OBJECTIVE:To investigate the effect of thymosin α1 combined with chemotherapy on immune function in patients with advanced gastric cancer and quality of life. METHODS:90 patients with advanced gastric cancer were randomly divided into observation group and control group with 45 cases in each group. Control group was treated with FOLFOX4 chemotherapy plan(so-dium oxaliplatin+calcium folinate+fluorouracil),and observation group was additionally treated with thymosin α1 1.5 mg subcutane-ously,once a day,on the basis of control group. A treatment course lasted for 3 weeks,and both received 3 courses of treatment. The immune function and quality of life were evaluated in 2 groups. RESULTS:The effective rate of observation group was 57.8%,and that of control group was 53.3%;there was no significant difference between 2 groups (P>0.05). The incidence of leukopenia in observation group was 24.4%,which was significantly lower than control group (55.6%),with statistical signifi-cance(P<0.05). There was no statistical significance in CD4+,CD8+ and NK score between 2 groups before chemotherapy(P>0.05). After treatment,above index of observation were all higher than those of control group,with statistical significance (P<0.05). The total health QLQ-C30 EORTC score in observation group was higher than in control group after chemotherapy,with sta-tistical significance(P<0.05). CONCLUSIONS:Thymosin α1 combined with chemotherapy can significantly improve the immune function and quality of life.

Objective To observe the effect of external fixator combined with limited internal fixation in the treatment of complex ankle fractures.Methods According to the digital table,65 patients with complex ankle fracture were randomly divided into treatment group(33 cases) and control group(32 cases).The treatment group was treated with external fixator combined with limited internal fixation,the control group was treated with internal fixation.All patients were followed up for 5 to 20 months.The curative effect and incidence rate of complication of the two groups were observed.Results The excellent rate of the treatment group was 84.85%,which was higher than 62.50% of the control group,the difference was statistically significant(x2=4.20,P<0.05).The incidence rate of complications in the treatment group was 3.03%,which was lower than 18.75% of the control group,the difference was statistically significant(x2=4.18,P<0.05).Conclusion External fixator combined with limited internal fixation can effectively treat complex ankle fractures,the method can not only make patients satisfied with the reduction effect,but also the internal fixation complications such as infection are minimized,the clinical value is extremely high,it is worthy of wide application.

Objective To compare the efficacy of holmium laser and traditional surgery for the treatment of varicosis of the lower limbs.Methods From March 2005 to December 2006,226 patients with varicosis of the lower limbs(274 limbs)were treated using holmium laser(laser group,120 patients with 148 diseased limbs)or high ligation and stripping of the great saphenous vein(traditional group,106 patients with 126 diseased limbs).Results The mean operation time of the laser group was significantly shorter than that in the traditional group [(38.0?10.8)min vs(61.5?12.3)min,t=-15.294,P=0.000].None of the patients in the laser group need analgetics after the operation,while 58 patients in the traditional group received the drug after the surgery(0 vs 54.7%,?2=88.329,P=0.000).The patients in the laser group returned to activities earlier and had shorter postoperative hospital stay than those in the traditional group [(6.2?0.8)h and(3.0?0.5)d vs(22.5?1.5)h and(8.5?2.5)d;t=-105.034,P=0.000 and t=-23.632,P=0.000,respectively].The rates of complications and 1-year recurrence were similar in the two groups [16.9%(25/148)vs 18.3%(23/126),?2=0.087,P=0.768 and 3.8%(3/78)vs 3.1%(2/65),?2=0.000,P=1.000].Conclusions Holmium laser has advantages of shorter operation time and hospital stay,fewer surgical incisions,milder postoperative pain,and earlier return to activities.Closure of the great saphenous vein is the key to ensure the effect of laser therapy.High ligation of the great saphenous vein should be done simultaneously if necessary.

