Objective　To study the clinical features, diagnosis and treatment of multiple primary cancer of digestive tract (MPCDT). Methods　The clinical data of 33 cases of MPCDT were analysed retrospectively. Results　The incidence of MPCDT was 2.7% in all patients with primary cancer of digestive tract. 24 cases was synchronous carcinoma (SC), of whom, 20 was misdignosis. All the cases of SC received comprehensive treatment, including radical resection, traditional medicine and radiotherapy respectively. 9 cases were metachronous carcinoma (MC), of them, only 1 case misdiagnosed. All the MC cases received radical resection, palliative resection and radiotherapy. The 5-year survival rate in cases of MPCDT, SC and MC were 45.4%, 37.5% and 55.5% respectively. Conclusions　The incidence of MPCDT is low, but misdiagnosis rate is hight. For MPCDT, comprehensive treatment, and radical resection and re-operation should be done. It is advisable not to diagnose MC as recurrence or metastasis.

Objective To investigate the safety and feasibility of Minocycline Hydrochloride Ointment and metronidazole membrane in the treatment of periodontal abscess.Methods80 cases of patients with periodontal abscess in our hospital from May 2014 to May 2016 were selected, these patients were randomly divided into Minocycline Hydrochloride Ointment group (n=40) and metronidazole membrane group (n=40) two groups, the periodontal probing depth, gingival bleeding index, plaque index, attachment loss, clinical efficacy, the incidences of adverse reactions and recurrence of the two groups were statistically analyzed.ResultsThe periodontal probing depth, gingival bleeding index, plaque index, attachment loss of the Minocycline Hydrochloride Ointment group were significantly lower (P<0.05), the total treatment efficiency 95% (38/40) was significantly higher than the metronidazole membrane group 77.5% (31/40) (P<0.05), the recurrence rate 2.5% (1/40) was significantly lower than the metronidazole membrane group 15% (6/40) (P<0.05), but the difference of the incidences of adverse reactions 10% (4/40), 7.5% (3/40) between the two groups was not significant.ConclusionMinocycline Hydrochloride Ointment metronidazole membrane in the treatment of periodontal abscess has higher safety and feasibility than metronidazole membrane, so is worthy of promotion in the clinical.

Objective To analyze the anesthetic effect of Compound Articaine on Children's dental pulp without pain, and provide reference for clinical treatment.Methods124 patients with children with dental pulp disease in hospital from February 2015 to May 2016 were selected, patients were randomly divided into observation group and control group, every group with 62 cases.Control group patients were given Lidocaine anesthesia, observation group patients were taken trentment of compound articaine anesthesia, anesthetic effect of patients were compared.Changes in heart rate, blood pressure, adverse effects, and patient pain were recorded before and after anesthesia.ResultsThe total effective rate (96.8%) in the observation group was significantly higher than that in the control group (80.9%) (P<0.05).Observation group (79%) was significantly higher than the control group (1.6%,P<0.05), the observation group of severe pain rate (58.1%) was significantly lower than the control group (11.3%) (P<0.05),The heart rate and blood pressure in the observation group were no significant change, In the control group, the diastolic blood pressure (71.7±10.8) mmHg was significantly lower in the observation group (74.5±12.8) mmHg and the heart rate (80.2±8.8)/min was significantly higher than that in the observation group (76.2±8.3).Two groups of patients in the treatment of adverse reactions, including tachycardia, dizziness, headache, observation group of adverse reaction rate and the control group was not significantly different.ConclusionCompound articaine anesthesia was the implementation of children's dental painless treatment, can reduce the pain of patients, maintain the blood pressure and heart rate stable, has the use value.

Objective To evaluate the validity and reliability of multi-slice spiral CT (MSCT) in preoperative TNM staging judgment of rectal carcinoma. Methods Three hundred and one patients with rectal carcinoma were diagnosed and treated consecutively in Colorectal and Anal Surgery Department of Shanxi Province Tumor Hospital from January 2009 to December 2009. The clinical data of these patients were analyzed retrospectively. The diagnosis results were compared between the preoperative MSCT staging and the postoperative pathological staging,the ROC curve and the diagnostic concordance test were analyzed by software Medcalc 11.2. Results The sensitivity, specificity, Kappa value, area under the curve of TNM staging were 64.7% ,96. 8% ,0. 667,0. 808 for T2 staging tumors; 93.8% ,75.0% ,0.709,0.844 for T3 staging tumors;87. 8% ,98. 1% ,0. 859,0. 929 for T4 staging tumors; 72. 0% ,91.2% ,0. 619,0. 816 for N staging tumors;92. 7%, 99. 7%, 0. 925,0. 963 for M staging tumors respectively. Conclusion The diagnostic value of independent use of MSCT in estimating the infiltration degree and lymph node metastasis of rectal cancer is very poor and cannot be used in preoperative staging judgment.

