Objective To investigate the effect of surgical treatment in left colorectal carcinoma with acute colorectal obstructive.Methods Clinical data of 70 patients with acute left obstructive colorectal carcinoma treated by emergent operation were collected.65 cases received one stage tumor resection and 5 cases received two stage tumor resection were retrospectively analyzed.Results The complication rate was 20.0%(14/70),mortality rate was 1.0%(1/70);radical surgery after 1,3,5-year cumulative survival rates were 100.0%,93.6%,66.7% wich were higher than the palliative surgery 69.2%,0.0%,0.0%(all P＜0.01);With univariate analysis,radical resection,Dukes stage,tumor differentiation,and chemotherapy were found to be significant factors associated with the overall survival(χ2 = 16.546,20.649,5.953,all P＜0.01);with the overall survival.With multivariate analysis,radical resection independently affected the overall survival(Wald = 5.877,P＜0.01).Conclusion One stage radical resection was feasible for left obstructive colorectal carcinoma,and could improve survival rate after operation.

Objective To investigate the therapeutic efficacy of lactulose combined with Bacillus subtilis duplex living bacterium in patients with constipation-predominant irritable bowel syndrome.Methods A total of 98 patients with constipation-predominant irritable bowel syndrome were divided into 3 groups according to the therapeutic drugs:lactulose group (33 cases),Bacillus subtilis duplex living bacterium group (30 cases) and combined treatment group (35 cases),and patients in all groups received mosapride.The course of treatment was 2 weeks in all groups.The symptoms of patients with abdominal pain,abdominal distention,defecate condition and quality of life before and after treatment was observed.Results The total efficacy of abdominal pain,abdominal distention in combined treatment group was higher than that in lactulose group and Bacillus subtilis duplex living bacterium group,in lactulose group was higher than that in Bacillus subtilis duplex living bacterium group,and there was significant difference (P ＜ 0.05).There was no significant difference in defecate Bristol grade before treatment among three groups (P ＞ 0.05).There was significant difference in defecate Bristol grade after treatment among three groups(P ＜ 0.05).There was significant difference in defecate Bristol grade before and after treatment in three groups(P ＜ 0.05).There was no significant difference in the quality of life before treatment among three groups (P ＞ 0.05),the quality of life after treatment in three groups was higher than that before treatment,and there was significantdifference (P ＜ 0.05).After treatment,the quality of life in combined treatment group was higher than that in lactulose group,in lactulose group was higher than that in Bacillus subtilis duplex living bacterium group,and there was significant difference (P ＜ 0.05).Conclusions The combined regimen of lactulose and Bacillus subtilis duplex living bacterium is more effective than lactulose or Bacillus subtilis duplex living bacterium alone.Thus the combined regimen of lactulose and Bacillus subtilis duplex living bacterium is an effective therapeutic method for constipation-predominant irritable bowel syndrome.

Objective To compare the impact of Telbivudine (LDT) and Entecavir (ETV) administration on estimates of glomerular filtration rate for anti-viral therapy in patients with hepatitis B virus (HBV)-related compensated cirrhosis by an open, prospective randomized controlled study.Methods Patients with HBV-related compensated cirrhosis at clinic or hospitalized in Shaoxing Municipal Hospital from January 2012 to June 2013 were included.A total of 170 patients were randomly divided into LDT (600 mg/d) or ETV (0.5 mg/d) groups at a ratio of 1∶1 according to the random number table method.All patients were treated for more than 36 months.The LDT group was optimized according to the roadmap.Patients with poor response or resistance in both treatment group were added with Adefovir dipivoxil (ADV) 10 mg/d for optimal treatment.The clinical outcome, creatinine (CR), estimated glomerular filtration rate (eGFR) of patients before and after 36 months of treatment were compared between two groups.All categorical data were analyzed using chi-square test and data accorded with normal distribution were compared by t test.Results After 36 months of treatment, the virological and biochemical responses in LDT group and ETV group were similar.The mean CR levels at month 24 and 36 in LDT group were (74.25±22.98) μmol/L and (70.72±24.75) μmol/L, respectively, which were both lower than baseline level ([83.09±17.68] μmol/L, t=2.811 and 3.145, respectively, both P<0.01).The mean CR levels at month 36 between two groups were statistically different (t=3.431, P=0.001).The mean eGFR levels at month 12, 24 and 36 in LDT group were all significantly lower than that at baseline (t=3.976,8.297 and 10.629, respectively, all P<0.01).The mean eGFR levels at month 24 and 36 between two groups were statistically different (t=9.684 and 15.019, respectively, both P<0.01).A total of 64 patients including 34 in LDT group and 30 in ETV group had mild nephritic injury at baseline.The mean eGFR in patients with mild nephritic injury at baseline in LDT group at month 12, 24 and 36 were significantly different compared to baseline (t=6.098,10.191 and 14.378, respectively, all P<0.01).The mean eGFR level at month 36 in ETV group had statistical difference compared to baseline (t=2.058, P<0.05).The mean eGFR levels at months 12, 24 and 36 were all statistical different between two groups (all P<0.01).The mean eGFR levels at month 24 and 36 in the optimized group were superior to ETV group (P<0.01).Conclusions In patients with HBV-related compensated cirrhosis, LDT and ETV treatment have similar clinical efficacy.LDT is more effective in protecting nephritic function than ETV.

