Objective To investigate the efficacy of metholrexate combined with rmifepristone and laparoscopic surgery for treating ectopic pregnancy.Methods 85 patient with ectopic pregnancy were selected.41 cases treated with methotrexate and mifeprisione were considered as the control group,while 44 cases with laparoscopic surgery were considered as the observalion group on the voluntary basis.The clinical efficacy,serum β-HCG value and recovery time after 7d were compared between the two groups.Results After the treatment,the cure rate in the observation group was 100％ which was significantly higher than 90％ of the control group ( P ＜ 0.05 ),the serum β-HCG value of the observation group was lower and the restoration normal time was shorter than the control group ( P ＜0.05).Conclusions Laparoscopic surgery and conservative treatment of methotrexate combined with mifepristone are effective in the treatment of ectopic pregnancy.However,the clinical efficacy of the laparoscopic surgery is better and it has rapid recovery time,and it can completely cure the patients.

Objective To observe the anti-inflammatory effects of rhamnocitrin in Oxytropis falcata Bunge;To provide experimental evidence for searching the anti-inflammatory active component of Oxytropis falcata Bunge. Methods Kunming mice or Wistar rats were randomly divided into model group, naproxen group and rhamnocitrin high-, medium-, low-dose groups, and corresponding medicines were administered by gavage for 7 days. Animal inflammatory models were established respectively by the mice ear swelling induced by dimethylbenzene, the mice abdominal capillary permeability induced by acetic acid, the rat paw edema created by injection of albumen and the rat granuloma induced by cotton pellet wool. The effects of rhamnocitrin on acute and chronic inflammatory animal models were observed. Results Different doses of rhamnocitrin groups could reduce the animal ear swelling, abdominal capillary permeability, paw edema and granuloma. Compared with the model group, there were obvious differences in rhamnocitrin groups (P<0.05). High dose rhamnocitrin group and naproxen group showed relatively strong inhibition effects on swelling, with statistical significance (P<0.05). Conclusion Rhamnocitrin has anti-inflammatory effects and is an important biological component of Oxytropis falcata Bunge.

Objective To study the risk factors influencing the prognosis in the children patients with acute gastrointestinal dysfunction and to seek their therapeutic measures. Methods The clinical data of 125 cases patients with acute gastrointestinal dysfunction were retrospectively analyzed. The risk factors possibly influencing the prognosis were analyzed by multivariate statistical Logistic analysis. Results Among 125 children patients, 61 cases died, and the mortality rate was 48.8%. Logistic regression analysis indicated that poor circulation, cardiovascular system failure, hepatic failure, brain failure were significant risk factors of death associated with acute gastrointestinal dysfunction. (OR = 4.156, 3.330, 6.903, P<0.05 or<0.01). Conclusions Poor circulation, cardiovascular system failure, hepatic failure and brain failure are significant risk factors of death associated with acute gastrointestinal dysfunction.

Third-grade class A hospitals undertake three tasks-medical service,scientific research and teaching.scientific research is the motivation for third-grade class A hospitals' continuous development and also an important symbol of their medical and academic level.On the purpose of evaluating overall scientific level of such hospitals this thesis analyze the scientific projects and the outcomes of 34 hospitals by using the method of literature research and questionnaire,extracting advantages for scientific research,seeking their problems and coming up with corresponding strategy.have analyzed the achievements we acquired as well as the problems still existing.According to the reality of Fujian Province,some suggestions are coming up with so as to improve the scientific research.

Objective To observe the clinical role of Qiliqiangxin capsules uniting conventional western medicine interfering with chronic heart failure(CHF).Methods 61 cases of CHF were randomly recruited into a control group(31 cases)and a treatment group(30 cases).The control group was treated with conventional anti-hean failure treatment,and the treatment group was added Qiliqiangxin capsules on the treatment of the control group.After having been treated for 2 courses (fonr weeks),such indexes as clinical efficacy,body weigbt,urine volume,6 min walking distance(6MWD),electrocardiogram,and cardiac ultrasound were measured for both groups.Results The overall efficiency of cardiac function was 93.33%for the treatment group and 74.19%for the control group.There was significant difierence between the two groups(χ~2=4.07985,P＜0.05).The enhance rate of left ventricular ejection fraction(LVEF)was(16±4)%in the treatment group as compared to(11±3)%in the control group,also showing statistical difierence between the two groups(t=5.509,P＜0.001).Conclusion Qiliqiangxin capsules combined with conventional western medicine could effectively improve the cardiac function,LVEE clinical symptoms,and quality of life in the patients with ehronic heart failure.

