The invasion and metastasis of esophageal carcinoma is associated with several tumor marker on oncogenesi and tumor development,including matrix metalloproteinase,cell adhesion molecules CD44,pituitary-tumour transforming genes.Studies have shown that these tumor markera are over-expression in esophageal carcinoma,which affect the progress and prognosis of esophageal carcinoma,and their specificity and value for clinical application need to be futher studied.

005) As compared with those before operation ERO_2, VO_2I, DO_2 and DO_2I increased significantly during early neohepatic stages (P

Objective To explore the effect of the single maximum of alcohol consumption on vomiting induced by chemotherapy in male patients with nasopharyngeal carcinoma.Methods According to the single maximum of alcohol consumption,48 cases of male patients with nasopharyngeal carcinoma were divided into two groups:group A (small capacity for liquor group 10-50 g),group B (large capacity for liquor group ＞50 g).The amount of alcohol intake was assessed by a questionnaire.The responses of vomiting and the effects of antiemetic therapy between the two groups during the first cycle after induction chemotherapy were observed.Results The incidence rates of vomiting induced by chemotherapy between the two groups were 52.0％ and 17.4％,respectively.There were significant differences between the two groups (x2 =6.273,P ＜0.05).The incidence rates of grade 0,1,2 and 3 of vomiting in group A were 48.0％,20.0％,20.0％,12.0％,in group B were 82.6％,13.0％,4.4％,O,respectively.There were significant differences between the two groups (x2 =6.013,P =0.024).In the two groups,the complete control rate for acute vomit were 48.0％ and 82.6％ (x2 =6.273,P =0.012),for delayed vomit were 36.0％ and 65.2％ (x2 =4.090,P =0.043).There were also significant differences between the two groups.Conclusion With the increasing of capacity for liquor,the incidence of vomiting is significantly reduced,the degree of vomiting is distinctly alleviated,and the antiemetic efficacy is distinctly increased.

Objective To study the role of serine protease encoding gene prtP carried by Lactoba-cillus paracasei (Lp) in regulating mouse intestinal immunity. Methods Female BALB/c mice were ran-domly divided into seven groups and respectively administered with PBS, medium (5×108CFU/ml) and high dose (1×109CFU/ml) of Lp, Lp△prtP and ReLp△prtP for 21 consecutive days by intragastric ga-vage. Parameters including immune organ index, splenic lymphocyte transformation rate, energy metabolism in celiac macrophages, phagocytic ability of celiac macrophages and cytokines were detected. Quantitative changes in CD11c+CD80+cells in culture supernatants of splenic mononuclear cells were analyzed by flow cytometry. Results Compared with Lp△prtP, Lp could significantly promote the natural transformation of splenic lymphocytes, increase the level of energy metabolism in celiac macrophages, enhance the phagocytic ability of celiac macrophages, and up-regulate the expression of IFN-α, IL-10 and IFN-γ and the percentage of CD11c+CD80+cells. Conclusion Serine protease encoding gene prtP in Lp can regulate the mucosal im-mune system in mice.

Objective:To investigate the imaging features of solitary bone plasmacytoma (SBP) and to improve the diagnosis of SBP.Methods:The imaging and clinical data of 8 cases clinically diagnosed as SBP at different sites from September 2012 to September 2020 in Yuanping First People's Hospital of Shanxi Province were retrospectively analyzed. Imaging examinations included CT, magnetic resonance imaging (MRI) plain scan and enhanced MRI scan.Results:The lesion sites of 8 patients included 3 cases of thoracic vertebrae, 2 cases of lumbar vertebrae, 2 cases of skull, and 1 case of rib. Among them, 1 case was misdiagnosed as thoracic metastatic tumor, 1 case as thoracic tuberculosis, 1 case as lumbar lymphoma and 1 case as cranial meningioma. Osteolytic destruction of bone was found in all cases accompanied by expansible changes of bone and soft tissue masses. There were 5 cases of vertebral bodies compressed and flattened; CT showed equal/low density, T1WI showed equal/low signal, T2WI showed low/slightly high signal, and 2 cases showed typical "mini brain sign". There were 2 cases of skull with slight hyperintensity on CT, isointensity on T1WI, and equal/mixed hyperintensity on T2WI. The rib cases showed isodensity on CT, T1WI showed isointensity, T2WI showed slightly high intensity. The lesions of 4 SBP patients showed obvious uniform enhancement on MRI enhanced scan.Conclusions:SBP at different sites can show osteolytic destruction with uniform enhancement of lesions and soft tissue masses. "Mini brain sign" is the SBP-specific imaging sign of the spine.

