Drug Resistance, Bacterial ; Female ; Humans ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases ; drug therapy ; Klebsiella Infections ; drug therapy ; Klebsiella pneumoniae ; enzymology ; Male ; Pneumonia, Ventilator-Associated ; prevention & control ; beta-Lactamases ; biosynthesis

Objective To establish a cell level-based negative enrichmen technique to detect circulating tumor cells (CTCs) in the peripheral blood of patients with epithelial ovarian cancer.Methods The colon cancer SKOV-3 cells were mixed with 2 ml whole blood from healthy donors at different ratio.Quantification of CTCs was performed using immunomagnetic bead based negative enrichment combined with immunofluorescence antibody method.The method was evaluated the recovery rate of target cells,Samples of 32 patients with ovarian cancer and 10 controls were assayed for CTCs detection by above method.Results ①The recovery rate was ranging from 64％ ～80％ by spiking varying numbers of SKOV-3 into 2 ml blood samples of healthy volunteers.Regression analysis of number of recovered SKOV-3 cells yielded a regression equation of Y=0.782X-1.408 and a coefficient of determination of R2 =0.998.②Did not detect CK8/18-+ circulating tumor cells in 10 controls,and CK8/18+ circulating tumor cells in 18 cases of 32 Patients with ovarian cancer.The positive rate of CK 8/18 + circulating tumor cells was significantly differences between the two groups (x2 =7.681,P＜0.01).③The presence ofCTCs was significantly correlated with distant metastasis (x2 =5.776,P＜0.05).Conclusion The method of immunomagnetic bead based negative enrichment combined with immunofluorescence antibody technique for CTCs detection in peripheral blood of patients with ovarian cancer has a clinical value of application and extension.

Objective To compare the therapeutic efficacies and toxicities either of pemetrexed or paclitaxel combined with oxaliplatin as a chemotherapy in postoperative with non‐small‐cell lung cancer(NSCLC) .Methods The clinical data collected from 86 patients who admitted into the first affiliated hospital of Kunming medical university from January 2010 to December 2011 who had been diagnosed with non‐small‐cell lung cancer(NSCLC) were retrospectively analyzed .All of these patients received the radical resection of pulmonary carcinoma ,in which 65 patients received pemetrexed combined with oxaliplatin treatment(named as peme‐trexed combination group) .Another 40 patients were treated with paclitaxel combined with oxaliplatin (named as paclitaxel combi‐nation group) .Survival analysis was evaluated by Kaplan‐Merie .Single factor analysis and COX regression model were employed to analyze the relationship between the influencing factors and the prognosis of disease .Results We found that neither OS (χ2 =0 .648 ,P=0 .421) nor PFS(χ2 =0 .758 ,P=0 .384)was statistical different between two groups .However ,the incidence of leucope‐nia above Ⅲ degrees was 34 .8% in pemetrexed combination group ,and 60 .0% in paclitaxel combination group(χ2 = 5 .469 ,P=0 .019) .The incidence of of ALT increase above Ⅲ degrees was 12 .2% in pemetrexed combination group ,and 35 .0% in paclitaxel combination group(χ2 =7 .238 ,P=0 .007) .The incidence of AST increase rate above Ⅲ degrees was 13 .0% in pemetrexed combi‐nation group and 32 .5% in paclitaxel combination group(χ2 = 4 .706 ,P= 0 .030) .The incidence of neurotoxicity was 28 .2% in pemetrexed combined group ,65 .0% in paclitaxel combined group (χ2 = 11 .652 ,P= 11 .652) .The incidence of gastrointestinal tract reaction above Ⅲ degrees was 47 .8% in pemetrexed combined group ,57 .5% in paclitaxel combined group was ,(χ2 = 0 .803 , P=0 .370) .Cox regression analysis revealed that PS score(HR=0 .207 ,95% CI:0 .090-0 .479) and clinical stages(HR=0 .089 , 95% CI:0 .041-0 .191) had significant effects on survival of patients .Conclusion Two kinds of treatment in two groups showed the similar curative effects and promised to be first‐line chemotherapy strategy for postoperative patients with NSCLC .However , the pemetrexed combined group showed less drug toxicity compared with that of the paclitaxel combined group .

