For stage Ⅱ colon cancer patients after surgery,the benefit of adjuvant chemotherapy remains controversial.Several studies indicate that the patients with high-risk stage Ⅱ colon cancer can benefit from adjuvant chemotherapy after surgery.According to the clinical and pathological features,the stage Ⅱcolon cancer patients including T4 lesion,perforation,peritumoral lymphovascular invasion can benefit from the adjuvant chemotherapy of oxaliplatin.In the horizontal of molecular and genetic levels,the stage Ⅱ colon cancer patients can express high microsatellite instability (MSI-H) and cannot benefit from the chemotherapy of Fluorouracil.The guiding functions of 18q loss of heterozygosity (18q LOH),Cx43 and gene expression profiling in adjuvant chemotherapy are still unclear,and need further study.

Objective To understand the status of hand hygiene(HH) among patients hospitalized in departments of infectious diseases and their families in Yantai City, and provide reference for HH intervention.Methods Patients and their families(n=221) in departments of infectious diseases of secondary and above levels of hospitals as well as infectious diseases hospitals in Yantai in July-August 2015 were selected for questionnaire survey, education and implementation status of HH were investigated;hand bacteriological sampling was performed on some patients and their families (n=62) to investigate effect of hand-washing.Results 61.99% of patients and their families had received verbal HH education, only 18.55% indicated to have seen health care workers(HCWs) to perform the six step hand-washing method;50.68% of the respondents didn't understand the six step hand-washing method, and 85.52% never performed the six step hand-washing, the main reason is that they didn't know how to perform.93.21% of patients(n=206) and their families believed that hand-washing was important.The cognition of HH opportunities in daily life was relatively higher(61.54%-94.51%),and in hospital environment was relatively lower(36.15%-49.23%),only 36.15% of the families washed hands before left the hospital.Unqualified rate of detection results of sampling of hands of patients with infectious diseases and their families was 83.87%.Conclusion Patients with infectious diseases and their families are deficient in HH knowledge and behavior, medical institutions should carry out systematic and standard HH education to reduce the risk of healthcare-associated infection.

Objective To analyze the correlative factors of prognosis of neonatal stress-induced ulcer bleeding.Methods Fifty-four cases of NICU admitted stress-induced ulcer bleeding newborns were divided into mild group and severe group according to bleeding endurance,transfusion requirement,and clinical turnover.Compared with gender,gestational age,birth weight,and score for neonatal acute physiology(SNAP) Ⅱ and score for neonatal acute physiologyⅡ perinatal extension(SNAP-PE) Ⅱ of two groups.Results Based on the output of SPSS statistical package,the SNAP Ⅱand SNAP-PE Ⅱ had a significant deviation between two subgroups((?~2=)15.207,10.311 all P

Adult ; Aspergillosis ; etiology ; therapy ; Aspergillus fumigatus ; Heart Transplantation ; Humans ; Male

Clinical features and thyroid-stimulating antibody(TSAb)in 32 newly diagnosed patients with Graves' ophthalmopathy(GO)were compared with those in 27 Graves' disease(GD)patients without GO(as control group).All of the patients with GO received intravenous glucocorticoids.The level of serum TSAb in patients with GO was significantly higher than that in patients without GO.TSAb was also associated with the prognosis.It suggests that TSAb seems to be the most active component among the TSH receptor antibodies related to ophthalmopathy and may act as a predictive parameter.

