OBJECTIVE To discuss the best scheme for fungemia detection by analyzing and comparing the ability and performance characteristics of the BACTEC 9120 automated blood culture system and 4 kinds of blood culture bottles in the detection of simulated fungemia.METHODS Simulated blood culture was produced using 65 fungi isolates from clinical specimens and BACTEC Plus Aerobic/F,Plus Anaerobic/F,Peds Plus/F and Myco/F Lytic blood culture bottles and detected by BACTEC 9120 automated blood culture system.The final inoculum densities were 1-5 CFU/ml blood.The(time to detection TTD) of simulated blood culture with different concentrations of suspension produced using 2 kinds of standard strains and 4 kinds of blood culture bottles was compared.RESULTS From the 260 bottles in this study 216 had growth detected by the BACTEC 9120 blood culture system.The positive rates of BACTEC Plus Aerobic/F and Anaerobic/F,which were 90.77%and 41.54%,respectively,were significantly(P

Objective To investigate the management of pseudomyxoma peritonei originated in the appendix.Methods The clinical data of 51 patients with pseudomyxoma peritonei originated in the appendix who were admitted to the Beijing Hospital from 1970 to 2010 were retrospectively analyzed.The results of operation,reoperation,adjuvant treatment and follow-up were analyzed.The time from pseudomyxoma peritonei recurrence to the reoperation between patients who did or did not receive chemotherapy was compared by two tailed t test.Results Of the 51 patients,48 received operation,and the operation time was (135 ± 72 )minutes.Tumor recurrence was observed in 34 patients,and 16 of them received cytoreduction procedure,and 33 cytoreduction procedures were performed in total.The median time of follow-up was 49.7 months (range,3-132 months).The disease-specific survival was observed in 25 patients and disease-free survival in 16 patients.Four patients died of tumor recurrence or progression.The results of postoperative pathological examination confirmed that 19 patients were with benign disseminated peritoneal adenomucinosis (DPAM),26 were with malignant peritoneal mucinous carcinomatosis (PMCA) and 6 were with intermediate subtype (PMCA-1).The 3-,5- and 10-year survival rates were 75％ (38/51),55％ (28/51) and 22％ ( 11/51 ),respectively.The survival time and reoperation time interval for patients who received postoperative chemotherapy were ( 21 ± 4) months and ( 10 ± 6 ) months,which were longer than (19 ±7 )months and (7 ±4)months of those who did not receive postoperative chemotherapy (t =1.027,0.361,P ＞ 0.05).The median survival time of patients with benign DPAM,PMCA-1 and malignant PMCA were 96,63,23 months,respectively.The tumor recurrence interval for patients with benign DPAM and those with malignant PMCA were ( 15 ± 5 ) months and (7 ± 4) months,with significant difference ( t =2.193,P ＜ 0.05 ).Conclusions An active cytoreduction surgery is feasible for patients with pseudomyxoma peritonei originated in the appendix in improving survival.Repeated cytoreduction is a treatment of strategy to prolong the recurrence time and improve the prognosis of selected patients.

Objective To observe the eftccts of the extract of termitarium on the climbing ability and life span of Parkinson disease (PD)drosophila(Ddc GAL4/+ ;UAS-wild type α-synuclein/I ),and to explore its mechanism of anti- PD. Methods The termitarium was extracted by ethanol.PD drosophilas overexpressed α-synuclein were fed with 1,10 and 100 mg of termitarium per 100 g culture medium.The climbing ability and life span of drosophilas and pathological changes of its brain tissue (Congo red staining) were observed and compared among different concentrations. Results Termitarium enhanced the climbing ability of PD drosophilas and the most significant improvement appeared from 18 d to 36 d after eclosion,increasing with more termitarium concentrations and growing age of PD drosophilas.Termitarium also prolonged the life span among which male and female drosophila were longer 31.82 ％ ～ 3.34 ％,1.47 ％ ～ 3.34 ％ as compared with PD drosophila control (all P＜0.05).The brain cells number in the PD drosophilas were increased and empty bubble was decreased by rermitarium, accompanying with improvement of behavior and life span.Conclusions Termitarium can improve behavior and prolong life span of PD drosophilas.