4D Flow MRI is a new phase contrast MR technique,which can spatially encode velocity in three-direction,collect multi-directional blood flow data,and result in complex three-dimensional dynamic parameters.4D Flow MRI is more accurate and comprehensive than 2D phase contrast MRI and Doppler echocardiography.However,4D Flow MRI have some disadvantages,such as long scanning time,noise,etc.,which are the future key technical issues to be addressed.4D Flow MRI technology has a great potential in clinical applications,such as intracranial vascular diseases,cardiac magnetic resonance imaging,and other aspects of aortic diseases.Research advances in clinical application of 4D Flow MRI were reviewed in this paper.

Clinical novitiate is not only a significant part in the training of basic comprehensive ability of clinical medicine students,but also a weak link in current teaching practice link. This research is guided by the educational reform of the"5+3"talent training mode and it carries out reforms by constructing three-stage novitiate mode, realizing curriculum integration and PBL teaching as well as multi-dimensional performance appraisal etc.It is student-centered and lays emphasis on developing students' autonomous learning ability,basic clinical skills and thinking ability,so as to improve the training quality of the medical professionals and provide a referable novitiate teaching mode for the training of medicine professionals under the new situation.

Background and purpose: XB130 protein plays an important role in proliferation and invasiveness of tumor cells. However, there is little research on the role of XB130 protein in hepatocellular carcinoma (HCC) and the effect of XB130 is still unclear. This study investigated the role of XB130 gene in the proliferation of HCC cell and its potential mechanism. Methods: The protein expressions of XB130 in HCC cell lines, Huh7, HepG2 and SNU449, and liver cell line HL7702 were detected by Western blot. Huh7 cells were transfected with XB130-siRNA. Then cell viability was measured using cell counting kit-8 (CCK-8), and cell cycle was examined by flow cytometry. Protein expressions of p-AKT, p-GSK3β, cyclin D1 and p-Rb were detected by Western blot, while mRNA expression levels of E2F/DP1 target genes (cyclin E1, c-Myc and PCNA) were measured by reverse transcription-polymerase chain reaction (RT-PCR). Results: The relative protein expressions of XB130 in Huh7, HepG2, SNU449 and HL7702 cells were 0.66±0.10, 0.78±0.11, 0.83±0.08 and 0.32±0.06, respectively. The difference between HCC cell lines and HL7702 cell line was statistically significant (P＜0.01). The transfection efficacy of XB130-siRNA was confirmed to be highly effective in Huh7 cells, and the viability of XB130-siRNA transfected Huh7 cells declined 72 h after transfection (P＜0.001). The ratio of Huh7 cells in G0/G1 phase was increased, while the ratio in S or G2/M was decreased 48 h after XB130-siRNA transfection (P＜0.01). In addition, compared with negative control, protein expressions of p-AKT, p-GSK3β, cyclin D1 and p-Rb, and mRNA expression levels of cyclin E1, c-Myc and PCNA were all decreased in XB130-siRNA transfected Huh7 cells (P＜0.001). Conclusion: XB130 promotes the proliferation of HCC cells by regulating cell cycle-related proteins and downstream transcription factors.

Objective To obtain more insight into the genetic and structural bases of the selective advantage of new GGⅡ.4 variants over the old GGⅡ.4 variants.Methods We sequenced the complete capsid of 13 full-length GⅡ.4 norovirus virus VP1 region from 2008 to 2014 and find the key variable sites.Results GⅡ.4 norovirus virus has gone though three big variation during the past seven years.The noroviruses in 2008 and 2009 were the 2006b variant; virus detected in 2010 and 2011 were the 2010 variant ; virus detected in 2012-2014 were the latest 2012 variant.At the amino acid level,we found 77 information sites (540 amino acids in the 14.3％).39 of them located in the P2 region,N-terminal,4; S region,18; P1 region,16.Conclusions GⅡ.4 noroviruses have been recognized as a leading cause of severe viral gastroenteritis worldwide.During the past decades,four worldwide epidemics of acute gastroenteritis caused by emerging variants of GGⅡ.4 noroviruses have been described.Emerging new variant lineages replaced the previously circulating dominant types rapidly and completely.

