Objective To observe effect of Dermlin and silver zinc emulsion in treatment of phase Ⅱ and Ⅲ pressure ulcer, and explore a new method which is easy to operate, safe and easily accepted by elderly patients. Methods 38 elderly patients with pressure ulcer from July, 2007 to June,2010 were selected and divided into the treatment group and the control group with 19 patients in each group. The treatment group adopted Dermlin and silver zinc emulsion, while the control group used Comfeel dressing. The treatment effect and cure time of the two groups were compared. Results The treatment effect of the treatment group was better than that of the control group, time used to achieve significant effect was also less in the treatment group. Conclusions Application of Dermlin and silver zinc emulsion in treatment of phase Ⅱ and Ⅲ pressure ulcer can achieve better effect than comfeel dressing, besides it is easy to operate and worthy of clinical practice.

【Objective】To observe the effect of Gastritis Prescription Ⅰ(GPⅠ) on the ultrastructure of gastric mucosa in spleen-deficiency atrophic gastritis(AG) patients.【Methods】Thirty chronic AG patients were treated with GPⅠ(mainly composed of Radix Codonopsis,Poria,Rhizoma Atractylodis Macrocephalae,Pericarpium Citri Reticulatae,Rhizoma Pinelliae,Fructus Amomi,Radix Angelicae Sinensis,Herba Taraxaci,Radix Paeoniae Alba,Radix Glycyrrhizae Preparata,etc.).The histological features of gastric mucosa sampled under gastroscope were observed before and after treatment under light microscope and electron microscope.【Results】After treatment,43.3% of moderate-degree and above atrophic area of gastric glands disappeared,and 16.7% became mild;36.7% of the disappeared gastric groove recurred and the thin gastric mucosa became normal.Microvilli of gastric gland became normal in 12 patients,accounting 54.5% in 22 patients with intestinal metaplasia.【Conclusion】GPⅠis effective in recovering the gastric mucosa of AG patients with deficiency of spleen and stomach Qi,and has an effect in counteracting intestinal metaplasia.

Objective To evaluate the clinical outcomes of PCI in elder patient four years after the operation.Methods One hundred and one elder patients with ACS were divided into two groups according to the treatment during hospitalization:48 patients in the experimental group underwent primary PCI ;53 patients in control group underwent conservative treatment without PCI.For all the patients,the clinical data on admission and during the four-year follow-up were retrospectively analyzed and the incidence of cardiovascular events at different period,all-cause mortality and prognostic risk factors were compared.Results There was no statistical difference in baseline data between the two groups.The success rate of PCI in experimental group was 93.75％.Imaging examination suggested that the numbers of single vessel lesion,double- vessel lesion and three-vessel lesion were observed in 6,20 and 22 of the patients,respectively.One hundred and fifty-eight cases had lesions involved more than 70％ of the vascular diameter.The numbers of type A,B1,B2 and C vessel lesions were 12,36,48,and 62,respectively.There was no significant difference(8.33％ vs 9.43％,x2 =0.04,P =0.85 ) in the lost follow-up rates in the two groups in the four years' follow-up.The adverse cardiovascular events incidence inthe experimental group were significantly lower than that in the control group during the first 12 months after operation ( RR =2.89,x2 =3.83,P =0.05,RR95 ％ CI:1.00,8.35 ).The adverse cardiac events incidence in the experimental gr?up was significantly lower than in control group during the second 12 months after speration ( RR =3.18,x2 =6.55,P =0.01,RR95 ％ CI:1.09 - 9.29).There was no significant difference in the incidence of adverse cardiac events between the two groups during the 36 - 48 months after the operation.There was no significant difference in the survival rate between the two groups during the follow-up period ( x2 =2.22,P =0.14).The logistic regression analysis for the cardiac events and risk factors such as age,smoking,high blood pressure,Cr,CHO,TG,BS,UA,LDL-C and so on demonstrated that age ≥ 80 years,high blood Cr,BS,LDL-C and high blood pressure were risk factors for adverse cardiac events ( P ＜ 0.05 ).Conclusion The adverse cardiac events incidence was significantly lower in elder patients with ACS who underwent PCI in the following 24 months after operation,but there was no significant difference in terms of the long-term survival rate and adverse cardiac events incidence between the two groups.Age ≥80 years and high blood Cr,BS,LDL-C,high blood pressure were risk factors for adverse cardiac events.