Objective To explore the influence of self-concealment level on patients'quality of life and clinical curative effect for curing refractory chronic prostatitis(RCP)by high-intensity focused ultrasound(HIFU). Methods Patients of RCP who meet the diagnostic criteria were assessed with the Self-Concealment Scale(SCS), TDL's table of self-assessing quality of life and National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI).The patients whose SCS score were above the average score plus a standard deviation were taken as the high SCS group,and whose SCS Score were below the average score minus a standard deviation were taken as the low SCS group.The scores for CPSI and TDLs table of self-assessing quality of life and the clinical curative effect of the two groups were determined before and after the treatment by HIFU, respectively.Results The SCS score(35.75±10.34) of the RCP patients before HIFU treatment was significantly higher than the norm for male college students(29.20±8.73)(t=4.26,P<0.01).Two and six weeks after the HIFU application,the CPSI of both the high and the low SCS group decreased significantly(P<0.01),and the CPSI of the low SCS group de-creased more greatly than that of the high SCS group(P<0.01).The scores for TDL Life Quality Scale of low SCS group were significantly higher before and after two and six weeks'HIFU treatment than that of high self-concealment group(P<0.01).The TDL quality of life scale score of thelow SCS group increased respectively after two and six weeks'HIFU treatment (P<0.01),while for the high SCS group,this score increased only after six weeks' HIFU treatment(P<0.05).Six weeks after HIFU treatment,the clinical curative effect for the low SCS group was, observably better than that for high self-concealment(P<0.05).The SCS scores was significantly positive with CPSI scores(P<0.01),and significantly negative with the scores of TDL Life Quality Scale (P<0.01).Conclusion The symptom abatement,quality of life and clinical curative effect the RCP patients with a high self-concealment level were respectively worse after the HIFU treatment than that for whom with a low self-concealment level.

Objective The incidence of cardiovascular and cerebrovascular diseases in postmenopausal women with type 2 diabetes is grim.The study was designed to explore the effect of ω-3 polyunsaturated fatty acids (PUFA) on endothelial function in postmenopausal women with type 2 diabetes. Methods 50 patients admitted to Dingli Medical College of Wenzhou Medical Univer-sity from March 2014 to October 2014 were divided into group A and Group B by random number table .Cross-design of two stages ( I, II) was applied in the investigation .At stage I(3 months ahead of the experiment ), Group A took oral ω-3 PUFA while Group B took placebo .At stage II ( 3 months after the experiment ) , Group B was given oral ω-3 PUFA, while Group A was given placebo .T1 and T3 time was the beginning of the stage I and stage II experiment , while T2 and T4 time was the end of stage I and stage II experiment .At the beginning and end of each stage , detection was made on LDL-C, TG, IL-6, plasminogen activator inhibitor-1 (PAI-1) and endothelium-dependent flow-mediated vasodilation (FMD). Results After the intervention on Group A at stage I , FDM at T2 time was significantly increased compared with that at T 1 time([7.23 ±3.28]% vs [3.62 ±2.13]%, P<0.05), while all the other indexes at T2 time decreased significantly in comparison with T1 time: LDL-C ([2.85 ±0.47]mmol/L vs [3.36 ±0.57] mmol/L), TG([2.41 ±1.06]mmol/L vs [2.96 ±1.12] mmol/L), IL-6([2.83 ± 0.30]ng/L vs [3.42 ±0.32]ng/L), PAI-1 ([7.23 ±3.28]ng/L vs [3.62 ±2.13]ng/L) (P<0.05).After receiving ω-3 PUFA intervention on Group B at stage II , FDM at T4 time was significantly increased compared with that at T 3 time([6.88 ±2.06]% vs [3.60 ±2.18]%, P<0.05), while all the other indexes at T4 time decreased significantly in comparison with T3 time: LDL-C ([3.26 ±0.77]mmol/L vs [3.63 ±0.73] mmol/L), TG([2.28 ±0.94]mmol/L vs [2.77 ±1.25] mmol/L), IL-6([2.91 ± 0.48]ng/L vs [3.30 ±0.52]ng/L), PAI-1 ([45.7 ±24.4]ng/L vs [56.3 ±24.4]ng/L) (P<0.05).Two-period crossover design analysis of variance showed that there was significant difference effect on LDL -C(F=2.754, P=0.019), TG(F=3.115, P=0.011), IL-6(F=1.825, P=0.032), PAI-1(F=2.324, P=0.023) and FMD(F=3.784, P=0.006)between ω-3 PUFA and placebo . Conclusion ω-3 PUFA can improve endothelial function in postmenopausal women with type 2 diabetes , which is of great significance for the primary prevention of cardiovascular disease .

