ObjectiveTo evaluate the therapeutic effect of endoscopic full-thickness resection (EFTR) for gastric stromal tumors.MethodsA total of 33 patients with gastric stromal tumor orgination from deep muscularis propria layer received EFTR from January 2010 to July 2011.The effectiveness and safety of EFTR were compared with those of other 34 patients with gastric stromal tumor origination from muscularis propria layer who underwent endoscopic submucosal dissection (ESD).ResultsExcept in 2 patients with lesions larger than 3.0 × 3.0 cm,EFTR was successful in others 31 patients,who recovered well and had no recurrence during the follow-up within 12 months.There were no significant differences in resection rate,incidence of complications,body temperature,white blood cell counts or recovery time between 2 procedures (P ＞ 0.05 ).However,the number of clips used in EFTR ( 7.0 ± 3.5 vs.4.9 ± 3.1,P =0.013 ) and postoperative fasting days (3.4 ± 1.5 vs.2.0 ± 1.0,P =0.001 ) were significantly higher than those of ESD procedures.ConclusionEFTR is effective and safe for gastric stromal tumors with no higher risk than ESD,but it is more complex technically.EFTR can be used as an expanding method of ESD in endoscopic treatment of gastric stromal tumors.

Objective:To investigate the Foxp3 expression in murine model of type 1 diabetes mellitus and the effects of Foxp3 in the pathogenic mechanism of type 1 diabetes mellitus.Methods:Type 1 diabetes mellitus of mouse was induced by STZ.The Foxp3 expression in the spleen cells was detected at the mRNA level by RT-PCR and at protein level by Western blot.The percentage of CD4+CD25+ Treg cells in the spleens were detected by Flow cytometry.Results:The expressing levels of Foxp3 mRNA and scurfin in the model group was higher than those of control group within the first week after induction,but the expressing level of Foxp3 mRNA and Scurfin began to decrease on day 7 and were lower than those of control group on day 30.The percentage of CD4+CD25+ Treg cells in model group was similar with that of control group within the first week after induction,but after day 7,the percentage of CD4+CD25+ Treg cells in model group began to get lower than contol group.Conclusion:The expressing level of Foxp3 is decreased,then the proportion of CD4+CD25+ Treg cells is decreased accordingly,which may contribute to the pathogenic mechanism in type 1 diabetes mellitus.

OBJECTIVE:To evaluate the efficacy and toxicity of paclitaxel combined with cisplatin in the treatment of advanced non-small cell lung cancer(NSCLC) by weekly-,biweekly- and three-weekly-regimens.METHODS:180 patients who had been confirmed by pathology and cytology as having NSCLC(Ⅲ～Ⅳstage) were enrolled into the study and divided to three groups:Biweekly - regimen(n= 60):paclitaxel 80 mg?m~(-2) plus cisplatin 40 mg?m~2 ivgtt on day 1 and day 8 in every 21 days;Weekly- regimen(n= 60):paclitaxel 55 mg?m~(-2) plus cisplatin 30 mg?m z ivgtt on day 1,8,and 15 in every 28 days;Three - weekly regimen(n = 60):paclitaxel 160 mg?m~(-2) plus cisplatin 80 mg?m~(-2) ivgtt on day 1 in every 21 days.Serum concentrations of paclitaxel at 3,12,24 h after administration were determined,and the efficacy and toxicity after two- cycle treatment were evaluated.RESULTS:The overall response rates of weekly-,biweekly -and three weekly regimens were 43.1%,35.8%and 34.0%respectively,showing no statistical differences among groups,but the incidence of main toxicities of biweekly-regimen was lower as compared with the other regimens.CONCLUSION:Biweekly -regimen is optimal for the treatment of advanced NSCLC with mild toxicity,which deserves to be applied in clinical practice.

Xiyanping is used to treat infectious diseases with antibiotics in clinic. The aim of this study is to investigate the mechanism of Xiyanping through studying the effect of the combination of Xiyanping with Cefazolin on the chemotaxis and phagocytic function of peripheral blood neutrophils in mice. Ten healthy mice were in control group. Forty healthy mice in experimental group were infected with staphylococcus aureus, and were randomly divided further into four groups, i. e. model group, Xiyanping group, Cefazolin group and combination group (Xiyanping with Cefazolin). Mice in the control group and model group were given normal saline (NS) through abdomen while those in other groups were given Xiyanping, Cefazolin, and Xiyanping with Cefazolin, respectively. The chemotaxis of peripheral blood neutrophils was detected with the transwell method, and the phagocytic function of peripheral blood neutrophils was analyzed with flow cytometry (FCM). In the present study, there was no significance on the chemotactic index of peripheral blood neutrophils in all the groups (P > 0.05). The actual phagocytotic rate and index of peripheral blood neutrophils in the blank group, Xiyanping group, and the combination group were significantly higher than those of the model group and Cefazolin group (P < 0.05). However, those were not significant in the blank group, Xiyanping group, and the combination group (P > 0.05) or between the model group and Cefazolin group (P> 0.05). Our results suggested the combination of Xiyanping and Cefazolin could enhance the therapeutic effect by improving the phagocytic function of peripheral blood neutrophils.
Animals ; Anti-Bacterial Agents ; pharmacology ; Cefazolin ; pharmacology ; Chemotaxis ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacology ; Mice ; Neutrophils ; cytology ; drug effects ; Phagocytosis ; Staphylococcal Infections ; immunology ; Staphylococcus aureus

