Objective To analyze and compare the short-term efficacy and daverse reaction of postoperative adjuvant radio -chemotherapy versus simple chemotherapy in advanced gastric cancer .Methods A total of 64 patients with locally advanced gastric cancer were randomly but equally divided into 2 groups ,experimental group and control group .The experimental group patients ini-tially receive 4-cycles chemotherapy with Capecitabine Tablets 1 000 mg /m2 ,bid ,d1 - 14 plus Oxaliplatin 130 mg/m2 ,d1 ,and then receive Capecitabine Tablets 825 mg /m2 ,bid ,d1 - 35 plus 3DCRT 45 Gy/25 Fx /5 w concurrent radio-chemotherapy .Control group patients receive 6-cycles Capecitabine plus oxaliplatin combined chemotherapy .Then we observed the disease progression time ,toxic reaction ,1 year survival rate and 2 year survival rate simultaneously in two groups .Results The follow-up rate were 100% .The comparative results are listed as follows (experimental group and control group) :the rates of Ⅰ /Ⅱ grades of nausea and vomiting were 87 .50% and 62 .50% respectively (P< 0 .05) ,other adverse reactions were not statistically significant ;1-year overall survival rate and recurrence-free survival rate were 90 .63% ,87 .50% respectively (P > 0 .05) and 84 .38% ,62 .50% respectively (P <0 .05) ;2-year overall survival rate and recurrence-free survival rate were respectively 84 .38% ,59 .38% (P< 0 .05) and 75 .00% , 50 .00% respectively (P< 0 .05) .Conclusion The advantages of 3DCRT combined with Capecitabine Tablets chemoradiotherapy can raise the successful rate of local control in patients with advanced gastric cancer after operation and 4 cycles chemotherapy .The toxic reactions are tolerable for patients .

0. 05), and there seemed to have some statistical correlation between the incidence of Eales disease and PPD (P

Objective To analyze the clinical and histopathologic characteristics in children with subcutaneous panniculitis-like T-cell lymphoma(SPTCL),and explore the pathological diagnosis and differential diagnosis,in order to boost paediatricians to better understanding the disease.Methods One case was diagnosed SPTCL with over 2 years protracted course of fever and multiple skin lesions.The evolvement of clinical presentation,the misdiagnosed experience,the histopathological features,the immunohistochemical results and T cell receptor(TCR)gene cloning rearrangement were observed.The related literatures published were reviewed.Results Skin biopsy showed that the histopathologic findings were limited within subcutaneous fatty tissue,the atypical lymphocytes characteristically rimmed individual fat cells in a lace-like pattern.Immunophenotypic studies showed CD45,CD45RO,CD3,CD5,T cell intracellular antigen-1(TIA-1)and perforin usually expressed possitive,while CD10,CD20,CD56,CD68,epithelial membrane antigen(EMA)and cytokeratin(CK)were negative,implying tumor cells derived from T-cell.The results of TCR gene rearrangement as following:IgH FR2(+),FR3A(-);TCR ? JVI(-),JVII(+);TCR? JD1(-),JD2(-).Although the protocol of children's T-cell Non-Hodgkin lymphoma was administrated,the treatment outcome was poor.Conclusion SPTCL is a special primary cutaneous lymphoma with poor prognosis,skin biopsy of suffered lesion is an important method for the diagnosis of SPTCL children with unclear recurrent fever and multiple skin lesions.

Objective To evaluate a new system,Vitek 2 Compact,for identification of bacteria and yeasts.Methods 185 clinical isolates of Peking Union Medical College Hospital,including 69 gram- positive strains,66 gram-negative strains and 50 yeasts,and 50 reference strains in our laboratory,including 25 gram-positive and gram-negative strains respectively,were studied.All the strains were identified by Vitek 2 Compact with GP,GN or YST identification cards.The API method was used as the reference method.Results Among the 93 gram-positive strains,85 strains(91.40%)were correctly identified, including 5 low discrimination identified strains,and 8 strains(8.60%)were correctly identified to the genus level,but misidentified to the species level.About 90% of gram-positive strains were identified within 7 h.Out of 91 gram-negative strains,90 strains(98.90%)were correctly identified,with 5 low discrimination identified strains,only 1 strain(1.1%)was correctly identified to the genus level,but misidentified to the species level.Above 90% of Enterobacteriaceae were identified within 5 h,and over 90% of nonfermenting bacteria were identified within 10 h.In the 50 strains of yeasts,46 strains(92%) were correctly identified,including 8 low discrimination identified strains,and 4 strains(8%)were correctly identified to the genus level,but misidentified to the species level.In all the yeasts,45 strains (90%)were identified in 18.25 h,and another 5 strains(10%)were identified in 18.50 h.Conclusions As Vitek 2 Compact system can give us reliable identification results of clinically relevant bacteria and yeasts,together with its significant reduction of handling time,it will definitely become a powerful tool in clinical microbiology laboratory.

