Objective The intracardiac electrocardiogram (ecg) positioning technology in the clinical appli -cation of PICC catheter tip to locate effect were discussed .Methods 115 cases of our department in October 2013-2014 December PICC placement of patients admitted to the study .All patients completed according to uniform pro -cedures catheter, and the use of intracardiac electrocardiogram positioning technology in the catheterization process PICC catheter tip positioning, again catheter positioning X -ray film.Results Intracardiac electrocardiogram PICC tip into the superior vena cava sensitivity of 93.03%, and the situation is a total of seven cases no P wave changes , the rest of the patient P or T wave changes .X -ray showed 108 cases of catheter tip is located on the within the vena cava, and two cases in the subclavian vein (intravenously to two cases of circular motion , resulting in a circular mo-tion intravenous catheter insufficient length , which does not reach the superior vena cava ), and two cases in the inter-nal jugular vein, three cases in the brachial vein .Conclusion PICC catheter tip positioning taking intracardiac elec -trocardiogram positioning technology , with high sensitivity and specificity , which can be clinical application .

The tumor hospital has its unique resources superiority.To collect and utilize the information from tumor patients,information from their diagnosis and treatment,and biological specimens,through clinical epidemiology methods and design,would facilitate the deep development in the management and research at tumor hospitals in the new circumstances.Nantong Tumor Hospital,a first rate 3A hospital,and also one of the earliest-run specialized tumor hospitals in prefecture-level cities,possesses own basis for clinical epidemiological research,medical follow-up,and application of biobanking.In this paper we report the specific work plan and work contents,including:to establish a hospital-based cancer registry system for serving clinical epidemiology; to set up a follow-up system for clinical cases with tumor,in order to assess the effect of factors on tumor treatment and to analyse their survival rates; to build a biobank of tumor cases with perfect epidemiological information and background,fitting in with the needs of the development of translational medicine.The bottleneck problems in the work are also discussed.

Objective To detect the activity of transglutaminase1(TGM1)and gene mutation in a family with lamellar ichthyosis.Methods Immunohistochemistry technique was used to detect the activity of transglutaminase1.Complete encoding sequences of TGM1gene were analyzed in this family by using PCR-DNA sequencing.Results No activity of transglutaminase1was detected in the proband's skin.A nonsense mutation of C604T located in exon4of TGM1gene was identified by PCR-DNA sequencing,which caused a premature termination of Q202X and a defective polypeptide truncated by615amino acids in C-terminus.A heterozygous C604T mutation was carried by both of the proband' s parents.Conclusions The proband of lamellar ichthyosis in this family shows loss of transglutaminase1activity,which is resulted from a truncated transglutaminase1coded by the homozygous mutant TGM1gene.

Objective:To observe influence of cardiac resynchronization therapy (CRT ) on ventricular remodeling and inflammation in patients with chronic heart failure (CHF) .Methods :A total of 84 CHF patients treated in our hospital from Jun 2012 to Feb 2015 were selected , according to randam number table , they were randomly and e‐qually divided into routine treatment group (received routine medication ) and combined treatment group (received CRT based on routine treatment group) .Left ventricular ejection fraction (LVEF) ,left ventricular end -diastolic dimension (LVEDd) ,6min walking distance (6MWD) ,levels of high sensitive C reactive protein (hsCRP) ,inter‐leukin (IL)‐6 and tumor necrosis factor (TNF)–αwere compared between two groups before and three months after treatment .Results:Compared with before treatment ,three months after treatment ,there were significant rise in LVEF and 6MWD ,and significant reductions in LVEDd ,levels of hsCRP ,IL‐6 and TNF‐α in combined treatment group ( P<0.05 or < 0.01 ) ,while there were no significant improvements in above indexes in routine treatment group .Compared with routine treatment group ,there were significant rise in LVEF ± [(29.42 ± 4.32)%vs .(37.16 ± 4.72)% ] and 6MWD [ (232.66 ± 40.54) m vs .(304.12 ± 51.65) m] ,and significant reductions in LVEDd [ (64.35 ± 7.81) mm vs .(57.64 ± 6.12) mm] ,levels of hsCRP [ (23.21 ± 3.45)μg/ml vs .(16.31 ± 2.02)μg/ml] ,IL‐6 [ (22.08 ± 3.82)μg/ml vs .(15.79 ± 2.09)μg/ml] and TNF‐α[ (32.66 ± 5.66)μg/ml vs .(23.23 ± 3.12)μg/ml] in combined treatment group , P<0.05 or <0.01. Conclusion:CRT can significantly reduce levels of hsCRP ,IL‐6 and TNF‐αin CHF patients ,which may be the main mechanism delaying ventricular remodeling and improving cardiac function .

