula.Group 2 consisted of 286 patients with their 131I activity calculated by individualized method based on clinical experience.(2) The patients who were not cured for the first time were retreated after 3 months in the same way until remission.(3) All patients were followed for more than 1 year after GD was cured.The clinical outcome was compared between the 2 groups.x2 test and two-sample t test were used for data analysis.Results There were no significant differences in age,gender,disease course,ATD pretreatment,the time of ATD discontinuation,level of thyroid hormone and autoantibody before 131I therapy,131I uptake rate,size of thyroid and duration of follow-up between the two groups (t=0.156-1.430,x2 =0.159,all P＞0.05).Group 1 had less 131I dose than group 2 ((247.9± 107.3) MBq vs (329.3±177.6) MBq,t=6.102,P＜0.05),fewer patients whose disease was controlled at early stage (x2 =25.279,P＜0.05) and lower remission rate for the first time of treatment (x2 =13.074,P＜ 0.05),but higher repeated treatment rate (t =2.735,P＜0.05) and ratio of hypothyroidism to normalized patients at the first treatment (x2=10.190,P＜0.05).The number of patients with permanent hypothyroidism between the two groups had no statistically significant difference (x2=1.138,P＞0.05).Conclusions The first treatment dose of 131I by individualized experience method is slightly higher than that by radioactive iodine uptake formula.Individualized treatment method for GD based on experience might help to control the GD earlier and improve the one-off remission rate without increasing the rate of hypothyroidism.

Langerhans cell histiocytosis is an uncommon disease, involvement of the thyroid by langerhans cell histiocytosis is rare. Two cases of Langerhans cell histiocytosis of the thyroid confirmed by pathology were reported in this paper. The main clinical feature was enlargement of the thyroids. One patient had hypothyroidism. Meanwhile, the lungs and pituitaries of the two patients were affected. Langerhans cell histiocytosis of the thyroid had no typical symptoms and specific laboratory examination, and might be clinically diagnosed as chronic lymphocytic thyroiditis, benign or malignant thyroid tumors. Thyroid fine needle aspiration cytology might be useful in confirming the diagnosis. The effective treatments include systemic chemotherapy, local radiation therapy and surgical excision. The chemotherapy is still the major technological approach. Most patients can relieve partially after receiving the systemic chemotherapy.

In July 2009, some farms of breeding Muscovy ducks on the peak of egg laying suffered the decrease of hatching rate and the quality of the eggs showing low mortality and no evident respiratory symptoms. The swelling and congestive ovary was visible after autopsy. This study was brought out for the diagnosis of these cases. The virus was isolated and identified by the methods of virus culture in chicken embryo, physical and chemical properties test, hemagglutinin test, NDV (Newcastle diseases Virus) interference test, electron microscope observation, pathogenicity test and the gene sequence analysis. The results indicated the virus showed the characters of inducing dwarf embryo after inocubation, the sensibility to lipid solvent and the hemagglutination capacity after pancreatic enzyme treatment, the typical morphology of coronavirus, the interference to NDV replication and the homology among 84.7% - 99% of the particial N gene sequences to the reference IBV (Avian infectious bronchitis virus) strains. The strain was identified as IBV isolate and this study confirmed the pathogenicity of IBV to Muscovy ducks.
Amino Acid Sequence ; Animals ; Chick Embryo ; Coronavirus Infections ; veterinary ; virology ; Ducks ; virology ; Female ; Infectious bronchitis virus ; classification ; genetics ; isolation & purification ; Molecular Sequence Data ; Phylogeny ; Poultry Diseases ; virology ; Sequence Alignment

Objective To investigate the diagnostic and prognostic value of neutrophil-to-lymphocyte rate ( NLR) in acute pancreatitis related acute kidney injury patients .Methods Peripheral blood specimens and clinical information of 98 acute pancreatitis patients in Wenzhou Center Hospital were collected .The WBC, neutrophils , lymphocytes were detected and NLR were calculated when they were admitted .The patients were divided into two groups by their NLR and whether they were with AKI respectively .Besides, ALT, Hct, TC, TG, blood calcium concentration , serum creatine and urea nitrogen , C reactive protein were detected and patients′APACHEⅡ score were also recorded to analyze the difference between the two groups .Results There is no significance in the age , BMI, Hct, TG, TC, ALT and blood calcium between AP patients with and without AKI.The blood creatinine, BUN, CRP, APACHEⅡscore were (395 ±122)μmol/L, (28.2 ±5.2) mmol/L, (34.0 ±8.2)mg/L, (11.5 ±3.8) score, respectively in AP patients with AKI, and which were (79 ±17 )μmol/L, ( 7.3 ±2.0 ) mmol/L, ( 14.8 ±2.9 ) mg/L, ( 6.9 ±2.4 ) score, respectively in AP patients without AKI.The blood ALT, blood creatinine, BUN, CRP, APACHEⅡscore were (257 ±76)U/L, (159 ±62)μmol/L, (20.5 ±6.6)mmol/L, (24.8 ±5.5)mg/L and (12.4 ±4.6) score in the patients with higher NLR respectively , and which were ( 165 ±30 ) U/L, ( 98 ±23 )μmol/L, ( 14.3 ±5.2 ) mmol/L, (19.5 ±3.0)mg/L and (5.4 ±2.1) score in the patients with lower NLR respectively .NLR was 4.97 ±0.19 in AP patients with AKI, and was 9.62 ±0.81 in AP patients without AKI.The difference between the two groups was significant(P=0.0001).The area under ROC curve of diagnosing AP by NLR was 0.895 (95%CI 5.75).the sensitivity was 89.5%and the specificity was 77.2% when using 5.75 as the cut-off value to diagnose AP related AKI with NLR .Conclusions NLR can be a potential predictive index of the severity and relate to renal function in acute pancreatitis related acute kidney injury patients .