BACKGROUND: In the process of bone defect healing, the use of biological materials loaded with drugs for local defect intervention can accelerate the repair of the defect, which provides a new method for the local treatment of bone defects. OBJECTIVE: To introduce the local application of bone tissue engineering scaffolds loaded with bisphosphonates in bone defect repair and to summarize the effects of bone tissue engineering scaffolds as a drug delivery system on the bone defect healing. METHODS: The authors retrieved PubMed, Web of Science, Springerlink, Medline, WanFang and CNKI databases with "bisphosphonates, alendronate, zoledronate, bone defect, bone tissue engineering" as key words for relevant articles published from 2006 to 2018. Initially, 235 articles were retrieved, and finally 70 articles were selected for further analysis. RESULTS AND CONCLUSION: Bisphosphonate drug is an effective inhibitor of osteoclast dissolution. It can form a drug sustained release system on the local defect by being loaded to composite scaffolds, promote the formation of new bone and accelerate the healing of the defect. For the drug delivery system of bisphosphonates, suitable scaffold materials are crucial to the osteogenic effect of composite scaffolds in the defect area. At present, the carrier materials used for bisphosphonate-loaded composite scaffolds are mainly divided into organic materials and inorganic materials. Most polymeric organic materials can directly load bisphosphonates to form good drug sustained release in the local area and obviously exert their pro-osteogenic effects, while natural materials and most inorganic materials are often combined with other materials to form composite materials as carriers to optimize the carrier performance. Most studies have also confirmed that these composite materials loaded with bisphosphonates in the defect area exert osteogenic effect in the defect area.

Objective:To investigate the clinic opathological features, treatment and prognosis of children newly diagnosed with ependymoma.Methods:Clinical data of 127 pediatric ependymoma (EPN) patients (0-16 years old) treated with tumor resection and postoperative radiotherapy at Xinhua Hospital Affiliated to Shanghai Jiao Tong University between 2001 and 2021 were retrospectively analyzed. Among them, 53 children were female and 74 were male. Local control (LR), event-free survival (EFS) and overall survival (OS) rates were analyzed by Kaplan-Meier method. The relationship between clinic opathological factors and clinical prognosis, and the effect of treatment on clinical prognosis of patients were analyzed by Cox proportional hazards model.Results:At a median follow-up time of 29 months (3-251 months), the 3-year OS and EFS rates were 89.5% and 71.5%, respectively. For patients undergoing incomplete resection followed by postoperative adjuvant radiotherapy, the 3-year LR, OS and EFS rates were 78.3%, 65.8% and 85.7%, respectively. A total of 43 children were aged <3 years old when diagnosed and 84 aged ≥3 years old. The interval time between surgery and radiotherapy in children aged <3 years old was 91 d, and 35.5 d in those aged ≥3 years old ( P<0.001). For patients <3 years old, the median EFS was 90 months when initiating radiotherapy within ≤70 d after surgery, compared to 43 months for those who initiated radiotherapy at >70 d after surgery ( P=0.053). According to fifth edition of the WHO classification of tumors of the central nervous system (WHO CNS5), 39 children were classified as posterior fossa ependymoma group A (PFA group). The OS and EFS rates in the PFA group were significantly less than those in other groups (3-year OS rate were 69.2% vs. 94.6%, P<0.001; 3-year EFS rate were 46.9% vs. 79.1%, P<0.001). In the PFA group, 12 patients received postoperative adjuvant chemotherapy, 14 did not receive chemotherapy, and whether chemotherapy was given was unknown in 13 cases. No significant differences were observed in OS and EFS between patients treated with and without chemotherapy ( P=0.260, P=0.730). Univariate Cox analysis showed that tumor location and WHO CNS5 molecular classification were significantly associated with EFS, and WHO CNS5 molecular classification was significantly correlated with OS. Multivariate Cox analysis showed that tumor location in the posterior fossa was an independent risk factor for EFS ( HR=2.72, 95% CI=1.1~6.71, P=0.03). Conclusions:Patients newly diagnosed with pediatric ependymoma can obtain favorable survival after surgery combined with postoperative adjuvant radiotherapy. Patients with residual tumors can achieve favorable LC and survival after postoperative adjuvant radiotherapy. Delaying of radiotherapy tends to lead to poor survival for patients aged <3 years old when diagnosed. Children in the PFA group obtain worse prognosis compared to their counterparts in other groups. The tumor location in the posterior fossa is an independent risk factor for pediatric ependymoma.

