Eighty-five endophytic fungal strains were isolated from the roots、stems and leaves of Polygala tenuifolia Willd, among which, fifty-two from natural plants and thirty-three from cultivated ones. Sev-enty-six strains were classified as twenty-three fungal genera. The inhibitory activity screening to fourteen microbe were conducted research. The results showed that some endophytic fungi had remarkble inhibitory activities to Bacillus subtilis, Shigella sonnei, Escherichia coli, Candida albicans, Fusarium kyrushuense and they were all belonged to Fusarium, Alternaria, Aphanocladium respectively. All of the endophytic fungi isolated from Polygala tenuifolia showed no inhibitory activities to Staphyloccocus aureus, Salmonel-lae enteritis, Bibrio parahemolyticus.

Objective To study and observe the change of nerve function and erythrocyte immune indexes of patients with severe craniocerebral injury during the perioperative period.Methods Forty patients with severe craniocerebral injury treated with surgery in our hospital from July 2013 to August 2015 were selected as the observation group and 40 healthy persons with the same ages in the same period were selected as the control group.The nerve function related indexes and erythrocyte immune indexes of observation group before and at first,third,fifth,seventh,tenth and fourteenth day after the surgery and those of control group were compared.Results The serum nerve function related indexes of observation group before and at first,third,fifth,seventh,tenth and fourteenth day after the surgery were higher than those of control group.The erythrocyte immune indexes of observation group before and at first,third,fifth,seventh and tenth day after the surgery were worse than those of control group.The erythrocyte immune indexes at fifth and seventh day after the surgery were worse than those before and at first,third,third,tenth and fourteenth day after the surgery.The differences of comparison indexes were all significant (P＜0.05).Conclusion The change of nerve function and erythrocyte immune indexes of patients with severe craniocerebral injury during the perioperative period are obvious.Those indexes should be paid with enough monitoring and intervention.

Abstract: Objective　To analyze the treatment outcomes of elderly patients with pulmonary tuberculosis in Chongqing, so as to provide reference for the prevention and control strategies of the epidemic of elderly pulmonary tuberculosis. Methods　The data of tuberculosis cases aged ≥65 years in Chongqing from 2015 to 2020 were collected from the National Health Insurance Information Project Disease Prevention and Control Information system. Descriptive statistical methods were used to analyze the data. Results The registration rates of elderly active pulmonary tuberculosis patients and etiological positive patients were 110.95/10-5and 32.25/10-5 in 2015 and 84.06/10-5 and 57.29/10-5 in 2020. The annual decline rate of active tuberculosis registration was 5.40%, and the annual increase rate of pathogenic-positive tuberculosis registration was 12.18%. The registration rates of active tuberculosis patients and etiological positive patients in the whole population were 70.75/10-5 and 17.63/10-5 in 2015 and 50.34/10-5 and 29.14/10-5 in 2020. The annual decline rate of active tuberculosis registration was 6.58%, and the annual increase rate of pathogenic-positive tuberculosis registration was 10.57%. From 2015 to 2020, a total of 25 931 cases of elderly pulmonary tuberculosis were registered, of which 21 374 (82.43%) cases were successfully treated and 4 010 (15.80%) cases had unfavorable outcomes. The proportion of cured and death patients showed an increasing trend year by year (χ2trend=313.853, 100.502, P<0.01). From 2015 to 2020, the average annual successful treatment rate of elderly pulmonary tuberculosis in the whole city was 82.43%, with the lowest rate in southeast Chongqing (74.23%), followed by urban areas (81.99%). The success rate of elderly pulmonary tuberculosis treatment in the whole city, west Chongqing, northeast Chongqing and southeast Chongqing showed a downward trend year by year (χ2trend=230.199, 35.278, 108.076, 112.130, all P<0.01), with annual decline rates of 2.77%, 2.26%, 3.0% and 4.12%, respectively. Among the registered elderly patients, female, 65-<75 years old, Han nationality, newly diagnosed, no complications, and negative for etiology (χ2=15.234, 255.910, 146.842, 179.998, 25.575, 131.170, P<0.01) had higher success treatment rates. Conclusions The prevalence of pulmonary tuberculosis in the elderly population in Chongqing City is declining, but the positive registration rate of etiology is increasing annually, and the success rate of treatment is decreasing. Therefore, it is necessary to strengthen the systematic management, publicity and education of elderly patients (especially those in southeast Chongqing, male, positive patients and severe patients) to effectively control the epidemic of tuberculosis in the elderly.