Objective Deleting the cysteine-rich region (22-37 amino acids)of HIV-1 HXB2 Tat protein(whole length is 101 amino acids) to improve its stability and expression level in E.coli and to analyze the immunogenicity of Tat protein without the cystein-rich region [Tat(△C)protein]. Methods Tat DNA deleted the cysteine-rich region (64-111 nucleotides), named as Tat(△C)DNA, was obtained in vitro by PCR and cloned into pET-32a vector. pET-32a-Tat(△C)plasmid and the pET-32a-Tat plasmid were established and transformed into E.coli BL21(DE3) strains respectively to express and purify the protein. Three rabbits were vaccinated with pET-32a-Tat(△C)protein, then testify the reactivity of sera from rabbits by ELISA and Western blot. Results The dense of the purified pET-32a-Tat(△C)protein was 7.12 mg/ml,which was greatly more than pET-32a-Tat protein(1.50 mg/ml). Dimer of pET-32a-Tat protein can be observed just after the protein purification and stored at 25℃ and 4℃ for 7 days, but dimer of pET-32a-Tat(△C)protein was not formed at the same condition. Experimental rabbits were immunized with pET-32a-Tat(△C)protein and produced high titre of anti-pET-32a-Tat(△C)serum(1∶320 000), the antibody can react specifically with Tat(△C)protein, Tat protein (1-101 AA)and synthetic Tat(1-86 AA) protein. Deletion mutation of the cysteine-rich region of Tat protein was first performed in the study. Conclusion The expression level in E.coli and the stability of Tat protein deleted the cysteine-rich region can be increased greatly, and the protein remains good immunogenicity. The results may provide a novel antigen for further development of HIV-1 Tat vaccine.

Abstract: Objective To analyze the resistance and spatial distribution of Mycobacterium tuberculosis (MTB) to six commonly used anti-tuberculosis drugs in Qinghai Province from 2016 to 2019, so as to provide a reference for tuberculosis treatment and drug-resistant tuberculosis control. Methods A total of 1 182 identified strains of Mycobacterium tuberculosis in Qinghai Province from 2016 to 2019 were collected, and 6 anti-tuberculosis drugs were subjected to drug susceptibility tests and strain confirmed by the proportional method. By means of ArcMap10.7 and SaTScan10.1 software, map visualization, spatial autocorrelation analysis and spatial scanning of MTB drug resistance were performed to identify MTB drug resistance clusters in Qinghai Province. Results From 2016 to 2019, the total drug resistance (TDR) rate of 1 182 Mycobacterium tuberculosis strains in Qinghai Province was 23.77% (281/1 182), with a mono-resistance (MR) rate of 11.08% (131/1 182), a poly-resistance (PDR) rate of 3.89% (46/1 182), a multi-drug resistance (MDR) rate of 8.80% (104/1 182), and an extensive drug resistance (XDR) rate of 0.85% (10/1 182). The rates of MDR, XDR and TDR all showed a decreasing trend year by year (P<0.01). The drug resistance spectrum displayed 21 combinations. The TDR rate and MDR rate in the retreatment patients were higher than those of the initial treated patients, and the difference was statistically significant (χ2 TDR=22.784, χ2MDR=45.082, P<0.01). In terms of demographic characteristics, the TDR rate in males was higher than that in females, and the middle-aged group was higher than other age groups, and the differences were statistically significant (χ2=7.541, 10.825, P<0.05). The results of global spatial autocorrelation analysis showed that there was no statistical significance in the autocorrelation and obvious spatial clustering of MTB drug resistance in Qinghai Province from 2016 to 2019 (P>0.05), which indicated a random distribution. The results of spatiotemporal scanning showed that there was a kind of clustering area, but the clustering effect was not significant (P>0.05), indicating a random distribution. Conclusions The TDR of MTB in Qinghai Province from 2016 to 2019 showed a downward trend year by year. In comparison with the national average, the rate of multi-drug resistance and extensive drug resistance was still high, and most of the multi-drug resistance resulted from rifampicin and isoniazid. The drugresistant population mainly consisted of retreatment, males, and young and middle-aged pop

Objective: To investigate the clinical features of adult B-cell acute lymphoblastic leukemia (B-ALL) with E2A-PBX1 fusion gene positive. Methods: The clinical data of 91 Philadelphia chromosome negative B-ALL patients who received chemotherapy regularly in Nanfang Hospital of Southern Medical University from March 2015 to December 2017 were collected. According to the fusion gene detection results, the patients were divided into E2A-PBX1 fusion gene positive group and E2A-PBX1 fusion gene negative group. The clinical features and prognosis of both groups were retrospectively analyzed. And then E2A-PBX1 fusion gene negative group was further divided into MLL-AF4 fusion gene positive group and the other ALL groups,which were compared with E2A-PBX1 fusion gene positive group in the prognosis. Results: There were 11 ALL patients with E2A-PBX1 fusion gene positive, and 80 ALL patients with E2A-PBX1 fusion gene negative. The level of lactic dehydrogenase (LDH) in E2A-PBX1 fusion gene positive group was higher than that in E2A-PBX1 fusion gene negative group [4 063 U/L (1 070- 9 554 U/L) vs. 454 U/L (103- 18 651 U/L), U=-4.700, P < 0.01], and there were no statistically significant differences in age, gender, white blood cell count and extramedullary invasion (all P > 0.05). The immunophenotypes of ALL patients with E2A-PBX1 fusion gene positive were all common B-cell phenotype. Out 4 of 7 ALL patients showed the different expression of Philadelphia-like ALL phenotype CRLF2 or phosphorylated CRKL or phosphorylated STAT5 by using flow cytometry. The complete remission (CR), minimal residual disease (MRD)-negative and the recurrence for 11 cases of E2A-PBX1 fusion gene positive group included 9, 7, 8 cases, respectively after first course of induction chemotherapy. The CR, MRD-negative and the recurrence for 80 cases of E2A-PBX1 fusion gene negative group included 71, 53, 26 cases, respectively after the first course of induction chemotherapy. There were no statistically significant differences in the CR and MRD-negative between the two groups after the first course of induction chemotherapy (P= 0.721, P= 0.487), but there was a statistical difference in the recurrence (χ²= 7.751, P= 0.012). The median follow-up time was 17 months (1-44 months), and the 1-year overall survival (OS) rate and 1-year event-free survival (EFS) rate of E2A-PBX1 fusion gene positive ALL group were lower than those of the negative group (OS: 43.6% vs. 70.0%, P= 0.020; EFS: 13.6% vs. 60.0%, P= 0.002). Subgroup analysis showed that there were no statistical differences between E2A-PBX1 fusion gene positive group and MLL-AF4 fusion gene positive group in 1-year OS rate and 1-year EFS rate (P= 0.617, P= 0.984). Conclusions E2A-PBX1 fusion gene positive rate is low in adult B-ALL patients with a good response to traditional chemotherapy in the early stage, but its cumulative recurrence rate is high. It is a high-risk cytogenetic abnormality which is similar to MLL gene rearrangement and needs to explore novel therapy strategies.