Objective The aim of this study was to evaluate the feasibility of three-dimensional printing (3DP) for the preparation of porous titanium implant and to investigate the impacts on microstructure and mechanical properties with different sintering temperatures.Methods The CAD model of the specimens was designed to be 25 mm in diameter,20 mm in height,and with 0.5 mm pore size mesh.On every cross-section,80％ bonding area was designed.Titanium powder (purity of 98.5％,75 μm diameter) was selected as raw material.Polyvinyl alcohol powder (160 μm diameter) was selected as a binder,and polyvinylpyrrolidone powder was selected as an auxiliary binder.The green porous titanium implants were fabricated by 3DP followed by sintering at 1 200,1 300,1 400 ℃,separately,under the protection of argon gas.After sintering,the properties of porous titanium implants were evaluated,including the porosity,microstructure,microhardness,compressive strength and elastic modulus.Results After sintering,the specimen had uniform contraction and no obvious distortion.The specimen sintered at 1 200,1 300 and 1 400 ℃ sintering temperatures had porosity of (65.01±1.03)％,(46.73±0.73)％ and (41.06±0.31)％,hardness of 115.2±0.6,148.6±1.1 and 182.8±2.1,elastic modulus of (5.9±0.5),(16.2±0.9) and (34.8±1.5) GPa,compressive strength of (81.3±4.3),(135.4±8.5) and (218.6±7.1) MPa,respectively.A porous structure with three-dimensional network of connected pores was observed under scanning electron microscope.Conclusion It is feasible to fabricate porous titanium implants by three dimensional printing technique.The mechanical properties of the porous titanium implants match well with bone tissue which has excellent biomechanical compatibility.

Background Selective laser trabeculoplasty (SLT) is a safe and effective therapy to the treatment of primary open angle glaucoma (POAG),and the clinical application is approved by American FDA.However,the relevant researching outcomes from several single-center study are in dispute owing to non-uniform approach in China.A muhicenter clinical trial is need to verify the effectiveness of SLT for Chinese POAG.Objective This study was to investigate the safety and efficacy of SLT in Chinese POAG patients.Methods A prospective,multicenter and self-controlled clinical trail was designed.Sixty-two eyes of 62 POAG patients with the age of ≥ 18 years were enrolled.Frequency SLT was performed around 360° angle using Lumenis Selecta DuetTM or Lumenis Selecta Ⅱ laser instrument,with the 100 non-overlapping spots,3 ns preset time,400 μm size of laser spot and 0.6 mJ energy.The operated eyes were followed-up for 6 months.The curative effects were checked including intraocular pressure (IOP),IOP-lowing value,number and percentage of IOP-lowing 20％ and 30％.The therapyrelated complications were recorded including the number of conjunctival congestion and cloudy of the anterior chamber.Results The preoperative IOP was (25.7±2.6) mmHg in the 62 eyes.The IOP was significantly lowed 1 day,2 weeks,4 weeks,3 months and 6 months after SLT in comparison with preoperative IOP (all at P＜0.001) with the lowest value of (16.5±4.5)mmHg in postoperative day 1.IOP was stable from 4 weeks to 6 months after operation.The mean lowing-value of IOP was 5.3-9.2 mmHg from 1 day through 6 months after SLT.The percentage of eyes 20％ drop in lOP was 83.9％,and that of 30％ drop was 58.1％ in postoperative day 1.In 6 months after SLT,percentages of eyes 20％ and 30％ drop in IOP were 56.5％ and 27.4％,respectively.Conclusions SLT is a safe and effective method of lowing IOP for POAG eyes in Chinese population.

OBJECTIVETo investigate the clinical application of different perforator neurofasciocutaneous flaps at the distal legs for defects at the lower legs and feet.

METHODS24 patients with defects at the lower legs and feet were treated with five kinds of perforator neurofasciocutaneous flaps, including 7 flaps with the retrolateral supramalleolar cutaneous perforator, 2 flaps with the lateral retromalleolar perforator, 2 flaps with the higher cutaneous perforator of the peroneal artery, 8 flaps with the anterolateral supramalleolar cutaneous perforator of the peroneal artery, 5 flaps with the medial supramalleolar cutaneous perforator of the posterior tibial artery. The flap size ranged from 5 cm x 4 cm-14 cm x 12 cm.

RESULTSPartial necrosis occurred at the distal end of flap in one case. All the other flaps survived completely with primary healing. 15 cases were followed up for 1-36 months with satisfactory cosmetic and functional results.