AIM:To research the effects of lithium chloride on transforming growth factor beta (TGF-β) and connective tissue growth factor (CTGF) in cultured human Tenon capsule fibroblasts (HTFs) and explore its mechanism.METHODS:HTFs were cultured and identified by vimentin staining with immunofluorescence and the morphological characteristics.The experimental group was processed 48h with LiCl in concentration of 80mmol/L, the control group without LiCl.The mRNA expression of TGF-β and CTGF in two groups were analyzed with real-time fluorescent quantitative polymerase chain reaction (real time-qPCR) and the protein expression was detected with Western blot.RESULTS:The cultured HTFs expressed TGF-β and CTGF.The mRNA expression of TGF-β and CTGF significantly decreased compared with the control group(t=20.042, 14.995, P<0.05).the protein expression of TGF-β and CTGF also decreased significantly compared with the control group(t=46.058、12.452, P<0.05)CONCLUSION:The cultured HTFs can express TGF-β and CTGF in mRNA and proteins' level.LiCl can reduce the expression of TGF-β and CTGF both in gene and proteins' level.LiCl has the potential to modulate wound healing for glaucoma filtration surgery.

Objective To compare the bronchial blocker and double-lumen tube for one-lung ventilation in patients undergoing esophageal cancer resection.Methods Forty ASA physical status Ⅰ-Ⅲ patients of both sexes,aged 42-63 yr,scheduled for elective esophageal cancer resection,were randomly divided into 2 groups (n =20 each):double-lumen endotracheal tube group (group DLT) and bronchial blocker group (group BB).After induction of anesthesia,the patients were intubated with a left-sided double-lumen endotracheal tube and correct positioning was verified by fiberoptic bronchoscopy in group DLT.After induction of anesthesia,the patients were intubated with a conventional single-lumen endotracheal tube,and then the bronchial blocker was inserted under the guidance of fiberoptic bronchoscope in group BB.The intubation time,one-lung ventilation time,time to achieve lung collapse,operation time,extubation time,tube malposition and hypoxemia were recorded.The lung collapse was scored at the end of operation.Hoarseness and throat sore within 2 days after extubation and pulmonary infections within 7 days after operation were recorded.Results Compared with group DLT,intubation time and time to achieve lung collapse were significantly prolonged,and the incidence of hoarseness and throat sore within 2 days after extubation was decreased in group BB (P ＜ 0.05).There was no significant difference in the one-lung ventilation time,operation time,extubation time,lung collapse score,incidence of tube malposition,hypoxemia and pulmonary infections within 7 days after operation between the two groups (P ＞ 0.05).Conclusion The efficacy of bronchial blocker is similar to that of double-lumen tube when used for one-lung ventilation in patients undergoing esophageal cancer resection.

Objective To investigate the teaching effect of applying idea of ‘ integrating world with specialty' in teaching ward - round.Methods Totally 112 undergraduates from department of anesthesiology in Chongqing medical university were randomly divided into 2 groups:group C and group T.The students in group C and group T were received traditional method and teaching ward-round applying idea of ‘integrating world with specialty' respectively.The teching effects were compared.Results Constituent ratio of performance of written test and defence of case analysis in group C and group T were respectively as follow,excellent ( 12％,19％) vs.(31％,37％),good (25％,19％ ) vs.(50％,44％ ),middle (54％,50％ ) vs.( 19％,13％ ),bad (9％,12％ ) vs.(0,6％ ),and there were statistically differences between the two groups.Conclusion Teaching ward-round applying idea of ‘ integrating world with specialty' integrates medical knowledge with social skills and common sense of life,making it easier for medical students to understand and master professional knowledge,as a result of improving the students' ability of problem analysing and solving.

