Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; pathology ; Female ; Humans ; Laryngeal Neoplasms ; pathology ; Lymphatic Metastasis ; pathology ; Lymphatic Vessels ; pathology ; Male ; Middle Aged ; Neck ; pathology ; Neoplasm Staging

Objective To examine the prevalence ofHelicobacter pylori in Shanghai and relevant risk factors, evaluate the resistance proifle ofH. pylori isolates to antibiotics used in ifrst-line therapy in two hospitals in Shanghai.MethodsH. pylori were isolated from the biopsy samples of gastric mucosa collected from September 2013 to January 2015. Antimicrobial susceptibility test was performed by E-test method for 131H. pylori strains to 4 antibiotics, clarithromycin, metronidazole, amoxicillin and tetracycline. Results A total of 955 patients receiving gastroscopy were enrolled. And 248 (26.0%)H. pylori strains were isolated from the biopsy samples of gastric mucosa. Overall, 14.5%, 64.1%, 0 and 0.8% of the strains were resistant to clarithromycin, metronidazole, amoxicillin and tetracycline, respectively. Resistance to two drugs was found in 10.7%(14/131) of the strains, and majority (92.8%, 13/14) of which were resistant to clarithromycin and metronidazole.Conclusions The prevalence ofH. pylori in gastric mucosa is rather lower compared with the data reported previously. It is associated with the sex, age and clinical outcome of patients, however, antibiotic resistance profile is not related to these factors.H. pylori eradication therapy should be individualized according to the results of susceptibility test in Shanghai.

The structure and 5-HT immunoreactivity in the brain and suboesophageal ganglion of three beetles, Ambrostoma quadriimpressum, Henosepilachna vigintioctomaculata and Oxycetonia jucunda, were first studied by means of colophony-paraffin embedding serial section technique and strepteavidin-peroxidase immunohistochemical method. The results showed that the brains of these three taxonomically closely related beetles were remarkably different in composition and size. Mushroom bodies and antennal lobes in Oxycetonia jucunda were conspicuous. Calyces and lobes of the mushroom bodies.were much developed. In contrast, calyces of Ambrostoma quadriimpressum and Henosepilachna vigintioctomaculata were extremely undeveloped. However, the postretinal fibres and circumpharyngeal nerves of Ambrostoma quadriimpressum were highly developed. In the three beetles, 5-HT immunoreactivity was present in all neuropils of the brain and the suboesophageal ganglion. The pattern of 5-HT immunoreactivity and the localization of immunoreactive somata which often clustered into groups were similar among these beetles, while the immunoreactivity intensity was distinct, especially in the lamina. The results suggest that the three beetles have given rise to adaptive radiation under the evolutionary pressure because of the long-term different life styles and living environments in which the taxonomic status of Ambrostoma quadriimpressum is relatively low. The similarity of the pattern of 5-HT immunoreactivity and localization of some positive somata among the three beetles raise the possibility that 5-HT seemes to serve similar physiological function in different insects. Furthermore, 5-HT might be involved in modulating the ingestion by regulating muscular activity and visual sensitivity.

ObjectiveTo investigate the biomechanical characteristics of different types of fixation with bioactive cervical fusion cage made of hydroxyapatite and poly L-lactic acid in cervical spinal fusion.MethodsIliac crest bone,bioactive cervical fusion cage and bioactive cervical fusion cage with plate fixation were used for anterior interbody implants after anterior discectomy across C5-6 in six fresh human cervical spine specimens respectively,and the range of motion of the cervical vertebrae interbody fusion were measured through the motional stability test.Results After discectomy,Bioactive Cervical Fusion Cage with plate fixation exhibited a significant increase in stability and a decrease of range of motion in angular motion than others in all motional directions ( P ＜ 0.005 ). Bioactive cervical fusion cage exhibited a decrease in stability and an increase of range of motion (6.25 ± 0.29) in angular motion than the intact spine (5.76 ± 0.40) in extension,but the difference was not significantly ( P ＞ 0.05 ).Bioactive cervical fusion cage exhibited a decrease in angular motion than iliac crest bone and a significant increase in stability in all motional directions except extension (P ＜ 0.005).ConclusionsBioactive cervical fusion cage' s biomechanical performance was excellent and bioactive cervical fusion cage with plate fixation was excellent in stability in all motional direction,and could remain initial stability of cervical vertebrae.