Objective To determine the levels of plasma histamine and oxidative status in patients with dermatographism before and after the treatment with anti-histamine drugs. Methods Totally, 85 patients with dermatographism were randomly divided into two groups to receive oral desloratadine and cetirizine respectively for 4 weeks. Enzyme linked immunosorbent assay (ELISA) was performed to detect the plasma level of histamine, superoxide dismutases (SOD), glutathion peroxidase (GSH-PX) and malondialdehyde (MDA) in all the patients before and after the treatment and in 15 normal human controls. The efficacy of desloratadine and cetirizine for dermatographism was estimated. Results The response rate was 83.72% and 78.57% in patients treated with desloratadine and those with cetirizine, respectively (x2 = 0.369, P> 0.05). The untreated patients with dermatographism showed an elevation in the plasma level of histamine (3.87 ± 1.21 ng/ml vs. 1.76 ± 0.56 ng/ml, P< 0.05) and MDA (3.86 ± 1.03 nmol/ml vs. 2.19 ± 0.82 nmol/ml, P< 0.05), but a decline in the activity of SOD (86.29 ± 19.9 U/ml vs. 112.12 ± 27.88 U/ml, P< 0.05) and GSH-PX (74.52 ± 47.67 vs.915.06 ± 115.96, P< 0.05) compared with the normal human controls. The treatment with antihistamine induced a reduction in the plasma level of histamine (1.61 ± 0.47 ng/ml vs. 3.87 ± 1.21 ng/ml, P< 0.05) and MDA (2.65 ± 0.77 nmol/ml vs. 3.86 ± 1.03 nmol/ml, P< 0.05), but an increment in the activity of GSH-PX (921.46 ± 157.37 vs.74.52 ± 47.67, P < 0.05) with no changes of SOD in patients with dermatographism. Conclusions In patients with dermatographism, plasma histamine is increased and there is an imbalance of oxidation-antioxidation.Desloratadine and cetirizine are effective for the treatment of dermatographism.

Objective To evaluate the diagnosis and treatment of duodenal neuroendocrine tumors.Method We retrospectively analyzed data of 15 patients with duodenal neuroendocrine tumors admitted between August 1999 and July 2012.Result In all the 15 cases accurate and definitive diagnosis were achieved via pathological examination and immunohistochemistry.Clinical diagnostic methods included ultrasound,endoscopy,upper gastrointestinal imaging,abdominal CT,MRI,etc.7 cases underwent pancreaticoduodenectomy,2 cases were treated by local excision,4 cases by endoscopic excision,and total gastrectomy and distal gastrectomy was performed in one each case.Conclusions The diagnosis of duodenal neuroendocrine tumors is established mainly by endoscopy and diagnostic imaging.Surgical resection is the treatment of choice.Pancreatoduodenectomy and local excision is applicable for G2 and G3 patients while endoscopic excision can be used for G1 patients.

Objective To assess the relationship between fruit intake and gastric cancer.Methods Articles published during January 2001 and October 2012 that assessed the relationship between fruit intake and gastric cancer were searched on PubMed,Ovid and Willey database.Adjusted relative risk (RR) and 95％ confidence intervals (CI) were calculated by using fixed-effect or random-effect model.Variants of subgroup analysis included living regions,followup duration,and adjusted factors.Results A total of 3679 gastric cancer patients and 1 173 859 subjects from 7 prospective cohorts were included in this metaanalysis,and the pooled RR was 0.89 (95％ CI:0.78-1.01).In the subgroup analysis,the pooled RR in the 10-year followup group was 0.94 (95％ CI:0.85-0.99) before age,cigarette smoking and alcohol drinking were adjusted (RR =0.81,95％ CI:0.54-0.99).Conclusion Fruit intake may prevent the development of gastric cancer.

Objective:To explore the application effect of optimizing diet management in patients with hyperphosphatemia.Methods:Seventy-seven patients who underwent regular hemodialysis in the blood purification department of the First Affiliated Hospital of Guangxi Medical University from September 2018 to June 2019 were selected. Patients were randomly divided into control group (39 cases) and intervention group (38 cases) by the method of random number table. The control group received routine nursing, while the intervention group received optimized dietary management intervention. The blood phosphorus, blood calcium, hemoglobin, albumin, dietary phosphorus related knowledge level and phosphorus control diet compliance of the two groups before and after the intervention were compared respectively.Results:After 3 months of intervention, the scores of knowledge about food phosphorus, compliance of phosphorus control diet and total score of the intervention group were (22.00±3.92), (34.82±4.69) and (56.82±7.48) points, which were higher than (18.46±3.57), (30.54±3.52) and (49.00±6.13) points of the control group, the difference was statistically significant ( tvalues were 4.146, 4.536 and 5.022, P<0.05). After 6 months of intervention, the scores of knowledge about food phosphorus, compliance of phosphorus control diet and total score of the intervention group were (25.74±3.36), (41.63±5.27) and (67.37±7.67) points, which were higher than (20.97±3.81), (32.36±4.38) and (53.33±6.80) points of the control group, the difference was statistically significant ( tvalues were 5.815, 8.403 and 8.504, P<0.05). After 3 months of intervention, the blood phosphorus level in the intervention group was 1.81 (1.67, 2.10) mmol/L, which was lower than 2.13 (1.87, 2.32) mmol/L in the control group, the difference was statistically significant ( Zvalue was-3.237, P<0.05). After 6 months of intervention, the blood phosphorus level in the intervention group was 1.75 (1.63, 1.91) mmol/L, which was lower than that in the control group 1.90 (1.83, 2.13) mmol/L, and the difference was statistically significant ( Zvalue was-3.343, P<0.01). Conclusion:Optimizing dietary management can improve patients' knowledge level of food phosphorus and dietary compliance of phosphorus control, effectively reduce blood phosphorus level, and have no obvious effect on nutritional status.

