Objective To explore the methods and clinical effects of dimple plasty with syringe needle guiding.Methods From February 2008 to May 2012,36 dimple plasties in 21 patients were performed with using a syringe needle guiding the absorbable suture,including 15 cases in bilateral side and 6 cases in unilateral side.There were 4 cases in unilaterally right side and 2 cases in unilaterally left side.Two patients with inborn dimple in unilateral side received the dimple plasty in the other side for facial symmetry.Results 34 dimples in 21 patients were satisfied with the results.Two dimples were re-operated after three months because of disappearance.There were scleromas in 2 cases,which was disappeared by hot compress in three months.There were no hemotoma and infection in 21 patients.Conclusions The procedure of dimple plasty under syringe neddle guiding is safe,reusable and effective.It is a minimally invasive surgery and the patients are satisfied with the dynamic results after operation.

Objective To investigate the effects of the point-injection combined with neuromuscular facilitation rehabilitation techniques on post-stroke shoulder-hand syndrome. Methods A treatment group, 36 cases, was treated with the point-injection combined with neural facilitation of rehabilitation techniques. And a control group, 30 cases, was treated with massage therapy. Observed the clinical manifestations and used Fugl-Meyer to assess the joint activities, pain degree and motion function of upper limbs before and after therapy. Results Compared with the control group, the treatment group showed better improvement of joint activity scope and degree, and alleviation of pain (P<0.05). Conclusion Point injection and neuromuscular rehabilitation treatment has a better effect ain treating sequelare of brain stroke and it is worth applying.

Objective To screen the pathogenic locus and gene in a primary open angle glaucoma(POAG),and to provide a basis for molecular genetic study of POAG.Methods A POAG pedigree with 35 members was diagnosed in Sichuan peoples' Hospital from January to August 2005.The disease history and clinical data were collected.Genome-wide scan was performed for the families.Specific software was used to calculate the LOD value,which based on the allele (haploid) typing result with two-point method to definite the positive loci by the largest LOD value.Results The POAG family had 35 members of 4 generations.18 patients were diagnosed as juvenile open angle glaucoma from visual disc shape abnormality and loss of typical visual field.All of the patients in this family suffered various degrees of binocular vision loss and vision loss in childhood,with poorly visual function.The LOD values of 3 short tandom repeat (STR) markers on chromosome 2 were greater than 3.0,they were D2S2369 (LOD value 4.0033),D2S2332 (LOD value 3.8402) and D2S337 (LOD value 4.7520).There was a genetic linkage near the three genetic markers in the family.The primary glaucoma positive locus was a in chromosome p15 to chromosome p16.2,and the genetic distance was about 9 Mb,locating in between the markers D2S2369 and D2S2397.Conclusions GLCIH is a pathogenic locus for this POAG pedigree,which supplies an evidence for elucidating the pathogenesis of POAG.

Anopheles minimus was once a main malaria vector in Hainan Island and had been e-liminated basically through the campaign of indoor residual spraying launched in 1959. It again became an incriminated vector of some focal malaria outbreaks in recent years. The present study was conducted in a selected county-Danxian and a typical hilly area-Feibar in the west part of Danxian county in 1989-1990.An. minimus was found in 50% and 62. 5 % of the surveyed sites at mountainous and hilly area of Danxian county,but not found in coastal region. An. minimus was found in all 18 sites surveyed in Feibar district constituting 52% of anopheline composition. Man-biting rate made by human-baited collection was 3. 2 before midniaght and 38. 2 when collected through whole night in some sites. However, the behaviour characteristics of An. minimus has changed. It has become exophilic,exophagic, and has an equal preference for man and cattle. The vectorial capacity of An. minimus estimated by quantitative data was in accord with malaria infection rate in Feibar district ,and the malaria infection rate among the inhabitants in three types of residential quarter with different socioeconomic conditions. Malaria infection rates of residential quarter of land-reclamation outcomers, villagers and state farm residents were 10%,2. 9% and 0. 5% respectively during 40 days from July to August,1990.Owing to the fact that An. minimus has become a secondary vector only next to An. dirus, with a wide range of distribution and a considerable different characteristics in behaviour compared to that before spraying campaign , it is suggested that a malaria control programme must be seriously planned to adjust the new problem of malaria epidemiology in Hainan Province.