Objective To identify the changes of body composition with acromegaly before and after pituitary adeno-ma surgery,and to evaluate the relationship between these changes and serum growth hormone(GH),insulin-like growth factor-1(IGF-1).Methods Serum GH with OGTY,IGF-1 levels,BMI,fat percentage,FFM and total body water(TBW) in patients were measured in active and relieved period of the disease.Results The BMI and FFM with active acromegalic males were significantly higher,but fat percentage was significantly lower than that of healthy males.After the disease was relieved by surgery,serum GH and IGF-1 concentrations of patients were sig-nificantly reduced to normal level,but their BMI was still significantly higher,the fat percentage increased and the FFM decreased was correlated with serum nadin GH and IGF-1 levels.The BMI and FFM with active acromegalic females were significantly higher than healthy females,but the fat percentage had not significant change after sur-gery,and FFM decrease was correlated with reduced serum GH level.The fat percentage did not change signifi-cantly.Conclusion There was significant change of body composition with acromagely before and after treatment,and a relationship between these changes and serum GH and IGF-1 levels was identified.

Objective To evaluate the clinical efficacy and safety of sibutramine (Reductile )in Chinese obese patients. Methods Obese adults (BMI 27～45 kg/m 2) in six research centers received sibutamine 10 mg or placebo one tablet each day with a controlled-energy diet for 24 weeks by randomized, double-blinded, placebo-controlled study. Results For intent-to-treat analysis, 125 sibutramine-treated subjects and 126 placebo-treated subjects were evaluated. After 24 weeks, sibutramine-treated patients lost more weight (6.52?3.95)kg than placebo-treated patients (3.18?3.59)kg(P

ObjectiveTo investigate the effect of HBsAg on the expression of interferon-α (IFN-α) in peripheral blood plasmacytoid dendritic cells (pDCs) induced by the stimulator of interferon genes (STING) signaling pathway activated by cyclic GMP-AMP (cGAMP). MethodPeripheral venous blood was collected from healthy adults and the patients with chronic hepatitis B virus (HBV) infection who attended the outpatient service or were hospitalized in Department of Infectious Diseases, The Affiliated Hospital of Xuzhou Medical University, from February to December 2016, and peripheral blood mononuclear cells (PBMCs) were isolated and extracted. After the STING agonist cGAMP was added to PBMCs, ELISA was used to measure the levels of IFN-α, interferon-β, and tumor necrosis factor-α in supernatant. PBMCs from healthy adults were pre-incubated with HBsAg and then stimulated by cGAMP, and supernatant was collected to measure IFN-α. The magnetic-activated cell sorting method was used to remove pDCs from PBMCs, and after culture with cGAMP, ELISA was used to measure the level of IFN-α in supernatant. PBMCs from healthy adults were stimulated by HBsAg and/or cGAMP, and then flow cytometry was used to measure the frequency of pDCs. The independent samples t-test was used for comparison of continuous data between two groups. ResultsPBMCs from the patients with chronic HBV infection stimulated by cGAMP in vitro had a significantly lower level of IFN-α than healthy controls (469.72±18.95 vs 599.90±84.06, t=4.868, P=0.001). PBMCs from healthy adults co-cultured with HBsAg and stimulated by cGAMP had a significantly lower level of IFN-α than those in the non-HBsAg group (448.5±52.0 vs 571.0±30.8, t=4.500, P=0.011). Compared with PBMCs containing pDCs, PBMCs without pDCs stimulated by cGAMP had a significant reduction in the level of IFN-α (164.50±40.73 vs 339.50±35.33, t=6.482, P=0.001). Compared with PBMCs from healthy adults stimulated by cGAMP, PBMCs pre-incubated with HBsAg and then stimulated by cGAMP had a significant reduction in the frequency of pDCs (0.12%±0.04% vs 0.24%±0.04%, t=5.176, P=0.014). ConclusionHBsAg can inhibit the expression of IFN-α induced by the STING pathway in pDCs activated by cGAMP.