Objective:To investigate the effect of tegafur combined with oxaliplatin on the life cycle and serum alpha-fetoprotein (AFP) and carbohydrate antigen 242 (CA242) levels in patients with advanced gastric cancer.Methods:A total of 100 patients with advanced gastric cancer admitted to Hefei Third People′s Hospital from October 2016 to October 2019 were selected and divided into two groups according to randomization, with 50 cases in each group. The patients in the control group received calcium leucovorin and fluorouracil and oxaliplatin, and the patients in the observation group was treated with tegafur combined with oxaliplatin. The remission rate, disease control rate, median progression-free survival (PFS), median overall survival (OS), side effects and serum tumor markers AFP, CA242, carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), carbohydrate antigen 19-9 (CA19-9), tumor growth promoting indicators vascular endothelial growth factor (VEGF), matrix metalloproteinase (MMP)-2, MMP-9, insulin-like growth factor-1 (IGF-1), platelet endothelial cell adhesion molecule-1 (PECAM-1), microRNA (miR) 216a, miR95, miR4286 before and after treatment of the two groups were compared.Results:The remission rate in the observation group was higher than that in the control group: 42.0%(21/50) vs. 22.0%(11/50), and the difference was statistically significant ( P<0.05). After treatment, the levels of AFP, CA242, CEA, CA125, CA19-9 in the observation group were lower than those in the control group: (15.04 ± 3.65) μg/L vs. (20.65 ± 4.17) μg/L, (20.88 ± 6.37) kU/L vs.(35.46 ± 7.33) kU/L, (8.65 ± 2.13) μg/L vs.(15.39 ± 3.25) μg/L, (26.15 ± 8.49) kU/L vs. (34.16 ± 7.50) kU/L, (22.29 ± 5.80) kU/L vs. (38.81 ± 6.79) kU/L, and the differences were statistically significant ( P<0.05). The levels of VEGF, MMP-2, MMP-9, IGF-1 and PECAM-1 in the observation group were lower than those in the control group; the level of miR216a in the observation group was higher than that in the control group, and the levels of miR95 and miR4286 were lower than those in the control group, and the differences were statistically significant ( P<0.05). The median PFS in the control group was 3.0 months, the median OS in the control group was 6.6 months, the median PFS in the observation group was 3.3 months, the median OS in the observation group was 7.0 months, and the differences were no statistically significant ( P>0.05). The incidences of myelosuppression and skin damage toxicity in the observation group were lower than those in the control group: 6.0%(3/50) vs. 24.0%(12/50), 4.0%(2/50) vs. 18.0% (9/50), and the differences were statistically significant ( P<0.05). Conclusions:Tegafur combined with oxaliplatin in the treatment of advanced gastric cancer can improve the anti-cancer effect and promote the relief of the disease, and has high safety. The mechanism may be related to the inhibition of tumor growth promotion indexes and the regulation of miR.

Objective To investigate the effect of CCAAT/enhancer-binding protein homologeus protein (CHOP) in Tan Ⅱ A treated acute promyelocytic leukemia (APL) cells.Methods APL cell differentiation was monitored by morphology and membrane differentiation antigens; expression of CHOP was inhibited by siCHOP; mRNA and protein expression of CHOP in Tan Ⅱ A-intervened APL cells were examined by RT-PCR and Western blot.Results Expression of CHOP was increased in Tan Ⅱ A induced differentiated APL cells (proteins levels 1.933±0.987 vs 0.537±0.110,F =114.852,P ＜ 0.01,mNRA levels 1.587±0.815 vs 0.713±0.090,F =52.256,P ＜ 0.01),combination of CHOP gene silencing with Tan Ⅱ A treatment induced strong APL cell differentiation [(50.767±1.241) ％ vs (16.167±2.122) ％,F =989.431,P ＜ 0.05] and apoptosis [(89.233±5.581) ％ vs (27.433±2.957) ％,F =308.961,P ＜ 0.05].Conclusion CHOP acts as a negative regulator in Tan Ⅱ A induced differentiation.Inhibition of CHOP may be a promising therapeutic strategy.

2.83 cm(left-right).The density of lymphocele was homogeneous ,with 0~15 HU(mean value,5.7HU).Adjacent organs were displaced by compression of lymphocele.Conclusion It should be diagnosed as a lymphocele if a pelvic cyst is found in postoperation of pelvic malignant tumor.

