Objective To investigate the impact of palliative radiotherapy to the prognosis of patients with stage Ⅳ non-small cell lung cancer (NSCLC).Methods Two hundred and forty-four cases of stage Ⅳ NSCLC were collected from our hospital.The study group (n =129) received the treatment of primary tumor and metastases palliative radiotherapy after chemotherapy.The control group (n =115) received only chemotherapy.Followed-up and compared 1-year and 2-year survival rate of the patients,and explored the factors affecting palliative radiotherapy.Results The 129 patients in the study group were followed up for 2 years,and 16 patients survived and 110 patients died.Three patients were lost to follow-up.The median survival time was 8 months.1-year and 2-year survival rates was 29.46％ (38/129) and 12.40％ (16/129) respectively.In the control group,7 patients survived,and 106 patients died.Two patients were lost to follow up.The median survival time was 6 months.1-year and 2-year survival rates was 11.30％ (13/115) and 6.09％ (7/115)respectively.Survival rates between the two groups were significantly different (x2 =8.451,P =0.014)Univariate regression analysis found that factors affecting the prognosis of stage Ⅳ NSCLC were KPS score (x2 =5.057,P =0.031),occurrence of brain metastases (x2 =4.781,P =0.029),number of organs of metastasis (x2 =6.341,P =0.010),and the primary stove radiotherapy dose (x2 =5.893,P =0.015) ; Cox regression model analysis showed that the number of organs of metastasis (HR =1.719,95％ CI 为 1.172-3.126,P =0.008),the primary focal radiotherapy dose (HR =1.560,95％ CI 为 1.082-2.761,P =0.022) were independent prognostic factors.Conclusion Palliative radiotherapy plays a role of prolonging survival time in the treatment of Ⅳ NSCLC.In palliative radiotherapy,we should pay attention to the control of the primary tumor and metastases radiotherapy dose,therefore prolonging the survival time of patients.

Objective To report the clinical observation and nursing points for recurrent or refractory and aggressive non-Hodgkin's lymphoma treated with MINE regimen. Methods Patients (46 cases) with recurrent or refractory and aggressive non-Hodgkin's lymphoma were given mental nursing,preparation and evaluation of the condition of patients before chemotherapy. Complications especially extravasation of infusion fluid should be prevented during chemotherapy and myelosuppression and long-term complications should be prevented after treatment. Results No patient died after treatment but several complications such as infection(14 cases), nausea and vomiting (grade Ⅰ～Ⅱ, 22 cases, grade Ⅲ,2 cases), alopecia (grade Ⅰ～Ⅱ, 27 cases), mucositis (grade Ⅰ～Ⅱ, 4 cases), liver function lesion (grade Ⅱ, 1 case) were found and improved after proper treatment. No nephrotoxicity and hemorrhagic cystitis were found. Conclusions Selective mental nursing,proper chemotherapy preparation,evaluation of patients' condidtion and positively prevention of chemotherapy-related complications could increase the chemotherapy effect of patients with recurrent or refractory and aggressive non-Hodgkin's lymphoma.

Objective To compare diagnostic performance of ultrasound and radionuclide imaging in diagnosis of Meckel's diverticulum.Methods Totally 46 children suspected with Meckel's diverticulum were enrolled.Ultrasound,radionuclide imaging data were analyzed and compared with pathology.Results In 46 children suspected with Meckel's diverticulum,38 cases were confirmed by operation.Thirty-three cases of 38 were diagnosed Meckel's diverticulum by ultrasound,5 cases of 38 were false negative,there was no false positive case.Radionuclide imaging was positive in 24 cases of 46,false positive in 4 eases and false negative in 18 cases.The ultrasound diagnostic accuracy rate was 89.13％ (41/46),sensitivity was 86.84％ (33/38),specificity was 100％ (8/8).Diagnostic accuracy rate of radionuclide imaging was 52.17％ (24/46),sensitivity was 52.63 ％ (20/38) and specificity was 50.00 ％ (4/8).The sensitivity of ultrasound and radionuclide imaging in diagnosis of Meckel's diverticulum had significant difference (P＜0.01).Conclusion Ultrasound in diagnosis of Meckel's diverticulum has advantages of non-invasive,no radiation,acceptable price and high sensitivity.

