Objective To discuss the indication, technique, effect, and safety of endoscopic treatment of SMT in gastrointestinal tract. Methods Endoscopic therapy was performed in 94 patients with gastrointestinal diagnosed by endoscopy. 22 cases underwent EMR; 61 cases were treated with ESD; MBM was exercised on 7 cases; and nylon endoloop ligature were carried out on 4 cases. Results Complete resection was achieved on 86 cases, and 1 case was excised partially. 1 patient with SMT was transferred to open surgery. Lumps of 4 SMT cases treated by nylon endoloop ligature were found disappeared at subsequent visit after a month. All patients were followed up for one year, and no recurrence was found. Conclusions Gastrointestinal SMT can be completely resected by EMR, ESD and MBM. Nylon endoloop ligature can be used for the treatment of SMT in position difficult to deal with. Endoscopic therapy is relatively safe, effective, and minimal invasion for SMT.

Objective To investigate the effect of persistent ST-segment elevation after successful direct percutanous coronary intervention (PCI) on the late phase of left ventricular (LV) systolic function in acute anterior wall myocardial infarction.Methods Serial electrocardiograms were record before PCI and 1 hour after reperfusion in 72 patients with acute anterior wall myocardial infarction. The reduction of ST-segment elevation after successful PCI more than 50% was defined as ST-segment resolution (ST reduction group). Persistent ST-segment elevation was defined as ≥50% of peak ST elevation (ST elevation group). Echocardiography was performed on 2 to 3 weeks (early phase) and 5 to 6 months(late phase)after PCI to evaluate the LV function and ventricular wall motion abnormality (VWMA). Results Fifty-three patients (74%) had early ST segment elevation resolution and 19 patients (26%) did not. The LV function and VWMA were similar in two groups during early phase. But during the late phase, ST elevation group patients had lower LVEF and higher LVEDVI, LVESVI, VWMA index compared with ST reduction group (P

Objective To investigate the resistance of Staphylococcus aureus (S.aureus) to vancomycin and linezolid in Sichuan Province, and provide reference for clinical anti-infection treatment.Methods S.aureus and methicillin-resistant S.aureus(MRSA) from 71 hospitals in Sichuan Province in 2011-2015 were collected, minimum inhibitory concentration(MIC) values of vancomycin and linezolid against S.aureus and MRSA in each year were calculated.Results A total of 51 976 strains of S.aureus were collected in 5 years, 14 361 of which were MRSA, isolation rate of MRSA decreased from 36.02％ in 2011 to 25.56％ in 2015, which showed a downward trend (x2=160.72,P<0.05).From 2011 to 2015, MIC50 of vancomycin against S.aureus were 1, 0.5, 0.5, 1, and 1μg/mL respectively,MIC90 increased from 1μg/mL to 2μg/mL;the mean MIC50 of linezolid was 2μg/mL,MIC90 increased from 2μg/mL to 4μg/mL.Change in MIC50 and MIC90 of vancomycin against MRSA in 2011-2015 were obvious, which increased from 0.5, 1μg/mL to 2μg/mL respectively;the mean MIC50 of linezolid was 2μg/mL,MIC90 increased from 2μg/mL to 4μg/mL.Conclusion The isolates rate of MRSA had a decreasing trend,but there is a upward trend of MIC50 and MIC90 of vancomycin and linezolid against MRSA, bacterial resistance surveillance needs to be strengthened to provide evidence for rational clinical antimicrobial therapy.

Antitussive Agents ; poisoning ; Child, Preschool ; Dextromethorphan ; poisoning ; Humans ; Male

Objective To explore the establishment of peptide mapping database of Candida albicans ,laying the foundation for rapid diagnosis of Candida albicans infection .Methods 96 Candida albicans were collected clinically ,and its DNA was extracted . Polymerase chain reaction(PCR) was used to amplify the ITS1-5 .8S-ITS2 gene fragments and restriction endonucleases were a-dopted to identify them .Surface enhanced laser desorption ionization-time of flight-mass spectrometry(SELDI-TOF-MS) instrument was applied to detect the Candida albicans peptide mapping ,and Ciphergen ProteinChip software was used to collect data automati-cally .The established peptide mapping database was verified by confirmed Candida .Results According to restriction fragment length polymorphism analysis ,96 strains were confirmed as Candida albicans .15 peptide peaks were captured by SELDI-TOF-MS chips .Five peptide peaks of them with stable expression were screened out ,and the similarity analysis software was used to estab-lish peptide mapping database of Candida albicans .More than 95% of similarity was found between peptide mapping of Candida albicans and established database ,while less than 50% was found between peptide mapping of other Candida species and database . Conclusion The establishment of peptide mapping database of Candida albicans provides a theoretical basis for the rapid diagnosis of Candida albicans infection .