Objective To explore clinical significence of soluble vascular cell adhesion molecular(SVCAM - 1),immunoglobulin A (IgA) anti- endothelial cells antibodies(AECA) in Henoch-Schonlein purpura(HSP) and their relationships. Methods SVCAM-1 were detected by ELISA between 55 cases with HSP (40 cases in acute stage and 15 cases in recovery) and 20 controls. Results The levels of serum SVCAM - 1 of the HSPN cases were significantly increased compared with the other HSP. In addition, the serum level of SVCAM - 1 in acute stage HSP children was significantly higher than that in recovery stage and normal controls. IgA AECA positive rate in HSPN was higher than that of without nephritis group. The level of serum SVCAM - 1 in IgA AECA positive children was higher than that of IgA AECA negative children. Conclusion SVCAM - 1 and IgA AECA may participate in the pathogegesis of HSP, and the level of molecule is correlated with the progress of HSP.

Objective To compare the clinical efficacies of totally laparoscopic and laparoscopy-assisted radical total gastrectomies.Methods The retrospective cohort study was conducted.The clinicopathological data of 373 patients with gastric cancer who underwent totally laparoscopic or laparoscopy-assisted radical total gastrectomies from the 7 medical centers in China (82 patients in the Affiliated Hospital of Qinghai University,80 in the Traditional Chinese Medicine Hospital of Guangdong Province,60 in the First Affiliated Hospital of Xiamen University,51 in the Hangzhou First People's Hospital,46 in the First Affiliated Hospital of Xi'an Jiaotong University,30 in the Second Affiliated Hospital of Jilin University and 24 in the Xijing Hospital of the Fouth Military Medical University) between January 2015 and December 2016 were collected.Of 373 patients,the 183 and 190 patients were respectively divided into the totally laparoscopic group (undergoing totally laparoscopic radical total gastrectomy) and laparoscopy-assisted group (undergoing laparoscopy-assisted radical total gastrectomy),including 63 and 19 in the Affiliated Hospital of Qinghai University,36 and 44 in the Traditional Chinese Medicine Hospital of Guangdong Province,25 and 35 in the First Affiliated Hospital of Xiamen University,20 and 31 in the Hangzhou First People's Hospital,10 and 36 in the First Affiliated Hospital of Xi'an Jiaotong University,17 and 13 in the Second Affiliated Hospital of Jilin University,12 and 12 in the Xijing Hospital of the Fouth Military Medical University.Routine five-port method was applied for laparoscopic radical total gastrectomy and D2 lymphadenectomy.Roux-en-Y anastomosis was applied for digestive tract reconstruction,and digestive tract reconstruction was performed under laparoscopy in the totally laparoscopic group and via upper abdominal median incision in the laparoscopy-assisted group.Observation indicators:(1) operation and postoperative situations;(2) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect the postoperative overall survival and tumor recurrence or metastasis up to March 2017.Measurement data with normal distribution were represented as x±s.Comparison between the groups was analyzed by the t test.Measurement data with skewed distribution were represented as M (range).Comparisons of count data were analyzed using the chi-square test and Fisher exact probability.Results (1)Operation and postoperative situations:all the patients in the 2 groups underwent successful operations,without perioperative death.Esophagojejunostomy methods of 183 patients in totally laparoscopic group:conventional circular stapler method were performed in 28 patients,anti-puncture circular staplar method in 6 patients,OrVilTM method in 5 patients,functional end-to-end esophagojejunostomy method in 65 patients and peristalsis side-to-side esophagojejunostomy method in 79 patients.Conventional circular stapler method was applied to 190 patients in the laparoscopy-assisted group.Operation time,time of esophagojejunostomy,length of assisted incision,using time of analgesics and expenses of digestive tract reconstruction were (238± 55)minutes,(29±9)minutes,(5.1 ± 1.1)cm,(2.2±l.0)days,(18 332±2 141)yuan in the totally laparoscopic group and (217±39)minutes,(26±7)minutes,(7.8 ±2.0)cm,(2.7± 0.9)days,(16 237 ± 1 923)yuan in the laparoscopy-assisted group,respectively,with statistically significant differences between the 2 groups (t =4.324,3.455,-16.835,-5.561,9.949,P＜0.05).The cases with postoperative overall complications,anastomosis leakage,anastomosis stricture,anastomosis bleeding and expenses of esophagojejunostomy were respectively 24,9,7,5,(9 668±2 814)yuan in the totally laparoscopic group and 24,8,9,6,(9 331 ±2 067)yuan in the laparoscopy-assisted group,with no statistically significant difference between the 2 groups (x2 =0.036,0.107,0.189,0.059,t=1.322,P＞0.05).All the patients with postoperative complications were cured by symptomatic treatment.(2) Follow-up and survival situations:of 373 patients,336 were followed up for 4-26 months,with a median time of 13 months,including 166 in the totally laparoscopic group and 170 in the laparoscopy-assisted group.During the follow-up,cases with overall survival,tumor recurrence and tunor metastasis were respectively 150,10,16 in the totally laparoscopic group and 154,9,16 in the laparoscopy-assisted group (10 and 9 patients in the totally laparoscopic and laparoscopy-assisted groups with simutaneous tumor recurrence and metastasis),showing no statistically significant difference between the 2 groups (x2 =0.075,0.010,P＞0.05).Conclusions Total laparoscopic and laparoscopyassisted radical total gastrectomies are safe and feasible,with equivalent overall outcomes and effects of esophagojejunostomy.Compared with laparoscopy-assisted radical total gastrectomy,the postoperative pain time of patients in total laparoscopic radical total gastrectomy is less,but there are longer time of esophagojejunostomy and higher expenses of digestive tract reconstruction.