Objective To observe the changes of esophageal motility in patients with achalasia (AC) before and after peroral endoscopic myotomy (POEM ) and to evaluate the effects of POEM on esophageal motility in AC .Methods A total of 35 patients with AC received POEM .The esophageal motility in response to different food swallows (5 mL liquid and 2 cm × 2 cm × 2 cm solid food) was evaluated by high-resolution manometry (HRM) system before operation and one month after operation .The changes of parameters of esophageal body and lower esophageal sphincter (LES) were analyzed and compared before and after operation .The t-test ,non-parametric test or single factor analysis of variance was performed for statistical analysis .Results Before POEM operation ,lower esophageal sphincter pressure (LESP) of 35 patients in response to liquid swallows and solid swallows was (28 .94 ± 18 .70) mmHg (1 mmHg=0 .133 kPa) and (26 .41 ± 11 .57) mmHg ,respectively ;after operation it was (16 .02 ± 5 .46) mmHg and (15 .82 ± 5 .04) mmHg ,respectively ;and the differences were statistically significant (t= 4 .338 and 4 .726 ,both P<0 .01) .Before operation ,4 s integrated relax pressure (4 s IRP) during liquid swallows and solid swallows was (27 .18 ± 14 .63) mmHg and (28 .46 ± 11 .15) mmHg ,respectively ;after operation it was (12 .22 ± 6 .75) mmHg and (14 .54 ± 7 .83) mmHg ,respectively ;and the differences were statistically significant (t= 5 .902 and 5 .436 ,both P< 0 .01) .And after operation intra boluspressure (IBP) of liquid swallows and solid swallows also decreased compared to that before operation (t=5 .075 and 2 .944 ,both P< 0 .01) .Lower esophageal sphincter relaxation rate (LESRR) during liquid swallows and solid swallows increased compared to that before operation (t= -2 .990 , P< 0 .01 ;t=-0 .340 ,P>0 .05) .There was no difference in the distal contractile integral (DCI) and distal esophageal peristaltic amplitude in subtype Ⅰ and Ⅲ patients before and after operation (all P>0 .05 ) .All those parameters decreased in subtype Ⅱ patients (Z= -2 .704 and -2 .489 ,P< 0 .05 ;Z= -1 .929 and-0 .747 , P> 0 .05 ) . Proximal esophageal peristalsis was observed in two patients after operation , however there was no integrated esophageal body peristalsis .Clinical symptoms quickly relieved in all patients after POEM operation and clinical score significantly decreased compared to that before operation (0 .86 ± 1 .19 vs 8 .16 ± 1 .84 ,t=20 .605 , P<0 .05) .Conclusions POEM can effectively relieve LES relaxation disorder in AC patients and improve esophageal body peristalsis to a certain degree .The efficacy is regardless of AC types ,and further studies are need to shed light on the long-term efficacy .The long-term efficacy still need further follow-up study .

