Objective To investigate the clinical effect of flupentixol and melitracen tablets combined with macrogol 4000 powders on treatment of irritable bowel syndrome with constipation (IBS-C) in elderly patients. Methods Fifty paients aged from 65 to 95 years with IBS-C were randomly divided into 2 groups: control group (23 patients) and treatment group (27 patients). The patients in treatment group received flupentixol and melitracen tablets (1 tablets, once a day) combined with macrogol 4000 powders (1 bag/time, 2 times a day) , while the patients in control group received macrogol 4000 powders alone. The treatment period was 4 weeks. The curative effect, the scores of self-rating depression scale (SDS) and self-rating anxiety scale (SAS) and adverse reaction were compared between two groups. Results At the improvement of depressive symptoms, the effective rate in treatment group and control group was 88.9%(24/27) and 39.1%(9/23), and there was significant difference (P<0.01). At the improvement of anxiety symptoms, the effective rate in treatment group and control group was 74.1%(20/27) and 26.1%(6/23), and there was significant difference (P<0.01). The total effective rate in treatment group and control group was 88.9%(24/27) and 65.2%(15/24), and there was significant difference (P<0.05). Conclusions Flupentixol and melitracen tablets combined with macrogol 4000 powders on treatment of aged IBS-C patients have more distinguished therapeutic effect in improving constipation symptoms, stools times, anxiety and depression.

Objective To investigate the expression of extracellular matrix metalloproteinase inducer (CD147), nuclear factor kappa B (NF-κB) in esophageal squamous cell carcinoma tissue and probe their relationship to invasion and metastasis of esophageal carcinoma. Methods Immunochemical staining was performed to detect the expression of CD147 and NF-κB protein in 40 cases of esophageal carcinoma tissues and 40 cases of normal control. Results The positive rate of CD147 and NF-κB in esophageal carcinoma tissues and in adjacent noncancerous tissues were 77.5%/87.5% Vs 25%/42. 5%, P＜0.05.The positive rate of their prophase and metaphase-advanced stage esophageal carcinoma tissues were 33.3%/90.3% Vs 55.6%/96.8%, P＜0.05..The positive rate of non-metastatic and metastatic esophageal carcinoma tissues were 28.6%/87.9% Vs 42.9%/97%, P＜0.05.Conclusions Our results suggested that the increased expression of CD147 and NF-κB contributed to tumor angiogenesis in esophageal squamous cell carcinoma, which might be through the common pathway.

Objective To investigate the significance of K-ras gene status and ras protein expression in immunophenotypic classification of gastric signet ring cell carcinoma.Methods The expression of ras protein in 180 cases of gastric signet-ring cell carcinoma was detected by tissue microarray immunohistochemistry.Meanwhile,the mutation in codon 12,13 of K-ras gene was determined by using PCR-based DNA direct sequencing analysis.Results The rate of ras protein expression was 27.8％.The rate of ras protein expression in intestinal phenotype was significantly higher than those in gastric and gastrointestinal phenotypes(P<0.05).The rate of ras protein expression in cases with lymph node metastasis was significantly higher than those in cases without nodal involvement(P<0.05).The rate of ras protein expression was significantly higher in cases with deeper invasion(P<0.05).The frequency of K-ras gene mutation was 22(12.2％).All of them were found in codon 12.The types of mutation included GGT→AGT(1 case),GGT→TGT(1 case),GGT→GCT(2 cases),GGT→GTT(8 cases)and GGT→GAT(10 cases).K-ras mutation was significantly associated with intestinal phenotype(P<0.05).The rates of ras protein expression in cases with mutational type of K-ras gene was higher than those in cases with wild type(P<0.05).The ras protein expression was positively associated with K-ras gene mutation(r=0.61,P<0.05).Conclusion The ras protein expression is correlated with nodal involvement and invasion.K-ras gene mutation and expression of ras protein is related to phenotypic classification,and they might influence the phenotypic transformation in gastric signet ring cell carcinoma.

Objective To investigate molecular epidemiology profile of methicillin-resistant Staphylococcus aureus (MRSA) in ICU ward.Methods Twenty-five MRSA strains were typed by arbitrarily primed PCR (AP-PCR).Results Ten different AP-PCR patterns (A-G) were found among 25 MRSA strains.Most of MRSA in ICU ward were A and B pulsotype.Conclusion Hospital acquired MRSA is multi-resistant to antibiotics.A and B pulsotype MRSA outbreak occures in ICU ward.

Objective To investigate the clinicopathological and immunophenotype features of hemangiosarcoma.Methods The clinical,pathologic features of 5 cases of hemangiosarcoma,admitted in our hospital during 2006-2014,were retrospectively analyzed.Results Tumors were located in the spleen (n =3),liver(n =1),scalp(n =1),tumor metastasis to the lung or marrow was found in 4 cases.Preoperative misdiagnosis as lymphoma,cavernous haemangiomas or parasite cyst was suggested by ultrasonography or CT,and final diagnosis was established by typical pathological pictures.CD34,CD31,FⅧ and Vim were positive in tumor cells while CK,EMA were negative.The survival time of the patients receiving resection only was 2 days,4 months and 13 months.The survival time of the patients receiving operation plus chemotherapy was 6 months or 48 months.Conclusions Hemangiosarcoma is a rare and aggressive malignant tumor of soft tissue which has poor prognosis.The additional survival benefits provided by chemotherapy remains unproven.