ObjectiveTo investigate the protective effects of panax quinquefolium 20s-protopanaxtriol saponins (PQTS) on ventricular remodeling in rats with pressure overloaded hypertrophic myocardium.Methods Wister rats were randomly divided into operation,model,positive captopril,and low,moderate,high PQTS groups.The model of pressure overload-induced ventricular remodeling was established through the method of rat's abdominal aorta deligation.After 6 weeks of PQTS treatment ( 12.5,25.0 and 50.0 mg · kg-1 · d-1,i.p),myocardial morphological and hemodynamic parameters were determined.The content of malondialdehyde (MDA) and activity of superoxide dismutase (SOD)in serum,and the concentrations of prostacycline (PGI2),thromboxane A2 (TXA2),endothelium (ET) and angiotensin Ⅱ( Ang Ⅱ ) in plasma were also determined.ResultsCompared with remodeling group,PQTS could inhibit myocardial pathological changes,decrease significantly ventricular weight and cardiac coefficient,increase significantly systolic blood pressure,diastolic blood pressure,mean arterial pressure,left ventricular systolic pressure and the maximum left ventricular pressure rising and dropping rates(dp/dtmax),reduce the heart rate and left ventricular end-diastolic pressure in ventricular remodeling rats.PQTS could also decrease the content of MDA and enhance significantly activity of SOD in serum.In addition,PQTS could decline the contents of ET,Ang Ⅱ and TXA2 in plasma while increase significantly the content of PGI2 in plasma and PGI2/TXA2 ratio(P＜0.05 or P＜0.01).ConclusionsPQTS has protective effects on ventricular remodeling through improving systolic and diastolic function in ventricular remodeling rats,increasing anti-oxidase activity,reducing the damage of free radicals and vasoactive substance onmyocardium,and correcting disequilibrium of PGI2/TXA2 in ventricular remodeling rats.

Objective To investigate the effect of trimetazidine postconditoning on myocardial cell apoptosis in acute ischemia-reperfusion injury in rats.Methods 40 healthy adult Wistar rats were randomly assigned to Sham-operated group,MIRI group(I/R group),trimetazidine group and ischemic postconditioning group(IPOC group).The left anterior descending coronary artery of rat was ligated and the acute myocardial ischemia-reperfusion injury model was established.After that,ultrastructural changes of apoptotic myocardial cells were observed under electron microscope,and apoptotic cells were detected under optical microscope.The expressions of the Bcl-2,caspase-3 apoptosis related proteins were determined.Results ① The degree of ultrastructural injury of apoptotic myocardial cells was mild and basically the same in trimetazidine group versus IPOC group,and had a significant improvement as compared with I/R group.② The degree of myocardial apoptosis was basically the same in trimetazidine versus IPOC group,and lighter than in I/R group.③ Bcl-2 protein expression levels were(61.9 ± 2.9) ％,(21.4 ± 3.2) ％,(46.8 ± 3.5) ％ and (49.7 ± 3.1) ％,and caspase-3 protein expression levels were(38.1±4.5) ％,(72.8±5.7) ％,(47.2±5.1) ％ and(39.8 ±4.6)％ in Sham-operated group,I/R group,trimetazidine group and IPOC group respectively.Compared with I/R group,the expression of Bcl-2 protein was increased obviously,while the expression of easpase-3 protein was decreased in trimetazidine group and IPOC group.But there were no significant differences in the protein levels of Bcl-2 and caspase-3 between trimetazidine group and IPOC group(both P＞0.05).Conclusions Trimetazidine postconditoning can inhibit the myocardial cell apoptosis in acute ischemia-reperfusion injury in rats,and has a protective effect on myocardial cells.

Objective To understand the prevalence of human intestinal parasite infections in Lahu Ethnic residents so as to provide the evidence for effective control. Methods The prevalence of soil-transmitted nematode infections in local people was determined by Kato-Katz technique and individual sanitary behaviors and habits were requested by a standardized questionnaire in 3 villages of Xiaojie Township,Jinghong City,Yunnan Province. The relationship between intestinal parasite infections and behav-ioral characteristics was analyzed. Results Of 289 subjects,255 individuals were infected with soil-transmitted nematodes;the prevalence was 88.24%. Among the infected individuals,210 were found infected with hookworm and the infection rate was 72.66%;154 subjects were infected with Ascaris lumbricoides and the infection rate was 53.29%;13 were infected with Trichuris trichura,and the infection rate was 4.50%;16 were infected with other parasites and the infection rate was 5.54%. The percentag-es of people with light infection of hookworm,A. lumbricoides and T. trichura were 90.48%,97.40%and 100%,respectively. Con-clusions There is high prevalence of soil-transmitted nematode infections in Lahu Ethnic residents in Jinghong City,but the in-fection intensity was generally low. The control and monitoring of soil-transmitted parasite infections should be strengthened in this area.

