Objective To investigate the effect of needle sizes and aspiration techniques on sample quantity. Methods Aspiration was performed on porcine liver in vitro for 10 times with three different sizes of needles(19 G, 22 G and 25 G) and four different aspiration techniques[non?negative pressure(NP), 10 ml NP,20 ml NP and slow?pull], 20 mm in depth. A total of six aspirations were performed with each needle by the same aspiration technique. All the obtained specimens were fixed in formalin with the cell block method. The samples were evacuated according to our grading criteria. Results The mean±standard deviation(SD) score for 19 G,22 G, 25 G were 5?71±0?69,4?63±1?24, 3?79±1?84 respectively. The mean±SD score for methods non?NP,10 ml NP,20 ml NP and slow?pull were 4?72±1?53,4?56±1?46,4?72±1?50,4?83±1?76 respectively. The multi?analysis of variance results showed that there were statistical differences between different needles size( F=12?00,P<0?001) with 19 G being the best,followed by 22 G and the least specimen obtained by 25 G needle. There were no statistical differences among aspiration techniques ( F=0?128, P=0?943).The analysis showed that the thicker the needle was,the better sample quality was 19 G yielded to the highest quantity of specimens. The most specimens could be obtained with 19 G needle and non?NP, 22 G needle and 20 ml NP and 25 G needle and slow?pull. Conclusion In clinic, aspiration technique should be selected according to different aspiration needles. 19 G is superior to others, with non?NP method. For 22 G needle, 20 ml NP is preferred and for 25 G needle,slow?pull is preferred.

Objective To investigate the indication,techniques,safety and efficacy of medical suture versus traditional suturein thoracoscopic surgery incision closure.Methods From October 2014 to January 2016,121 patients undergoing thoracoscopic surgery were divided into two groups according to the method of incision closure:53 cases of traditional suture group and 68 cases of medical suture hasp group.The time of closure,healing time,wound healing scores and patient's satisfaction were recorded and statistically analyzed.Results All patients were successfully operated without perioperative death.One patient underwent postoperative bleeding in the medical suture hasp group.The medical suture hasp was found to be reliable and easy to remove in secondary operation.The postoperative incision was changed to traditional suture.Two patients in each group had delayed healing.Two patients of medical suture hasp group were caused by incision bleeding,of whom one case switched to traditional suture,and one patient was treated with pressure bandage and healed.The wound closure time of the medical suture hasp group was significantly shorter than that of the traditional suture group:(110.0 ± 12.7) s vs.(305.0 ± 31.6) s,P ＜ 0.01.The wound healing scores of medical suture hasp group were higher than those of traditional suture group 2 weeks and 1 month after surgery (P ＜ 0.01).There was no significant difference in healing rate between two groups (P ＞ 0.05).The satisfaction scores of the patients in medical suture hasp group were higher than those in traditional suture group (P ＜ 0.01).Conclusions The use of medical suture hasp in the thoracoscopic surgical incision closure process is safe and reliable.It can accelerate the early repair of incision,and improve patient's satisfaction.

