Objective To investigate the effect of methylation inhibitor decitabine (DAC) alone and combination with As2O3 on apoptosis of NB4 cells. Methods NB4 cells were treated with DAC, As2O3 and the combination of them in different concentrations. The cell proliferation was analyzed by MTT assay and the apoptosis of NB4 cells was detected by flow cytometry. Results Both DAC and As2O3 induced time and concentration-dependent cell death, in which the inhabitation rate were 12.18 %, 22.72 %, 35.54 %, respectively, after 24 h, 48 h, 72 h on treatment by DAC at 1 μmol/L and the inhibition rates were increased to 22.14 %, 31.18 %, 45.21 % by DAC at 1 μmol/L. The inhibition rates were 21.09 %, 32.43 %, 44.93 %, respectively, by treating with As2O3 0.5 μmol/L after 24 h, 48 h, 72 h, which were increased to 31.69 %, 41.12 % and 54.27 %, respectively after 24 h, 48 h, 72 h. The inhibition rates were significantly increased by using both DAC and As2O3 with significant differences (P <0.05). DAC and As2O3 in combination produced a greater inhibition of growth against NB4 cells (by treating with DAC 1 μmol/L + As2O3 0.5 μmol/L after 24 h, 48 h, 72 h, the inhibition rates were 42.10 %, 48.75 %, 60.78 %) (P <0.05). In each concentration group and control group the differences were statistically significant (P <0.05). The incubation for 48 h with As2O3 1 μmol/L alone or combined with DAC 2 μmol/L showed apoptosis cells by 5.8 % and 17.3 %. Conclusion Decitabine can significantly inhibit the proliferation of NB4 cells and the apoptosis with synergistic effectiveness can be found when Decitabine combination with As2O3.

OBJECTIVE:To effectively prevent and treat antibiotic-associated diarrhea (AAD). METHODS: Take some clinical cases to analyse and summarize the result about multiple micro-ecological preparations such as probiotic yoghurt,lively bacterium preparation and prebiotics being used to prevent and treat AAD. RESULTS: It was showed by cases that probiotic yoghurt and lively bacterium preparations could effectively prevent AAD in patients with AAD risk factors,and the application of micro-ecological preparations exhibited a remarkable efficacy for the patients with AAD. CONCLUSION: Rational application of micro-ecological preparations is conducive to the prevention and treatment of AAD.

Objective To perform a nationwide external quality assessment for detection of Chlamydia trachomatis, and to improve the performance of laboratories in the detection of Chlamydia trachomatis. Methods Totally, 419 quality control samples were sent to tested laboratories, including 76 samples in 2007, 168 samples in 2008 and 175 samples in 2009. The laboratories were required to test the samples and report test results, within stipulated time, to the reference laboratory in National Center for Sexually Transmitted Disease (STD) Control, Chinese Center for Disease Control and Prevention. The reported results were statistically analyzed by the National Center for STD Control, who finally fed back the statistical results to all of the participants. Results The percentage increased from 84.93% in 2007 to 92.14% in 2009 for laboratories showing an 80% or more consistency with the reference laboratory in the detection of Chlamydia trachomatis from quality control samples (qualified), from 47.95% in 2007 to 70% in 2009 for those showing a 100% consistency (excellent), and dereased from 5.48% in 2007 to 0.71% in 2009 for those showing a consistency of lower than 60% (unqualified). The centralabs of provincial CDC and volunteer laboratories exhibited a satisfactory performance for the detection of Chlamydia trachomatis, while the performance of a small number of national STD surveillance sites needed to be increase. Conclusion The external quality assessment reveals a continuous improvement in the capability of detecting Chlamydia trachomatis in STD laboratories at different levels in China.