0.05).Conclusions The serum concentration of C_3 rises and the titer of AChRAb decreases in MG patients after treatment with glucocorticoid. There is no correlation between C_3 concentration and titer of AChRAb. The complement possibly cooperates with AChRAb in pathogenesis of MG.

【Objective】To investigate the clinical characteristics of acute pancreatitis(AP) in Guangzhou area.【Methods】A retrospective analysis was carried out in 273 AP inpatients hospitalized in the First Affiliated Hospital of Guangzhou University of TCM from 1996 to 2004.The onset time,seasonal distribution,syndrome patterns and prognosis of PA,and sex,age and disease course of the patients in Guangzhou area were carefully analyzed.【Results】The incidence rate of AP in Guangzhou was increased in recent years,lower in summer while higher in winter.The male and the female had the same incidence(the ratio approaching to 1∶1).In terms of age,there was a lower incidence in teenagers and the highest in the group aged 20 to 39.The incidence reached a plateau in the group aged 40 to 79 and sharply decreased in the group aged 80 and over.In terms of disease course,the majority of the AP patients were much improved and left hospital within 1～2 week(s) and the frequency valve arrived at the peak about one week later.In terms of the prognosis,72.9% of the patients were cured after timely traditional Chinese and western medicine treatment,the fatality rate being 2.9%.In terms of syndrome patterns of AP,damp-heat in the liver-gallbladder accounted for 69.9%,liver and Qi stagnation 11.7%,phlegm-stasis blocking collaterals 7.8%,deficiencycold in fu-organs 7.3% and excess in Yangming fu-organ 3.4%.【Conclusion】The incidence rate of AP in Guangzhou area tends to increase in recent years,the young and the middle aged have the highest incidences,most cases are manifested as damp-heat in the liver-gallbladder pattern,and AP attack usually occurs in winter and spring,and holidays,indicating that AP attack has a relation with unhealthy lifestyle,especially improper diet,in developed areas.This should be taken into consideration by the department concerned.

OBJECTIVE:Study regarding Smad3/transforming growth factor-β1(TGF-β1)signal transduction in pathological scars mainly focus on in vitro cultured fibroblasts,however,the correlation study was rare on keloid.The aim of this study is to detect the expressions of Smad3 and TGF-β1,and investigate their relationship in pathogenesis and development of pathological scars METHODS:Experimental samples were obtained frOm the patients who underwent burn and plastic surgery at the Department of Burn and Plastic Surgery,Workers'Hospital of Tangshan,Hebei Medical University,from June 2004 to June 2008,including 48 patients with Keloid,aged 16-52 years,and 40 patients with hypertrophic scars aged 18-56 years.Normal skins from additional 40 cases were served as controls The expressions of Smad3 and TGF-β1 protein in keloid,hypertrophic scars and normal skin were examined by flow cytometry.RESULTS:The expression of Smad3 and TGF-β1 were obviously greater in the experimental group than that of the control group (P＜0.05),but the difference between keloid and hypertrophic scars had no significance(P＞0.06).There was a positive correlation between Smad3 and TGF-β1 in keloid and hypertrophic scars(r=0 489 2,P=0.000 4:r=0.471 0,P=0.002 2).No notable correlation was found between Smad3 and TGF-β1 in normal skins(P=0.471 4).CONCLUSION:The expressions of Smad3 and TGF-β1 are up-regulated and the synergism of Smad3 and TGF-β1 may promote the development in pathological scars.