Objective To investigate the prognostic value of serum P-cadherin( P-cad)level in patients with non-small cell lung cancer(NSCLC). Methods A total of 80 patients with NSCLC in Hanzhong 3201 Hospital of Shaanxi Province from January 2012 to December 2013 were selected as study subjects. The relationships between serum P-cad level and clinicopathological characteristics were analyzed. The Cox regres-sion analysis was used to analyze the risk factors affecting prognosis of NSCLC patients. The survival curve was drawn by Kaplan-Meier method and the difference test was carried out by log-rank method. Results There were significant differences in lymph node metastasis(χ2 = 14. 31,P < 0. 001),vascular invasion(χ2 = 5. 56, P = 0. 018)among NSCLC patients with different levels of serum P-cad. Multivariate Cox regression analysis showed that lymph node metastasis(HR = 0. 856,95％ CI:0. 702-0. 955,P = 0. 012),TNM stage(ⅢA HR =1. 315,95％ CI:1. 058-1. 991,P = 0. 024;ⅢB HR = 1. 448,95％ CI:1. 124-2. 215,P = 0. 011;Ⅳ HR =1. 569,95％ CI:1. 182-2. 441,P < 0. 001)and high level of serum P-cad(HR = 1. 815,95％ CI:1. 224-3. 562,P < 0. 001)were risk factors for progression-free survival in NSCLC patients,and lymph node metasta-sis(HR = 0. 755,95％ CI:0. 652-0. 915,P = 0. 022),poor differentiation(HR = 1. 622,95％ CI:1. 112-2. 015,P < 0. 001),TNM stage(ⅢA HR = 1. 335,95％ CI:1. 064-2. 014,P = 0. 011;ⅢB HR = 1. 489, 95％ CI:1. 129-2. 297,P < 0. 001;Ⅳ HR = 1. 622,95％ CI:1. 192-2. 501,P < 0. 001)and high level of serum P-cad(HR = 1. 677,95％ CI:1. 193-2. 668,P < 0. 001)were risk factors for overall survival of NSCLC patients. The results of Kaplan-Meier survival curve showed that the overall survival and progression-free survival of patients with high level of serum P-cad were shorter than those of patients with low level of serum P-cad(χ2 = 5. 18,P = 0. 015;χ2 = 5. 48,P = 0. 011). Conclusion High level of serum P-cad is closely related to poor prognosis in NSCLC patients.

Objective To investingate the effect of SGK1 expression level on the prognosis of patients with NSCLC,and provide new biological predictors for the prognosis assessment of patients with NSCLS.Methods One hundred and twenty patients with NSCLC received radical resection in Hanzhong 3201 hospital from Jan 2011 to Dec 2013 were selected.There were 75 males and 45 females,age (63.15 ± 16.44) years,age range 45-80 years.According to the results of immunohistochemical staining,the SGK1 cut-off value determined by the integral was determined,and NSCLC patients were divided into SGK1 high expression group (n =70) and SGK1 low expression group(n =50).The relationship between the expression of SGK1 and clinicopathological features (age,sex,smoking history,alcoholism history,BMI,tissue type,tumor diameter,T stage,N stage,TNM stage,differentiation degree) in NSCLC were analyzed,and the overall survival rate in NSCLC were also analyzed.Followup was carried out by telephone or patient admission.The follow-up period was up to June 1,2018.Chest X-ray and ultrasonography were reviewed every 3 to 6 months after operation,and enhanced CT or MRI were performed if the results were abnormal.The measurement data conforming to normal distribution were expressed by t test and showed by (Mean ± SD);the counting data were tested by x2 test;the 5-year overall survival rate was used as the endpoint event for univariate analysis,and the significant variables for univariate analysis were analyzed by COX risk ratio model for multivariate analysis.The cumulative survival curve was drawn by Kaplan-Meier method,and the difference was tested by Log-rank method.Results The expression level of SGK1 in tissues was not related to age,sex,smoking history,alcoholism,BMI,tissue type and tumor diameter (P ＞ 0.05),but it was related to T stage,N stage,TNM stage and differentiation degree (P ＜ 0.05).The univariate and multivariate COX risk ratio model showed that TNM stage and SGK1 expression were independent factors affecting the 5-year overall survival rate of NSCLC patients (P ＜ 0.05).The results of Kaplan-Meier survival curve showed that the 5-year overall survival rate in NSCLC with low expression of SGK1 was significantly higher than that in NSCLC with high expression of SGK1 (P ＜ 0.05).Conclusions The expression of SGK1 in tissues is closely related to the prognosis of patients with NSCLC.The high expression of SGK1 in tissues is not conducive to the prognosis of patients with NSCLC.