Objective:To analyze the correlation of glycosylated hemoglobin (HbA 1c) level in the late pregnancy gestational diabetes mellitus (GDM) patients and fetal weights, neonatal Apgar scores, maternal and infant adverse outcomes. Methods:One hundred and eighty-seven pregnant women who were diagnosed with GDM from January 2015 to July 2019 and delivered in Yixing People′s Hospital after standard diagnosis and treatment were divided into four groups (A group: HbA 1c<6.0%, 65 cases; B group: HbA 1c: 6.0% - 6.5%, 49 cases; C group: HbA 1c 6.6%-7.0%, 39 cases; D group: HbA 1c>7.0%, 34 cases) according to the HbA 1c examination results at 28 to 32 weeks of gestation. General data, fetal weights, neonatal Apgar scores and maternal and infant adverse outcomes were compared among the four groups. The correlation between GDM HbA 1c and fetal weights, neonatal Apgar scores and maternal and infant adverse outcomes were analyzed by unconditional Logistic regression. Results:In general data of GDM pregnant women with different HbA 1c levels, only oral glucose tolerance test (OGTT) fasting blood glucose: (4.68 ± 0.60), (4.89 ± 0.69), (5.23 ± 0.90), (6.48 ± 2.17) mmol/L; postprandial 1 h blood glucose: (9.84 ± 1.56), (10.09 ± 1.84), (10.6 ± 2.01), (12.74 ± 4.12) mmol/L; postprandial 2 h blood glucose: (8.65 ± 1.49), (8.86 ± 1.76), (9.28 ± 2.15), (11.56 ± 4.93) mmol/L, showed statistically significant differences ( P<0.05). Among the newborns of GDM pregnant women with different HbA 1c levels, there were statistically significant differences in the macrosomic infant rates: 1.54%(1/65), 10.20%(5/49), 12.82%(5/39), 17.65%(6/34); rates of neonatal Apgar scores<7 points:13.85%(9/65), 16.33%(8/49), 25.64%(10/39), 44.12%(15/34); the proportion of maternal and infant adverse outcomes: 24.62%(16/65), 24.49%(12/49), 28.21%(11/39), 50.00%(17/34), showed statistically significant differences ( P<0.05). After adjusting OGTT by unconditional Logistic regression analysis, HbA 1c (6.6%-7.0% and>7.0%) was independent risk factor for macrosomic infants: OR = 1.430, 95% CI = 1.035-1.977, P = 0.030; OR = 2.042, 95% CI = 1.311-3.180, P = 0.001; maternal and infant adverse outcomes: OR = 1.774, 95% CI = 1.130-2.874, P = 0.010; OR = 3.387, 95% CI = 1.608-7.133, P = 0.001. HbA 1c>7.0% was independent risk factors for neonatal Apgar scores<7 points: OR = 1.848 95% CI = 1.086-3.143, P = 0.023. Conclusions:There was a significant correlation between HbA 1c in GDM pregnant women in the late pregnancy and macrosomic infants, neonatal Apgar scores, and maternal and infant adverse outcomes. In particular, GDM pregnant women with HbA 1c>7.0% should be alert to the risk of macrosomic infants, neonatal Apgar score<7 points, and maternal and infant adverse outcomes.

OBJECTIVETo investigate the feasibility of no nasogastric intubation and early oral feeding at will after thoracolaparoscopic esophagectomy for patients with esophageal cancer.

METHODSBetween January 2013 and January 2014, the feasibility of no nasogastric intubation and early oral feeding at postoperative day(POD) 1 after thoracolaparoscopic esophagectomy was prospectively investigated in 156 patients (trial group) with esophageal cancer in the Henan Cancer Hospital. One hundred and sixty patients previously managed in the same unit who were treated routinely after thoracolaparoscopic esophagectomy were served as control group.

RESULTSOf 156 patients of trial group, 6(3.8%) patients could not take food early as planned because of postoperative complications. The overall complication rate in trial group was 19.2%(30/156), which was 25.0%(30/160) in control group (P=0.217). The anastomotic leakage in trial group and control group was 2.6%(4/156) and 4.3%(7/160) respectively (P=0.380). Compared with control group, time to first flatus [(2.1±0.9) d vs. (3.3±1.1) d, P<0.001], bowel movement [(4.4±1.3) d vs. (6.6±1.0) d, P<0.001] and postoperative hospital stay [(8.3±3.2) d vs. (10.4±3.6) d, P<0.001] were significantly shorter in trial group.