OBJECTIVE To investigate trans-fatty acids (TFA)contents in bakery food and assess TFA intake via bakery food and its energy contribution in Beijing and Guangzhou city.METHODS Bak-ery food sa mples were collected in 201 1 ,standard GC-method were used to determine TFA content,da-ta of TFA content were analyzed by t-test to evaluate for statistically significant differences.Si mple distri-bution model(determinative risk assess ment)of TFA intake was used to calculate individual TFA intake per day(g·d -1 ,% of total energy)in different populations(grouped by ages).RESULTS Average TFA content was ranging fro m 0.01 to 0.83 g /100 g sa mple in various kinds of bakery food.TFA con-tents were equal to or lower than 0.3 g /100 g in 77.1 % of biscuits,71 .8% of bread,67.0% of pas-tries.Wafer biscuit,sandwich biscuit,puff,cake,and croissants had higher TFA contents than others, and the level was 0.65 -0.83 g /100 g sa mple.TFA content in sandwich biscuit and pie decreased sig-nificantly after 2007.Average TFA intake via bakery food was 0.049 g·d -1 in Beijing and Guangzhou city,energy contribution was 0.027% which was far below the WHO reco mmended level (1 %). Population that are 3 to 6 years old had highest TFA intake and the TFA energy contribution was 0.041 %.CONCLUSION Most of bakery products in China contained low levels of TFA;consequently, health risk caused by TFA intake in Beijing and Guangzhou was unlikely to be a concerned.However, so me type of bakery foods had higher TFA contents which could be of greater concerned for risk management.

Objective:To detect the expression of inhibitor of DNA binding-2(ID-2) in colorectal adenocarcinoma and analyze its relationship with proliferation.Methods:A total of 67 patients with colorectal adenocarcinoma diagnosed in North China University of Science and Technology Affiliated Hospital were selected from November 2014 to September 2015, tumor tissue as the research objects.All patients underwent radical operation.The tumor tissue was taken as the observation group, and the normal colonic mucosa tissue>3 cm from the edge of the tumor was taken as the control group.Immunohistochemistry was used to detect the expression of ID-2 of the two groups and the Ki67 of cancer tissue.SW480 cell line of ID-2 overexpression was constructed.The expression of proliferating cell nuclear antigen(PCNA)was detected by Western Blot.Cell activity was detected by CCK-8 test.Correlation was analyzed between ID-2 and Ki67 by pearman correlation analysis.Prognostic value of ID-2 was analyzed by Kaplan-Meier survival analysis and Log-rank test in colorectal adenocarcinoma.Results:The positive rate of ID-2 was 49.3%(33/67) in the observation group, which was higher than 9.0%(6/67) in the control group, and the difference between the two groups was was statistically significant(χ 2=23.927, P<0.05). In the observation group, the expression of ID-2 was statistically significant in different invasion depth(serosa and extraserosa was 68.7%(22/32), serosa and extraserosa was 31.4%(11/35)), degree of differentiation(low differentiation was 80.0%(8/10), medium differentiation was 57.9%(11/19), high differentiation was 36.8%(14/38)), clinical stage(Ⅲ and Ⅳ stage were 64.3%(18/28), Ⅰ and Ⅱ stage were 38.5%(15/39)), lymph node metastasis(metastasis was 70.8%(17/24), no metastasis was 37.2%(16/43)) and tumor thrombus(yes was 75.0%(12/16), no was 41.2%(21/51)). The difference was statistically significant (χ 2 value were 6.311, 4.023, 4.349, 6.967 and 5.575, respectively, all P<0.05). Positive correlation was found between ID-2 and Ki67( r=0.65, P<0.05). Survival analysis showed that the expression of ID-2 was related to the prognosis of patients (X2=5.29, P=0.013). Compared with empty vector transfection group and blank control group, the expressions of PCNA and the activity ID-2 overexpression colon cancer cells increased( P<0.05). Conclusion:The higher expression of ID-2 is related to clinicopathological features and prognosis in colorectal adenocarcinoma.The abnormal expression of ID-2 may play a role in regulating the proliferation of colon adenocarcinoma.