Objective To evaluate the effects of limited fluid resuscitation on systemic inflammatory responses in rats with traumatic hemorrhagic shock through comparing with unlimited fluid resuscitation.Methods Sixty pathogen-free male Sprague-Dawley rats,aged 2-3 months,weighing 250-290 g,were randomly divided into 6 groups (n =10 each) using a random number table:sham operation group (group S),no fluid resuscitation group (group NF),unlimited fluid resuscitation group (group ULF),limited crystalloid fluid resuscitation group (group LR),and limited colloid fluid resuscitation groups (group LSG and group LHES).Traumatic uncontrolled hemorrhagic shock was induced by withdrawal of blood from the femoral artery at 2.5 mL/100 g over a 20-minute period,followed by tail amputation at 10 min after the end of blood withdrawal.At 10 min after the end of blood withdrawal,fluid resuscitation was performed.Lactated Ringer's solution (ULF and LR groups),4 ％ succinylated gelatin (group LSG),or 6 ％ hydroxyethyl starch 130/0.4 (group LHES) was infused intravenously.The initial infusion rate was 2 ml · kg-1 · min-1.The target MAP was maintained at 50 mm Hg in rats with limited fluid resuscitation,while at 80 mm Hg in rats with unlimited fluid resuscitation.After 60 min of fluid resuscitation,bleeding in the tail was stopped by ligation and fluid infusion was replaced with blood resuscitation.After 60 min of blood resuscitation,180 main of observation was started.At 10 min after catheterization of the femoral artery and vein (T0),10 min after the end of blood withdrawal (T1),the end of fluid resuscitation (T2),the end of blood resuscitation (T3),and the end of observation (T4),arterial blood samples were collected to measure hematocrit (Hct)and concentrations of plasma tumor necrosis factor-alpha (TNF-α),interleukin (IL)-6,and IL-10.Blood samples were collected from the femoral artery at T2 for determination of the expression of Toll-like receptor 4 (TLR4) and myeloid differentiation factor 88 (MyD88) and activity of nuclear factor-kappaB (NF-κB) in monocytes.The amount of blood loss from the tail and volume of fluid infused were also recorded.Another 120 Sprague-Dawley rats were randomly divided into 6 groups (n =20 each) and resuscitation was performed according to the method previously described.The rats were observed for 72 h survival rate.Results Compared with group S,Hct was significantly decreased,the concentrations of plasma TNF-α,IL-6,and IL-10 and activity of NF-κB were increased,and the expression of TLR4,and MyD88 in monocytes was up-regulated in the other groups (P ＜ 0.05).Compared with group NF,the concentrations of plasma TNF-α and IL-6 and NF-κB activity were significantly increased,and the concentration of plasma IL-10 and Hct were decreased,and the expression of TLR4 and MyD88 in monocytes was up-regulated in ULF,LR and LSG groups,and the concentrations of plasma TNF-α and IL-6 were significantly increased,the concentration of plasma IL-10 and Hct were decreased in group LHES (P ＜ 0.05).Compared with group ULF,the concentrations of plasma TNF-α and IL-6 and NF-κB activity were significantly decreased,the concentration of plasma IL-10 and Hct were increased,the survival rate was higher,the expression of TLR4 and MyD88 in monocytes was down-regulated,and the amount of blood loss from the tail was decreased and the volume of fluid infused was reduced in LSG,LHES and LR groups (P ＜ 0.05).Compared with group LR,the concentrations of plasma TNF-α and IL-6 and NF-κB activity were significantly decreased and the expression of TLR4 and MyD88 in monocytes was down-regulated (P ＜ 0.05),and no significant change was found in the concentration of plasma IL-10 in group LHES (P ＞ 0.05),and the volume of fluid infused was reduced and the survival rate was increased (P ＜ 0.05),and no significant change was found in the amount of blood loss from the tail in LSG and LH-ES groups (P ＞ 0.05).Conclusion Compared with unlimited fluid resuscitation,limited fluid resuscitation exerts less effect on systemic inflammatory responses in rats with traumatic hemorrhagic shock,especially when resuscitation with 6％ hydroxyethyl starch 130/0.4 is performed,and inhibition of TLR4/NF-κB signaling pathway is involved in the mechanism.

Talents are core competitiveness of a hospital.In view of the nature of long and slow development cycle of medical talents,Wuxi No.2 People' s Hospital has innovated aTalent-tree program.This program develops talents by categories and stages,in the model oftree root-tree trunk-tree crownto fit different stage needs of these people.The program features a categorized education mode to establish hierarchical individualized plan for the whole career.The hospital has explored a special pathway for talents development,for the purpose of providing talents to ensure sustainable and innovative growth of the hospital.