Objective To evaluate a new system,Vitek 2 Compact,for antimicrobial susceptibility testing(AST)of gram-negative and gram-positive bacteria.Methods Eighty-nine clinical isolates of Peking Union Medical College Hospital,including 48 gram-negative strains and 41 gram-positive strains,and 66 reference strains kept in our laboratory,including 41 gram-negative strains and 25 gram-positive strains, were studied.The antimicrobial susceptibility of these strains were tested by Vitek 2 Compact with AST- GN09(for gram-negative bacteria),AST-P536(for Staphylococci),AST-P534(for Enterococci and S.agalactiae),and AST-P533(for S.pneumoniae)susceptibility cards.The Etest was used as the reference method for comparision.Thirty-two ESBL-producing strains assessed with the confirmatory tests for ESBLs of CLSI(16 strains of them had been confirmed by PCR amplified and sequencing)were detected for ESBLs by Vitek 2 Compact.Results According to the breakpoints of Clinical and Laboratory Standards Institute (CLSI),for the 1 626 microorganism-antibiotic combinations,Vitek 2 Compact gave 90.83% strains with category agreement(CA),4.91% strains with very major errors(VME),2.09% strains with major errors (ME),6.40% minor errors(MIE).The AST for more than 90% of Enterobacteriaceae,nonfermenting bacteria,micrococci and streptococci were completed within 11h,13h,11h and 12h,respectively.The ESBLs tests for thirty-two strains by V-itek 2 Compact are all positive.Conclusions Vitek 2 Compact system can give rapid,reliable and reproducible result with high sensitivity and specificity in assessment of antimicrobial susceptibility testing for clinically relevant gram-negative and gram-positive bacteria,and would become a powerful tool in clinical microbiology laboratory.

Objective:To discuss the etiology, clinical manifestations and renal pathological features of acute interstitial nephritis (AIN) in children.Methods:The etiology, clinical manifestations, pathological characteristics, clinical effects and outcome of the children with AIN diagnosed by renal biopsy from January 2010 to December 2019 in Nanjing Jinling Hospital were analyzed retrospectively. The Kaplan-Meier method was used to evaluate the kidney survival rate. Cox regression model was built to analyze the risk factors for developing end-stage renal disease (ESRD) at baseline in AIN children.Results:A total of 51 children with AIN were diagnosed by renal biopsy, including 36 males and 15 females. The age was (12.94±2.55) years old (2-17 years old). The clinical manifestations of AIN in children were various and lack of specificity. Only 2 cases (3.92%) had triad. All of the 51 children with AIN showed acute renal injury (AKI), accompanied by increased serum creatinine and decreased estimated glomerular filtration rate. The stage of AKI was mainly stageⅢ(33 cases, 64.71%). Infection was the main cause (38 cases, 74.51%) and drug factor was the second cause (27 cases, 52.94%) in children with AIN. Nonsteroidal antiinflammatory drugs (NSAIDs) were the main inducers of drug-induced AIN (18 cases, 35.29%). The interstitial inflammatory cell infiltration or interstitial edema was found in 51 children. The infiltration of inflammatory cells was mainly mononuclear cells (46 cases, 90.20%). After 4 weeks of treatment, 32 cases (62.75%), 11 cases (21.57%) and 8 cases (15.69%) showed complete, partial and no recovery of renal function, respectively. After 12 weeks of treatment, 49 cases (96.08%), 0 cases (0) and 2 cases (3.92%) showed complete, partial and no recovery of renal function, respectively. After an average follow-up of 4.0(2.0-15.0) months, 2 case (3.92%) patients developed ESRD. The cumulative survival rates of ESRD at 1 year and 2 years after renal biopsy both were 100%, and renal survival rates at 5 years and 10 years were 96.55% and 72.41%, respectively. Multivariate Cox regression analysis results showed that N-acetyl-β-D-glucosidase (NAG) enzyme level>17.6 U/g·cr ( HR=15.729, 95% CI 1.045-15.977, P=0.042) and IgM deposition in renal tissue ( HR=7.523, 95% CI 1.142-9.541, P=0.033) were independent risk factors for developing ESRD in AIN children. Conclusions:AKI is the main clinical manifestation of AIN in children. The characteritic of renal pathology in AIN is tubulointerstitial lesions. After active treatment, most of the patients have a good prognosis. Prevention of infection and rational use of drugs are the key to reduce the incidence rate of AIN in children. The N-acetyl-β-D-glucosidase enzyme level>17.6 U/g·cr and IgM deposition in renal tissue are independent risk factors for developing ESRD in AIN children.

