Purpose: To study the clinical efficacy, toxicity of preoperative chemotherapy and survival time with Gemicitabine-Cisplatin combination in the treatment of stage Ma( N2) NSCLC. Methods: Thirty patients with stage IIIa( N2) NSCLC were included. Gemicitabine was administered on dl, 8 and 15 at a dose of 1000 mg/m" and Cisplatin at a dose of 100 mg/m on d2. The chemotherapy was repeated every 28days. Results: Thirty patients were evaluable for response. The overall response rate was 70%. Surgical'excision rate after preoperative chemotherapy was 93%. Total surgical excision rate was 70%. Median survival time was 15 months, one year survival rate was 67%. The main toxicity was hematological, thrombocytopenia of grade III-IV appeared in 46% course of treatment, but it did not lead to hemorrhage. Conclusions: Preoperative chemotherapy with Gemicitabine-Cisplatin combination is effective and well-tolerated in the treatment of stage IIIIa( N2) NSCLC. So it is worthy to be further studied and popularized.

AIM: To investigate the effects of Chlamydia pneumoniae infection and hyperlipidemia on the expression of NF-?B and AP-1 in the myocardium. METHODS: The indirect immunofluorescence method was used to examine wild C57BL/6J mice infected with Chlamydia pneumoniae and fed with an atherogenic diet. The expression of the subunit of NF-?B, P50, and c-Fos in the murine myocardium was observed. RESULTS: Chlamydia pneumoniae infection and hyperlipidemia induced the activation of NF-?B and AP-1 in murine myocardium. P50 and c-Fos were not detected in the controls, but there were different levels of positive expression in the experiments (P

Objective To investigate the infection status and drug resistance of imipenem‐resistant Pseudomonas aeruginosa (PAE) isolated from the submitted specimens from children patients in our hospital between October 2012 to September 2013 for mastering the antimicrobial resistance status of Pseudomonas aeruginosa infection among children in Guangzhou and the occurrence situation of imipenem resistant strains .Methods The detection situation of Pseudomonas aeruginosa from infected children during this period was analyzed and the VITEK 2 Compact analyzer produced by the France bioMerieux company was used to identify the bacteria .The minimal inhibitory concentration(MIC) of imipenem resistant Pseudomonas aeruginosa to 11 kinds of antibiotics was detected .Results 161 strains of Pseudomonas aeruginosa were detected from 36 600 specimens ,including 24 strains(14 .9% ) of imipenem resistant Pseudomonas aeruginosa ,the positive strains were mainly originated from phlegmy (50 .3% ) ,the isolation was highest in ICU (27 .4% ) and NICU(21 .8% ) .The drug resistance rate of imipenem‐resistant P .aeruginosa was higher to ceftriax‐one sodium(91 .7% ) ,cefoperazone(29 .0% ) ,ceftazidime(29 .0% ) ,cefoperazone /shubatan(29 .0% ) and aztreonam (25 .0% ) .Con‐clusion Imipenem‐resistant Pseudomonas aeruginosa has the higher detection rate among children in this area and usually has re‐sistance to multiple antibiotics ,which should be paid more attention to and antibiotics should be rationally used .

Objective To investigate the most suitable anaesthesia method for the tension-free herniorrhaphy.Methods A total of 422 unilateral inguinal hernia cases from 2002 to 2005 were collected and randomly divided into the local anaesthesia group and epidural anaesthesia group. Observation indices and some relative data, such as operative duration, date of ambulation, date of foodintake, length of hospital stay, operation-correlated complications, anaesthesia complications, usage rate of ancillary drug, satisfactory rate for anesthesia, cost of hospitalization, were included and recorded in the questionnaire, and all the patients who took the tension-free herniorrhaphy were asked to answer it as the follow-up research. Results It was found that the occurrence of postoperative anaesthetic complications, the cost of hospitalization, length of stay of local anaesthesia group were significantly less than those of epidural anaesthesia group, and the date of moving and the date of foodintake were also significantly earlier than those of the other group (P0.05). Conclusion The local anaesthesia is suitable for most of the tension-free herniorrhaphy, and it may be used as the conventional anaesthetic method.

