Desmoplastic small round cell tumor( DSRCT) is a kind of highly uncommon malignant tumor which is reported in very recent years.Since it has been firstly reported by Gerald in 1991,DSRCT has only a-round one hundred reported cases globally, and very limited cases domestically.This report illustrates the first case of DSRCT in our hospital so as to share and to discuss with clinicians.

OBJECTIVE:To study the anti-inflammatory effect of Fukang granules (FK,prepared from traditional Chinese herbs,such as Radix Astragali,Radix Codonopsis,Angelica sinensis,etc.). METHODS:The anti-inflammatory action of FK was studied by carrying out rat paw edema test,mouse auricular swelling test,rat chronic pelvic inflammation test and rabbit salpingitis test.RESULTS:FK could lessen rat paw edema,mouse auricular swelling and rat pelvic inflammation and rabbit salpingitis,reduce blood viscosity and blood reduction viscosity and the coefficients of cell aggregation and thrombosis. CONCLUSION:FK has anti-inflammatory effect and the action of activating blood circulation to dissipate blood stasis.

ObjectiveTo observe the effect of combined acupuncture-medication anesthesia on visceral function of patients undergone laparoscopic cholecystectomy, and to furtherexplore its clinical and theoretical significance.MethodSixty patients who were going to receive laparoscopic cholecystectomy were enrolled and randomized into an observation group (combined acupuncture-medication anesthesia) and a control group (conventional general anesthesia) by the random number table, 30 subjects in each group. The total bilirubin (TBIL), alanine aminotransferase (ALT), aspertate aminotransferase (AST), urea nitrogen, creatinine, and Mini-Mental State Examination (MMSE) were observed to evaluate the effect of combined acupuncture-medication anesthesia on visceral function of patients undergone laparoscopic cholecystectomy.ResultBefore operation, there were no significant differences in TBIL, ALT, urea nitrogen, creatinine, and MMSE between the observation group and the control group (P>0.05), while the AST level of the observation group was significantly higher than that of the control group before operation(P<0.05). On post-operation day 1, there were no significant differencesin comparing ALT and AST levels between the two groups (P>0.05); the TBIL level in the observation group was significantly lower than that in the control group (P<0.01); there were no significant differences in comparing the urea nitrogen and creatinine levels between the two groups (P>0.05). The MMSE score of the observation group was significantly higher than that of the control group 6 h after the operation (P<0.01). on post-operation day 1, there was no significant difference in comparing MMSE score between the two groups (P>0.05).ConclusionThe combined acupuncture-medication anesthesia and conventional general anesthesia play equal effects on liver and kidney functions in laparoscopic cholecystectomy, thus the two anesthesia methods are both safe andeffective. The combined acupuncture-medication anesthesia has certain protective effects on brain function in early stage, and possibly produces certain protective effectson liver function.

Objective To investigate the damage mechanism of fluetuant high glucose on the INS-1 cells (pancreatic β-cell lines).Methods The cells were divided into five groups:the control groups (A group:5.5 mmol/L of glucose),the continuing high glucose group (B group:16.7 mmoL/L of glucose),the fluctuant glucose group ( C group:16.7 mmol/L of glucose for cultivation for 2 h,then the concentration changed to 5.5 mmol/L for cultivation for 3 h,which was repeated 3 times per day;the ceils were kept in the medium containing 5.5 mmol/L of glucose during night time for 9 h),the continuing high glucose plus NAC ( 1.0 mmo/L) group ( D group),the fluctuant glucose plus NAC group ( E group).The intracellular reactive oxygen species (ROS) was observed by the flow cytometry.The activity of glucose-6-phosphate dehydrogenase (G6PD) was estimated by the tetrazolium linked cytochemical method.Results 72 h after intervention,the levels of ROSwere 37.77±2.31,86.97±7.97,124.27±10.04,60.92±2.61 and 51.47±3.36,respectively,in A～E group;the activities of G6PD were 1.25±0.03,1.09±0.02,1.03±0.01,1.12±0.02 and 1.21±0.01,respectively;the levels of NADPH were (0.123±0.003) mmol/mg prot,(0.112±0.004) mmoL/mg prot,(0.099±0.002 ) mmol/mg prot,( 0.116±0.005 ) mmol/mg prot and ( 0.120±0.002) mmol/mg prot,respectively.The level of ROS in the cells of the fluctuant glucose group were significantly higher than that in the continuing high glucose group ( P ＜ 0.01 ).The G6PD activity and NADPH was significantly lower in fluctuant high glucose group than those in the continuing high glucose group (P ＜0.01 ).NAC co-cultivation decreased the extent of cell's change.Conclusions Exposure of INS-1 to high glucose lead to increased oxidative stress, possible mechanism included decreased G6PD activity and subsequent imbalance between oxidation and reduction.

