Objective To investigate the characteristics of personal injuries in motorcycle accidents in Chongqing area to provide the reliable information and reference basis for reducing the injury and death risk of the motorcycle accidents.Methods Two hundreds and thirteen cases of motorcycle traffic accident occurred in Chongqing area from January 2015 to June 2016 were deeply collected,the collected contents included the basicinformation,driver information and personal injury,etc.Then accident data were statistically analyzed.Results The death rate of motorcycle drivers was higher than that of the pillion passengers.The death causes of craniocerebral injuries and craniocerebral injuries complicating thoracic and abdominal organ injuries accounted for 58.8％ and 20 ％ respectively,the proportions of head and neck,chest and back,lower extremity,upper extremity,abdominal and pelvic part and perineal part MAIS ≥2 were 71％,59％,33％,25％,20％ and 7％ respectively.The perineal injury rate of motorcycle drivers was higher than that of the pillion passengers.The ratio of occurrence rates between lower extremity fracture to upper extremity fracture was 1.8 ∶ 1,the persons in motorcycles-trucks accidents were easier to suffer from vehicle crushing.Conclusion Head and chest injuries are important causes leading to motorcycle drivers and pillion passengers' death and injury.The perineal injury can serve as an important basis for identifying the drivers and pillion passengers in partial motorcycle accidents.

Autoimmunediseasesofthecentralnervoussystem（CNS）aremediatedbyabnormalautoimmunerespon⁃ sesintheCNS.Thepathogenesisofthesediseasesisunknown，whiletheclinicalmanifestationsarediverseandthelack ofeffectivetreatmentmethodsmadethediagnosisandtreatmentgreatchallenges.Alongwiththedevelopmentofbigdata technology，gene，proteomicsaswellasnewimagingtechnologies，ithasbecomepossibletoidentifyindividualbiomark⁃ ersforspecificdisease，explorenewtherapeutictargets，andfinallyachievetheprecisiondiagnosisandindividualtreat⁃ ment.ThepresentarticlewilldiscusstheprecisiondiagnosisandtreatmentofautoimmunediseasesoftheCNSbycombin⁃ ingwiththeworkinourresearchgroup.

Surgery remains the primary treatment for patients with localized gastrointestinal stromal tumor (GIST), however, even after complete resection of the tumor, there is still a part of patients with tumor recurrence and metastasis. Imatinib, as adjuvant therapy in GIST patients with intermediate and high risk of recurrence, can significantly improve the disease-free survival, but whether it can prolong the overall survival is still unknown. It has reached a consensus that the intermediate and high risk patients should receive adjuvant therapy, but the duration for adjuvant therapy is still under investigation, especially for high-risk patients. Adjuvant therapy is recommended for at least 3 years, while in the end of adjuvant therapy, some patients still develop recurrence and metastasis. In 2017, results from PERSIST-5 study reported by the ASCO conference indicated that 5-year adjuvant therapy may further prolong disease-free survival of intermediate and high risk patients. In addition, adjuvant therapy is still not individualized based on the combination with different genotypes, and present adjuvant therapy is recommended for GIST patients with positive CD117 and intermediate-high risk of recurrence. It remains controversial whether different genotypes are associated with alternative adjuvant treatment options. Results of more researches are expected to provide better guidance for clinical treatment in the future.

Objective　To investigate the relationship between p53 gene and tumors of adipose tissue at the level of protein and gene. Methods　Immunohistochemical LSAB, PCR-SSCP and DNA sequencing were used in 82 cases. Results　p53 protein is expressed only in liposarcomas, in which the positive staining rate was 48.08% (25/52). In different subtypes of liposarcomas, the positive staining rate in well differentiated liposarcomas was 30.00% (9/30), which is much lower than that of the poorly differentiated liposarcomas (P<0.005). Abnormality in the single-stranded DNA pattern was determined in 2 samples (pleomophic liposarcomas) by PCR-SSCP analysis. Missense mutations in exon 8 codon 268 of p53 gene (AAC→ATC) were detected by DNA sequencing. Another heterozygotic cosense mutation may exist at exon 6 codon 221 of p53 gene (GAG→GAA). Conclusions　The data suggest that the p53 protein has a relationship with development, differentiation and malignancy of liposarcoma. Detecting the level of p53 protein expression may be valuable in evaluating the level of differentiation and malignancy of liposarcoma. There appear point mutation on exon 8,6 of p53 gene.

