Objective To compare the effectiveness of nose jejunal tube (NJT) and nasogastric tube (NGT) in providing early enteral nutrition for patients with severe craniocerebral injury. Methods Forty patients with severe craniocerebral injury and required early enteral nutrition were equally and randomly divided into NJT group and NGT group based on the tube type. The biochemical indicators, gastrointestinal tract tolerance, and complications were compared between these two groups. Results Serum albumin, blood glucose, and lymphocyte count were not significantly different between these two groups before and immediately after nutritional support (all P ＞0. 05). However, 14 days after nutritional support, the blood sugar level significantly decreased compared with the baseline levels in the NJT group (P =0. 0001). The incidences of reflux (P = 0. 001) and abdominal distension (P =0.011) were significantly lower in NJT group than in NGT group. Conclusion NJT is superior to NGT in providing early enteral nutrition for patients with severe craniocerebral injury.

Malignant fibrous histiocytoma (MFH) is a common soft tissue sarcoma, which shows a strong predilection for distant metastases. Due to its limited response to radiotherapy and chemotherapy , poor prognosis is generally observed. A patient with MFH, who developed pulmonary metastases, postoperatively took ZD1839, an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, because it was found that there was EGFR expression on the surface of the tumor cells. After a course of treatment (28 days), the pulmonary metastases disappeared, and the patient enjoyed a complete remission.

Objective To evaluate the immunogenicity of a Haemophilus influenzae type b capsular-tetanus toxoid(Hib-TT) conjugate vaccine produced by Lanzhou Institute of Biological products(LIBP).Methods In an open-controlled,randomized trial,the eligible and consented 6-59 months-old young children injected 2 or 1 times 1 month apart with Hib-TT conjugate vaccine,the 3-5 months-old infants received 3 injections 1 month apart for primary immunization with Hib-TT or a licensed international Hib-TT conjugate vaccine as the control vaccine,and the boosting dose of two 3-5 months-old groups was injected at the 15-17months-old.The serum anti-Hib PRP IgG GMC in both groups after primary and boosting vaccination was measured by ELISA,the percentage of geometric mean concentration (GMC) ≥ 0.15 μg/ml and ≥ 1.0μg/ml was calculated,respectively.Results The Hib-TT conjugate vaccine produced in LIBP elicited satisfactory IgG antibody response in 3-59 months-old young children,the serum IgG GMC of anti-Hib PRP were 14.52 μg/ml(95％ CI:12.31-17.14)in 3-5 months-old,14.04 μg/ml(95％ CI:12.40-15.90) in 6-11 months-old.the ratios of IgG antibody concentration ≥ 1.0 μg/ml were 96.90％ (95％ CI:92.50-99.20) in study vaccine group and 98.55％ (95％ CI:92.20-99.90) in the control vaccine after 3 doses,respectively.100％ of the 6-11 months-old young children who injected 2 times with the Hib-TT conjugate vaccine had IgG antibody concentration ≥ 1.0 μg/ml (95％ CI:95.94-100.00),91.35％ (95％ CI:86.13-99.48) of recipients in 12-59 months-old young children induced the IgG antibody concentration ≥ 1.0 μg/ml after a single dose.The serum IgG antibody GMC in recipients who received the study or and control vaccines increased from 6.27 μg/ml (95 ％ CI:5.28-7.48) and 5.57 μg/ml (95 ％ CI:4.45-6.97)at pre-boosting injections to 63.14 μg/ml(95％ CI:52.14-76.47) and 73.48 μg/ml (95％ CI:57.37-94.11) one month after boosting injection,respectively.The percentage of IgG antibody concentration ≥ 1.0 μg/ml increased from 76.35％ and 79.55％ of pre-boosting to 100％ in the two groups after booting dose.Although the serum IgG GMC in two groups appeared to decline markedly,it remained at a relatively high levels of 25.02 μg/ml (95％ CI:20.51-30.48) in the study vaccine and 23.64 μg/ml (95％ CI:18.40-30.43) in the control vaccine,and all of the recipients in both groups remained 100.0％ of IgG antibody concentration ≥ 1.0 μg/ml.Conclusion The study vaccine elicited a protective immune response and induced the IgG antibody concentration which indicated long-term protection of anti-Hib PRP in 3 to 59months-old infants and young children.

