Objective To analyze acute coronary syndrome patients with clinical characteristics and the sta-tus survey of the interventional treatment in the datong area.Methods 162 cases of hospitalized patients with unsta-ble angina pectoris(UA)and non ST segment elevation myocardial infarction(NSTEMI)were selected through clini-cal records,with UA78 cases and NSTEMI 84 cases.Results Clinical features:(1 )Two groups of high incidence were men,and incidence cases were 2 times than that in women.Peaks in males were 50 -60 years old,and lasted 20 years in UA group;Peaks delayed 10 years of women thanthat of men in UA group,delayed 20 years in NSTEMI group.Over the 70 -year -old,there were no gender,number differences in the two groups.Hypertension,hyperlipi-demia,diabetes,number of cases were quite in two groups.(2)The history of coronary heart disease (CHD)were respectively:in UA group,patients with 1 year or less were 48 (61.5%),30 cases (38.5%)>1 year.NSTEMI group had 67 cases (79.8%)in 1 year or less,>1 year with 7 cases (20.2%),(t =2.915,-2.743,all P <0.01).In the subgroups which the morbidity was 1 day or less,UA group had 5 cases (6.4%),NSTEMI group had 25 cases (29.8%)(t =4.066,P <0.01).(3)History of OMI respectively:UA group 18 cases (23.1%),the NSTE-MI group 8 cases (9.5%)(t =-2.533,P <0.05),the difference between the two groups had statistical signifi-cance.Coronary lesions:(1 )stents:During 78 cases of patients with UA,direct percutaneous coronary intervention (PCI)treatment were 71 cases (91.0%).During 84 NSTEMI patients,direct PCI were 63 cases (75.0%).(2)Sin-gle lesion:UA group of stents treatment were 18 cases (11.1%),the NSTEMI group were10 cases (6.2%),and had a statistically significant difference between the two groups (χ2 =26.309 P <0.01).The third.The incidence of heart for death in hospitalized patients:In the 162 cases of patients,hospital death was 3 patients (1.9%),and had occurred in NSTEMI group (3.6%),there was statistically significant difference between the two groups (χ2 =2.838 P1 -sided <0.05).Conclusion In front of coronary heart disease incidence peak,the high -risk groups:hyperten-sion,hyperlipidemia,diabetes,to carry on the curative effect of standard treatment for a long time,it is the key to avoid the risk of coronary heart disease (CHD).NSTEMI cardiac mortality,need hospital treatment.Not only secondary pre-vention of coronary artery disease focus groups of HP,hyperlipidemia,DMand also cannot ignore OMI crowd.because myocardial ischemia often,even NSTEMI.Correct myocardial ischemia is the key of the coronary heart disease treat-ment,if the drug is invalid,stents treatment should be taken into account.

Objective To investigate the relationship between the serum concentrations of brain derived neurotrophicfactor (BDNF) and its G196A polymorphism in the amphetamine induced-psychosis inpatients.Methods The cross-sectional study included 233 amphetamine abuses and 110 healthy participants who served as controls.The serum concentration of BDNF was measured by sandwich ELISA,and the genotype of BDNF G196A polymorphism was determined used polymerase chain reaction (PCR) techniques.The data were analyzed using SPSS 12.0 statistics software.Results The serum concentration of BDNF in case group((205.81±75.36) pg/ml) were significantly higher than that in control group((95.04±31.63) pg/ml;t=15.02,P＜0.01).There was no significant difference about the BDNF serum concentrations between the inpatients with the amphetamine induced psychosis and the inpatients with the amphetamine abuse (P＞0.05).The BDNF serum concentration showed no significant difference in the genotype distributions and allele frequencies (P＞0.05).The genotype distributions and allele frequencies of BDNF G196A showed no significant difference among three groups(P＞0.05).Conclusion The BDNF serum concentration is correlated with methamphetamine abuse,while the BDNF G196A gene polymorphism may not be associated.