Objective The multiple malformation of upper eyelid,including the excessive width of fold line,sunken and/or multiple folded upper eyelid are the common complications after blepharoplasty.The aim of this study was to investigate the clinical effect of orbital septum fat redistribution on correcting these deformities.Methods From September 2015 to September 2017,38 patients with multiple malformations of upper eyelid were treated.The incision of upper eyelid and the excessive skin was designed and resected.After completely relieving the scar adhesion zones,we set the lateral orbital septum fat free and transposed it to the inner side of orbital septum or superior border of tarsus with suturing fixation.Then we routinely completed the double eyelid operation.Results Thirty-eight patients with multiple malformations of upper eyelid were treated successfully.The patients were followed up for 6 months to one year,and the results were totally satisfactory.The operation was not performed again.Conclusions The orbital septum fat redistribution can successfully correct the multi ple malformation of upper eyelid.It should become a regular procedure in blepharoplasty.

Objective To explore the molecular mechanisms of resistance to phosphatidyl inositol 3?kinase ( PI3K) inhibitors in triple?negative breast cancer ( TNBC) cells. Methods HCC70 cells ( TNBC) were transfected with siFZD7, siWANT5B or siGSK3 using lipofectamine 2000 transfection reagent. The expression levels of key proteins of WNT/β?catenin and PI3K/AKT/mTOR pathways were determined by Western blot analysis. After HCC70, MCF?7 ( ER?positive ) and SK?BR3 ( HER2?positive ) cells were treated with PI3K/AKT/mTOR inhibitors, the inhibition rates of cell proliferation were measured by MTT assay, and half maximal inhibitory concentrations ( IC50 ) were calculated. The altered activities of WNT/β?catenin and PI3K/AKT/mTOR proteins were detected by Western blot and luciferase report gene assay, respectively. The nuclear translocation of β?catenin protein was examined by immunofluorescence assay. Xenograft nude mouse model was used to evaluate the tumorigenicity of breast cancer cells treated with BKM120 in vivo. The expression levels of p?LRP6, p?4EBP1 and β?catenin proteins in the tumor tissues were determined by immunohistochemical staining. Results The expression levels of FZD7, WANT5B and GSK3 proteins were significantly reduced in the HCC70 cells transfected with the target siRNAs. Meanwhile, the activity of WNT/β?catenin was enhanced and PI3K/AKT/mTOR pathway was inhibited. PI3K/AKT/mTOR inhibitors suppressed MCF?7 and SK?BR3 cell proliferation. The IC50 of GDC?094, BKM120, XL147, perifosine, everolimus, and BEZ235 in MCF?7 cells were 0. 46 mmol/L, 1. 44 mmol/L, 4. 34 mmol/L, 11.35 μmol/L, 53. 71 μmol/L and 12. 87 μmol/L respectively, and 0. 63 mmol/L, 0. 58 mmol/L, 3. 74 mmol/L, 13.22μmol/L, 60.00μmol/L and 11.38μmol/L in the SK?BR3 cells, respectively. The results of luciferase report gene assay showed that the luciferase activities in HCC70, MCF?7 and SK?BR3 cells treated with BKM120 were 1.75±0.05, 1.13±0.02 and 0.43±0.01, respectively. The luciferase activities in HCC70 and SK?BR3 cells were significantly different from that of the control cells (1.00±0.02, P<0.05). The immunohistochemical analysis showed that BKM120 inhibited mTOR activity, and the enhanced WNT/β?catenin activity reversed the phenotype of inhibitory mTOR induced by BKM120. BKM120 suppressed the tumorigenic ability of MCF?7 and SK?BR3 cells in vivo, but had no effect on cultured HCC70 cells. The immunohistochemical analysis showed nuclear translocation of β?catenin protein and increased expression level of p?LRP?6 protein in transplanted tumor tissues from HCC70 cells treated with BKM120, increased the level of p?LRP?6 protein, and no changes of p?4EBP1 protein expression. However, no nuclear translocation of β?catenin protein and no decrease of p?LRP6 and p?4EBP1 protein levels in the transplanted tumor tissue of MCF?7 cells after treatment with BKM120. Conclusions The triple?negative breast cancer HCC70 cells have drugs?resistance to PI3K inhibitors. The WNT/β?catenin signaling pathway may regulate the PI3K/AKT/mTOR pathway, therefore, inducing the drug?resistance of TNBC cells to PI3K inhibitors.

