Objective To asses the value of detecting bacterial DNAs in rat's blood with PCR for early diagnosis of colonic anastemotic leakage.Methods 48 healthy female Wistar rats were random divided into three groups: Group A(n=8,sham operation group),Group B(n=20,colonic anastomosis group),Group C(n=20,colonic anastomotic leakage group).Group B and C rats underwent standardized colon resection 3cm away from the ileocecal junction 10cm,Group B rats were done with a complete anastomosis(end-to-end single layer anastomosis with 0# silk sutures) while Group C rats were done with an anastomosis leaving a 5mm opening in colonic anterior wall.lml and 3ml venous blood samples were collected from Group A,B and C.DNAs were extracted from these blood samples and PCR techniques were used to amplify lacZ genes from Escherichia coli and 16S ribosomal RNA genes(16SrRNA genes) 3 days after operation.The data were analyzed by chi square test.Specimens of the experimental intestine were HE stained for pathological studies.Results The positive ratios of expressing lacZ genes in peripheral blood(PB) with PCR in Group C were significantly higher than that in Group B(P<0.05),hut there were no differences between the two groups in expressing 16SrRNA genes(P>0.05).Conclusions It could be a useful way to detect lacZ genes of Escherichia coli from PB by PCR but not 16SrRNA genes for diagnosis of colonic anastomotic leakages.

0.05),but the positive ratio of 16SrRNA genes expression in PB in Group C and Group E was significantly higher than that in group B and Group D respectively(P0.05).Conclusions(1)Detecting 16SrRNA genes from PB with PCR has certain significance for early diagnosis of jejunal anastomotic leakage and ileal anastomotic leakage,(2)PCR might be a useful tool for early diagnosis of jejunal anastomotic leakages and ileal anastomotic leakages by detecting lacZ genes or 16SrRNA genes from ascites.

Objective To evaluate clinical features and the clinical application of radical transabdominal operation for the senile cardiac cancer by using the EEA(end-to-end anastomosis) stapler.Methods 80 senile patients underwent curative intent due to cardic cancer from 1991 to 2001,and the clinical effects of transabdominal operation for cardiac carcinoma by using the EEA stapler were investigated retrospectively.Results The average age of the patients was 70-year old, and the ratio of men to women was 5∶1. The average course of the disease was 3 2 months. Only 2 5% of the patients got early diagnosis, and the rate of the preoperative complications was 60%. Patients were treated by radical transabdominal operation by using stapler, and the rates of radical dissection and palliative dissection were 71 3% and 18 8% respectively. The incidence of postoperative complication was 5%, and the in-patient mortality was 1 25%, and the above indexes were significantly lower than those in the trans-thoracicoabdominal approach. The 5-year survival rate was 20% after gastrectomy.Conclusions This study showed that the approach exerted little effect on the respiratory and circulatory systems, and it could decrease the surgical risk and the incidence of diverse complications.