Objective To investigate the clinical characteristics and survival analysis of T-cell lymphoma with hemophagocytic syndrome (HPS).Methods The clinical features,laboratory tests and survival of 30 patients of T-cell lymphoma with HPS were analyzed comparing with 50 random patients of T-cell lymphoma without HPS (control group),and the data were obtained from department of hematology,Ruijin Hospital,Shanghai Jiaotong University School of Medicine from January 2006 to December 2011.Results 30 cases of T-cell lymphoma with HPS manifested for high fever [100.00 ％ (30/30)],splenomegaly [96.67 ％ (29/30)],more than two-line reduction in blood cells [93.33 ％ (28/30)],bone marrow with bloodthirsty phenomenon [86.67 ％ (26/30)],LDH increased [100.00 ％ (30/30)],hypertriglyceridemia [46.67 ％ (14/30)],low fibrin hyperlipidemia [60.00 ％ (18/30)],ferritin increased [93.33 ％ (28/30)],liver damaged [86.67 ％ (26/30)] from patient group,which were higher than those of control group,the differences were statistically significant (x2 =23.11,22.50,36.05,64.20,21.82,5.31,16.54,26.82,46.43,all P ＜ 0.05).But the incidence of superficial lymph nodes enlargement was not high,only 33.33 ％,which made the diagnosis of primary disease difficult.Combined chemotherapy of CHOP or etoposide plus dexamethasone could make the symptoms and laboratory indicators improved,but the median survival time was only 20 days.Compared with the control group,there were significant differences on the survival curves (x2 =35.05,P ＜ 0.0001).Conclusion In T-cell lymphoma with HPS,the clinical manifestations are complex,usually with multi-organ dysfunction,aggressive course,and poor prognosis.The pathogenesis and treatment of HPS should be further studied.

Objective To investigate the expression of Foxp3~+ lymphocytes in breast carcinoma tissues and their correlation with other pathological factors,and to investigate the mechanism of action of Treg cells.Methods The expression of Foxp3~+ lymphocytes in the breast cancer tissue and non-cancerous tissue was detected by flow cytometry (FCM) in 30 breast carcinoma patients, and its correlation with other pathological factors was statistically analyzed by multiple linear regression analysis.The expression of TGF-β and IL-10 in the lymphocytes infiltrated in breast cancer tissue and non-cancerous tissue was measured by immunohistochemistry, and their correlation with the expression of Foxp3~+ lymphocytes was statistically analyzed by linear correlation dependability analysis. Results There was significant difference in the expression of Foxp3~+ lymphocytes between the malignant and non-cancerous breast tissues(P<0.05),and it was positively correlated with the clinical stage,blood vessel invasion and the matter of axillary lymph node metastasis(P<0.05). The expression of IL-10 in the tumor infiltrating lymphocytes was positively correlated with the expression of Foxp3~+ lymphocytes(P<0.05).Conclusion The expression level of Foxp3~+ lymphocytes is correlated with invasion and metastasis of breast carcinoma, and the IL-10 secreted by Foxp3~+ lymphocytes may be involved in this effect.Foxp3~+ lymphocytes can be used as an assistant marker for prediction and new therpeutic target of breast cancer.

Objective To investigate and evaluate the iodine nutritional status of school-age children in Yi county of Heibei Province,and to provide scientific basis for the development of control measures to iodine deficiency disorders.Methods Retrospectinely analyzed school-age children urinary iodine monitoring results of Yi County of Hebei Province from 1998 to 2011.One township was selected randomly in each of the five directions (east,west,south,north and center) from 1998 to 2011.One elementary school was randomly chosen in each of the five townships.And at least 20 urine samples of 8-10 years old children were randomly collected in each school selected.Urinary iodine contents were determined through arsenic cerium catalytic spectrophotometric method.Urinary iodine determination standard according to The Standard of Iodine Deficiency Disorders Elinination (GB 16006-2008) and The Iodine Deficiency Disorders Elinination Guide.Results A total of 1725 children urinary samples were collected from 1998 to 2011,urinary median was 243.26 μg/L,each of the median urinary iodine was higher than 100 μg/L.The ratio of urinary iodine less than 100 μg/L was ＜ 50％ over the years,and less than 50 μg/L was ＜ 20％.Overall,the highest value of urinary iodine stayed at approximately 200 μg/L,showing positively skewed distribution that was skewed to the right.Urinary iodine level was compared among different ages,gender and ethnicity,and the difference was not statistically significant(P ＞ 0.05).Conclusions In recent years,the iodine intake of school-age children of Yi County can meet the body needs,and the iodine nutrition is at an appropriate level.