To elucidate the latest progress of proteomics research of central nervous system diseases and drugs. Proteomics , an important discipline in postgenomic era, is the integrated study of protein properties on a large scale. Currently, the best established application of proteomics are in the clinical and biomedical fields. Proteomics will facilitate the elucidation of network mechanism of the development, progress and prognosis of central nervous system diseases. Proteomics offer a unique opportunity to identify disease specific proteins, accelerate the development of target driven drugs, build up molecular pharmacological models, screen and analysis of the efficacy, toxicity and side effects of potential drugs on a large scale. It is predictable that proteomics will play a tremendous role for the diagnosis, detection and pharmaceutical development of central nervous system diseases.

Objective To investigate the clinical value of color Doppler ultrasound (CDFI) in the diagnosis of carotid atherosclerosis lesion in patients with acute stroke.Methods Totally 60patients with acute cerebral infarction were examined with CDFI to observe vessel diameter and stenosis degree of common carotid artery,internal carotid artery and external carotid artery and the results were compared with digital subtraction angiography (DSA) test.Results Among 60patients,normal ultrasound diagnosis was in 28 cases,occlusion and stenosis in 32 cases,stenosis in 25 cases; mild,moderate and severe stenosis were in 18,20,12 vessels,occlusion in 7 cases,14vessels.DSA examination results showed normal in 29 cases,stenosis and occlusion in 31 cases,stenosis in 26 cases,mild,moderate and severe stenosis of the 18,16,18 vessels; occlusion in 5 cases,10 vessels.The consistency test results between carotid artery color Doppler ultrasound and DSA were Kappa=0.786,0.667(P＜0.05).All carotid DSA results were considered as gold standard,CDFI diagnosis of moderate to severe stenosis was in high accuracy compared with DSA.Conclusions CDFI in the diagnosis of different degrees of carotid stenosis is in good agreement with DSA diagnosis,and may replace invasive DSA diagnosis of moderate to severe stenosis.

In the process of cultivating TCM clinical postgraduates of TCM clinical college in Shanxi university of Chinese medicine,we emphasized the importance of clinical application ability and innovation ability in scientific research,stressed the clinical practice and check management,to formulate the objective,effective and quantified assessment index system in keeping with the real institution of our college,so as to improve the all-round quality of TCM clinical postgraduates.

AIM To study the effects of propofol on membrane fluidity and intracellular free Ca 2+ concentration ([Ca 2+ ] i ) in PC12 cells and discuss its relevant mechanism. METHODS PC12 cell lines were divided into seven groups: control, solvent and propofols(1,3,10,30,100 mg?L -1 ). Fluorescence depolarization method was used to measure dynamically microviscosity in PC12 cells and [Ca 2+ ] i was detected using calcium fluorescentprobe Fluo 3/AM and a laser scanning confocal microscope. RESULTS ①Acute administration of various doses of propofol induced a significant decrease of microviscosity in PC12 cells dose dependenty. ② Solvent, propofol at dose of 10 mg?L -1 had no effect on [Ca 2+ ] i in PC12 cells, however, after 30 and 100 mg?L -1 administration, [Ca 2+ ] i increased markedly at 20～30 seconds (increase percentage were 119% and 140% respectively) and then recovered to their pre administration levels within 50 seconds. CONCLUSION The propofol can significantly increase membrane fluidity in PC12 cells in a dose dependent manner and elevate [Ca 2+ ] i in PC12 cells at doses of 30 and 100 mg?L -1 . These changes are consistent with each other and related closely with anesthetic effect of propofol.