Objective To investigate the relationship between acute biliary pancreatitis (ABP) and anomalous pancreaticobiliary duetal union (APBDU). Methods 131 patients with ABP were enrolled to test the serum total bilirubin (TB), alanine amintransferase (ALT), aspartate amintransferase (AST), alkaline phosphates (ALP), γ-glutamyl transferase (γ-GT). All the patients received medical treatment, and then these tests were performed again. Thereafter, all the patients underwent selective surgery and intra-operative cholangiography was performed to observe the pancreaticobiliary duetal union. Results 27 patients (20.6%) with APBDU were found in 131 patients. Among them, 8 cases (29.6%) was B-P subtype (TypeⅠ), 16 cases (59.3%) was P-B subtype (TypeⅡ) , and the remaining 3 cases was mixed subtype (TypeⅢ). A significant decrease of ALT, AST, ALP, γ-GT after non-surgical treatment in both group of APBDU and NAPBDU was noted (P＜0.05). The serum levels of ALT, AST,γ-GT in APBDU patients were (71.81± 23.19) U/L, (47.85±27.87) U/L, (52.86±31.49) U/L, respectively; and in NAPBDU patients were (51.96±15.40) U/L, (40.77±16.58) U/L, (34.86±26.47) U/L. The difference was statistically significant (P＜0.05). Condusions APBDU is an important etiology of ABP.

Objective To study the effect of tanshinone ⅡA on the expression of P-selectin and ICAM-1 after cerebral ischemia reperfusion (I/R)injury in rats. Methods Rats were randomly divided into 4 groups: Sham operated group, I/R group, low dose Tan ⅡA treated group and high dose Tan ⅡA treated group. The focal middle cerebral artery occlusion (MCAO) model was made by suture-occluded method. Rats were pretreated with Tan ⅡA, ig for 3d,respectively before MCAO. After 90min MCAO following 24 hours of reperfusion, the expression of P-selectin and ICAM-1 was detected with using immunohistochemistry method. Result Compared with sham operated group, the expression of P-selectin and ICAM-1 increased after reperfusion for 24 hours in the ischemic territory(all P＜0.01).Compared with I/R group, the expression of P-selectin and ICAM-1 decreased in a dose dependent manner in low and high dose Tan ⅡA treated group(P＜0.01).Compared with that of I/R group, cerebral infarction volume was decreased in a dose dependent manner in low dose Tan ⅡA treated group and high dose Tan ⅡA treated group(all P＜0.01).The change of ischemic impairment in low or high dose Tan ⅡA treated group was less than that in IR group, and the change of ischemic impairment in high dose Tan ⅡA treated group was less than that in low dose Tan ⅡA treated group. Conclusion Tan ⅡA may reduce cerebral ischemia-reperfusion inflammation injure by decreasing the expression of p-selectin and ICAM-1.Tan ⅡA plays protective effect on cerebral ischemia injury, especially when high dose of Tan ⅡA(30mg/kg)was used.