CONCLUSIONSNo nasogastric intubation and early oral feeding postoperatively in patients with thoracolaparoscopic esophagectomy is feasible and safe. This management can shorten postoperative hospital stay and fasten postoperative bowel function recovery.

Eating ; Esophageal Neoplasms ; surgery ; Esophagectomy ; Fasting ; Feasibility Studies ; Humans ; Intubation, Gastrointestinal ; Postoperative Complications ; Postoperative Period

Fusion Proteins, bcr-abl ; genetics ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; genetics ; Mutation

OBJECTIVETo retrospectively analyze the clinicopathology of patients with gastric gastrointestinal stromal tumor(gGIST) who underwent radical excision within 18 years in 10 domestic medical centers in order to understand the status of domestic surgical treatment of gGIST.

METHODSClinicopathological data of gGIST patients undergoing radical excision in 10 medical centers from January 1998 to January 2016 were collected, and their operational conditions, postoperative adjuvant therapy, gene detection and survival were analyzed retrospectively.

RESULTSA total of 1 846 cases were recruited in this study, including 246 cases from Guangdong General Hospital, 331 cases from Sun Yat-sen University Cancer Center, 374 cases from Union Hospital, Tongji Medical College of Huazhong University of Science and Technology, 342 cases from Nanfang Hospital of Southern Medical University, 265 cases from Fujian Medical University Union Hospital, 148 cases from Fudan University Shanghai Cancer Center, 49 cases from West China Hospital of Sichuan University, 43 cases from Peking University Cancer Hospital and Institute, 28 cases from the 81st Hospital of Pepole's Liberation Army(PLA), 20 cases from Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute. There were 918 male (49.7%) and 928 female patients (50.3%) with median onset age of 59(18 to 95) years old. Fundus(735 cases, 39.8%) and body (781 cases, 42.3%) of stomach were the common sites of lesions. The average size of tumor was (5.3±4.6) cm. There were 1 421 cases with mitotic count ≤5(77.0%). According to the operation procedure, 924 cases (50.1%) underwent laparoscopic surgery, 759 cases (41.1%) laparotomy, 120 cases (6.5%) endoscopic surgery, and 20 cases (1.1%) laparoscopic combined with endoscopic surgery, 6 cases (0.3%) laparoscopic excision surgery through gastric wall and cavity, and 17 cases (0.9%) laparoscopy and then were transferred to laparotomy. Wedge excision were performed in 1 308 cases (70.9%), proximal gastric excision in 226 cases(12.2%), distal gastric excision in 92 cases (5.0%), total gastrectomy in 94 cases (5.1%), and local gastrectomy in 126 cases(6.8%). Multi-visceral excision was performed in 138 cases, and the splenectomy was performed in 83 cases(60.1%)with the highest ratio. According to modified NIH classification, 399 cases(21.6%) were extreme low risk, 580 cases(31.4%) were low risk, 424 cases(23.0%) were moderate risk, 443 cases (24.0%) were high risk. A total of 461 cases received postoperative imatinib adjuvant therapy, accounting for 53.2%(461/867) of patients with moderate and high risk. Among 1 846 cases, 1 402 cases (75.9%) had complete follow-up data and the median follow-up time was 33.6 (0.1 to 158) months. The 5-year survival rates of extreme low risk, low risk, moderate risk and high risk were 100%, 98.5%, 92.5%, and 79.2% with significant difference(P=0.000).

CONCLUSIONSGastric GIST occurs mostly in fundus and body of stomach in China. Wedge excision is the main operational procedure and laparoscopic operation is over 50%. General prognosis of gastric GIST is quite good.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents ; therapeutic use ; China ; Combined Modality Therapy ; Female ; Gastrectomy ; Gastrointestinal Neoplasms ; Gastrointestinal Stromal Tumors ; pathology ; surgery ; Humans ; Imatinib Mesylate ; therapeutic use ; Laparoscopy ; Laparotomy ; Male ; Middle Aged ; Postoperative Period ; Prognosis ; Retrospective Studies ; Splenectomy ; Stomach Neoplasms ; pathology ; surgery ; Survival Rate ; Young Adult