Objective To explore the molecular mechanisms of resistance to phosphatidyl inositol 3?kinase ( PI3K) inhibitors in triple?negative breast cancer ( TNBC) cells. Methods HCC70 cells ( TNBC) were transfected with siFZD7, siWANT5B or siGSK3 using lipofectamine 2000 transfection reagent. The expression levels of key proteins of WNT/β?catenin and PI3K/AKT/mTOR pathways were determined by Western blot analysis. After HCC70, MCF?7 ( ER?positive ) and SK?BR3 ( HER2?positive ) cells were treated with PI3K/AKT/mTOR inhibitors, the inhibition rates of cell proliferation were measured by MTT assay, and half maximal inhibitory concentrations ( IC50 ) were calculated. The altered activities of WNT/β?catenin and PI3K/AKT/mTOR proteins were detected by Western blot and luciferase report gene assay, respectively. The nuclear translocation of β?catenin protein was examined by immunofluorescence assay. Xenograft nude mouse model was used to evaluate the tumorigenicity of breast cancer cells treated with BKM120 in vivo. The expression levels of p?LRP6, p?4EBP1 and β?catenin proteins in the tumor tissues were determined by immunohistochemical staining. Results The expression levels of FZD7, WANT5B and GSK3 proteins were significantly reduced in the HCC70 cells transfected with the target siRNAs. Meanwhile, the activity of WNT/β?catenin was enhanced and PI3K/AKT/mTOR pathway was inhibited. PI3K/AKT/mTOR inhibitors suppressed MCF?7 and SK?BR3 cell proliferation. The IC50 of GDC?094, BKM120, XL147, perifosine, everolimus, and BEZ235 in MCF?7 cells were 0. 46 mmol/L, 1. 44 mmol/L, 4. 34 mmol/L, 11.35 μmol/L, 53. 71 μmol/L and 12. 87 μmol/L respectively, and 0. 63 mmol/L, 0. 58 mmol/L, 3. 74 mmol/L, 13.22μmol/L, 60.00μmol/L and 11.38μmol/L in the SK?BR3 cells, respectively. The results of luciferase report gene assay showed that the luciferase activities in HCC70, MCF?7 and SK?BR3 cells treated with BKM120 were 1.75±0.05, 1.13±0.02 and 0.43±0.01, respectively. The luciferase activities in HCC70 and SK?BR3 cells were significantly different from that of the control cells (1.00±0.02, P<0.05). The immunohistochemical analysis showed that BKM120 inhibited mTOR activity, and the enhanced WNT/β?catenin activity reversed the phenotype of inhibitory mTOR induced by BKM120. BKM120 suppressed the tumorigenic ability of MCF?7 and SK?BR3 cells in vivo, but had no effect on cultured HCC70 cells. The immunohistochemical analysis showed nuclear translocation of β?catenin protein and increased expression level of p?LRP?6 protein in transplanted tumor tissues from HCC70 cells treated with BKM120, increased the level of p?LRP?6 protein, and no changes of p?4EBP1 protein expression. However, no nuclear translocation of β?catenin protein and no decrease of p?LRP6 and p?4EBP1 protein levels in the transplanted tumor tissue of MCF?7 cells after treatment with BKM120. Conclusions The triple?negative breast cancer HCC70 cells have drugs?resistance to PI3K inhibitors. The WNT/β?catenin signaling pathway may regulate the PI3K/AKT/mTOR pathway, therefore, inducing the drug?resistance of TNBC cells to PI3K inhibitors.

Objective To evaluate the efficacy and safety of different antimicrobial regimens in patients with bloodstream infections caused by carbapenem-resistant Klebsiella pneumoniae (CRKP).Methods The clinical date of patients with CRKP bloodstream infections were retrospectively analyzed at the First Affiliated Hospital of Zhejiang University Medical College between January 2017 and January 2018.All subjects were separated into three groups based on antibiotics regimens over 72 hours,including meropenem 2.0 g every 8 hours,tigecycline 200 mg as initial dose and 100 mg every 12 hours,and polymyxin B 1.25 mg/kg every 12 hours as salvage treatment of tigecycline.Results A total of 86 patients were finally recruited,including 14,52 and 20 patients in groups of meropenem,tigecycline and polymyxin B salvage,respectively.All of the strains were resistant to meropenem and susceptible to tigecycline and polymyxin B initially,while 2 of them became resistant to tigecycline during treatment.The 28-day mortality was significantly higher in meropenem group (13/14) than that in tigecycline group and polymyxin B salvage group (61.5％,32/52) and (12/20),respectively (P＜0.01),while as no significant difference was seen in the last two groups (x2=0.014,P＞0.05).The incidences of hepatic impairment [3.8％(2/52) vs.1/20] and renal dysfunction (0 vs.1/20) between tigecycline group and polymyxin B salvage group were both comparable (P＞0.05).Conclusion The meropenem-based therapy is not recommended for CRKP-related bloodstream infections.Tigecycline-based therapy is still disappointing despite salvage use of polymyxin B after 72 hours.Hepatic and nephretic toxicities caused by additional polymyxin B are acceptable.