Objective:To compare the survival rate and adverse reactions of patients with advanced hypopharyngeal squamous cell carcinoma undergoing surgery combined with chemoradiotherapy, and to analyze the prognostic factors of patients.Methods:The clinicopathologic data of 78 patients with advanced hypopharyngeal squamous cell carcinoma admitted to the Department of Radiation Oncology of the First Affiliated Hospital of Bengbu Medical University from August 2013 to December 2018 were retrospectively analyzed. The patients were divided into surgery combined with chemoradiotherapy group ( n=27) and chemoradiotherapy group ( n=51) according to different treatment methods. The median follow-up time was 46 months (20-84 months). The main observation indicators were overall survival (OS), progression-free survival (PFS) and local control rate (LCR). Cox regression model was used to analyze the prognostic factors. Results:Until July 31, 2020, 51 of the 78 patients with advanced hypopharyngeal squamous cell carcinoma died, including 6 cases of local recurrence, 11 cases of distant metastasis, and 34 cases of other causes (15 cases of hemorrhage, 15 cases of cachexia, and 4 cases of other diseases). In the surgery combined with chemoradiotherapy group, 12 patients died, accounting for 44.44%. In the chemoradiotherapy group, 39 patients died, accounting for 76.47%. The 1-, 3- and 5-year OS rates of 78 patients were 57.7%, 36.3% and 27.2% respectively, the 1-, 2- and 3-year PFS rates were 49.5%, 38.7% and 32.6% respectively, and the 1-, 2- and 3-year LCR were 53.4%, 40.0% and 34.2% respectively. The 1-, 3- and 5-year OS rates in the surgery combined with chemoradiotherapy group were 74.1%, 50.1% and 44.6%, and those in the chemoradiotherapy group were 49.0%, 29.3% and 12.8%, with a statistically significant difference ( χ2=5.142, P=0.023). The 1-, 2- and 3-year PFS rates in the surgery combined with chemoradiotherapy group were 62.1%, 54.3% and 44.4%, and those in the chemoradiotherapy group were 43.1%, 30.6% and 26.7%, with no statistically significant difference ( χ2=3.222, P=0.073). The 1-, 2- and 3-year LCR of the surgery combined with chemoradiotherapy group were 69.8%, 54.3% and 44.4%, and those in the chemoradiotherapy group were 45.1%, 32.9% and 29.6%, with no statistically significant difference ( χ2=3.576, P=0.059). The results of univariate analysis showed that tumor T stage ( χ2=7.140, P=0.008), N stage ( χ2=4.493, P=0.034) and treatment method ( χ2=5.142, P=0.023) were all independent influencing factors of the OS of patient with advanced hypopharyngeal squamous cell carcinoma; T stage ( χ2=5.807, P=0.016) and N stage ( χ2=6.587, P=0.010) were both independent influencing factors of PFS. The results of multivariate analysis showed that tumor T stage ( HR=2.121, 95% CI: 1.142-3.938, P=0.017), N stage ( HR=2.088, 95% CI: 1.144-3.811, P=0.016) and treatment method ( HR=0.430, 95% CI: 0.226-0.815, P=0.010) were all independent prognostic factors of the OS of patients with advanced hypopharyngeal squamous cell carcinoma; T stage ( HR=1.884, 95% CI: 1.011-3.510, P=0.046) and N stage ( HR=1.904, 95% CI: 1.058-3.429, P=0.032) were both independent prognostic factors of PFS. During the treatment period, there were statistically significant differences in the incidences of radioactive pharyngitis [7.41% (2/27) vs. 39.22% (20/51), χ2=8.821, P=0.003] and radioactive dermatitis [3.70% (1/27) vs. 29.41% (15/51), χ2=7.156, P=0.007] between the surgery combined with chemoradiotherapy group and the chemoradiotherapy group. However, there were no statistically significant differences in the incidences of radioactive oral mucositis [11.11% (3/27) vs. 17.65% (9/51), χ2=0.186, P=0.666], bone marrow suppression [37.04% (10/27) vs. 50.98% (26/51), χ2=1.381, P=0.240], pharynx infection [11.11% (3/27) vs. 5.88% (3/51), χ2=0.143, P=0.706] and tracheal fistula [7.41% (2/27) vs. 0 (0/51), P=0.117] between the two groups. Conclusion:The 1-, 3- and 5-year OS rates in the surgery combined with chemoradiotherapy group are higher than those in the chemoradiotherapy group, and the incidences of adverse reactions are low. T stage, N stage and treatment method are independent prognostic factors for OS of advanced hypopharyngeal squamous cell carcinoma patients, while T stage and N stage are independent prognostic factors for PFS.

OBJECTIVE To explore the drug-resistance,the existing forms,genotype,and transfer ways of extended spectrum ?-lactamases(ESBLs) and plasmid AmpC enzyme in Klebsiella pneumoniae.METHODS The drug sensitivity of K.pneumoniae to 17 antibiotics was done by slip-diffusion and microdilution methods.The genotype of two enzymes was assessed by PCR and sequencing.The transfer ways of K.pneumoniae drug-resistant gene were identified by transconjugants-test.RESULTS The ESBLs were mainly produced in 55 cefoxitin resistant K.pneumonia strains.The major genotypes of ESBLs and plasmid AmpC nzyme were CTX-M,MIR and DHA.These genes could be transferred from clinical isolates to recipient bacteria.CONCLUSIONS ESBLs as well as AmpC enzymes are the most important resistance mechanism in K.pneumoniae.The resistance could be transferred through the bacterial conjugation.

