Circulating tumor cell ( CTC ) testing is characterized by its invasiveness, sampling convenience and facility for real-time monitoring.The booming detection technologies based on physical or immunological features, as well as the subsequent molecular analysis of CTCs including subtype classification, single cell sequencing and in vitro culture, has greatly enriched our comprehension of CTCs and cancer heterogeneity.Meanwhile, a great of researches have demonstrated the significance of CTCs testing in the clinical practice of cancers involving aspects of early diagnosis, treatment monitoring and prognosis.

Objective To explore the clinical application of the special use of antibacterial drugs in Department of hepatobiliary surgery by analyzing the typical cases of the use of antibiotics.Methods This paper analyzes and comments on the typical cases of the use of special antibiotics in Department of hepatobiliary surgery.Results Department of hepatobiliary surgery the special use level of antibacterial drugs,should be based on the pathogenic characteristics of drug resistance and drug sensitivity test results and timely adjustment of antimicrobialtherapy,severe infection should be given sufficient medicines in a timely manner,should adjust the antibiotics dose according to liver and kidney function,drug dose attention to drugs with narrow therapeutic index,combined medication,caution should be avoided unnecessary repeat medication.Conclusion Through the analysis of the typical cases of the special use of antibiotics in Department of hepatobiliary surgery,it can promote the rational use of antibiotics.

The rapid development of silicon microelectrode arrays provides an ideal means for the study of spatio-temporal features of neuronal activity in the brain. The stability of the linear silicon electrode array (LSEA) in recording neuronal potentials and its validity in recording unit activity are investigated. The experimental results showed that during the recording of field potentials in the hippocampal CA1 region of anesthetized rats, upward and downward movements of the recording probe for a distance of 200 ?m did not affect the orthordromic and antidromic evoked potentials significantly. The data indicated that the probe movements caused very small damage to the neurons, and the recording was stable. The contact sites that located in the pyramidal cell layer acquired CA1 neuronal unit activity validly. Different types of unit activity from independent neurons were easily distinguished in epochs of recording from a same recording site. These results demonstrated the features of the LSEA, including the facility of probe manipulation, the stability of recording and the abundance of data acquirement. The data will be helpful to the researchers involved in the application of microelectrode array for neuroscience researches.

Sodium succinate (0.8 g?kg~ -1,ig) could significantly shorten afterdischarge duration (ADD), lower Racine’s score on amygdala electrical kindling in rat.Additional sodium succinate capsule (0.25g,po) was effective on patients with epilepsy administrated with common antiepileptic drugs which showed little effectiveness on these patients. The results supposed sodium succinate would be effective in epilepsy therapy.

OBJECTIVE:To standardize the clinical use of adjuvant therapy drugs. METHODS:To establish the clinical use management mode of adjuvant therapy drugs in our hospital and summarize the usage amount and irrational drug use of adjuvant therapy drugs before and after implementing the management,and the management effect was assessed. RESULTS:The manage-ment mode of adjuvant treatment drugs in our hospital included ensuring the directory for adjuvant therapy drugs,establishing the management system and ensuring its basic principles,then conducting drug use review with the ranking of drug dosages and mak-ing full use of evidence-based medical evidence,as well as developing principle of classification disposal for the irrational drug use (off-indications,overdose,ultra treatment) of adjuvant therapy drugs. After more than one year of management practice,the use of adjuvant therapy drugs in our hospital is increasingly standardized. The sales amount of adjuvant therapy drugs to all drugs was reduced from 20.90％ before management(Aug. 2014-Jul. 2015)to 15.99％(reduced by 5％)after management(Aug. 2015-Jul. 2016). Compared with Aug. 2015,the sales amount of 48 varieties in the 93 adjuvant therapy drugs was dropped more than 15％in Aug. 2016,and irrational drug use decreased obviously. CONCLUSIONS:The established management mode of adjuvant thera-py drugs in our hospital has effectively improved clinical rational drug use and reduced medical costs.