Objective To summarize and analyze the clinical phenotypes,hereditary features and treatment and follow-up strategies of different hereditary pheochromocytoma/paragangliomas(PCC/PGL)and related syndromes.Methods Forty-four clinically diagnosed PCC/PGL patients admitted in our hospital from January 2000 to August 2022 were enrolled,and the clinical data of them and their family members were collected.Second-generation sequencing was performed on 43 patients for genetic detection,and Sanger sequencing was applied to verify the mutation of the probands and family members.Results There were 15 patients diagnosed with hereditary PCC/PGL,including 7 cases of von Hippel-Lindau(VHL)syndrome,3 cases of multiple endocrine neoplasia type 2(MEN2),and 5 cases of familial paraganglioma syndrome.Seven VHL syndrome families were diagnosed as VHL2A(c.500G＞A),VHL2B(c.239G＞T and c.444_457del),and VHL2C(c.293A＞G)according to their clinical manifestations.All probands received surgical treatment,and 2 cases of recurrent PCC and the patients with multiple renal cancer also received targeted therapy with sunitinib.Three MEN2 families carried c.1901G＞C,c.1832G＞A,and c.1901G＞A missense mutations,respectively,and were diagnosed with MEN2A clinically.All of them underwent adrenalectomy and thyroidectomy,including one for preventive thyroidectomy.Among the 5 familial paraganglioma syndrome families,4 patients carried SDHB mutations(SDHB:c.343C＞T,c.541-2A＞G,c.575G＞A,c.268C＞T)and 1 patient carried an SDHD mutation(SDHD:c.337_340del).Sporadic retroperitoneal PGL were most common.Conclusion More than 1/3 of PCC/PGL patients carry germline gene mutations,showing obvious genotype-phenotype correlation.Genetic diagnosis technology plays an important guidance role for clinical precision treatment and follow-up,and genetic counseling.

Objective To retrospectively analyze contrast-enhanced ultrasound ( CEUS ) manifestations of neuroendocrine tumors ( NETs) liver metastases ,and explore the relationship between CEUS parameters and differentiation of NETs . Methods From January 2014 to June 2018 ,36 patients who had been performed CEUS due to liver metastasis of NETs with pathological diagnosis and immunohistochemical staining results were enrolled in this study . The CEUS findings of NETs liver metastases were summarized . According to the Ki-67 index ,CgA results ,and the stage G ,the patients were divided into Ki-67>20％ group and Ki-67≤20％ group ,CgA negative group and CgA positive group ,and group G1+G2 and group G3 ,respectively . The CEUS parameters of NETs liver metastases between the above groups were compared . Results In 36 lesions ,during the arterial phase of CEUS ,66 .7％ (24/36) showed hyperenhancement ,16 .7％ (6/36) isoenhancement ,13 .9％ (5/36) rim-like enhancement ,and 5 .6％ ( 2/36 ) hypoenhancement ; During the portal phase , 13 .9％ ( 5/36 ) showed hyper or iso enhancement ,86 .1％ (31/36) showed hypoenhancement . The average washout time was ( 67 .5 ± 56 .1)s ,of which 5 (13 .9％ ) lesions were washed out after 120 s . The mean starting washout time was statistically different between the CgA negative group and the positive group[(91.6±81.5)svs(60.1±38.7)s,P =0 .001] . There was no statistically significant difference in all observations between the group of Ki-67≤20％ and >20％ ,group G1+G2 and group G3( P >0 .05) . Conclusions CEUS of NETs liver metastasis has certain characteristics ,among which hyperenhancement is its main enhancement mode ,and some lesions have a longer wash out time . The relationship with the degree of differentiation needs further investigation .