Objective To study risk factors associated with predisposition to Lm -ABM in adult patients and to evaluate the clinical features,management and out in this cohort of patients because Listeria monocytogenes (Lm) is the third most common cause of acute community acquired bacterial meningitis (Ac-ABM),after Streptococcus pneumoniae and Neisseria meningitides aetiologies.Methods A descriptive,prospective study carried out in a tertiary grade medical center emergency department in Beijing over a 10 -year period.During the study period,15 patients of Lm- ABM were included.Comparison of episodes of Lm - ABM versus other aetiologies was made.Results Fifteen episodes of Lm - ABM were identified in327 adult Ac - ABM patients.Three cohorts of individuals were vulnerable to Lm - ABM:the elderly ( RR=3.14; 95％ CI 1.84-5.35),the immunocompromised (RR =3.34; 95％ CI2.08-5.38),and pregnant women ( RR 12.48 ; 95％ CI 3.29 ～ 47.39 ).The classic triad of fever,neck stiffness,and altered mental status was present in 40％ (6 of 15) Lm - ABM patients.Similarly,40％ patients had at least one of cerebrospinal fluid (CSF) samples with features met the criteria of typical bacterial meningitis.The coverage of empirical antimicrobial therapy was microbiologically inadequate for 13 ( 86.7％ ) patients.The mortality rate was 33.3％ (5 of 15),and 7 (46.7％ ) of 15 patients led to an unfavorable outcome ( GOS ＜ 4),both of which were significantly higher than those in other aetiologies of Ac - ABM ( P =0.015P =0.009 respectively). Conclusions Our study showed the elderly,the immunocompromised patients,and pregnant women predisposed to Ac - ABM most likely to be Listeria monocytogenes aetiology.In contrast with similar previous reports, the current study showed that patients with meningitis due to Listeria monocytogenes did not present with atypical clinical features.A high proportion of patients received empirical antimicrobial therapy that did not cover Listeria monocytogenes.Lm - ABM is still a serious disease that leads to high morbidity and mortality rates.With these important caveats in mind,our findings have implications for clinical practice and food safety policy makers.

Objective To understand the status of Toxoplasma gondii infection in the population of Pu er City so as to pro-vide the evidence for formulating the strategy of toxoplasmosis control. Methods The population from Jingdong Jinggu and Menglian counties in Pu er City was surveyed IgG of T. gondii in serum was detected by ELISA. Results Totally 906 resident serum samples were detected and the IgG positive rate was 24.2%. The positive rates were higher in the aged groups of 30-39 years and 60-69 years and the difference among different aged groups was significant χ2=17.77 P 0.01 . There were no si-gnificant differences between different sexualities and among different educational levels and living habits P 0.05 . The posi-tive rates were 26.6% 194/730 15.5% 22/142 and 8.8% 3/34 in farmers students and other occupations respectively and there was a significant difference among them χ2=12.51 P 0.01 . The positive rates were 23.3% 198/849 and 36.8%21/57 in the farmers who had the habit of rearing pigs in pens and the farmers who had the habit of free ranging pigs respec-tively and there was a significant difference between them χ2=5.33 P 0.05 . Conclusion The IgG positive rate of T. go-ndii is very high in Pu er City and therefore the health education for toxoplasmosis control should be strengthened.

Objective To summarize the clinical characteristics of papillary thyroid microcarcinoma with diameter ≤ 5 mm. Methods The clinical data of 259 papillary thyroid microcarcinoma patients who had underwent radical thyroidectomy from January 2015 to December 2017 were retrospectively analyzed. The patients were divided into 2 groups according to the preoperative tumor diameter: ＞5 mm group (88 cases) and ≤ 5 mm group (171 cases); then according to the lymph node metastasis, the 2 groups were divided into non-lymph node metastasis sub-group and lymph node metastasis sub-group. The reason of lymph node metastasis was analyzed. Results There were no statistical difference in gender composition, age and combined Hashimoto thyroiditis rate between ＞5 mm group and≤5 mm group (P＞0.05). The rates of T3-4 stage, N1a-1b stage and multifocal tumors in＞5 mm group were significantly higher than those in ≤ 5 mm group: 34.1% (30/88) vs. 18.7% (32/171), 45.5% (40/88) vs. 22.8% (39/171) and 39.8% (35/88) vs. 22.8% (39/171), and there were statistical differences (P＜0.05 or＜0.01). In＞5 mm group, lymph node metastasis sub-group had 40 cases, non-lymph node metastasis sub-group had 48 cases; the rate of T3-4 stage in lymph node metastasis sub-group was significantly higher than that in non-lymph node metastasis sub-group: 55.0% (22/40) vs. 16.7% (8/48), and there was statistical difference (P＜0.01). In≤5 mm group, lymph node metastasis sub-group had 39 cases, and non-lymph node metastasis sub-group had 132 cases; the rate of T3-4 stage in lymph node metastasis sub-group was significantly higher than that in non-lymph node metastasis sub-group:51.3% (20/39) vs. 9.1% (12/132), and there was statistical difference (P＜0.01). In＞5 mm group and≤5 mm group, there were no statistical difference in gender composition, age, combined Hashimoto thyroiditis rate and multifocal tumors rate between 2 sub-groups (P＞0.05). Conclusions The clinical behavior of papillary thyroid microcarcinoma with diameter ≤ 5 mm has a less aggressive nature compared to that＞5 mm. Tumor capsular invasion or extra thyroidal extension has a great influence on lymph node metastasis in thyroid papillary microcarcinoma of different diameter.