Objective To study the effect of early nutrition on the development of physique and small intestine inrats with intrauterine growth retardation (IUGR). Methods Eight normal pubs fed with normal protein diet (20 % )were used as normal controls. The IUGR pups were assigned into normal protein diet group (IC group), low-protein dietgroup (IL group) and high protein diet group (IH group). On the 1st, 21st and 28th day after birth respectively, theweight and length of small intestine (SI), the body weight and length, and the activities of disaccharidase weremeasured. Results The body weight and length, weight and length of SI in rats with IUGR at birth were allsignificantly lower than those in normal rats ( P ＜ 0.05). Body length, body weight, length and weight of SI in ILgroup were all lower than those in IC, IH and normal control groups in the first 4 weeks after birth. The physique andsmall intestine in IH group caught up growth quickly, the body weight in the 4th week reached the normal value. In thethird week, the lactase activity in IL and IH groups were higher than that in normal control group ( P ＜0.05). In the4th week, the sucrase activity in IL group was lower than that in normal control ( P ＜ 0.05). Conclusions Earlynutrition after birth has an important effect on the development of physique and SI in rats with IUGR.

OBJECTIVETo evaluate antifungal combination strategy in children with hematologic diseases and invasive fungal disease( IFD).

METHODSA retrospective clinical study was performed based on 67 childhood patients with hematologic diseases and IFD who firstly accepted combination antifungal therapy for ≥ 7 days during January 2012 and December 2014. Of them, 11 cases received combination of echinocandin with azole, 10 cases received combination of echinocandin with amphotericin B, and 46 cases received combination of azole with amphotericin B.

RESULTSOverall response rate was 79.1%. Univariate analysis revealed that granulocyte recovery (P=0.031), status of underling disease (P=0.023) and the duration of the therapy (P=0.046) were significantly associated with efficacy. Multivariate analysis showed that the independent prognostic factor was the duration of combination antifungal therapy (OR=0.229, 95% CI 0.061- 0.863, P=0.029). The response rates of echinocandin combined with azole, echinocandin combined with amphotericin B and azole combined with amphotericin B were 81.8%, 60.0% and 82.6%, respectively (P>0.05), and 12-week survival rates were 81.8%, 80.0% and 86.5%, respectively (P>0.05). The drug- related adverse reactions occurred 59 times in 34 patients. BUN increasing, hypokalemia and abnormal liver functions were considered the main side effects.

CONCLUSIONFor IFD in children with hematologic disease, to extend the duration of treatment (≥ 14 days) could significantly improve the curative effect. Combinations of echinocandin with azole, echinocandin with amphotericin B and azole with amphotericin B can be used as a combination treatment options. Combination of Azole with amphotericin B is efficacious, safe and economic treatment option considering efficacy, survival rate, cost and dosage form.

Amphotericin B ; administration & dosage ; therapeutic use ; Antifungal Agents ; administration & dosage ; therapeutic use ; Child ; Drug Therapy, Combination ; Echinocandins ; administration & dosage ; therapeutic use ; Hematologic Diseases ; microbiology ; Humans ; Mycoses ; drug therapy ; Retrospective Studies ; Survival Rate ; Treatment Outcome

OBJECTIVE: Tried to find the relationship between tinnitus and each testing method, provided information for objective diagnosis and treatment for tinnitus patients with sensorineural hearing loss. METHOD: The characteristics of audiology tests, including pure tone audiometric, acoustic immittance, middle ear muscle reflexes, matching test, distortion products otoacoustic emission(DPOAE) were compared in 79 ears of 69 tinnitus patients with sensorineural hearing loss. RESULT: The RI positive rate was higher in Convergence curve in tinnitus patients of sensorineural hearing loss, with the rate being 51.3%. The detection rates of DPOAE were 15.2% in patients of sensorineural hearing loss tinnitus groups, which were significant lower than those in control group. CONCLUSION Psychoacoustic techniques can produce a useful amount of clinical data regarding tinnitus in different aspects, these data can help clinicians design needed based managements. DPOAE test is helpful for the diagnosis of lesions in some tinnitus patients.
Audiometry, Pure-Tone ; Hearing Loss, Sensorineural ; complications ; physiopathology ; Hearing Tests ; methods ; Humans ; Otoacoustic Emissions, Spontaneous ; Psychoacoustics ; Tinnitus ; complications ; physiopathology