Objective To determine whether Cox-2 inhibitor can reduce the risk of cardia carcinoma. Methods Paraffin-embedded specimens from 48 patients with esophageal, gastric or cardia carcinomas were analyzed by immunohistochemistry for expression of Cox-2 protein. Expression of Cox-2mRNA was assessed by RT-PCR and ISPCR in 29 cases of them. None of these patients were currently taking NSAIDs or glucocorticoid. Results The staining scores were 4.15?1.9 in the group with esophageal cancer, 3.66?1.16 in the group with gastric cancer, and 2.93?1.03 in the group with cardia cancer, respectively. There was no significant difference between groups of gastric cancer and cardia cancer. The ratio of cases with positive expression of Cox-2 mRNA was 87.5% in the group with cardia carcinoma, 100% in the group with esophageal cancer and the group with gastric cancer. And no significant difference was found between them. Cox-2mRNA was mainly located in cytoplasm but was found in nuclear too. No difference was found in the location of Cox-2 expression in the three kinds of cancers. Conclusion Cox-2 expression in cardia carcinoma was higher than in the normal group. Its pathological characteristics were almost the same as those in gastric and esophageal cancers. Cox-2 inhibitor possibly have a chemopreventive effect on cardia carcinoma.

Objective:To investigate the levels of dose to eye lens of interventional radiology workers in China from 2017 to 2019.Methods:The monitoring data on eye lens doses to the interventional radiology workers in 28 provinces across the country were collected from National Individual Dose Registry. Monitoring was carried out using TLDs on their left eyes and evaluated in terms of the personal dose equivalent Hp(3). By using Mann-Whitney U test and Kruskal-Wallis H test, statistical analyses were made of the average annual lens doses to interventional radiology workers in the hospitals of different types at different levels for different years. Results:From 2017 to 2019, the data on eye lens doses to 2 981 interventional radiology workers were collected, with doses ranging from below the minimum detectable level (MDL) to 64.48 mSv, the average annual eye dose of 1.38 mSv, and the annual doses incurred by 0.97% monitored workers exceeding the recently recommended dose limits, 20 mSv per year. The average annual lens dose monitored in general hospitals and in cancer hospitals were 1.33 and 1.77 mSv, respectively, without statistically significant difference ( P>0.05). The average annual lens dose in tertiary hospitals was 1.39 mSv, significantly higher than that in secondary hospitals where the value was 1.16 mSv ( Z=2.894, P<0.05). Conclusions:The estimated annual eye lens doses to the interventional radiology workers during 2017-2019 were in accordance with the current national standard GB 18871-2002, but with a few exceptions exceeding the current international standards. This means that there exists, to a certain degree, a potential risk for the eye lens in this work category to exceed the international limits. It is suggested to continue in effort to enhance the monitoring of eye lens dose for these workers and to increase risk awareness, and take effective protective measures so as to lower the level of eye lens doses.