Objective To compare radiation dose and image quality between prospective electrocardiograph(ECG)-triggered axial seau and retrospective ECG-gated helical scan in coronary 64-slice CT angiography(CTA).Methods Seventy-seven consecutive patients[group A.Average body mass index (BMI):24.6,heart rate＜70 bpm]underwent 64-slice CTA using prospective ECG-triggered axial scan protocol(120 kV,mA tailored to BMI).For each patient,the simulated radiation dose using retrospective ECG-gated scan protocol without ECG-driven X-ray current modulation technology was calculated and recorded at sanle kV and mA.Retrospective ECG-gated scan protocol was performed on 30 consecutive patients in another group(group B.Average BMI:23.9,heart rate＜70 bpm).The image quality was blindly evaluated between group A and B(paired t-test was used and P＜0.05 as a significant difference).Results There Was a significant difference(t=18.50,P＜0.01)between radiation dose of group A (3.37 mSv)and that of group B(18.13 mSv),decreased by 81.4%.The image quality of group A could fulfill clinical diagnostic needs.The average radiation dose of using simulated helical scan without optimization was 17.29 mSv,which wag similar to that of group B(18.13 mSv)(t=0.87,P＞0.05).Condusion Prospective ECG-triggered axial scan in 64-slice coronary CTA Call significantly reduce radiation exposure and the image quality can fulfill clinical diagnostic needs.

When MR image's area is too small compared with the whole picture, the use of the current auto-window algorithms usually gets poor clarity and contrast. In order to address this problem, an improved auto-window algorithm is proposed in this paper and can solve the problem effectively and get clear and rich layers of MR images quickly and easily.
Algorithms ; Image Interpretation, Computer-Assisted ; methods ; Magnetic Resonance Imaging ; methods

Objective To evaluate the clinical efficacy of the local drug resistance spectrum antibiotics and foreign guideline in the treatment of patients with community acquired pneumonia(CAP). Methods A prospective,randomized,single blind,and positive drug parallel controlled design was used in the treatment. CAP patients with no underlying disease outpatients and inpatients<48 hours were selected as the research object. The patients in the trial group were given sensitive local drug resistance spectrum antibiotics: moxifloxacin,400 mg and 1 times a day. The patients in the control group were given azithromycin tablets(each 500 mg,once daily) promulgated by the 2007 version of the IDSA / ATS adult CAP guideline. Results There were 106 cases of CAP patients,of which 77 cases completed treatment,including 39 cases in the experimental group and 38 cases in the control group. There were significant differences in the clinical efficacy and bacterial clearance rate between the two groups,with the clinical efficacy of 89.7% and 68.4%(P < 0.01),the bacterial clearance rate of 87.9% and 54.5%(P < 0.05),respectively. Conclusion The clinical efficacy of drug resistant spectrum sensitive antibiotics in the treatment of CAP in Kunming was better than that of IDSA/ATS. Clinicians should pay attention to the characteristics and composition of resistance of common pathogenic bacteria in our country during the study and reference from foreign guideline,and adjust the therapeutic regimen according to the changes of the local drug resistance monitoring data rather than copy the recommended treatment plan by foreign countries.

ABSTRACT:The virulence genes ,hemolytic and antibiotic resistance characteristics from 19 isolated Streptococcus suis se‐rotype 2 in Anhui Province were investigated in this study .The PCR method was developed for detecting cps2J ,mrp ,ep f and sly gene;the plate method and micro‐ELISA were developed for detecting the hemolytic type and hemolytic titer ;the K‐B method was developed for detecting antibiotic resistance of 25 kinds of antibiotics .Results showed that there were 11 strains with the dominant virulence genotype of cps2J+ /mrp+ /ep f+ /sly+ accounting for 57 .9% .All strains were α‐hemolysis orβ‐hemolysis ,with hemolytic titer of 1∶4 to 1∶128 .Strains sensitive to rifapentine ,ceftazidime ,florfenicol and cefazolin was existed in high frequency with the sensitive rates for 84 .2% ,and the resistance to doxycycline ,tetracycline ,bacitracin and sul‐famethoxazole was existed in high frequency with the resistance rates for 82 .9% .The multi‐antibiogram typing was doxycyc‐line ,tetracycline ,bacitracin and sulfamethoxazole account for 63 .2% .In conclusion ,the distribution of virulence genes of S .suis 2 Anhui isolates was similar with that of domestic reported strains ,and there was some differences with that of over‐seas reported strains .CPS ,MRP ,EPF and SLY are important virulence factors and the incompleteness of sly gene had no effect to its haemolyticus .The multi‐antibiotic resistance of S .suis 2 Anhui isolates was serious .There is difference for anti‐biogram typing between S .suis 2 Anhui isolates and those in other areas .