Objective To evaluate the therapy and turnover of Kawasaki disease(KD)with glucose-6-phosphate dehydrogenase(G-6-PD)deficiency.Methods Six hundred and twenty-four patients with KD were selected including 32 patients who had G-6-PD defected.The same dose intravenous immunoglobulin(IVIG)was used in all 624 patients(2 g/kg),but used Dipyridamole in 32 patients had G-6-PD deficiency which replaced the role of acetylsalicylic acid(ASA)after acute period.The coronary artery of these patients were checked and followed-up through echocardiograph.The turnover of 32 patients with G-6-PD deficiency and 356 case selected randomly from all the KD patients were compared.SPSS 10.0 software was used to analyze the data.Results In 32 cases of KD with G-6-PD deficiency,4 children had coronary aneurysm(12.5%).After 6-12 months follow-up,the coronary lesions were recovered in 62.5% children,improved in 21.9% children and not improved in 15.6% childern,which were not significantly different from all the KD patients(Z=-1.604 P=1.09).Conclusions IVIG and Dipyridamole are feasible in treating KD with G-6-PD deficiency.J Appl Clin Pediatr,2009,24(1):26-27

Bronchi ; Diagnostic Errors ; Female ; Foreign Bodies ; Humans ; Middle Aged

Objective:To evaluate the effects of intermittent change the angle of operating table on the skin in pressure areas of patients in prone position.Methods:A total of 150 hospitalized patients for elective surgical treatment in Yantai Yuhuangding Hospital from January 2019 to June 2019 were selected as subjects. The patients were divided into control group, 15° test group and 30° test group by random number table method, with 50 patients in each group. The control group received routine intraoperative pressure ulcer prevention measures, the 15° test group on the control group, the itinerant nurses adjusted the angle of the operating table according to the left 15°-supine-right 15° every half hour, and the 30° test group on the control group, the itinerant nurses adjusted the angle of the operating table according to the left 30°-supine-right 30° every half hour. The incidence of surgically related pressure ulcers and doctors' satisfaction with the surgical position of the three groups of patients were evaluated.Results:Pressure ulcers occurred in 8 patients of the control group, the incidence of pressure ulcers was 16%. Pressure ulcer occurred in 0 patient of the 15° test group, the incidence of pressure ulcers was 0. Pressure ulcers occurred in 2 cases in the 30° test group, the incidence of pressure ulcers was 4%. The difference was statistically significant ( χ2 value was 10.120, P<0.05). Further comparison showed that the incidence of pressure ulcers was statistically significant between the control group and the 15° test group ( P<0.016 7), while the incidence of pressure ulcers was not statistically significant between the control group and the 30° test group, between the 15° test group and the 30° test group ( P>0.016 7). The results of the postoperative doctors' satisfaction with the surgical body position were (27.880 ± 1.637), (27.520 ± 1.693), (26.920 ± 1.947) points in the control group, the 15° test group and the 30° test group, there was a statistically significant difference among the three groups ( F value was 3.779, P<0.05). Further comparison showed that there was no statistically significant difference in the score of surgical position satisfaction between the control group and the 15° test group, between the 15° test group and the 30° test group ( P>0.05). The satisfaction score of surgeons in the control group was higher than that in the 30° test group, and the difference was statistically significant( P<0.05). Conclusions:Intermittent adjustment of surgical position can reduce the incidence of pressure ulcers and improve the quality of nursing in the operating room without affecting the convenience of the surgeon. The optimal effect was achieved by adjusting the angle of the operating bed according to the left-leaning 15°-supine-right-leaning 15°at an interval of 30 minutes.

Prostate cancer (PCa) is a major health risk for older men worldwide. Existing systemic therapies mostly target androgen receptor (AR). Although treatments are initially effective, the disease always recurs. A potential mechanism for the treatment failure is that PCa contains, in addition to the AR-positive luminal type tumor cells, a small component of neuroendocrine (NE) cells. The function of NE cells in PCa remains poorly understood, and one important characteristic of these cells is their lack of expression of AR and resistance to hormonal therapy. In addition, many patients develop the more aggressive small-cell neuroendocrine carcinoma (SCNC) after hormonal therapy. Although this clinical phenomenon of disease transformation from adenocarcinoma to SCNC is well established, the cell of origin for SCNC remains unclear. Recently, loss of function of Rb and TP53 and amplification and overexpression of MYCN and Aurora A kinase have been identified as important biomarkers and potential disease drivers. In this article, we systematically review the histology of normal prostate and prostate cancer including the main histologic types: adenocarcinoma and SCNC. We also review the findings from many studies using cellular and animal models as well as human specimens that attempt to understand the molecular mechanisms of treatment failure, disease progression, and tumor transformation from adenocarcinoma to SCNC.

Abstract: Objective　To analyze the drug sensitivity and the carrying of carbapenem resistant gene of Acinetobacter baumannii isolated from clinical patients and clinical objects, and analyze the homology of strains to provide support for the control of nosocomial infection. Methods　A total of 38 strains of Acinetobacter baumannii isolated from patients and clinical objects surface were collected from January 2019 to August 2020. The antimicrobial susceptibility was tested by the minimum inhibitory concentration method. In addition, the resistance related genes were detected by polymerase chain reaction method, and homology analysis was performed by enterobacterial repetitive Enterobacterial Repetitive Intergenic Consensus Polymerase Chain Reaction (ERIC-PCR). Results All 34 strains of Acinetobacter baumannii isolated from Clinical patients and 4 strains isolated from clinical objects carried blaOXA-51 and imp resistance genes, neither of them carried blaVIM gene. 32 Acinetobacter baumannii carrying blaOXA-23 gene, 28 strains carrying blaTEM gene, 7 strains carrying blaOXA-58 gene. After cluster analysis, 38 Acinetobacter baumannii isolates were classified into 7 genotypes (expressed A, B, C, D, E, F, G), and cluster E and cluster G were the main clusters, containing 12 strains (12/38, 31.6%) and 18 strains (18/38, 47.4%), respectively, as the main prevalent clonal strains. Conclusions　Acinetobacter baumannii isolated from different sources have the significant differences in drug resistance and carry different resistance genes. There is no direct correlation between patients and environmental isolates of Acinetobacter baumannii belonging to different clonal strains. Also, there aren’t significant correlation between clinical patients infected with Acinetobacter baumannii.