Objective To study the inhibitive effect of adenovirus mediated CD gene and 5-FC on proliferative human retinal pigment epithelial (HRPE) cells, and to search for an effective method to take precautions against proliferative vitroretinopathy (PVR). Method Different concentrations of CD and 5-FC were added respectively to the cultured third-growth-generation HRPE cells.Transferance rate was detected by positive HRPE cells marked by X-gal and LacZ. The number of HRPE cells were counted and evaluated by methylthiazol-tetrazollium (MTT) method. Results The adenovirus mediated CD gene could be transfered into HRPE cells with a dose-dependent manner. Positive HRPE cells with CD gene could transform 5-FC to 5-Fu,which could inhibit the increase of HRPE cells effectively. No obvious bystander effect on the growth of HRPE cells was detected. Conclusions The adenovirus may introduce a foreign gene into cultured HRPE cells efficiently. It could be a good method to treat and prevent PVR by medication.

Objective To study the dose-response relationship between propofol and isoflurane in balanced anaesthesia. Methods 30 patients, age ranged from 46 to 68 years and body weight from 48 to 72 kilograms, were se-lected. Anaesthesia was induced with propofol 1.5mg/kg,vecuroniura 0.12 mg/kg, fentanyl 2～4μg/kg,and main-rained with vecuronium 1.2μg/kg,fentanyl 2μg/kg. Isoflurane was inhaled at first so that BIS could be maintained on the level of 50～60. Then, minishing the isoflurane concentration by 0.3%～0.5 % and adding the dosage of propofol synchronously, establishing 4～6 balanced level spots of anaesthesia, which could maintain BIS on the level of 50～60 all the time. Recording the isoflurane concentration, the dosage of propofol, MAP, HR, etc, and making the scatterplot graph in virtue of SPSS software. Results The relationship between propofol and isoflurane was accordance with ex-ponential curve model,of which the equation is :y= 102.991 x exp (-1.4456x), R2= 0.784 ; and the ratio of their dosages is 54/1. When isoflurane was inhaled alone at first, MAP was decreased significantly ( P<0.05 ). As the isoflurane concentration minished and the dosage of propofol added, MAP and HR were increasing gradually, but when isoflurane concentration was minished to zero, there is no significant difference as compared with the preanesthesia baseline ( P>0.05 ). Conclusion When BIS was on the balanced level of 50～60, exponential curve relationship ex-ists between the dosage of propofol and isoflurane concentration. If applied reasonabhly, propofol could be good for re-ducing circulation aide-effect of isoflurane.

Objective To analyze the findings of recurrent/residual caner after thyroidectomy for thyroid cancer in both ultrasonography (US) and contrast-enhanced CT (CECT),and to assess the diagnostic value of combination of these two modalities.Methods Forty-six patients with recurrence/ residue of thyroid cancer underwent both high-frequency US and CECT examinations and were enrolled in this study.The imaging features on US and CECT were reviewed and diagnostic accuracies for local residual lesions and cervical lymph node metastasis were evaluated according to pathological results.Results In 46 patients,the average period between thyroidectomy and diagnosis of recurrent/residual cancer was (14.6 ± 12.1) months(range,7 days-10 years).Twenty patients had local recurrent tumors at the surgical bed and the average size of tumors was 2.1 cm(range,0.5-4.6 cm).On US finding,the recurrent/residual tumors were hypoechoic in 60 ％ of cases,had microcalcification in 40 ％.Cervical lymph node metastasis were found in 40 patients,and 75％ of them were located in zone V[.The smallest size of abnormal lymph node which can be detected by US was 3 mm.In cases of lymph node metastasis,12 cases (30％) became cystic,10 (25 ％) presented microcalcifications,and 5 (12.5 ％) showed microcalcifications and cystic change within a lymph node.Microcalcifications,cystic change and hyperechoic appearance within a lymph node suggested malignant.The detection rate of US and CECT in the local recurrent/residual cancer were 90％ and 90％,respectively.The detection rate of cervical lymph nodes metastasis were 80 ％ and 72.5 ％,respectively.The diagnostic accuracy of US and CECT in local recurrence,cervical lymph node metastasis and both were 65％,67.5％ and 65.2％ vs 75％,55％ and 65.2％,respectively (P ＞ 0.05 for all comparisons).the diagnostic accuracy of combination of US and CECT were increased to 86.4％,77.5％ and 91.3％,respectively.US combined with CECT significantly improved the diagnostic capability compared with US or CECT alone(P ＜0.05).Conclusions US should be used as the first choice of imaging examination for post-thyroidectomy of thyroid cancer.US combined with CECT could further increase the diagnostic accuracy in recurrent/residual thyroid cancer.