Objective To analyze the image and histological results of the combined use of allograft/extracorporeally frozen tumor-bearing bone and vascularized fibular flap for the reconstruction of bony defects following tumor resection,guiding clinical practice.Methods From March 2007 to June 2013,we enrolled 63 patients who had combinative biological reconstruction after bone tumor resection (11 in humerus,22 in femur,21 in tibia,4 in calcaneus).There were 36 male and 27 female in this series.The average age at time of operation was 20 years,ranging from 9 to 48 years.The follow-up ranged from 16 to 102 months with average of 48 months.We investigated the X-ray and CT images for all patients and histological findings of two patients.Patients were assessed functionally with the Musculoskeletal Tumor Society 93 score.Results Three patients with local soft tissue recurrence and one patient with infection underwent amputation.The survival of construct was 93.6％.Bone union achieved in all cases with the average MSTS score of 92.8％.Bone union ranged from 11 to 28 months in allograft group and 9 to 14 months in devitalized tumor bearing bone group.Significant difference of bone union time was found between two groups (Z=-3.638,P=0.000).Viability of the fibular grafts was verified in 58 of 63 patients (92％).Three types of images were observed in complex.Osteopenia and spongy change in fibula were found in 51 patients (81％) with stable fixation of the complex.Five complexes with failed blood supply of fibula and stable fixation revealed no density change of fibula,small amount of callous formation and relative delayed union.In seven complexes (11％) with unstable complex due to patients' incompliance,fibula reacted with dense hypertrophy and microfracture.Fusion of grafts with amount of callus was obviously observed.Union at allograft-host bone junctions occurred by residual host bone-derived external callus and fibular-derived internal callus that bridged the junction and filled the gap between abutting cortices.Callus from fibular graft was mature than that from periosteum of residual host bone.Internal repair was observed at the internal surface of the allografts.Fibula showed significant spongy changes.Conclusion Recycled tumor-bearing bone in combined with fibular flap is a reliable reconstruction as an alternative to traditional Capanna technique.The survival of the fibula is a cornerstone in success of complex reconstruction.Sponginess of fibula and internal repair of allograft compromise the intensity of complex,necessitating the strong instrumentation during reconstruction.

Objective:To explore the methods to improve the professional core competencies of medical students in the standardized residency training.Methods:A total of 82 medical students who participated in the standardized residency training ("resident students" for short) in the same period were selected in this study, and the self-edited professional core competencies textbooks were used for regular theoretical study, and at the same time, clinical practice cases were collected for regular scenario reduction teaching. When the resident students entered the department and after 12 months of the standardized training, the professional core competencies training evaluation scale was used to evaluate and compare the scores of the resident students, and the value of the above-mentioned training model to improve the professional core competencies of the resident students was evaluated. SPSS 18.5 was performed for t test between groups. Results:After being trained by the above model, the selected students had significantly improved such competencies as communication, cooperation and problems solving ( P<0.05). Compared with the scores of resident students before and after the training, there was no significant difference in communication and cooperation with other students ( P>0.05), with low satisfactory communication with the leader ( P>0.05), but the problem-solving ability had been significantly improved ( P<0.05), while the score of which was low and it should be pay more attention to in the future training. Conclusion:In the process of standardized residency training, the application of the above-mentioned training model can significantly improve the professional core competencies of resident students, and at the same time, it's necessary to strengthen the cultivation of satisfactory communication with leaders and problem solving ability.

Objective To determine the fluoride contents in dried chilies in Southwest China to provide the basis for the prevention of the fluoride contamination in chili.Methods The dried chili samples collected from the markets and farmers in 76 counties of 9 regions in Southwest China.Their dehydration methods and storage time were investigated.These dried chilies were classified by Bailey'Criteria.The total fhorine content in chili were determined with ion wlective electrodes,fluoride forms with acid-soluble ultrasonic and water-soluble ultrasonic methods,Based on the differences of chili variety,edible part,dehydration method,storage time and fluoride form, a systemic statistics of the fluoride content in dried chili Was established.Results Theere were 296 dried chili samples collected from 76 counties of 9 regions.The geometric mean of fluoride content in dried chili was 19.6 mg/kg;The dried chili samples were classified into 4 types:cherry chili,corn chili,long chili and cluster chili; their ranges of fluoride content in cherry chili,corn chili,long chili and cluster chili Were 1.7～233.4,3.4～ 367.3,2.0～380.3,3.9～104.0 mg/kg,respectively,and the high to low sequence of fluoride content was cherry chili(25.9 mg/kg),long chili(20.3 mg/kg),corn chili(19.5 mg/kg) and cluster chili(15.3 mg/kg).The waler- soluble fluoride content in dried chili about 27.9 mg/kg occupies 77.5%(15.2/19.6)of total fluoride content and the acid-soluble fluoride content about 33.5 mg/kg reached as high as 93.0%(1 8.2/19.6).The high to low sequence of fluoride content in dried chili Was the sun-dried stored less than 1 year(10.9 mg/kg),the sun-dried stored more than 1 year(13.7 mg/kg),the fumace-dried stored less than 1 year(21.4 mg/kg),the fumace-dried stored more than 1 year(53.9 rag/ks).Conclusions The research shows that inappropriate dehydration method and storage time are the two main reasons leading to fluoride contamination in chili.