BACKGROUND:Mimics software is a three-dimensional (3D) image processing and editing tool based on CT scan data. Mimics software can rebuild the data and images gotten in CT, MRI and ultrasound scans into 3D images and display on the computer screen so as to help clinicians understand the type of fracture and the relationship of the 3D structure of the surrounding tissue and to provide a great help in the development of orthopedics operation. OBJECTIVE:To explore the application effect of Mimics software 3D reconstruction on perioperative period of Pilon fracture. METHODS:This study selected 61 cases of Pilon fracture, who received the surgery in the Zhongshan City Xiaolan People’s Hospital from September 2008 to September 2013, as research objects. They were randomly divided into 3D group and control group in accordance with the time of admission. Al patients underwent anterioposterior and lateral X-ray film examination and multi-slice spiral CT scan. Patients in the control group received internal fixation according to above examination results. Patients of the 3D group, on the base of those of the control group, were subjected to internal fixation after three-dimensional entity reconstruction by using Mimics V 10.0 software. Operation time and functional curative effect in the postoperative folow-up were compared between the two groups. RESULTS AND CONCLUSION:The operation time was significantly less in the 3D group than in the control group (P < 0.05). The number of patients with excelent 6-month functional curative effect was more, and the number of patients with poor effect was less in the 3D group than in the control group. The 6-month functional curative effect was better in the 3D group than in the control group (P < 0.05). These results showed that the application of Mimics software 3D reconstruction to the perioperative period of Pilon fractures can give comprehensive assessment of the situation of fracture, optimize and improve the preoperative plan and reduce the risk of surgery, and promote the successful completion of internal fixation.

Objective To investigate the antimicrobial resistance of clinical isolates in Tongling People′s Hospital during 2013. Methods A total of 2 281 nonduplicate clinical isolates were collected.Kirby-Bauer disc diffusion method was employed to study the antimicrobial susceptibility.The data were analyzed with WHONET 5.6 software according to CLSI 2012 breakpoints. Results The top 5 most frequently isolated microorganisms were E.coli (479,21.0%),K.pneumoniae (360,15.8%),A. baumannii (271,11.9%),P .aeruginosa (240,10.5%),S.aureus (171,7.5%).Gram negative and gram positive microorganisms accounted for 76.5% and 23.5%,respectively.The prevalence of methicillin-resistant strains in S.aureus (MRSA)and coagulase negative Staphylococcus (MRCNS)was 38.6% and 73.1%,respectively.The resistance rates of MR strains to beta-lactams and other antimicrobial agents were much higher than those of MS strains.No staphylococcal strain was found resistant to vancomycin or teicoplanin.E.faecalis showed relatively lower resistance to penicillin,ampicillin and nitrofurantoin.E.faecium strains were more resistant than E.faecalis to most of the antibiotics tested.Approximately 50.5% of E.coli and 44.5% of Klebsiella isolates produced extended-spectrum beta-lactamases (ESBLs).The ESBLs-respectively.And 29.8% and 23.4% of the P .aeruginosa strains were resistant to imipenem and meropenem.Nearly all (94.0%)P .aeruginosa isolates were susceptible to amikacin.Conclusions There appears a trend of increasing resistance in the clinical bacterial isolates in this hospital,especially the carbapenem-resistant Enterobacteriaceae,which is of great concern.It is mandatory to take effective antibiotic policy and infection control measures.

Objective To investigate the protective effect and its potential molecular mechanism of Nec-1 on cytotoxicity induced by cyclosporine A.Methods MRTEpiC, glomerular endothelial cell MGEC and mesangial cell line MMC were co-administered with Nec-1 and cyclosporin A in mouse renal tubular epithelial cell line, and then MTT assay and soft agar clone formation assay were used to detect Cell growth curve changes, clonal formation ability.Apoptosis was detected by flow cytometry.The expression of cyclin D1, CDK4, CDK2, Cyclin E and apoptosis-related Caspase 3 were detected by Western blot.Results After cyclosporine A action, the cell growth ability was significantly decreased and the clone formation ability was significantly decreased(P<0.05).Cyclin D1, CDK4, CDK2 and Cyclin E were significantly increased(P<0.05), but the ratio of apoptosis and the expression of Caspase 3 did not change.Nec-1 has obvious protective effect on cytotoxicity induced by cyclosporine A, which can increase the cell growth ability and clone formation ability, and reduce the cell cycle-related proteins Cyclin D1, CDK4, CDK2, Cyclin E.Conclusion Nec-1 has cytotoxic effect on the glomeruli and renal tubular cells by up-regulating the cell cycle-related proteins Cyclin D1, CDK4, CDK2 and Cyclin E, while Nec-1 has protective effect.