OBJECTIVE:To analyze the differences of drug instructions between hospital directory and OTC standard model in-structions,and to provide reference for enhancing instruction management and reducing the safety risk of clinical drug use. METH-ODS:1 324 drugs of hospital directory in a hospital in 2014 were compared with OTC directory from CFDA websites. The instruc-tion of drug types included in OTC directory were compared OTC model instruction. According to the degree of risks which the dif-ferences may bring,differences were divided into four levels for analysis as negligible,general,important and severe. RESULTS:244 drugs belonged to OTC,of which 32.38%were different from standard model instructions. The four risk levels rates of negligi-ble,general,important and severe accounted for 29.11%,34.18%,7.59% and 29.11%,respectively. Among important risk,the difference of“indication limit”occupied the highest proportion,being 50.00%. Among severe risk,the difference of“forbidden for special disease”and“forbidden for pregnant women”accounted for 43.48% and 39.13%. CONCLUSIONS:There are problems, such as the absence of important medication information,statement conflicts. The hospital and administration departments should en-hance the standard management of drug instruction to guarantee safe and rational drug use in the clinic.

Objective To understand the schistosomiasis endemic situation at a national surveillance site in Gong an Coun-ty Hubei Province. Methods According to The Scheme of Schistosomiasis Surveillance in China the schistosome infection rates of residents and cattle and the Oncomelaniahupensissnail status were investigated yearly in Zhangjiahu Village a nation-al surveillance site in Gong an County from 2004 to 2013. Results From 2004 to 2013 the human schistosome infection rates decreased from 10.66%to 0.58% and the cattle schistosome infection rates from 12.75%to 0. Meanwhile the snail areas and densities reduced and the schistosome infected snails were eliminated. Conclusion The schistosomiasis endemic situa-tion declined dramatically at the surveillance site and schistosomiasis is well-controlled.

Objective To investigate the dynamic changes of nuclear factor-κB(NF-κB) during brain injury of irradiated rats.Methods According to the random number table method,82 healthy Sprague-Dawley rats were divided into two groups:50 rats in the irradiation group and the other 32 rats in the control group given sham-irradiation.The whole brains of rats in the irradiation group were irradiated with a single dose of 20 Gy electron beam to establish an animal model of radiation-induced brain injury.All brain tissues were respectively taken out 1,3,7,14 and 28 d after irradiation.The quantificational real-time-polymerase chain reaction (QRT-PCR) was used to detect the expressions of the NF-κB mRNA while the expression of NF-κB protein was analyzed by ELISA and Western blot.The positioning expression of NF-κB protein in the hippocampus was measured with immunohistochemical staining.Results In the irradiation group,the expression of NF-κB mRNA significantly increased at 3 and 7 d following irradiation (t =37.79,35.30,P ＜ 0.05) and it approached a peak value on the third day following irradiation.The expression of NF-κB protein in whole brain tissues after irradiation was up-regulated and reached a peak on the first day post-irradiation and it was significantly higher than controls at 1,3,7,14 d after irradiation (t =30.94,14.87,27.17,13.27,P ＜ 0.05) then declined and dropped to the normal level by 28 d.The results of immunohistochemical staining showed that the number of NF-κB positive cells in the hippocampus increased at 1,3 and 7 d following irradiation (t =-8.49,-4.47,-3.46,P ＜ 0.05).Conclusions After irradiation,the expressions of NF-κB mRNA and corresponding protein first increase and then later decrease,which promotes the development of brain injury.

Objective To explore the relationship of molecular biology characteristic and the treatment outcome,and influence factors of neoadjuvant chemotherapy (NAC) in inflammatory breast cancer (IBC).Methods The clinicopathological data of 103 IBC patients who were treated with NAC from January 2005 to June 2013 were analyzed retrospectively.Immunohistochemical method was used to detect the expression of estrogen receptor (ER),progesteron receptor (PR),human epidermal growth factor receptor 2 (HER-2) and E-cadherin.The treatment outcome were evaluated.Results In 103 IBC patients,ER negative was 48 patients,PR negative was 51 patients,HER-2 positive was 45 patients,E-cadherin positive was 66 patients.The effective rate of chemotherapy was 72.8％ (75/103).The effective rate of chemotherapy in taxane-based group was significantly higher than that in anthracycline-based group [80.6％ (50/62) vs.61.0％(25/41)],and there was significant difference (P ＜ 0.05).The effective rate of chemotherapy in ER,PR,E-cadherin negative patients was significantly higher than that in ER,PR,E-cadherin positive patients [83.3％ (40/48) vs.63.6％ (35/55),82.4％ (42/51) vs.63.5％ (33/52),83.8％ (31/37) vs.66.7％ (44/66)],and there was significant difference (P ＜ 0.05).The effective rate of chemotherapy in taxane-based group with E-cadherin positive patients was significantly higher than that in anthracycline-based group with E-cadherin positive patients [77.5％ (31/40) vs.50.0％ (13/26)] (P ＜0.05).No correlation existed between the expression of HER-2 and the treatment outcome of chemotherapy (P ＞ 0.05).Conclusion ER,PR and E-cadherin negative patients with IBC is chemosensitive to NAC.The positive expression of E-cadherin may be an important factor of chemotherapy resistance.For the patients with E-cadherin positive,taxane-based chemotherapy regimen can achieve a better effective rate.

Marginal liver donor,a way to expand the liver pool,has been maximized in the unique position due to the shortage of donors.But the definition of marginal donor liver varies from center to center and the standard is very complex.With the enhancement of organ perfusion solution,preservation methods and surgical techniques,the edge donor criteria are also gradually expanding.What decision should we make,facing such clinical controversies.This paper makes a review on the marginal liver donor in the donation after citizen deceased,so as to improve its clinical application.