Objective To investigate the significances of monitoring urine neutrophil gelatinase -associated apolipoprotein (NGAL)and kidney injury molecule -1 (KIM-1)levels before and after coronary intervention in early predication of contrast -induced nephropathy.Methods The clinical data of 249 patients with coronary heart disease undergoing percutaneous coronary intervention were collected.All patients were divided into contrast -induced nephropathy group(n =21 )and non -contrast -induced nephropathy group(n =228)according to whether had contrast -induced nephropathy.Before surgery and 4h,12h,24h,48h,72h after surgery,the levels of serum creatinine were tested.Before surgery and 4h,12h,24h,48h after surgery,the levels of urinary NGAL and KIM-1 were detected by using enzyme -linked immunosorbent assay(ELISA).Results Compared with before surgery,the serum creati-nine level of contrast -induced nephropathy patients after surgery 48h[(101.7 ±20.3)μmol/L]was elevated,the difference was statistically significant(t =15.972,P <0.05).Compared with before surgery,the urinary NGAL levels of contrast -induced nephropathy patients after surgery 4h ~48h were (12.3 ±1.6)μg/L,(14.5 ±1.5 )μg/L, (14.1 ±1.2)μg/L and (14.3 ±1.4)μg/L,which were significantly elevated(t =8.672,11.817,15.942 and 17.641,all P <0.05),and the urinary KIM-1 levels after surgery 24h and 48h were (5.1 ±0.9)μg/L and (5.5 ± 1.3)μg/L,which were elevated,the differences were statistically significant(t =9.672,14.381,all P <0.05).The urinary NGAL levels of contrast -induced nephropathy patients after surgery 4h ~48h were higher than non -contrast-induced nephropathy patients,and the urinary KIM-1 levels after surgery 24h and 48h were higher than non -contrast -induced nephropathy patients,the differences were statistically significant(t =17.838,19.370,13.996, 18.172,2.792,3.307,all P <0.05).Pearson correlation analysis showed that the urinary NGAL levels after 4h and urinary KIM-1 levels after 24h were positively correlated with serum creatinine levels after surgery 48h(r =0.698, 0.576,all P <0.05).ROC curve analysis showed that urinary NGAL levels in predicting contrast -induced nephrop-athy,the area under the curve was 0.963 (95% CI:0.931 ~0.995 ),sensitivity was 85.7%,and specificity was 94.3%,for urinary KIM-1 levels,those were 0.839 (95%CI:0.768 ~0.909),81.0% and 72.8%.Conclusion The urinary NGAL levels of contrast -induced nephropathy patients after interventional treatment 4h were increased, and the urinary KIM-1 levels appeared increased after surgery 24h,which were earlier than serum creatinine.They were expected to be early indicators for determining acute kidney injury and predicting contrast -induced nephropathy after intervention treatment.

Objective To clone and express of Rv0091 encoding protein in Mycobacterium tuberculosis,identify and characterize of the enzyme activities.Methods Construct the Rv0091 prokaryotic expression plasmid,the vector was transformed into E.coli strain BL21trxB.After induced by IPTG,recombinant protein was purified by Ni2+-NTA chromatography and analyzed for purity by SDS-PAGE gels stained with Coomassie Blue.Immunological activity was identified by Western blot.The recombinant protein molecular weight was identified by Mass spectrometry.The enzyme-coupled assay detectes enzyme activity.Results The expression plasmid pET32a-Rv0091 was constructed and expressed in E.coli.BL21trxB,and the optimum expression system was conformed.The purity of the recombinant protein was more than 95％.Western blot analysis confirmed that recombinant protein was one of Mycobacterium tuberculosis proteins.Mass spectrometry identified the relative molecular weight and theoretical molecular weight was basically the same.Enzyme assay showed the recombinant protein able to catalyze the substrate MTA.Enzymatic properties showed that the optimal buffer for the phosphate and Hepes buffer,the poor thermal stability of the enzyme,the optimal temperature of 37℃,optimal pH10-12,when the pH ≤7,the protein denaturation and loss of some vitality.Conclusion The recombinant protein methylthioadenosine nucleosidase(MTAN) was obtained and enzyme activity was detected and plays a key role in the metabolism of Mycobacterium tuberculosis.