Objective To explore the diagnostic value of conventional ultrasound(US) and contrast enhanced ultrasound(CEUS) in predicting extrathyroidal extension of papillary thyroid cancer(PTC).Methods Eighty-five PTCs in 75 patients were selected for thyroid surgery underwent ultrasound and contrast-enhanced ultrasound.The degrees of contact between PTCs and capsule were observed by US and CEUS respectively(0,0-25％,25％-50％,≥50％),and the diagnostic efficiency in different degree of contact (＞0 ％,≥25 ％,≥50％) as preoperative diagnostic criteria were analyzed.The diagnostic efficiency between US and CEUS in predicting extrathyroidal extension of PTC were compared.Results Of the 85 PTCs,extrathyroidal extension was presented in 57 (67.06％) based on pathologic results.When the degree of contact (＞ 0 ％,＜ 25 ％,25 ％-50 ％,≥ 50 ％) was gradually increased,the incidence of extrathyroidal extension of the thyroid cancer was also gradually risen (P ＜0.001).Comparing the sensitivity,accuracy,odds ratio,and Az value of three groups(＞0％,≥25％,≥50％),it showed that the general diagnostic efficiency between two groups(＞0％,≥25％) was similar by US and CEUS.However,the sensitivity and accuracy of ＞0％ contact with the adjacent capsule were markedly higher than those of the other two groups(P ＜0.001).Selecting ＞0％ contact with the adjacent capsule as preoperative criteria,the Az value of CEUS was markedly higher than that of US (Z =2.208,P =0.027).Conclusions The preoperative imaging feature of more than 0％ contact with the adjacent capsule is more sensitive and accurate degree in predicting extrathyroidal extension of PTC.Compared with US,CEUS may serve as a better useful tool to predict extrathyroidal extension of PTC.

Objective To evaluated the impact of obesity on surgical site infection (SSI)following colorectal cancer surgery.Methods A total of 215 patients undergoing radical surgery for colorectal cancer in a hospital be-tween January 2008 and December 2013 were investigated retrospectively,100 patients were with body mass index (BMI)≥25 kg/m2 (obesity group)and 115 patients with BMI<25 kg/m2 (normal weight group),the intra-opera-tive and postoperative indicators and surgical complications were compared between two groups.Results In obesity group,72(72.00%)patients had intra-operative blood loss of >60 mL,58(58.00%)patients’duration of surgery was >220 min ,20 (20.00%)of whom developed postoperative SSI;in normal weight group,30(26.09%)patients had intra-operative blood loss of >60 mL,20(17.39%)patients’duration of surgery was >220 min,8(6.96%)of whom developed postoperative SSI.Intra-operative blood loss and incidence of SSI in obesity group were both signif-icantly higher than normal weight group,duration of surgery and postoperative length of hospital stay were both longer than normal weight group(both P <0.05).Conclusion Incidence of SSI in colorectal cancer patients is high. Obesity,long duration of surgery,and more bleeding are high risk factors for SSI in colorectal cancer patients.

Objective To evaluate the role of contrast-enhanced ultrasound (CEUS) on the the detection of hepatic metastases in comparison with conventional ultrasonography (US) and contrastenhanced computed tomography (CECT).MethodsNinety-seven patients with hepatic metastases underwent US,CEUS and CECT images.Their detection of hepatic metastases were compared.Results Hepatic metastases showed five enhancement patterns with CEUS,including bolus hyper-enhancement,peripheralrimenhancement,inhomogeneousenhancementwithnecrosis,hypo-enhancement,isoenhancement with liver parenchyma,all hepatic metastases showed dark defects in portal and delayed phase.The mean number of metastases at CEUS was greater than that of US (2.6±1.9 vs 1.6 ±1.2,P＜0.05).The detection of hepatic metastases was 53.4％ and 87.1％ respectively(P＜0.05).CEUS and CECT have no statistically significant difference in the detection of hepatic metastases (P＞0.05).ConclusionsCEUS can improve detection of hepatic metastases.

Objective To study the enhanced patterns of papillary thyroid carcinoma (PTC)on contrast-enhanced ultrasound(CEUS),and explore the relationship between the degree of enhancement and extracapsular invasionand cervical lymph node metastasis of the tumor.Methods Seventy-three PTCs in 61 patients selected for thyroid surgery underwent conventional ultrasound andcontrast-enhanced ultrasound. The enhanced patterns were analyzed.The differences between different degree enhancement and extracapsular invasion and cervical lymph node metastasis of PTCs were compared.Results Seventy-three PTCs enhanced patterns showed that 52(71 .2%)nodules with hypoenhancement,13(1 7.8%)nodules with isoenhancement,8 (1 1 .0%)nodules with hyperenhancement.Twenty-three (44.2%,23/52 )nodules with extracapsular invasion in hypoenhancing patterns,and 1 5 (71 .4%,1 5/21 ) nodules with extracapsular invasion in isoenhancing or hyperenhancing patterns.There were significant differences between them(P <0.05).Twenty-five (48.1 %,25/52 ) nodules with cervical lymph node metastasis in hypoenhancing patterns,and 13 (61 .9%,13/21 ) nodules with cervical lymph node metastasis in isoenhancing or hyperenhancing patterns,there was no significant difference between them(P >0.05 ).Conclusions The degree of enhancement are correlate to invasiveness in PTCs,PTCs with isoenhancement or hyperenhancement patterns were more often with extracapsular invasion.