Objective To evaluate the influence of different hemoperfusion (HP) intensities on prognosis in patients with acute paraquat (PQ) poisoning. Methods The data of patients with acute PQ poisoning admitted to Department of Emergency of Shengjing Hospital Affiliated to China Medical University from January 2012 to February 2016 were retrospectively analyzed. Patients satisfied the following criteria were enrolled in the study: adult patients, ingestion PQ within 12 hours and receiving HP treatment within 24 hours. Depending on the intensity of HP, patients were divided into lower intensity HP group (LHP, defined as receiving HP for less than 2 hours, 1 column) and higher intensity HP group (HHP, defined as receiving HP longer than 6 hours, 3 columns). Patients were divided into three groups, i.e. small dose (< 20 mL), medium dose (20-40 mL), and high dose (> 40 mL) poisoning groups on the basis of PQ ingestion volume. The baseline data of patients after hospital admission and arterial partial pressure of oxygen (PaO2), white blood cell (WBC), proportion of neutrophils (NEUT), alanine aminotransferase (ALT), total bilirubin (TBil), MB isoenzyme of creatine kinase (CK-MB), blood urea nitrogen (BUN) and serum creatinine (SCr) on the 4th day after hospital admission were compared, and 28-day mortality was followed up. Multiple logistic regression model was used to evaluate the characteristics of the dead patients within 28 days. The predictive value of each indicator for death in early stage of poisoning was analyzed with receiver operating characteristic curve (ROC). Results ① LHP group consisted 67 patients of 144 patients included with 24 in small dose group, 27 in medium dose group and 16 in high dose group. HHP group consisted of 77 patients with 28 in small dose group, 29 in medium dose group and 20 in high dose group. There were no significant differences in age, ingestion dose, time from poisoning to gastric lavage, and the time from the admission to HP between different intensities groups. ② Compared with LHP group, 28-day mortality in HHP group was significantly lowered (46.8% vs. 70.1%, χ2 = 8.032, P = 0.005). The patients receiving HHP in medium and small doses groups had lower 28-day mortality compared with those receiving LHP (41.4% vs. 74.1%, χ2 = 4.841, P = 0.017; 21.4% vs. 50.0%, χ2 = 4.661, P = 0.043). But there was no significant difference in 28-day mortality in high dose group between HHP and LHP (90.0% vs. 93.8%, χ2 = 0.000, P = 1.000). ③ The survival time of 12 patients with high dose poisoning was less than 72 hours, which were excluded for statistical analysis. Compared with LHP, the indexes of medium and small dose groups were obviously improved after HHP for 4 days. ④ Compared with survival group, PQ ingestion dose in non-survival group was increased, time from poisoning to gastric lavage and the time from the admission to HP were prolonged, and lower patients receiving HHP. ⑤ It was indicated by multiple logistic regression model that PQ ingestion dose [medium dose: odds ratio (OR) = 0.018, 95% confidence interval (95%CI) = 0.004-0.085, P < 0.001; high dose: OR = 0.075, 95%CI = 0.018-0.322, P < 0.001], time from poisoning to gastric lavage over 120 minutes (OR = 0.146, 95%CI = 0.045-0.470, P = 0.001), time from admission to HP over 4 hours (OR = 0.108, 95%CI = 0.029-0.395, P = 0.001), and LHP selection (OR = 0.363, 95%CI = 0.142-0.930, P = 0.035) were risk factors for the death at 28 days in patients with acute PQ poisoning. ⑥ It was shown by ROC curve that area under ROC curve (AUC) of PQ ingestion dose was 0.804 (95%CI = 0.723-0.885); when the cut-off value was 5.50 mL, the sensitivity was 94.0%, and the specificity was 65.6%. The AUC of time from poisoning to gastric lavage was 0.702 (95%CI = 0.617-0.786); when the cut-off value was 85.00 minutes, the sensitivity was 48.2%, and the specificity was 83.6%. AUC of time from the admission to HP was 0.719 (95%CI = 0.636-0.801); when the cut-off value was 3.50 hours, the sensitivity was 59.0%, and the specificity was 78.7%. Conclusions PQ ingestion dose, time from poisoning to gastric lavage, and time from the admission to HP are valuable factors for prognosis of the patients. HHP can improve the prognosis of patients with ingestion PQ less than 40 mL as early as possible, but for high dose group patients there was no much effect.

ObjectiveTo evaluate the feasibility and clinical significance of emergency bedside ultrasound-guided central venous catheterization performed by emergency department doctors.Methods The clinical data of 216 patients, who underwent central venous catheterization in the Department of Emergency of Shengjing Hospital of China Medical University from January 2009 to June 2014 were retrospectively analyzed. All the patients received femoral vein puncture or internal jugular vein catheterization. The patients were divided into three groups according to the method of catheterization: 72 patients received emergency ultrasound-guided central venous catheterization by emergency doctors independently were assigned as A group, 72 patients underwent catheterization by emergency doctors after being demarcated by ultrasound doctors served as B group, and 72 patients who underwent catheterization method guided by traditional landmark served as C group. Success rate, time spent for catheterization, number of attempts for intubation, and incidence of complications were compared among three groups.Results As compared with that of groups B and C, a higher success rate [98.61% (71/72) vs. 83.33% (60/72), 73.61% (53/72), bothP< 0.01] was found in group A, also with a shorter successful time for insertion of the catheter (minutes: 5.5±2.5 vs. 9.6±3.7, 16.6±7.2, bothP< 0.05), less frequency of the catheter insertion (times: 1.0±0.0 vs. 1.8±0.7, 2.7±2.6, bothP<0.05), and lower incidence of changing puncture site due to insert failure [1.4% (1/72) vs. 8.3% (6/72), 20.8% (15/72), bothP< 0.05], lower incidence of mechanical and infective complication [15.3% (11/72) vs. 41.7% (30/72), 59.7%(43/72), bothP< 0.05], and also lower catheterization related infection risk [13.9% (10/72) vs. 15.3% (11/72), 12.5%(9/72), bothP> 0.05].Conclusion Emergency bedside ultrasound-guided catheterization resulted in higher success rate and less related complication, therefore it can be recommended for widely application in emergency department treatment.

