Objective:To investigate the difference of clinical characteristics of children and adults with brucellosis osteoarthritis in Yinchuan, Ningxia.Methods:The clinical data of patients with brucellosis osteoarthritis who were diagnosed in General Hospital of Ningxia Medical University from January 2009 to September 2019 were collected retrospectively. According to age, the patients were divided into two groups: children (0-14 years old, 50 cases) and adults (≥15 years old, 236 cases). Epidemiological characteristics, clinical manifestations and laboratory examination results of the two groups were compared and analyzed.Results:Among children, 39 were males and 11 were females, school age children (8-14 years old, 25 cases) were more common; among adults, 179 were males and 57 were females, middle-aged and elderly people (46-65 years old, 128 cases) were more common. The peak incidence of both groups was from March to August (39 children and 142 adults). In the two groups, a total of 266 patients (40 children and 226 adults) were recorded with a history of exposure, of which 226 patients (28 children and 198 adults) had contacted with cattle, sheep and other live animals. In clinical manifestations, compared with children, adults had higher incidences of low back pain [38.00% (19/50) vs 63.98% (151/236)], hyperhidrosis [6.00% (3/50) vs 30.08% (71/236)] and fatigue [8.00% (4/50) vs 34.75% (82/236)], and lower incidences of single joint pain [70.00% (35/50) vs 19.49% (46/236)], fever [72.00% (36/50) vs 49.15% (116/236)], and lymph node enlargement [30.00% (15/50) vs 2.54% (6/236)], and the differences were statistically significant ( P < 0.05). Among children, the knee joint involvement (62.00%, 31/50) and hip joint involvement (42.00%, 21/50) were more common, but spinal involvement was not found; while among adults, spinal involvement (55.51%, 131/236) was the most common. The incidences of elevated white blood cell count [18.00% (9/50) vs 6.36% (15/236)], elevated percentage of lymphocytes [82.00% (41/50) vs 27.12% (64/236)], elevated platelet [24.00% (12/50) vs 8.90% (21/236)], elevated aspartate aminotransferase [64.00% (32/50) vs 30.08% (71/236)], elevated alanine aminotransferase [38.00% (19/50) vs 20.76% (49/236)] and anemia [42.00% (21/50) vs 16.53% (39/236)] in children were higher than those in adults; the incidences of elevated percentage of neutrophils [0 (0/50) vs 9.75% (23/236)], hypoalbuminemia [2.00% (1/50) vs 14.41% (34/236)], low sodium [2.00% (1/50) vs 10.17% (24/236)], elevated C-reactive protein [50.00% (25/50) vs 77.12% (182/236)] in children were lower than those in adults, and the differences were statistically significant ( P < 0.05). The positive rate of blood culture in children (65.22%, 30/46) was higher than that in adults (40.54%, 60/148), and the difference was statistically significant ( P < 0.05). Conclusions:There are differences in clinical characteristics between children and adults with brucellosis osteoarthritis in Yinchuan, Ningxia. In particular, there is a significant difference between children and adults in the location of bone and joint involvement.

Objective The individualized treatment of breast cancer have attracted more and more attention .Different mo-lecular subtypes of breast cancer have different kinds of prognosis and therapeutic regimen .Studies have found that miR-342-3p is asso-ciated with breast cancer of hormone receptor and endocrine therapy resistance , as well as tumor cell apoptosis .This study was to fur-ther investigate the expressions of miR-342-3p in different breast cancer molecular subtypes and breast cancer cell lines to reveal the importance of miR-342-3p in individualized treatment of breast cancer . Methods A total of 90 tissue samples from patients with breast cancer surgery were collected .Three types of breast cancer cell line were cultured , including MCF-7, SKBr3 and MDA-MB-231.Real-time fluorescent quantitative PCR was applied to detect the expression of miR-342-3p in breast cancer tissue . Results Expression of the miR-342-3p increased the most in Lumina B type breast cancer tissue (1.594 ±0.465), followed by Lumina A type (1.386 ±0.443), Her-2 high expression type (1.165 ±0.337), and the lowest in the tripe negative breast cancer tissue (0.837 ± 0.351), representing significant difference (P<0.05).There was no statistical difference in the expression of the miR-342-3p as to different age groups, lymph node metastasis and tumor size, histological grading and staging (P>0.05).As to the expression of miR-342-3p in three types of breast cancer cell line , taking SKBr3 as the reference, the relative ratio was 126(118-134) and MDA-MB-231 was 0.017(0.014-0.018). Conclusion The expressions of miR-342-3p are different in different molecular subtypes and cell lines of breast cancer , which are relevant to different molecular subtypes of breast cancer , making it possible reference index for breast cancer typing and relevant to good prognosis .