Objective To identify risk factors of systemic inflammatory response syndrome (SIRS) after percutaneous nephrolithotomy (PCNL).Methods We retrospectively reviewed 438 renal calculi patients after PCNL from August 2015 to July 2016.Among them,there were 251 men and 187 women,the mean age was (49.4 ± 11.1) years.The positive preoperative urine WBC,culture and nitrite rates were 29.7％ (130),12.1％ (53) and 15.1％ (66),respectively.The stone size was (851.2 ± 663.6) mm2,the stone CT value was (960.4 ± 303.4) HU,the operative time was (63.5 ± 33.4) min,124 (28.3 ％) were infection stones and multiple-tracts PCNL was performed in 69 (15.8％) patients.Univariate and multivariate logistic regression analysis were used to analyze perioperative predictors after PCNL.Results Thirty-nine patients developed SIRS (8.9％) after PCNL.The univariate analysis showed that positive preoperative urine WBC,nitrite,culture,operation time,stone size and transfusion had significantly impacts on the outcome of postoperative SIRS after PCNL (P ＜ 0.05).Multivariable logistic analysis showed that positive preoperative urine nitrite (OR =5.990,P ＜ 0.001),stone size (OR =2.251,P =0.027) and transfusion (OR =7.501,P =0.007) were independently related to the postoperative SIRS.Conclusion The positive preoperative urine nitrite,stone size and transfusion are independent risk factors for postoperative SIRS after PCNL.

Objective: To analyze the clinical features and microbial characteristics of patients with pyogenic liver abscess (PLA), and to determine the risk factors and biomarkers for early diagnosis of sepsis caused by PLA. Methods: The demographic and clinical data of 198 patients with liver abscess admitted to Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2013 to June 2017 were analyzed retrospectively. Patients with non-bacterial liver abscess, death on admission and tumor metastasis were excluded. The 198 patients with liver abscess were divided into the sepsis group and non-sepsis group according to the disease progression. The general data of the two groups were analyzed to explore the risk factors of sepsis caused by liver abscess, biomarkers for early diagnosis, and the prognosis. Patients with positive culture were further divided into the Klebsiella pneumoniae group and non-Klebsiella pneumoniae group, and the general clinical data of the two groups were analyzed. Among the PLA patients with positive culture, 80.0% were Klebsiella pneumoniae, followed by E. coli. SPSS 19.0 software was used for statistical analysis, and univariate and logistic multivariate regression analysis was used to determined the risk factors of sepsis induced by PLA. The diagnostic value of white blood cell, neutrophil percentage and procalcitonin (PCT) at admission on the progression of liver abscess to sepsis was evaluated by the receiver operating characteristic (ROC) curve, area under the curve (AUC), sensitivity and specificity. Results: The mortality of patients with sepsis caused by liver abscess was 20.8%. The white blood cell count, neutrophil percentage, and PCT at admission predicted the progression of sepsis in PLA patients, and the AUC were 0.76 (95%CI: 0.623-0.898), 0.818 (95%CI: 0.691-0.945), and 0.869 (95%CI: 0.765-0.974), respectively. Patients with diabetes were prone to develop sepsis after the occurrence of liver abscess. There was no significant difference in microbial characteristics between the sepsis group and non-sepsis group. Length of stay (LOS) in patients with sepsis was significantly prolonged [(19.6±12.5) d vs (16.0±9.3) d, P=0.033]. Conclusions Diabetes is an independent risk factor for the progression of liver abscess to sepsis. Klebsiella pneumoniae is the first pathogen of liver abscess. Patients with elevated glycated hemoglobin (≥9.9%) are prone to develop sepsis. White blood cell count (≥12.55×10⁹/L), percentage of neutrophils (≥84.8%), and PCT (≥6.96 ng/mL) in patients with liver abscess indicated the progresses to sepsis, and thus the LOS of patients with sepsis is significantly prolonged and the mortality is significantly increased.