Objective To measure the setup errors in thoracic esophageal carcinoma treated with intensity modulated radiotherapy (IMRT) using kilo-voltage cone-beam CT (kV-CBCT),and to evaluate the impact of the setup errors on the dose distributions in tumor target volume and the peripheral normal tissues.Methods Twenty-one patients with thoracic esophageal carcinoma undergoing image guided IMRT (IG-IMRT) were included in this study. Using kV-CBCT,173 setup errors of these patients were acquired before treatment.By shifting the isocenters,these setup errors were simulated in the 3-dimentional treatment planning system and the corresponding impact of the dose distribution in tumor target volume and peripheral organs were evaluated.Results The translational deviations of lateral,longitudinal and vertical directions were ( 2.73 ± 1.85 ),( 3.19 ± 2.71 ),and ( 2.35 ± 1.71 ) mm,respectively.The dose of gross tumor volume (GTV) was not impacted significantly by the setup errors. However,comparing with the standard plan without setup errors,the setup errors in the simulated plan reduced the dose of 95％ planning target volume (PTV) by 3.38 Gy.The dose to PTV Dmin and PTV Dmean were also reduced by 9.83 Gy and 0.65 Gy respectively. The correction of setup errors improved the conformity index (CI) and the homogeneity index (HI) for PTV.The C1 and HI for the standard plan were 0.74 ± 0.10 and 1.07 ±0.02, respectively. The C1 and H1 for the simulated plan were 0.69 ± 0.08 and 1.13 ± 0.07,respectively.Statistically significance was observed in these differences ( t =3.43 and -3.91 respectively,P ＜ 0.05 ). No statistical significance was observed in the dose differences in lungs,spinal cord and heart between the two plans ( P ＞ 0.05).The mean maximum dose of the spinal cord was (42.20 ± 4.97 ) Gy in the simulation plan,which was (41.37 ± 2.75 ) Gy in the standard plan.For some patients,the maximum dose of the spinal cord exceeded the tolerance level of 45 Gy in the simulation plan,and one case even reached 52.8 Gy.Conclusions Using the image guidance of kV-CBCT,the setup errors can be reduced significantly for patients with esophageal carcinoma receiving IG-IMRT.The correction of setup errors can increase the treatment precision and enhance the dose in PTV.No significant dose changes were observed in the lung,spinal cord and heart as a result of setup error correctio.

Objective To understand the mutation characteristics of drug resistance-associated genes rpoB, katG and inhA in Mycobacterium tuberculosis (MTB) strains using gene chip method, and evaluate its clinical application value. Methods A total of 76 MTB strains were collected from Shijiazhuang area in 2013 to 2014. Gene chip was used to detect the mutations of rpoB, katG and inhA, and the L-J proportion drug susceptibility test was used as the gold standard to evaluate the overall concordance, sensitivity and specificity of gene chip. The consistency of microarray and phenotypic resistance was evaluated by Kappa test. Results Of all the 76 strains detected, 69 harbored mutations in katG/inhA. The predominant mutation site of katG was 315 codon with the mutation rate of 89.9%(62/69), and 5.8%(4/69) carried mutations at inhA-15(C→T), and 4.3%(3/69)carried combined mutations of katG 315 and inhA-15. The rpoB mutations were detected in 73 strains, of which 64.4%(47/73)carried mutations at codon 531, 15.1%(11/73)at codon 526, 12.3%(9/73)at 516 codon, 1.4%(1/73)at 513 codon, 1.4%(1/73)at 533 codon and 5.5%(4/73)had combined mutations. Compared with results from the L-J proportion method, the sensitivity, specificity and concordance rates of gene chip for RFP were 96.1%(73/76), 100%(50/50)and 97.6%(123/126). The sensitivity, specificity and concordance rates of gene chip for INH were 90.8%(69/76), 100%(50/50)and 94.4%(119/126). The sensitivity, specificity and concordance rates of gene chip for MDR-TB were 86.8%(66/76), 100%(50/50) and 92.1%(116/126). Conclusion The predominant mutation loci of MDR strains in Shijiazhuang area are katG315 and rpoB531. Gene chip is a fast and useful tool for clinical diagnosis of MDR strains.