Objectives To evaluate the safety and immunogenicity of Haemophilus influenzae type b capsular-tetanus toxoid(Hib-TT) conjugate vaccine.Methods In an open-controlled,randomized trial,the eligible and consented infants of 3 to 5 months-old received 3 doses of Hib-TT or a licensed Hib-TT conjugate vaccine(Anerbao) as the control vaccine to evaluate safety; The serum anti-Hib PRP IgG antibody mean geometric concentration (GMC) in both groups after primary and boosting vaccination were measured by ELISA.Results No apparent difference in the frequency of total adverse reactions observed between two groups (study vaccine 23.85％ vs.comparator 31.40％) (x2=0.5,P＞0.05).The mild and severe fever reaction of both vaccines was 3.67％ and 4.48％ respectively,with no significant difference.The local reactions including erythema,swelling and induration reported was 1.22％ in study vaccine group.After 3 injections,the serum anti-Hib PRP IgG antibody GMC was 6.6686 μg/ml in study group and 7.5346 μg/ml in control group,with no significant difference in both of the antibody GMC (x2 =0.147,P=0.702).After one dose boosting injection,the serum antibody GMC in study group increased from 2.6396 μg/ml of preboosting to 6.2044 μg/ml of post-boosting.Conclusion The Hib-TT conjugate vaccine is proved to be safe in 3-5 months-old infants.The primary immune schedule for 3-5 months-old infants of 3 injections 1 month apart with the Hib-TT conjugate vaccine could induce IgG antibody response against Hib PRP with the GMC of long-term protection concentration in serum.A boosting dose after primary vaccination elicited obviously immunological memory.

BACKGROUNDIt is uncertain that the effect of multimodality treatment with operation on survival for locally advanced non-small cell lung cancer (NSCLC). The aim of this study is to evaluate the effect of multimodality treatment with or without operation on survival for locally advanced NSCLC.

METHODSFrom May 1992 to May 1999, 114 patients with locally advanced NSCLC were divided into two arms. Arm A (n=56): 39 cases were at stage IIIA, and 17 at stage IIIB; Median KPS was 80 (range from 70 to 90 ); Multimodality treatment program included operation, chemotherapy, radiotherapy and traditional Chinese herb medicine. Of them, lobectomy plus mediastinal systematic lymph node dissection or lymph node sampling accounted for 49 cases, sleeve lobectomy plus mediastinal lymph node dissection for 5 cases, and pneumonectomy for 2 cases. Preoperative or adjuvant chemotherapy regimens included MVP (mitomycin C, vindesine, cisplatin), NP (vinorelbine, cisplatin), TC (paclitaxel, carboplatin), GP (gemcitabine, cisplatin), which were repeated every 4 weeks for 4-6 cycles. Total dose of radiotherapy for lesions in the lung or mediastinal field was 5000-6000cGy. Arm B (n=58): 23 cases were at stage IIIA, and 35 at stage IIIB; Median KPS was 70 (range from 60 to 90); Treatment program was the same approximately as arm A except for no operation.

RESULTSArm A: (1) Metastatic locations in follow-up, in turn, showed as: lymph node, pleural-lung, bone, brain, liver, pericardium, skin and adrenal; (2) Median survival was 27 months, and 1-, 2- and 5-year survival rate was 82.1%, 60.7% and 25.0% respectively. Arm B: (1) Metastatic locations in follow-up, in turn, showed as: lymph node, pleural-lung, bone, brain, liver, pericardium, skin, adrenal, pancreatic and esophageal metastasis; (2) Median survival was 13 months, and 1-, 2- and 5-year survival rate was 53.4%, 31.0% and 1.7% respectively. Median survival duration of Arm A was significantly superior to Arm B (P=0.0001). There were significant differences in 1-, 2- and 5-year survival rate between the two groups (Chi-Square=9.4, P < 0.01; Chi-Square=8.9, P < 0.01;Chi-Square=11.5, P < 0.01).