BACKGROUND:In recent years, animal models of lumbar disc degeneration have been popularized to explore the effect of tissue engineering, cel engineering and genetic engineering technologies on intervertebral disc degeneration.
OBJECTIVE: To investigate the influence of biological patches on rabbit anulus fibrosus repair.
METHODS:L3-4, L4-5, L5-6 segments from rabbits were randomly divided into normal control group (the intervertebral disc was exposed correspondingly), control group (the annulus fibrosus was only cut with a surgical scalpel) and experimental group (the annulus fibrosus was cut and sutured with the surgical biomaterial). Six rabbits were selected randomly to take the lumbar X-ray and MRI preoperatively and 1, 2, 4, 8, 12 weeks postoperatively; one rabbit was chosen preoperatively and three rabbits selected respectively at 1, 2, 4, 8, 12 weeks postoperatively to execute hematoxylin-eosin and type II colagen immunohistochemistry.
RESULTS AND CONCLUSION:At postoperative 1, 2 and 4 weeks, the disc height index decreased significantly in the control and experimental groups. MRI and histopathological examination showed that the T2WI signal intensity and hematoxylin-eosin grading were both increased significantly in the control and experimental groups at 2 weeks after surgery (P < 0.05). With time, the number of nucleus pulposus cels gradualy reduced in the control and experimental groups. Annulus fibrosus defects were filed with granulation and fibrous tissues, and the biofilm was tightly fused with the annulus fibrosus. Findings from the type II colagen immunohistochemical staining showed that the histological staining of the nucleus pulposus was gradualy changed from positive to negative in the experimental and control groups. Therefore, cutting the annulus fibrosus can lead to severe disc degeneration at early period, and surgical biomaterials can be integrated with the annulus fibrosus wel to seal annulus fibrosus defects and further prevent nucleus pulposus protrusion. However, this approach cannot restrain the continuous process of disc degeneration.

OBJECTIVE To analyze the resistance feature and the distribution of Enterococcus species isolated from bile specimens.METHODS Totally 715 samples of bile in intra-operation were cultured,and the drug resistances were tested.RESULTS From them 511 strains in 469 cases were detected out(65.6%),among whith 156 were Enterococcus strains and 159 were strains of Escherichia coli.The mixed infection with two kinds of germs was found in 35 cases.The results of drug susceptibility showed the resistant rates of Enterococcus faecalis to penicillin and high concentration gentamicin were lower than those of E.faecium.None of E.faecalis,and E.faecium resisted to vancomycin.CONCLUSIONS The detective rate of the Enterococcus is high in bile samples.The results reveal a different resistance to common antibiotics,but a high sensistivity to vancomycin and teicoplanin.The result of antibiotic susceptibility testing guides rational use of antibacterial agents.

ObjectiveTo analyze the prevalence and epidemic trend of human brucellosis between 2007 -2010 in Qian'an county,and to provide a basis for future prevention and control measures. Methods Epidemiological data of brucellosis between 2007 - 2010 were obtained from the national disease surveillance report on management information system, population data were from the national disease surveillance information management system for basic information reporting system, and descriptive epidemiological methods was used for statistical analysis. Results A total of 86 cases were infected with brucellosis in Qian'an county from 2007 to 2010, with 68 cases of male and 18 cases of female, and male to female ratio was 3.78 : 1. Patients were mainly in the age of 20 - 55, with 40 - ＜ 45 year-old group the highest. All patients were local residents. Most professional were livestock acquisition, processing and aquaculture personnel. The majority of patients lived in Jianchang town,with 51 cases, accounting for 59.30％. Thirteen patients were reported in 2007, incidence was 0.0201‰(13/ 647 983). Thirty-nine patients were reported in 2010, and incidence was 0.0563‰(39/657 380). There was a fluctuations increase from 2007 to 2010. In 2007 brucellosis occurred in only two townships(towns), which spread to eight townships (towns) and urban areas in 2010. ConclusionsThe epidemic of human brucellosis in Qian'an is in a spreading trend. We recommend the government to strengthen the quarantine of livestock, and the infected livestock should be timely treated. Strengthen the prevention and control in Jianchangying. At the same time increase the brucellosis propaganda, and enhance self-protection awareness of the occupational groups.

Abstract: Objective　To investigate the early diagnostic value of peripheral blood procalcitonin (PCT), C-reactive protein (CRP), fibrinogen (FIB) and D-dimer (D-D) levels in patients with pulmonary tuberculosis (PTB) complicated with bacterial pneumonia. Methods　A total of 102 patients who admitted to Department of Tuberculosis of Affiliated Nantong Hospital of Shanghai University from Jan 2021 to May 2022 were enrolled in this study and divided into a group (52 cases) with pulmonary tuberculosis (PTB) patients and a group (50 cases) with PTB patients complicated with bacterial pneumonia. The levels of PCT, CRP, FIB and D-D in the peripheral blood were measured, the differences and correlations in all indicators were compared among two groups. The sensitivity and specificity of these indicators in the early diagnosis of PTB complicated with bacterial pneumonia were analyzed by receiver operating characteristic (ROC) curve. Results　The levels of PCT, CRP, FIB and D-D in the peripheral blood from the PTB complicated with bacterial pneumonia group were 0.06 (0.04, 0.16) ng/mL, 38.00 (3.88, 96.10) mg/L, 4.51 (3.02, 6.07) g/L, and 0.59 (0.34, 1.88) mg/L, respectively, which were significantly higher than corresponding 0.04 (0.03, 0.04) ng/mL, 3.20 (0.84, 7.22) mg/L, 2.96 (2.48, 3.77) g/L, and 0.27 (0.17, 0.36) mg/L in the PTB group (Z=-4.784, -5.233, -3.853, -4.199, all P<0.001). Furthermore, the levels of CRP and FIB in the PTB complicated by bacterial pneumonia group were highly positively correlated (r=0.855, P<0.001). The area under the ROC curve (AUC) of PCT, CRP, FIB and D-D for early diagnosis of PTB complicated with bacterial pneumonia were 0.757, 0.794, 0.747 and 0.764, respectively. In addition, the AUC obtained by simultaneous measurement of PCT, CRP, FIB and D-D was as high as 0.916, and the sensitivity and specificity of diagnosing PTB complicated with bacterial pneumonia were increased to 85.7% and 96.9%, respectively, which were higher than those of individual indicators. Conclusions　Levels of peripheral blood PCT, CRP, FIB, and D-D all show varying degrees of increase in patients with PTB complicated with bacterial pneumonia, and detecting the levels of all four markers, rather than any single marker, can assist in early monitoring whether the tuberculosis patients are complicated with bacterial pneumonia.