Objective To analyze the epidemiological characteristic of New Delhi metallo-β-lactamase (NDM)-1-positive bacteria in China and explore its mechanism of drug-resistance.Methods The published papers from 2010 to 2015 about domestic blaNDM-1 were collected and analyzed according to the bacteria species,regional distribution,NDM-1-positive bacteria,infectious source,drug-resistance spectra and transfer mechanism.Results NDM-1-positive bacteria were isola-ted from 25 provinces (municipalities)in China,Guangdong Province was predominant and accounted for 39.49%(P <0.05).The number of Klebsiella pneumoniae and Enterobacter cloacae were predominant in the NDM-1-positive bacteria (P <0.05).Number of patients under the age of ten and among 60 -80 years which infected by NDM-1-positive bacteria were predominant of all the reported patients(P <0.05).The most kinds of samples and diseases were sputum sample (P <0.05)and pulmonary diseases(P <0.05).NDM-1-positive bacteria which found in China had the lowest resistance to amikacin and tigecycline accounted for 7.69% and 2.33%(P <0.05).Conclusion Antibiotic resistant bacteria with NDM-1 resistant gene have become a global public health problem,and significant difference among age,districts and sources,which need active surveillance and more studies to find how it happens and epidemic in the future.

Objective To discuss the effects of pressure control (PC) and positive end-expiratory pressure (PEEP) incremental method lung recruitment maneuver (RM) on haemodynamics in piglets with acute lung injury (ALI) induced by paraquat (PQ) poisoning. Methods The ALI/acute respiratory distress syndrome (ARDS) model was reproduced by intraperitoneal injection of 20% PQ (20 mL) in 10 healthy female piglets, and they were randomly divided into PC lung RM group (RM1 group) and PEEP incremental method lung RM group (RM2 group), with 5 piglets in each group. Heart rate (HR), mean arterial pressure (MAP), and cardiac index (CI) were monitored by pulse-indicated continuous cardiac output (PiCCO) monitoring before model reproduction (baseline), on the time of successfully set up of model and at 5, 15 and 30 minutes after RM. At the same time the arterial partial pressure of oxygen (PaO2) and arterial partial pressure of carbon dioxide (PaCO2) were recorded, and oxygenation index was calculated. Lung tissues were collected before model reproduction, on the time of successfully set up of model, and at 30 minutes after RM respectively, and pulmonary pathology changes were observed after hematoxylin and eosin (HE) staining under light microscopy. Results The HR, MAP, and PaCO2 on the time of successfully set up of model in both groups were increased obviously while CI, PaO2, and oxygenation index were decreased obviously as compared with those at baseline, all of which conformed to the expression of ALI/ARDS. With RM time extended, the HR in both groups was declined while MAP and CI were increased gradually. The HR and MAP at 5 minutes after RM of RM1 group were significantly lower than those of the RM2 group [HR (bpm): 126.8±5.2 vs. 134.0±3.8, MAP (mmHg, 1 mmHg = 0.133 kPa): 98.4±3.3 vs. 102.8±2.6, both P < 0.05]. The CI at 5 minutes and 15 minutes after RM of RM1 group was significantly higher than that of the RM2 group (mL·s-1·m-2: 56.7±5.0 vs. 46.7±6.7, 65.0±5.0 vs. 56.7±5.0, both P < 0.05). PaO2 and oxygenation index at 5 minutes after RM in both groups were significantly higher than those on the time of sucessfully set up of model. The PaO2 and oxygenation index were gradually decreased, and PaCO2 was increased with RM time extended, but no statistically significant differences at all time points were found between the two groups (all P > 0.05). The lung tissue in both groups showed a variety of pathological changes at 30 minutes after RM. The main performances were the loss of alveolar epithelial cells, the further wideness of alveolar interval and the distension of alveolar, and the part breakage of alveolar interval. The wideness of alveolar interval was more significant in RM2 group than that of RM1 group, and alveolar cleft was more common too. Conclusion Both PC and PEEP incremental method lung RM can improve the oxygenation of the piglets with ALI/ARDS induced by PQ, and the PC lung RM has less impact on haemodynamics.

Objective To study the imaging findings of the normal acromioclavicular joint and acromioclavicular dislocation.Methods CR films of normal shoulder in 68 cases and normal chest in 400 cases were collected.The distances of the acromioclavicular joint were measured,and the inferior cortex line of the acromioclavicular joint was observed on CR.MRI in 30 cases with normal shoulder,24 cases with acromioclavicular dislocation and 7 cases with shoulder impingement syndrome were also presented.Results The normal distance of the acromioclavicular joint was (3.36±0.44) mm.There was an arch line on the inferior cortex of the acromioclavicular joint for normal subjects.According to the Rockwood classification,acromioclavicular dislocation included type Ⅰ in 7/24 cases,type Ⅱ in 5/24 cases and type Ⅲ in 12 cases.The distances of the acromioclavicular joint were increased(＞4.3 mm) in type Ⅱ and type Ⅲ,and the inferior cortex lines of the acromioclavicular joint were not continual in type Ⅲ.MR imaging showed that the intra-articular fibrocartilaginous disk,the capsular and acromioclavicular ligament structure were ruptured in type Ⅱ,and coracoclavicular ligament torn in type Ⅲ.Conclusion The distance and the inferior cortex line of the acromioclavicular joint are of important value in diagnosis and classification of acromioclavicular dislocation.MRI is the most significant method in diagnosis of acromioclavicular dislocation.