Objective To investigate the earlier diagnostic methods and operative procedures of gastric remnant cancer. Methods Clinicopathologic data of 19 cases of gastric remnant cancer were retrospectively analysed,and the diagnostic value of the gastroscopy and barium meal was compared.Influencing the prognosis of gastric remnant cancer treated by different operations according to the situation seen during operation were observed. Results The diagnostic rate of gastroscopy and barium meal was 78.9% and 47.4%, respectively.All the 5 cases who underwent radical remnant gastrectomy sarvived≥3 years postoperatively.Two of the 3 cases who underwent palliative remnant gastrectomy survived 2 years and 1 alived 1.5 years postoperatively. In 6 cases of gastrojejunostomy, 4 cases died within half year, 2 cases died 12.5 and 14 months postoperatively. Conclusions The diagnostic value of gastroscopy takes advantage over barium meal examination. The patients who treated by radical remnant gastrectomy have better prognosis.

Objective To study the toxicity of benzene combining with formaldehyde on reproductive cells in mice.Methods Male mice were randomly divided into different groups:three experimental groups with different doses of benzene combining with formaldehyde(mg?kg~(-1))(10+10,50+50 and 100+100),control group and vegetable oil group(n=10).After 8 weeks by oral poison,the mice were killed,testis was weighed,sperm count was peformed,the rate of sperm deformation was counted and the SOD activity was measured.Results The quantities of sperm in various poison groups were obvious decreased and the rate of sperm deformation were obvious increased with dose increasing.Compared with control group,they both had obvious difference(P

Objective We aimed to explore the expression of FHIT and investigate its correlation with clinicopathological features and prognosis of gallbladder carcinoma.Method Immunohistoehemieal detection of FHIT was performed on samples from 43 gallbladder carcinoma and 43 cholecystitis,and 2 years follow up was performed.Result FHIT protein was overexpressed in eholecystitis(x2=31.74,P=0.000).The overexpression was significantly related to differentiation and Nevin staging of gallbladder carcinoma(x2=4.47,P=0.035;x2=8.33,P=0.015);(rs=-0.56,P=0.031;rs=-0.68,P=0.014).Log-rank test showed that overexpression of FHIT had a good prognosis(x2=4.11,P=0.042).Cox analysis showed that expression of FHIT was all independent prognostic marker for postresectional survival of gallbladder carcinoma(RR:2.89,95%CI[2.46-3.32]).Conclusion Loss expression of FHIT closely correlated with clinicopathological features of gallbladder carcinoma.The expression of FHIT was an independent prognostic marker for post-resectional survival of gallbladder carcinoma.

Objective To determine the resectability of recurrent gastric malignant tumor and its clinical value, and to search an effective way to cure recurrent gastric malignant tumor. Methods The clinical data of 18 cases of sucessfully resected local regional recurrent gastric malignant tumor were analysed retropectively. Results In the 18 cases of recurrent malignant gastric tumor, 6 received total gastrectomy and lymphadenectomy, 5 received body and tail pancreatectomy plus splenectomy with lymphadenectomy, 2 got tumor resection in gastric bed, and the other 5 got periceliac tumor resection with lymphadenectomy. Pathology evidence revealed that 14 of them were gastric adenocarcinoma and the other 4 were gastric sarcoma. They were all recovered and got well when discharged. Follow up results revealed that resection of recurrent malignant gastric tumor could survive 16.4 months (7～38 months) averagely.Conclusions Patient's life quality and survival time could be improved if the local regional recurrence was resectable and other subsidiary therapeutic methods were used.

Objective: To analyze the epidemiological characteristics of mumps outbreaks in Guangzhou city from 2006 to 2018, and to provide evidence for prevention and control strategy of mumps. Methods: Descriptive epidemiological method was used to analyze the reported data of mumps in Guangzhou from 2006 to 2018. The chi-square test was applied to analyze the outbreaks in different years and types of schools, and the attack rate in different types of schools. The spearman correlation was used to analyze between timing of intervention and duration of the outbreak. Results: A total of 32 mumps outbreaks were reported during 2006-2018, with 992 reported mumps cases in 26 764 students (attack rate was 3.71%). The outbreaks peaked in 2006 (28.13%) and 2012 (18.75%). Mumps outbreaks occurred mainly in March to June and December. The highest peak was in April with 7 outbreaks accounting for 21.88%. The largest number of outbreaks occurred in Conghua district(9,28.13%) and the primary schools(25,78.13%). Spearman correlation coefficient was 0.35 between timing of intervention and duration outbreak (r=0.35，P=0.05). Conclusion Primary schools in the suburb of Guangzhou are at high-risk for mumps outbreak. Early intervention can shorten the duration of outbreaks. Morning check, school attendance and mumps-specific IgG antibody surveillance should be improved.