Objective To observe clinical effect of Huxiang-Yangwei powder combined with conventional western medicine on gastric motility and gastrointestinal hormones in patients with chronic atrophic gastritis. Methods A total of 100 patients with chronic atrophic gastritis according to the inclusion criteria were randomly divided into the observation group and the control group, with 50 cases in each group. The control group was given routine symptomatic treatment. Based on the treatment of control group, the observation group was given Huxiang-Yangwei powder therapy. After 1 month, the gastroscope score, pathological tissue score, gastric motility index (gastric motility rhythm, gastroelectric rhythm and gastric antrum motility), and the improvement of plasma gastrointestinal hormone (MTL, GAS, SS) were compared. Results The total effective rate of the observation group was 92.0% (42/50), and the total effective rate of the control group was 78.0% (39/50), with statistically significant (Z=-2.978, P=0.003). After treatment, the under gastroscope score (0.59 ± 0.06 vs. 1.23 ± 0.17, t=4.877) and the pathological organization score (0.65 ± 0.08 vs. 1.33 ± 0.19, t=5.096) of the observation group were significantly lower than those of the control group (P<0.05). After treatment, the gastric motility rhythm (76.15% ± 8.77% vs. 62.35% ± 7.31%, t=5.301), gastroelectric rhythm (81.02% ± 9.23% vs. 73.02% ± 8.43%, t=5.286), gastric antral motility (0.012 ± 0.002? vs. 0.008 ± 0.001 ?, t=4.160) of the observation group were significantly higher than those of the control group (P<0.05). After treatment, the plasma MTL (246.73 ± 31.82 pg/ml vs. 203.86 ± 27.91 pg/ml, t=5.832), GAS (49.55 ± 6.25 pg/ml vs. 35.81 ± 4.63 pg/ml, t=5.126), SS (17.35 ± 2.76 pg/ml vs. 15.01 ± 2.60 pg/ml, t=4.970) of the observation group were significantly higher than those of the control group (P<0.05). Conclusions The application of Huxiang-Yangwei powder in the treatment of chronic atrophic gastritis patients can repair gastric mucosa, regulate gastrointestinal hormone levels and increase gastric motility.

Objective To observe the effects of Tongluo-Jiedu-Huazhuo decoction on hemorheological indexes and gastric juice components in patients with chronic atrophic gastritis.Methods According to the inclusion criteria,84 patients with chronic atrophic gastritis were randomly divided into the observation group and the control group,with 42 cases in each group.The control group received the routine clinical treatment,and the observation group was treated with Tongluo-Jiedu-Huazhuo decoction on the basis of the control group.The clinical symptoms were scored before and after treatment.The blood viscosity,plasma viscosity,hematocrit,fibrinogen and erythrocyte aggregation index were measured bY automatic hemorheology instrument,and gastric juice pH,free acid,pepsin and nitrite levels were measured by serial gastric juice detection method.The clinical efficacy was evaluted.Results The total effective rate of the observation group was 90.5％ (38/42),and the total effective rate of the control group was 76.2％ (32/42),with statistically significant difference (Z=-2.683,P＜0.05).After treatment,the scores of epigastric pain,stomach swelling,nausea and vomiting,acid reflux and dietary deficiency in the observation group were significantly lower than those in the control group (t were 4.865,4.632,4.716,4.582,4.433,respectively,all Ps＜0.05),and the whole blood viscosity,plasma viscosity,hematocrit,fibrinogen and erythrocyte aggregation index were significantly lower than those in the control group (t were 5.044,4.462,5.274,4.231 and 4.485,respectively,all Ps＜0.05).The gastric juice pH (2.28 ± 0.33 vs.2.75 ± 0.38,t=4.825),nitrite (33.27 ± 4.45 mg/L vs.38.80 ± 4.93 mg/L,t=5.136) in the observation group were significantly lower than the control group (P＜0.05).The free acid (22.13 ± 3.36 mmol/L vs.18.65 ± 2.54 mmol/L,t=5.382),pepsin (144.56 ± 15.86 U vs.137.16 ± 14.63 U,t=5.736) in the observation group were significantly higher than the control group (P＜0.05).Conclusions The application of Tongluo-Jiedu-Huazhuo decoction in patients with chronic atrophic gastritis can improve the hemorrheology index and regulate the function of gastric secretion,which is helpful to protect the gastric mucosa and relieve the clinical symptoms.

Objective To detect the proteins levels of RhoA and CDC42 in bone marrow mononucleated cells (BMMC) of patients with primary acute leukemia,and further determine the role of abnormal interactions between hematopoietic progenitor and bone marrow microenvironment on abnormal behaviors of leukemia cells. Methods BMMC samples were separated from 54 primary acute leukemia patients and 22 normal donors and the cell lysis samples were prepared. RhoA and CDC42 proteins were determined by Western blotting. Independent pair T test was conducted to evaluate whether the differences in RhoA and CDC42 expression were statistically significant between leukemia patients and normal donors. Spearman was applied in analyzing the correlation between expression of RhoA and CDC42 proteins and clinical characters of patients. Results RhoA and CDC42 proteins level of primary acute leukemia patients was significantly higher than that of normal samples. Especially, patients with M2,M3 and M5 subtypes exhibited significant higher RhoA proteins levels and M3 subtype exhibited significant higher CDC42 protein levels. Conclusion RhoA and CDC42 protein levels of primary acute leukemia patients are significantly higher than that of normal donors. This result suggests that RhoA and CDC42 associated efficient migration of leukemia cells could be implicated in abnormal interaction of leukemic cell with bone marrow microenvironment.