Objective To analyse the clinicopathological features of primary small intestine lymphoma(PSIL), and explore the relationship between clinical stage,histological findings,therapeutic modality and prognosis. Methods The clinical data of 34 cases of PSIL were collected,the pathohistological features and results of immunohistochemical examinations were obtained,and the follow-up findings were adopted for comprehensive analysis. Results Among these 34 cases of PSIL,abdominal pain or discomfort,gastrointestinal bleeding and abdominal mass were the predominant symptoms.PSIL mainly involved ileum,especially the bottom of ileum and ileocecal area.Among the 26 patients with follow-up for more than one year,the 1-year survival rate was significantly higher in patients without tumor perforation than those with tumor perforation(76.2% vs 20.0%)(P

Objective To establish a stable primary culture of rat cerebellar granule neurons in vitro for further study the toxic effects of chronic arsenic exposure on cerebellar cells.Methods Cerebellar cortices were taken from brain of Wistar rat 5-7 day old after born under stereoscopic microscope.Single cell suspension was acquired after digestion and washing with trypsin (0.25％) and DNase Ⅰ solution,respectively.Granule cells were purified from other cells by differential velocity adherence method for two times.Rat cerebellar granule neurons were seeded in culture plate pre-coated with poly-L-lysine.Neurons growth,development and synaptic connections were observed daily.The neurons were identified by neuron specific enolase (NSE) immunofluorescence technique.Results The neurons were affixed to the culture plate in 24 hours,in reticular arrangement observed under contrast microscope.Granule cells gradually turned round from oval and outlines became clearer in 2-3 days.In 4-6 days,there were a wide range of synaptic connections among the neurons and a mature nerve cell network formed.A large quantity of cerebellar granule neurons was seen by NSE identification.Few bigger cells such as purkinjes cells and glial cell outlines were also seen in the same visual field.Conclusions This is a successful primary culture method for acquirement of rat cerebellar granule neurons.The method can provide experimental basis for future studies the toxic effects of chronic arsenic exposure on cerebellar cells.

Radical retropubic prostatectomy (RRP) has been one of the most effective treatments for prostate cancer.This study is designed to identify the related predictive risk factors for complications in patients following RRP.Between 2000 and 2012 in Department of Urology,Fudan University Shanghai Cancer Center,421 cases undergoing RRP for localized prostate cancer by one surgeon were included in this retrospective analysis.We reviewed various risk factors that were correlated with perioperative complications,including patient characteristics [age,body mass index (BMI),co-morbidities],clinical findings (preoperative PSA level,Gleason score,clinical stage,pathological grade),and surgeon's own clinical practice.Charlson comorbidity index (CCI) was used to explain comorbidities.The total rate of perioperative complications was 23.2％ (98/421).There were 45/421 (10.7％),28/421 (6.6％),24/421 (5.7％) and 1/421 (0.2％) in grade Ⅰ,Ⅱ,Ⅲ,Ⅳ respectively,and 323/421 (76.8％) cases had none of these complications.Statistical analysis of multiple potential risk factors revealed that BMI ＞30 (P=0.014),Charlson score ≥1 (P＜0.001) and surgical experience (P=0.0252) were predictors of perioperative complications.Age,PSA level,Gleason score,TNM stage,operation time,blood loss,and blood transfusion were not correlated with perioperative complications (P＞0.05).It was concluded that patients' own factors and surgeons' technical factors are related with an increased risk of development of perioperative complications following radical prostatectomy.Knowing these predictors can both favor risk stratification of patients undergoing RRP and help surgeons make treatment decisions.

The clinical characteristics of patients who presented in poor clinical grade due to ruptured middle cerebral artery aneurysms (MCAAs) associated with large sylvian hematomas (SylH) were analyzed and an ingenious designed prophylactic hinged craniectomy was introduced. Twenty-eight patients were graded into Hunt-Hess grades IV-V and emergency standard micro-neurosurgeries (aneurysm clipping, hematoma evacuation and prophylactic hinged craniectomy) were performed, and their clinical data were retrospectively analyzed. 46.43% of the patients reached encouraged favorable outcomes on discharge. The favorable outcome group and the poor outcome group significantly differed in terms of patients' anisocoria, Hunt-Hess grade before surgery, extent of the midline shift and time to the surgery after bleeding (P<0.05). There were no significant differences in age, sex, volume and location of the hematoma, size of aneurysm between the favorable and poor groups (P>0.05). However, ingenious designed prophylactic hinged craniectomy efficiently reduced the patients' intracranial pressure (ICP) after surgery. It was suggested that preoperative conditions such as Hunt-Hess grading, extent of the midline shift and the occurrence of cerebral hernia affect the prognosis of patients, but time to the surgery after bleeding and prophylactic hinged craniectomy are of significant importance for optimizing the prognosis of MCAA patients presenting with large SylH.