Background and purpose:Paclitaxel and cisplatin were demonstrated to be effective and well-tolerated for advanced gastric cancer.The clinical efficacy of hyperthermic intraperitoneal perfusion(CHPP) has been established in numerous studies in recent years.The purpose of the study was to evaluate the efficacy and toxicities of paclitaxel combined with CHPP with cisplatin in the treatment of patients with advanced gastric cancer.Methods:51 patients with advanced gastric cancer were randomized into systemic chemotherapy group(25 patients) who received paclitaxel 70 mg/m2,iv,1/wk?8wk,DDP 25 mg/m2,iv,d1-3,reapeated every 3 weeks for 4 cycles and systematic plus CHPP group(26 patients)who received paclitaxel 70 mg/m2,iv,1/wk?8wk,DDP 60 mg/m2,CHPP,d1,8,22,29,and abdomen hyperthermia treatment twice a week in the whole chemotherapy period.Results:The response rate(CR+PR),the clinical benefitial response(CBR) in systematic plus CHPP group were 65.4% and 92.3%,and those in systemic chemotherapy group were 36.0% and 68.0%.There was obviously a statistical difference between two groups(P0.05).The major toxicities were myelo-suppression and nausea/vomiting.There was no significant difference in side-effect between the two groups.Conclusions:Paclitaxel administered by weekly infusion combined with hyperthermic intraperitoneal perfusion chemotheraphy with cisplatin in the treatment of advanced gastric cancer is effective and tolerable.It is worth studying in the future.

Objective To study the changes of acetyl-histone H2B in the cochlear hair cells of the guinea pig model of noise-induced hearing loss (NIHL).Methods Sixty guinea pigs were randomly divided into control and noise-exposure group.Thirty guinea pigs in the noise-exposure group were exposed to narrowband noise at 122 dB SPL for 3 hours , while thirty guinea pigs in the control group were not exposed to noise.Auditory thresholds were assessed by auditory brainstem response (ABR), prior to noise in two groups and 3, 7,14 and 21 days after noise exposure in the noise group.Then we investigated the expression of acetyl-histone H2B levels in the sensory cells of basilar membrane after noise expose by immunofluorescence staining and western blot.Results Compared with pre-exposure hearing, ABR thresholds were increased at 1h, 3, 7, 14 and 21 days after noise exposure, and recovered gradually with time and reached a permanent threshold shift at 14 days.The expression of acetyl-histone H2B was down-regulated in the hair cells and Hensen''s cells of the guinea pig cochlea after the noise expose , The ratio of H2B-AcK5 / β-actin was 0.6179±0.1260 in the control group and 0.3102±0.0839 in the noise group, and the difference was statistically significant (P<0.01).Conclusion Noise decreased the inner ear sensory cells histone acetylation level and histone acetylation imbalance may be involved in the occurrence of NIHL.

Objective To investigate changes in serum levels of antinuclear antibody(ANA), anti?double?stranded DNA(dsDNA)antibody and anti?extractable nuclear antigen(ENA)antibody before and after anti?tumor necrosis factor?α(TNF?α)therapy in psoriatic patients. Methods Clinical data obtained from 32 patients with psoriasis were analyzed retrospectively. Of the 32 patients, 13 received intravenous injection of 5 mg/Kg infliximab at week 0, 2, 6 for 3 sessions, then once every 8 weeks(infliximab group), while other 19 received subcutaneous injection of 25 mg etanercept twice every week(etanercept group). The treatments in the 2 groups both lasted more than 3 months. Serum levels of ANA, anti?dsDNA antibody and anti?ENA antibody and changes of clinical symptoms were detected and observed respectively before each treatment in the infliximab group, as well as every 3- 6 months in the etanercept group. The 75%reduction in psoriasis area and severity index(PASI75)and disease activity score of 28 joints(DAS28) were used to evaluate clinical efficacy. Serum levels of ANA, anti?dsDNA antibody and anti?ENA antibody were measured by indirect immunofluorescence(IIF)assay, Western blot analysis combined with enzyme?linked immunosorbent assay(ELISA), and Western blot analysis, respectively. Results After 3?month treatment, the 32 patients achieved clinical remission to different extents. Of 32 patients receiving anti?TNF?αtherapy, 7(21.9%)developed new autoantibodies. Concretely speaking, 4 patients in the infliximab group developed autoantibodies in 8.3 ± 5.1 months, including 3 cases positive for ANA and 3 for anti?ENA antibody. Three patients in the etanercept group developed autoantibodies in 9.0 ± 3.0 months, including 3 cases positive for ANA and 1 for anti?ENA antibody. Conclusion Partial patients with psoriasis may develop autoantibodies after anti?TNF?αtherapy.