AIM:To investigate the renal function and pathological changes in Npc1 mutant ( Npc1-/-) mice. METHODS:Different genotypes of Niemann-Pick disease type C1 (Npc1) mice were identified by PCR.Subsequently, the renal function of Npc1-/-and Npc1 +/+mice at postnatal day 60 ( P60) was evaluated by measuring the activity and con-tent of important indicators in the serum including ALT , AST, LDH, urea, UA and Cr.Furthermore,β-galactosidase stai-ning and Masson staining were performed to examine the aging and fibrosis of the renal tissues , respectively .RESULTS:Compared with the Npc1 +/+mice, the body weight and kidney weight had a significant reduction ( P<0.01) in the Npc1-/-mice.The results of hepatic and renal functions showed that the activities of ALT , AST and LDH, and contents of urea, UA and Cr had marked increases (P<0.05) in the Npc1-/-mice.Moreover, the results of senescence-associatedβ-galacto-sidase staining in the renal tissues demonstrated accelerated aging in the Npc1-/-mice (P<0.01), and these results were confirmed by Masson staining, which clearly showed the formation of collagen fibers (P<0.01).CONCLUSION:Muta-tion of the Npc1 gene results in abnormal lipid metabolism , which accelerates kidney senescence by promoting fibrosis in the renal tissue and subsequently causes reduction in renal function .

Objective To apply the multimodal analgesia (MMA) in minimally invasive surgery (MIS) for patients in spine surgery.Methods 21 patients undergoing MIS were selected to be reviewed, including haemodynamics, respiratory parameters, analgesia and sedation scale, side effects, satisfaction of operators and patients in the course of the operation. Results All the MIS was successful with excellent analgesia, conscious sedation, stable haemodynamics, unsuppressed respiratory function, and satisfaction of operators and patients. Conclusion Patients under MMA would accept MIS in a comfortable state and the communication between patients and operators would not be inhibited.

Objective To explore the curative effect of fibular flap with limbs composite soft-tissue.Methods From February,2013 to February,2016,13 cases with body severe trauma patients were treated,which including 5 cases of upper limbs and 8 cases of lower limbs,and all existed bone defect,soft tissue defect and trunk vessel defect.Three cases with limbs distal non blood supply were emergency treated with debridment and flow-through fibular flap transplantation renovation,peroneal artery repairing defective blood vesscls to rcstorc limbs distal blood supply,fibular flap repairing bone defect,skin flap repairing soft tissue defect.The limb blood supply for other 10 cases were in good condition,but one case with main artery defect did the second phase of fibular flap transplantation and repaired defective blood vessels,bone and skin soft tissue synchronously according to wound condition.According to the postoperative observation for flap survival and appearance,X-ray films to observe fracture healing after 6 weeks,three months and 6 months of operation as well as evaluating limb function recovery,then analyzed the results.Results Flaps survived successfully for 11 cases,and flaps for the other 2 cases were partial necrosis.One Case was edge flap necrosis,heal scabby after dressing,and the other case was necrosis for 1/3 of the area,but the deep fascia survival,and the skin graft healing after dressing.One case with forearm rolling was in vascular crisis after operation,but tbe crisis was relieved after detection,and fingers blood supply was recovered.All the patients were followed up for 6 to 36 months(mean,14 months).All flaps were survived,fractures healed well and limbs distal blood supply was good.Bone healing time was 8 to 24 weeks,and patients with lower limbs injury could bear load after 3 to 8 months.Lower limbs restored walking function.Upper limbs and hands restored rotation function.Transplant flapshad good elasticity and satisfactory appearance.Conclusion Using fibular flap to repair defective blood vessels,bone and soft tissue synchronously,not only can rescue the limbs on the verge of amputation,but also can repair defective composite tissue and get a good prognosis.It is an effective method for open injuries severely treatment in clinic.

Objective To study the incidence and clinical significance of the herniation pits of the femoral neck.Methods 600 cases(299 men,301 women,18～82 years)were collected.The incidence,radiologic finding and clinical significance of the herniation pit of the femoral neck were analysed.Results Of 1200 hip joints in 600 cases,there was 58 cases(64 sides)(5.3%)with herniation pits of the femoral neck,including 39 men(68.7%)and 19 women(31.3%),the lesions localized in the left joint in 25 eases(39.1%),in the right joint in 27 cases(42.2%)and in bilateral joints in 6 cases(18.7%).There were a obvious significant differences on both sexes,and no significant differences on age groups.On X-ray film,the lesions appeared as a round radiolucency with thin clear sclerotic rim.Conclusion The incidence of the herniation pit of the femoral neck is 5.3%,which has a typical X-ray feature,and may indicate the femoroacetabular impingement.