Objective:To investigate the characteristics of distribution and drug resistance of urinary bacteria in the mid-stream urine of patients with infectious stones.Methods:The retrospective study analyzed the clinical data of 254 patients with infectious stones in the First Affiliated Hospital of Guangzhou Medical University from September 2016 to September 2018. All patients were treated with PCNL. Overall, there were 101 male and 153 female patients, with the mean age of(51.5±12.3) years, and the mean stone burden of 1443.5(660.8, 2837.5) mm2. There were 58 (22.8%) patients with hypertension, 17(6.7%) patients with diabetes and 195(76.8%)with hydronephrosis. The mid-stream urine samples were obtained for bacterial culture and susceptibility test, and the results of urine culture and antimicrobial susceptibility were recorded and analyzed.Results:Of 254 patients involved in this study, 89(35.0%) were positive and 165 (65.0%) were negative for urinary bacterial culture of the mid-stream. The proportion of patients with positive urine bacterial culture of the mid-stream who had positive urine leucocytes, positive urine nitrite and postoperative pyrexia were 86.5%(77/89), 64.0%(57/89), 25.8%(23/89), respectively, which was higher than that of patients with negative urine bacterial culture of the mid-stream [50.3%(83/165), 14.5%(24/165), 14.5%(24/165), P<0.05]. Four teen kinds of bacteria were detected from the mid-stream urine, and the three bacteria with the highest detection rate in turn were Escherichia coli of 38.2%(34/89), Proteus mirabilis of 15.7%(14/89), and Pseudomonas aeruginosa of 11.2%(10/89). The results of this study showed that three common bacteria had high resistance to drug including Cefazolin, Cefuroxime, Cefuroxime ester, Ampicillin and Co-trimoxazole (all resistance rate>40%). The resistance rates of Escherichia coli and Pseudomonas aeruginosa to Ciprofloxacin and Levofloxacin were higher than or equal to 40%. The resistance rates of Escherichia coli and Proteus mirabilis to meropenem, imipenem, ertapenem, piperacillin/tazobactam and amikacin were all lower than 10%. In addition, the resistance rates of Escherichia coli to nitrofurantoin and tigecycline and Proteus mirabilis to tobramycin, aztreonam and cefoxitin were all less than 10%. The resistance rates of Pseudomonas aeruginosa to ceftazidime, cefepime, gentamicin and aztreonam were less than 10%. Conclusions:The highest detection rate of urinary bacteria in culture of the mid-stream with infectious stones are Escherichia coli, Proteus mirabilis and Pseudomonas aeruginosa, all of which showed high resistance to Ampicillin, Cotrimoxazole, and some cephalosporins. Escherichia coli and Pseudomonas aeruginosa showe high resistance to Ciprofloxacin and Levofloxacin, and all of the three bacteria have low resistance rates to some β-Lactamase inhibitor complex and carbapenems, suggesting a reference for clinical empirical medical treatment.