Objective To compare the effect of water-infusion colonoscopy and conventional air-infusion colonoscopy on the bowel cleanliness during withdrawing.Methods A single blind randomized controlled trial was conducted. 222 patients were randomly divided into water-infusion group (group A, 112 cases) and air-infusion group (group B, 110 cases). The cleanliness scores, scores improvement, pain scores, time of reaching cecum, depth of colonoscopy, rate of whole colon examination, adenoma detection rate (ADR), operator’s dififculty and complications were compared between the two groups.Results The cleanliness score during withdrawing was higher in group A [M(8)/IQR(1) vs M(8)/IQR(2),P = 0.000], the improvement was higher in group A [(0.53 ± 0.74) vs (0.23 ± 0.55), P = 0.000], the abdominal pain score was signiifcantly lower in group A [M(2)/IQR(1) vs M(4)/IQR(2),P = 0.000] and the ADR was higher in group A (36.61 % vs 23.64 %,P = 0.041). The operator’s dififculty evaluation score was signiifcantly lower in group A [M(1)/IQR(1) vs M(2)/IQR(1),P = 0.005]. There were no signiifcant differences at the time of reaching cecum, the depth of colonoscopy and the whole colon examination rate between the two groups.Conclusion Water-infusion colonoscopy could signiifcantly improve the bowel cleanliness during withdrawing scope, improve the ADR and reduce abdominal pain of patients, without increasing the time to reach cecum.

Objective To summarize our experience on diagnosis and treatment of bilateral primary breast cancer (BPBC). Methods Clinicopathologic records, including clinical manifestations, diagnosis and immunohistochemical expressions of 16 patients with BPBC, treated from 2001 to 2009 in Jiangsu Provincial Cancer Hospital, were analyzed retrospectively. Results The 16 patients with BPBC accounted for 0.47% of all patients diagnosed as malignant tumors of breast during the same period in our hospital. All of the 16 patients were women, with the median age of 53 years (ranged 41-69 years). 7 patients were in bilateral synchronous breast cancer (BSBC), with the median age 47 years (ranged 41-54 years), among whom 5 patients got BSBC just before menopause. 9 patients were in bilateral asynchronous breast cancer (BABC), with the median age 58 years (ranged 43-69 years), among whom 1 patient got BABC before menopause. The median interval between the first and second breast carcinoma of BABC was 52 months (ranged 14-196 months). Conclusions Compared with BABC, the occurrence age of the patients with BSBC was smaller. BABC was more common in premenopausal women. The interval time of BABC was irregular. The active follow-up after the occurrence of contralateral breast cancer and endocrine therapy for estrogen receptor-positive patients were recommended.

Objective To explore the expression of human epidermal growth factor receptor -3( HER3) in human epidermal growth factor receptor-2(HER2)-positive breast cancer and its relationship with the therapeutic effect of trastuzumab and clinical prognosis .Methods Clinicopathological characteristics of 235 HER2-positive breast cancer patients undergoing surgery in Jiangsu Cancer Hospital from Jan .2007 to Jun.2012 were analyzed retrospectively.The expression of HER3 was detected using immunohistochemisty staining .The expression of HER3 and its correlation with the clinicopathological characteristics were analyzed .All patients were followed-up to find out the impact of HER3 on the disease free survival and the therapeutic effect of trastuzumab .Results The positive rate of HER3 in Luminal B ( HER2 +) and HER2-overexpressing breast cancer was 100/135 (74.1%), and 85/100(85%)respectively.The difference had statistical significance (P<0.05).The histolog-ical grading and the lymph node metastasis were significantly different in Luminal B ( HER2+) breast cancer .The tumor volume , histological grading and lymph node metastasis were significantly different in HER 2-overexpressing breast cancer .The 5-year disease free survival of HER 2-positive breast cancer patients with negative HER 3 was higher than that with positive HER3.The non-relapse survival time was not significantly different between the pos-itive and negative HER 3 expression in Luminal B ( HER2+) breast cancer patients receiving trastuzumab treat-ment , but was significantly different in HER 2-overexpressing breast cancer patients .Conclusions HER3 is cor-related with unfavourable prognosis in HER 2-positive breast cancer .The treatment targeting HER3 may improve the clinical prognosis of both HER 2-positive and HER3-positive breast cancer patients .The HER2-overexpressing breast cancer patients with negative HER 3 may benefit more from trastuzumab treatment .