Objective To study the metabolic change of proton magnetic resonance spectroscopy (1 H-MRS)in the visual cortex and optic radiation region of patients with diabetic retinopathy (DR).Methods 1H-MRS was performed in 20 patients with DR and 20 healthy volunteers on GE 1.5 T MR system respectively.Metabolic peaks of N-acetylasparte(NAA),creatine(Cr,in 3.02 and 3.94 ppm),choline-containing compounds(Cho)and myo-inositol(mI)were observed,and the ratios were analyzed by each other.Independent-samples t test was performed between two sets of data.Results In both visual cortex and optic radiation,the ratios of ml/Cr and mI/CrSee in DR group(0.664 ± 0.052 and 1.453±0.068 in visual cortex,0.717±0.074 and 1.484±0.114 in optic radiation)were significant higher than those in normal group(0.602±0.047 and 1.249±0.044 in visual cortex,0.679 ± 0.075 and 1.334±0.089 in optic radiation,P＜0.05).In DR group,the ratios of CrSec/Cr,Cho/Cr and NAA/Cr in visual cortex and optic radiation were 0.458±0.043 and 0.488±0.052,0.481±0.057 and 0.807±0.110,1.633±0.105 and 1.709±0.140 respectively.In control group.the ratios of those were 0.484±0.041 and0.502±0.056,0.471±0.065 and 0.786±0.109,1.625±0.098 and 1.716±0.135 respectively.The ratios of CrSec/Cr,Cho/Cr and NAA/Cr had no statistic difference between two groups(P＜0.05).Conclusion mI/CrSec is a typical change in the visual cortex and optic radiation region,1H-MRS as a noninvasive examination could provide biochemical and metabolic informations for diabetic patients.

Female ; Hemifacial Spasm ; etiology ; Humans ; Male ; Mastoiditis ; complications ; Middle Aged

Bone Marrow Transplantation ; Corneal Transplantation ; Heart Transplantation ; Humans ; Kidney Transplantation ; Liver Transplantation ; Lung Transplantation ; Organ Transplantation ; Poisoning ; etiology ; surgery

The bleeding in liver resection is an important factor influencing the operation risk and postoperative out comes.Hepatic vascular exclusion technique is an effective method to control the bleeding,which has been improved after being widely used in clinical practice.In this paper,the research progress on the clinical application of various kinds of hepatic vascular exclusion techniques was reviewed.

Objective To evaluate the outcomes of open reduction and internal fixation of complex tibial plateau fractures with improved three combined approaches.Methods In the period from July 2014 to February 2016,7 complex tibial plateau fractures underwent surgical treatment.These patients included 5 male and 2 female,aged from 24 to 68 years old (average,39.7± 15.3 years).According to Schatzker classification,they were all of type V.And all of type 41B-3.1 by AO/OTA classification.All these fractures were exposed and reduction via three combined approaches.First let the patients lied in lateral prone position,expose the anterolateral and the posterolateral of the tibia1 plateau,and fix the fractures of the posterior in the posterolateral approach,then fix the fractures of the lateral in the anterolateral approach.Then turn the patients to supine position,fix the fractures of the medial in the anteromedial incision.All patients received regular reexamination.The knee function was evaluated at the final follow-up using The Hospital for Special Surgery (HSS) score,the activity of the knee was evaluated by Lysholm score,and the stability of the knee was checked by Lachmantest and Pivot-shift test.The tibial plateau angle,the posterior slope angle and Rasmussen X-ray score were assessed on the X-ray films.Results The average time of operation is (3.3±0.9) h,and the hemorrhage volume in operation was (341± 106) ml for the 7 patients.The wounds of 6 patients healed by (11.8± 1.3) days,while the wound of the rest one of them occurred fat liquefaction after operation who is very fat (BMI ＞ 30) and suffered from diabetes.His wound healed by 21 days.These patients obtained follow-ups of 8 to 14 months (average,11.4±2.8 months).The average full weight-bearing time was 2-3 months (average,2.5±0.4 months).The fractures healed after 8 to 16 weeks (average,11.1 ±2.8 weeks).No displacement of the fractures or breakage of the implants occurred in our series.Nobody has activity limitation of the knee or pain because of the implant,and no never symptoms were noted postoperatively,so we would not take out the implant for these patients.The mean HSS score was 93.1±4.8 (range,from 85 to 100) at the final follow-up,and the excellent rate is 100％.The Lysholm score was 97.1±3.6 (range,from 90 to 100) at the final follow-up.The Lachman test and the Pivot-shift test were negative in our patients,and the mean knee flexion was 128.6±12.8°(range,from 105°to 140°).The fractures were all anatomical reduction by the X-ray after operation,and there had being no displacement of the fractures or breakage of the implants occurred during the follow-up period.The mean posterior slope angle was 8.29±2.87° (range,from 4 °to 12°),which was 8.71±2.63° (range,from 5 °to 14°) 6months after operation.The mean tibial plateau angle was 86.00± 1.41° (range,from 84 °to 88°),which was 86.43± 1.62° (range,from 84 °to 89°) 6 months after operation.The mean Rasmussen X-ray score was 16.86±1.57 (range,from 14 to 18),which was 16.57±1.51 (range,from 14 to 18) 6 months after operation,and the excellent rate are 100％.Conclusion For the complex tibial plateau fractures which simultaneous involved the medial,the lateral and the posterior,the improved three combined approaches showed the advantages of the convenient operation,the satisfactory results of reduction and fixation,and the less trauma and secondary damage,and could be worth for clinic.