Objective To study the effect of magnetic nanoparticles on human cholangiocarcinoma xenograft in nude mice, and compared with otherchemotherapy drugs Methods We established human cholangiocarcinoma xenograft in nude mice with QBC939 cell line.The nude mice were devided into 4 groups randomly.Saline,5-FU, Gemcitabine and magnetic nanoparticles were given to nude mice through tail vein on 20d after implanting QBC939 cell line. Calculations were done at different time after treatment in order to compare tumor volume,inhibition ratio of tumor and tumor growth curve of each group. The nude mice were killed on 35d after treatment to harvest tissue for electron microscopic examination to observe ultra-structural changes. Results The tumor volume of control, 5-FU, magnetic nanoparticles and Gemcitabine groups was (2256.1?267.1) mm3, (2096.5?237.9)mm3,(1392.2?189)mm3, and (1534.9?115 )mm3 respectively.The last two groups have significant difference compared to the first two groups(P

Objective To assess the choice between direct operation and followed- up observation for subclinical esophageal submucosal mass. Methods The clinical data of 133 patients with subclinical esophageal submucosal mass from February 1996 to October 2013 were retrospectively analyzed. The patients were divided into 2 groups according to the modes of intervention: direct operation group (82 cases) and followed-up group (51 cases). Their clinical data, imaging, endoscopy information, modes of intervention and final outcome were compared. Results All of the 133 patients were considered as esophageal leiomyoma. The age and body examination detection rate in direct operation group were significantly lower than those in followed-up group: (47.7 ± 13.1) years vs. (52.2 ± 10.1) years and 15.9% (13/82) vs. 37.3% (19/51), the tumor diameter, case history and incidence of chest and abdominal pain were significantly higher than those in followed-up group: (2.2 ± 1.4) cm vs. (1.7 ± 1.0) cm, 51 (44, 60) months vs. 47 (40, 55) months and 28.0% (23/82) vs. 9.8% (5/51), and there were statistical differences (P＜0.05 or ＜0.01). There was no operative mortality in direct operation group, and the incidence of mild surgical complication was 8.5% (7/82); the pathological result showed that esophageal leiomyoma and other benign diseases were in 70 cases, and malignant disease in 12 cases (12 cases of malignant diseases who missed diagnosis before operation were mostly caused by incomplete examination.). In followed-up group, the mean observation time was 35.5 (3 to 240) months, disease progression was in 23 cases (45.1%, 23/51), 3 cases developed new-onset symptoms, 20 cases increased in diameter, and the average doubling time was 856 (126 to 2 891) d. Twenty-seven patients eventually underwent surgery (52.9%, 27/51, post-observation intervention group), without perioperative death, and the incidence of surgical complication was 7.4% (2/27). The pathological result showed that esophageal leiomyoma and other benign diseases were in 23 cases, and malignant disease in 4 cases. Compared with direct operation group, post-observation intervention group had no delayed treatment due to the observation and did not increase the surgery risk and difficulty, and no malignant transformation occurred. Conclusions Subclinical esophageal submucosal mass could be followed up, but endoscopic ultrasonography, CT and gastrointestinal angiography must be performed and must be followed up closely.