OBJECTIVE:To establish the quality standard for Gastrodia elata hency-fired tablet. METHODS:TLC was used to identify the gastrodin and benzyl alcohol and determine the content of moisture,ash and extract;HPLC was used to determine the content of gastrodin and benzyl alcohol. Column was Diamonsil C18 with mobile phase of acetonitrile-0.05% phosphate(3:97,V/V) at flow rate of 1.0 ml/min,detection wavelength was 220 nm,column temperature was 25 ℃ and volume injection was 10 μl. RE-SULTS:The TLC of gastrodin and benzyl alcohol showed clear spots and good separation. The moisture content<35.0%,total ash contents<2.0% and extract content>40.0%. Linear range of gastrodin was 25.2-126.0,12.7-63.5 μg/ml(r=0.999 9),respectively;RSDs of precision,reproducibility and stability tests were lower than 2.0%;recovery was 99.49%-102.40%(RSD=1.09%,n=6), 98.75-102.63%(RSD=1.53,n=6),respectively. CONCLUSIONS:The method is simple and good reproducibility,and can be used for the quality control of Gastrodia elata hency-fired tablet.

Objective:To analyze the value of low dose enteral nutrition (EN) in treatment of septic shock combined with acute gastrointestinal injury Ⅲ (AGI Ⅲ).Methods:Clinical data of septic shock patients combined with AGI Ⅲ admitted at our hospital were analyzed.Patients were divided into two groups according to the nutrition therapy they received:treatment group (EN,n =41) and control group (no EN,n =46).The mortality and ICU hospital stays were collected.The intestinal barrier,inflammatory cytokines,and oxidative stress were evaluated before and after EN treatment.Results:For patients in the treatment group,the dosages of EN ranged from 200 to 410 kcal/d,with the median dose of 350 kcal/d.No significant differences were found on death rates between the two groups (24.4％vs 32.6％,P =0.398).Patients in the treatment group had shorter ICU hospital stays than those of the control group (11.8 ± 3.7 vs 16.2 ± 5.3,P ＜0.01).After one week EN treatment,patients in the treatment group had lower levels of CRP,IL-6,TNF-α,diamine oxidase,endotoxin and D-lactate than those of the control group (P ＜ 0.05).Conclusion:For septic shock patients combined with AGI Ⅲ,low dose EN can improve the intestinal barrier function and systemic inflammatory responses.

AIM:To observe the alterations in cognition of growing rats exposed to chronic intermittent hypoxia (CIH) and to explore its underlying mechanisms. METHODS:Forty male Sprague-Dawley rats (3-week-old～4-week-old and 80 g to 100 g),which had been trained to complete the 8-arm (4-arm baited) radial maze,were randomly divided into 4 groups:2-weeek-CIH group (2IH),4-week-CIH group (4IH),-week -control group (2C) and 4-weeek-control group (4C). The intermittent hypoxia model was induced by putting the animals in an intermittent hypoxia cabin. When intermittent hypoxia was terminated,spatial memory of these growing rats was tested by 8-arm (4-arm baited) radial maze task,then,one rat in each group was randomly selected for ultrastructural observation. The hippocampus and prefrontal cortexes of the rats were collected for analyzing the mRNA and protein expression of CREB by RT-PCR and Western blotting,respectively. RESULTS:(1) In the 8-arm (4-arm baited) radial maze task,the results indicated that the rats in the 4 groups displayed significant difference in their performance assessed by three measuremens:the reference memory error,the working memory error and total memory error (P 0. 05,respectively). CONCLUSION:Exposure to experimentally-induced IH in growing rats is associated with time related spatial memory impairment. Chronic intermittent hypoxia leads to the disorders of neuron ultra-structure in memory related brain regions. It also inhabits the CREB transduction,expression and CREB phosphorylation,decreases the synthesis of the memory related protein. These factors maybe contribute to learningmemory impairment of growing rats exposed to chronic intermittent hypoxia.

OBJECTIVETo study the respiratory system injury in fur processing environment.

METHODSEnvironmental fungal survey was conducted in the fur processing procedures. Investigation of respiratory symptoms and chest X-ray examination were also carried out in 138 fur processing workers and 40 control workers. At the same time, the serum antibodies to fungi were analyzed by ELISA.