Objective: To investigate the imaging features of cerebral small vessel disease(SVD) in systemic lupus erythematosus(SLE) patients with impaired renal function and their related risk factors. Methods: Seventy-six SLE patients and forty age- and sex-matched healthy controls were recruited, and SLE patients were divided into the impaired renal function group [estimated glomerular filtration rate (eGFR) <90 ml/(min·1.73 m²)] (n=38) and the normal renal function group [eGFR≥90 ml/(min·1.73 m²)] (n=38) according to their eGFR. All subjects underwent brain MRI, cognitive and psychiatric testing. The SVD scores were measured, total white matter hyperintensity (WMH) and SVD scores were calculated, and the risk factors of SVD scores were analyzed by using ordinal logistic regression. Results: SLE patients in the impaired renal function group showed higher basal ganglia PVS, centrum semiovale perivascular space (PVS), periventricular WMH, deep WMH and total SVD scores compared with normal controls or patients with normal renal function (H=44.568, 31.380, 31.172, 43.419, 24.317, P<0.001) . The ordinal logistic regression analysis showed that C-reactive protein was a risk factor for SVD in patients with SLE(OR=1.323, P<0.01). Conclusion SLE patients with impaired renal function had a higher SVD burden on MR imaging, particularly PVS in the basal ganglia and deep WMH, which was affected by the C-reactive protein level.

Objective:To investigate the unqualified hepatitis C virus (HCV) detection result of blood donors from the served area of blood institutions.Methods:The data related to HCV markers detected of the first and repeat blood donors were collected from the system of practice comparison for the Chinese mainland blood institutions from 2017 to 2021. The anti-HCV reactive rate and the rates of anti-HCV negative but HCV-RNA reaction and all the relationship between rates and the annual, regional and different blood donors were statistically analyzed.Results:During 2017-2021, the number of anti-HCV reactive per 100 000 blood donors decreased from 444.3 to 250.44 in the served area of 22 blood institutions ( χ2=49.677, P<0.05). The number of HCV RNA detected positive per 100 000 anti-HCV negative increased from 0.69 to 2.05 year by year, but there was no statistical significance ( χ2=0.643, P>0.05). The anti-HCV unqualified rate was significantly different among regions ( χ2=3 260.283, P<0.05). The anti-HCV unqualified rate of the first blood donors was significantly higher than that of the repeated blood donors ( F=130.993, P < 0.05). The annual number of HCV RNA detected positive per 100 000 anti-HCV negative blood samples from donors ranged from 0 to 17.28. Conclusions:The anti-HCV unqualified rate of blood donors in the served area of 22 blood institutions decreased year by year. Compared with repeated blood donors, HCV infection should be emphasized in first-time blood donors. The implementation of HCV RNA test can detect out much more HCV infections and reduce the risk of transfusion transmitted infectious HCV.

Objective To investigate antimicrobial resistance among Streptococcus pneumoniae clinically isolated from 14 teaching hospitals located at different areas in China in 2005-2008 and to give logical guidance for clinical empirical therapy.Methods A total of 1 317 non-repetitive S.pneumoniae isolates in 14 teaching hospitals from 2005-2008 were collected and sent to the central lab for reidentification and susceptibility testing, including 271 isolates collected in 2005, 391 isolates collected in 2006, 363 isolates collected in 2007 and 292 isolates collected in 2008. Most of the isolates were from community-acquired respiratory tract infections, which were isolated from outpatient or emergency department patients with respiratory tract infections or those patients with respiratory tract infections within ≤48 hours hospitalization.The districts where the organisms were isolated include North China, Northeast China, South China, Central and Northwest China and East China.The patients included adults, teenagers and children.The minimum inhibitory concentrations (MICs) or inhibitory zone diameter of 17 antimicrobial agents were determined by Etest method, agar dilution method or disk diffusion method.WHONET5.5 software was used to analyze susceptibility rate, intermediate rate, resistance rate, MIC50 and MIC90.Results Linezolid (100%) and fluoroquinolones (95.2%-99.7%) showed excellent activities against S.pneumoniae.Among β-lactams, amoxicillin-clavulanic acid remained high activities (73.8%-92.1%),followed by penicillin, ceftriaxone and cefepime with year-over-year decrease in activities.The activities of three second-generation cephalosporins were low (36.3%-38.4% in 2008).The activities of erythromycin, azithromycin, clindamycin, trimethoprim/sulfamethoxazole and tetracycline against S.pneumoniae were poor and decreased year over year.The incidence of penicillin non-susceptible S.pneumoniae (PNSP) was increasing especially for PISP (from 4.4% in 2005 to 20.2% in 2008).The incidence of PNSP in North China was low (6.0%), while this value were high in central China and East China (30.1% and 38.7%, separately).The incidence of PNSP in adults (15.7%) was obviously lower than that in children(≤5 years:33.0%) and teenagers (6-17 years:38.2%).Conclusions linezolid and fluoroquinolones showed excellent in vitro activity against S.pneumoniae, followed by penicillin and cephalosporins with year-over-year decrease of activity. Clinicians should pay more attention when using those antimicrobial agents with poor activity against S.pneumoniae, which include macrolides, clindamycin, trimethoprim/sulfamethoxazole and tetracycline.