CONCLUSIONSSuitable perforator neurofasciocutaneous flaps at the distal legs can be selected for differently located defects at the lower legs and feet, leaving comparatively less morbidity at donor site.

Adolescent ; Adult ; Aged ; Child ; Female ; Humans ; Leg ; surgery ; Male ; Middle Aged ; Perforator Flap ; Young Adult

Objective To evaluate the value of echocardiography in diagnosing infective endocarditis (IE) in children. Methods The shape, size, echogenicity, distribution of vegetations and valvular function of the heart were observed by transthoracic echocardiography (TTE) in 30 patients with suspected IE. We correlated TTE ifndings with the results of hemoculture and serologic test. Results Vegetations were observed in all patients by echocardiography:seven patients with tricuspid valve vegetations, two with mitral valve vegetations, three with pulmonary valve vegetations, three with main pulmonary artery vegetations, three with aortic valve vegetations, two with aortic valve abscess, and two with vegetations in right atrium. After anti-infection therapy, the size of vegetations in iffteen patients became smaller and the less echogenic than before. Vegetations disappeared in two patients. Vegetation was recurrent repeatedly in one case. Ten patients recovered after operation. Two severe cases died. Five patients underwent TTE again one week after the previous negative TTE. Of them, echocardiography demonstrated vegetations in three cases. However, no vegetations were found in rest two cases because antibiotics had been used at early stage. In addition, echocardiography demonstrated one patient with mitral valve vegetation. But the lesion was ifnally conifrmed to be operating suture. The sensitivity and specificity of TTE in detecting vegetations were 88.0% and 80.0%, respectively. Blood cultures were positive in twenty-seven cases and were negative in three cases. Conclusions The early diagnosis of IE is important to improve patient′s prognosis. It takes a long time in organism cultivation before achieving the clinical diagnosis. TTE can help obtain an early diagnosis stage of IE, and provide the assessment of size and location of vegetation. It plays an important role in treatment and prognosis prediction.

OBJECTIVETo study the relationship between JWA polymorphisms and the susceptibility to hypertension in workers exposed to heat stress.

METHODSThe exposure group included 158 steelworkers and rollers and 76 workers unexposed to heat stress served as control group. The general information was collected according to a questionnaire and the blood pressure was examined for all subjects. The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique was used to analyze the site 76 in promoter and site 723 in the 3rd exon of JWA gene in the peripheral lymphocytes. PHASE 2.0 software was utilized to calculate the haploid type.

RESULTSIn the exposure group, JWA76 G/G genotype frequencies of sub-group with normal blood pressure, sub-group with higher blood pressure and sub-group with hypertension were 82.35%, 69.70% and 65.00%, respectively, there were significant differences among 3 sub-groups (P < 0.05). JWA 76 G/G genotype frequencies decreased with blood pressure (χ² = 4.86, P = 0.027). The multiple logistic regression analysis showed that the subjects with G/C genotype were compared to the subjects with G/G genotype in the exposure group, the adjusted OR value was 3.67 (95%CI: 1.21 approximately 11.05) for the risk of hypertension and higher blood pressure. the subjects with GG/CT haploid type were compared to the subjects with non-GG/CT haploid type in the exposure group, the adjusted OR values for the risks of hypertension and higher blood pressure were 8.30 (1.39 approximately 49.44) and 8.55 (1.53 approximately 47.48), respectively.

CONCLUSIONThe gene polymorphisms at site 76 and GG/CT haploid type of JWA gene were associated with hypertension in workers exposed to high temperature.

Adult ; Blood Pressure ; genetics ; Control Groups ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Heat-Shock Proteins ; genetics ; Hot Temperature ; Humans ; Hypertension ; epidemiology ; genetics ; Intracellular Signaling Peptides and Proteins ; genetics ; Male ; Polymorphism, Single Nucleotide ; Workplace