BACKGROUND:The surface of dental impression is inevitable to carry various bacteria caused by direct contact with the patient saliva, mucosa and blood during preparation;therefore, disinfection of the dental impression is necessary. OBJECTIVE:To evaluate the disinfection efficiency of glutaraldehyde, chlorine dioxide and electrolyzed oxiding water on dental impressions and to investigate the dimensional stability of impressions after disinfection, thus providing basis for establishing a standard and reasonable disinfection method. METHODS:Alginate impression materials were contaminated in vitro, and then immersed in glutaraldehyde, chlorine dioxide and electrolyzed-oxiding water for 5, 10 and 15 minutes, respectively. The colonies were counted after germiculture to compare the disinfection efficiency of three disinfectants. The impressions were poured in die stone after immersion, the dental models were structured-light scanned and three-dimensional digital dental models were reconstructed. Al the data were global y registered, and linear dimensions were measured on the digital models to deduce the influence of disinfection on surface accuracy and dimensional stability of the impressions. RESULTS AND CONCLUSION:The disinfecting rate reached 100%through immersion in 2%alkaline glutaraldehyde for 5 minutes, and the disinfection of kil ing the hepatitis B virus was effective after 10-minute immersion. The disinfecting rate of 600 ppm chlorine dioxide for 15 minutes kil ing experimental bacteria reached 99%and effective for kil ing the hepatitis B virus. While the disinfecting rate of kil ing experimental bacteria was less than 99%through immersion in electrolyzed oxiding water for 15 minutes, and was not effective for hepatitis B virus. The three-dimensional digital dental models did not differ significantly. These results suggest that immersion in 2%alkaline glutaraldehyde for 10 minutes or 600 ppm chlorine dioxide for 15 minutes can effectively disinfect alginate impressions and make no significant effect on the dimensional stability.

Objective To explore the safety and feasibility of vagus nerve-preserving Da Vinci robotassisted radical gastrectomy for gastric cancer.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 12 gastric cancer patients who underwent vagus nerve-preserving Da Vinci robotassisted radical gastrectomy at the Southwest Hospital of the Third Military Medical University from January 2015 to November 2016 were collected.All patients underwent vagus nerve-preserving Da Vinci robot-assisted radical gastrectomy for gastric cancer.During operation,lymph node dissection of the pyloric region,the right side of the cardia and the superior margin of the pancreas were noticed,and other surgical procedures were the same as the traditional Da Vinci robot-assisted radical gastrectomy.Observation indicators:(1) intra-and post-operative situations:surgical methods,digestive tract reconstruction,operation time,volume of intraoperative blood loss,number of lymph node dissected,results of postoperative pathological examination,recovery time of gastrointestinal function,time for liquid diet intake,duration of postoperative hospital stay,short-term surgery-related complications (postoperative bleeding,anastomotic fistula,obstruction and intra-abdominal infection);(2)follow-up situations:postoperative long-term complications (gastric retention,alkaline reflux gastritis,dumping syndrome,gallbladder disease and cholelithiasis),postoperative quality of life (diet,upper abdominal discomfort,nausea,vomiting and diarrhea),postoperative nutritional status [body weight,hemoglobin (Hb),total protein (TP),albumin (Alb)] and tumor recurrence.Follow-up using telephone interview and outpatient examination was performed up to December 2016.Telephone interview included detecting diet of patients,digestive tract symptoms and body weight.Routine blood test,liver and kidney functions,tumor markers,chest X-ray,abdominal computed tomography (CT) or color Doppler ultrasound and gastroscopy of outpatient examinations were performed to detect tumor recurrence and metastasis.Measurement data with normal distribution were represented as x±s and measurement data with skewed distribution were described as M (range).Results (1) Intra-and post-operative situations:all the 12 patients underwent successful vagus nerve-preserving Da Vinci robot-assisted radical gastrectomy for gastric cancer,without conversion to laparoscopic surgery or open surgery,including 2 patients with D1 lymphadenectomy,2 patients with extended D1 lymphadenectomy and 8 patients with D2 lymphadenectomy.Five and 7 patients underwent respectively Billroth Ⅰ anastomosis and Billroth Ⅱ anastomosis of digestive tract reconstruction.Operation time,volume of intraoperative blood loss and number of lymph node dissected of 12 patients were (247± 34) minutes,(94 ± 23) mL and 27 ± 7,respectively.Results of postoperative pathological examination showed that distal and proximal surgical margins of 12 patients were negative and achieved R0 resection;326 lymph nodes were dissected,6 patients didn't have lymph node metastasis and 18 positive lymph nodes were detected in 6 patients.Recovery time of gastrointestinal function,time for liquid diet intake and duration of postoperative hospital stay in 12 patients were (57±14)hours,(64± 14)hours and (7.3±0.9)days,respectively.There was no occurrence of short-term surgery-related complications.(2) Follow-up situations:12 patients were followed up by telephone interview (10 receiving outpatient exaninations) for 9 months (range,1-20 months).Of 12 patients with long-term complications,2 had loss of appetite,1 had diarrhea,without occurrence of cholelithiasis,cholecystitis,gastric retention and dumping syndrome.Of 10 patients receiving outpatient examinations,body weight,Hb,TP and Alb were (56± 12) kg,(126± 10) g/L,(69.9±5.1) g/L,(43.2±3.3)g/L at 1 month postoperatively and (52±13)kg,(126±10)g/L,(72.1±2.4)g/L,(45.2±1.6)g/L at 3 months postoperatively,respectively,with negative carcinoembryonic antigen.There was no tumor recurrence and metastasis in 12 patients.Conclusion Vagus nerve-preserving Da Vinci robot-assisted radical gastrectomy is safe and feasible for gastric cancer,which has not affected the lymph node dissection and incidence of surgeryrelated complications,and it also can improve the postoperative quality of life and maintain good nutritional status.