Objective: To investigate the clinical efficacy of reduced port laparoscopic radical resection on colorectal cancer. Methods: Clinical data of 46 patients with colorectal cancer undergoing reduced port laparoscopic radical resection were retrospectively analyzed. Results: All of 46 patients underwent laparoscopic surgery, with an average operation time of 206 minutes, an average intraoperative bleeding of 56 ml, an average number of lymph nodes removement of 12/case (ranged from 6 to 21). One case had incision infection, 2 cases had anastomotic leakage, and they all recovered and discharged after treatment. Conclusions Reduced port laparoscopic radical resection of colorectal cancer is safe and feasible, reduces labor costs, and has a good clinical efficacy, which is worthy of clinical promotion.

Objective To analyze the distribution of clinically isolated pathogenic bacteria in Xi′an area during 2014 and their drug resistant characteristics in order to provide the data of pathogenic bacterial drug resistance for medical pharmaceutical adminis ‐tration departments and clinical rational use of antibacterial drugs .Methods The pathogenic bacteria of nosocomial infections were cultured and isolated by using the routine method .The bacterial species was identified by using the semi‐automatic or full‐automatic bacterial identification and analysis systems .The drug susceptibility test was conducted according to CLSI standards .The data sta‐tistics and analysis were performed by using the WHONET 5 .6 software .Results 31 013 strains of pathogenic bacteria were isola‐ted in 2014 ,including 20 029 strains (64 .58% ) of Gram‐negative bacilli ,9 888 strains (31 .88% ) of Gram‐positive cocci and 1 096 strains (3 .54% ) of fungi ;the top bacteria was E .coli(20 .29% ) ,vancomycin resistant Staphylococcus aureus was not be found ;the resistance rates of Enterococcus faecium and faecalis against Vancomycin were 3 .00% ,1 .00% ,which against to linezolid was 1 .00% ;the generation rates of extended‐spectrum beta‐lactamase(ESBLs) in E .coli and Klebsiella pneumoniae were 65 .0% and 56 .0% respectively .Conclusion The important pathogenic bacteria ,including MRSA ,vancomycin resistant enterococcus ,carbapen‐em resistant Enterobacteriaceae bacteria ,pan‐drug resistant Pseudomonas aeruginosa and Acinetobacter baumannii ,in nosocomial infection should be performed the intensive monitoring and the communication with clinic should be strengthened in order to make the detection results serve the clinic well .

Objective To investigate the effect of the amputation order of pulmonary artery and pulmonary artery on pulmonary residual blood volume in total thoracoscopic lobectomy.Methods Sixtyeight patients who were scheduled to underwent total thoracoscopic lobectomy from June 2015 to April 2019 in Beijing Aerospace General Hospital were selected.The patients were divided into first amputation pulmonary artery group and first amputation pulmonary vein group by random envelope method with 34 cases in each group.Five cases in first amputation pulmonary artery group and 4 cases in first amputation pulmonary vein group were excluded because of the procedure modification or the fragmentation of the specimen during the course of operation.In the end,29 cases were enrolled in first amputation pulmonary artery group and 30 cases in first amputation pulmonary vein group.In first amputation pulmonary vein group,all arteries were ligated before interruption of the veins;and in first amputation pulmonary artery group had a reverse sequence.The perioperative period status were recorded,and the crude pulmonary quality,dry pulmonary quality,pulmonary residual blood volume and adjusted pulmonary residual blood ratio were measured or calculated.Results All 59 patients were operated successfully.No serious complications occurred,no perioperative death occurred,and no patients needed blood transfusion.There was no statistical difference in the incidence of minor complications between first amputation pulmonary artery group and first amputation pulmonary vein group:27.6％ (8/29) vs.33.3％ (10/30),P＞0.05.There were no statistical differences in operative time,transoperative bleeding volume,pulmonary residual blood volume,crude pulmonary quality,dry pulmonary quality,adjusted pulmonary residual blood ratio,hemoglobin difference before and after surgery,postoperative drainage time and postoperative hospitalization time between 2 groups (P＞0.05).Conclusions The amputation order of pulmonary artery and pulmonary vein sequence of vessel interruption during total thoracoscopic lobectomy has no effect on the pulmonary residual blood volume,can be reasonably selected according to the intraoperative situation.