Objective To explore the change of serum HER2/neu concentration during neoadjuvant chemotherapy for HER2-overexpressed breast cancer and its correlation with the response to the neoadjuvant chemotherapy.Methods The concentration of the serum HER2/neu in 78 cases of HER2-overexpressed advanced breast cancer treated with neoadjuvant chemotherapy were detected with enzyme-linked immunosordent assay(ELISA).The relationship between the serum HER2/neu concentration and the response of neoadjuvant chemotherapy was analyzed.Results The serum HER2/neu concentration of befor and after neoadjuvant chemotherapy was 18.6 ± 10.0ng/ml,11.6 ± 6.lng/ml respectively.The serum HER2/neu concentration decreased significantly(P ＜ 0.001).The response of neoadjuvant chemotherapy was correlated with the change of the serum HER2/neu concentration.The pathologic complete response was correlated with the serum HER2/neu concentration of prechemotherapy and the change of the serum HER2/neu concentration.Conclusion The change of serum HER2/neu concentration may serve as a marker predicting the response of neoadjuvant chemotherapy in HER2-overexpressed breast cancer.

Objective To investigate the effects of remifentanil on lipid peroxidation druing hemorrhagic shock-induced acute lung injury (ALI) in rabbits. Methods Thirty-two healthy adult rabbits weighing 2.0-2.5 kg were randomly divided into 4 groups (n = 8 each): sham operation group (group S); ALI group; low-dose remifentanil group (group LR); high-dose remifentanil group (group HR). The left femoral artery was cannulated for blood-letting and blood sampling. The right femoral artery was cannulated for remifentanil administration. The model of hemorrhagic shock was established by modified Wigger' s methods. In group S, only cannulation was performed. In group LR and HR, remifentanil was infused intraperitoneally at 0.66 and 1.32 μg·kg-1 ·min-1 15 min before blood-letting respectively, while group ALI received equal volume of normal saline instead. Arterial blood samples were taken at 0, 20,70 and 100 min after blood-letting (T1-4) for blood gas analysis. The animals were then sacrificed and the lungs were immediately removed for histological examination with light microscope and determination of W/D lung weight ratio, MDA content and SOD activity. Results W/D ratio and MDA content were significantly increased, while SOD activity was significantly decreased in group ALI compared with group S (P ＜0.05). The pH value at T2 and PaO2 at T2-4 in group LR and the pH value and PaCO2 at T2-4 in group HR were significantly higher than those in group ALI (P ＜ 0.05). W/D ratio and MDA content were significantly lower,while SOD activity was significantly higher in group LR and HR than in group ALI, and in group HR than in group LR (P ＜ 0.05). Remifentanil infusion significantly attenuated the pathologic changes in a dose-dependent manner. Conclusion Remifentanil pretreatment can attenuate hemorrhagic shock-induced ALI through inhibiting lipid peroxidation in rabbits.