Objective Common bile duct stones are common in elderly patients.The laparoscopic transcystic approach with micro-incision of the cystic duct confluence in common bile duct exploration (LTM-CBDE) is a modified laparoscopic transcystic approach.This study evaluated the safety and efficacy of LTM-CBDE in the elderly (≥65 years) patients with choledocholithiasis and compared the results in the elderly with those in younger patients.Methods In this retrospective analysis,128 patients underwent LTM-CBDE from March 2007 to December 2013.The patients were divided into two groups:aged ≥65 years (n=50,the elderly group) versus aged ＜65 years (n=78,the younger group).The preoperative morbidity rate,American Society of Anesthesiologists (ASA) score,previous abdominal operations,operation time,postoperative hospital stay,open conversion rate,postoperative complication rate,residual stone rate,recurrence rate and mortality rate were compared between the both groups.Results The preoperative morbidity (41 vs.28) and ASA score (2.5± 0.7 vs.1.8±0.6) were higher in the elderly group than in he younger group (x2=26.063,t=-6.030,P =0.000,in both).No significant differences in previous abdominal operations,operation time,postoperative hospital stay,open conversion rate,postoperative complication rate,residual stone rate,recurrence rate and mortality rate (P＞0.05) were found between the two groups from March 2007 to December 2013.Conclusions LTM-CBDE is a safe and effective treatment procedure for elderly patients with choledocholithiasis.For LTM-CBDE-suitable patients,we recommend LTM-CBDE as the treatment of choice.

Objective To investigate the effect of radiofrequency ablation (RFA) in treating unresectable liver caneer. Methods 43 patients(78 lesions) who suffered from unresectable liver cancer were treated with cool-tip RFA from May 2006 to November,2008 in our hospital. 26 cases were treated with RFA in laparotomy besides with reseet of lesion in 6 eases and with alinjection in 5 cases,while 17 eases were treated only with percutaneous RFA. Results All patients were diagnosed by CT and B-ultrasound or MRI,among whom 18 cases were confirmed with primary hepatic carcinoma, 12 eases experienced recurrence following resect of primary hepatic carcinoma and 13 eases developed metastatic carcinoma;Every patient was followed up with AFP, abdominal B-ultrasound, CT scans or MRI from 1 to 28 months after treatment (mean 13.6 months). Before procedure, AFP increased in 20 eases which recovered within 3 months of treatment. 2 cases were suspected having residual on CT scan ,6 cases were found with new masses on liver on CT scan, 1 case complicated with gastrointestinal fistula and then died of systemie metas-tasis 3 months later,1 ease died of postoperative bleeding and 1 died of bleeding and infection after reseet + RFA treatment,and 3 cases died of multi-metastasis during following up who survived on average of 6 months. Conclu-sions B-ultrasound -guided cool-tip circulation RFA is an effective and safe method in treating unresectable liver cancer.

Objective The present study was designed to investigate the risk factors affecting bleeding during percutaneous nephrolithotomy. Methods The records of 218 patients with percutaneous nephrolithotomy procedure by a single surgeon were retrospectively reviewed.The mean age was 48 years ( range,19 -70).One hundred and forty six patients had staghore stones,and 7 patients had previous open or percutaneous nephrolithotomy histories.Forty-one patients had concomitant diabetes mellitus,and 89 cases had hypertension.The following factors including age,sex,BMI,diabetes status,hypertension status,stone type,calix of puncture,previous open or percutaneous nephrolithotomy history,number of accesses,size of accesses,operative time,and surgeon experience were analyzed.Univariate analysis and multivariate step regression analysis were used for statistical assessment. Results 207 procedures were successfully performed,and 11 patients failed because of difficulty to establish the accesses.Single-tract was used in 176 cases and multiple-tract was used in 31 cases.163 cases were performed via a 18 F access and 44 cases via a 24 F access.The mean operative time was 78.4 min.The overall blood transfusion rate was 7.7％,and stone type ( P =0.034),diabetes ( P =0.030),number of accesses ( P =0.019 ),size of accesses ( P =0.008) and operative time (P =0.001 ) were the risk factors affecting blood transfusion requirement.The average hemoglobin (Hb) drop after percutaneous nephrolithotomy procedures was 11.2 g/L,and stone type ( P ＜ 0.001 ),diabetes ( P =0.015 ),number of accesses ( P =0.016),size of accesses ( P ＜ 0.001 ) and operative time ( P ＜ 0.001 ) were the risk factors affecting Hb drop.The following covariates including Hb drop:age,sex,BMI,previous open or percutaneous nephrolithotomy history,hypertension status,calix of puncture and surgeon experience were not risk factors affecting blood transfusion requirement and Hb drop.Multivariate stepwise regression analysis showed that diabetes ( OR =1.75 ),stone type ( OR =1.92),number of accesses ( OR =2.45 ),size of accesses ( OR =1.32) and operative time ( OR =1.66) significantly increased risk of bleeding. Conclusions Stone type,diabetes,number of accesses,size of accesses and operative time were the risk factors affecting blood loss during percutaneous nephrolithotomy.