Objective: To discuss the methods and items for clinical linear accelerator (Clinac) and 3D treatment planning system (TPS)/intensity modulated radiotherapy(IMRT) system based on 2D ionization chambers array(2D-ICA). Methods: The 2D-I-CA laid on the anthropomorphic phantom with five centimeters and which was put on another five centimeters same phantom.All data have gained as following conditions: the SAD is 100 cm and the SSD is 90 cm; the fields' size are 2 cm, 5 cm, 10 cm,15 cm ,20 cm respectively and 2 cm×10 cm ,5 cm×20 cm ,20 cm×5 cm, MU=100 cGy;the Clinae and TPS were verified by some special items for checking their dose accuracy, such as, square fields, rectangular fields, and rectangular fields with 600 wedge or 300 wedge, which were measured for verification their flatness and symmetry. And some measured items were only for checking multileaf collimator (MLC) and TPS calculated accuracy. So, we developed moveable MLC fields and IMRT plans and compound fields to evaluate leafs side effects and leafs end effects and transmission effects. Results: The flatness value of square and rectangular fields was 100.07%～102.66%,and their symmetry value was 0.10%～1.49%; and these irradiate fields' size were compared with light fields' sizes, which the X direction deviation was-1.5%～0.7% ,the Y direction deviation was-1.4%～1.0%,and their average value was-0.47%.To verify calculated data for TPS ,we developed Gamma value and ab-solute value (<4%)to evaluate their accuracy. For square and rect-angular fields, The Gamma value was 92.02%～96.35%.In com-pound fields Which were composed with two half fields (X1 = 5 cm, X2 =0 cm, Y= 10 cm and X1 = 0 cm,X2 = 5 cm, Y=10 cm),the maximum deviation was about 5%.And five fields (2 cm×10 cm) composed one fields (10 cm×10 cm),the maximum deviation was about 10% in the joint place. The Gamma value of one fields was 96.6%, another was 93.2% in the moveable fields. Conclusions: To dollop 2D ionization chambers array to verify the dose for Clinac and TPS, it was so quick and simple, and it was important that it bring more accurate dose evaluation and more clinical quality assurance and quality control methods.

Objective To detect the expression of microRNA(miRNAs)in the late stage terminal hindgut de-velopment in fetal rats.Methods Twenty -four female rats were randomly divided into 2 groups.They were matched in proportion of male and female 21 .The experimental rats(n =1 2)received 1 0 g/L ethylenethiourea (1 25 mg/kg)by gavage on gestational day 1 1 ,and the control rats (n =1 2)received same amount of distilled water.The fetal rats were obtained by caesarean section on the gestational day 1 6 in each group.One centimeter rectum was taken out from 2 similar weight fetal rats for extracting total RNA by Trizol method.There were 24 fetal rats in each group.Chip hybri-dization was conducted after Poly(A)and biotin added to the RNA.Then,the chip was washed and dyed,and scanned thereafter.According to the differences in the expression profile of miRNAs and target gene analysis results,the miRNAs probably regulating the key gene of hindgut development was selected for target genes expression analysis.Results Compared with control group,expressions of 1 1 1 miRNAs in terminal hindgut of experimental group were up -regulated on the gestational day 1 6,and 1 1 7 miRNAs were down -regulated.Ten miRNAs of biggest differential expression be-tween them were selected for target genes prediction,pathway analysis,and Gene Ontology analysis.The results showed that some genes were closely related to rat fetus terminal hindgut growth and development,such as Shh,Hoxd13,and so on.According to the differential expression of miRNAs and target genes analysis,miR -1 93 might have an important role in the Hoxd13 gene for anorectal development.Real -Time PCR and Western blot showed that the expression of Hoxd13 and its protein level were significantly decreased when miR -1 93 highly expressed in rat intestinal epithelial cells,and the difference was statistically significant compared with the control group(1 .00 ±0.1 2 vs 0.71 ±0.1 0) (0.88 ±0.06 vs 0.75 ±0.08)(t =3.329,3.1 30;P =0.029,0.01 1 ).Conclusions miRNAs probably have an im-portant regulatory role in their target gene expression in terminal hindgut development of fetal rats,and miR -1 93 can significantly inhibit the expression of Hoxd13 gene in rat intestinal epithelial cells.