Objective To study the efficacy of intra-tumoral injection of different concentrations of ethanol for nude mice with implanted pancreatic cancer and provide evidence for choosing appropriate concentration of ethanol for clinical treatment of pancreatic cancer.Methods A subcutaneous xenograft mouse model of human pancreatic cancer SW1990 was established.Forty-eight nude mice with similar tumor size were randomly divided into 20％,40％,60％,80％,95％ ethanol injection groups and saline injection group.The longest (a) and the shortest diameters (b) of tumor of nude mice were measured.Tumor volume (TV),relative tumor volume (RTV) and the relative rate of tumor proliferation (T/C％) were calculated.Eight days later the nude mice were sacrificed.The tumor tissue was harvested for pathologic examinations.Results RTV in 20％ ethanol injection group was similar that of saline injection group (P =0.212).RTV in 40％,60％,80％ and 95％ ethanol injection groups were significantly lower than that in saline injection group (P ＜ 0.01).RTV was less than 1 and T/C％ was less than 30％ in 60％,80％ and 95％ ethanol injection groups.The values of RTV and T/C％ decreased with the increase of ethanol concentration.RTV in 80％ and 95％ ethanol injection groups were significantly lower than that of 60％ ethanol injection group (P =0.003 and P =0.009).RTV was similar in 80％ and 95％ ethanol injection groups (P =0.819).The pathologic examinations showed no tumor necrosis in saline injection group,while small amounts of necrosis in implanted pancreatic cancer was observed in 20％ and 40％ ethanol injection groups,while a large area of coagulation necrosis could be found in 60％,80％ and 95％ ethanol injection groups.Conclusions Intra-tumoral injection of 80％ ethanol is feasible therapy method for nude mice with human pancreatic cancer xenografts.

Objective To explore the feasibility for the tissue dispersion quantitative analysis software of ultrasonic strain elastography in diagnosing benign or malignant of thyroid lesions.Methods Eighty-two patients with 98 lesions were examined by ultrasonic strain elastography.There were 11 parameters of elastography imaging obtained by the tissue dispersion quantitative analysis software,including average relative strain value(MEAN),standard deviation of relative strain value(SD),area ratio of low-strain region (AREA％),complexity(COMP),kurtosis(KURT),skewness (SKEW),contrast (CONT),entropy(ENT),inverse different moment (IDM),angular second moment (ASM),correlation (CORR).The receiver operating characteristic (ROC) curve was constructed if there were statistically significant differences between benign and malignant lesions,and the areas under the ROC curve were got.Results All parameters except CORR had statistically significant between the groups of benign and malignant thyroid lesions (P ＜0.05).The AREA％ and IDM were the best valuable parameters,the areas under the curve(AUC) of which were 0.965 and 0.908,respectively.Their cut-off point were 81.96％ and 0.42,the sensitivity and specificitywere 98.4％ and 89.2％,91.8％ and 86.5％,respectively.Conclusions The tissue dispersion quantitative analysis software is helpful in the evaluation of benign ormalignant of thyroid lesions,parameters of AREA％ and IDM has the highest relationship with pathology and good diagnostic value.

Objective To investigate the change in distribution and antimicrobial resistance of Acinetobacter baumannii (AB) in an intensive care unit(ICU),and provide basis for rational use of antimicrobial agents in the clinical practice.Methods Using retrospective investigation study,data about pathogenic bacteria isolated from patients who were hospitalized in ICU in 2010-2014 were collected,distribution and antimicrobial resistance of AB were statistically analyzed.Results A total of 3 807 bacterial strains were isolated from ICU patients in 2010-2014,488 (12.82％) of which were AB,isolation rate increased from 6.94％ in 2010 to 17.33％ in 2014 (x2 =45.58,P＜0.01).AB was mainly isolated from sputum,accounting for 72.13％,followed by wound secretion,blood,catheter,urine and so on;AB had the lowest resistance rate to amikacin(＜30 ％),resistance rates to imipenem and meropenem increased significantly year by year (value of trend x2 test were 42.99 and 53.91 respectively,both P＜0.001);resistance rates of AB to other antimicrobial agents were all＞50％.Conclusion Detection rate and antimicrobial resistance rate of AB increased year by year,clinical surveillance on bacterial resistance should be paid more attention,patients should be isolated by effective measures,so as to control and prevent the prevalence of AB in ICU.