Objective To evaluate the correlation between microvascular invasion(MVI) and prognosis in patients with hepatocellular carcinoma (HCC),and to analyse the influencing factors of MVI in patients with HCC.Methods Total of 81 patients with hepatocellular carcinoma treated in Beijing Hospital from January 2014 to December 2016 were retrospectively studied.There were 65 males and 16 females.The mean age was 59.6± 12.7 years,and the age ranged from 21 to 87 years old.Pathological examination showed presence of MVI in 35 patients.Results Total of seventy-six patients with hepatocellular carcinoma were followed-up.The 1-,2-,3-and 4-year overall survival rates in the 35 patients with microvascular invasion of hepatocellular carcinoma were 78.6％,55.4％,38.3％,and 32.2％,respectively.The 1-,2-,3-,and 4-year overall survival rates of the 41 patients without microvascular invasion were 93.4％,76.5％,68.2％ and 68.2％,respectively.The difference was significant (P＜0.05).Cox multivariate regression analysis showed that microvascular invasion was an independent risk factor of overall survival after surgery (HR=3.071,95％ CI:1.239～7.610,P＜0.05).Sub-group analysis was done on patients with microvascular invasion based on pathological results which included the number of MVI lesions,the call number in the MVI lesion,the distance of the MVI to the primary liver cancer,and the gradings of MVI.There were no significant differences in the overall survival outcomes (P＞0.05).Multivariate logistic regression analysis showed the maximum diameter of tumor ＞ 5 cm (OR =6.340,95％ CI:2.000 ～ 20.096),preoperative total bilirubin (TBil) ＞ 17 μmol/L (OR =5.067,95％CI:1.386 ～ 18.525),and preoperative alpha-fetoprotein (AFP) ＞400 μg/L (OR =6.042,95％ CI:1.435 ～ 25.444) were independent risk factors of microvascular invasion (P＜ 0.05).Conclusion Hepatocellular carcinoma patients with microvascular invasion had poor prognosis.Preoperative AFP,preoperative TBil,and diameter of tumor were independent risk factors of microvascular invasion in patients with hepatocellular carcinoma.

Objective:To evaluate the perioperative safety of pancreaticoduodenectomy(PD)in elderly patients.Methods:Clinical data of 152 patients undergoing PD in Beijing Hospital between 2016 and 2019 were retrospectively analyzed.According to the age, patients were divided into the elderly group(age≥65 years)and the non-elderly group(age<65 years). The perioperative and postoperative parameters were compared between the two groups.Results:There was no significant difference in the operative time, intraoperative blood loss and intraoperative urine output between the elderly group and the non-elderly group(352.7±69.5)min vs.(359.0±94.4)min, (708.7±672.7) vs.(662.6±896.7)ml and(875.8±497.3)ml vs.(1010.6±568.2)ml, all P>0.05). The perioperative mortality, postoperative complications(Clavien-Dindo classification ≥ grade Ⅲ)and reoperation rate had no significant difference between elderly group and the non-elderly group(6.1% vs.1.2%, 21.2% vs.19.8%, 10.6% vs.8.1%, respectively, χ2=1.487, 0.048 and 0.272, all P>0.05). The incidences of operation-related complications, cardiovascular or cerebrovascular adverse events in elderly group were comparable to non-elderly group( P>0.05). The postoperative hospital stay had no significant difference between the elderly group and the non-elderly group[(28±19)d vs.(27±18)d, P>0.05]. Conclusions:PD is safe in elderly patients.Age is not a contraindication to pancreaticoduodenectomy.The comprehensive systemic evaluation, intraoperative delicate operation and enhanced perioperative management are necessary in the elderly patients undergoing PD.