Objective To investigate the distribution and constituent of drug‐resistant bacteria of lower respiratory tract in‐fection among different regions (outpatient department ,wards ,RICU) to provide the basis for the clinical reasonable application of antimicrobial agents .Methods The K‐B disc diffusion method and the instrument method (VITEK‐TWO) were adopted and the detection results were interpreted according to the standards of CLSI 2010 .The detection data of 480 drug‐resistant strains isolated from the sputum ,branchoalveolar lavage fluid samples submitted in 3 regions of respiratory outpatients department by bacterial cul‐ture identification and drug susceptibility test were analyzed by using the WHONET5 .6 statistical software .Results The distribu‐tion and constituent of drug‐resistant bacteria of lower respiratory tract infection had obvious difference among 3 different regions . The top 4 of drug resistant bacteria were dominated by Gram‐negative bacteria .The drug resistance rate of Klebsiella pneumoniae in RICU was higher than that in the respiratory outpatients department and wards(P<0 .05) ,the resistance rate in the respiratory outpatients department ,wards and RICU to commonly used antibacterial drugs was similar;the multiple drug resistance of ESBLs‐producing strains was obviously higher than that of non‐ESBLs‐producing strains (P<0 .05) .Pseudomonas aeruginosa maintained the higher antibacterial activity to quinolone ,aminoglucosides ,cefepime ,imipenem ,cefoperazone/sulbactam ,and piperacillin/tazobactam ,but the resistance rate in RICU was significantly higher that in the respiratory outpatient department and wards (P<0 .05);the drug resistance of Acinetobacter baumanii in the respiratory wards and RICU was higher than that in the respiratory out‐patient department ,the resistances to imipenem were 64 .6% and 70 .4% respectively .The resistance of MRSA to rifampin in RICU was higher than that in the respiratory outpatient department and wards(P<0 .05) .Conclusion The distribution constituent and drug‐resistance rates have obvious differences among the respiratory outpatient department ,wards and RICU .Except being familiar with the drug resitant bacterial distribution and drug resistance rate monitoring situation ,clinical doctors should grasp the drug re‐sistance situation of drug resistant bacteria among different areas in various departments of own unit in order to rationally and effec‐tively use antibacterial drugs .

Objective Implement etimicin polymethylmethacrylat (PMMA) bone cement implantation treatment for the postoperative patients suitable with intramedullary infection after open fracture surgery,and observe the efficacy,provide new ideas for clinical treatment.Methods Selected 60 patients in Second People's Hospital of Kunshan from Jan.2009 to Dec.2016 whose infection was confined to the fracture caused by trauma after the internal fixation.Thirty cases of etimicin bone cement implantation were treated group,30 cases of CEMEX GEN antibiotic bone cement (containing gentamicin) implantation were control group.The internal fixation was taken out of 9 cases of autogenous PMMA bone graft with bone cement cover in the treatment group,debrided and taken first phase of bone grafting internal fixation combined with etimicin PMMA bone cement,21 patients with direct bone cement filling underwent surgery to remove the internal fixation devices,debridement cavity filling etimicin bone cement.Six months later when the infection was controlled,the second phase of autogenous bone graft fixation was done.Ten cases of autogenous bone graft with bone cement cover in the control group,debrided and taken first phaes of bone grafting internal fixation combined with CEMEX GEN antibiotic bone cement (containing gentamicin).Twenty patients with direct bone cement filling underwent surgery to remove the internal fixation devices,debridement cavity filling CEMEX GEN antibiotic bone cement (containing gcntamicin).Six months later when the infection was controlled,the second phase of autogenous bone graft fixation was done.SPSS 19.0 software was used for statistical analysis.The t test was used for measurement data,and the counting data were checked by chi-square.Results The pathogens were mainly staphylococcus aureus and coagulase-negative staphylococci.Thirty-seven strains of pathogenic bacteria were detected with MIC ≤ 2 mg/L in the treatment group,which was in the safe and effective drug concentration range of etimicin(MIC ≤ 12 mg/L).Thirty strains of pathogenic bacteria were detected with MIC ≤ 8 mg/L in the control group,which was in the safe and effective drug concentration range of gentamicin(MIC ≤ 12 mg/L).The average follow-up period of the treatment group was 11.2 months (range 8 to 24 months),29 cases were controlled.The average follow-up period of the control group was 15.6 months (range 6-35 months),24 cases were controlled.The difference of infection control rate between treatment group and control group was statistically significant (x2 =4.043,P =0.044).Conclusion The complete debridement,a lot of washing,and etimicin bone cement implantation can effectively control the infection after the internal fixation of fracture and reduce the recurrence,which can be used in clinical practice.