Objective To investigate the impact of HLA-A antigens carrying Bw4 epitopes on disease course of HIV-1 infection.Methods Three hundred and forty subjects chronically infected with HIV-I were recruited and their HLA-A and B alleles were genotyped with sequence-based high resolution typing assay.HLA-Bw genotypes of these HIV-1 infected subjects were determined and their association with CD+4 T cell counts and viral load were analysed.Results When compared with subjects canting no Bw4 epitopes in HLA-A and HLA-B loci (OBw4) (median of CD+4 T cell counts:294/μ1;plasma viral load median 6.29×104 copies/ml),CD+4 T cell counts in subjects with genotypes of 1Bw4-A and 2Bw4-AA were comparable (307 and 308/μ1,respectively),but higher viral load (1.53×105 and 2.68×105 copies/ml,respectively) was observed.In subjects with Bw4 epitopes in HLA-B alleles but no in HLA-A,significantly higher CD+4 T cell counts (417/μ1,P=0.013) and lower viral load (2.10×104 copies/ml,P=0.007) were observed compared with those without Bw4 in HLA-A and HLA-B.Conclusion HLA-B antigens carrying Bw4 epitope were protective in HIV-1 infection by maintaining higher CD+4 T cell counts and lower viral load,but such protective effect was not observed in HLA-A antigens earring Bw4 epitope.

The ITS/ITS2 barcodes were used to simply and effectively identify Codonopsis Radix and its adulter-ants. In this study, ITS (internal transcribed spacer of unclear ribosomal DNA) regions were amplified using PCR (polymerase chain reaction) from thirty-three samples of Codonopsis Radix and ITS2 regions were obtained from the ITS sequences using the hidden Markov model (HMMer)-based annotation methods. The sequences of ITS/ITS2 regions were aligned and the genetic distances were computed by MEGA5.0. Species identification efficiency of ITS/ITS2 sequences were evaluated using BLAST1 and nearest distance methods. The results indicated that The sequences lengths of ITS regions of Codonopsis Radix were 654-655 bp, and the lengths of ITS2 regions were 239 bp. The intraspecific genetic distances among Codonopsis Radix were obviously lower than the interspecific genetic distance between Codonopsis Radix and its adulterants. Therefore, ITS/ITS2 regions can stably and accu-rately distinguish Codonopsis Radix and its adulterants.

Objective To clone the human Islet neogenesis associated protein(rhINGAP)gene,express the gene extraeellulary in Pichia yeast for.further study on biological function and animal test on INGAP.Methods INGAP gene Was amplified with PCR and inserted into the recombinant plasmidα/pUC18.Then,the fusion gene of α and INGAP was digested and inserted into the expression plasmid pPIC9K.The positive recombinant plasmid which integrated INGAP Was confirmed by restriction enzyme digestion and sequencing,and it Was linearized with Sal Ⅰ digestion and transfered into the yeast host strain GS115 through electroporation.The yeast transformants that harbor the desired gene INGAP with high copy were selected by the auxotroph mediam G418,and verified by PCR.The condition of hake-flask culture was optimized,and the recombinant human INGAP Was induced expression with methanol as the only Carbone source.The antigen activity of the desired protein Was detected by Western blotting and ELISA method.Results Recombinant plasmid αINGAP/pPIC9K were successfully constructed and three positive Pichia yeast transformants were obtained.The expressed protein had satisfactory antigen activity,which Was confirmed by the Western blotting and ELISA method.Conclusions Pichia yeast expressing human Islet neogenesis associated protein (rhINGAP)gene was successfully constructed.