Objective To explore the main pathogenic bacteria and antibiotic resistance patterns in children with bacterial diar‐rhea from Guangzhou region .Methods Regular bacterial culture of stool samples from children with suspicious bacterial diarrhea was performed to isolate the pathogen during 2011 to 2012 ,followed by the analysis of its composition and serum type ,ward distri‐bution characteristics and drug resistance to 12 antimicrobacterial drugs .Results 416 strains of pathogenic bacteria were isolated from diarrhea children during 2011-2012 ,in which salmonella ,enteropathogenic E .coli ,Campylobacter jejuni and Candida albicans isolates accounted for 53 .61% ,37 .98% ,5 .29% and 1 .68% respectively .Drug resistance rate of the main strains to 12 antimicrobi‐al agents was 85 .25% to ampicillin ,54 .28% to compound sulfamethoxazole ,44 .70% to cefotaxime ,42 .53% to ceftriaxone , 40 .66% to chloramphenicol ,23 .55% to ceftazidime ,23 .36% to aztreonam ,14 .88% to ciprofloxacin ,8 .07% to cefepime ,7 .99% to cefperazone/sulbactam ,7 .42% to piperacillin/tazobactam respectively ,and no resistance to imipenem was detected .Conclusion The pathogenic bacteria causing diarrhea mainly includes salmonella ,pathogenic e .coli ,campylobacter jejuni in children from guang‐zhou region ,the top five sensitive antimicrobial reagents for the main strains includes imipenem ,piperacillin/tazobactam ,cefpera‐zone/sulbactam ,cefepime and ciprofloxacin .

Objective To explore the value of magnetic resonance cholangiopancreatography (MRCP) and MRI in the diagnosis and differential diagnosis of periampullary carcinoma. Methods Plain and dynamic multi-phase enhanced MRI data of 54 patients with periampullary carcinoma proved by pathology were retrospectively analysed. χ~2 test and two independent samples t test were used to examine the relative results. The results of MRI were compared with that of pathology. Results Of 32 cases with carcinoma of head of pancreas, 7 cases (21.9%) exhibited "four-duct sign". 16 cases were carcinomas of the lower part of common bile ducts, 9 cases (56.3%) showed "three-duct sign". The difference between carcinomas of head of pancreas and carcinomas of the lower part of common bile ducts was significant (P<0.05). Additionally, the ratio of the largest area of masses and the diameter of com-mon bile duct in pancreatic cancer tumors was larger than that in common bile duct cancer (P<0.05) for whether the intraoperative or MRI measurement. Conclusion MRI and MRCP are very helpful in diagnosis of periampullary carcinoma.

Objective To sum up the application and the technique of CT-guided percutaneous puncture biopsy of thoracoabdominal masses.Methods 107 cases of thoracoabdominal masses were made percutaneous puncture biopsy,in which chest disease 81 cases,abdominal disease 26 cases.Biopsy was done using 18～20 G Franseen needle and 18 G coaxial automatic cutting needle.Routinely chose vertical plane angle,horizontal plane angle and vertical plane angle on one side of the body outline when needle was been entered.Results The successful rate by first puncture was 100%,and the total verification rate was 92.52%.The rate of thoracic complication was 11.11%.No obvious abdominal complication was found.Conclusion The technique of CT-guided percutaneous puncture biopsy of thoracoabdominal masses is simple,practical,high accuracy and only few complications.It should be emphasized that the needle angle should be having definite reference and the needles should be chosen accurately.

Objective To explore the relationship of plasma norepinephrine (NE) and epinephrine (E) level with TCM syndrome differentiation of attention deficit hyperactivity disorder (ADHD) in children. Methods Plasma NE and E levels in 80 ADHD children (Group A) and 32 normal volunteers (Group B) were measured by the method of high performance liquid chromatography_electrochemical detectio n (HPLC_ECD). Among 80 ADHD children, 49 were differentiated with kidney_yin def iciency and liver_yang hyperactivity syndrome (Group A 1) and 31 with heart_sp leen deficiency syndrome (Group A 2). Results Plasma NE and E levels in Gro up A we re higher than Group B (P 0.05 ). Conclusion Hyperactivity and impulsi veness in ADHD children may be related with the high levels of plasma NE and E. The exc essively sympathetic excitement in ADHD with kidney_yin deficiency and liver_yan g hyperactivity syndrome is uncertain.