RESULTSFungal number(629-3,681 cfu/m3) in fur processing procedures was much higher than those in the control environment. Cladosporium and Alternaria were the leading strains of fungi in fur processing procedures. The rates of respiratory symptoms(cough, sputum, chest tightness, dyspnea, and fever) in fur processing workers were higher than those in the control workers. The rates of the symptoms in female workers were 37.9%, 28.4%, 10.5%, 22.1%, 4.2%, respectively. Abnormalities of chest X ray were found in 7 workers. The serum antibodies to Cladosporium and Alternaria(A450 nm 0.631, 0.724, respectively) in fur workers were significantly higher than those in the control workers(P < 0.05). The positive rates of the antibodies to Cladosporium and Alternaria(44.2%, 42.8%) were significantly higher than those in the control workers(P < 0.01).

CONCLUSIONCladosporium and Alternaria may be the pathogens of occupational respiratory diseases in fur processing workers.

Alternaria ; isolation & purification ; Antibodies, Fungal ; blood ; Cladosporium ; isolation & purification ; Environmental Microbiology ; Female ; Hair ; Humans ; Occupational Diseases ; etiology ; Radiography, Thoracic ; Respiratory Tract Diseases ; etiology

OBJECTIVE Aimed to observe the changes of acetylated histone H2B in the marginal cells of stria vascularis and spiral ganglion cells from the noise-induced hearing loss model (NIHL). METHODS Fifty guinea pigs were randomly divided into control and noise-exposure group. Auditory brainstem response threshold shift was examined before noise exposure and at 1h after noise exposure (122 dB SPL, 3 h). Immunofluorescence staining and western blot were used to observe the expression of acetyl-histone H2B both in the marginal cells of stria vascularis and spiral ganglion cells of modiolus 2 h after noise expose in two groups. RESULTS There was no significant difference in hearing threshold of 4, 8, 16, 32 kHz for the two groups before noise exposure. The hearing threshold was beyond 90dB (the maximum output) at 4,8,16 and 32 kHz 1h after noise exposure. The expression of acetylated histone H2B significantly decreased with immunofluorescence staining in the marginal cells after noise stimulation. Accordingly, the protein level of acetylated histone H2B in the lateral wall of cochlear decreased obviously in the noise group compared to the control, the ratios of H2B-AcK5/p-actin were 0. 3471 ±0. 0843 and 0. 6114 ±0. 0207 respectively(t=5. 268,P＜0. 01). There was no obvious difference for the expression of acetylated histone H2B in the modiolar tissue between two groups, the ratio of H2B-AcK5/p-actin was 0. 4993 ± 0. 0994 for the noise group and 0. 5139±0. 0132 for the controI (P＞0. 05). CONCLUSION Noise exposure significantly decreased histone acetylation expression in the nuclei of strial marginal cells, whereas the level in the spiral ganglion cells remained stable. Histone acetylation imbalance in the marginal cells of stria vascularis may contributed to the occurrence ofNIHL.

Objective? To observe the effects of continuous quality improvement on the incidence rate of ventilator-associated pneumonia (VAP) in intensive care unit (ICU). Methods? Totally 158 patients using ventilators in ICU of Hangzhou Red Cross Hospital between January and June 2016 were selected as the control group using convenient sampling, and another 165 patients using ventilators between January and June 2017 were selected as the observation group. Patients in the control group received conventional nursing care, while patients in the observation group received Plan-Do-Check-Act (PDCA) Cycle Management with the quality of standardized nursing process, standardized upper respiratory tract management and hand hygiene continuously improved. Incidence rate of ventilator-associated pneumonia(VAP), rate of pass in oral nursing care and hand hygiene compliance in medical and nursing workers were compared between the two groups before and after improvement. SPSS 17.0 was used for statistical analysis. Results? The incidence rate of VAP during the first half of 2017 totaled 5.07‰, a decrease of 6.42‰ compared with the first half of 2016. There was statistically significant difference in the incidence rate of VAP between the two groups (P＜0.01); the rate of pass in oral nursing care after improvement (93.17%) was statistically higher than that before improvement (57.31%) (P＜ 0.01); and the hand hygiene compliance after improvement (93.67%) was statistically higher than that before improvement (67.33%) (P＜ 0.01). Conclusions? Continuous quality improvement can reduce the incidence rate of VAP in ICU, which is operable and worth promoting in clinical practice.