CONCLUSIONSCompared with non-operative multimodality treatment, operative multimodality treatment including lobectomy or pneumonectomy with mediastinal lymph node dissection can remarkably improve the survival in patients with locally advanced NSCLC.

Objective To analyze the values of renal resistance index(RRI),cystatin C(CysC),blood β2-microglobulin(β2-MG)and urinary N-acetyl-β-glucosamine glycosidase(NAG)in early prediction of contrast-induced acute kidney injury(CI-AKI).Methods A retrospective cohort analysis on 207 postoperative patients after intervention therapy was conducted.The patients were divided into AKI group(18 patients)and non-AKI group(189 patients)based on whether CI-AKI occurred.General and clinical data were collected and compared.Accord-ing to the time of diagnosis of AKI(D0 on the day of surgery or D1 on the first day after surgery),the AKI group was divided into AKI(D0)group and AKI(D1)group.Indicators RRI,CysC,and blood β2-MG,serum creatinine(sCr),and urinary NAG were compared between the two groups.The risk factors of CI-AKI were explored using logistic regression and linear regression.Results In the AKI group,males,preoperative sCr,acute physiological and chronic health(APACHⅡ)score and sequential organ failure(SOFA)score,surgical duratrion,sCr,CysC,blood β2-MG,urinary NAG on the day of surgery and the first day after surgery,and RRI were higher than those in the non-AKI group;Higher APACHEⅡ and SOFA scores and higher CysC level on D1 were independent risk factors for the occurrence of CI-AKI(P<0.05).Levels of CysC and urinay NAG on D0 were higher in the AKI(D0)group than in the AKI(D1)group(P<0.05).RRI,urinary NAG and blood β2-MG were not independent risk factors for CI-AKI.Conclusions CysC and urinary NAG are powerful predictors for the prediction of CI-AKI,and RRI and blood β2-MG cannot predict the occurrence of CI-AKI early.

Objective: To observe the morphological changes of root canals in maxillary second premolars at various ages by using cone-beam CT (CBCT) in order to provide imaging and theoretical reference for clinical treatments. Methods: The digital CBCT data of the maxillary second premolars in 440 cases from the patients in Department of Stomatology, The First Affiliated Hospital, Jinan University during March 2011 and December 2017 were collected. The CBCT images were divided into 4 groups according to the patients′ ages: groups ≤20, 21-40, 41-60 and>60 years old, respectively. Changes of morphologies of root canals with aging including such parameters as types of the root canal, incidence of double root canals in single rooted teeth, distance between both root canal orifices of double rooted canals, and morphological change of the cross section of roots. Chi-square test and liner trend test were adopted in statistical analysis in the present study. Results: Most maxillary second premolars had only one root [95.2% (419/440)]. Type Ⅰ of the root canals was the most common type [57.3% (252/440)], and the following prevalent groups were type Ⅱ[16.8% (74/440)], type Ⅳ [10.2% (45/440)] and type Ⅲ [8.9% (39/440)]. The distribution of type Ⅰ~Ⅳ of the root canals were significantly different amongst various aged groups (P<0.05). Along with aging, the percentages of type Ⅰ decreased while type Ⅱ increased. However, there were no remarkable changes of type Ⅲ and type Ⅳ observed. The incidence of double canal in single rooted teeth gradually increased with aging especially in 20-year-old and above groups, e.g. 13.1% (13/99) in group of ≤20 years old and 45.0% (86/191) in group of 21-40 years old. However, there was no significant increase observed after the age of 40. The distance between two root canal orifices of double rooted canals became shorter with aging except in groups of 40-year-old and above. The morphologies of the cross sections of root canals in most groups were flat shaped [57.8% (1 121/1 938)] and oval shape [31.3% (607/1 938)]. Along with aging, the percentage of circular shape gradually increased while flat and oval shapes decreased. Conclusions The morphology of root canal could be clearly showed by the CBCT images. Most maxillary second premolars had only one root and one apical foramen. Along with aging, the morphology of the root canals became more and more complicated.