Objective To investigate the distribution of fluoride content in fresh chili in southwestern China and provide the fluoride background content for the confirming fluoride contamination discrimination value for fresh chili.Methods The method of analyzing fluoride in food as stipulated in GB/T 5009.18-2003 was adopted to determinate fluoride content in chilies.175 fresh chili samples were collected from 76 counties in southwestern China.Based on the origin and types of the chilies,we systemically analyzed the fluoride content in fresh chilies.Results In fresh chilies directly sampled from farms,the averaging content was up to 8.9 mg/kg(dry weight)and the fluoride content in more than 95.54% of fresh chili samples was less than 24.7 mg/kg(dry weight).Conclusions The current fluoride content standard for vegetables as stipulated in GB 2762-2005(≤1.0 mg/kg)is unsuitable for chili,therefore it is essential to draw a new value for discriminating fluoride contamination in fresh chili.

Abstract: Objective To compare the diagnostic efficacy of the upgraded version of the GeneXpert automated fluorescent quantitative PCR system (GeneXpert MTB/RIF Ultra, GeneXpert Ultra) and the original version of the GeneXpert system (GeneXpert MTB/RIF, Xpert), real-time fluorescent quantitative nucleic acid detection (FQ-PCR), real-time fluorescent thermostatic amplification of Mycobacterium tuberculosis RNA (SAT-RNA), real-time fluorescent thermostatic amplification detection of DNA (thermostatic amplification method) and traditional BACTEC MGIT 960 liquid culture (culture method) for special specimens of tuberculosis, in order to analyze its application value in clinical detection. Methods Using prospective research methods, a total of 170 special specimens (including 47 pleural and ascites effusion samples, and 34 24-hour urinary sediment specimens, 49 tissue specimens and 40 fester specimens) were collected i'an Chest Hospital from January to September 2021. GeneXpert Ultra, Xpert, FQ-PCR, SAT-RNA, isothermal amplification, and traditional culture were used for detection. Clinical diagnosis was used as the standard, and sensitivity, specificity, positive predictive value, negative predictive value, coincidence rate, and Kappa value were compared among the methods. Results The sensitivities of GeneXpert Ultra, Xpert, FQ-PCR, SAT-RNA, isothermal amplification, and traditional culture were 65.18% (73/112), 49.11% (55/112), 37.50% (42/112), 19.64% (22/112), 8.04% (9/112), and 22.32% (25/112), respectively. The sensitivity of GeneXpert Ultra was higher than that of the other five methods, and the differences were statistically significant (χ2=66.25, 42.10, 28.89, 13.09, 4.92, 15.18, all P<0.05). GeneXpert Ultra result analysis showed that: 5.48%(4/73) cases had trace, that is, trace Mycobacterium tuberculosis load, 79.45% (58/73) cases were extremely low, 10.96% (8/73) cases were low, 2.74% (2/73) were medium, , and 1.36% (1/73) were high load. In 4 trace samples, the Xpert detection was negative for all. Of the 73 GeneXpert Ultra positive reports, 63 were rifampicin-sensitive, 6 were rifampicin-resistant, and 4 were rifampicin-resistant but of unclear resistance. Of the 55 Xpert positive reports, 45 were rifampicin-sensitive, 2 were rifampicin-resistant, and 8 were rifampicinresistant but of unclear resistance.. Conclusions The new generation of GeneXpert MTB/RIF Ultra has high sensitivity, specificity and drug resistance detection rate, and its advantage is even more apparent in the pathogenic diagnosis of special specimens of tuberculosis. It can be used as one of the preferred methods in samples with low bacterial load.