BACKGROUND: How to determine the proximal section of electricity-injury nerve which is available for nerve grafting, is key point to the functional recovery. The method used before is to observe if there is normal axonal structure under operating microscope. But the clinical result proves unsatisfactory.OBJECTIVE: To evaluate the appliance value of somatosensory evoked potential (SEP) technique in the detection of nerve injury after electrical injury.DESIGN: Retrospective analysis based on the cases.SETTING: Department of Plastic Surgery, Ninth People's Hospital Affiliated to Shanghai Jiaotong University PARTICIPANTS: Totally 12 patients with severe electrical injury who received treatment in the Department of Plastic Surgery, Shanghai Ninth People's Hospital were included in this study. Among them, there were 9male and 3 female, aged from 6 to 54 years.METHODS: SEP of injured nerve was measured progressively and pathological section observation was given correspondingly. The function recovery of patients receiving nerve transplantation by using SEP was evaluated and compared with that before treatment through a follow-up.MAIN OUTCOME MEASURES: Amplitude, latency and corresponding pathological section of SEP of injured nerve as well as the functional recovery of the SEP plane of the cases with patients receiving nerve transplantation by using SEP to choose transplanted plane.plitude and latency of SEP was positively correlative with the quality of were repaired with SEP technique to select the anastomosis site for nerve transplantation and 8 cases were followed up after operation. The average follow-up time was 22.7 months ranging from 17 to 26 months. And 2-point resolution sense reaches grade Ⅱ or Ⅲ in 5 cases. (America hand surgery association criterion: 2-point resolution distance ＜ 6 mm was grade Ⅰ ,6-10 mm was grade Ⅱ ,11-15 mm was grade Ⅲ ,＞ 15 mm was grade Ⅳ).CONCLUSION: Electricity-injured nerve owns complicated pathology.SEP technique is a valuable method for function evaluating or selecting of the anastomsis site for nerve grafting in those cases.

Objective To analyze the CT and clinical features of acute pancreatitis(AP) patients with perirenal space(PRS) invasion.Methods CT images and renal function tests(serum urea,creatine) changes of 64 AP patients were retrospectively studied. PRS invasion by inflammation on CT scan and the relation between PRS invasion and renal function changes were analyzed. Results 81% patients had PRS invasion in which 52% were grade B, 25% were grade C. CT features of the PRS invasion varied from mild inflammatory changes to fluid collection or phlegmonous.The PRS invasion was detected in 35 of 52 patients with mild pancreatitis and all severe pancreatitis. Renal function abnormity was 47%, only 3% patients had abnormal renal function in patients without PRS invasion compared to 44% patients with PRS invasion. PRS invasion in patients with abnormal renal function attenuated on CT scan after the pancreatitis was controlled. Conclusions The CT clearly reveals the features of PRS in acute pancreatitis patients. The attenuation of PRS invasion in acute pancreatitis patients on CT parallels renal function recover.