OBJECTIVE: To investigate hidden hearing loss in tinnitus patients with normal audiograms by means of auditory brainstem response (ABR) and explore the origin of tinnitus. METHOD: Pure tone thresholds, ABR thresholds, amplitude of wave I and wave V of ABR were analyzed in 40 tinnitus patients and 15 controls. RESULT: There was no significantly difference in pure tone thresholds and ABR thresholds between those tinnitus patients and controls while a reduced amplitude of wave I and normal amplitude of wave V of ABR in the tinnitus patients became evident. CONCLUSION Tinnitus patients with normal audiograms have hidden hearing loss at the level of primary auditory nerve and the generation of tinnitus is likely attributed to a homeostatic response of neurons in brainstem.
Acoustic Stimulation ; Adolescent ; Adult ; Audiometry, Pure-Tone ; Auditory Threshold ; Case-Control Studies ; Evoked Potentials, Auditory, Brain Stem ; Female ; Hearing Loss ; diagnosis ; physiopathology ; Hearing Tests ; Humans ; Male ; Middle Aged ; Tinnitus ; etiology ; physiopathology ; Young Adult

Objective: To investigate the efficacy and safety of micafungin (MCF) for pulmonary invasive fungal disease (PIFD) in pediatric patients with acute leukemia or post hematopoietic stem cells transplantation. Method: Twenty-five neutropenic PIFD children with acute leukemia or post hematopoietic stem cells transplantation in Sun Yat-sen Memorial Hospital of Sun Yat-sen University were selected from January 2012 to June 2015, including 12 males and 13 females, age range 2-15 (average 6.2±2.0) years. There were 12 cases of acute leukemia (AL) after chemotherapy, 4 cases of acute leukemia (AL) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and 9 cases of β-thalassemia major after allo-HSCT. All children received MCM for the treatment of PIFD, the dosage of MCM was 3-4 mg/ (kg·d) , once a day. The children received 2 to 6 courses of treatment, individually with a course of 7 days. 1, 3-β-D glucan assay (G test), galactomannan antigen test (GM test), high-resolution CT and the biochemical indexes for organ functions were closely monitored. Result: Twenty-five cases were diagnosed as PIFD, including 2 patients diagnosed as proven, 6 as probable and 17 as possible. Of the 25 cases, 1 was confirmed aspergillus by biopsy pathology and 1 was candida albicans by blood culture. The G and GM test with positive results was 5 and 2 respectively. Chest CT scans of the 25 cases had obvious lesions: air crescent sign and cavitation in 4 cases, diffuse ground glass change in 9 cases, double lung scattered patchy, small nodules and cord like high density shadow in 7 cases, unilateral or bilateral chest wall wedge-shaped consolidation edge in 5 cases and pleural effusion in 5 patients. The effective rate of MCF in treatment of PIFD was 68% (17/25), including 13 cases cured, 4 cases improved, 4 cases were improved clinically and in 4 cases the treatment was ineffective. Eight cases were effective in MCF monotherapy group (12 cases) and nine were effective in MCF combined therapy group(13 cases), respectively. Side-effects including allergies, gastrointestinal side effects, electrolyte disturbances, impairment of liver and kidney function, and myelosuppression were not found in those children treated with MCF. Conclusion Micafungin is effective and safe in the treatment of pulmonary invasive fungal disease in pediatric patients with acute leukemia or post hematopoietic stem cell transplantation.

Organ transplantation is one of the effective methods for the treatment of end-stage diseases, but the lack of donors has hindered the development of organ transplantation. Extracorporeal membrane oxygenation (ECMO) can improve the hypoxia and hypoperfusion of organs, shorten the warm ischemia time, and maintain the function of donor organs effectively, in case of emergency or donor hemodynamic instability. It helps to make effective use of donor organs and benefit patients who are in urgent need of organ transplants. This article summarized the progress on application of ECMO in donor maintenance and provided suggestions for its application in organ transplantation.