Objective:To explore the application of enhanced recovery around surgery (CMERAS) by integrated Traditional Chinese Medicine & western medicine in perioperative period of laparoscopic anterior resection for rectal cancer patients.Methods:100 patients with rectal cancer who were treated by laparoscopic anterior resection in Shuguang Hospital from July 2017 to July 2019 were divided into two groups with random number table method, 50 patients in each group. The control group received enhanced recovery after surgery (ERAS) perioperative treatment and the observation group received CMERAS perioperative treatment. Both groups were treated for 7 days. The degree of intestinal cleansing during the operation and postoperative rehabilitation quality were observed of the two groups, including the time of first exhaust, hospitalization time and the incidence of complications. Serum CRP level was detected by immunoturbidimetry, serum IL-6 level was detected by chemiluminescence immunoassay and peripheral blood CD4, CD8 and CD4/CD8 were detected by flow cytometry. Adverse reactions were recorded for the two groups.Results:There was no significant difference in the degree of intestinal cleansing between the two groups during operation ( Z=-1.140, P=0.254). The first postoperative exhaust time in the observation group (29.7 ± 4.6 h vs. 36.1 ± 3.8 h, t=7.590) was earlier than that of the control group, the hospitalization time (4.2 ± 0.5 d vs. 4.7 ± 0.6 d, t=4.379) was less than that of the control group, and the incidence of complications [8.0% (4/50) vs. 30.0% (15/50), χ2=6.498] was lower than that of the control group ( P<0.01). On the third day after the operation, serum CRP (11.84 ± 4.69 mg/L vs. 23.63 ± 5.04 mg/L, t=12.106) and IL-6 (34.31 ± 5.93 ng/L vs. 44.39 ± 8.81 ng/L, t=6.714) in the observation group were lower than those in the control group ( P<0.05). CD4 levels [(37.74 ± 7.28)% vs. (33.55 ± 5.07)%, t=-3.344], CD4/CD8 ratio (1.36 ± 0.27 vs. 1.13 ± 0.22, t=-4.920) were higher than those in the control group ( P<0.01), and CD8 levels [(28.04 ± 4.68)% vs. (30.22 ± 4.04)%, t=2.487] was lower than that of the control group ( P<0.05). There were no adverse reactions in two groups during the treatment. Conclusion:CMERAS could promote the perioperative recovery of patients with rectal cancer if treated with laparoscopic anterior resection and fewer complications would occur.

Objective To investigate the effect of medical rescue of the Maritime Medical Team (Corps) for mass sick and wounded in maritime disaster so as to improve the medical rescue capacity for maritime disasters.Method The construction of maritime medical teams (corps) constituted with various numbers of 10, 15,50 and 120 team members, and the development of algorithm in practice were reviewed. In 68 maritime disasters from January 2003 to December 2009, 937 wounded were rescued by first-aid at sea. The patients were classified and given cardiopulmonary cerebral resuscitation, emergency operation, complication prevention, comprehensive treatment for seawater immersion wound and rapidly referred to hospitals. Results Of 937 patients, 872 survived (93%) and 65 died (7%). Of the dead, 16 died in one hour (25%), 43 died in 24 hours after injury (66%),andofthem, 61died of trauma (94% ) , 2 died of drowning and 1 died of poisoning. Conclusions Besides a good command of the features of mass sick and wounded, organization and program, treatment strategies and measures, the timely and effective assignment for on-site first aid at sea and safe transfer were very important for medical rescue of mass patients in maritime disaster. After the practice of maritime medical team (corps) in medical rescue during maritime disaster, the rapid response capability, cooperation and the quality of rescue were improved, and the experience of medical service of marine medical team (corps) was enriched.

Objective To investigate clinical features and antifungal therapeutic effect of chronic severe hepatitis (CSH) patients with invasive fungal infection (IFI), and to improve the diagnosis and treatment.Methods Clinical manifestation, blood routine, imageology and mycetology characteristic, antifungal treatment perscription and therapeutic effect of 79 CSH patients with IFI were retrospectively analyzed. Antifungal therapeutic effect was compared between fluconazole and voriconazole. Results Thirteen (16.5%) patients received glucocorticoid or other immunodepressants for a relatively long time, 40 (50.6%) patients had invasive operation, and 61 (77.2 %) patients were administered 1-6 kinds of broad-spectrum antibiotics. Seventy-three patients had fever. Leucocytes and neutrophilic granulocyte increased in 96.2% of the patients. Lung (31.6%), intestinal tract (26.2%) and oral cavity (14%) infections were common. Fungus was found in 70.9% of the patients. Candida albicans (40.9%) and aspergillus (21.1%) were often seen. Halo signs and crescent signs on lung CT were relatively specific in 40% of the patients with fungal pneumonia. Voriconazole was more effective than fluconazole(71.4% vs. 39.0%, P<0.05). Twelve patients with lung aspergillus infection were administered voriconazole, 8 (66.7%) patients of whom was effective, and the other 4 (33.3%) patients died. Conclusion There are high risk factors in major CSH patients with IFI. The most common clinical manifestations of CSH patients with IFI are fever, leukocytosis, lung and intestinal tract infection. Candida albicans and aspergillus infection are common. Voriconazole is more effective than fluconazole, and can increase the survival rate of CSH patients with IFI.