Objective:To observe the expression of connective tissue growth factor(CTGF) and its receptor-low density lipoprotein receptor-related protein (LRP), and the relevant signaling pathway for the regulation by long-term high glucose exposure in cultured podocytes. Methods:The effects of high glucose on the expression of CTGF and its receptor LRP were analyzed by western blotting. The activation of mitogen activated protein kinase ( MAPKS )signaling pathway by high glucose was also examined. Results: Basal levels of CTGF were observed in cultured mouse podocytes, the levels of CTGF protein were increased by high glucose medium groups on the 2nd day, reached the peak on the 4th day(P0.05).The levels of CTGF expression in normal glucose and mannitol glucose groups did not change markly. High glucose medium induced phosphorylation of ERK_ 1/2 at as early as minute 30, reached the peak at hour 6; maintained the activity at hours 12 and 24, and declined to the basal level at hour 48. However, phosphorylation of ERK_ 1/2 was not detected in normal glucose and mannitol glucose groups. Blockade of phosphorylation of ERK_ 1/2 with PD98059, a specific ERK_ 1/2 activation inhibitior, did decrease the high glucose-triggered expression of CTGF protein in 4 days. High glucose had no effect on the expression of LRP protein at each time point. Conclusion: Acute high glucose (2-4 days)stimulated the expression of CTGF protein via ERK_ 1/2-dependent signaling pathway in cultured podocytes, while cultured in high glucose for 6-8 days, the podocytes did not increase its CTGF level. Long-term high glucose had no effect on the expression of LRP in podocytes.

Abstract: Objective To analyze and compare the differences in serum lipid metabolomics between patients with moderate to severe acne and healthy controls to understand the characteristics of serum lipid metabolism in acne patients. Methods Serum samples were collected from 30 patients with moderate to severe acne and 30 healthy controls matched for age, gender and body mass index in the Department of Dermatology, the Affiliated Hospital of Southwest Medical University from May 2019 to Apr. 2020. Serum lipid metabolomics was analyzed by liquid chromatography-tandem mass spectrometry. Partial least squares discriminant analysis (PLS-DA) was used for multivariate statistical analysis of differentially expressed lipid metabolites. The metabolic pathways with significant differences between the two groups were screened by Kyoto Encyclopedia of Genes and Genomes (KEGG) database. Using Mann-Whitney U test to calculate differential metabolites. Spearman correlation analysis was used to analyze the correlation between serum PC (18: 2e/20: 2) concentration and acne severity. Results The PLS-DA results showed that the composition of serum lipid metabolites in acne patients was significantly separated from that in healthy controls. Of the top 30 lipid metabolites with the most significant differences, four kinds of triglycerides (TG), two kinds of diglycerides (DG), six kinds of phosphatidylcholine (PC), one kind of MePC, two kinds of sphingomyelin (SM), two kinds of phosphatidylinositol (PI), two kinds of ceramide (monohexosyl ceramide, Hex1Cer;dihexosyl ceramide, Hex2Cer), two cardiolipin (CL) were found to be increased in the acne group (P<0.05). The levels of one kind of DG, two kinds of lysophosphatidyl ethanolamines (LPE), one kind of dimethylphosphatidyl ethanolamine (dMePE), one kind of bismethyl phosphatidic acid (BisMePA), three kinds of phosphatidyl ethanolamine (PE) and one kind of ceramide were found to be decreased in the acne group (P<0.05), and most of them belonged to phospholipid metabolites. Spearman correlation analysis showed that serum PC (18:2e/20:2) concentration was positively correlated with acne severity (r=0.456, P=0.004). KEGG enrichment function analysis revealed that the differential lipid metabolites were primarily enriched in metabolic pathways such as sphingolipid signaling pathway, cholesterol metabolism, insulin resistance, glycerophospholipid metabolism, among which the sphingolipid signaling pathway may play an important role. Conclusion There are significant differences in serum lipid metabolism between acne patients and healthy controls. Lipid metabolism disorders may be related to the pathogenesis of acne, but it’s molecular mechanism still needs further experimental exploration.