This study was aimed to evaluate the clinical effect and safety of Chinese medicine treatment of lumbar disc herniation with qi-tonifying, stasis-resolving and kidney-tonifying method. The randomized con-trolled trial (RCT) was applied in the study to evaluate the clinical effect of qi-tonifying, stasis-resolving and kidney-tonifying method in the treatment of lumbar disc herniation . A total of 122 lumbar disc herniation pa-tients were randomly divided into the treatment group ( n = 61 ) and the control group ( n = 61 ) . Chinese medicine treatment with the qi-tonifying, stasis-resolving and kidney-tonifying method was applied in the treatment group . And Celecoxib and Methycobal were orally administered in the control group . Then , the VAS scores, JOA scores, Oswestry disability index (ODI) were recorded and analyzed pre-treatment, four weeks af-ter treatment and the twelfth week of follow-up in order to evaluate the clinical effect . Adverse reactions were also observed and recorded at the same time to give a comprehensive evaluation on its safety . The results showed that there were no significant differences between the treatment group and control group in the baseline data before treatment . Hence , data from two groups were comparable . Compared with pre-treatment , the VAS scores and ODI scores were obviously reduced in both groups after four-week treatment . The JOA scores were increased obviously ( P < 0 . 05 ) . There were no statistical differences on ODI scores and JOA scores between two groups . The VAS scores of the treatment group were obviously higher than the control group ( P < 0 . 05 ) . In the twelfth week of follow-up , the VAS scores , ODI scores and JOA scores had increasing tendency in
both groups . There were no statistical differences between two groups . There were no statistical differences on the total effective rate between two groups . In the treatment group , four patients received surgery , four cases lost to follow-up , and four cases with mild adverse event . In the control group , six patients received surgery , three cases lost to follow-up , and two cases with mild adverse event . It was concluded that the RCT of Chi-nese medicine treatment of lumbar disc herniation with q i-tonifying , stasis-resolving and kidney-tonifying method received same clinical effect as the combination of Celecoxib and Methycobal . The Chinese medicine treatment can effectively relieve pain degree of lumbar disc herniation , improve function of the lumbar vertebrae and improve the daily life and social activity ability of patients. The short-term follow-up effects were con-firmed . However , the long-term efficacy still requires further study .

ObjectiveTo summarizeand the law of lymph node metastases from adenocareinoma of esophagogastric junction ( AEG),analyses the extent of lymphadenectomy for AEG.Methods198 cases of AEG had been retrospectively analyzed from 2006.6.6 to 2010.12.31,and kept detailed record of the operation type、Siewert's type、TNM stage and group of metastatic lymph nodes.ResultsThe thoraco-abdominal two field lymph node dissection had been performed for 198 AEG,the total number of lymph nodes had been dissected was 3069,the average number was 15.50,the number of metastases lymph nodes was 859.In the 198 AEG,132 cases with lymph node positive,The metastatic rate and incidence was 66.67％ and 27.99％,respectively.The manner of the metastasis about 130 cases was station by station and 2 cases was skipping over station,accout for 98.48％ and 1.52％ of all nodes-positive cases,1 case skiped to left gastric and celiac axis and another case skiped to tracheal bifurcation.The location of positive lymph nodes about Siewert Ⅰ and Ⅱ were recorded:tracheal bifurcation(6.25％,3.33％ ) 、lower posterior mediastinum and paraoesophageai(25.00％,14.67％ ),right paracardiac (47.92％,52.00％ ),left paracardiac (31.25％,36.67％ ) 、lesser curvatura(43.75％,43.33％ ),greater curvatura( 27.08％,22.00％ ) 、left gastric and celiac axis( 27.08％,30.00％ ).The lymph nodes metastastic rate of stage T1 + T2 and T3 + T4 were 40.43％,74.83％,respectively,the difference were significantly.The lymph nodes metastastic rate of different tumor length were analyzed,≤ 3cm group were 40.74％,3 ～5cm group were 70.71％ and ≥5cm group were 88.89％,the difference were significantly;but there were no significant difference related to different differentiation grades and different Siewert types.The mediastinal lymph node metastase rates between Siewert Ⅰ (27.08％) and Siewert Ⅱ (14.67％) were significant difference,but the difference were not found in pericardiac lymph nodes.ConclusionSiewert Ⅰ 、Ⅱ AEG trend to metastasized to middle and low mediastinal and pericardiac,the modified left thansthoracic route and two field lymph node dissection maybe suitable to the lymphadenectomy for AEG.

Objective To investigate the effect of liver cirrhosis on the potency of propofol for sedation in rats. Methods Fifty-eight male SD rats, aged 10-12 weeks, weighing 180-220 g, were randomly divided into 3 groups: control group (group C, n = 18), mild liver cirrhosis group (group M1, n =20) and severe liver cirrhosis group (group M2, n = 20). The model of liver cirrhosis was established using four factors described by Chen et al. After successful establishment of the model, propofol was injected intravenously. The dose of propofol was determined by up-and-down sequential method for loss of righting reflex. The dose of propofol was 5.912 mg/kg in the first rat and the ratio of the doses between the two consecutive rats was 0.85. ED50 of propofol was calculated using up-and-down sequential method. Results ED50 of propofol was significantly lower in group M1 and M2 than in group C and in group M2 than in group M1 ( P ＜ 0.05 or 0.01 ). Conclusion The liver cirrhosis can enhance the potency of propofol for sedation in rats.