Objective To analyze the epidemiologic characteristics of epidemic hemorrhagic fever syndrome (EHF) from 2004 to 2010 and provide scientific basis for formulating control measures.Methods Epidemiological data of EHF between 2004 to 2010 were obtained from the“National Disease Surveillance Report on Management Information System”,and the population data were from the“National Disease Surveillance Information Management System for Basic Information Report System”.Descriptive epidemiological methods was used for statistical analysis.ResultsA total of 173 cases were reported in Qian'an from 2004 to 2010.From 2004 to 2010,the cases were 86,67,12,1,0,1,and 7 cases,respectively,and the rate were 13.12/10 million ( 86/640 249 ),10.42/10 million (67/642 688 ),1.86/10 million ( 12/645 124),0.15/10 million (1/647 983 ),0(0/650 720),0.15/10 million( 1/653 839),and 0.11/10 million(7/657 380),respectively.The overall rate was 3.86/10 million(25/648 283) of population.From 2004 to 2008 the incidence reported declined rapidly,then increased slowly after 2009.The cases were found intensively in winter(November - next January) and spring season (february - may).The incidence in the age group of 10 - 45 was higher than that of other age groups,and the total number of cases was 82.08％(142/173).The incidence in males( 114 cases) was higher than that of females(59 cases).Occupational distribution mainly to peasants and students,which accounted for 87.86％ (152/173).Conclusions Epidemic in the city declines rapidly follows by a slow recovery,suggesting that in the future surveillance,mice-killing and protection of vulnerable population should be strengthened.

Objective To investigate the effect of electroacupuncture or exercise preconditioning on neurological function after focal ce-rebral infarction in rats and the possible mechanism. Methods A total of 24 male Sprague-Dawley rats were randomly divided into model group (n=6), sham group (n=6), exercise preconditioning group (n=6) and electroacupuncture preconditioning group (n=6). The model group and the sham group did not accept any treatment, while the exercise preconditioning group and the electroacupuncture precondition-ing group accepted treadmill training and electroacupuncture for two weeks, respectively. Their middle cerebral arteries were occluded with modified Longa's approach, except the sham group that was ligated the same arteries but did not result in infarction. They were evaluated with Neurologic Severity Scores (NSS) 24 hours after modeling, and the laminin expression in the ischemic area was detected with Western blotting. Results There was no neurological deficit in the sham group. The NSS was lower in both preconditioning groups than in the model group (P<0.05), but was not significant different between preconditioning groups (P>0.05). The expression of laminin was the most in the sham group, and was more in both preconditioning groups than in the model group (P<0.05), but was not significant different between pre-conditioning groups (P>0.05). Conclusion Preconditioning with exercise or electroacupuncture can both reduce the neurological deficits in rats after focal cerebral infarction, which may associate with the protection of laminin from inhibition in early stage.

Objective To observe whether mesenchymal stem cells(MSCs) which have been induced by 5-azacytidine(5-aza) can differentiate into cardiac like cells. To find out the role of TITIN playing during the development of cardiomycytes among structure proteins. Methods To establish a recombinant plasmid vector involving a shRNA which matching the base pair of rat TITIN N2B region mRNA perfectly,transfect it into normal neonatal cardiomyocytes and MSCs which have been induced by 5-aza respectively and investigate the expression of TITIN Z band,MHC,ACTIN as well as cTnT by immunofluorescence. Results The expression of TITIN was weakened after recombinant plasmid has been transfected into neonatal cardiomyocytes.The same thing happened upon MSCs that have been induced by 5-aza. The expression of cTnT was weakened after TITIN been silenced by small interfering RNA (siRNA). But there was obvious change in MHC and ACTIN. Conclusion Our results demonstrate that MSCs can be induced into cardiomyocyte-like cells by 5-aza in vitro,although the degree of differentiation is still lower and can not form intact contractive structure. TITIN plays an important role in the development of structure proteins.